March Trades Council receives presentation on “Bittersweet Brexit”
From March 2018
Many local Trade Union representatives will know Charlie Clutterbuck from his days as a TUC course tutor at Blackburn College.
He is also, however, an agricultural scientist who across his career has combined academic accomplishment with practical farming experience and a lifetime of work as a Health and Safety and Trade Union activist. His involvement with British farmworkers’ Unions goes back to the days of the National Union of Agricultural and Allied Workers, which became part of the TGWU and thence UNITE. He was the North West representative on UNITE’s National Committee for the Rural and Agricultural Sector, until it merged with the Food Sector. He has represented farmworkers on the HSE and has had, through the World Health Organisation, practical contact with Trade Unions representing farmworkers around the globe.
One of Charlie’s strengths has been his ability to see the links between different aspects of the food chain – how the way that food is produced relates to the conditions of farmworkers, the quality of the product, healthy nutrition, sustainability, health and safety and the quality of social life.
Charlie attended the March meeting of Blackburn and District Trades Union Council to talk to delegates about his latest project – the publication of a book (by Unite Education and Pluto Press) “Bittersweet Brexit: The Future of Food, Farming, Land and Labour” and of a website www.bittersweetbrexit.co.uk to encourage continuing dialogue.
He packed a lot into the time available. He began by outlining how the Labour government, following World War 2, had looked to maintain a level of forward planning and state support for agriculture. Farmers were given forward price guarantees and supported by a network of agricultural colleges and research institutions.
Much of this infrastructure was lost after Britain joined what was then the “Common Market”. The driving force, however, was not so much the Common Market itself as the determination of Mrs Thatcher’s Conservative government of the 1980s to let “market forces” determine the shape and future of British farming.
These “market forces” amounted principally to the domination of the food retail sector by a small number of big supermarket chains.
Several consequences emerged. From producing 70% of its own food in the 1980s Britain is now 50% dependent on imports. We have a Food Trade Deficit in cash terms, importing $66bn food products a year whilst exporting $33bn. Leading agricultural research stations have been sold off to the private sector. The East of England has become dominated by a “plantation” model of agriculture – large monoculture farms run with high levels of casual and migrant labour to the long-term detriment of land quality and employment conditions. Subsidies under the current Common Agricultural Policy were most beneficial to those possessed of large land holdings.
Charlie argued it was noticeable that the referendum vote to leave the EU had been particularly strong in areas where the plantation model was prevalent. He saw this as a sign not just of hostility to migrant workers but of a sense of dislocation between this model and the local populations.
“Brexit”, however, would not necessarily make the situation any better.
The “Free Trade” wing of the movement to leave the EU had argued that “Brexit” would allow the British government to strike trade deals outside of the Union that would allow for the import of cheaper food (and clothing). 50% of our current food imports come from the EU. Depending on what new arrangement we eventually reach with the Union these could become subject to the existing tariff regime facing most non-EU countries. Meanwhile, trade outside of the EU would need to be on existing WTO schedules, which rarely amounted to “free trade” – unless and until Britain made alternative deals with individual countries. The only country that appeared to be actively in the market for such a deal was the USA – whose own agricultural sector was prone to overproduction but riddled with potential “standards” issues; such as “hormone beef”, “chlorinated chicken” and the use of ractopamine to produce leaner pigs.
Charlie felt that the Labour Movement needed to be advocating a much deeper revision of agricultural and food policy – one which sought to subsidise labour and “good jobs” rather than land ownership, which promoted diversification and mixed land use, which prioritised local supply chains and food quality, which reduced our dependence on ultra-processed food, which contributed more to maintaining sustainable rural communities and which better protected the health of land workers, of consumers and of the soil itself.
The issues raised by “Bittersweet Brexit” were clearly too complex to be fully covered in one meeting. The Trades Council, however, felt that it had been given a thought-provoking insight into serious matters that are often side-lined or ignored. How we work, how we eat and how we manage the earth’s natural resources are all matters of profound importance to our welfare. “Bittersweet Brexit” shows how they are often also profoundly interconnected.
NHS “Sustainability and Transformation Plan”
From January 2017
Sustainability and Transformation plans (STPs) were announced in NHS planning guidance published in December 2015. NHS organisations and local authorities in different parts of England have come together to develop ‘place-based plans’ for the future of health and care services in their area, with the objective of avoiding the deficits that seem inevitable on current projections. Draft plans were produced by June 2016 and ‘final’ plans were submitted in October.
There are 44 STPs across the country and each is based on a “footprint”. The one for our area is “Lancashire and South Cumbria”.
Much of the early development of the STPs was shrouded in secrecy. Trade Unions and NHS campaigners quickly came to the conclusion that they would involve cuts and/or a drastic reconfiguration of health provision. They also have potential to be the coup de grace in the dismantling of the NHS and handing over its profitable parts in marketable entities to the private sector.
There are fundamental problems with the process being undertaken.
The first of these is the presumption that the growing NHS deficit is a delivery rather than a funding problem. The 2016 “Kings Fund” report “Deficits in the NHS 2016” found, to the contray, that “The principal cause of the deficit is the fact that funding has not kept pace with increasing demand for services” (p 1) – “exacerbated” by the recruitment of additional staff to improve quality of care in hospitals. Whilst there is nothing wrong in seeking continual value-for-money improvement, this is not a guaranteed solution to under-funding and the context is one in which cost-saving measures can easily have an adverse impact on standards.
The second is that the strategy adopted could add to difficulties where the financial situation is already most pressing. The “Lancashire and South Cumbria “STP, for instance, envisages that funding to primary and community services will increase by 20% to 2020/21 in the context of an overall increase of 11%. This can only mean that acute services will, conversely, receive less of an increase than the planned 11%. Yet the pattern identified in the aforementioned “Kings Fund” report was one where the overall NHS deficit was particularly concentrated in the acute sector – there were surpluses in the mental health, ambulance, specialist and community sectors reducing the NHS deficit overall and thus potentially disguising how big the problem was in hospitals in particular (Table 1, p 9).
The third is the possibility that the process will lead to a “re-packaging” of some functions so that they might appeal to private sector providers, whether these be new GP “combined practices” or new “centres” for specific procedures. After all, the NHS Improvement Business Plan says that it is a “priority” to “explore and, where appropriate, facilitate independent sector providers to form NHS partnerships that deliver improvement across the sector” and the “Health Service Journal” has reported that NHS Improvement plans to look at “outsourcing of new, novel or restructured clinical services”.
Finally, the plans rely heavily on a “review” of NHS spending by Lord Carter, which appears to have been uncritically received by Government. Lord Carter has “form” in having been involved in the development of the National Offender Management Service, which has had such a bad impact on Probation services. Our view is that his NHS review is not a sound foundation. He usefully identified that there is a divergence between spending in defined areas between NHS Trusts, but he did not drill down to find out what the reasons for this might be. There was no attempt, for example, to see if there was any correlation between spending and, say, local morbidity or outcomes. He told Ministers that £5bn savings were available, but the figure really appears to have been just plucked from thin air – derived from the fact of variations rather than from any analysis of them.
The “Lancashire and South Cumbria” STP is written in such a way as to make it difficult to know what precisely it is proposing.
The idea behind the plan is that £572m will need to be saved by the 20/21 financial year to stop the NHS being £433m in deficit, and social care £129m in deficit, by that point. It talks about saving £176m in the NHS through “Carter Review” “efficiencies”. It says that use of “all 4 independent primary care contractors” will be “maximised” and of “primary care providers working at scale” – code, possibly, for outfits like “Virgin Care” being given contracts to run new GP “super-practices”. There is reference to “optimal configuration” of acute services – ie. that patients may have to travel “out of district” for some procedures. It also refers to a “review” of A+E and “urgent care” provision.