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Proletarian issue 58 (February 2014)
Cutting the NHS, killing its patients
The core premise of the NHS is simple: free health care at the point of use. The execution is simple: everyone pays relatively little through taxes but receives access to treatment no matter what the cost. The benefit is incredible both socially and economically: no-one lives in fear of bankruptcy if they become ill or injured and we have a much healthier and able population than we would otherwise.

From the 1980s onward – under Thatcher, Major, Blair, Brown and Cameron – we have seen a steady and inexorable undermining of the NHS through marketisation and privatisation. With the post-war boom at an end and a new capitalist overproduction crisis looming, providing a decent and all-encompassing service for the benefit of all was no longer an adequate rationale for the existence of the NHS, and it was slowly and cruelly transformed into a shadow of its former self.

Whilst ‘efficiency’ and ‘effectiveness’ are indeed qualities we would expect our health service to strive for, the policies Labour and Tory governments have pushed through under the guise of achieving those noble objectives have in fact been producing the opposite effects – the NHS is less efficient and effective than ever before.

And this is not an accident, of course. The aim was always privatisation, but no politician who wanted to stay in power could have come straight out and said so. Hence all the weasel words about ‘improving services’, ‘reducing waiting lists’ (lists that were unknown before the privatisation-by-stealth policies were introduced), ‘cutting red tape’ and so on.

And hence all the baffling jargon that accompanies the regular reinvention of the NHS’s systems – PFI! Foundation Trusts! Primary Care Trusts! Clinical Commissioning Groups!. These reinventions are now coming so thick and fast that most of us are left feeling utterly baffled.

The jargon, the new systems, the slick presentation etc are all meant to blind us to what has really been going on – the gradual hollowing out of our public healthcare system and its replacement with a cash cow for the privateers.

One thing is perfectly clear to the ‘service users’ formerly known as patients, however: if you want an appointment with a doctor who is senior enough to know what s/he’s talking about and long enough to be able to take in what s/he is saying, it is increasingly likely that you are going to have to pay for it. And the same goes for getting hold of the most useful or recent treatments, if those treatments also happen to be expensive.

Take, for example, the recent report that even though certain life-saving treatments have been approved for use, at least 14,000 patients are not receiving them. Even though the treatments were supposed to be provided to any person that required them, the squeeze on budgets means that some areas simply don’t have enough money to afford them.

The government, by inflicting capitalist mismanagement on the NHS, is denying health care to the people who need it most – often simply because they live in the wrong area.

This is a direct attack on the working classes – the people who have no real choice in the matter of where they live or whether they can afford to pay for health care.

Running the NHS like a business totally negates its supposed premise. It’s not meant to be profitable; it’s meant to help people in need. But the institution has been declawed and defanged and is now being served up to wealthy private companies like a choice delicacy.

The creators of these policies will never suffer the consequences of their actions; the cost of health care will never be a concern for them. The people who suffer are the ones trying to care for sick friends or relatives, and the people who need care.

Defend the NHS from capitalist greed!
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