An Emergency, but No Accident

Our health and social care systems are under severe pressure.

We see the evidence for this in the overcrowded A&E departments, patients lying on trollies in hospital corridors, ambulances unable to respond to emergencies and an acute shortage of community care packages to support people in their own homes.

We can see it in the overworked and underpaid staff trying desperately to provide quality and lifesaving services. We see it in the ever-lengthening waiting lists, in the targets that are missed month after month, in the chronic shortages of GPs and in the underfunded, but high demand, and outrageously neglected, services like mental health.

Everyone seems agreed that the NHS and its staff are on the brink, but there is far less agreement about why this is the case.

Underfunding

For the past two decades, at least, NHS staff and services have been severely and deliberately underfunded. This is not an economic issue, it’s a political decision.

From its inception in the late 1940’s the NHS has been targeted and undermined by those who wish to profit from a private medical insurance model. They have played a long game, but must now feel that they are perilously close to their objective. Not only are services and staff overstretched and under resourced, but the private healthcare lobby is in the process of securing its greatest victory yet.

It has convinced large numbers of people, many of them young people, that the days of publicly funded, free at the point of delivery health and social care are over and that the NHS, a great thing while it lasted, is now in terminal decline. 

It is now the received wisdom, and a repetitious media message, that the NHS has had its day and that a new, and profitable, model of care is required.  

Two Tier

We are very, very, close to a two-tier health and care system. Private, profitable, care for those who can afford it and an underfunded, under resourced second-class system for everyone else.

The deliberate erosion of our health and care system is part of a larger agenda which seeks to abolish concepts of community, solidarity, citizenship and collective responsibility.

Private healthcare, private insurance companies, investors and profiteers are waiting in the wings, emboldened by the crisis and the culture that they have been cultivating for years.

‘No Society’

The underfunding, under resourcing and privatisation of the NHS is an example of the right-wing agenda which says that everyone is an individual and should only look after themselves – a mantra articulated by Margaret Thatcher in 1987 when she claimed “…there is no such thing as society”. The out-workings of this doctrine are also clearly on view in calls for an end to welfare benefits and the withdrawal of the right to strike.  

The deliberate erosion of our health and care system is part of a larger agenda which seeks to abolish concepts of community, solidarity, citizenship and collective responsibility.

Principle

Can we afford a fully funded, fully resourced NHS? Of course we can. Is the principle of a national health and social care service worth defending? Of course it is.

The NHS’s founding father, Nye Bevan, was well aware of the intentions of the private profiteers and the lengths to which they would go when he said “…there will always be a cradle to the grave Health Service free at the point of use, as long as people are willing to fight for it”

We owe it to the generations of front-line workers and support staff who have developed and delivered one of the best healthcare services in the world to defend it against those who would sell it off to the highest bidder.

For now, a concerted effort will keep the NHS afloat, but only in a socialist society can it be guaranteed to achieve its full potential.

Good health in 2022?

While we still need to applaud the work of the NHS and all the staff who help provide it, we also need to watch its back.

The Stormont Executive has been discussing the introduction of charges for a range of services including prescription charges, fees for domiciliary care, and paying to see a GP or attend an Emergency Department (A&E).

Other measures thought to be included are fees for hearing aids, paying for non-emergency patient transport, paying for missed GP appointments and a review of eligibility for free eye tests.

The foundation of the NHS in 1948, and the securing of the principle that health care would be free at the point of use and available to every citizen from the cradle to the grave, was amongst the most significant social developments of the 20th century in Britain and Northern Ireland. These changes were not given freely, they were won by the struggles of the organised working class.

Everyone who values that principle should now be prepared to stand in defence of the NHS and the publicly funded, free at the point of delivery services that it provides.