"The bourgeoisie has stripped of its halo every occupation hitherto honoured and looked up to with reverent awe. It has converted the physician, the lawyer, the priest, the poet, the man of science into its paid wage-labourers."
Thus wrote Marx in the Communist Manifesto 101 years ago; it is still just as up to date now as when written. The doctors in those days was a wage-labourer as to-day, in spite of the fact that many looked upon him as a minor capitalist. The doctor was dependant for his livelihood upon the sale of his labour power, his ability to work, to give advice, to dispense, to diagnose, to operate and to heal. For these services he received his rewards whether he worked as a private physician, or whether he sold his services to a local municipal council, or worked for a hospital or institution.
The National Health Service of the Labour Party has not changed the doctor’s economic relationship to society one iota, except that it should have made it plainly visible to the doctors themselves that they are members of the working class, whose wages can by Government decree be drastically reduced.
When the Labour Party decided to inaugurate the National Health Service, which means in effect the Nationalisation of medicine, Bevan approached the doctors to ascertain what the average General Practitioner was earning. The representatives of the doctors were not a little concerned with such a question, knowing that some form of nationalisation was in the air. If they plugged for high wages (or salaries) by stating they were earning let us say £3,000 to £4,000 a year, their income tax returns could easily be investigated; and if it were discovered that they were paying income tax on, let us say £1,000, the ministry would know at once what was happening. The long and protracted negotiations between the Minister of Health and the medical profession were not a little due to this awkward position which the doctors very reluctantly had to face. In the struggle the Labour Party won, and Bevan triumphantly proclaimed to the doctors that the State would pay them a salary commensurable with that which they were earning, that is what the doctors said they were earning. That being done, they became pafd wage labourers of the State, Civil Servants of a type.
It is quite well known that every doctor formerly lost a large percentage of his fees by bad debts. Although doctors have the legal privilege to sue for unpaid fees, very rarely did any doctor take advantage of such facilities of the law. If Doctor Brown sued poor old Mrs. Jones (who let us say was bedridden and poverty stricken), his name would be mud in the district, and his fellow-practitioners would soon scoop up his practice. Under the National Health Scheme, since the Government collected the cash in weekly instalments that everybody must pay, a guarantee could be given to the doctors that there would be no loss of fees. This did not appear to enthuse the doctors who sulked and acted as if they were getting a raw deal. Is it possible that they were taking cash and forgetting (it is easy enough) to record it for His Majesty’s Inspectors of Inland Revenue?
The net result of all this is that many of the doctors are not very interested in the National Health Service, which has been witnessed by thousands who have consulted doctors under the new plan. For the nationalised physician it means more work for less fees, hence the reason why they have discussed the possibility of mass resignation at an early date.
Another economic aspect of the National Health Service must not be overlooked. Since its introduction a year ago, the value of the shares in all the drug companies has increased and record profits have been made. At the recent shareholders’ meeting of the Boots Drug Stores, the chairman declared that “they had had a record year with profits over £600,000 and that had they had more staff to cope with orders, they would have done a great deal better.” It is, therefore, no accident that the National Health Insurance has been introduced. In actual fact it is no insurance at all from the workers aspect, but a national disease treating scheme, whose real function it is to get workers back to work as soon as possible. It means that the big problem of absentee-ism has been tacked nationally. No longer can a worker offer an excuse that he was ill and could not get a doctor or afford treatment. If the Health Insurance insures anything, it insures that the worker is got back to work in double quick time! Strange is it not that this peculiar service has been introduced at terrific costs in time and labour, by a political party which has been shouting itself hoarse to get increased production! The net result is lower wages for workers by compelling them to pay insurances, lower salaries and more work for doctors, and larger profits for the big drug houses.
Thus does the Labour Party in but another field not only carry on the task of running capitalism in the interests of the real ruling class (the capitalists) as we have consistently claimed, but does it more efficiently and effectively than previous capitalist Governments.
Horace Jarvis
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