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Austerity: it’s bad for our health

Austerity measures are hitting CSP members, wherever they work. And they are blighting patients’ lives as well. The CSP explains how you can respond.

CSP members see and experience the effects of what is now often called ‘austerity’. Maybe it’s the challenges of getting by in your everyday life – paying higher fares to work or meeting the heating bills – that worry you most.

Or maybe it upsets you that many patients may face long-term difficulties because the number of follow-up appointments available on the NHS is being reduced.

CSP members working in the NHS have experienced pay freezes, down-bandings, attacks on their terms and conditions of employment, rising workloads and increased stress levels as trusts seek to take £20 billion out of the budget in England alone.

Compounding this are worries about outsourcing physiotherapy services at a time when the government is expanding competition and proposing to water-down employment protections for employees transferred outside the NHS.

In the private and independent sectors, CSP members are feeling the squeeze too. Sue England, who’s on both CSP council and Physiofirst’s executive council, says: ‘Private practitioners are seeing reduced fees from insurers and cuts in referrals, including from patients suffering from whiplash.’

According to a new CSP survey, due to be published shortly, more than 20 per cent of physiotherapy staff employed in private hospitals and other independent or voluntary sector settings haven’t had a pay rise for at least two years.

One in four hasn’t received a pay rise at all from their current employer.

Beyond our shores

It’s not just Britain that’s affected by the austerity approach – cuts to benefits, job losses, a squeeze on the public sector and a general downturn in the economy.

We’ve seen the demonstrations in Greece and Spain already. Meanwhile, international studies are showing the impact of austerity on public health.

A Doctors of the World (Médecins du Monde) report, titled Access to healthcare in Europe in times of crisis and xenophobia, was released in April.

The study was based on data collected from consultations with more than 8,000 patients in seven countries, including England.

The subjects included migrants, children and older people, pregnant women and people who were chronically ill.

One in five of those studied had been denied access to care by a healthcare provider in Europe in the last 12 months and eight in 10 had no possibility of accessing care without paying the full costs in advance.

A recent Lancet article concluded that major cuts in public spending and health services in Europe had triggered a drastic deterioration in people’s overall health.

Suicides and outbreaks of infectious diseases are becoming more common in Spain,Greece and Portugal, where swingeing austerity measures have been taken, say the authors. And budget cuts have restricted access to healthcare.

Researchers from the London School of Hygiene and Tropical Medicine have highlighted rising tides of HIV and malaria in Greece, which is in its sixth year of recession.

Needle exchange programmes for intravenous drug users and mosquito spraying had been axed.

‘Austerity measures haven’t solved the economic problems and they have also created big health problems,’Martin McKee, the professor of European Public Health who led the research, told Associated Press

Last August’s The Austerity Britain Report found that 76 per cent of British GPs who took part in a survey felt the economic downtown had had a negative impact on their patients’ health in the last four years.

The CSP’s annual survey of NHS physiotherapy managers, published in Frontline on 2 January  brought home the impact on physiotherapy patients.

There was growing evidence of budget-driven cuts to services. Funding shortfalls, Frontline revealed, drove the closure in March of a highly specialised brain injury unit in Bath, page 10 17 April 2013 , leaving very vulnerable patients high and dry.

The closure of the unit also put eight talented, hard-working CSP members out of work.

‘Plan B’

So what can concerned CSP members do? As individuals, we can do little but grin and bear it.

But collectively, through the TUC, the CSP and other union affiliates can do plenty, argues TUC president Lesley Mercer, director of CSP employment relations and union services.

‘The TUC has argued for a Plan B and – from being an almost lone voice – the trade union movement is now part of an ever-widening body of opinion, including world-renowned economists such as Paul Krugman and Nobel Prize winner Joseph Stiglitz,’ says Ms Mercer.

‘Even the International Monetary Fund (IMF) is having second thoughts about austerity.’

Just last month, the IMF urged chancellor George Osborne to slow down the government’s £130 billion programme of spending cuts and tax rises, the Daily Telegraph reported.

On 1 May, the TUC fleshed out a Plan B for the economy, as the ‘Future that works’ campaign continues.

The Plan B included:

  • a jobs’ guarantee for young people;
  • spreading the living wage across the public and private sectors;
  • putting communities, not profits, at the heart of public services;
  • creating a stronger voice for workers in the management of companies;
  • moving to a new economy that is greener, less reliant on finance, founded on quality employment, fair wages and taxation.

As part of the TUC’s demand for good services and decent welfare, the campaign will focus on the impact of outsourcing and privatisating public services. It will also continue to campaign on issues such as expanding  competition in the NHS.

Furthermore, the TUC will also continue its defence of workplace rights, including the retention of rights to paid holidays, a proper lunch break and reasonable hours at work.

These are currently under threat across the entire workforce, not just the NHS, as the government attempts to opt out of agreements with the EU.

The TUC campaign plans a series of events across the UK this summer, and will also provide what it describes as ‘a platform for advocates of pro-growth policies and new economic ideas’.

Says Ms Mercer: ‘The government cuts taxes on the wealthiest and presides over a return to millionaire bonuses in the City, while large companies continue to dodge billions in taxes.

Meanwhile, wages for the majority are depressed, prices are rising, unemployment is going up, and despite a “ring-fenced” budget, the NHS is cutting back services for patients.

‘We need a Plan B for the economy.  This is exactly what the new campaign plan from the TUC offers.’ fl
For more details on the TUC campaign

Access to healthcare in Europe in times of crisis and xenophobia
Financial crisis, austerity, and health in Europe The Lancet 381:9874;1323-31 (doi:10.1016/S0140-6736(13)60102-6) McKee M et al Austerity: a failed experiment on the people of Europe Clinical medicine 12:(4);346-50  The Austerity Britain Report

What can CSP members do?

  • As an affiliate of the TUC, the CSP is fully behind the TUC campaign against austerity measures.
  • It will also continue to gather evidence of cuts to physiotherapy services and the negative impact of enforced competition.
  • This will underpin its influencing and campaigning work.
  • It is essential CSP members get involved, says Alex MacKenzie, chair of the CSP industrial relations committee:‘Austerity is hurting patients and undermining the care CSP members can deliver.
  • Members need to get in touch with the CSP with examples of how squeezed budgets are leading to poorer patient care.
  • And they also need to get organised locally,’ she says.
  • ‘Members need to stick together, with CSP stewards and their colleagues in other professions, and build links with patient groups and local campaigners.
  • In this way, we can be in the best position to make the case for protecting physiotherapy services, jobs, employment conditions and – above all – patient care.’

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