Preparing to Mark the 70th Anniversary of the National Health Service:

The National Health Service was founded on July 5, 1948. It is a vital public service, whose modern watchword must be that health care is a right. As such, marking the 70th anniversary of its founding must be in keeping with this direction. Looking back and comparing the NHS of today to that of 70 years ago misses the point, in that the people are invited to divide on the basis of whether to say that there should be a positive or negative spin in assessing the NHS today. The principle must be to defend the NHS, and to safeguard its future on the basis that the claims of the people on society for their health care and good health must be granted as of right.

Although the NHS was set up in 1948, the ground had been prepared during the years of World War II in the context of the impending defeat of Nazism and the aspirations of the people for a new society and the inspiration of the example of the Soviet Union.

When the Labour government came to power in 1945, the new Prime Minister, Clement Attlee announced the introduction of the social welfare state as outlined in 1942 by the Liberal Peer Lord Beveridge. This included the establishment of a National Health Service with free medical treatment for all.

In the Report Full Employment in a Free Society published in 1944, Beveridge had written in a section subtitled “National Health Service”: “The development of the health services of the community is one of the most generally accepted of post-war aims. Maintenance of health does not depend solely or primarily on health services, and still less on medical treatment. It depends even more on good food; on sufficiency of the other necessaries of life; on healthy homes. … But the organisation of adequate health services, both for prevention and for treatment, is in itself a major task with high priority. … Whether the medical profession is organised in part or in whole as a public service, there is room and need for a great increase of hospitals and institutions of all kinds. There are special services, such as rehabilitation after injury, or dentistry, ripe for development.”

Further on, Beveridge refers to the White Paper on the National Health Service, published in March 1944. He writes: “This White Paper, outlining for discussion with the medical profession, the hospitals and the local authorities concerned, a scheme for the organisation of a comprehensive health service free for all, opens the way to a revolution in the health of the people. Removal of any economic barrier between patient and treatment is an essential negative step for bringing avoidable disease to an end. But while essential, it is only a small part of all that is required. There is needed an immense positive extension both of preventive treatment and of curative treatment, through more and more hospitals, more and more doctors, dentists and other practitioners. There is needed, as an essential part of the attack on disease, a good policy of nutrition carried through by the wisdom of the State in using science. Here is a large field for communal outlay, using resources for purposes of high priority, in preserving the health and vigour of all.”

Since then, the social welfare state as envisaged by Beveridge has come and gone, coming into crisis in the 1970s and being dismantled as such under Margaret Thatcher under the ideology of neo-liberalism, with the doctrines of privatisation and so-called “shrinking the state”. So far has this come that the so-called “internal market” in the health service is premised on GPs, organised in Clinical Commissioning Groups, with the CCGs being run by a governing body, “purchasing” health care from the “providers” of health care. It is reported that Unite the union surveyed the 3,392 CCG board members in 2015 and reported that 513 were directors of private healthcare companies: 140 owned such businesses and 105 carried out external work for them. More than 400 CCG board members were shareholders in such companies[1]

That the health service should provide to grant the claims of human beings on society for health care has been negated in this context. Budgets have been set that demand “efficiency savings” of the hospitals who are the “providers”, in fact the sellers, of health care. It is only a small step in this argument to assert that private healthcare companies are more efficient, despite contrary evidence, and that “purchasers” should put their requirements out to competitive tender. It is in this context that Theresa May has made some proposal that an additional £20 billion in real terms will be made available for the NHS in England by 2023/24. Where will this money end up? There seems to be no clarity on this. Furthermore, it appears that far from taking responsibility for funding the claims for health care, the government is planning to “pay” for this £20 billion through taxation.

This is an archaic, backward-looking way of looking at NHS funding, amounting to a scam. It has all the makings of the government making further claims on the social wealth of the people in order to fund some further pay-the-rich scheme. Meanwhile, the wrecking of the NHS as a vital public service continues apace.

What is needed to move forward is the negation of this wrecking of the NHS and its funding of private interests which has been the negation of the conception of a health service as a public service in a civilised society. This requires everyone to take a stand, to speak out in defence of the right to health care, oppose the wrecking of the health service, and fight for public oversight and for the right of health workers and professionals, and the people as a whole, to set the agenda and be involved in decision-making.

Note

[1] “Over a quarter of board members on new bodies commissioning NHS care have links to the private health sector”. Independent. March 15, 2015.

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