Tuesday, March 24, 2020

NHS priorities (1991)

From the March 1991 issue of the Socialist Standard

In recent years the National Health Service has suffered as a result of reduced expenditure. District health authorities have closed wards and reduced services to stay within their dwindling budgets.

These cuts in income have led to announcements that a further 3,500 beds will be closed to the public as hospital administrators are ordered to clear existing debts before the implementation of the government's changes to the NHS that begin in April (Guardian, 26 January).

Despite the government's attempts to reduce the politically embarrassing waiting list for treatment of a million people this has continued to grow. North East Thames regional health authority with the worst waiting list, for its size, in the country has found an answer to the difficulty in reducing its huge waiting list: in the future certain categories of patients will be prevented from joining the queue.

There have been informal restrictions for some time and it is claimed that a million operations have been cancelled in the last three years (Radio 4, 4 February). Screening for cancer could save an estimated 1,250 deaths a year by the end of the decade but the programme may have to be curtailed in some areas because surgeons are unable to cope with the extra work that would be involved (Guardian, 31 January). The women most affected by breast cancer who could be helped by the screening are in the 55-69 age group and, from capitalism's point of view, at the end of their economic usefulness.

The operations for which it is now difficult to even join a waiting list tend to affect people’s well-being rather than their ability to work. These operations are still available privately for those who have the means to pay. But the poor will have to live with uncomfortable disabilities.

In January the NHS was provided with more money to open beds for certain categories of patients—casualties from the Gulf War. Some districts have opened beds which had remained closed due to underfunding from previous years. Professor Angus McGrouther, head of surgery at University College Hospital, London, has stated that the NHS is fully prepared for the chemical injuries, burns or conventional war wounds that may arise from the Gulf War (Daily Telegraph, 28 January). These type of injuries are not new to British hospitals. There were many burns and war wounds sustained during the Falklands' War and victims of chemical weapons from the Iran-lraq war in the 1980's. The chemical disaster at Bhopal also provided grim experience of chemical poisoning on a large scale.

The effects of sulphur mustard gas are well-documented as it was extensively used by both British and German armies during the First World War. The continuous development of chemical and biological weapons in Britain has enabled knowledge to be accumulated, and provides deadly materials ready for offensive use.

War casualties
Two psychiatric patients have been staying in a doctor's office at St Bartholomew's Hospital, London, because of a shortage of beds. A hospital spokesman, while denying that this was a result of accommodation being set aside for war casualties, stated: "It was thought appropriate to create additional space" (Guardian, 28 January).

At a time when the government is urging workers to settle for smaller wage increases. members of the armed forces have been offered a 12.2 percent increase to encourage them to kill others and risk being killed themselves for oil and profits. Nurses have been offered a 9.2 percent pay rise instead of the expected 6-7.5 percent. Student nurses have even been offered 11 percent. This is because nursing skills are going to be in short supply if the expected 500 casualties a day start to arrive from the Gulf War. The government cannot afford to have a repeat of the strike action taken by North Manchester General Hospital's night nurses in January 1988.

Security in British hospitals has been increased on the advice of the Ministry of Defence and employees are being issued with identity passes. There have been an increasing number of assaults on patients and staff in recent years but attempts by nurses’ unions to obtain better security have been largely disregarded. The Gulf War has changed all that and money has been found very quickly.

Although poverty is the cause of the greater degree of ill-health and premature deaths suffered by the working class the NHS does help relieve some of the misery of illness. The resources to run an efficient health service are available as the response to the Gulf War has shown. The preservation of workers' health in a recession is not important under capitalism because there is always a supply of unemployed labour which can be used to maintain production. But keeping workers in uniform fit enough to kill those who have temporarily been designated as “enemies” is. The provision of beds to assist in the prosecution of a war for oil and profits while the rest of the NHS is slowly being dismantled shows capitalism’s anti-working-class priorities.
Carl Pinel

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