We have, as far back as anyone remembers, logged and commented on the attacks on, and, the undermining of, the NHS under both Labour and Tory administrations in this journal on a regular basis. Both exhorting defence of the service where possible and highlighting the total necessity of a socialist system as the only measure possible to ensure real and permanent growth of the NHS into the health service that both its staff and those who use the service deserve and one which will become a leading saver and enricher of the lives of all.
That the NHS has a tremendous importance to our class cannot be overstated but it can be said that all of our current society, even our enemies, have a dependency on the service that they don’t always understand or appreciate.
Writing in the Financial Times on 17 October 2022, Matthew Taylor, the chief executive of the NHS Confederation, enlarged on a report his organisation had commissioned to determine the impact of investment in healthcare on not just health outcomes but labour productivity and broader economic activity. The results, he tells us, should be taken as seriously in the Treasury and Downing Street as the health and social care department. In presenting the report he points out that “The NHS is the fifth biggest employer globally and by far the biggest in the UK. In most towns and cities, it is the single biggest employer and makes a vital contribution to the local economy through job creation, purchasing of local services and keeping people healthy for work.”
He continues; “The economic activity of a local area, and how productive it is, is heavily influenced by its inhabitants’ health. Unmet health and care needs are among the key reasons for people of working age being out of the labour market. Relatively small reductions in the number of those off for long-term sickness could have a huge impact on labour productivity and economic activity.” And he then highlights this truth with the following common-sense example; “A one per cent decrease in the proportion of workers off due to long-term sickness is associated with an additional 180,000 workers joining the workforce. This would be a significant boost to the economy at a time of ongoing challenges in labour market participation, widespread labour and skills shortages and the rising cost of living.”
So why, if the NHS is so important financially to our economy as a means of keeping all workers fit to work and have their surplus value milked by their employers, are there so many private companies trying to muscle into the health business, weakening its power to do what it should be doing? Why do drug manufacturing giants continue to bleed the NHS of the public funding that is put into it by all governments of various hues, by foisting on it outrageously over-priced medicines that have usually been developed first in the public sector by universities, etc? Welcome to the contradictions of capitalism, Matthew Taylor!
The NHS is also needed by our imperialist society as an employer, meaning every NHS worker has a wage to purchase the fruits of all production, but! Capitalist mentality demands that it be run as any capitalist enterprise and so it slashes wages, cuts jobs, sheds hospitals and beds, puts even greater workloads and stress on those who remain working in the NHS. Result, extremely poor service with staff struggling to do their jobs and struggling to help the economy through purchasing power. This does not make sense unless you are a capitalist in the cut-throat reality of our society taking the opportunity of taking profits out of the NHS to enhance yourself – you would not be fit to be a capitalist if you did not do it!
The NHS is not the only place where you will find the crazy contradictions: capitalism needs the best possible transport systems to get its products to the markets and its workers to their places of work etc., yet rail services are butchered and split into many different companies, while more and more haulage is driven onto clogged roads that are overstretched as soon as they are open, but! There are profits to be made in breaking up the railways, in road haulage etc. Bus services were privatised and now only run on routes that guarantee maximum profits cutting the costlier ones that many may still need.
Basically, we live in a political system where the greed of the wealthy is the basis of all activity. Profits always before people, and maximum profits at that, even if it interferes with the successful and common-sense organisation of other sectors of industry!
At this moment in time the NHS has many vacancies for staff ranging from claimed figures of 60,000 to over 130,000! We are not here to sit in judgment on the correctness or otherwise of these wildly differing claims – suffice to say that the NHS is criminally short of staff of all types, but provides such an unwelcoming and harsh environment in terms of hours, workloads, financial rewards etc. that many people would not even try to apply to work within it, or, if they do, it is to become, in very quick time, part of a massive turnover of labour, ensuring that there will always be a huge demand for more staff across the NHS.
So, how bad is it for the patient?
If you need to phone for an ambulance, the August results tell us that the average category one (calls from people with life-threatening illnesses or injuries) response time was nine minutes and eight seconds. The current target time is seven minutes. The response times for category two calls (burns, epilepsy and strokes etc) have a target of 18 minutes and on average these were taking 42 minutes and 44 seconds in August. The response time for category three calls (things such as late stages of labour, non-severe burns and diabetes) which should be within two hours were averaging two hours, 16 minutes and 23 seconds.
The latest figures are truly shocking:
“Severe NHS ambulance delays are contributing to the avoidable death of 230 heart patients a week, analysis shows.
“The British Heart Foundation (BHF) said there had been 30,000 ‘excess’ deaths involving heart disease in England since the beginning of the pandemic. This is linked to a collapse in ambulance response times and gridlock in A&E units, meaning patients are not getting help until it is too late.
“The latest NHS data shows that heart attack and stroke patients are having to wait 48 minutes on average after calling 999, well above the 18-minute target” (Eleanor Hayward and Rhys Blakely, ‘NHS ambulance chaos blamed for 230 heart patient deaths a week’, The Times, 3 November 2022).
There are more than six million of us at the moment on various healthcare waiting lists, 10% of the population!
Nearly 380,000 people have waited for over one year and 2,800 have been stuck in the growing waiting list backlog for at least two years.
If you are unlucky enough to need to go to an A&E department you will find that some 30% of attendees will wait longer than 4 hours to be treated while around 1,000 patients every day have to wait longer than 12 hours in an A&E department.
More than a quarter of a million people had been checked for cancer after an urgent GP referral in August this year. This is the highest number since records began and yet only 75.6 per cent of patients in England saw a specialist within two weeks that month against a 93 per cent target, the second worst performance on record.
The NHS has now warned ministers that it may have to make cutbacks to cancer care, GPs and mental health to cover a £20 billion hole in its budget. We have to wonder what, if anything, Steve Barclay the new Health Minister (the fifth in 5 months although he was the third as well), will or can do. The contradictions stated above do mean that whatever he may want to do to curb the flow of public money out of the NHS coffers into private pockets, or however much he may want to make jobs within the NHS more appealing, he will be pushing against a brick wall of vested interests from some imperialist high roller. And any health minister from a future Labour government will be in exactly the same boat!
When we look at the working class within our society we see many parents unable to work because they have young children, and the high price of private childcare (where childcare still exists) puts beyond the ability of those in low paid work (including many who work or would work in childcare) to pay for that childcare and also provide for the family! We see middle aged to older workers with ailments which could be treated leaving the workforce because they cannot get that treatment and cannot work without having had it!
The society run along the lines of capitalism is constantly jarring and smashing its parts into each other, and for the most part it is real living breathing workers who are battered and bloodied in these daily collisions or realisation of contradictions.
We have after thousands of years developed a system of production that can produce enough for everyone, so that none should go without. But because that system is still held in the private hands of the few, an elite who can only chase maximum profit, we have to watch so much of what we produce left to go to waste or else to be destroyed, not because we don’t want or need it but because we cannot afford it!
While ever this system survives there can be no sensible system of healthcare or any other service or the production of anything at all! Common-sense and sensible are not words that can be properly applied to any major production inside a capitalist society.
We have, as a society, everything we need to live peaceful, happy and full lives, it requires us only to reach out and take it from that tiny group of beings who tell us it’s all theirs to do with as they see fit.
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