The following summary of the main tendencies within the health sector in the UK was written for a health workers meeting in Bristol in May 2026. We will circulate the minutes of the meeting in the coming weeks, please watch this space.

The text was also formulated for an international gathering in Vienna in July 2026 – a wider audience that might not be too familiar with the UK situation. Therefore a few paragraphs about the general set-up of the NHS are included.

Feel free to send us your thoughts and criticisms.

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Centralised spending

Compared to other countries the health spending in the UK is highly centralised. Around 80% of total health spending (around £345 billion in 2025) is funded through taxes by the government, mainly going to the national health service NHS. The other 20% comes through private insurance schemes or private spending etc..

The government’s spending on health in 2025 was £280 billion. The vast majority of this spending, around 94%, was on day-to-day items such as salaries and medicines. The remainder was largely capital expenditure on long-term fixed assets such as new buildings or equipment. Between 1997 and 2024, capital expenditure on healthcare grew by an average of 3.1% per year, slower than the average rate for current healthcare expenditure of 3.5% over the same period.

In the two years 2024/25 around £12 billion of NHS money was paid to private companies, which made around £1.6 billion profit from that. (This must be money paid to private companies operating ‘within the NHS’ as subcontractors, as in 2024 the NHS paid £34.5 billion to private pharma-companies alone).

In 2022, the UK was spending around 9.3% of GDP on health. That was higher than Canada (7.9%) and Italy (6.8%) as well as the EU average, but less than Germany (10.9%) and France (10.2%). The US was the real outlier, spending 14.1% of GDP on health. By 2025 UK spending increased to 11.4% of GDP.

 

Reduction in health spending, increase in military spending

We can see a slight decrease in health spending and a still modest increase in military spending in the UK.

Between 2015/16 and 2023/24 health spending increased by 3.1% a year on average in real terms – below average growth rates. The current government tries to curb health spending over the next three years to 2028/29 to an average annual increase of 2.2% (inflation taken into account) – below historic levels.

In the 2024/25 financial year, the UK spent £60.2 billion on defence. Spending plans set out in the 2025 Spending Review show that defence spending is expected to total £62.2 billion in 2025/26, increasing to £73.5 billion in 2028/29. This is equivalent to an annual average real-terms growth rate of 3.8% over this period.

The origins of the NHS are deeply rooted within the collaboration with the military, as the national health service emerged also as an effort to centralise local hospitals during the war effort. In that sense many of the legal measures that we can currently see in western Europe, to subject the civilian health sector to the central state command in case of a military emergency, is already enshrined within the relation between the state and the NHS. 

Still, we can see further processes of militarisation in the UK, e.g. during Covid, when army units were used within hospitals or to build extra-capacity together with civilian health staff. Shortly after, military paramedics were used as scabs during the national ambulance strike. During the current war in Ukraine, UK consultants train Ukrainian military surgeons and Ukrainian soldiers are treated in UK hospitals. 

Otherwise the process of global war and militarisation seeps into daily life, e.g. in the form of hurried medical research into lab grown blood vessels to avoid amputations.

 

Decentralising the deficit

The NHS budget is distributed to more than 200 local NHS Trusts (comprising one or two hospitals or community clinics). These Trusts are supposed to act within budget limits. If they overspent, local Trust management runs the danger of losing control over investment decisions etc., and the Trust is put under central control. 

Apart from sticks, the government also offers carrots to ‘well performing’ Trusts. They can be elevated to so-called ‘Foundation Trusts’, which comes with the privilege, for example, to retain any cash raised from the sale of Trust property assets, such as spare NHS land and buildings. While most NHS workers’ wages are fixed nationally, local Trusts can determine top managers’ wages freely.

Total Trust deficit peaked in 2015/16, when the net deficit was £2.5 billion and 66% of Trusts were in deficit. The government tends to jump in if deficits become unsustainable, e.g. the 2024 Autumn Budget announced a £22.6 billion cash injection for the NHS to deal with the deficits. At the same time they are tightening the screw. 

The centralisation vs. decentralisation within the NHS is supposed to defuse discontent. For example, local trade union officials state that local job cuts cannot be opposed, as Trust management can only deal ‘within their range of possibility’, which is defined by the central budget. At the same time local management has a certain degree of autonomy, e.g. they can decide whether to pass on the national pay increase to local bank staff (workers on zero-hour contracts within the NHS Trusts) or not, whether to grant certain department ‘over-time bonuses’ or not. 

This ‘autonomy’ and decentralisation is meant to create ‘incentives’ and push local managers to increase productivity, but it comes at a substantial general cost: with the creation of the ‘internal market’, where each Trust has to relate to other Trusts as separate economic entities, buying and selling their services, the keeping track of ‘internal financial transactions’ is supposed to account for 10% of all admin labour – and around 30% of all labour within an average hospital is classified as ‘admin’.

 

Central and local redundancies

In terms of closing the central finance tap, 2024 was a turning point. Trusts had to cut agency staff levels and drastically reduced recruitment. In our local Trusts, 500 job cuts (out of 18,000 staff) were announced, primarily through voluntary retirement and ‘non-replacement’ of leaving staff. Most vacancies are now ‘internal’ vacancies. In April 2026 the trade union Unison published a survey, stating that there was a combined deficit of more than £1.1 billion last year across all NHS Trusts and that Trusts plan to cut 20,000 jobs, out of which 3,600 are clinical roles.

The other big central attack in terms of redundancies is the Labour government plan to scrap the administrative entity ‘NHS England’. They claim that NHS England mainly comprises management roles that engage in work that is already been taken care of by other administrative levels. This is not true, as many national programs, e.g. for diabetes prevention including data collection and analysis, are done by NHS England. In November 2025 the government stated that axing NHS England could cut 18,000 jobs. 

An immediate outcome of the budget cuts are a drying up of vacancies for resident doctors who just came out of medical training and for post-grad nurses, physios and other registered staff, who are now settled with large sums of debts from studying. The first result is an increased mobility and job rotation, e.g. physios have to accept to travel to different Trusts. The new doctors made the lack of vacancies one of their main issues in the recent round of strikes.

 

The aggravating health crisis

In March 2026, Module 3 of the UK Covid-19 Inquiry, detailing the effect of the pandemic on the UK’s healthcare systems, was published. It stated the obvious: the UK’s healthcare systems entered the pandemic with workforce shortages, an ageing hospital estate, a lack of equipment, low numbers of hospital beds, and high bed occupancy. (As an important side note in relation to Covid and future pandemics, also in March 2026 at the World Health Assembly in Geneva, the ‘international community’ failed to agree on an international treaty for the exchange of pandemic related information.) 

Austerity measures have rundown the health system, but this creates costly problems. The government is in a bind, as the cuts in health spending increases the social costs of an increasingly sick population. 

Around 7.3 million people are currently on a NHS waiting list for surgery and other treatments, with an average waiting time of 18 weeks plus. 

Almost 3 million people who are in ‘working age’ are long-term sick and not able to work – the highest level on record. A survey in November 2025 stated that the ‘economically inactive population’ cost the UK economy as much as £85 billion a year. The government reacts by sending (or at least pretending to send) job centre advisors into hospitals, trying to ‘help people back into work’. 

A survey from April 2024 said that the healthy life expectancy for men in the UK has fallen from 62.9 years in the 2012-14 period to 60.7 years in 2022-24 and from 63.7 to 60.9 years for women over the same timeframe. It means that the proportion of life a man spends in good health is down from 79% to 77% and, for a woman, from 77% to 73%, the analysis by the Office for National Statistics showed.

The cuts to local community and social care also means that patients stay in hospitals longer than they medically have to – which is first of all a health risk for the patients, but also an expenditure for the health system, around £210 million a month, over £2 billion a year. Inside the hospital the discharge pressure increases – and at the same time the frustration, as more and more patients are re-admitted shortly after discharge.

This long-term structural contradiction the state finds itself in, is the dangerous context for the current debate about the so-called ‘Assisted Dying Bill’ in the UK.

 

Pressure on migrant health workers

Another major line of attack on the health workforce shows similar contradictions: on one hand the UK state is utterly dependent on labour migration in order to staff hospitals and care homes, on the other hand it has to keep this workforce under constant pressure in order to curb wage pressures and other demands from below.

In June 2025 the NHS employed 218,727 non-British doctors, nurses, health visitors, and midwives (that is around 35 percent of the total). Training them domestically would have cost £14 billion, a massive saving for the cash-strapped NHS. At the same time the Labour government announced to restrict the access to work visa by increasing the annual minimum wage that would entitle you to a sponsorship to £25,000. Many international health care assistants were affected by this, some of them left the country others were threatened with deportations. 

Another planned change is to increase the period to obtain Indefinite Leave to Remain from five to ten years. That would mean, for example, that children of migrant NHS workers would have to wait ten years before being able to study at local study fee costs, as ‘international fees’ are unaffordable. 

We could see that many EU based nurses left the UK after Brexit. In the case of Spanish nurses, working in the UK was counted as ‘years of experience’ which would then be included in a point-system when applying for jobs in the Spanish public health sector. After Brexit, working in the UK doesn’t count anymore. The reliance on nurses from former British colonies becomes even more acute, but the visa changes turn many workers away. A study from November 2025 claimed that up to 50,000 nurses could quit the UK over the government’s immigration proposals.

 

Trade war and pharma

The pharmaceutical sector is central to the health service in many ways. Our two local hospitals spend nearly 10% of their total budget on drugs. Many drugs rely on global supply-chains, e.g. the main raw materials are made in India, the final processing and packaging is done in the UK. The UK exported over £20 billion worth of pharmaceutical products, most of them to the US. With Brexit the state had hoped to be able to transform the UK into a de-regulated ‘global laboratory’, but actually its position as an export hub has weakened.

Pharma is one of the main sticky points in the UK-US trade deal. The US state demands that the NHS should pay more money for drugs, in particular on drugs that have been developed in the US. After an initial rejection of the UK government to raise the pay ceiling for the NHS, the domestic and international pharma corporations reacted with an investment strike. Pharma investment projects worth more than £1.8 billion have been pulled or paused in the UK in 2025. Britain’s biggest drugmaker AstraZeneca announced to invest £11billion in China instead of the UK. The government caved in and in October 2025, the media reported that the government agreed to raise the amount that the NHS can pay for new (drug) treatments by up to 25%.

The international trade war, which affected the pharma supply, has turned into an increase in actual wars, which impact on pharma supply even more: in the UK, paracetamol prices went 30% up due to war US-Israel war in Iran, and the helium supply crisis interferes with various medical treatments, for example MRI scans.

 

Limits to large scale privatisation

The political proposals of large scale privatisation, e.g. in the form of an introduction of a (private) health insurance system or the expansion of private hospitals have been curbed primarily by the structural limits of the market system and the ‘private sector’ itself. Actually, the share of government spending compared to private spending on health has been increasing in recent decades: from 73.1% in 1997 to 81.3% in 2025.

The main recent blows to the confidence of the liberal mind were, for example, a) the collapse of some of the large private sector companies that deal with public-private hospital construction schemes (PFIs) and outsourced services, such as Carillion; b) the enormous cock-ups of private companies during the Covid pandemic, amongst them the Serco track-and-trace system which cost £37 billion and delivered little c) the realisation that even pension funds, like health insurances, are interlinked with global stock markets and can come close to collapse in crisis moments, such as the announcement of Liz Truss’s government ‘mini budget’ plans.

The main lines of privatisation of the ‘core’ of the NHS can be briefly summarised as follows: a) privatisation of NHS land and the construction and maintenance of hospitals through PFI models; b) the subsidising of private clinics and surgeons by providing them with NHS patients from the long waiting lists for treatments; c) the increasing dependencies on private corporations to, e.g. to run the massive data and software network or the complex supply-chain. If we look at each of these levels we can see that they are contested:

1. The PFI systems have proven to be fairly costly and have come under public scrutiny. The big expansion drive of PFIs seems to have slowed down and a few Trusts have cancelled their PFI contracts recently. Still, the amount of NHS expenditure that is paid to private companies purely in interests is considerable: out of the £12 billion paid by the NHS to private companies over 2 years, £352 million went towards paying interest on debt rather than on patient care.
2. The latest figures show the number of NHS patients treated by ‘independent sector’ hospitals and clinics has increased by almost 10% in Labour’s first year (535,000 in the 12 months to July 2025), compared to the equivalent in July 2024. The latest figures show a decrease in subsidised surgeries though, they have fallen 12% from its July 2025 peak. The private sector share of elective NHS care has dropped to just 6.4%, its lowest level in comparable years in the dataset. That doesn’t mean that all ‘private treatments’ declined, as more people pay for surgeries privately: nearly 950,000 operations and treatments were carried out in the private sector in 2025. Almost one in eight Britons now has medical insurance – the highest proportion since 2008.
3. The use of US based software and datacloud systems has been rattled by the shaky ‘special’ relationship between the US and the UK state and by solid campaigning against companies, such as Palantir. Also the supply-chain, largely run by Novation / DHL showed severe hick-ups. This doesn’t mean that the NHS is able to stem this infrastructure work itself, given the general curb on investment and actual reduction, for example of numbers of employees dealing with data. 

The fact that private hospitals and health services are still marginal in the UK doesn’t mean that there are not massive dynamics at play. In May 2026, the board of Britain’s largest private hospital operator Spire Healthcare (38 hospitals, 60 clinics) backed a buyout proposal worth £1bn by Toscafund, founded by a City investment banker. At the same time the ‘start-up’ bubble of private tele-health companies seems to deflate, because the national health services apply more and more ‘tele-technology’ themselves.

 

The restructuring of the relation between hospitals and ‘community care’

One of the main proclaimed trajectories of the Labour long-term ‘10 Year Plan for the NHS’ is the strengthening of community care in relation to hospital care. Hospitals are costly and it is more difficult to enforce cost-cutting measures against a large and concentrated work-force. In the community it is easier to outsource care to private providers, charities or unpaid/low-paid family members. 

We can see that ‘privatisation’ as one of the main forms of restructuring, is most developed in the so-called ‘community setting’, e.g. when it comes to care or nursing homes or mental health services. Whereas up until the 1990s the NHS provided long-term elderly care beds, this sector is now more or less completely privatised. A study from March 2025 estimated that 30% of England’s mental health hospital capacity was in the private sector. The same report also revealed that “independent” mental health care providers were in fact dependent on the NHS for 91 per cent of their income, on which their typical profit margins were 15% to 20%. In Bristol, North Somerset and Gloucestershire, no less than 95% of mental healthcare beds were owned by private providers, and three-fifths owned by US companies.

Another social backbone of community care is the fact that most General Practitioners (GPs) retain a certain business autonomy, as they are not wage workers, but NHS ‘contractors’. On the other hand, only around 3,000 GPs are actual private business owners, which is 4% of the total. The building stock of GP practices is also largely privatised and now run by multi-national funds: in August 2025 a bidding battle started for the NHS landlord Assura, the US-based fund KKR put in a bid of £1.7 billion.

In addition to GP clinics the government wants to focus on “Neighbourhood Health Centres” (NHCs), around 80% of the new build NHCs will be financed through ‘Public Private Partnerships’. The question is if even with ‘private help’ the state is able to vamp up the required numbers: the promised 100-120 NHCs by 2029 would not even provide one NHC for each of the 150 top-tier local councils.

 

General restructuring on Trust level

If the tendencies mentioned above are the big and more obvious picture, the main and daily attacks and measures of restructuring happen on a smaller and more individualised level, managed on a Trust by Trust basis. The central state administration increases the pressure on Trusts, e.g. through the government plan of introducing a public ‘League Table’ of Trusts and their performances, with additional incentives and penalties, but the daily ‘dirty work’ is left to Trust management. What are the formal ways of restructuring? 

We have seen several Trust fusions recently, for example of our Trusts in Bristol. During the process management tends to try and shrink certain departments or enforce more flexibilisation, e.g. by forcing workers to work ‘across Trusts’.

Another tendency is the creation of so-called subcos, these are sub-companies created by the Trusts themselves, which first of all allows them to pay fewer taxes, but also sometimes come along with deterioration of pay and conditions for outsourced workers, for example access to hospital parking. The number of workers affected by subcos is relatively low, in the four digit range.

Then there are constant disputes around the actual outsourcing of services to private companies. These often affect the so-called auxiliary tasks, such as catering or cleaning, but also some of the technical medical tasks, such as MRI scans. Differences are significant, for example nearly all of the linen laundry work is outsourced to private companies, only around 40% of the catering and cleaning services. In April 2026 a Trust in the South West of England announced to outsource all NHS bank staff to a private company. Often these privatisations are even more minute, e.g. the hiring of surgical theatres to private companies on weekends. 

Part of the Trust’s range of decisions is to close or reduce certain departments or services. In the case of our local hospitals this happened to a detox clinic and a sexual health clinic. Often the work that has been performed in these departments is redistributed more arbitrarily amongst the general hospital workforce, e.g. people end up detoxing on general wards. This increases the workload and the Trust can save on wage costs.

In some cases the attack on pay and conditions is not left to private companies, but enforced by the Trust management directly. These attacks happen within the constraints of a nationally negotiated pay and banding system. Trusts have only a certain autonomy to define pay levels and re-grade certain professional categories or not, which limits the scope for direct attack on wages. Examples of attack on wages are: a) delay the up-grading of workers, e.g. the health care assistants from Band 2 to 3, the nurses from Band 5 to 6, the health visitors from Band 6 to 7; b) the exclusion of bank staff from the nationally negotiated pay increase and the withdrawal of certain bonuses (for example for ‘allocation on arrival’), which can affect a large number of workers, around 800 bank staff in our hospitals which employ 18,000 in total; c) the refusal to pay over-time rates (50% extra) and instead pay normal bank rates.

The process of restructuring most difficult to analyse are the changes in the mode of work or changes to the division of labour. Currently two most obvious tendencies are a) the increase of tasks amongst lower paid workers, e.g. the addition of venepunctures or blood sampling work to the job of health care assistants and b) the introduction of lower paid and ‘lower skilled’ new job categories, such as advanced medical practitioners, nurse practitioners or physician assistants/associates, who undertake routine tasks of doctors. 

Often this new division of labour is supported or disguised through the application of new technologies, such as artificial intelligence or other forms of digitalisation. Here artificial intelligence is primarily used as scanning and prediction aids, e.g. in order to plan seasonal shifts in work loads (‘flu season’ etc.). In some Trusts AI is combined with volunteer work: at two Warwickshire NHS hospitals, the volunteer organisation Helpforce uses Deep Medical, ‘equipping’ unpaid workers  with AI tools to target the calls they make to people ahead of appointments. 

In other cases new technologies and techniques reduce the work load, e.g. laparoscopic surgery tends to reduce the need for post-surgical rehab compared to open surgeries, while certain pharmaceutical treatments are sold as replacing more labour-intensive surgeries.

 

Crisis for the patients

Apart from the above mentioned general health crisis, the under-staffing and lack of general investment causes a crisis situation for patients more immediately. This also impacts on the worker-patient relation. 

In 2025 there were more than 16,600 deaths of patients linked to very long waits in A&E for a hospital bed. There has been a 525-fold increase in the number of instances of corridor care (also known as “trolley waits”) of 12 hours or more since 2015/16.

More than 295,000 incidents of physical violence and aggression by patients against staff were recorded by 212 NHS trusts in England between 2022 and 2025. Hospitals records show that the number of violent incidents, which range from violent threats to attempted and actual assaults, rose from 91,175 in 2022-23 to 104,079 in 2024-25. This is equivalent to about 285 cases being reported every day in the most recent year. (These are big numbers. At a recent staff survey in our hospital, ‘only’ 10% of workers said that they have been victims of bullying, violence or sexual harassment by patients in the last 12 months).

In turn we have seen an increase in cases of brutalisation of nurses and doctors, with highly publicised scandals of nurses killing infants or doctors brutalising patients.

In addition to these more direct short-comings and aggravations there is a pretty uninterrupted flow of ‘medical scandals’, from large disasters, such as the HIV blood transfusion incident in the 1980s to 10,000 women in the UK having been injured through problematic vaginal mesh implants in the 2020s. Patient organisations form around these obvious cases of medical oppression, but there is little collective ‘patient struggle’ in general.

 

Current disputes and struggles

This is just a brief overview of the main lines of struggles and some of their limitations. The NHS is relatively highly organised in quantitative terms, many nurses are union members – but that doesn’t necessarily translate into a combative workforce. Often the trade union competition creates additional divisions, rather than unity. 

The main combative segment on a national level have been the BMA resident doctors and their strikes for higher wages. At least initially the strikes had a significant material impact (70% elective surgeries cancelled), but the strike was otherwise not visible within the hospital and didn’t connect with other hospital workers. The participation is shrinking from strike to strike. Doctors also developed a new form of struggle: in May 2026 the BMA urged GPs to perform a transfer boycott of certain patient data in response to the 2026/27 contract which had been imposed by the government.

The main nurses strike in 2022/23 was a highlight, the first national nurses strike in 30 years. The government decides about the annual pay increase of (nearly) all NHS workers, the unions tend to ballot several months after this decision, which causes a ‘cooling down’ of worker anger. The main weaknesses of the nurses’ strike were a) that the derogation / minimal service was decided by the top of management and union; b) that the various unions that organise nurses did not manage to strike together; c) that it was only nurses and paramedics that went on strike for the national pay increase, not other workers who were also affected (as they often didn’t meet the ballot threshold).

Since then the wage pressure remains, in particular on the lower pay brackets. Each general management wage increase pushes the Band 2 workforce below the legal limit (after working for the NHS as a cleaner, porter, health care assistant etc. for 20, 30 years!), and NHS management has to increase their wage haphazardly. This leads to distortions, as for example in our Trust Band 2 bank staff earn more than Band 3 bank staff on certain shifts. The RCN currently ballots whether nurses and health care assistants want to accept the 3.6% government pay increase. More likely than national industrial action is that the RCN decides to split nurses off from the general pay negotiations of the ‘Agenda for Change’ (comprising most NHS staff, from porters to managers) and, like the doctors, create their own separate bargaining entity. 

As an overview, the current Band hourly wages: Band 2 £12.92 (cleaners, porters, health care assistants) / Band 3 £13.17 (admin, senior health care assistants) / Band 4 £14.52 (nursing associates, therapy technicians, admin) / Band 5 £16.40 (registered nurses, physios) / Band 6 £20.44 (senior nurses, midwives) / Band 7 £25.26 (lower managerial positions). The banding system is based on a bourgeois notion of merit and ‘responsibility’.

Since the pay strike in 2022 the ballots for a national pay increase have been unsuccessful. People retreat into smaller-scale disputes for an ‘up-grading’ of their particular professional pay band. The widest impact would be amongst nurses. (“Band 5 review: 44% of nurses in England are at band 5. That is the single largest group in the NHS nursing workforce. Only 8% of nurses progress to band 6 within two years of registration”.) The logic is often that the local Trust should implement what other Trusts and national job profiles have already done. The most prominent struggle was the strike of phlebotomists in Gloucester, which went on for nearly a year. The main weakness of the strike was that the union did not manage (or want) to prevent nurses and health care assistants doing the work of their striking fellow workers, meaning, not taking blood samples. 

Unlike in many European countries, there are hardly any struggles that address the lack of staffing directly. In July and September 2024 around 100 theatre nurses at Guy’s and St Thomas’ in London went on strike against the extension of their working day by 1 hour and against the lack of staff. We don’t have much information on the outcome of the strike. In other situations nurses went on strike against enforced mobility in December 2025. Nurses from the intensive care unit (ICU) at Bassetlaw Hospital don’t want to be forced to rotate between hospitals.

There are numerous local disputes around outsourcing. For example in February 2026, more than 600 workers at Barnsley Hospital NHS Foundation Trust balloted for action. The NHS Trust threatened workers with ‘fire and rehire’ under new contracts, allegedly removing all paid breaks and imposing longer unpaid breaks.

All these struggles remained isolated within one professional group, one particular union (out of four, five who organise the same job category of workers) and/or one particular Trust.

In terms of patient and ‘user’ struggles there are several local struggles to ‘defend services’, for example the women’s hospital in Liverpool or local dental surgeries. The efforts to connect these struggles are often swallowed up by general ‘campaigning’ to ‘defend our NHS’.

 

Independent initiatives within the health sector

There are numerous self-aid groups, health charities or NGOs. It would be a larger research to see whether these organisations are actually based on patient self-organisation and on the defense of their collective interests, or rather on patient representation and integration into the process of ‘privatisation light’ of the NHS. In addition we see:

• Larger campaign organisations that organise events and demonstrations to defend the NHS: for example ‘Keep Our NHS Public’ or ‘Defend our NHS’. There is the People’s Health Movement in Scotland.
• Left-leaning health ‘think tanks’ and academic research such as Lowdown or Future Health.
• Left tendencies and caucuses within the mainstream trade unions that organise within health, for example Time for Real Change in Unison.
• Left-leaning doctors’ organisations, such as MedAct or Every Doctor.
• Rank-and-file nurses organisations that span various trade unions, such as NHS Workers Say No, which has largely become defunct after the last round of strikes.
• There are organisations that support migrant patients who have become the target of state repression, such as Docs not cops or Patients not passports.
• The most dynamic element in recent months were anti-war groups such as Health workers for Palestine, but also the Campaign against Palantir in the NHS. While the activities often remained marginal and symbolic, such as union branch resolutions and small protests in front of hospitals, it created a ground for wider collaboration. It also created new hospital newsletters, such as The Handover in the south of London. 
• There are radical midwifery and feminist women’s health collectives, although they often remain at the margins of the ‘official’ health sector.
• The same is true for many of the radical mental health organisations (such as A Disorder 4 Everyone, Antidepressant Risks, Mad in the UK, Abolitionists etc.). There are interesting new podcast forums, such as Red Medicine.

All these seem partial activities that have very little impact on the daily operations in hospitals and clinics, but they are perhaps potential organisational reference points in future larger movements.

 

Conclusions

What are the main tendencies or points of conflict and intervention? This is to be discussed in a larger circle, but here are some preliminary suggestions:

• The struggles around the question of ‘change in the division of labour’ and the ‘intensification of work’ are absolutely underrepresented and often invisible. Any inquiry or intervention should try to unearth these changes and politicise them.
• Of course it makes sense to fight attempts of privatisation on the larger scale, but the main changes are often imposed on the departmental level: hiring out of theatres, shifting of services to the charity sector etc. These smaller, piece-meal attacks have to be put in the focus of general resistance.
• The catch-up game with the minimum wage is not only economically strenuous for Band 2/3 workers, but a moral slap in the face and it would be good to start a general wage campaign from below.
• After relatively dynamic campaigning around Palestine and Palantir it would be good to address the ‘enemy at home’ and start a campaign against the military spending and militarisation of the health sector.