PHM UK: The ‘War’ Without Bullets - The 2nd National Health Assembly

14 Jul 2014

From behind owls-eye spectacles, Cathy McCormack’s diminutive frame breathlessly declaims: “We are fighting a war without bullets”.

In many ways this feisty wee woman — who from her days living in a Glasgow council estate now campaigns for healthy housing and against poverty– best sums up the People’s Health Movement (PHM) and what it symbolizes today.

It’s about the little man trying to make things right; the battle between David and Goliath. It’s about fighting injustice despite all the odds.

What McCormack’s “war without bullets” refers to is the war on the poor. In an assembly looking at health in an era of ‘austerity’, social marginalisation and environmental injustice, it became clear that — whether we know it or not — we have all been coerced into a war. And, despite differences in class, gender and ethnicity, we are all casualties.

Held between April 10th — 12th at Queen Margaret University in the East Lothian town of Musselburgh — an area hit hard by past deindustrialisation and present austerity — the 2nd UK People’s Health Assembly (PHA) drew more than 100 participants representing civil society organizations, activist and community health networks, health professionals and academics from all over the UK. Medact was one of the groups proud to be present.

The idea of PHA grew out of the People’s Health Movement (PHM) — a global network of grassroots health activists, civil society organizations and academics from around the world. The movement emerged from discontent with the emerging global order, growing inequities within and between countries around the world, and the failure of governments and the WHO to meet the promise of “Health for All by the year 2000”, despite the Alma Ata endorsements of 1978.

The 1st global PHA took place in Dhaka, Bangladesh in 2000 — and since then the movement has expanded in its reach both in geographical terms (with presence in 70 countries) as well as in impact on local and international policy. Mirroring the 3rd global PHA in Cape town in July 2012, the very first UK People’s Health Assembly took place in Nottingham, to reflect concerns about the attack on social care in the UK.

An important outcome of the Nottingham Assembly was the resolve to build on grassroots experiences and gain a region specific understanding on health issues that could inform the development of strategies to influence policy and practice .

The 2nd UK PHA in Scotland reflects this commitment, and it is clear from the richness of discussions that emerged from the assembly that this focus was on the mark. Spread over three days to allow personal testimonies and story-telling as an opening to analysis of the data on health issues, the assembly’s aim was to provide a platform from which grassroots organisations could move towards collective action on health issues.

And being in Scotland provided the assembly with added urgency. Scotland remains one of the worst performers in the EU for its health indicators, evidenced by the much debated ‘Scotland’ or ‘Glasgow effect’ used to identify the higher levels of mortality and poor health found in Scotland and Glasgow. These inequalities are worsening in the wake of austerity. As Scotland is deeply immersed in discussions over self-determination and the devolution agenda — and given the positive differences in the way that public services, such as the NHS, have been handled in Scotland in contrast to over the border — the assembly provided fertile opportunity for discussion on pertinent health issues facing the UK today.

From Medact’s perspective, the assembly served to underline that research on deepening health inequities is not enough. There was a call for academics and health professionals to shoulder the responsibility for turning evidence into policy action. The need to move away from fetishizing quantitative trial data to valuing personal testimonies — and for this information to be seen as observational rather than merely anecdotal — was made clear. It is here that groups such as Medact can help to guide researchers, who have the ability to provide campaigns with key pieces of data as leverage points. Often research is not done on the critical questions that can impact people’s lives — but with joined up thinking it doesn’t need to be this way.

Another important theme was that of solidarity. In this war without bullets, we are all pitted against each other. Austerity and its attendant welfare reforms point the finger at the unemployed, immigrants and chronically-ill in a game in which we are all culpable. The social solidarity of Britain’s post-war era has gone. The PHA called for a stop to victim blaming and a move instead toward “system framing”. As more people recognise that their situation is due not to personal failings but to structural factors and policies, they will gain the strength to oppose those social and economic forces, and seek structural change. Health professionals have a key role in actualising this change. For instance, what use is it to tell patients to exercise more if they cannot access the means with which to do so? Doctors can go further than merely give advice; they can — and should — campaign for healthy built environments in which that advice can be realised.

At the same time as putting the burden of care back into the government’s hands — and a clear desire for the people to stand shoulder to shoulder — there was recognition that self-reliance and ingenuity were needed to overcome the crises of today. And it was here that the utility of something like the People’s Health Movement became clear.

Because the People’s Health Movement is just that. It is a movement of people who share health concerns and join hands in the international struggle for justice. In Scotland, as in other parts of the UK, Labour has failed to mount a compelling or serious opposition to the onslaught of austerity and restriction on civic freedoms imposed by our current government. In this political void, a horizontally-based movement of networks might be just what this country needs to restore solidarity for and with the people.

In this war without bullets, where the demoralization of psychological stresses and economic pain rains down on us, solidarity may be the only weapon we have. For the war against the poor is a world war. PHM’s strength is in its many links to the world-wide community fighting the same battles on their own patches. In these times of ‘planetary crisis’ and financial instability, we ask ourselves, how do we reclaim our humanity? The answer is not in just standing firm, but standing together.

Dr. Guddi Singh, PHM UK
Dr. Anuj Kapilashrami, Lecturer & PHM UK

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