In his 1992 book, What Uncle Sam Really Wants, Noam Chomsky attributed the role of the US administration in its interventions in places like El Salvador, Chile and Nicaragua in part to the desire to negate the ‘threat of a good example’.

He argued that these countries were showing their neighbours that ownership of the means of production could be retained within the country rather than handed over to US multinationals, and that it was possible to run a country reasonably successfully without it being a de facto colony of the US. Such ‘good examples’ had to be crushed as soon as possible, lest the lesson should spread. Various methods have been used in pursuit of this purpose over the years, from ‘agent orange’ in chemical weapons used in Vietnam to the backing of violent coups by US henchmen such as Pinochet and the bloodthirsty Nicaraguan ‘Contras’. They have, by and large, been successful.

all-out assault

Fast forward to the present and the same principle can be seen at work in our very own National Health Service. The all-out assault on the NHS and its basic provision of quality healthcare to all, regardless of ability to pay, has been well documented in this publication and elsewhere. The deliberate breakup of the service and the subordination of its constituent parts to market principles have been hard on both patients and workers, whilst providing an unprecedented windfall for an army of financial consultants, shareholders and other assorted parasites.


The whole process is presented by the government and the media in a confusing way which leaves many unsure of what is happening, who is benefiting and who is to blame for the endless rounds of cuts and sell-offs. The general feeling among NHS workers has been one of disgruntled pessimism. ‘What are we supposed to do about it?’ and ‘hopefully things will turn around soon’ are the mottoes of the day and, as long as they remain so, the asset-stripping of the NHS by private capital will continue.

In this climate, activists within the health service who argue for the kind of response anarcho-syndicalists would like to see are often isolated both by the brick wall of the union bureaucracy and the pessimism of their fellow workers. It’s hard to argue for the kind of sustained, collective direct action that is needed to win this fight as an isolated, lone voice, especially when the idea of such a successful fightback seems so far from the meek capitulation which appears to be the norm across the country.


However, some groups of NHS workers haven’t given up quite so easily. A number of strikes have occurred at London’s Whipp’s Cross hospital by cleaners, domestics and porters who oppose the second rate pay and conditions which have resulted from the use of a private contractor, whilst some of our IWW comrades in the National Blood Service are involved in a promising campaign to catalyse resistance there.

Perhaps the most prominent and successful story of opposition to these attacks, however, can be found in Manchester, where employees of that city’s ‘Mental Health and Social Care Trust’ have shown us all that where the ‘proper channels’ fail, direct action can get the goods.

There has been a long standing campaign by the workers’ Unison branch against cuts and involvement by the private sector. This culminated in a January 2007 strike which saved over 40 nursing, therapy and support worker posts. It also prevented a hostile regrading by management which would have seen a reduction in pay for many workers.

Activists working in the NHS around the country now had the ‘good example’ we had been craving – a concrete, contemporary demonstration of a successful fightback that stopped those who are trying to destroy the NHS in their tracks.

Enter stage left Manchester’s answer to General Pinochet, new Chief Executive Sheila Foley. Appointed soon after the successful strike, Foley was given only a twelve month contract and, at 62, seems unlikely to want to work again – especially with the unusually high £135,000 she is being paid for her year in office to fall back on.


Subsequent events have demonstrated that Foley was brought in for one purpose and one purpose only – to break the union, crush the workers’ spirit and ensure the threat of this ‘good example’ does not spread any further. She has chosen to do this by making an example herself – by sacking one of the workers for speaking out against the ongoing cuts and sell offs.
Mental health nurse Karen Reissmann’s reinstatement campaign has used the slogan ‘Silent Nightingales’ to highlight the ‘gagging’ of NHS employees who criticise cuts. In reality the shop steward’s statement to the local media was simply the excuse Foley and her henchmen were waiting for to sack a prominent activist and restore the Trust to the ‘business as usual’ of rampant cuts, sell-offs and ever poorer quality services. It has been clear from the start that the dismissal had nothing whatsoever to do with Reissmann’s work as a nurse. Indeed she was farcically promoted for her high quality clinical performance on the very same day she was fired.

The official reason behind Reissmann’s sacking was that she had criticised the transfer of NHS services to a voluntary sector organisation. It is alleged that she claimed such an organisation would find it harder to attract experienced nurses due to its lower wages and less favourable pension entitlements. She was suspended for this ‘offence’, then compounded this ‘gross misconduct’ by telling people she had been suspended, telling them that she was innocent, and “allowing the press to print misleading statements about her case”.

show trial

Karen’s colleagues recognised this for the show trial that it was and went on immediate indefinite strike to have her reinstated. This strike lasted six weeks, during which time donations and messages of support flooded in from across the country. Pickets were well attended and regular lobbies and demonstrations took place, including a large march last November. However, no reinstatement was forthcoming and, following the rejection of Reissmann’s appeal on December 11th, the strikers voted to return to work six days later.

At present the plan is to continue by means of a ‘national Unison campaign’ involving a tribunal claim for unfair dismissal, an early day motion by Unison sponsored MPs and a national lobby of parliament in the New Year. The ‘threat of a good example’ appears to have been negated – for now.

This is a dispute that came close to being won. The Trust was struggling to manage without the strikers. Strike pay was being maintained at a reasonable level thanks to over £200,000 of financial support from around the country and the action had the support of most people in Manchester. Crucially, this included service users, who passed a resolution calling for the Trust board to resign ‘for the good of the people of Manchester’.

failure to spread strike

The decision to return to work appears to have been based on the fear of losing momentum and strikers returning to work in dribs and drabs, as well as the legal statute allowing workers to be sacked once they have been on strike for 12 weeks, even if the strike is entirely legal. A key factor was the failure to spread the strike. Astonishingly, social workers from a different Unison branch were used by Trust bosses to cover work of those on strike. Apparently they were not allowed to be balloted due to anti-union laws so the strikers were left isolated and were eventually frozen back into work. Whilst those involved insist that they haven’t given up and are still fighting, it is hard to see legal challenges and lobbying of politicians succeeding where industrial action has failed.

One positive feature is the further radicalisation of the workers involved. Many of them travelled around Britain to speak at support meetings, there were active picket lines, a significant increase in the number volunteering to be stewards and a raised consciousness of the depths the bosses will stoop to protect their class interests. One striker explained this general feeling in the phrase “there are now a hundred Karen Reissmanns in Manchester”. As such it seems things could flare up again at any time. If it does then we need to be ready to show solidarity once again.

As anarcho-syndicalists, this is exactly the sort of direct action we want to see in defence of jobs and the social wage. SolFed locals did their bit in the wider solidarity effort with financial donations, attendance at demonstrations and awareness raising in our own union branches and among local NHS workers. We need to be ready to mobilise like this again so workers who put our belief in direct action into practice are not left isolated.

Perhaps the most important lesson of this struggle is the capacity for workers to be left high and dry by the unholy alliance of government anti-union laws and the trade union officials who revere them. The key to victory was spreading this strike, but since secondary picketing and strikes are illegal this appears to never have even been seriously considered, an attitude which will always leave workers fighting with one hand tied behind our backs. In future, the likes of these brave Manchester health workers must not be left to fight alone.

We wish Karen Reissmann all the best in the continuing campaign to get her job back. The ‘good example’ she and her fellow workers gave us is an inspiration we won’t forget, even if it appears to have been temporarily snuffed out by the ruling class.

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