The Labour party has for many decades been seen by the British working class as the champion and protector of our National Health Service (NHS). Whilst the Attlee government did create this entity, this was merely a tactic aimed at appeasing working-class Brits post-WW2. The aim was to block the rising desire for proletarian revolution that had spread from the great Union of Soviet Socialist Republics (USSR) to our own country.
Any illusions of a Labour administration benignly bestowing goodness or succour to the proletariat must surely have been smashed by the experience of the 21st century. The party’s abysmal record in office speaks for itself both on the international and domestic fronts. We can expect nothing better from the present Labour government.
The NHS itself has been crippled financially by private finance initiatives (PFIs) and divided into the four regions, with the effect of accelerating regional health inequalities and dividing the opposition of both NHS staff and British workers to the privatisation ‘reforms’.
Roll forward to spring 2025 and our present Labour prime minister Sir Keir Starmer has announced the abolition of NHS England, the body brought in by the 2012 Health and Social Care Act to run the NHS at ‘arms length’ when direct ministerial responsibility for the health service was formally abolished.
Under the leadership of Simon Stevens and Amanda Pritchard, this body has been wedded to the agenda of privatisation, and first pushed the internal market further by handing over funding to GP consortia – so-called clinical commissioning groups (CCGs) that took controll of around £90bn of the health budget.
The CCGs were encouraged to ration services and also to ‘commission’ provision from outside the NHS – awarding huge sums to the private sector. They have now been transformed into 42 ‘integrated care systems’, which spend our health budget in their regions. They are managed by Integrated Care Boards (ICBs) composed of a few token local councillors, a few token NHS doctors, the same NHS England managers and, crucially, a host of private care and health insurance managers.
In 2022/3, Integrated Care Boards in England received £107.8bn in funding, representing just over 70 percent of NHS England’s total budget. Notably, almost all ICBs are overseen by Optum, the British subsidiary of United Health – the largest US health insurance company.
Following the announcement of the “bonfire of the quangos”, the immediate response from most hospital trusts was to inform their staff that further cuts are looming. Cuts have become the usual policy of the NHS trusts – all of which are now operated as business units, and all of which are given instructions to cut their budgets each year.
Wages in the NHS are ‘banded’, and the lowest pay band of NHS staff is now below minimum wage. Every year, the paltry minimum wage rise outpaces the pay increment of our health support workers. Management at my own hospital this year responded by ‘promoting’ most of this band to a higher banding – so that they are now paid at a rate just a few pence above minimum wage.
It is scandalous how little these workers earn, considering the heavy responsibilities they bear and the broad range of skills they possess. The pay review body is notoriously slow in awarding NHS staff their annual pay rise, which is routinely well below inflation.
The multiple unions representing NHS staff pay lip service to ‘demanding’ restorative pay rises, but tend to capitulate to their cronies in the Labour party – not wanting to ‘embarrass them’ for fear of hurting their ‘electoral chances’ and instead instructing members to accept what are, in effect, pay cuts.
Another blow to NHS staff relates to the rules for what are called ‘bank shifts’. This is a system under which NHS employees can sign up to a ‘bank’ of employees who are willing to do overtime as needed. In future, however, staff doing overtime will no longer be paid in accordance with their seniority, but only at the lowest rate for a person of their status. Additionally, despite massive staff shortages, hardly any overtime is offered as the hospital trusts are forced to scrimp and save.
This is all very demoralising and necessarily leads to staff being overworked and feeling under-appreciated. Low staffing levels compromise patient safety. Despite this, most staff still work hard to actually put their patients first and give them the best care that they possibly can. But nurses carry the increased risks posed by working in an environment that is being financially rather than clinically engineered.
The unions are in thrall to the Labour government and, as the prime minster has already warned public sector workers to be more productive (!) if they want to receive a pay rise above inflation, it is unlikely that workers will receive any meaningful redress. Our unions have failed us and will continue to do so until and unless the grassroots organise and act creatively to force the government to meet their demands – the least of which should be to demand a living wage for all, with additional benefits for those with greater qualifications, experience and responsibility.
We need to be imbued with the spirit of the valiant miners’ strikers. Bearing in mind that the NHS is being deliberately undermined in order to pave the way for more and more privatisation, we also need to be creative in the ways we resist, ensuring that our actions hurt primarily the privateers and the political parties who serve their interests.
Our NHS is, and has been, in crisis for a long time, and this is no accident. It is in exactly the state desired by the ruling elites, who are openly plotting to slice and dice it into sellable entities to their cronies and to start the roll-out of American-style healthcare systems – the so-called ‘accountable care organisations’ of which our ‘integrated care systems’ are the British equivalent.
It is clear from our experience as patients and NHS professionals that access to frontline care is worsening. Long waiting lists effectively ration care, and more and more British workers – who can afford it – are choosing to have private health insurance.
The terrible results, of course, will be: firstly, the legions of working-class people unable to afford adequate medical care; and, secondly, the unashamed looting of NHS funds by the private sector. Private healthcare in the USA and elsewhere is notorious for subjecting patients to unnecessary tests and procedures in order to boost profits.
There’s trouble at the mill. Most student nurses are encouraged to read and assimilate the horrendous failings of Mid Staffs NHS Trust in order to ensure such scandalously high mortality rates “never happen again”, but no amount of reading and assimilation will of themselves change the conditions of a service geared to delivery of profit rather than considerations of care.
It is these deliberate managerial decisions that lead to staff cuts, down-skilling, overwork and the general environment of penny-pinching which were the basic reason why the Mid-Staffs failures occurred.
The Francis report was damning, rightly so, about the negative culture and failings in delivery of patient care at the Mid Staffs NHS foundation trust. But the ‘solutions’ put in place to ensure it ‘never happens again’ are underwhelming, to say the least. In 2013, the ‘Six Cs of Care’ for so-called NHS Professionals was introduced, basically to teach granny to suck eggs. Every trust brandishes its ‘trust values’ from on high and produces positive statistics about how it “makes the patient the centre of the care” etc etc.
Indeed, candidates at interview for NHS jobs receive negative feedback if they are unable to hold forth upon said values – allegedly unique to each trust, but overwhelmingly homogenous and corporate. (Report of the Mid Staffordshire NHS foundation trust public inquiry, known as the France report, 6 February 2013)
Yet, notwithstanding all this righteous virtue-signalling, there have been multiple incidences of suboptimal patient care, serious neglect and even deaths in recent weeks, let alone years, across the whole of Britain.
‘Corridor care’ has become the new normal, as have so-called ‘boarding areas’ (ie, the temporary installation of patients wherever it might be possible to find space), even though it is clear that care delivered in these conditions is substandard. Patients in my own hospital’s overcrowded Accident and Emergency ‘waiting room’ are routinely hooked up to drips or left to sit uncomfortably for hours, regardless of their mobility, whilst waiting for admission or test results.
In fact, one NHS trust recently advertised for a specialist corridor care doctor, despite calls for this practice to be halted and for the government to take action. (Sussex hospital advertises for “corridor care doctor” as A&E crisis deepens by Rachel Clun, The Independent, 27 February 2025)
It is difficult to spot ‘trust values’ being followed in all this, despite the tremendous efforts of the beleaguered staff.
Where staff do try to intervene to prevent malpractice occurring before their very eyes, they are frequently silenced by management bullying tactics. And this in spite of the much-vaunted ‘Freedom to speak up’ guardians who are supposed to protect whistleblowers.
Introduction of culture wars demoralises staff further
If there is one thing that NHS workers are very well acquainted with it is the basics of human biology. What better weapon, therefore, could be used to demoralise them than forcing them to deny realities and subjecting to disciplinary action anyone who deliberately or even accidentally claims that it is the biological difference between them that distinguishes men from women and vice versa.
NHS staff are now forced on pain of dismissal to accept the notion that men can be pregnant, give birth to children and lactate. A mother therefore becomes a birthing parent, and he or she (!) is encouraged to ‘chest-feed’ their baby, although that is literally impossible for a biological male.
Trusts appear more concerned about silencing than protecting staff who point out the idiocy of asking adult men whether they may be pregnant before being offered x-rays. One member of staff who failed to enquire about the pregnancy status of a male patient was required to attend mandatory training to support them in addressing their ‘bias’ – and was supplied with copious rainbow badges to wear and share with their colleagues.
In another case, a very experienced nurse was called to assist with a highly aggressive patient, a man to all appearances as well as according to hospital notes, brought in handcuffed to two prison officers. In trying to persuade that person to calm down, she politely addressed him as ‘Sir’, which set the patient off in a torrent of racist abuse against the nurse, amidst a claim that to address him as Sir, when he identified as female, was equivalent to addressing a black person using the ‘N word’.
Although the nurse responded to all this abuse in a highly professional manner, and saw to it that the patient received the appropriate treatment, and despite the fact that she had had no possible way of knowing that the person identified as female, the nurse was suspended! Could anyone blame her if she decamped to a private hospital?
Case studies in gender bullying and the response of nursing unions
Sandie Peggie is a nurse working for the NHSe in Fife, Scotland. Sandie, who has an unblemished record and has worked in the health service for 30 years, brought a case before an employment tribunal against both NHS Fife and Dr Beth Upton, a male member of staff who self-identifies as a woman, after she was suspended from work for complaining that she had been forced to share a changing room with a man, namely Dr Upton.
Peggie pointed out that by being forced to share a changing room with a man she had been unlawfully harassed under the 2010 Equality Act.
Sandie told the employment tribunal, which commenced on 3 February 2025, that she felt “embarrassed and intimidated” when Dr Upton began to use the female changing rooms in accordance with a policy, adopted by NHS Fife in accordance with wider NHS guidance, which states that changing facilities are available to anyone in accordance with their ‘gender identity’.
The term ‘gender identity’ in this context meaning whatever gender the person in question decides that they are, regardless of their biological sex.
Sandie raised the issue of Dr Upton accessing the women’s changing room on three occasions. The first of these was in August 2023, when she entered the changing room to see Dr Upton using the facility. She raised the matter with her line manager, who assured her her concerns would be addressed. Yet despite this assurance, Sandie found herself again having to share the changing room with Dr Upton on or around late October 2023, when Dr Upton entered the changing room while Sandie was in a state of partial undress.
The third occasion was on Christmas Eve 2023, when Sandie challenged Dr Upton’s presence in the women’s changing room, telling him that it was inappropriate for him to be there and that she felt intimidated in his presence. Dr Upton claimed that he believed that he was entitled to be there because he was a ‘woman’, to which Peggie reiterated that Dr Upton was not a woman and that her safety was put a risk by him being there.
When Dr Upton complained to the health board about Sandie’s behaviour towards him after this exchange, she was placed on leave and then suspended by NHS Fife pending an investigation. According to a report in the Daily Telegraph, NHS staff even considered calling in the police to investigate Dr Upton’s allegations that he had been ‘misgendered’ by Ms Peggie.
She was suspended whilst working at Victoria Hospital in Kirkcaldy, but was encouraged by her employer to work at a different hospital, whereupon her suspension from work would be lifted.
The response of the trade union movement to Sandie’s case has been little short of appalling.
Unison, a trade union that supposedly ‘organises’ thousands of workers in the NHS, held its Women’s Conference in Edinburgh from 13-15 February, at the same time as Sandie Peggie’s tribunal was taking place. At this conference, delegates carried Motion 1, which included:
“This conference believes:
“i. That trans women are women and trans men are men, all our LGBT+ comrades must be respected.
“ii. That trans equality is a trade union issue. Trade unions are about uniting us to make us stronger and we oppose all divisions amongst our class.
“iii. Women’s rights are not diminished by trans people having more rights. Rights are not in finite supply. In fact, when we unite and organise together, we can often win more rights for all.
“iv. Therefore, that women have a vested interest in standing alongside our trans comrades in solidarity and in resistance and all of us fighting back together.”
The motion went on to call for the production a “myth-busting factsheet” to counter the idea that an increase in trans rights would mean a decrease in the rights of others, and to campaign for the Labour government to introduce self-ID for trans people “as they had originally pledged to do in 2019”.
Steve North (he/him), president of Unison, took to social media to proclaim: “Today Unison’s women’s conference passed a motion stating:
“‘That trans Women are women and trans men are men, all our LGBT+ comrades must be respected.’ Not one delegate spoke against [probably because nobody dared!]. In a world of increasing hate and division, I’m proud that our union is a beacon of unity.”
Mr North opted to restrict replies to his post to his followers on X. However, those who read his post would almost certainly have speculated as to why a motion which claimed that “women’s rights are not diminished by trans people having more rights” was not challenged by a single delegate at the conference.
Arguably, the action of the union in abandoning its own women members when in strife was foremost in the minds of any gender-critical delegates. Unison’s contemptible actions in sacrificing its own members on the altar of this unscientific, idealist and divisive gender identity ideology will be detailed later in this article.
Meanwhile, Sandie’s own trade union, the Royal College of Nursing (RCN), refused to represent Sandie either at her employment tribunal or at a separate disciplinary hearing – a hearing that was called whilst she was at employment tribunal, in a poorly-disguised and deliberate attempt by NHS Fife to intimidate and harass her. The RCN’s website states: “We celebrate trans nursing staff, and remain unwavering in our commitment to end transphobia in nursing.”
Peggie’s solicitor, Margaret Gribbon, said: “Many trade unions’ track record on this issue is poor, causing many of their members, especially women, to feel abandoned and betrayed. If they are to fulfil their core function of representing their members, they must be at the forefront of advocating for women’s right to single-sex spaces in the workplace and to challenging employers who discriminate, harass and victimise those holding lawful gender-critical beliefs.”
The RCN put out a predictably mealy-mouthed statement: “We do not comment on individual cases, treat all our members’ right to confidentiality with the utmost importance, and believe it is vital that all parties are treated with dignity and respect.”
The employment tribunal has now adjourned until July. We will then no doubt see how it applies the recent supreme court ruling to the effect that the word ‘woman’ can only be used to denote an adult biological female.
The Darlington nurses
Meanwhile, eight nurses working for the County Durham and Darlington NHS foundation trust are pursuing a case at employment tribunal over their employer’s decision to allow a man identifying as a woman, Rose Henderson, to use the changing facilities at Darlington Memorial hospital. The nurses are claiming sexual harassment, discrimination, victimisation and breaches to private life under Article 8 of the European Convention on Human Rights.
The trust, again following guidelines issued by the NHS, permitted a fully intact male who self-identifies as a woman to use women’s changing facilities that have no cubicles. The nurses reported that the man appeared to be ‘very masculine’ and was accused of staring at their breasts and lingering in the changing room for longer than was considered reasonable, which made the nurses feel vulnerable and intimidated.
Twenty-six nurses wrote to the NHS trust in March 2024 to raise their concerns. They claimed that more staff, who are working in the country on visas, wanted to sign the letter but were worried that if they did so their visas would be revoked, meaning they would lose their jobs. In response to the letter, the ward manager was called to a meeting with human resources and informed that the nurses needed to be “re-educated”.
The story hit headlines and everyone from JK Rowling to health minister Wesley Streeting proclaimed their support for the nurses. However, one entity which declined to offer its support was Unison, the union that the nurses had paid their subscriptions to in order that, when they needed help, it would be provided.
Unison declined to support its own members in this case and, given the content of the motion passed at their recent women’s conference, it is easy to see why. The nurses decided to found their own trade union, which they called the Darlington Nursing Union, and were invited to London to meet with Wesley Streeting in October 2024.
Unison were deeply displeased at this meeting, with union president Steve North taking to X to condemn Streeting for “pandering to anti-trans bigotry”.
The nurses were forced to found their own trade union, but still needed the aid of an organisation called Christian Legal Centre for the financial assistance to pursue their case at employment tribunal. The tribunal opened on 2 April, only to be immediately adjourned when the NHS trust claimed that it needed time to carry out an internal investigation – despite the case being over eighteen months old.
Judge Stuart Robertson, who chaired the preliminary hearing, said that the trust’s actions “subordinated [proceedings] to an independent investigation”. The tribunal will reconvene in October.
Freedom of speech
In addition to all this, hospital staff have absolutely no freedom of speech. It may be fair enough to expect them not to allow their political or religious opinions to come to the attention of patients, since they have no relevance to clinical treatment, but this prohibition now extends to what staff do in their spare time and even to private conversations among staff members.
Any suggestion that a staff member may have been speaking out about the ongoing genocide in Gaza and Palestine, where genuine victims abound, is frowned upon by most trusts. Those who disseminate factual information that counters the establishment narrative can expect serious repercussions.
Fight back
The whole system is broken, but that is exactly how the ruling class needs it to be. This includes the Labour government, whose minister make so much play about being the “party of the NHS”.
The truth is quite the opposite. Labour is fully complicit in driving the NHS into crisis – and in using the crisis to further the agenda of privatisation.
