Break-Up of Free Healthcare Threatened by UK Tory/Liberal Democrat Coalition

By Graham Durham

For sixty years the British labour movement has been able to point to the creation of the National Health Service (NHS) as a crowning achievement of the Labour Party and the NHS has often been cited by social democracts as the difference that separates Labour from other parties.

Certainly the NHS is a universally respected model—access to emergency, acute and routine medical services is funded through universal National Insurance contributions and taxes, and remains free with access to all. No one in Britain needs to produce any evidence of insurance to access local healthcare or be transported to hospital, an NHS number issued at birth suffices.

Although local doctors (GP’s) had to be bribed to join the NHS in 1948 (“I stuffed their mouths with gold” boasted the Labour minister Nye Bevan), the system established provided a guarantee of healthcare which survives in 2012. As a post-war boom baby I was one of millions who benefited from NHS milk, orange juice, pre- and post-natal services and successful national campaigns against killer diseases from diptheria to TB. The NHS remains the largest employer in the UK and has huge popular support providing new modern services such as local drop-in services, organ donor campaigns, 24 hour telephone advice lines and effective public health campaigns. One example is the health war against the killer tobacco corporations. Having driven through measures to force up the price of cigarettes and enforce severe health warnings on all cigarette packets there is now a proposal to end all tobacco advertising and sponsorship. As a result, smoking rates dropped from 82 percent of men in 1948 to 20 percent in 2010, and women smokers halved in the same period. In the UK, though, smoking still accounts for 90 percent of deaths from lung cancer and 17 percent of heart disease death.

Of course social democratic Labour in government often reacted to crises in capitalism by chipping away at the NHS—prescription charges for medicines were introduced on a means-tested basis as early as 1951—but the mass support for the NHS has prevented even Tory governments from attacking the NHS directly. Even the ruling class warrior Thatcher only managed to abolish free milk for children back in the 1980s.

At the start of the 21st century the Blair/Brown alliance of so-called New Labour were obsessed with the alleged greater efficiency of capitalist organisations and experimented in several areas to seek to force NHS commissioners to allow private sector health providers to gain contracts. However most of the private contractors introduced were on a relatively small scale although Labour remained committed to expanding private penetration of the health “market” if re-elected in 2010.

Unsurprisingly therefore the Coalition government of Tories and Liberal Democrats (the latter essentially Tories who talk more nicely but attack workers just the same) has enthusiastically proceeded with the attempt to break-up the NHS and award contracts to their corporate friends.

The Health and Social Care Act 2012 passed in to law in March despite overwhelming opposition from all doctor and nurse organisations as well as rank-and-file and trade union campaigns. Even the Liberal Democrat conference choked and opposed it, only for their Parliamentary leaders to ignore them and vote for the privatisation

Tory/Lib Dem spin has stated that the Act will free doctors to commission services. In practice the new arrangements will force many doctors away from patients to local meetings where they will have strict rules imposed to ensure that 49 percent of health providers to the NHS are from the private sector. This measure has got the health fat-cats buzzing in a frenzy around doctors. Already the Virgin Group, headed by Tory donor Richard Branson, has acquired more health companies and won a £500-million contract to deliver community health services to the area south of London. Even more concerning is the shortlisting of Virgin to deliver childrens’ health services in Devon. The careful co-ordination of services for mental health, child protection and many others are threatened as new providers work to contracts and seek to maximise profits. Other corporations including Balderton Capital, owner of “socially useful” businesses such as Betfair (online gambling) and (loan sharks exploiting the poor), and Black Rock, the owners of Fannie Mae and Freddie Mac, amongst others, are seeking contracts to run hospitals and wider services.

The Tory/Lib Dem government is seeking to break-up the NHS leaving only the name to mask a privatised service. Already the NHS employers are attacking health worker pension rights and private employers will seek to drive down wages and destroy the highly unionized NHS.

Faced with this attack, campaigns against Virgin and others are underway but a co-ordinated response from national trade unions is lacking. An urgent task for socialists in Britain is to ensure that the support amongst workers for “our” NHS is translated into co-odinated strike action against the break-up of the service. Any failure to do so will encourage Cameron and Clegg to consider options for medical insurance and a return to the days of healthcare for the rich seen in Britain before the Second World War and still in evidence around the world.

—April 19, 2011