Sunday, February 04, 2018

Understanding the NHS

Thousands of campaigners have marched on Downing Street to protest NHS funding shortages, as the health service suffers its worst ever winter crisis. Protesters carrying placards with the words “kick the Tories out”, and “more staff, more beds, more funds”, gathered in central London in large numbers in support of fixing what they say is a “crisis” in the NHS.“Keep your hands off our NHS,” they chanted as they marched towards Downing Street. The demonstration, called “NHS in crisis: Fix it now”, was organised by the People’s Assembly and Health Campaigns Together.
It comes just days after it was revealed hospitals are at their fullest point this winter, as the health service struggled to perform under significant strain. Bed occupancy pressures in the weeks after Christmas saw the heads of major A&E departments write to Theresa May warning that patients were “dying prematurely in corridors” because they could not be properly cared for. But now bed occupancy, for the week ending 28 January, has crept even higher, reaching 95.1 per cent across the NHS – the highest weekly average since reporting began at the end of November.
The government is doing its best to dismantle all state services and the NHS is no exception. The point is the service is currently free at the point of use: whether firms are called in to do the work or if it is state directed is neither here nor there.  If capitalists want to rob the taxpayer, that's fine, no concern of ours.  the bottom line is that, since workers have no property, the only way we get health care is if the capitalists pay for it.  Whether they pay for it through our paypackets or via the state is, for us, it is a secondary consideration on to the actual use-value of medical care received, i.e. the quality of the care.  Obviously, if they reduce the cost of healthcare, that lowers the exchange value we receive, and means lower wages as a share of the total propduct.
The UK decided that allocating health care through the NHS was the most cost effective way for them (and it was, and still is), but that means a vast market where profits could be made, but aren't.  Obviously, those capitalists who employ fewer workers feel the burden of the tax to pay for healthcare more, and so they want to pass the cost off into wages (and thus onto those capitalists who employ lots of workers).  We shouldn't allow ourselves to be blinded by loyalty to the NHS badge, what matters is the care we receive, and we need to be aware that it is a bargain between us and the capitalists.
We naturally support workers in struggle, on a general principle that the alternative is that they are slaves.  But we can also show how the wages system itself harms health care, as, under labour, lots of extra spending went to those sections of the workers with the most industrial muscle. 
A discussion took place on the NHS at the SPGB 2010 Conference. Here's the Report of the Proceedings on this item which shows a variety of views of Socialist Party members:
Quote:
Item for Discussion from West London: “What is our attitude to the NHS?”

Bond, West London In the forthcoming election, all the major parties have pledged to safeguard the NHS from public expenditure cuts, and the TUC is organising a rally in support of the NHS. Many workers value this public healthcare service. When the NHS was introduced in 1948, the Party regarded it as a capitalist scheme to save money, to get workers fit for military duty, and to appease workers’ demands for a better society. Since then the Party’s position seems to have softened. We now recognise that there is popular support for it, and that the workers do benefit from it, despite its inadequacies. What do other delegates think on what our attitude to the NHS ought to be?
Martin, Central London Some American politician recently said that their recent healthcare reforms would impact their military effectiveness and spell the end of American imperialism. The NHS is commonly pointed to as a model of free access, though it still contains elements of private ownership, and some people are trying to bring it under greater influence of market forces. We don’t support the NHS; we support a world of free access. If you accept the idea of a national health service, why not a national food service, a national food service, and a national clothing service? And why not worldwide rather than national? We have to be clear in our propaganda that the NHS is still very much enmeshed in the world capitalist system. Perhaps we should put out a leaflet with the title “We don’t support the NHS”.
Allen, East Anglian Regional I am extremely grateful to the NHS, as their only concern is my health. I also support the anti-smoking reforms. I know this isn’t socialism, but these reforms make capitalism much more pleasant to live in. I think the NHS is a wonderful institution.
Buick, non-delegate We are prepared to concede in theory that some reforms can be in the interest of workers, and the NHS can be given as an example of this. Many party members applauded Michael Moore’s film Sicko as it indicted America’s private health care industry. We shouldn’t participate in pro-NHS demonstrations, but we should be present to hand out our literature.
Corey, non-delegate Surely the Party is not being challenged over this issue. The capitalist system needs a healthy working class and healthy army recruits. I get necessary treatment under the NHS, but this is irrelevant. We want socialism, not the NHS under capitalism. The working class may be compelled to avail themselves of benefits offered under capitalism, but we should be demanding the whole cake.
Kelly, non-delegate We’ve all used the NHS. In many parts of the world basic preventative medicine is not available; here we take it for granted. Any improvement in our health should be recognised, and we don’t want to alienate people by disparaging it.
Shodeke, non-delegate I agree fully with Cde Martin’s statement. We want free access to goods and services for the world, not just health care here in England.
Hart, South London We shouldn’t make a point of claiming opposition to the NHS, though we should recognise its limitations and restrictions. Americans are completely gobsmacked when you tell them  you can walk into a doctor’s surgery here without paying money.
Bond, West London I agree with Cde Martin that the NHS is enmeshed in capitalism, that doctors’surgeries and pharmacies remain in private ownership, and that the NHS is a capitalist rather than socialist institution. But for all its limitations, the NHS does benefit workers in capitalism.

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