Build rank-and-file committees
On the 70th anniversary of its creation, the National Health Service (NHS) is in grave danger.
Its establishment in 1948 as a universal health provider, free at the point of use, is fiercely defended by working people as their fundamental social right. That right is now in jeopardy as the NHS is transformed into a skeleton, for-profit service, modelled on the US healthcare market.
This is the result of the privatisation policies of successive Labour, Liberal and Conservative governments. Whatever the acronyms used—Private Finance Initiative, Sustainability and Transformation Plans, Accountable Care Organisations, etc.—a two-tier system is being created in which not only the standard of healthcare but ready access to it is determined by the ability to pay.
An investigation last year by the Independent found the total amount of income NHS England made from private patients leapt by a third between 2011-12 and 2016-17. It cited the example of London’s best-known cancer-specialist hospital, Royal Marsden, whose income from private patients rose by 105 percent, from £44.7 million in 2010/11 to £91.9 million—some 31.4 percent of its total funds. While soaring waiting lists and bans on certain “elective” surgeries are forcing those who can to pay privately for care, companies such as Virgin Care, UnitedHealth, Health Care America and Circle are making vast profits.
Recent figures show that £9 billion of NHS services have been outsourced to private providers. Meanwhile, under the Naylor Review, a fire-sale of NHS land and property to private developers is underway. This is in addition to the transfer of whole sections of the NHS estate—buildings bought and paid for by generations of workers—to NHS Property Services, which charges market rents and inflated property management fees to NHS trusts and others.
While corporations cream off a fat slice of the NHS budget, a decade of austerity has seen NHS spending per capita decline in real terms. Hospitals and wards have been closed, and beds cut, so that in December, 300,000 people were left waiting more than four hours in England’s A&E departments to be treated due to an “emergency” brought on by the cold snap.
This situation will worsen dramatically due to the imposition of “wholly-owned subsidiaries” or “special purpose vehicles”—a means of transferring workers off the NHS pay roll to break nationally agreed terms and conditions.
Across the country, health workers—from porters and cleaners to ambulance staff and others—are involved in industrial action to defend their jobs and conditions and fight privatisation. They have the support of millions of workers and their families who depend on the NHS.
No confidence, however, can be placed in the trade unions or the Labour Party to reverse NHS underfunding and privatisation, much less defend the principle of socialised health care.
The 2016 fight by junior doctors against the attack on their conditions and NHS privatisation was isolated by the Trades Union Congress (TUC) and betrayed by the British Medical Association.
Only recently, the majority of health unions campaigned in favour of a three-year pay deal linked to performance and below the predicted rate of inflation. This was after they helped enforce a seven-year pay freeze that saw NHS workers suffer an average pay cut of £2,000 in real terms.
The TUC and the People’s Assembly, which are the principal organisers of today’s demonstration, hope to channel opposition to the attack on the NHS behind political support for Jeremy Corbyn and a Labour government.
But Labour has said only that it would make the NHS the “preferred provider” of health services.
Its failure to defend the single most significant reform associated with the post-war Labour government speaks volumes as to the real role that will be played by any Corbyn-led administration. It underscores that—whatever the “left” noises made by Corbyn, John McDonnell and company—Labour is a right-wing, pro-capitalist party, beholden to the Blairites who boast that their political mentor is Margaret Thatcher!
The NHS was not a benevolent policy choice, granted from on high. Like similar healthcare reforms in Europe, it was the result of militant mass struggles by the working class after the Second World War, who were determined not to return to the “hungry ’30s.”
Behind the decision of the ruling elite to finally concede the NHS was the 1917 October Revolution in Russia. Notwithstanding the degeneration of the Soviet Union under the Stalinist bureaucracy, its example had inspired workers throughout the world and put the fear of revolution into Britain’s rulers.
But the NHS was never a socialist healthcare system. Barely tolerated by the powers that be, it was dependent on tax revenues and the vagaries of the profit system. Crucially, no attempt was made to nationalise the pharmaceutical industry, which has leeched off the NHS ever since.
Moreover, it was part of a system of welfare, “from the cradle to the grave,” that has largely been obliterated over the past three decades. The huge growth of social inequality, with the attendant rise in ill health, is now overwhelming an eviscerated NHS.
Behind all the lies of a “Brexit dividend,” the crisis of the capitalist profit system, which is giving rise to trade and military war, is intensifying the assault of healthcare across the world. The situation in Greece, where the health service has been destroyed under the diktats of the international banks—administered by the Syriza government—is a warning to workers everywhere.
Earlier this week, Lord Houghton, who retired as chief of defence staff in 2016, complained that talk of more NHS funding was good for winning votes but not for defending “Britain’s standing in the world.”
Calling for a steep increase in military funding, he said the UK must “make a decision” as to “what country we aspire to be.” His statement was made as MPs on the Commons Defence Committee said military spending must rise by 50 percent—an additional £20 billion year—to protect Britain’s position within NATO.
This is behind claims that the NHS is no longer “sustainable” and demands for the introduction of charges—already introduced for non-British citizens—and a tax hike for working people. All while Britain’s super-rich, which includes Richard Branson, whose Virgin Care group has won millions of pounds in NHS contracts, saw their combined wealth rise by 10 percent on average in the last year.
The Socialist Equality Party initiated the NHS FightBack campaign in 2012. It is leading the fight for the building of rank-and-file committees, independent of the Labour and trade union bureaucracy, to unite all sections of the working class in defence of a free, comprehensive and universal healthcare service.
It calls for an immediate end to the outsourcing and privatisation of the NHS, the nationalisation of Big Pharma and billions of pounds of investment in healthcare and other vital social provision.
This requires breaking the monopolisation of society’s resources by the financial and corporate elite and the radical redistribution of wealth in favour of working people. It means workers and young people taking up the fight against capitalism and for socialism.