Socialist Sonnet No. 212: COP . . . out (2025)

   From the Socialism or Your Money Back blog

COP…out

Assemble fifty thousand delegates,

From around the world. Ask what the price is,

When considering the climate crisis,

Of convening fourteen days of debates.

Then there’s the press corps and TV news,

Social media that requires broad banding,

The wining, the dining, the glad handing:

A towering Babel of discrepant views.

Far, far too many are still enraptured

With fossil fuels and profits they’re making.

For all the hot air there’s no mistaking

That not a gram of carbon is captured

After the fortnight, despite pressing need.

Just lots of motions with nothing agreed.

 

D. A.

Never trust a Trust (1993)

 

From the November 1993 issue of the Socialist Standard

The government has recently announced that thirty more district health authorities are to become self-governing in the fourth wave of trusts, and that the remainder will follow suit within two years.

The National Health Service enjoys considerable public support and attempts to return to private medicine have to be carried out cautiously whilst protesting vociferously that there is no such intention. But despite this cautious approach at least three-fifths of all self-governing trusts have run into financial difficulties. And in August, four London hospitals announced that they were going to cancel routine operations for the rest of this financial year. With seven months to go, from the date of these cancellations, to the next financial year, the waiting list for treatment will continue to grow, with pain and discomfort for patients.

The financial difficulties experienced by the health service trusts is only to be expected as an internal market does not put any more money into the system but costs considerably more to administer it. Whilst administrative costs have risen sharply to cope with the extra paperwork many newly-qualified nurses have been unable to obtain jobs and others have been given temporary contracts, only to find themselves unemployed three or six months later.

Despite the greater technological expertise required for modem nursing, the number of qualified nursing staff fell by 5.2 percent between September 1990 and September 1991 according to the Department of Health. But unqualified staff have increased by 17 percent. (Nursing Times. 1993, no.7)

The increase in total staff has been necessary to compensate for the removal of student nurses from the wards into colleges for the Project 2000 training courses. This change from traditional training methods has been introduced to improve academic standards and technical knowledge but also to pay students less by giving them grants instead of employing them as salaried workers.

Despite the dearth of jobs, financial hardship and the prospect of unemployment at the completion of training has led to a 5.5 percent wastage rate for Project 2000 students compared with 4.7 percent for students undertaking traditional training (Nursing Times). While the government juggles with the figures and nurses find out the hard way that professional status counts for little in the job market, the waiting list for treatment has increased by 60,000. A number of hospital trusts have changed nurses’ patterns of shift work, worsening their conditions of service and reversing some of the hard-won gains of the last thirty years. The Bradford Hospital Trust announced up to 300 redundancies shortly after it became a trust.

During recessions the bargaining power of workers is weakened and they are vulnerable to attacks upon their living standards. This will always be the case while capitalism lasts because trade unions tackle effects and not causes. Thus, any gains made during booms will be attacked by employers when there is a surplus of labour during a slump.

The government has repeatedly stated that it wishes to reduce public expenditure. Indeed, public health service employees have been held to a 1.5 percent pay increase this year (equivalent to a pay cut after allowing for inflation), and a proposed wage freeze for next year.

At first glance it seems curious and inconsistent to try to reduce expenditure on the one hand and to increase it on the other by opting for a system of management which is much more expensive. But a consideration of the ideological and political motives underlying the formation of the National Health Service and the reasons for the attempts to dismantle it show that both courses of action are consistent with capitalism’s priorities. When Henry Willink, Conservative Minister of Health in the wartime Churchill coalition government presented the 1944 White Paper setting out the proposals for a unified national health service, free at the point of use, centrally funded and administered by Local Authorities it was because it was recognized that after the sacrifices made by the working class in fighting a lengthy war to protect the capitalists’ interests they were not prepared to accept a return to the heartbreak conditions of the 1930s. It was also recognized that, with an acute shortage of labour, a reliable health service would be needed to conserve workers’ health in the critical postwar years of reconstructing industry. It was also necessary to provide concessions to blunt working-class militancy as strikes would have placed British capitalists at a disadvantage with their competitors.

A centrally-administered health service was more efficient and cost effective than the fragmented, piecemeal provision of health care which had hitherto been available in the 1930s. But by the 1980s, capitalism’s priorities had changed. A worldwide recession had reduced the capitalists’ profits making less money available for social programmes; a large pool of unemployed labour had weakened the power of the trade unions and made it no longer necessary to conserve the health of all the workers. The National Health Service now represents a cost against production that the capitalists would prefer to see drastically reduced if not abolished.

The NHS is an institution welcomed by the working class and its abolition, however desirable from capital’s point of view, is politically damaging, therefore, the moves towards replacing it with private services have been gradual. Laundering, catering and Portering services have been contracted out private companies in the last few years with reduction of staff, lower wages and poorer working conditions in the majority of cases.

Once all district health authorities become self-governing trusts it will be possible to break the power of the trade unions by dismantling the Whitley Council which negotiates health service employees’ pay. The trusts will be able to set their own pay and conditions which will lead to further downward pressure on wages. And with each trust being independent and no longer part of a nationally administered service then a national strike by health service employees over a dispute in an individual trust would be considered to be an illegal "sympathy" strike. Also with an internal market in place it will be possible for a hospital trust to break a strike by sending patients to other hospitals.

It has been claimed that the internal market, with buying and selling of health care on business lines, can make the most efficient use of resources and expertise by sending patients to other hospitals for services which may be in short supply in their own areas, but the 60,000 increase in the waiting list for treatment shows this not to be the case. There is a consultation process between health districts, regional health authorities and the public at each trust application but the public’s response is not disclosed by the Department of Health. We can be certain that if the public’s response to hospital trusts was enthusiastic then this would be widely publicised and trumpeted as a vindication of the government's policies. The secrecy surrounding this information is an attempt to conceal the lack of support for their plans. The announcement by the Government that it intends all health districts to become trusts within the next two years makes a mockery of the so-called consultation process and makes the public meetings little more than a declaration of intent.

In addition to the plans for NHS trusts, the 1989 White Paper Working for Patients (sic) provides for a range of optional extras such as single rooms, television and a choice of meals for those who wish to pay for them which will create a two-tier system with only basic amenities being provided for the poor and better services being provided for the not-so-poor.

A visit to any of the older district general hospitals will provide evidence of expensive refurbishment having been carried out on some of the surgical wards whilst, in many cases, even basic repairs are not carried out on the geriatric wards, reflecting capitalism's attitude to non-producers. Obviously, the majority of elderly patients will be unable to pay for "extras’' out of their pensions. A return to Victorian values, particularly the Victorian workhouse, is beginning to look an unpleasant reality for the poor and needy.

The government’s policies have caused problems for the mentally handicapped. Dr David Tod, President of the National Association of Fundholding Practitioners, told the Conservative Party conference in October that he cannot accept any more mentally handicapped patients in his practice without extra funding (Independent, 9 October).

The proportion of pay which general practitioners earn from the number of patients that they have on their books has been increased from 46 percent to at least 60 percent and this has, predictably, led to a reluctance to treat patients requiring a lot of medical care. There is no doubt that further attacks will be made on the NHS and that the present cumbersome structure is being set up with a view to selling it off to private speculators in due course. For the poor, only the most basic provision will be retained, and the mentally ill will continue to swell the ranks of the homeless as long-stay hospitals continue to be closed without adequate alternative care being allocated.

But the attacks on the NHS provide an object lesson to those who wish to reform capitalism. The reforms were gained only after years of struggle, implemented when it was no longer in capital’s interests to obstruct them, and are being reversed when it was no longer expedient for capital to accede to workers' demands and a recession makes it difficult for workers to resist the encroachment upon their living standards. Nothing less than the complete overthrow of capitalism and its replacement by socialism can prevent this happening to reforms over and over again.

Carl Pinel

Why nurses are angry (1993)

From the November 1993 issue of the Socialist Standard

In September nurses from University College Hospital (UCII) in central London went back to work after a six-week strike. What made them angry enough to strike?

Why is it that approximately two months ago south London hospitals were crying out for extra nurses to care for patients on the wards, but there was not an agency nurse to be found?

A recent survey done by the Institute of Manpower Services found that one nurse in four would leave the NHS if they could. Why?

The creation of the internal market within the NHS has meant there is increasing pressure on trusts to keep within their budget. With the old system it did not matter if budgets weren’t kept to, the money was just replaced. In the new system if you don’t keep within your budget, then you don’t meet your contracts and eventually you go bankrupt like any other business.

In trusts most of the money goes on nurses’ wages (they are the majority of the workforce).

Constant pressure

There is constant pressure to cut this budget and this lias been addressed in a variety of ways.

First, freezing posts as nurses leave. Second, possible redundancies, though on the whole this has not been widespread as yet. However in the College of Health Studies where I work, there has been an amalgamation of two colleges of nursing which involved redundancies. The College is about to amalgamate with a further two colleges of nursing and more reductions are planned. It has been suggested that the 183 teaching posts in the three colleges will be cut to 52.

Third, alteration to nurses’ hours. Nurses have traditionally worked a shift system of earlies, middles, lates and nights. The hours are different from hospital to hospital but used to be roughly: Early: 7.30am to 3.30pm; Late: 1.30pm to 9.30pm; Night: 9pm to 7.45am.

Managers did not see why there should be an overlap of nurses on duty between 1.30pm and 3.30pm. This did not appear to be cost effective. What were the nurses doing during this time? On investigation it was found that education of students and professional updating of staff went on. As the extra nurses were not directly involved in patient care, managers felt it was a waste of time having them and altered the hours accordingly. Extra money was also being paid to the night shift for working "unsocial hours"; again managers fell this could be tampered with in some way.

At one particular hospital the nursing shift hours are now: Early: 7am to 3pm; Late: 2pm to 10pm; Night: 9.45pm to 7.15am. This hospital may have reduced the nursing budget on hours, but its sickness rate has soared and it is having to pay agency staff to work.

Finally, alteration in ward skill mix. There is a trend to employ more care assistants (unqualified nurses) instead of qualified staff, who are paid more. This leads to a decrease in the quality of nursing care given to patients.

Two research studies (Skill Mix and the Effectiveness of Nursing Care, Centre for Health Economics; York and Ward Nursing Quality and Grade-Mix, Report No. 504, York University’s Health Economics Consortium.) showed that where wards were staffed wholly by qualified nurses the standard of care given to patients was high, but where wards were staffed with combinations of unqualified and qualified nurses the standard of care delivered to patients was lower.

Fragmented care

This appears to be because unqualified staff cannot give the total nursing care to the patients. For example, they lack the knowledge to interpret signs and symptoms and cannot give out drugs. This means that patient care becomes fragmented and patients have to wait for qualified nurses to gel to them to give them the appropriate drugs or interpret symptoms.

All these points mean that there is an increase in pressure on nursing staff which results in frustration because they cannot give the nursing care they want to.

A Trust’s survival depends on getting contracts from Health Authorities and GP fundholders. Since the reforms there has been an increase in productivity within hospitals. This increase in throughput of patients has a tendency to mean early discharges, which puts extra pressure on nursing staff to ensure that discharge arrangements are ready and that there are enough beds for patients coming in. It may also mean patients go home too early — and have to be readmitted. The government says that wage increases will come from increased productivity. But if contracts are completed early. Health Authorities and GP fundholders have no more money to buy more treatment for their patients. So hospitals simply have to stop work. Eventually this will mean that hospitals cut the number if nurses so that, although the amount of work remains the same, there are fewer people to do it and it takes all year to complete. This situation is worse in London due to high overheads and London weighting etc. For example Camden and Islington Health Authority stopped all elective surgery at some central London hospitals in September because it had used up all its money with these expensive Trusts.

The planned reduction in junior doctors' hours means that some things previously done by doctors will become the remit of the already overburdened nurse. Again, nurses are cheaper to employ than increasing the number of doctors.

All these things mean that the nurses are increasingly having to alter the way they care for patients and are increasingly leaving the patient's bedside, for which they have been trained, to deal with administration issues such as discharge arrangements or managing bed vacancies.

No wonder the nurses at UCH said enough is enough.

If the Tories win another general election, the next step is obvious. Trust hospitals will simply become private hospitals, contracting with both private health insurance companies and Health Authorities for their income. And Health Authorities themselves will simply stop buying some treatments. A Labour government would be no better as they would still face the fundamental problem of how' to finance an NHS which will need more and more money for research, new drugs and so on.

Within capitalism it is impossible to deal effectively with disease and illness with the NHS or any other healthcare system as the emphasis is on profits rather than peoples' health and researching into causes of ill health. The only way in which to have a proper Health Service is to form a society which is based on peoples' needs: socialism. Finance and the fundamental problems it brings will disappear as it would be a society based on need rather than profit. Emphasis would be on prevention — at the moment this is too costly. The McKinleys’s river approach ( where individuals are falling into a river and drowning and Health care staff pull them out. patch them up and send them back to the top of the river, where they fall back in again) would stop and society will address the reasons why people fall into the river, such as bad housing, air pollution, etc. All individuals would be looked after in the appropriate place hospital or community. In hospital, there would not be the pressure on beds that there is now and people could spend as much time there as they need, and when discharged to the community there would be the proper resources available

Adele Atkinson

"Capitalism just cannot come to terms with the necessity of meeting human needs." (1993)

From the November 1993 issue of the Socialist Standard

Who needs leaders? (1993)

From the November 1993 issue of the Socialist Standard

John Major looks like he’s in deep trouble with his party. But what difference does a change of leadership make to the operation of Capitalism?

Who would you like to be Prime Minister of Great Britain? Or leader of the Labour Party? Of the Liberal Democrats? And when you have made your choice ask yourself why — not why you chose that particular person but why you bothered to make a choice. Ask yourself what persuaded you that whoever is nominally in charge of things makes any noticeable difference to what happens to us.

We ask these questions in response to the present void in both Conservative and Labour parties, in which they are wracked with doubt over whether their recent choice of leader was advisable. In both parties the doubts have triggered off the usual frenzied but surreptitious campaigning by aspirants to the leadership, while they all deny any such ambitions and profess undying loyalty to the leader.

This is especially noticeable in the Tory Party because, as the government, their mistakes, disputes and obvious impotence to control capitalism are so clearly exposed. This is not good for John Major, who came to be Prime Minister on the assumption — which he encouraged — that his government's style would be different from Thatcher's and that this would ensure it would be more successful in tackling current problems like unemployment, housing, shortage of medical services and so on. His lack of success makes it embarrassing for Tories to remember his promise in November 1990, to lead "a nation at ease with itself.

After nearly three years of his government whatever the nation is at case with it is not John Major, whose popularity is at the point where it causes friction in his and a campaign lo replace him much as Thatcher was replaced. One seasoned MP tells of the day when a senior Tory minister advised him never to forget that loyalty was the party's secret weapon. Of an enquiring mind, this MP soon realized that the opposite is the ease — that the Tories are as disloyal and ruthless when they decide their leader is likely to lose them seats in parliament. When it gets down to it that is why Thatcher had to go and why Major’s job is in jeopardy.

The relentless and fruitless search for the perfect leader is, like so many of the delusions which bolster the capitalist system, clearly influenced by prejudice. For example, nothing in a leader appeals to British people so much as an apparent firmness of purpose. But when that same characteristic is shown by an "enemy" leader — like Saddam Hussein, it is a very different matter. Saddam, says the prejudice was not firm and consistent in his policies; he was mad, just like all the other bogeymen of the Sun and similar papers.

In any case, how valid are the memories of Thatcher single-handedly beating off all those mad, grasping foreigners and doing something called "putting the great back in Great Britain"? The decline of British capitalism since the First World War has done much to fashion the political history of this country. In one way or another every government has had to accept, and work with, that reality. Some have done this more readily than others; some have skilfully practised deceit on the issue, so that the voters were convinced they were not doing what they were.

Part of this deceit has been in the speeches of leaders who have suggested that the decline in British power was avoidable and that they could reverse the trend. This posture has not been confined to the Tories; Harold Wilson, especially during his first spell in power, consistently talked about British power and the British economy forcing their way to the top in the world. At times he was so absorbed in this crazy notion that his voice lost its Yorkshire twang and took on a Churchillian growl when he spoke about it.

The idea is to conceal reality so that all those voters who are deluded into thinking that if Britain is a super power they will become super-workers will gratefully vote for a Wilson or a Thatcher. For her entire period in Number Ten Thatcher was one of the cleverest at hiding the reality and persuading British workers that it could be avoided. That was why so many of them voted for her. But the deception is self-perpetuating because it reinforces the notion that the decline — or the rise — of a capitalist power is not a matter of history but of political policy. The assumption is then that the collapse of the British Empire would not have happened had it not been for feeble egalitarians such as Clement Attlee is mistakenly supposed to have been. It is a delusion which does not help to understand the place and the function of leaders nor what happens under capitalism.

And that brings us to the crucial question of how useful are leaders. Do they really change the course of events? One field in which they are confident they have control is the economy. When things are going badly — when British capitalism is in recession or a financial crisis — the Chancellor of the Exchequer assures us that they have the remedy; trust them and all will be well. And when things are going well — when there is a boom — they claim the credit, saying it is due to their skill and intelligence.

About a year ago British capitalism went through a crisis which has come to be known as Black Wednesday. It was a day when a panic-stricken Chancellor (who, as one of those clever political leaders, is supposed never to gel in a panic) ended a succession of juggling with interest rates by withdrawing sterling from the European Exchange Rate Mechanism. This was supposed to be yet another example of politicians’ skill but in fact it happened only a short while after the Chancellor — the hapless Norman Lamont — and John Major had lectured us on the theme that the only way to prosperity for us all was lo keep sterling in the ERM. They were in no doubt about this quite sure that sterling would not be taken out of the ERM. Now many Tory politicians are asserting that the withdrawal is an example of their cleverness and that things for British capitalism are better as a result. For example, Norman Lamont is now very clear on the issue, urging “the Prime Minister to stand up and say once and for all that Britain should never again have anything to do with a single currency. Then we could all sing in the bath" (Well he was writing in the Sun).

Parasitic minority

Different conclusions have been drawn from that muddle, as from all the other episodes of similar chaos which regularly burst on the scene, stimulating more speeches, lectures and promises from political leaders. But only one conclusion fits the facts. No matter how clever and learned leaders may be, they can have no significant effect on how capitalism works and how it affects us. This social system works to its own priorities, to the benefit of a small parasitic minority. It cannot be controlled or manipulated. The cleverer leaders may be able to conceal this for a time; the not so clever — like Lamont and Major — can’t conceal it and that is why they arouse such contempt. To choose one leader against another is to choose one style of futility before another. It would be better to abandon the whole sorry mess and opt instead for efficacy for our own ability to change society so that we operate it, trusting ourselves to run the world for ourselves.

Ivan

White supremacy is stupid (1993)

From the November 1993 issue of the Socialist Standard

In a world that is becoming smaller and societies that are becoming multicultural, it may be time for Western culture to examine critically its view of other cultures. For how much of Western culture is made up of prejudice about other cultures? How much of Western identity is constructed upon the negative identity of others?

Decolonization in a political sense has occurred. What remains to be addressed, however, is cultural decolonization. The legacy of several hundred years of Western expansion and domination, manifested in racism, continues to be recycled in Western cultures in the form of stereotyped images of non Western cultures.

Social Construct

It has often been observed that "race" is not a reality but a social construct. In his study of the "Jewish question'', Jean-Paul Sartre wrote, "Don't ask what the Jews are, but what we have made the Jews”. This applies equally to images of Africa and blacks. The term "White on Black” refers to the whole spectrum of relations in which Western interests were dominant — the trans-Atlantic slave trade, master-slave relations on plantations in the Americas, colonialism, the post-colonial era. and majority minority relations in the Western world. In each of these situations Europeans constructed images of Africa and blacks on the basis of selective perception, expedience, second hand information mingled with reconstructed biblical notions and medieval folklore, along with popular and "scientific” ideas that were current at the time.

Stereotypes of Africa and of blacks are still in circulation but old images have faded away or acquired new meaning and new images have arisen. In the second half of the 20th century, "race” is no longer invoked as the primary key to differences; it has been succeeded by systems of differences founded not on biology but on culture.

"Race" discrimination has increasingly yielded to discrimination along cultural lines, bringing with it different sets of images. Hence "racism" in the literal sense is no longer a satisfactory term to understand the changing realities. Culture as a new basis for differentiation is much more diffuse in its ideological claims than race theory, but in some ways equally effective in establishing boundaries and demarcations. While science marched forward, popular thinking in Europe still followed Christian modes of thought. Genesis (9:18-27) relates that "Noah drank wine and fell into slumber while naked”. Ham, his youngest son, saw him but did not cover his shame, whereas his brothers Japheth and Shem covered their father with cloth. Awakened, Noah praised Shem and blessed Japheth. but cursed Ham.

Curse of Ham

In the early Church the curse of Ham or Canaan was regarded as an explanation of slavery, but not simply of blacks because slavery at the time was "colour-less". The association of the curse of Ham with blackness arose only much later in medieval Talmudic texts. In the 16th century it became a Christian theme and by the 17th century it was widely accepted as an explanation of black skin colour. From here it was just a step to the interpretation of the curse of Ham as an explanation of and justification for the slavery of black Africans.

The view of Africa as a continent condemned to eternal servitude was well suited to a theological assessment of slavery. According to the theological explanation, the Continents were peopled by descendants of Japheth (Europe), Shem (Asia) and Ham (Africa), ranked in a master-servant relationship. Until well into the 19th century, even after the development of the theory of race, this remained the most popular explanation of slavery.

Minorities often a find place in society in certain specialized occupations. No matter how unreal and how dependent on circumstances its position in the labour market is. it is often extremely difficult for a minority to overcome the stereotyping that goes with that position.

The occupational roles allocated to blacks in Western society are an example a minority specialization which has been in existence so long that it seems to reflect the "natural" order: entertainment and sport.

The first role blacks were permitted to perform in White society, after that of slave or servant, was that of entertainer. Indeed entertainment was itself one of the functions of slaves. Entertainers do not threaten the status quo but embellish it. Emotive expression by blacks is accepted and conforms to the rhythm myth, the stereotype of musicality. Thus over the past century, blacks have become the musicians, dancers and buffoons of Atlantic culture.

Sporting challenge

Another terrain on which blacks have been permitted to manifest themselves is in sport. Several sports had travelled along with Africans to the New World and. according to a study by the tennis champion Arthur Ashe who died recently, by the mid-19th century several sports were integrated. The achievements of black athletes challenged "white supremacy" and breached the myth of "racial" inferiority. The integration of sport is part of overall black integration. But it is also a limited kind of success. Their success seems to confirm one of the stereotypes of the black as bestial brute, the all brawn-and-no-brains kind of athlete. At first the story was that blacks were inferior to whites in every respect, physically as well, and therefore unfit to compete with whites led to other stories about blacks having "abnormal muscular qualities, different from those of white men”.

Recently a Tory councillor in Derby was quoted as claiming that "black people do not use swimming pools because they cannot float":

"Retired teacher Colin Brown, 59, said: 'Black people are very heavily boned and they sink. It’s a physiological fact that was taught when I was studying physical education. You never see any black Africans in Olympic swimming finals, do you?’” (Sun, 9 September).

Racism never comes alone. It forms part of a hierarchical mental set which also targets other groups. The features attributed to groups define by “race" are not peculiar to racism, but are also attributed to entirely different categories defined according to social status, gender, age, nationality and so forth.

What racism and other forms of prejudice and discrimination all have in common is social inequality. The common denominator is power — the power that arises from a hierarchical situation and the power required to maintain that situation and, also the anxiety that comes with power and privilege.

Michael Ghebre