Consultation? No Thanks!

Consultation is very popular with the authorities in west London. Residents in Earls Court are still fighting to prevent the demolition of their homes following a deeply flawed consultation exercise by Hammersmith and Fulham Council. Now the local health service is under threat.

In the last couple of weeks there have been two big demonstrations by residents and health workers in Hammersmith (above) and Southall (below) over proposals to close the A&E departments of four local hospitals: Charing Cross, Central Middlesex, Ealing and Hammersmith. As with the Earls Court redevelopment scheme, the plans are 'out for consultation', but it is clear that NHS North West London has already made up its mind. In the current climate the powers that be will have a hard time convincing anyone that 'reorganisation' isn't just a euphemism for cuts in services. The demonstrations are likely to continue.

Access All Areas (almost)

The photographs above and below, shot in Musgrave Park Hospital, Belfast, are unusual. Not in the way they were taken, or for any exceptional artistic merit - but because they were taken at all.

I’ve written before about the ever-increasing privatisation of public space, the restrictions this imposes on our freedom of action, and how the public realm is becoming a smaller and smaller place. This modern day version of the Enclosures has not only handed control of our streets to private corporations, but also our hospitals, schools, prisons, sports centres and more. As a result, photography in many such workplaces has been almost impossible in recent years.

These photographs are evidence that the move from public to private can be, and is being, reversed. In Northern Ireland, Scotland and Wales all contracting out of hospital cleaning and many other hospital ancillary services has ended. The relevant authorities have ditched ideology and realised that they are better off with directly employed staff.

It’s not the sort of thing that gets on the front pages, but it has had a big impact on the quality of services, and on the wages, terms and conditions of the workers who provide them. And it means that, almost for the first time since the introduction of compulsory competitive tendering in the mid-1980s, it is possible to record something of their working lives.

Private companies are accountable to their shareholders, concerned for their image, and unwilling to grant access to independent photographers or journalists who might provide the wrong sort of publicity – and overstretched workers on the minimum wage and lousy terms and conditions are unlikely to make good PR. Walking around hospitals in Belfast and Glasgow recently with a camera and a trade union rep from Unison, talking to directly employed staff proud to be back as part of the hospital team, was a pleasure I hadn’t experienced for nearly 25 years. I look forward to being able to do the same closer to home.

More pictures here. A video interview with Unison Branch Secretary Tom Hughes is here.

Health Reform – Georgia style

We should count ourselves lucky that Andrew Lansley, our floundering Health Secretary, has not taken a study tour to Georgia. In the former Soviet Republic, public hospitals are being closed down or sold off at short notice, often in transactions with private buyers that are less than transparent. Resistance from trade unions is hampered by a draconian labour code, brought in by President Mikhail Saakashvili in 2006. According to the International Trade Union Confederation (ITUC), the code has undermined fundamental workers rights, and many trade unionists complain of intimidation by both government and employers.

In Tbilisi the leading hospital for reconstructive surgery in the Caucasus (above) has been sold to a private company and suffered a major reduction in beds and staffing levels. At the same time costs of treatment have risen while, as the ITUC also reports, government policies have led to rising levels of poverty - clearly visible in central Tbilisi (below). All an indication of what might happen in the UK, were Lansley’s star to rise again. More pictures here.