The N.H.S.—Was it worth it? (1975)

From the May 1975 issue of the Socialist Standard

There are still many people who will tell you that the British NHS offers the best medical attention, for patients of all social strata, in the world. In fact, nearly all its original claims have proved to be miserably false.

When discussing the “welfare state” one still often hears the completely false claim that “nobody starves to death in Britain any more.” Thousands of people die here every year from lack of food, clothing, blankets and fuel. The respectable term for this starvation is ‘hypothermia”. Strictly translated this means “low heat” and indicates that the victims suffer from an insufficiency of calories to support their basic vital metabolic needs. They starve from lack of calories.

An article in the November 8th 1974 issue of the periodical General Practitioner reads as follows:

Dr. Geoffrey Taylor, of Ilminster, near Taunton, retired Professor of Medicine in Lahore, India, and a leading campaigner in the nutrition and problems of old people, plans to ask local health officials and Somerset County Council to help him set up a team of volunteer street wardens.

These wardens, armed with room thermometers, will check the homes of old people to make sure the rooms they are living in have a temperature of at least 70°F. If necessary, they will block draughts, check insulation and advise the old people to live entirely in one room. “Very large numbers of old people suffer heart attacks as a result of extreme cold”, he said.

“About 700,000 have core temperatures of 95.5°F, and are on the verge of hypothermia in mild winters. In cold winters there must be three or four times that number. It is a question of action now. Our problem is getting volunteers”.

But the warden scheme is only a short-term answer. Dr. Taylor is hoping to persuade councils to back his long term scheme for district heating. He explained: "District heating uses waste material now thrown away to boil water which can heat homes.

Elderly invalids living alone are often victims of loneliness and depression. Rightly, they should have constant nursing attention and company. They often need frequent cleaning and changing and assistance with feeding and using the toilet. In the enormous numbers of homes that have no fixed bath or inside lavatory this is very difficult. Relatives with their own family responsibilities often just cannot properly cope with these cases. Yet there is a great shortage of hospitals for the frail and old — with waiting lists which will become even longer — since Mrs. Barbara Castle has intimated not only will there be no increased expenditure in this field but expenditure will have to be less for some years to come. An article in the General Practitioner of July 13th 1973, reads:

Strongly associated with chronic disability were low income, age, widowhood and living alone. More than a third of all persons living alone were chronically limited by disability and this proportion rose to 44% in the over sixties.

The proportion of chronic sick varied between 35% and 41% in families with a total income of £5 to £12.50 a week.

So much for the Welfare State. Did we really “never have it so good?”

It was once boasted that the NHS would provide free specialist treatment for all, and that the needy would not have to suffer ill health any more because of their poverty. But now, with waiting periods of months for specialist appointments and years for routine operations, this is an empty promise. When told of these waiting lists workers often ask how much it would cost to “go private” and so have their case dealt with much sooner. When told the probable fee, some struggle to find it and others turn away amazed and disappointed. Yet another example of the broken promises and boasts of the NHS was that patients would be able to receive treatment without having to pay the monstrous prices of drugs. Yet now, being handed a prescription, poor patients sometimes ask if one or more of the items prescribed for their health can be deleted because finding the extra 20p is beyond them.

The profits of drug manufacturers are enormous but they claim that these are necessary, to plough funds back into research for new drugs. But it is well-known that many drug companies manufacture and sell products introduced by other firms under different proprietary names. Their subsequent propaganda often points out that their product is more than just a pharmacological equivalent because, say, it is better absorbed or has less side effects. This one drug may be bought at different prices, in different make-up and under different proprietary names. Admittedly some companies spend a lot on research and introduction of completely new drugs. Nevertheless, far more of their returns are spent on advertizing their own brands in opposition to the pharmaceutical equivalents made by others. Figures vary, but it has been said that in certain cases five times as much is spent on advertising them as on research.

In a sane order of society research would be made finding the most efficacious and side-effect-free product and this alone would be manufactured and used. Such massive duplication with its attendant wastage would then be pointless.

R. B. Gill