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A limited democracy
• ISLINGTON'S LINk (Local Involvement Network) conference took place two days ago. Called jointly by Islington Council’s social services and Primary Care Trust managers, it was attended by more than 50 residents. It was the last opportunity for individuals or groups to volunteer to serve in the “core group” of the new organisation being set up as a successor to the recently disbanded PPIF (Patient and Public Involvement Forum).
The Government had created LINks, claiming it as a step forward to grassroots democracy, giving residents more say in the development and running of their local health and social services.
Small groups of participants were invited to draw up short lists of the issues they would like their LINk to discuss, and their views on its governance arrangements. But before joining in on this task one speaker raised a basic objection to the whole concept of LINks – localised by definition! She pointed out that restricting influence to local issues excludes wider concern about national policies. The most fundamental of these are measures for the privatisation and marketisation of the NHS and social services through commercial contracts. Approved in the recent proposals for NHS “modernisation” by Health Minister Lord Darzi, they have never been put forward for public consultation.
There seems a parallel between LINks as a channel for consultation on (local) health and social services and the recent consultations, also localised, on the privatisation of post offices.
There was no consultation on the principle as to whether post offices nationwide should be privatised at all! Comments from the public were restricted to the case for or against closures of local post offices.
As widespread protest over the proposed creation of commercially-run polyclinics clearly shows, many thousands of people, including GPs, members of the BMA and health professionals generally reject the whole concept rather than case by case (or district by district) considerations of particular polyclinics replacing GP surgeries.
Although removing a range of health services from hospitals (such as minor eye and skin treatments) into polyclinics could be helpful in reducing hospital workloads, consequent loss of personalised patient care in smaller GP surgeries could be a damaging and extremely unpopular development. Hence the huge number of signatures rapidly collected to petitions circulated by Keep Our NHS Public and others.
The idea of local bodies being given consultation in local health and social services issues sounds pleasingly democratic. But if it precludes consultation on national issues, such as introducing commercial, profit-making bodies into the NHS, it is profoundly limiting and far from democratic. It seems an ingenious innovation into a process of “divide and rule”: devote your attention to your local situation and ignore overarching government policy!
Professor Allyson Pollock’s book NHS plc and later publications explain her profound and well substantiated criticisms of such steps as undermining the NHS, which the general public is only now beginning to grasp. If you value NHS founding principles it needs your active support now, not only through local LINks!
ANGELA SINCLAIR
Islington Pensioners’ Forum
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