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International Socialism, June 1977


John Blake

Resisting the Hospital Cuts
in East London


From International Socialism (1st series), No.99, June 1977, pp.16-18.
Transcribed & marked up by Einde O’Callaghan for ETOL.


THE HOSPITAL cuts in East London have been more severe than elsewhere in the country. The resistance to cuts has been correspondingly intense, and the failure of moderate trade unionism more brutally exposed. This article shares our experience of the struggle.

Poplar and St. Matthews

IN 1974 management threatened to close Poplar, a general hospital near the docks. An active Save Poplar Hospital Campaign opposed this. They claimed 80,000 signatures on a petition. They held marches and public meetings. The MPs supported them and the Minister paid a visit. Alan Fisher spoke at a street meeting. The IS toured the local factories and docks drumming up support. In the later stages the campaign met weekly and included stewards from other hospitals and industries—even from Ford’s Dagenham.

But management was able to close down the casualty department without a real fight. When they close casualty, a hospital slowly dies. Fewer patients are admitted. Doctors get bored and fed up and leave. Ancillary workers lose their jobs or hve their overtime cut. In the end it was easy for management to close a moribund hospital.

Why did they get away with it? The revolutionaries on the Save Poplar Hospital Campaign argued that only strike action in other hospitals would save Poplar. But other hospitals refused to come out because Poplar itself wouldn’t.

And Poplar wouldn’t come out because union organization inside the hospital was weak. There were no regular union meetings in work time. There was no meeting of the workers in the hospital to consider the campaign. There was no strong shop steward organization. All they had was an outside campaign, and a faith that the Labour government wouldn’t close the hospital in the face of vocal opposition from the community and the unions.

They could. They did.

St. Matthews was a different kettle of fish. It is a small geriatric hospital in Hoxton. In 1976 the area management decided to close it eventually. The kitchens had deteriorated badly, and the Public Health Inspector insisted that the kitchens be closed or upgraded. Management seized the opportunity. They said they would bring in meals on wheels and close the kitchens. The unions felt that management could then close the hospital whenever they choose simply by cutting off the meals. And the loss of jobs and facilities when the kitchens closed would make closure easier by demoralizing the unions.

Both the NUPE and the T&G stewards had won the confidence of their members by handling the daily complaints which make up the nuts and bolts of trade unionism. When they recommended an all-out strike the members came out solidly. The stewards moved to spread the strike and on the third day the kitchens at St Bartholomew’s, a large teaching hospital nearby, came out.

The unions refused to compromise and accept any cuts. They insisted that every job and every minute of overtime be preserved. On the third day management agreed. They even agreed to pay the workers for the time they were on strike.

The workers went back feeling strong. The management have since treated St. Matthews as the only hospital in the East End which can’t be cut. They have even spent money doing it up.

The contrast between the two hospitals is clear. At St. Matthews they had strong union organization, they came out solidly at the first sign of cuts, they spread the strike, they refused to give an inch, and they won. At Poplar they did none of these things and despite high popular support they lost.

The One Day Strikes

BY THE autumn of 1976 the cuts were biting harder, and the argument between the ‘Poplar strategy’ and the ‘St. Matthews strategy’ took place in a wider arena. In August the City and Hackney District announced its plans for cuts by the end of the financial year. They said they would chop 400 jobs, wards in several hospitals, and the whole of the Metropolitan hospital.

The unions were appalled. The local ASTMS branch called for a half-day protest strike in September 23rd and the NUPE district backed the call. Meetings were held in each hospital and all but the Metropolitan voted to come out. There was a march and a public meeting.

After the march there was a meeting of all the stewards in the district. The stewards confronted a thorny problem. On the one hand, it was clear that a token protest would not stop the cuts. Not when the cuts were a central part of the economic strategy of a vicious and bewildered government. On the other hand, it would probably take an all-out strike throughout the East End hospitals to stop the cuts. This meant taking on the full power of the government. And over their politics, not over the terms of a wage deal.

They faced a clear choice between defeat or political struggle. Many people did not see it that clearly, of course. But the revolutionaries among the stewards did. They argued for an all-out strike. The two union full-timers (NUPE and ASTMS) at the meeting (both were members of the Communist Party) argued against an all-out strike. They wanted rolling short stoppages instead (called ‘guerilla’ stoppages to sound militant!). The stewards saw that this was a recipe for annoying management, not smashing them. Some of them also remembered the demoralisation this tactic led to in the 1973 national strikes. They voted for an all-out strike.

The individual hospitals were then supposed to meet. The CP and the full-timers from all the unions organized against the strike. On the appointed day two hospitals came out on a one day strike. In November some hospitals joined the national one day strike against the cuts. But the moment had been missed. It will be a while before it comes again.

Management felt free to cut. They closed wards at St. Bartholomews, St. Marks, and the Hackney hospital. They ran down the Metropolitan hospital, and it now stands virtually empty. Union leaders who had just been arguing against an all out strike in solidarity to stop the cuts were helpless. They could not suddenly turn around, bring their members out, and appeal for solidarity. The cuts went through. And not a peep was heard from the full-timers or the CP about rolling stoppages.

Defending Union Organization

BY EARLY 1977 the unions had clearly lost a battle. Management knew they would have to make further cuts. But union organization was not broken, and management knew they were sitting on a political powder keg. The British working class care deeply about the NHS. It is relatively easy for British Airways arid the AUEW to take on Heathrow engineers over shift pay. But a major confrontation over the cuts with hospital workers could shatter an aleardy feeble government. So management avoided confrontation and cut where they thought the unions were weak. Where they weren’t sure they tried to break the union, but retreated if trouble blew up.

This happened at St. Bartholomew’s (Barts) in February.

Then management annouced new kitchen rotas which would cut hours and pay throughout the district. And next they suspended three porters on the night shift in Barts. The men had refused a job on the instructions of their union, and one of them was the NUPE branch secretary. By morning the ancillary workers in all unions at Barts and St. Marks were out. Within three days management agreed to reinstate the men.

The union leaders at Barts were politically sophisticated men. Some were CP members. They were unwilling to risk taking on the government by staying out against all cuts. So once they had protected the union organization they recommended a return to work. The rotas and ward closures would be left on the table. The workers voted to go back.

Kitchen workers ended up with their earnings but not their hours guaranteed. So when wages went up they would stay at the same low gross pay for a while. New employees would have to work new rotas. Effectively, wages would be cut and different earnings levels would lead to bitterness and weakened trade unionism.

The unions could do little. They had just fought a defensive strike and gone back with a bit less than they came out with. This made it harder to get workers out the gate again. Which is why it is important not to compromise in strikes against the cuts.

What have we, the stewards in SWP, learned? Build a strong base, strike at the first sign of cuts, strike hard, strike together, forget the Labour Party, don’t trust the full-timers, don’t rely on the CP, and don’t go back till you’ve won.

So where do we got from? There are three main strategies.

The first strategy is that of Alan Fisher and the union full-timers. They’re under intense pressure to fight the cuts but have no intention of rocking the boat. So they call one token stoppage after another. This has the twin virtue of seeming militant and changing nothing. In the long run it leads to demoralisation and disillusionment with the union. So when NUPE had a London stoppage on May 11th, not one of the hospitals which had been struggling against the cuts for so long supported it.

The second strategy is a policy of defensive struggle. It is the obvious strategy for most militants, and it is the strategy of CP members who have to live on the shop floor. It involves the corridors, and on the picket lines. A year ago many hospital workers were reluctant to strike because they felt that we had to trust the government to find a way out and turn the corner. Today almost nobody thinks that. A year ago workers were reluctant to believe the crisis was here to stay. For to believe it they would have to revise their whole view of the world. Now they have accepted the evidence of their eyes. Their political views are changing.

So we need people in every hospital arguing for taking on the government, arguing for rank and file organization, arguing against moderate waffle. And we have to persuade people that there is an alternative to the cuts. It’s called socialism. For no matter how militant and decent people are, they will break and bend unless at least some of them can see an alternative to things as they are.

All this means recruitment to the Socialist Workers Party. It means building workplace branches. It means rank and file papers and conferences. But it also means joining wholeheartedly in the defensive struggle. For we are racing against time. It will take years to win the argument for smashing the cuts and the system with them. During that argument we have to hold the spirit and the organization of the working class in the hospitals together. If we don’t we may win the political argument but we will be broken industrially.

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