crew were elected.
For over ten years successive Labour shadow health ministers correctly denounced the massive increases in prescription charges forced through by the Thatcher and Major governments as a "tax on the sick": it was the Tories which jacked it up from 20p in 1979 to the hefty £5.65 figure 18 years later, a 28-fold increase far outstripping inflation.
Frank Dobson once even fa-. mously pledged a Labour government would cut and phase out the prescription charge (as Harold Wilson's Labour government did - for four years - in 1964).
Now, though 80% of prescriptions are issued free, meaning hat the charges result in only a marginal £300 million contribution to the £40,000 million NHS budget, ministers know that the increased charge weighs down most heavily on low-paid workers - those most likely to suffer ill-health as a result of social deprivation.
For New Labour, as with the Tories, raising the prescription charge is an ideological rather than a financial move. It is yet another example of the new bosses' government showing its eagerness to take "tough choices" which further disadvantage the poor and the sick in order to minimise the tax burden on the wealthy.
But the increased fee might not be the end of this process: there are dark hints that one of the outcomes of the financial review of the NHS now being carried out could be the imposition of means-tested charges for the contraceptive pill, and possibly the imposition of new prescription charges on "wealthy pensioners".
This descent into policies as bad SATURDAY March 14 12noon - 4.30 ULU, Malet St, London WC1 Called by Wolfare State Network Speakers include Tony Benn MP, Jeremy Corbyn MP, Geoff Martin (London convenor UNISON), John Lister (London Health Emergency) Details from WSN c/o Camden People's Centre, 183 Queen's Crescent London NWS 4DS. 0171-639-5068 plans to retain most of its component parts, including the "purchaser/provider split" which in itself massively increased bureaucracy. Self-governing Trusts, which Labour had promised to abolish, will remain as a centrepiece of a new network of quangos which will not only contain the Tories' smaller, less democratic health authorities but a new system of more "local", but completely unaccountable purchasing bodies, "Primary Care Groups", each covering a population of around 100,000 and dominated by GPs.
Doctors' orders
All GPs will be included in the new "Primary Care Groups" (PCGs), not just those who had previously opted to act as fundholders under the Tory reforms. They will gain increasing influence in decisions on the purchasing of care for their local resident population, working initially within a framework drawn up by the health authority.
The new system does not offer existing GP fundholders the scope to retain unspent "surplus", cash in the way they were encouraged to under the Tory market.
But is does offer encouragement for empire-building GPs, leving them in the driving seat in the able to allocate the time and energy to these wider responsibilities: the PCGs will swiftly be taken over by a new managerial bureaucracy acting on their behalf.
Decisions will be taken behind closed doors, with no wider involvement of the public, and with only token participation by community nurses and social service staff.
Though the long-term implications are that PCGs will be forced into making "tough decisions" on cuts to balance their books, the new system has even more serious implications for hospital services and up to a million NHS staff.
By placing the control of budgets firmly in the domain of GPs and "primary care", and giving hospital consultants and professionals no direct voice in planning. or purchasing decisions, the White Paper is opening up a damaging division in the NHS - and pointing the way to substantial cuts as the burden of "efficiency savings" is dumped squarely onto the hospital sector.
There should be no doubt that bigger cuts are on the way. NHS Finance Director Colin Reeves admitted at the end of last year that the combined deficits of health authorities and Trusts amounted to £460 million, which had to be cleared - £190m by next month, and the remainder by April 1999. This is why health authorities are planning wholesale cutbacks in "elective" services and the "rationing" of care to exclude many services from the NHS altogether.
The service is already lagging far behind rising demand, as the latest waiting lists confirm. Far from cutting NHS waiting lists by 100,000, nine months of Labour government has increased them by more than that amount, with worse to come. There is a huge increase in numbers waiting over a year for treatment, with the Patient's Charter maximum wait of 18 months already certain to be widely breached.
London retreat
To compound the misery, Labour's promise to reexamine the planned Tory hospital closures in London has also proved a largely empty gesture. While Bart's Hospital has won a partial reprieve as a specialist cancer and cardiac unit, the closure of acute services at Guy's and at Queen Mary's Roehampton have received a rubber stamp of approval.
Though the independent review found that Londoners had fewer acute hospital beds available per head than the rest of England, and urgently needs more beds for mental health sufferers there are no government plans to reopen closed beds or expand in-patient care: instead ruinously expensive privately-financed hospital schemes will axe hundreds more beds in central and south east London.
But while ministers backpedal furiously on Labour's pledges, seeking to cut back the NHS to meet the inadequate cash limits embraced by Gordon Brown, there are growing signs of communityled revolt at local level.
Protests at hospital cuts and closures have mobilised demonstrations of 1,000 in Watford, 6,500 in Canterbury and a staggering 2,500 in the sleepy little Oxfordshire market town of Wallingford. There are vigorous campaigns in Manchester, in Worcestershire and elsewhere.
The March 14 conference called by the Welfare State Network offers campaigners and health union activists an opportunity to share experience, and work through a programme of positive demands to unite in the fight to rescue the NHS from the ravages of private finance and Tory cash limits.