The Fight for Health
Today (30th June) people are coming together to mark and celebrate the 70th anniversary of the founding of the National Health Service. It is right that we do so as the NHS continues to be the greatest social reform won by the working class. However, must also recognise that it has been under attack for almost 40 years as the capitalist class has sought to roll back many of the reforms that were conceded in the past. This has resulted in a health service that is bureaucratic and in which private companies are playing an increasingly dominant role. We need only look to the recent scandals surrounding care homes to see the consequences of these trends. While the health service still benefits workers those benefits are becoming weaker and may soon disappear altogether.
This is why it is not enough to simply have a slogan of defending the NHS as it is today. Neither can we rely on a nostalgic yearning for how things were in an earlier period. You cant turn back the clock. It would also be a mistake to idealise the status of NHS even in its heyday. The post war programme of reforms - of which it was a major element - were reforms that took place within capitalism. There were not socialist as they did not challenge property relations or the class structure of society. This can be seen in the compromises that brought NHS into existence the continuation of GPs and dentists as private business; hospital consultants being allowed private patients; and the pharmaceutical industry being left in private hands. The capitalist element which today has become so dominant was in the NHS from the very start.
Despite these weaknesses the reforms at that time were genuine in that they did improve conditions for the working class. This contrasts with the so-called reforms of today as represented by the Bengoa report that seek to advance privatisation even further. Its recommendations would reduce the NHS to nothing more than a logo on a collection of private consortia. Yet the local political parties for all their other disagreements - are unanimous in their support for such reforms. This is why the calls that will be heard from the platform today - for the restoration of Stormont as a means to solve the problems within public services are so misguided.
If workers are to defend the health service they need to organise within their workplaces and communities and push back against privatisation. Private finance is the ringworm destroying the NHS which must be driven out if it is to survive in any meaningful form. Workers also need to go beyond struggles over public services to challenge the class inequalities in capitalist society that are the main determinants of well being and illness and of life and death. If we want health in the broadest terms we have to fight for it.