Where Now For the NHS?

Caoimhin O’Muraile ☭ On Wednesday 5th July the UK NHS will be seventy-five years old.

Founded in 1948 by the labour government of Clement Atlee it was designed to give health care ‘free at the point of need’ irrespective of a person’s income or personal wealth. A great idea spearheaded by the Welsh firebrand Aneurin Bevan under the slogan ‘never again’ meaning ‘never again’ will a person’s right to health care depend on how much money they had it their wallet. Now, seventy-five years on where is the National Health Service going under the misrule of capitalism and their various lackeys in government?

Originally the service was to be funded by general taxation, chiefly income tax, and under the post war political consensus it ran like a well-oiled machine. So, what went wrong? In today’s world of capitalist greed and rising unemployment, in real terms, it does not take the brains of a mathematical genius to work out that with fewer people working the income tax pot does not have as much in it for this funding. The rich and powerful won’t pay, they all have private health care, often using NHS consultants and doctors which should be stopped. These people, the owners of the means of production, don’t give a fuck for anybody else so long as their class continue to rule!

So, what is the answer? It is my view that various British Governments are trying to privatise the NHS while, at the same time, telling people the NHS is ‘safe in our hands’ which of course it evidently is not. Despite their hot air and filibustering various governments since the 1960s have presided over the cuts in the NHS. Ironically the government of Harold Wilson instituted the first round of ‘rationalisation’ in his first administration in 1964. This was not Wilsons choice as he soon found out who the real government, irrespective of which political party occupy the office, were and are. The money men and women, the capitalist class.

During the 1960s the first cracks appeared in the postwar political consensus in Britain. The six counties did not have this as they were governed, or misgoverned, by the Unionist party. With these cracks came cuts to public services including the NHS. Whether the six counties were governed by the unionists or not their funding came from the UK government in London so the cuts in the NHS affected them as well. Even Terence O’Neil voiced moderate concern about lack of funding, however I’m deviating from the main point here. The ruling classes no longer needed a large healthy workforce (wage slaves) and therefore perceived no real need for a fully funded NHS as technology could do much of the work once carried out by people. Today that technology is far more advanced than back in the 1960s as the quality of health care has deteriorated!

The staff in the NHS are not paid adequately for the work and service they provide, similar to the HSE in the 26 counties. For the first time in its 104 year history the Nurses union, the Royal College of Nursing (RCN) have taken, as a last resort and through desperation, strike action. This mode of action should tell us all something. The nursing profession do not go on strike for a laugh but because they have been pushed as far as they can be. Now junior doctors are taking industrial action and will soon be joined by senior doctors, the Consultants. They will provide emergency cover because that is the kind of people they are, caring, but they have to make a stance over this issue.

The RCN General Secretary, Patricia Cullen, has asked many times for talks over this year’s pay with government and each time she has been, quite frankly, insulted. British Health Secretary Steve Barclay keeps repeating in parrot fashion it is ‘not the job of government to get involved in management union pay talks.’ Well, what the fuck is the job of a Secretary of State for Health? This British Government appear to have washed their hands on the NHS but for what reason if this is the case, Privatisation? More and more advertising space is being given to private health companies like Bupa, Axa, Allianz, General Medical and many others as the landscape of the UKs health insurance is constantly evolving to respond to customer’s demand. This undermines the NHS which may well become a poor person’s safety net at best. As the maxim goes; ‘if health is something money can buy, then the rich will live and the poor will die’. Unfortunately, the Labour opposition are offering no radical alternative.

Here in the 26-Counties we have no National Health Service as such but we do have excellent doctors and nurses. Unfortunately, we do not have enough of them and the management of the HSE (Health Service Executive) is barely fit for purpose. Nurses are leaving in their droves as countries such as the USA and Australia offer far better packages in wages and working conditions. In the UK, NHS staff are joining this exodus! How much longer are people going to tolerate their health service not providing a service? The NHS is still ahead in terms of provision of the HSE but the gap is narrowing. This is not because the HSE is improving, it certainly is not, but the result of the NHS deteriorating. In the 26-Counties we have Voluntary Health Insurance (VHI) which is to all intents and purposes private health care and the UK appear hell bent on following suit. The difference in quality of care between private and public care in the UK is huge. The NHS was formed on the principle of ‘never again’ meaning ‘never again’ will a person’s standard of health care depend on how much money they have, ‘never again’ will money be able to buy life, but unfortunately that is now what has evolved! Aneurin Bevan must be turning in his grave!!

Today in Britain 15,000 people are in hospital beds who do not need to be. Why? Because there is a lack of care in the community. More staff are needed in this department just the same as staff are needed in hospitals. Much community care is managed by private companies who exist for profit and profit only. With less staff to provide a service working longer hours for shit pay there is little wonder a lack of community care exists. All care, hospital, GPs and community should be under the umbrella of a fully funded and fully staffed National Health Service. All private health care should be taken over by the government and incorporated into the NHS. On Sunday 2nd July David from the six counties texted Laura Kuenssberg on the Sunday Morning Politics Show to say;

I would never have seen the light of day if it was not for the excellent care my mother received from the NHS back in 1951. We must preserve the NHS even if this means increasing taxation.

Well said David, I couldn’t agree more and remember back in 1951 full employment and therefore larger income tax levels were the commitment of government under the post war political consensus. This is not the case today. The NHS needs a steady flow of cash not occasional lump sums, albeit large amounts, and general taxation always was the cornerstone of funding, much of this funding already comes from private concerns. Instead, the UK government are hell bent on tax cuts especially for the rich and the Labour opposition under Keir Starmer are little different. These tax cuts mean less money for public services including the already underfunded NHS.

The NHS does still offer treatment ‘free at the point of need’ but less services are covered. Already patients have to pay for treatment of certain kinds which were once covered by the ‘free at the point of need’ service. So, where now for the NHS? Further evidence of the government's - all British Governments - relentless pursuit towards privatisation of the NHS can be found in the 2017 Naylor report for raising funds for the NHS. In this report Sir Robert Naylor recommends the NHS, in conjunction with private companies will be forced to sell off property for a pittance, old obsolete hospitals for example to these private concerns who will renovate them and use them as private hospitals for profit, further undermining the NHS. Sir Robert claimed this would raise £10 billion for the NHS, which it may well have done. What would have been wrong with the government renovating these old hospitals, not all disused, raising taxes to fund them, and giving them back to the NHS? Why do we keep constantly hearing of ‘tax cuts’ which undermines even further NHS funding? Why do private companies have to have the buildings, whether the NHS wish to sell them or not? Simple, it is another step towards the ultimate privatisation of the health service in the UK!

The NHS will become at best a poor person’s safety net in decades to come. The Naylor recommendations were endorsed by then Prime Minister, Theresa May. Needless to say, the contents of the Naylor report were not common knowledge. When the NHS was formed back in 1948 it had a bed capacity of around 400,000 for a smaller population, the journalist John Pilger did an excellent review of the ‘governments war on the NHS’. Today it has less than a quarter of that number for a far larger population, all the slack is taken up by private health care for those who can afford.

‘What now for the NHS’? Work it out, my guess despite all the fancy talk about the ‘NHS being safe in our hands’ - a term first coined by compulsive liar, Margaret Thatcher - all the evidence suggests the opposite!!

Caoimhin O’Muraile is Independent Socialist Republican and Marxist.