What kind of health service do we need?
MARK FISHER in Capitalist Realism accuses the left and the unions today of limiting themselves to opposing Tory “change” rather than themselves posing a positive alternative. In the case of the NHS most people regard it as already socialist, as not in need of any alternative. In the enemy camp the Adam Smith Institute calls the NHS a “socialist relic.”
Certainly the the creation of a service free to all removed the terrible fear of illness that haunted working people before the War. It was the greatest achievement of any Labour government, however the pharmaceutical industry, most equipment suppliers and entire branches like the dentists and opticians were left out of the system. Free medicines did not last long; prescription charges were reintroduced under a Labour Government, Waves of “reforms” under Thatcher, Major, Blair and Brown have driven wedges of the market and private enterprise into the system and broken up its overall planning.
A socialist NHS
So what would be needed to create a truly socialist NHS? Firstly all the privatised elements should be re-nationalised with no compensation to the parasites who took them over. The huge debts run up under PFI schemes should be canceled. All the outsourced services with their workforces, often underpaid and with no job security, would be brought back into the NHS and paid a decent living wage.
GP’s practices could be amalgamated into a system of local polyclinics, providing minor operations, preventative care to their communities. The huge drugs companies should be nationalised.
Medical research would be freed from business secrecy and competition, management of every unit should be by representatives of nurses, doctors, auxiliary workers, and patients. Thus all the features of the NHS at its best could be restored and improved on. This must be an integral part of a programme for working class power.