The Doctor’s Dilemma by Bernard Shaw at the National Theatre
Bernard Shaw’s 1906 ‘serious comedy,’ The Doctor’s Dilemma, was recently produced at the National Theatre starring Aiden Gillett as Sir Colenso Ridgeon and Tom Burke as Louis Dubedat.
Shaw based Ridgeon on Sir Almroth Wright, a celebrated and fashionable bacteriologist, who when asked by Shaw what he would do if there were too many applying for a certain treatment, replied, ‘we should have to consider which life was worth saving’. This would become the central plot of the play where Shaw indicts privatised medicine because of its lack of impartiality, its pecuniary interest, rationing, moralising, unaccountability, ineffective treatments, negligence, and sees private doctors as competitive tradesmen in ‘a conspiracy to exploit popular credulity and human suffering’. The Doctor’s Dilemma is an argument for the creation of a public health care system such as the NHS in 1948 (which Shaw himself welcomed as an example of ‘gradualist Fabian socialism’).
Lenin felt that Shaw was ‘a good man fallen among Fabians’, and Alick West saw Shaw as a ‘second Proudhon’. In 1882 under the influence of Henry George and reading Marx’s Capital, Shaw wrote: ‘the importance of the economic basis dawned on me’, and was on the point of joining the Marxist SDF but instead opted for the Fabian Society. Shaw disagreed with Marxian concepts such as the labour theory of value and the class struggle and wanted ‘to place socialism on a respectable bourgeois footing’.
Shaw’s 1912 The Intelligent Woman’s Guide to Socialism and Capitalism was republished in 1937 and Hardy in the Socialist Standard wrote that Shaw’s views were ‘essentially utopian – that there will be money incomes under socialism, and that the capitalist foundation can be made to support a socialist system of society’. The welfare state and the NHS established from the 1942 Beveridge Report and the 1944 White Paper are Fabian ‘socialist’ constructs within capitalism. Marxists see the welfare state and NHS essentially as the ‘redistribution of poverty among the workers’ from those without to those with dependants, maintaining a sufficiently healthy and efficient working population, keeping unemployed workers from becoming unemployable, and insuring the capitalist class against working-class discontent. For the capitalist class the welfare state and the NHS meant increased profits and were seen as ‘a necessary expense of production’.
As we said in the Socialist Standard June 1944, ‘only under socialism can doctors truly serve their fellow workers, and a real health service for all be established’.