Medact Impact Report 2021-22 cover: Cover image features health workers in scrubs, facemasks, marching with placards. One placard reads in colourful letters: 'System Change Not Climate Change'.

Photo: Health workers at the COP26 climate talks in Glasgow on the Global Day of Action for Climate Justice, 6th Nov 2021. Credit: Emily Macinnes.

This is the digital edition of our Impact Report 2021–22. You can also download a PDF version.

A message from the Chair

Professor Alan Maryon-Davis
Chair, Board of Trustees

It’s 30 years since Medact was founded on the merger of two medical groups campaigning against war and nuclear weapons. In that time Medact has evolved from a more-or-less single-issue, single-profession pressure group to a progressive, inclusive movement of health workers campaigning on four all-pervasive areas of inequity – peace & security, climate & environment, human rights and economic justice.

At a seminal conference in 2013 with 250 delegates, Medact re-launched as the only charitable organisation of and for health professionals that, in the words of then-Chair David McCoy, was focused on the underlying social, political and ecological determinants of health from an explicit social justice platform. Medact was evolving, transforming into a major movement for change.

And that evolution has continued. In recent years the Medact movement has grown steadily, with more members, more partners, more local and interest groups. Although our remit is global, our focus is on challenging the many inequitable policies that characterise the UK today. We have our work cut out: health and social injustices continue to worsen across the UK. Fairness in so many spheres is threatened – from access to healthcare to the hostile environment, and from climate justice to the right to peaceful protest.

All this is exacerbated by the COVID-19 pandemic and its aftermath, by inflation and the cost-of-living crisis, and by ‘levelling up’ policies that encourage business investment rather than tackling the fundamental social and economic barriers that people face every day.

These are the sorts of issues the Medact team, together with our partners and wider membership, have been getting to grips with over the past year. On the climate front, COP26 triggered a flurry of intense activity, before, during and after the conference itself. Patients Not Passports, including its role in the Justice for Simba campaign, has challenged the injustices in migrants’ access to healthcare. And Medact’s Research Network’s briefing on the public health case against the Police, Crime, Sentencing and Courts Bill has helped to galvanise resistance to this crackdown on civil liberties.

Within the Medact office, Executive Director Sophie Neuburg was on parental leave for much of the year and the staff were very ably led by a cohesive team of interim co-directors: Becky Daniels, Ben Walpole and James Skinner, with Reem Abu-Hayyeh also sharing the role for several months. We warmly welcomed new team members: Campaigns Officer Sarah Lasoye, Operations Officer Rosie Clarke and Economic Justice Campaigner Jordi López Botey.

Finally, two changes to the Medact Board. Last year’s AGM saw the departure of long-standing trustee Jeremy Wight, whose painstaking adherence to due process and attention to detail was greatly valued. And, on a personal note, to say that I intend to step down as Chair at this year’s AGM. It has been a real privilege to be part of the Medact movement and I am deeply grateful to my fellow trustees and the staff team for their comradeship and support over the past four years. I wish my successor, whoever it be, all the very best. I have absolutely no doubt Medact will continue to make waves and rock boats in the next stage of our movement’s continuing evolution.

Economic Justice & Health

Health workers marching behind a Medact banner. One is wearing scrubs. They are holding placards including 'Britain needs a pay rise', 'Cut war not welfare', 'Cut energy bills now', and 'A real living wage for everyone'.

Photo: Medact members marching in London at the TUC national Cost of Living Demonstration, 18th June 2022. Credit: Medact.

Health workers witness the harm that rampant inequality does to our patients. It’s clear that we can’t have health justice without economic justice, yet in discussions about the economy, health and wellbeing are too often missing from the picture. We aim to change that. And this year we have worked on strategising new ways for health workers to help combat these harms to our patients.

It’s been a transformative year in this programme, not least because we said goodbye to Siddhartha Mehtha and welcomed Jordi López-Botey as the new campaigner. Continuing on from his previous role organising outsourced workers at the Independent Workers of Great Britain trade union, Jordi has been knuckling down with the Economic Justice Group, which launched in 2020, to think about how health workers can meaningfully come together to make a difference for patients.

We joined picket lines to stand in solidarity with outsourced fellow hospital workers, including at St Bartholomew’s Hospital in London, where workers won their hard-fought campaign to be brought back in house, with the same rights and pay as other key NHS workers. Medact members at Barts organised and delivered a letter signed by hundreds of workers at the trust with a clear message: “we are all one team supporting the NHS and we should all be employed by the NHS with equal terms and conditions”.

In June of this year, we took to the streets in London alongside other health organisations and trade unions to demand better from the government in response to the rapidly rising cost of living. One of our members, Dr Amaran Uthayakumar-Cumarasamy, appeared on Times Radio to explain why health workers care deeply about the impacts of the crisis on our patients.

The Public Health Case for Secure Housing front cover

The Public Health Case for Secure Housing front cover.

In early spring the group published three booklets on key economic issues that make the public health cases for secure housingliveable incomes and tax justice. These were conceived of and written by our group members, and provide other health workers with an introduction to the problems and pathways to get involved in affecting change.

Of these core issues, the Economic Justice & Health Group members decided that we can make the most difference by campaigning on housing and health. We will work to support local housing campaigns, organising meetings to build health-worker networks in towns and cities across the UK so that we can work effectively at a local level, and we will demand policy change on a national level for better support for social housing. Look out for health-worker mobilisations for secure housing near you in the year to come!

Health for a Green New Deal

Scottish health workers at the projection stunt ahead of COP26, outside Glasgow Royal Infirmary, 18th October 2022.

Photo: Scottish health workers at the projection stunt ahead of COP26, outside Glasgow Royal Infirmary, 18th October 2022. Credit: Alasdair Watson.

Some institutions are calling 2021 a ‘super year’ for climate. But the most powerful states failed to commit to the action required, and our own government is still rolling out regressive policies. In the first full year of the Health for a Green New Deal campaign, we’ve built on the health worker movement for climate justice so we can keep up the fight back.

The COP26 climate talks in Glasgow were a momentous disappointment, and will be remembered as one of the most exclusionary and unambitious UN climate conferences in history, right when the visions of communities most affected by climate violence were needed the most.

Nevertheless we took action both inside the conference walls and out. In the leadup, we projected huge messages on Glasgow Royal Infirmary, saying “the climate crisis is a health crisis”, and imploring others to join us on the streets in protest. At least 700 health workers and students took action in 17 places around the UK, joining the Global Day of Action for Climate Justice – with 350 joining the march in Glasgow alone. Ten of our activists went inside the talks to bear witness, and some joined a health worker ‘die-in’ protest to highlight the deadly nature of climate inaction. And we convened the People’s Health Hearing at COP26 – alongside the People’s Health Movement, Race & Health and Students for Global Health – where people from all over the world came together, giving and listening to testimony from the frontlines of climate violence.

Before COP26, health workers and students across the country were busy lobbying their local MPs to support the Green New Deal bill in parliament, which aims to bring about a rapid and just transition to a zero-carbon economy. They set up ‘Climate Clinics’ in their communities, helping residents to get their local MPs to support the bill – more climate clinics are being organised in summer 2022 around the UK! And Leeds Medact were part of the coalition that successfully fought to stop the expansion of Leeds Bradford Airport.

In February, we coordinated and delivered a joint letter to Downing Street calling for an end to new oil and gas investment – it was signed by over 600 individual health workers, and health organisations including Royal Colleges of Physicians, Paediatricians, Obstetricians, and more, representing over 250,000 people.

However, in June, still just months after the climate talks, the UK government approved the construction of two new gas fields in the North Sea: the Abigail and Jackdaw fields. There is now a race against time to stop them, and any other new oil and gas projects, before it’s too late. We co-organised a protest in June at the Treasury and Downing Street, and we will keep up the pressure until the government puts an end to these indefensible plans. Join us as we ramp up the pressure and strengthen our movement over the next year!

Patients Not Passports

Simba with his dad and fiancee at the Justice for Simba Carnival of Resistance in 2021. Simba is a Black man with short dreadlocks and a peaked cap in a wheelchair, holding a placard that reads 'Borders out of the NHS'. His dad victor is a Black man with short hair wearing sunglasses and a 'Solidarity knows no borders' t-shirt. Melissa is a white woman with long hair in a bun wearing a tartan short over her 'Solidarity Knows No Borders' tee.

Photo: Simba Mujakachi, his dad Victor and fiancée Melissa, marching to deliver the Justice for Simba petition, 18th September 2021. Credit: Manuchehr Maleki-Dizaji.

The Patients Not Passports campaign turns five this year, and continues to grow in depth and strength. Similarly, we are five years on from the introduction of upfront charging in the NHS, the most significant escalation of racist charging policies targeting migrants in our lifetime and a fundamental threat to the principle of universality that underpins the health service. We know that the NHS has neither the infrastructure or culture to support wholesale upfront charging for care and, alongside ever-growing health worker support for an end to the government’s cruel and hostile policies towards migrants, we firmly believe we can and will defeat NHS charging policies.

We have continued to pile on the pressure this last year with two national weeks of action, including in June where we joined the Solidarity Knows No Borders Network in saying 10 years of the Hostile Environment is 10 years too long. Patients Not Passports groups took action up and down the country: flyering outside hospitals, dropping banners from bridges, screening the NHS Borderlands Documentary in community centres, and running trainings to raise awareness with their colleagues.

The Patients Not Passports Network continues to support the Justice For Simba campaign, demanding the cancellation of the £100,000 hospital bill Sheffield resident Simba Mujakachi was landed with after suffering a stroke. In autumn of 2021, we took a Carnival of Resistance to the streets of Sheffield where Simba led a huge procession to deliver a petition, signed by 80,000 people, calling on the Sheffield NHS trust to stop charging people for care.

In June this year, Simba won! After being granted refugee status, his charges were scrapped. However, he continues to fight to win the rest of the campaign’s demands, and won’t rest until we end NHS charging for everyone.

As Patients Not Passports continued to grow this year, we’ve also been developing our organising structure and capacity. We’re connecting Patients Not Passports groups together as a national network, starting new National Working Groups to support with action planning, running regular meetings for new joiners, and launching a revamped website. There’s lots of ways to get involved, so come along to our next New Joiners meeting!

Peace & Security

Medact North East dropping a banner at the Millennium Bridge, Newcastle, in support of TPNW, 18th June 2021.

Photo: Medact North East dropping a banner at the Millennium Bridge, Newcastle, in support of TPNW, 18th June 2021. Credit: Alex Elliott – North News and Pictures.

This year, the UK government has doubled down on policies that attempt to turn parts of the health community into security forces, both through the policing bill and its defence of Prevent – but health workers are resisting. At the same time, we have kept pushing the government to take action on one of the biggest threats to life across the planet by joining the UN nuclear weapons ban.

Against all sense, and despite the added nuclear threat from Russia’s war on Ukraine, the UK government continues to ignore the Treaty on the Prohibition of Nuclear Weapons (TPNW). The UK cannot remain silent!

In May, we joined the Campaign for Nuclear Disarmament in urging the UK government to attend the first ever meeting of nuclear ban treaty states in a protest at Downing Street – we delivered a global letter signed by over 1 million people calling for an immediate ceasefire in Ukraine and for states to work toward the elimination of nuclear weapons. And in June, Medact North East dropped a huge banner off the Millennium Bridge in Newcastle, “Health Workers for the Nuclear Ban”, demanding that local governments voice support for the treaty.

One of our members, Dr Bimal Khadka, attended the First Meeting of State Parties of the TPNW in Vienna in late June in his capacity as Deputy Chair of the Board of the International Physicians for the Prevention of Nuclear War (IPPNW), making connections with campaigners and state representatives from around the world working toward nuclear abolition.

The Police, Crime, Sentencing and Courts Act was signed in May, posing a threat to communities already oppressed in the UK. However, some of the harms of the bill were mitigated thanks to a huge public outpouring of resistance. We were involved in successfully lobbying the government so that healthcare services were exempted from the ‘Serious Violence Duty’ proposed in the bill – a new requirement to share patient information with the police on demand, which would have further eroded patient confidentiality.

The government prepares to defend its counterterrorism programme Prevent, which damages patient trust by making police of health and other public service workers. We know from leaks that the upcoming review of Prevent led by William Shawcross will be a whitewash. Our Peace and Security campaigner has continued to work closely with a coalition of civil society organisations within the Community Counter to Prevent who launched a new website bringing together resources relating to Prevent, its harms, and resistance to it. And our Securitisation of Health Group has resisted, completing a run of four Alternative Prevent Trainings this year, and launching a pledge for health workers to oppose Prevent in healthcare and demand care, not surveillance.

We are building up to launch a week of action when the Shawcross report drops – we are prepared and ready to resist, so look out for actions to take to stop the whitewash!

Research

High-quality research underpins all of our campaigns for health justice. But research is also a way for health workers to come together and form communities, while using their skills to help bring about change. It’s been a year of joyful collaboration for the Medact Research Network (MRN), which has brought together people from across the breadth of the health community to deliver team research projects, all supported by Research Manager Hil Aked.

The Public Health Care Against the Policing Bill front cover

The Public Health Care Against the Policing Bill front cover

Last autumn, a team from the MRN dug into new and egregious policing encroachments on patient rights within the Police, Crime, Sentencing and Courts (PCSC) Bill. While it passed with measures to target already-marginalised communities and the right to protest intact, amendments had removed the threats to patient confidentiality and access to healthcare which we argued against in our briefing The Public Health Case Against the Policing Bill.

The long-term hard work of another team culminated this year in the publication of their chapter ‘Conflict and Health in the Era of Coronavirus’ in Global Health Watch 6. In it, we argued that the global Sustainable Development Goals agenda must be matched with a bottom-up approach to international peacebuilding that centres local voices and expertise. The authors wrote in a blog post that these kinds of projects “allow us to bring together different voices and opinions for lively and rich debate and eventually cohere around shared ideas”.

We have also produced research this year on Economic Justice & Health and Health for a Green New Deal. The MRN now has over 400 people signed up, and we connect as individual groups spanning Medact’s programme areas. We meet quarterly as a whole network to share interesting research findings, and discuss new research proposals. Anyone who is part of the health community is welcome, with no research experience required!

Going forward, we have just secured funding for a new primary research project into police impositions on mental health patients – our new report will come out next year!

Our movement

Two people wearing scrubs at a protest holding up pamphlets. The person on the left has brown skin and a green beanie hat, holding a 'prescription for planetary health' pamphlet that looks like a prescription slip. The person on the right holds a 'Docs Not Cops' flyer. They are outside surrounded by people and greenery.

Photo: Medact members hand out prescriptions for climate justice at the Glasgow climate march, 6th November 2021. Credit: Talissa Makdessi.

Over the last year, Medact members and supporters have come together from across local groups and national campaigns as we organise for systemic change. Our local groups have taken action up and down the country, organised demonstrations, banner drops, and climate clinics, and held film screenings, events and workshops. And we’ve had a surge of new members this year, with over 200 people joining Medact since last summer!

On top of all of the action our groups have taken, we took part in deep thinking at workshops and meetings to explore organising and the root causes of health injustice. We organised local training sessions with Medact groups, and joined national and global training courses!

Medact members alongside Nurses United took part in the Organizing for Power training, where we joined thousands of people from over 70 countries taking action in their communities and workplaces. Over the six weeks, we learnt and practised key skills to build power for health justice.

People from the staff team, the membership and the board also participated in the recent Feminise Politics Now course, held by Rosa Luxemburg Stiftung. The course aims to support and empower people to bring more feminist approaches to work and organising, including around power, care, cooperation and liberation, inspired by the successful European municipalist movement.

We are looking forward to building on this training next year, coming together as a movement with all our new members, and taking collective action!

Treasurer’s report

Hannah Wright
Treasurer, Board of Trustees

The continued increase in the scope of Medact’s activities is reflected in further growth in our organisational budget. Expenditure on our own operations grew from £368,085 in the financial year to 31st Jan 2021, to £432,172 in the same period to 31st Jan 2022.

On the income side, membership and appeals income increased by over 12%, from a combined total of £87,723 in the previous year, to £98,763 this year. This has been great to see, and represents a step-change from rather slow-and-steady growth in previous years.

However, a challenging grant fundraising environment led to a reduction of overall in-year income, from a total of £435,399 to £400,541 this year.

This resulted in a deficit of £31,631 on core funds for the year. This was comfortably absorbed from reserves accumulated through budget surpluses in the previous few years – taking reserves from a previously high level of £292,706 (10 to 11 months expenditure), to £258,719 (around 7 months), safely above the three months minimum required by our Reserves Policy.

We are, though, in a difficult economic period, with little end in sight: inflation poses a real challenge and the grant fundraising environment remains tight.

Given these challenges, income from membership continues to be vital as the financial foundation of our work, and so it’s been great to see it grow so significantly this year. I’d like to wish a warm welcome to all those new members who’ve joined during the course of the year, and a heartfelt thanks to the many members who have increased subscriptions.

Summary accounts

Our full Statement of Financial Activities is available to download from the Charity Commission website or on request from the office

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