Speech by Jane Beach,Unite the Union official Health sector, at the South East Regional TUC briefing for trade unionists on Politics in Greece, 24 October 2013, following her visit to Greece with the GSC.
I’d like to share with you my experience of being part of a delegation visit to Athens in April 2013. The visit was organised by the Greece Solidarity Campaign who are doing incredible work in sounding the alarm bells and opening our eyes to what is happening in Greece in terms of highlighting how austerity can suffocate a nation and lead to the rise of groups such as Golden Dawn. The aim of the delegation visit was to look at what was happening to the Greek health services and it is clear that there is a humanitarian crisis happening right on our doorstep!
We have to listen, we have to learn and we have to act.
The Greek health service consists of a private and a public health system, both based on insurance. If they don’t have their own, people depend on their employers paying for their health insurance to access the public health system. As people lose their jobs, they lose their insurance. If they want to use the public health system, they have to pay fees. If people have been out of work for 12 months, then they are no longer entitled to any cover. With increase rates of unemployment it is estimated that 1million people by 2015 will have no access to any health service.
As a consequence of the EU memorandum, cuts were applied to the Greek system, which have now reached around 40% in hospitals in just 3 years. Funding stands at only 3% of GDP, half the European average. There have been redundancies among health staff, 15,000 so far with at least another 20,000 to come. This has resulted in A&E departments merging, hospitals cutting services or being cut altogether. Some areas and islands, no longer have a hospital. At the public hospital we visited staff described how the cuts had resulted in severe shortages of staff, especially specialist staff, with ratios in intensive care of I nurse to 3 patients (1:1 here), on the wards 1 nurse to 40 patients. With these ratios and no funding for dressings, drugs, gloves or hand gel people are dying of hospital acquired infections!
During our visit to the hospital we were challenged by security staff, even though we had permission from the Director to be there. Whether it was this or the media attention that we attracted; three days after we had been, the hospital was raided by members of Golden Dawn wielding baseball bats and checking the ID of patients and staff, generally intimidating!
Primary care services in Greece have been almost wiped out. As a result people are presenting to secondary care at a later stage in their illness and experiencing life changing complications from conditions such as diabetes. Hospitals have seen an increase in amputations, which are of course preventable if the condition is managed and complications detected and treated early! In addition people needing lifesaving medication for something like cancer that can’t afford it, have to wait, often it is too late and they die.
Pregnant women are also being hit hard. Unless they are insured or have the means to pay, they are being turned away from hospitals, even in labour, and are then exposed to all the risks of giving birth unattended. Costs for delivery are double for those who may need a caesarean and also for tourists or immigrants. We heard stories of women who arrived in the latter stages of labour, giving birth in the hospital, that were told they could not take their baby home unless they paid! As a result of all of this infant mortality in Greece has doubled in just three years!
Public health has also vanished. Vaccinations are not on the shelves and health promotion programmes have disappeared. Without sexual health services, HIV is rapidly spreading with infection rates up 200%. Of course statistics like this get reported; attacks by members of Golden Dawn on gay men have increased; women with HIV have been publicly exposed and vilified. Unwanted pregnancies are also on the increase as family planning clinics are no longer available. Without mosquito spraying malaria has now returned to epidemic levels after four decades. Mental health is also being severely impacted on as a result of unemployment and financial worries with an increase in suicides, especially among young men of 25%.
Access to good health and public services when we need them is an expectation that we all have. As this becomes eroded people look to the politicians, when they find them lacking, they look for an alternative or become indifferent, weary, disillusioned by the fact that they are not represented by the political system. They don’t vote, leaving the door wide open for groups such as Golden Dawn.
The overriding message from the people we met during our visit was for us to tell their story and for us to fight our austerity measures because if we win, then this will give them hope. There is no difference between here and Greece – it is just that they are ahead of the curve.
The English austerity programme started identically, A&Es are closing, hospitals are reconfiguring, and access to services is being restricted unless you can pay.
The recent reports into poor care in the NHS have been used by the government to portray staff as uncaring and unworthy of public support, paving the way for them to implement changes of a magnitude we have never seen. Our hospitals too are running out of money. Some are closing, some being taken over by the private sector. By 2015 we will have seen £20bn of cuts to our health service.
The current reforms are also widening health inequalities; less money is allocated in the most deprived areas and top up fees are becoming common for many treatments. Public health has been moved to the local authorities. When the ring fence comes off, cash- strapped local councils will have to make tough choices- priority services like elderly care, will be funded under ‘public health’, and the long term protective health programmes like in Greece will vanish. Sexual health services are already seriously compromised since moving to the private sector and only yesterday we hear that rickets has returned!
But to finish on a positive note, there is an incredible story in Greece of health staff giving their time freely and after a full day at work. Doctors, pharmacists, and other clinicians, many of whom are union activists, to set up voluntary clinics where people can get seen and supported. With around 40 clinics now, they strive to ensure that people do get timely medication, cancer treatment, mums can deliver their babies safely and vaccination programmes are given.
Bevan said, “The NHS will survive as long as there are folk with the faith to fight for it”. Bevan knew that one day the vultures would circle to make a profit out of the sick. It is just that after 65 years, it is on our watch that they have landed. We have a duty to fight for the NHS because once it has gone we will never be able to bring it back.