Pursuing a political dispute

At the start of the London ambulance dispute the government and NHS management declared their only motivation was to hold down pay rises to keep inflation in the heat service under control, but it became clear very early on that the government had always been in the dispute as political rather than industrial.

Heath Secretary Kenneth Clarke gave the game away several times: in his haste to recognise the ‘breakaway’ union, the Association of Professional Ambulance personnel (APAP) — despite the union having ‘broken away’ 10 years earlier; in threatening speedier privatisation of the London Ambulance Service as a consequence of the dispute; in rejecting arbitration as a solution; in encouraging management to make the TUC code of conduct for disputes in the NHS unworkable; and in spurning the no-strike agreement proposed by the unions. Those decisions and stances, not the makeshift ambulance service of police vehicles and military trucks, made the dispute a political contest equivalent in significance, if not in size, to the 1984 miners’ strike.

The government was never interested in no-strike agreements inside the NHS, its aim was to establish a no- strike organisation representing ambulance crews, just as its aim has been to have nurses represented by a professional — non striking — body, the RCN, rather than by unions like NUPE and COHSE. Despite having less than 5,000 members spread throughout Britain, APAP, excluded from the Whitely council negotiations over ambulance crew pay, became the ideal vehicle for an alternative negotiating machine — until its members began to leave in droves disgusted with their leaders acceptance off a pay offer all ambulance crews had rejected at the outset.

The TUC code of conduct for industrial disputes in the NHS became another target for government attack. It had to be discredited as an effective union weapon if the ambulance dispute was to be worth fighting. Since the code relied on management co-operation in strike action, and was therefore a ‘gentleman’s agreement’, its demolition was not too difficult. In the Thatcherite view of things why should NHS management help the unions to wage industrial dispute? Pressure on management to refuse to let crews provide emergency services arose from the government’s need to neutralise the TUC code and ultimately prevent all forms of industrial action inside the NHS.

But breaking the ambulance union’s spirit has been of key importance to the government. Privatisation of the ambulance service will be much easier if trades union resistance is weakened or eliminated, and that could only be achieved if trades unions were shown to be ineffective. A long-drawn out ‘ industrial’ dispute has the advantage of exhausting staff and union energy and money, and one initiated just before Christmas gained extra leverage from the season. The departure of ambulance staff from the London service, which is likely following any prolonged dispute, particularly if the unions lose, will allow recruitment of new, potentially unorganised labour, aware of the fate of their troublesome predecessors.

Such a confrontational approach to labour relations is intended to impress other health service workers. NHS staff, including the persistently difficult medical profession, could draw lessons from the government’s intransigence and ruthlessness and apply them to their conduct during future rounds of privatisation, NHS cuts and job losses.

But the government has made one key error — it miscalculated the attitude of the public. Support for the ambulance crews has grown consistently during the dispute, the unions have dealt with the situation calmly and carefully and have avoided the posturing of the miners’ strike, and the Health Secretary has appeared as the intransigent and unreasonable bully. Whatever the immediate outcome for the ambulance service, that miscalculation on the part of the government may turn out to be crucial.