'Defending the NHS'

49 posts / 0 new
Last post
Lazy Riser's picture
Lazy Riser
Offline
Joined: 6-05-05
Mar 10 2007 12:00

Hi

Quote:
the ruling class could afford to provide us with decent health and housing if we were in a position to force them to

The ruling class can’t be forced to do anything we can’t (or won’t) do for ourselves. As has already been mentioned, the German model is privatised, better quality and just as inclusive. The NHS is typical example of the capital misallocation that Hayek predicted would occur when the state starts issuing “free” services funded by a regressive tax in the form of NI contributions.

If “the ruling class” wanted to spend more on the NHS and Council Housing, in order to maintain price stability throughout the rest of the economy, they’d have to embark on an economic policy that addresses our balance of payments problem (not to mention renationalise the BoE). They can’t afford to do that for a start.

Any road up, it would be useful if someone could point out a project to “defend public services” which, in hindsight, constituted meaningful action as we understand it.

Love

LR

magnifico
Offline
Joined: 29-11-05
Mar 10 2007 18:21
LR wrote:
If “the ruling class” wanted to spend more on the NHS and Council Housing, in order to maintain price stability throughout the rest of the economy, they’d have to embark on an economic policy that addresses our balance of payments problem (not to mention renationalise the BoE). They can’t afford to do that for a start.

The ruling class uses plenty of resources on fighting wars, buying itself strings of large houses and awarding itself hefty bonuses, if we put enough pressure on I don't see why some of this couldn't be spent on public health services. The capitalist class is called such because it has more property and wealth than the working class, so obviously they're not going to starve if we force them to spend some of this excess wealth on our healthcare. And even if they can't afford it, I don't see why we shouldn't demand it anyway - it's not our job to worry about whether capitalists can afford things or not, just to try to appropriate as much as possible for the working class. If they really can't afford it then I suppose it becomes a revolutionary demand, not such a bad thing in my book.

Lazy Riser wrote:
the German model is privatised, better quality and just as inclusive.

What's your point, that the government is really just trying to make our health service better quality and more inclusive? Curse me for being so cynical - let's all vote Labour! As I've explained and I think Joseph has put very well at the end of the last page, we're not hung up on the health service being nationalised or not, but the fact is that marketisation is the weapon the gov't is using to cut our healthcare, and so should be opposed regardless of how healthcare is organised in Germany or India. I'd say that every example of direct action against hospital cuts and closures is an example of meaningful action to defend public services. The strike in Manchester last month saved jobs and services, there's a recent example straight up.

Lazy Riser's picture
Lazy Riser
Offline
Joined: 6-05-05
Mar 11 2007 15:15

Hi

Quote:
The ruling class uses plenty of resources on fighting wars, buying itself strings of large houses and awarding itself hefty bonuses, if we put enough pressure on I don't see why some of this couldn't be spent on public health services.

With “free” health care, like free anything, especially in a low income economy, demand will automatically expand to put pressure on the budget set aside for health care. Britain’s health care is nationalised, so the government sets the budget. What’s really being demanded is higher taxation for the rich, which I suppose is OK. The thing is, in this bureaucratic economy, taxing the rich merely reduces the amount of money spare for working class wages. In the end, we pay for the health care with a higher cost of living.

Quote:
The capitalist class is called such because it has more property and wealth than the working class, so obviously they're not going to starve if we force them to spend some of this excess wealth on our healthcare.

If you tax the capitalist class they leave. Without a programme of import replacement for the resources required to run healthcare, at least, we can no more force the capitalist class to make more healthcare that we can force them to make more tractors. Either way, we’ve been throwing capital at healthcare for years, it’s the way it’s deployed that’s the problem.

Quote:
And even if they can't afford it, I don't see why we shouldn't demand it anyway - it's not our job to worry about whether capitalists can afford things or not, just to try to appropriate as much as possible for the working class. If they really can't afford it then I suppose it becomes a revolutionary demand, not such a bad thing in my book.

On the contrary then, it is our job to at least concern ourselves with whether capitalists can afford things or not. It’s that kind of “not my job”-public-sector attitude that’s responsible for the dire state of the NHS, not the ideological peccadilloes of the elite. As for demands in general, well in principle I have none, as Bone says, my banner simply reads “Behold Your Executioners”. Ha ha.

Quote:
What's your point, that the government is really just trying to make our health service better quality and more inclusive?

If by “quality” one means narrowly avoiding widespread civil disorder, then yes. Yes it is. I’ve forgotten my point actually, oh yes. The bourgeoisie can’t do anything without us, if we can’t set out how we’d provide ourselves with continuously improving healthcare it’s no use demanding the bourgeoisie make something up. They’ll just take out an IMF loan, and we’ll pay at the petrol pump.

Quote:
Curse me for being so cynical - let's all vote Labour!

Advice that logic suggests you’d have issued at the end of the Second World War.

Quote:
As I've explained and I think Joseph has put very well at the end of the last page, we're not hung up on the health service being nationalised or not, but the fact is that marketisation is the weapon the gov't is using to cut our healthcare, and so should be opposed regardless of how healthcare is organised in Germany or India.

Inclined to agree. It would be a mistake to dismiss the conflicts as irrelevant and the last thing the good folk caught up in them need is aggravation from the ultra-left for their unsophisticated beliefs. The question is not one of principle, but one of practice, what is our next objective? How do we achieve it? What are the consequences?

Quote:
I'd say that every example of direct action against hospital cuts and closures is an example of meaningful action to defend public services. The strike in Manchester last month saved jobs and services, there's a recent example straight up.

A few points. Firstly, the thing is not to defend public services but to implement a counter-project to transform these social institutions into something that achieves your goals. It doesn’t matter what all-singing-all-dancing democracy you put in place, there’s going to be conflict over what proportion of our resources should be expended on mental health services, and how those resources should be deployed.

Secondly, this particular incident in Manchester (in which the Trust was going to spend an extra £4 million per year on services) represents one of those management “blunders” designed to provoke a strike and force the union to enter into the official negotiation process over planned changes to terms and conditions. A tactic deployed at Exeter post office, if I’m not mistaken.

Finally, what is the meaning and content of this strike? I’m hardly likely to take a position against striking workers, but sending the union and management away to plan the running of Mental Health services increases the working class’s reliance on others to do things for them and the degree to which they can therefore be manipulated - even by those allegedly acting on their behalf. It may not be harmful, but it would be easy to argue it as sterile.

Quote:
I don't think we have that much of a different analysis on these issues, and where our analysis differs I think it basically comes down to decadence theory

Certainly decadence theory runs counter to your analysis, but it doesn’t invalidate your position. In fact, the resources set aside for nationalised industries reflects a careful exercise in public choice, personnel management and economic planning - not an end to the productive capacity of Capitalism or the unregulated greed of a shadowy elite (aside from the need of every GP for a buy-to-let and a posh school for their kids, not to mention the public sector pension bill).

Love

LR

magnifico
Offline
Joined: 29-11-05
Mar 11 2007 15:47

Seems to me if the working class is mobilising in large numbers to oppose cuts in our access to health services, which are taking the form of marketisation, then we should support and encourage this. If capitalism can afford to meet these demands then we have retained or improved our standard of living, if it can't then large numbers of working class people are making a revolutionary demand (to have access to decent healthcare) which i suppose is even better!

Lazy Riser's picture
Lazy Riser
Offline
Joined: 6-05-05
Mar 11 2007 16:42

Hi

The thing is, demands by definition are about getting other classes to do things for you, and so by their very nature are sterile, not revolutionary. What we need are proposals, not objections. It is, as they say, our job after all.

And as for encouraging it all, well you'll find no argument from me there. I've just donated £100 to the IWCA's local election campaigns, how's that for reformist.

Love

LR

magnifico
Offline
Joined: 29-11-05
Mar 11 2007 20:13

Ha you've gone soft wink

I'd love to be in a position to formulate proposals on how we will expropriate and run a health system that I could put to my colleagues but to paraphrase funnywump once we start using words like 'expropriate' what fucking chance have we got? I'll work on it.

Lazy Riser's picture
Lazy Riser
Offline
Joined: 6-05-05
Mar 12 2007 00:34

Hi

Quote:
I'd love to be in a position to formulate proposals on how we will expropriate and run a health system…but once we start using words like 'expropriate' what fucking chance have we got?

Enter Wilhelm, from “Listen, Little Man”.

Reich wrote:
Don't run away. Don't be afraid. It is not so terrible to be the responsible bearer of human society.


Love

LR

Lazy Riser's picture
Lazy Riser
Offline
Joined: 6-05-05
Mar 12 2007 00:34

...accidental double post...

ernie
Offline
Joined: 19-04-06
Mar 14 2007 19:11

Hi Magnifico, sorry not to have got back to this discussion for some day. On the question of the main difference being the question of decadence, as I said before: you hit the nail on the head. It could be useful to the discussion if we went a bit deeper on this. For the ICC capitalism has been decadent since 1914, I think you know all of the main points we make about decadence so I will not over them again. However, in relation to the question of the ruling class being able to pour billions into wars and armaments whereas they are cutting back health care, it is not a question of either, or. Decadent capitalism has not option but to prepare or fight wars, because that is the only way that they can increase their share of the limited cake. This said, that does not means should not struggle to defend their wages, working and living conditions, however it is essential to do so with no illusions about what capitalism can do for us. We cannot underestimate the weight of such illusions, however the increasing attacks on pensions, health care, care of the elderly, education are all working towards the undermining of these illusions. Whilst struggling against attacks on health are not directly revolutionary, they, as do all the struggles, help to demonstrate in reality that capitalism has nothing to offer the working class apart form attacks and war, they also help to increase the workers self-confidence in themselves and strength solidarity within the class. Even if the struggles do not succeed the experience of the struggle helps to generate many lessons about how to struggle etc. They also demonstrate to the ruling class that the working class is not willing to kneel down before its attacks but are going to defend their and their class's dignity.

Spikymike
Offline
Joined: 6-01-07
Mar 17 2007 16:04

A different angle on decadence theory which seems to fit ther bill better than its ICC derivative can be explored on:

[internationalist-perspective.org[/url]]

Spikymike
Offline
Joined: 6-01-07
Mar 17 2007 16:09

Sorry that link thing didn't work I will have to try again.

magnifico
Offline
Joined: 29-11-05
Mar 20 2007 01:07
ernie wrote:
Decadent capitalism has not option but to prepare or fight wars, because that is the only way that they can increase their share of the limited cake.

Have the wars in Afghanistan and Iraq increased the British bourgeoisie's share of any cake? Seems to me that they've cost far more than any increase in the share of oil or whatever that they have procured - so if this money has been wasted why could it not have been 'wasted' on kidney dialysis machines instead?

ernie wrote:
Whilst struggling against attacks on health are not directly revolutionary, they, as do all the struggles, help to demonstrate in reality that capitalism has nothing to offer the working class apart form attacks and war, they also help to increase the workers self-confidence in themselves and strength solidarity within the class.

Surely the whole point of decadence theory is that 'struggling against attacks on health' is directly revolutionary, on the grounds that capitalism can't give us decent healthcare and so to struggle for it is necessarily to aim to achieve something which can only be achieved by a revolution. So whether or not one prescribes to decadence theory it is still worth struggling to defend decent healthcare.

ernie wrote:
Even if the struggles do not succeed the experience of the struggle helps to generate many lessons about how to struggle etc. They also demonstrate to the ruling class that the working class is not willing to kneel down before its attacks but are going to defend their and their class's dignity.

What is the point on demonstrating anything to the ruling class? Do we give a fuck what they think? Surely the point is what we can force them to concede to us, and ultimately whether or not we can remove them from their position of power?

Lazy Riser's picture
Lazy Riser
Offline
Joined: 6-05-05
Mar 20 2007 20:04

Hi

Quote:
Have the wars in Afghanistan and Iraq increased the British bourgeoisie's share of any cake?

The wars will help maintain their pensions, the payments on their buy-to-let’s mortgage, the cost of their nannies, the acceptance of their parents, the desirability of their lovers, and the structure and morality of society.

Quote:
Seems to me that they've cost far more than any increase in the share of oil or whatever that they have procured

I expect we’ve lent Iraq rather a lot of Sterling, repayable in dollars, as part of the project to “rebuild their nation”. Those final salary public sector pensions, they’ll be paid for in the blood of Iraqi babies. Ha ha.

Quote:
if this money has been wasted why could it not have been 'wasted' on kidney dialysis machines instead?

Entertaining the premise for a moment, a likely explanation would be that kidney dialysis machines weren’t the next best punt. In the end, it’s the working class themselves who determine the amount of money set aside for the NHS by refusing to take responsibility for making the decision. The bourgeoisie just give us what we want more-or-less, or at least what we deserve.

Quote:
What is the point on demonstrating anything to the ruling class? Do we give a fuck what they think?

That’s the spirit.

Quote:
Surely the point is what we can force them to concede to us, and ultimately whether or not we can remove them from their position of power?

They’ve nothing to concede. Their “position of power” lies in the everyday yearning for security and the favour of social superiors, in the Pavlovian fear of taking responsibility for the prevailing situation.

Love

LR

Alf's picture
Alf
Offline
Joined: 6-07-05
May 9 2007 11:49

The May issue of World Revolution has an article about the discussion on this thread
http://en.internationalism.org/wr/304/defending-the-social-wage

Spikymike
Offline
Joined: 6-01-07
May 10 2007 18:59

I tend to support the main thrust of the arguments put forward on this thread by the ICC and their sympathisers, including I would add that these can be applied in much the same way to the debate around the 'privatisation' of Council Housing.

One point which is missing perhaps in how pro revolutionaries relate to current struggles in the Health, and to a lessor extent the housing sector, is the question of the 'quality of illusions'. The ICC's approach is essentially correct but we need to recognise that there is something positive hidden in workers illusions in the 'social, equal, fair and free nature of the NHS' and negative in their illusions in the opposite effect of 'privatisation', which we need to relate to our vision of social change. This doesnt meen supporting the illusion though, as the various left (including some anarchist) groups do.

The other point is to be critical of the 'capitalist health industry' which feeds off the health problems which capitalism itself creates. A communist solution to workers health problems isn't after all just a matter of a hugely expanded (and indeed bloated)socialsed version of the current system.

magnifico
Offline
Joined: 29-11-05
May 14 2007 17:09
ICC article wrote:
… In many ways it is a question of health workers rejecting the idea of being a special case, of having to link their struggle with the defence of the NHS -something the unions are endlessly pushing- and seeing the attacks they are under as part of the wider attacks that will be crucial to the development of the struggle.”

Magnifico takes the opposite view: “linking defence of health workers’ jobs with defence of the NHS does make it part of a struggle for the interests of the wider working class.” This view does not recognise the pressure on workers in the NHS to see themselves as primarily giving a service, rather than being workers earning a living. How for example are midwives in East London to react right now: faced with a crisis in maternity services, they are being asked to work 6pm – 9pm to catch up a backlog of antenatal care. Are they to defend the NHS and the service given or are they to react as workers and resist the attack? The health workers described by Ernie in 1988 reacted as workers, with a strike and an attempt to spread the struggle. That made their struggle stronger.

Fair point, and I can see how my argument could lead to that way of thinking. I didn't mean to say, though, that NHS workers should avoid fighting for pay, conditions etc in order to uncomplainingly 'provide a service', rather my point is that the same government policies which are attacking NHS workers as workers are also attacking the social wage of the rest of the working class. It makes sense to me to try to combine these two sources of opposition rather than treating them as entirely seperate issues - in practice this means workers whose jobs, pay or conditions are being threatened by funding cuts using the impact that this will have on the wider working class as part of their argument/propaganda when opposing such cuts, and patient/community groups fighting for decent healthcare supporting NHS workers' whose jobs are threatened. That's all I meant by that.

I've just read a very interesting (1978) book by a guy called Vicente Navarro, who is some kind of Marxist, called 'Class Struggle, the State and Medicine'. His argument is that the formation of the NHS was brought about mainly by extra-parliamentary class struggle (or the threat of) and that it did represent an important gain for the working class in that it extended National Health Insurance to the entire population. However he argues that all the attempts to argue that the NHS is some kind of public or socialist organisation are bollocks, since whilst working class activity precipitated its formation it was the ruling class which created it and have always controlled it - Navarro points out some interesting ways in which the ruling class were granted special privileges in the running of the NHS right from the beginning. I'd agree with this, and would argue that the current marketisation reforms are bad not because they represent the destruction of a 'public' organisation but because they are really a form of rationing in disguise, and a gradual, disguised withdrawal of National Health Insurance from the working class.

ernie
Offline
Joined: 19-04-06
May 15 2007 09:04

Hi Magnifico

Glade that you found the article helped to clarify the questions under discussion.
On Navarro, I think I read that book some time ago, and it does make important points about the way the NHS provides a much better service to the middle and upper classes than the working class. However, the question of extra-parliamentary working class struggle being behind the formation of the NHS is more problematic. what are the examples of such struggles that he gives? There were certainly strikes after the war, such as the dockers strike, but the general situation of the working class was at a very low point: 6 years of slaughter, austerity, the terrible impact of stalinism etc.
We can fully agree on this

Quote:
I'd agree with this, and would argue that the current marketisation reforms are bad not because they represent the destruction of a 'public' organisation but because they are really a form of rationing in disguise, and a gradual, disguised withdrawal of National Health Insurance from the working class.
magnifico
Offline
Joined: 29-11-05
May 15 2007 11:09

He goes through the various policy papers and initiatives which led up to the formation of the NHS (don't have the book with me so can't remember exact details). He demonstrates that each one came at a time of increased class struggle, such as following the 1926 general strike, that the plans were bigged up while the w/c threat continued and then quietly dropped when the threat was no longer there. So his argument is that in the decades leading up to WW2 the w/c were constantly being promised an NHS-type health system to buy them off, and had come to expect it. Expectations were apparently raised further during the war as the bourgeoisie made lots of promises about a new welfare state following victory in order to keep people loyal & patriotic and to keep morale up - he argues that the ruling class would have faced a real backlash if they had reneged on these promises.