10/03/2008 by admin.

As socialists we continue to defend the NHS but we need to ask “what are we defending?” by Norma Turner

 The NHS

The founding principles of the NHS we support and hold onto. These were: equitable, universal health care free at the point of use, financed on the basis of people’s ability to pay through progressive taxation. Providing health services would neither be an opportunity to make money nor a charity. To provide a comprehensive, universal, equitable service, the organisation and funding needed to be integrated across the country.

Unfortunately, right from the conception of the NHS, compromises meant these principles could never be fully achieved. Financial restraints meant that only hospitals were included, making it a service for sickness rather than health. GP surgeries, dentists, opticians, community pharmacists were left as private concerns linked to but not accountable to the NHS. Ambulance services, community health, prevention, child health and public health were the responsibility of local authorities. Distinction was made between health and social care. Within the NHS the power of the consultants ensured mental health and geriatric services were marginalised. But the worst compromise was that private health care was allowed to run alongside the NHS.

These compromises have provided the private corporations with a way in to public funding; and successive governments have helped this process. This current Labour Government has been by far the worst, and most inexcusable. Their project is one of changing the NHS from a public service with some semblance of democratic accountability into a full health care market.

In my opinion this process is now beyond the point of no return; it will be fully in place within the lifetime of this Government. The general public will not feel the effects for a few years because the private health care industry is not interested in a purely private market. Its interests lie in becoming for-profit providers in a basic health system funded out of taxation while also providing, for additional fees, a higher quality of service for those who can afford it.

As socialists we can remind people of the founding principles. Before the NHS, the system had only served the rich and the rest lived in fear of ill health. Now people have no experience of a time before the NHS and therefore it is harder to convince them of its importance.

But there is an increasingly unwilling public appetite for the privatisation of everything from private armies, prisons, probation, transport, housing, education, health and social services, water, and on it goes to include the air we breathe. We can link the opposition to what is happening to the health service to the anti-capitalist struggle against the rush to privatise to make the rich richer and the poor poorer across the globe.

A Socialist Alternative

To link these struggles we also have to link our vision. A socially responsible programme of community health care cannot be run outside of a socialist context. I think we can find inspiration and ideas by looking to Cuba.

Article 49 of the Socialist Constitution of the Republic of Cuba states:
“Everyone has the right to the care and protection of their health. The state guarantees this right: by offering free hospital and medical services…; by offering free dental treatment; by developing plans for sanitary efforts, health education, periodic medical exams, general vaccination, and other preventive medical means. In these plans and activities the entire population participates through the social and mass organisations.”

This commitment is achieved through a nationally integrated system of public health in which social legislation about its application is unified with the training programmes of the workers. Public health is integrated with social welfare. Family planning is free, abortion is available on demand. There is a nationalised pharmaceutical industry, a high doctor to patient ratio, and no-one is without access to a doctor either geographically or financially.

Every GP lives in the community they serve, they are highly trained and chosen for training not just on academic achievement but more importantly social criteria. The doctors are part of community activities addressing environmental problems, sources of community stress, e.g. bad housing, family dynamics. They also are involved in organising social, sporting and fun events. There are political structures which enable the whole community to participate in making life decisions around what the community needs and wants.

This works because people are educated from nursery school throughout their whole lives, about health issues, including physical, psychological, social and political aspects needed for a healthy person, and because they develop an obligation to their community. Any health service requires people to adhere to principles of co-operation, equality, self-government and individual freedom.

In Britain the biggest providers of health and social care are not health and social service professionals, it is mothers and carers who provide over £87 billion worth of unpaid care a year.

Long term health depends on strengths of social networks, family structures and economic self-sufficiency. We need a system for instilling values in our young people – of caring and sharing, for community aspirations and involvement in civil society. This requires a high level of education and an understanding and commitment against discrimination, because of class, race, sex, sexual orientation, age and disability.

The current provision of health and social care defines people by what they lack or need and has resulted in people losing a sense of what they have to give, thus becoming inhumane to others.

Children in Cuba learn that the person beside them is healthy if they are kind to each other. Here in this country children learn to grab what they can for themselves, resulting in increased mental illness and suicide among young people.

A World Out of Balance

The other vital consideration in creating a vision of health is tackling global warming. We live in a world out of balance. Thanks to climate change and the results of the free market, we will be faced with both new diseases and old diseases re-emerging.

Already because of increased poverty and poor housing there is an increase of tuberculosis and rickets. Climate change causing floods and testing an ageing sewage system will see the return of enteric water-borne diseases. Also insects will thrive due to global warming in places they previously did not live. We have more mosquitoes and in time malaria will be introduced. We have already seen blue tongue disease in animals from midges. Other bacteria, viruses, fungi, parasites will appear, causing disease in humans, plants and animals, threatening the eco-system. Any future discussion on health must be set in the context of strategies of environmental activists.

In conclusion a National Health Service can only be realised within a socialist ideology within which structures of organisation are developed to involve the participation of everyone in the needs of their own communities, linking education and health with environmental issues within an international perspective against global capitalism.

Easy – we start with nationalising the pharmaceutical industry.

Posted in People not profit, Statements | 1 Comment »

10/03/2008 by admin.

by John Nicholson

The Left is weak, organisationally. This doesnt mean a lack of campaigning activities - stop the war demonstrations, CND’s Easter rally at Aldermaston, Heathrow camps, solidarity with Gaza, support for trade unionists in Shelter, NHS Mental Health, and education. And maybe weakness means fluidity -  anything could happen?

But we are weak.

So, at this time, would it be good for The Left to seek to develop some agreement on both policies and practices - which could be useful for the future? For example, what should our policy be on migration - “no one is illegal” - no immigration controls, no borders? - and then how should we be organising this in practice - through a broad campaign against deportations and for the right to work? with a distinct current arguing for no-one is illegal position within it? This is a two-fold debate - what we want, and how do we get it.

Or perhaps we could ask questions rather than setting out policy - what should we support in Pakistan/Afghanistan/Iraq/Iran? what is our vision for socialist healthcare? should education be secular? should public services be re-nationalised - and if so how? what is a 21st century socialist response to the consequences of neo-liberal economics? can the planet be saved without socialism?

And how should we organise to achieve our demands?

[Answers on a blog please - www.socialistunity.com, www.conventionoftheleft.org.uk]

Or we could build up a programme for The Left from existing examples (such as Socialist Outlook’s recent four point outline - www.isg-fi.org.uk; or the Communist Party of Britain’s Left Wing Programme - www.communist-party.org.uk) and debate these openly in order to arrive at some broad agreement.

Then we can discuss how we should organise ourselves, to put such policies into practice: - generalising from the example above, for example, perhaps through a broad organisation with a distinct socialist current within it?

Could we debate any or all of this, over the weeks and months ahead? Would it be useful for the Convention of The Left to address further in September?

Posted in Planning | 1 Comment »