Thursday, 27 January 2011

Health-care in the Big Society.

We're All in this Together.

If you care dearly about the National Health Service and don't wish to see it destroyed in your life time, please sign this petition and partcipate as much as you can in any upcoming anti-cuts demonstrations.

The National Health Service was founded on the idea of universal health-care in the Labour government which was in power from August 1945 to January 1951. It was the creation of the great socialist Aneurin Bevan and we ought to remember his words "No society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means." Almost every developed society has a national health service of some form, the notable exceptions being South Africa and the United States. The NHS was established as the welfare state was created in order to combat the 'Giant Evils' identified in the Beveridge Report of '42, namely squalor, disease, idleness, ignorance and want. Since the very beginning there have been attempts to repeal the NHS, and take us back to a private health-care system, bit by bit over 30-odd years it has been undermined. By 2007 NHS had fallen in ranking to number 18 in the world standards of health-care. France held the position of number 1 and the United States was at number 37.

In the same month of Christmas the glare of the press shifted from student protests to the cuts the National Health Service is facing. Those of you who have a memory span longer than 6 months may recall the claims made by all three political parties to ring fence the NHS from public spending cuts. It should not surprise you that this was another instance of lying on the part of the political class. Just as the party-line of the Coalition - that the funding of the NHS is not being cut but increased by 1% over 5 years - is a misleading lie. The costs of health-care may rise by 1% or 2% above inflation which would make the "increase" a cut in effect. The rest of the cuts are being made under the guise of "efficiency savings", or "productivity savings", which involves moving work out of hospitals into poly-clinics and encouraging people to treat themselves. These cuts come to £20 billion in total, not including the effective cut in funding for the NHS over 5 years. For the sake of necessity these "savings" are already being made to avoid a shortfall of £10 billion.

The architect of the reforms is Andrew Lansley, the man who once claimed that the recession will allow most people to spend more time with their loved ones and was later forced to apologise. Lansley's office was bankrolled by private health-providers like Care UK, the CEO of which contributed £21,000 to fund the personal office of Mr Lansley in November 2009. In 2009 Care UK provided services for half a million patients last year, working with all ten Strategic Health Authorities and one in three Primary Care Trusts. It runs hospitals, NHS Walk-in Centres, GPs’ practices and care homes. As of January 2010 it ran 59 residential care facilities with over 3,000 beds. Close to all of Care UK's business is with the NHS, 96% to be specific, which amounted to £400 million in 2009. No wonder the Tories pledged to increase the use of private providers before the election and now we see these reforms on the menu. As with the contributions of banks to the Conservative Party from 2006 to 2010, which added up to £16 million, we should not be surprised when Cameron bails out the banks.

So it shouldn't surprise us that these health-care reforms favour the wealthy, after all a "reform" is a change you're supposed to like and is rarely interchangeable with "revolution" - except perhaps in the way that Thatcherism was "revolutionary". As part of the overhaul of public health Mr Lansley has set up five responsibility deal networks on which businesses and ministers come up with policies. Along side groups like Cancer Research UK and the Faculty of Public Health an array of private companies will sit, many of which are in the food and alcohol industry. The alcohol responsibility deal is chaired by the Wine and Spirit Trade Association. The food network includes Compass, the company attacked by Jamie Oliver for it's turkey twizzlers, as well as fast-food companies and processed food producers. Not only do the leading supermarkets have a place in this network, influencing health policy, but so does PepsiCo who own Walkers crisps along with the Fitness Industry Association - a lobby group for private gyms and personal trainers.

 The Time has come to Grow up!

So keep in mind that in the background there is a convergence of class interests invested in a health rationed by wealth and not need. The "policy community" in the shadows consists of corporations, management consultants, think-tanks, freelancers and hired hands, including some academics and doctors. Oh and of course there is the "revolving door" letting company envoys can get jobs in the Ministry of Health, and ex-ministers and officials can get well paid jobs in the private sector. The model is the American health-care system and it's unlucky for us that we have a government keen on defending our independence from the EU and not the US. We ought to look at the US to see what we might become if we lose universal health-care. There is public funding for health-care in the US, but it is only a way of covering the costs of private enterprise and providing the bare minimum. In many states public funding for health-care has been cut to balance the budget and reduce the deficit - sound familiar? In Arizona this process has gone as far as cutting funding for organ transplants, leaving people in need of such transplants to die, even though Governor Brewer has been given $200 million in stimulus funds to spend.

Then in the Monday of the New Year, formally known as the month of January, David Cameron told critics of the health reforms to "grow up". Along with some words about the NHS being "second rate", though he was keen to correct himself as the Freudian slip tore a fissure in his public image and revealed the truth to the "bewildered herd" who would surely trample him. Notice Cameron spoke of the importance of choice and claimed not to be speaking of any grand ideological vision. This is nothing new from a market liberal, the freedom of the individual to choose out of a wide range of options is placed above any interest of community or society as a whole. As Hayek thought, human beings are not naturally disposed to living in a market economy and will attempt to rebel against it. People don't really want the "material progress" promised by neoliberalism, it is an "involuntary" affair as seen around the world, people must be coerced or "educated" into accepting such radical reforms. In the case of Britain the government has chosen the method of "education", by which I mean telling us over and over again it's the only way to go.

"There is no alternative" is the mantra of the Con-Dems and the right-wing media, as it was under the Thatcherites. Of course the media neglects to mention that government debt as a proportion of GDP is 70%, which is far lower than the 260% of GDP it added up to after WWII which was before the NHS was founded. In recessions tax-revenue go into sharp decline as a result of rising unemployment and the collapse of companies. So the normal rate of public spending, which typically increases as tax-revenue increases, was no longer sustainable. However, the fall in tax-revenues is a result of the recession which means the best of dealing with the issue of debt is by increasing economic growth and creating jobs. This would require a move away from 'Big Finance' to manufacturing and maintaining a high rate of expenditure by raising taxes. Instead the government are making the deliberate decision to cut spending and in doing so increasing unemployment whilst undermining the safety-net that would soften the blow to those put out of work.

David Cameron has taken a hyper-active approach to governance with the intention of going further and faster than Thatcher ever did. The current incumbents have not even been in government for a year and we're seeing the economy being put through "shock therapy", at the same time universal education and health-care are being undermined. Now there is talk of the mass-privatisation of British forests. At the same time we've seen how fragile the Coalition is on a number of issues, the student protests wobbled the government and support among Lib Dems fell to 21 votes in the end as thousands stood outside in the cold being kettled. The stealth privatisation of the NHS is to be taken as seriously as an attempt to undermine suffrage. If voting is a civic duty because of the centuries of fighting that, so is defending universal health-care.

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