50 Years Ago: Major Douglas and Unemployment (1986)

The 50 Years Ago column from the November 1986 issue of the Socialist Standard

Nothing shows up so clearly the failure of Major Douglas and his followers to understand the nature of capitalism as their inability to explain the ups and downs of production and trade. A case in point is their forecast of constantly increasing unemployment.

In its issue of January 25th. 1934. the Douglas journal, New English Weekly, wrote:

As technology develops, there will be a growing mass of unemployed — 20 per cent. 30 per cent. 40 per cent or more — who are deprived of all demand-power, except such as we allow them by way of the dole.

Now let us contrast that prophecy of unemployment increasing for 20 per cent to 30 per cent, 40 per cent and more, with the actual happenings, as shown in the Ministry of Labour returns as to the percentages of insured workers unemployed. 

January, 1933 23 per cent.

January, 1934 18.6 per cent.

January, 1935 17.7 per cent.

January, 1936 16.3 per cent.

June, 1936 13.1 percent.

September. 1936 12.4 per cent.

In due course capitalism will experience another crash and then the Douglasites. silent as to their past failure, will rush into print, repeating their fallacious theories and prophecies.

[From an article "Douglasites Floored by Facts'", Socialist Standard, November 1936.]

Letter: Parliament and socialism (1986)

Letter to the Editors from the November 1986 issue of the Socialist Standard

Parliament and socialism

Dear Editors.

I am unhappy about the phrasing of principle 6 which argues that the state machine can be "converted" into an agent of emancipation. 1 feel that this wording introduces ambiguities into your Declaration of Principles which permit a reformist interpretation. For the Marxists the state is regarded as an organ of class power, the capitalist state as an organ of capitalist power and oppression, which cannot be used to build socialism. Even if reformists admit that the state can sometimes be very biased, they say this is something that can be changed in some way or other. Reformism leads to electoralism. and to a legalistic approach — treating illegal activities with abhorrence. This leads to my second point of concern about the SPGB.

In past issues of the Socialist Standard, you have advocated winning a socialist majority in Parliament because "Parliament is the centre of political authority" and "Parliament controls the state machine." This would appear to make the social democratic error of equating governmental office with political power. But more recently (e.g. commenting on the overthrow of Marcos in the Philippines) you adopt a more mature Marxist position by saying "what is decisive is not so much the socialist electoral victory as the understanding and the determination to achieve socialism which this would reflect" Have you changed your position regarding the role of bourgeois parliaments? Could you please clarify your analysis?

With best wishes.

Andrew Northall

Norfolk

Reply

We have not changed our position on the role of parliaments, nor is our Declaration of Principles ambiguous, as Clause 6 deals with the establishment of socialism, not the reform of capitalism. We hold that socialism cannot be established until an overwhelming majority of workers understand and support the socialist case. Without this socialist understanding, a socialist society could simply not function. Given this socialist majority, it will be easy enough to send socialist delegates to Parliament and thereby gain control of the power of the state. Besides demonstrating the existence of the socialist majority, this will prevent any of the machinery of the state from being used to obstruct the establishment of socialism. The coercive power of the state will be immediately abolished, and there is no question of the state being "used to build socialism".

Editors.

Letter: A realist writes (1986)

Letter to the Editors from the November 1986 issue of the Socialist Standard

A realist writes

The Editor.

Socialist Standard.

Being a realist rather than an optimist. I have to state the obvious fact that there are very few good points about being unemployed. Not because I feel particularly depressed, ashamed, useless, or guilty about not performing some type of so-called productive task, and thereby helping to maintain the coffers of our profit-orientated society. No, my reasons for finding my situation unpleasant, uncomfortable, and unenviable are purely financial, for I still recognise the truth that I am no less a person as a result of my lack of paid employment.

But there is one advantage to being unemployed it gives you plenty of time to think And during the past 14 months or so of serious mental application to matters political, social, and religious. I have definitely concluded that the only solid hope for this overcrowded and sadly exploited little planet is to be found in socialism. There can surely be no doubt any more that virtually every crime, either individual or international, originates from the obsession with profit and the motivation of material greed. I have finally come to understand just what my venerable, white-haired granny meant when she used to tell me that "money is the root of all evil"; although 1 would qualify that by saying that it is not money as such  — for it is merely a shorthand mode of exchange, being slightly more convenient than conventional barter — but it is rather the hunger for money that causes the problems. Hunger for money, hunger for power, and obsession for the temporal and temporary superiority which money and its power confer upon their holders, those are the evils which must be beaten before our species can begin, as a race, to become truly mature, social, human beings.

But all I have done so far is state the obvious, and repeat in my words some of the things which 1 could read in your magazine any time. The thing is. what do we do about it? Sure, we can write letters like this, we can hold meetings, we can even talk to our friends about our creed of world socialism. But this letter will only be read by people who are already convinced of our truths, and our meetings will usually only be attended by others with our interests, and friends have a tendency to become alienated by heavy political statements. So the question remains, what positive action can we take to throw the outmoded and genocidal politics of the present into the trash-can where they belong, so that they may be replaced with the only remaining logical system in which we believe?

The voting public of this (and most other) countries are very conservative in their attitudes. They are conditioned to the apparently comfortable limitations of party politics. They vote only for "acceptable" parties and candidates, in this country meaning Conservative. Labour or Liberal/ SDP. and they do not even consider voting for someone who, as far as they are concerned, does not stand a chance of success in an election.

Worse than that, our public image is not good. It is not yet viable The average person simply translates "Socialist" as "extreme left" or "Communist", and consequently we are doomed before we start. Of course, in order to promote our replacement social system, we must to some extent compromise our position by fitting into the existing system. Before we can become viable, we must have a public platform of some sort, which means finding public representatives of sufficient conviction and of strong enough image to become feasible candidates in public elections. The system will not change by itself, and we will not change it until we can get inside it. People form that system, and they will not change either their social attitudes or their political affiliations unless they are given a very sound and convincing alternative to their present ones.

So instead of wittering to each other from somewhere on the sidelines, let's work to build ourselves into a solid group — I try to avoid the term "party" because of its old connotations and then maybe we can really begin to change this world into something we can live in with humanity, justice and peace.

Yours fraternally, 

R K Chalmers

(Newton Abbot)

Reply:

We have some minor differences with Mr Chalmers but we think his letter is an interesting comment.

Editors.

SPGB Day School: Who wants to be a millionaire? (1986) (1986)

Party News from the November 1986 issue of the Socialist Standard

SPGB Meetings (1986)

Party News from the November 1986 issue of the Socialist Standard

Blogger's Notes:

So many meetings and, sadly, not enough space in the label section to list all the speakers featured. I even had to omit the branches from the label section this time around. Just not enough *cough* characters.

Despite all the meetings listed, it looks like only one of them is featured on the audio page of the SPGB website. The debate in Newcastle with Bill Etherington of the NUM — later a Labour MP — is available at the following link:

The crisis in Capitalism - What is the next step? 

Debate between Clifford Slapper (SPGB) and Bill Etherington (Gen. Sec. of Durham Mechanics, N.U.M.)

Venue: The Printers Pie, Newcastle upon Tyne 1986

I wonder if Harry Young's meeting in Chiswick under the title of 'A Socialist's trip to Siberia' covered the same ground as his article, 'Escape to Happiness (or drama on the Trans-Siberian Railway)', which appeared in the October 1986 issue of the Socialist Standard, and which generated some controversy at the time.

Wasting time at the seaside (1966)

From the November 1966 issue of the Socialist Standard

It is very considerate of the Labour, Liberal and Conservative Parties to hold their annual conferences in the autumn.

At any rate, the seaside hotel keepers must think so, because the conferences bring them some welcome business just as the season is dying; and so must all those seaside landladies, who can keep the secret machines which put lumps into the porridge and burn the toast in profitable operation for another week or so. There is even the sea, which everyone expects to be cold in the autumn, allowing politicians to prove what lovable eccentrics they are by having themselves photographed taking a dip.

It is all good fun, although since the object of it is to win the game of power politics it can hardly be described as clean. But more than other any other reason for feeling grateful for the autumn conferences is that they provide us with something to chuckle over in the long, dark evenings ahead.

There are two types of annual conferences. One sort is run by the parties which are out of power; a certain amount of freedom is allowed here. In most cases—although there have been some famous exceptions, of which more later critics can be treated indulgently, as living proof of ruthless self-criticism, a restless drive for new ideas and a young, zestful heart.

When, for example, Edward Heath was asked on television what he thought about the prospects of receiving a lot of criticism of his leadership at this year’s Tory conference he replied, with a huge grin, that he enjoyed conferences and would be there all the time. Jo Grimond, far from being upset at the noisy activities of the Young Liberals at their conference, went out of his way to praise them and was photographed having an amiable drink with some of them.

There is no such carefree goodwill towards the rebels in a party which is in power. At their conferences the leaders on the platform, are trying to justify broken promises, to explain away diametrical changes in policy and, above all, to convince everyone that, although the present times are hard, with patience and support and unity all will be well. In this situation, critics are not welcomed as a stimulus; they are condemned—sometimes outlawed—as traitors to their party and to what politicians like to call the country.

There are many weary hours to be spent in the conference hall, and it is common for the newspaper men to try to brighten these up a little by fastening their attention upon some so-called personality of the conference. This usually means a lot of publicity for someone who, although he does no more than repeat the same weary platitudes and misconceptions which have been heard so many times before, wakes everybody up by sounding as if he actually believed what he says.

So it was this year with the Young Liberals, who came storming down to Brighton to demand all sorts of reckless things like “workers control” in industry (the inverted commas are intended, and necessary). These young people laid about them and one of them went so far as to shatter the peace of the conference by swearing—or at any rate he said “bloody” and “damn”, which in this age of Kenneth Tynan probably no longer rate as swear words.

The newspapers loved it and decided that no title would be appropriate for the Young Liberals short of Jo Grimond’s Red Guards. It is interesting to wonder what the fanatical young hooligans in Peking would think about being compared with a few hysterical students daring to say “bloody” to an assembly of Liberals on an autumn afternoon at an English seaside resort.

Such, however, are the ways of the press, which also has a liking for putting the finger on what they consider to be political stars of the future who enter the limelight at a conference. This is what the papers did some years back to Ray Gunter, who has now risen so far and so fast that he has the important job of implementing the very policy on wages which his party once scorned. This year, at the TUC, some reporters decided that Leslie Cannon, President of the Electrical Trade Union, showed by his speech that he is a future MP, perhaps even a Minister.

It is hardly necessary to point out that to win this nomination for future stardom a man has to agree with official policy. No member of the Labour Party has ever been selected as a rising leader after making an attack, no matter how capable, on his party’s line on wages or nuclear armaments; Frank Cousins, the most prominent of the critics on those issues, has always been regarded as something of a joke. Still less would a person be noticed for attacking the fundamentals of the Labour Party—its capitalist policies, its obsession with leadership, its unavoidable failure. The newspapers have their own standards of success and they are sticking by them.

Behind all the ballyhoo and the alleged drama and excitement what are conferences for? Every man in the street knows that they are supposed to lay down their party's policy and to take decisions based on that policy. A simple man in a backward street may even think that, because the capitalist parties profess to be democratic, the decisions taken by their conference delegates are binding.

The first thing to say about this is that some of the delegates’ votes are cast in ways which are anything but an expression of their members’ opinions. At this year’s Labour conference the voting policy of the Amalgamated Engineering Union changed suddenly from support of the government to opposition. This was not because the AEU delegates had received different instructions from their members. It simply happened that their leader, Bank of England director Sir William Carron, who is an unmovable supporter of the government, left Brighton for a meeting of the board of the Fairfield shipyard.

This apparently left the AEU delegation floundering, until a series of other absences gave the leadership to Hugh Scanlon, who is generally critical of the government. The result of this was that the AEU, voting as whoever was their leader at the time wished, was one day for the government and another against it.

Yet even without this sort of maneouvering, the votes of a conference are anything but decisive. Labour this year declared several times in favour of the government—on wage freezing, Rhodesia, foreign policy. But when the conference went the other way on other issues—redundancy, Germany and support for America over Vietnam—Ministers made it plain that they would take no notice. It was all summed up by Harold Wilson himself, in one word, when he asked what he intended to do about the famous Cousins victory over work sharing—“Govern”.

This has of course happened before. In 1959, when Labour was licking its wounds after Macmillan had thrashed them at the polls, they decided at one of their rowdiest conferences not to follow Hugh Gaitskell’s advice to delete Clause Four from their constitution. So in theory, and by conference decision, the Labour. Party stands for the sort of capitalism where all the means of production, distribution and exchange are nationalised. But of course they have not the slightest intention of doing anything about it.

Poor Gaitskell had a knack of infuriating his party’s conferences. Another example of a refusal to accept inconvenient decisions was when, after the 1960 vote in favour of unilateral nuclear disarmament, he declared his intention to “fight, fight and fight again” and, because on that occasion some of the big unions had voted against him, questioned the morality of the block vote which had always been accepted as long as it docilely accepted the policy of the platform:

I sometimes think, firmly, that the system we have by which great unions decide their policy before even their conference can consider their executive's recommendation is not really a wise one or a good one.

It is clear that when a conference agrees with its leaders it is the authentic voice of democracy, rich in wisdom. When it disagrees it is irresponsible and treacherous. The peculiar thing is that, although the members of the capitalist parties must know this very well, they are still prepared to be delegates to their conferences, they still work for their party, they still welcome its taking power.

The plain fact is that whatever a conference may decide, a party’s policy is already fixed. No matter how bloodthirstily the Tory hangers and floggers pursued their prey at conference, Conservative Home Secretaries stuck out for penal reform. No matter what support the Rhodesia lobby gathers, the Conservative leadership must agree that the Smith regime should be brought to an end.

Similarly, even if the 1960 vote on nuclear weapons had not been reversed, no Labour government would have surrendered the British Bomb simply because their conference had told them to. Whichever way the vote went on this year’s battle over incomes, the government's mind was made up and the more coercive Part IV of the Prices and Incomes Bill was ready to be brought into operation.

And while we are on the subject, there is something which we should notice about the Prices and Incomes Bill. It is the first openly anti-trade union legislation for something like 40 years—and it is the work of a party which came into existence as a result of a conference decision of February, 1900, to establish

a distinct labour group in Parliament . . . which must embrace a readiness to co-operate with any party which for the time being may be engaged in promoting legislation in the direct interests of labour and . . . with any party in opposing measures having an opposite tendency.

What, we asked, are conferences for? Even if their decisions can be, and are, ignored they are often an opportunity for a party to pronounce on its policy. Perhaps some people may prefer to describe this as warning the working class what to expect, or as making the promises the breaking of which later conferences will have to explain away. In 1963, for example, Labour was hypnotised by the Wilson vision of a technological Britain, with a wise government guiding massive investment into the “science based” industries, with technicians enthusiastically at work in their laboratories and at their drawing boards and with everyone’s wages going up in a nice, steady, organised curve. It was all very good for the headlines, for the electoral image and all the other political public relations man's obsessions.

It usually happens that at such times there is so much concern with a party’s public image that nobody notices the policies which are being expounded from the platform do not amount to much. Consider George Brown’s unoriginal idea of settling the Vietnam war by recalling the Geneva conference—the very conference which first set up the division of the country and so played its part in bringing about the present war there.

At other times the publicity a conference receives can be disastrous for the party, like the 1960 Labour uproar over CND and the public spectacle of Tory leaders savaging each other as they clawed for the place left vacant by Macmillan’s retirement during the 1963 Blackpool conference.

Or a conference can be an outlet for a party's donkey workers. It can give them a break from the hard slog of committee work, canvassing, addressing. They can come to express their doubts and disappointments, to wonder what happened to the visions they once had, Then they can stifle their doubts, admire their leaders and finally submerge themselves in what they call loyalty, but for which there is an unkinder if more accurate name, at a mass rally. Then they can go back to the donkey work with renewed energy.

No conference ever probes, or even discusses the facts. No resolution ever says that the parties of capitalism exist to run the social system which oppresses and degrades millions of human beings, that this system can only be run in the interests of a minority and to the detriment of the majority. Labour’s “left wing” come to their conferences convinced that they are looking for the lost soul of their party—none of them points out, perhaps none of them realises, that a capitalist party is bound to deceive, to override its members’ wishes and to disappoint its followers by pushing through unpleasant and inhuman measures.

Conferences make a lot of noise, exhale a lot of hot air, attract a lot of publicity. But when it is all over, when the delegates have gone home and the hall has been cleared and the seaside has sunk back into its out-of-season doze, one thing is abundantly clear.

It was all a waste of time.

Ivan

So, this is Social Security (1966)

From the November 1966 issue of the Socialist Standard

"During the last 50 years a comprehensive scheme of national insurance has been gradually developed to become the central feature of our system of social security.” These were the words of the then Minister of Pensions and National Insurance Richard Wood, in a forward to a government booklet: Everybody’s Guide To National Insurance, May, 1964. If this statement does anything at all, it underlines capitalism’s continuing, indeed developing, need for all sorts of compulsory insurance provisions for its working population.

We have come a long way since the days of Lloyd George and his five shilling pension proposals, and the very limited dole and "panel” medicine of the inter-war years. To even these comparatively modest measures, there were always the objectors who thought “the country could not afford it,” but it was Lloyd George himself who shoved his opponents contemptuously aside with the observation that paying a pension was cheaper than maintaining old people in work-houses. And this has been the sort of criterion which has guided the reformers ever since; despite the professed humanitarianism of the Labour Party, their spokesman Jim Griffiths was under no illusion about the aims of national insurance when he commended his sweeping post-war proposals to the Commons on February 6, 1946:

The loss to the Nation caused by preventive illness alone is appalling, for it has been estimated at £300 millions a year, equal to 3/5ths of the cost of the scheme in its initial year. To those who fear we cannot afford this scheme, I would advise them to ask themselves if we can afford to go on without it. 

Under this National Insurance Bill, a wide range of “benefits” was enacted based to a large extent on the old Beveridge proposals, and estimated to cost some £452 millions in 1949 and £496 millions in 1955. Contributions were to range from 2/2d. to 4/7d. a week from workers, and their employers were to make weekly contributions ranging from l/9d. to 3/10d. per employee. There was also to be a grant from the Exchequer, and all of this money was to be pooled in the National Insurance Fund, to which would be charged the costs of benefits and administration.

This arrangement has remained largely unaltered over the years, but it is nonsense to suggest, as some Labourites and others were doing then, that the scheme would abolish poverty. Prime Minister Attlee claimed in a Commons speech (February 7, 1946) that “the Bill would help to maintain the high standard of purchasing power among the masses of the people.” But just take a look at some of the benefit rates then, and see if you agree with him: — 

Unemployment or sickness               26/-per week (£2 married couple)

Pension  . . .   . . .                             26/-per week (£2 married couple)

100 per cent Disability Pay                45/-per week 

Nat. Assistance (ordinary) . . .            50/-per week

    for man and wife (begun 1948)      65/- per week

Incidentally, an interesting and pertinent comment is made on the scheme by M. Penelope Hall in her book The Social Services of Modern England. She says:

One drastic modification in the Beveridge Plan was made at the start. Benefits have never been paid at subsistence level. Beveridge regarded this modification to his scheme as disastrous. 

In the 20 years since 1946, government cost estimates have been sadly put out by continuously rising prices and increases in the cost of living, so that various amending Acts have had to be passed, stepping up the benefits and the contribution rates. By 1959, for example, unemployment, sickness and pension rates all stood at 50/- per week single, while National Assistance was at 76/- (normal) and 96/- (special) for a man and wife. This was the year, you may recall, that the Tories were pointing with pride to their achievements in this field, ignoring such uncomfortable facts as 1¾ million people having to apply for National Assistance—about 1.4 millions of them old age pensioners.

But even the Conservatives, jubilant at their 1959 election victory, could not pretend that provisions were adequate, even by the miserable standards that capitalist politicians set, and not long after that their graduated pensions scheme was introduced, which meant larger contributions from those earning over £9 a week, to secure proportional payment in addition to a flat-rate pension. Under such an arrangement, you would get an extra sixpence a week added to your flat-rate pension for every £7 10s. paid in, and when you consider the piffling extent of these changes, you might wonder what all the song and dance was about. Certainly there was nothing from the workers’ point of view, although from the Government’s angle the new scheme gave the pension system some flexibility, and so no doubt was intended to keep down the extra cost.

The whole question of National Insurance was tossed about by the main parties at the 1964 election, and it was becoming apparent anyway that an overhaul was due in the system of payments and contributions. For example, while there was not the heavy and persistent unemployment of the twenties and thirties, there was the question of “labour mobility” and the tiding over of unemployed workers when retraining for new jobs, following the decline of some of the older industries. So the Labour Government’s measures now include compulsory compensation payments to any worker made redundant after a minimum of two years at the same job.

In the government’s social security arrangements, it is interesting that they have retained essentially unchanged the graduated pension scheme of which they had been so scornful when the Tories introduced it. In addition, there is the “Earnings-Related Short-Term Benefits Scheme” which just means that there will be a flat-rate sickness and unemployment benefit of £4 a week minimum, plus further payments, depending on your average weekly earnings between £9 and £30 a week. Here again we see the pressure of present-day conditions in the government’s attempts to offload at least some of the burden of the rising cost of benefits from the central Exchequer. Quite clearly also, the 1946 scales and payment methods no longer suffice to keep workers ticking over in sickness or between jobs, and once more the modern emphasis is on “flexibility”. It could be that this is something we shall see more of in the future, what with the growth of new industries and the decline of the old, to say nothing of plain old-fashioned unemployment because of trade crises.

And what other changes have there been recently? Oh yes, the old Ministry of Pensions and Njational Insurance has been replaced by the brand new “Ministry of Social Security” (surely a contradiction in terms) with responsibility for all the schemes which were formerly administered separately, such as National Assistance. These particular payments will be known as “supplementary benefits” and are a fitting reminder of the way in which reformers' plans can misfire. In 1953, Lord Beveridge admitted that he and the experts had originally expected National Assistance payments to be on a small scale only and to gradually diminish. But, in fact, the very opposite has' happened, and the government has resigned itself to the fact by allowing for increased rates of benefit when the new arrangements start in the autumn.

What all these measures add up to is merely the organisation of 1966 poverty by 1966 methods, and the usual attempts to maintain the workforce at the appropriate standards of health and efficiency to keep capitalism’s production and profits going. It has been the irritating habit of Labourites to claim that these Acts bring dignity to workers’ lives, but their very existence is an indication of the essential indignity of working class life. And despite the increasing intricacy of state insurance and widening of its scope, there are many who stay stubbornly poor even by “Supplementary Benefits” standards. Like the 15,000 families admitted by Assistance Board Chairman Lord Runcorn to be “living on assistance at the moment, at an income well below their needs, because allowances are based on the best estimate that can be made of a man’s future earnings.” Or like “those whose take-home pay is less than they need by assistance standards, although in full employment.”

Eddie Critchfield

The Health Services (1966)

From the November 1966 issue of the Socialist Standard

The school medical service was the first national health scheme to be established in Britain. In the earliest days of compulsory education a constant source of anxiety for the capitalist state was the suspicion that it was wasting money on many of the underfed and underclad children in its elementary schools, simply because their physical condition prevented them from really applying themselves to their books. But what finally shook the reformers into action were the press reports of widespread physical defects found in the young workers recruited into the army at the time of the Boer War. It was feared that the bulk of Britain’s. “C3 population” was not even fit enough to die defending the imperialist interests of the ruling class. Hence in 1904 the Inter-departmental Committee on Physical Deterioration emphasised the need for a system of medical inspection of school children. This led to the Education (Administrative Provisions) Act, 1907. It is, of course, no coincidence that the other principal improvements to the school medical service are linked with the First and Second World Wars. The drafting of hundreds of thousands of working men and women on both these occasions again showed to what extent social conditions had undermined health. It is against this background that the Education Acts of 1921 and 1944 can be understood. These made it a duty for all education authorities to provide routine health inspections to be conducted on school premises.

However, the Education Act of 1944 was largely overshadowed by the discussion which raged around the Beveridge Plan and eventually materialised as the National Health Service Act, 1946. If ever there was a case of a government feeling it could simply plan away the problems of ill-health arising from the capitalist system, this was it. What was envisaged was a unified scheme available for the whole population, except for those who had the money and inclination to pay for private treatment. As can be seen from the diagram following, in theory every form of illness was adequately covered.

Under the Act the vast majority of hospitals were transferred to the Minister of Health (i.e. formal ownership of the State) on July 5, 1948. The Minister was charged with the responsibility for providing adequate hospital accommodation together with the required medical, nursing and other facilities—including the services of specialists. Eighteen years later accommodation, in terms of the number of hospitals and the number of beds, still remains inadequate. As one government publication put it: “Scarcity of capital resources seriously limited hospital building in the early years of the service.” But, it proudly goes on, “. . . the annual expenditure on hospital building rose from £12.5 million in 1956-57 . . . to an estimated £54.6 million in 1963-64 . . .” To put such figures in perspective they must be measured against the “defence” expenditure for comparable years (£1,483 million in 1957-58 and £1,837 million in 1965-66—see the Socialist Standard, August, 1966).

But the problem is not just one of too few beds, even though the Guardian mentioned on June 9, 1966, that there are now about 10,000 patients waiting to enter a hospital. Low wages have resulted in a chronic shortage of nurses and doctors. Earlier this year the general secretary of the Confederation of Health Service Employees reported to his union that 13 per cent of the beds in the hospital service could not be used anyway at present—because of the lack of staff. Most doctors are continually overworked and reports of individuals putting in well over 100 hours a week are commonplace. However, despite all the statistics that could be quoted, perhaps the best appraisal of the hospital service can be made by referring to the comment of a Manchester consultant, reported in the Daily Mail, August 22, 1966:

“When I was doing my house training I’d do a stitching job in casualty after being up all night, and I’d know it wasn’t my best work.

"Today I should hate to be knocked down and become a patient. The odds are I’d get a young doctor who had been on duty for 48 hours. How could 1 expect his best work?”

Unless you can afford the fees of a private surgeon or those of the London Clinic, this is what the hospital service means for you.

The general medical and dental services are under the supervision of the local executive councils. There is one of these to each county and county borough and it is their function to organise the doctors, dentists, pharmacists and opticians in their areas so that a comprehensive medical service exists. Supplementing these are the local health authorities who are responsible for the ambulance and midwife services as well as employing health visitors, home nurses and so on. The fact is that everywhere in this supposedly “comprehensive medical service” there are gaps and inadequacies resulting from lack of staff and facilities. A few details should make this clear.

Ten years ago the report of a working party on health visitors (Min. of Health—1956) suggested that a total force of 11,500 would be required “for the Health Visitor to effectively discharge all the duties required of her.” Years later, when this estimate is outdated anyway, there are still only the equivalent of 8,000 whole-time health visitors employed in Great Britain. Similarly, there is still throughout the country an unsatisfied demand for home helps—especially among old people. At present the average for England and Wales is that for every 10,000 people only 68 are receiving some form of assistance in this way. Section 25 of the National Health Service Act places on local health authorities the duty of providing home nursing for invalids who require such attention. As one writer euphemistically put it: "The limiting factor for some time to come will probably be the number of nurses available.” (The New Public Health —F. Grundy, London, 1965). Again, under Section 21 of the same Act, the local health authorities were ordered to equip and maintain health centres in their areas. “(This) duty on local health authorities has not been enforced, largely because of the restrictions until recent years on capital investment in health and welfare projects . . . By the end of 1963 only 18 health centres had been opened . . .” (Health Services in Britain, HMSO, 1964).

One service not mentioned so far is that of health inspection. Every council, other than county councils, is required to appoint one or more public health inspectors who supervise slum clearance, inspect houses and factories, check food supplies and so on. In the same year that the National Health Service Act was passed, a report of the Central Housing Advisory Committee outlined a 16-point standard for a “satisfactory” dwelling. It should be stressed that these were minimum requirements and merely included such stipulations as that the house should be dry, equipped with a proper drainage system and have adequate heating facilities for each room. It was pointed out back in 1946 that it was not then practicable to put this standard on a statutory basis and immediately have the public health inspectors enforce it. Twenty years later this is still the case. Millions of workers continue to live in damp, insanitary, squalid buildings which the authorities label with the bureaucratic understatement of “unsatisfactory”.

The health services, just as much as the mines and factories, are organised and run by members of the working class. There can be no doubt that many of the overworked doctors and underpaid nurses stick at their jobs simply because of their conviction that they are doing worthwhile work. But, like all workers under capitalism, they find that their efforts are hemmed in and frustrated by a social system where health comes very low down on the list of priorities.

John Crump

Finance and Industry: Who goes bust? (1966)

The Finance and Industry Column from the November 1966 issue of the Socialist Standard

Who goes bust?

Many workers refuse to accept the hard fact that they have been condemned for life to work for a wage or salary for those who own the means of wealth production. Spurred on by stories of how ordinary workers have risen to be wealthy capitalists, they imagine that they, too, can do this. Such people long for their own shop or snack-bar or garage to escape from wage-slavery, Unfortunately for them they often find they have to work harder for themselves (or their creditors) than they had to when working for wages. For some it’s even worse—they go under and are cast back into the working class, less their savings.

The latest annual report of the Board of Trade on bankruptcy gives as the top lines among the 3,404 who went bust in 1965:

The list continues with hardware and electrical goods retailers, confectioners, tobacconists and newsagents, meat retailers, plumbers, fruit and vegetable retailers, general stores, electrical contractors, commercial travellers and so on. In other words the small shopkeepers and businessmen that workers often wish to be.

Next time you hear the story about how good capitalism must be because so-and-so rose to be a capitalist, remember the other side of the story: for every one who succeeds hundreds fail completely and thousands more are condemned to a life of drudgery and worry not unlike the rest of us. Besides capitalism can’t work without a working class, which means that most of us don't even get a chance of becoming a petty capitalist.

World Capitalism

Socialism can only be world-wide because capitalism, the system it will replace, is already so. Modern industry has a world-wide character which ignores frontiers. But although millions co-operate to produce wealth this wealth does not belong to society as a whole; it belongs to just a part of society. Today wealth is produced socially but owned privately. This is the basic contradiction of capitalism. Private ownership of the means of wealth production in fact conflicts with modern technology. One aspect of this is the division of the world into competing, and often warring, states.

Many people don’t realise that the typical firm today is not the small builder or motor repair man mentioned in the previous section. Production, in many lines, is dominated by a few giant, international firms such as Shell, ICI, Unilever and Philips. Sir Paul Chambers, head of ICI, made an interesting speech at the International Management Congress in Rotterdam on September 20. He doubted whether the creation of a Western European economic bloc could be more than a short-term solution to the problems created by the vast size and international character of some modern industries. Modern technology, he said, could be a source of “strife" if its international character were not taken into account. Chambers went on:

I have pointed to the aircraft industry and the inevitability of the growing integration of aircraft firms on an international basis. Almost every emergent country wants its own airline, but it has to rely upon the major makers—mainly British and American—for its needs. A similar trend can be seen in computers and in photographic materials and equipment. In car manufacture the integration of firms is beginning to take on a similar international character. The complete sovereign independence of small states is becoming inconsistent with the growing economic dependence upon large international industrial groups domiciled elsewhere. (Financial Times Sept. 21, 1966).

Men like Sir Paul Chambers do not think in national terms. They know that capitalism is international and act on it. The workers, those who run these industries from top to bottom , in all countries, might well learn from this.

The right to be lazy

Are you tired even before you start work? Do you dislike having to work hard for eight or more hours a day?

Peter Lennon, in the Guardian of September 22, wrote up some of the views put forward on these and other questions at a recent international conference on psychosomatic medicine in Paris:

Many citizens manage to reach a condition of distressed exhaustion before doing anything at all. They wake up tired, grouse through the day, and at night mourn departed sleep. A scrabble and tangle of humanity, they stew in bad air and petty psychological turmoil, buffeted by noise and needled by a multiplicity of unrewarding duties. In eternal competition with shadowy colleagues and goaded by social obligations beyond their capabilities they experience a feeling of impotence and inadaptability. Neurotic fatigue is the result.

Professor Chombart de Lauwe claims that fatigue, other than muscular fatigue, has its origins in the discrepancy between our means and our needs: between aspirations and social pressures—the eternal discrepancy between a possible life and the life we are forced to live.

At least one concrete conclusion to rejoice the civilised emerged from the conference: laziness, far from being the shameful attribute of the social renegade is the man of sensibility’s criticism of an unnatural activity: hard work. It is also his defence against a barbaric way of life.

A hard look at the conclusions of these eminent specialists leaves us with these convictions: the prestige attached to daily strenuous toil is a myth and a shabby modern one, and it is seriously probable that, in spite of generations of domesticity, intense, sustained daily work is incompatible with the realities of human physiology.

Lennon writes in an amusing way. But, when you come to think of it, it is a serious matter that most of us should be condemned to a lifetime of boring, toil. The least we should do is ask: Does this have to be?

Work, of course, is necessary in any human society. But it does not have to take the form of “intensive, sustained daily work”. If such boring, unsatisfying toil is “incompatible with the realities of human physiology” (as most of us must suspect anyway) then socialist society can abolish it. Indeed it should abolish it. Work itself cannot be abolished. However it is up to the defenders of capitalism to show that wealth can only be produced by people, working under unhealthy conditions, doing jobs they find dull and uninteresting.

Adam Buick

The Passing Show: A sad, sad story (1966)

The Passing Show Column from the November 1966 issue of the Socialist Standard

A sad, sad story

A week or two ago a four-page leaflet fell out of a laundry parcel. I read it later the same day in snatches, between mouthfuls of food at lunch time. It was a lament — in black, white and brown printing—by a group of launderers and dry cleaners, over the new taxes and other hardships they are having to bear under the present government. Did you know, for example, that the Selective Employment Tax will add another £7 million a year to the launderers' labour costs?

But the amusing note is struck in a paragraph on the prices “standstill”. The launderers have found a loophole (one of many) which allows them ‘‘some latitude" because their costs are affected by government action. "So you can see," they wail, ‘‘that our dilemma lies in balancing co-operation against financial suicide." A neat turn of phrase, coined to sugar the pill, because the local laundry has now slapped on a surcharge of a penny in the shilling.

Can you imagine yourself approaching your employer right now for a wage increase, and using the same sort of talk? Try moaning to him about balancing this against that, and see how far you get. He'll probably look at you as if you’ve gone mad, murmur something about the pay freeze, and bring the interview very effectively to a close. No good telling him you’re going to make a surcharge. He just won’t pay it to you. and that’s that. Your position is radically different from that of the launderers or any other capitalists. You have only your labour power to sell, and the government is determined that you are not going to get a pay rise for at least six months, but as far as price control in general is concerned the whole thing is just a very bad joke.

We have dealt with this situation elsewhere, so perhaps just one last thought is all that is necessary here. Were you one of those simple folk who believed what this and other governments have told you about being much better off if only you’d curb your wage demands? By that logic, then, you should be a lot better off by next spring. Perhaps you don’t believe it any more? No, and neither does the government.

Korea—some of the story

General MacArthur was sacked from his command because, among other things, he was pressing for the Korean war to be carried into China and for atom bombs to be used there. There was a sigh of relief from left-wingers when he went, and perhaps a murmur or two of applause for President Truman’s action.

Not long after that, Eisenhower became U.S. President and from his recent television talk (September 18) it seems that pressures to extend the “police action” did not all originate from MacArthur. In fact Eisenhower wielded the atom bomb as a strong diplomatic weapon in his armistice talks with the North Koreans and let them and the Chinese know that America was ready to use it if negotiations were protracted much longer.

It is only now, when the truth begins to trickle out in very small quantities, that people can begin to guess how perilously close to the brink of another big shooting war the capitalist world was drifting in the early .1950s. War is not fought to Queensbury rules; practically anything goes if one side or the other thinks it can get away with it. And nuclear weapons must have been a sore temptation to the U.S. authorities, whatever President Truman may have thought. 

The television interview was in the first of a series of programmes called The Struggle For Peace—surely a gigantic misnomer. Accordingly Eisenhower, the American forces alone sustained 135,000 casualties. Some “police action”; some “peace”.

The naked truth

You can be alternately bored and amused for an hour or two if you go and see one of the rather corny nudist films on in London's West End just now. 1 saw one called World Without Shame, and its plot, if such it can be called, is heavily laden with the delightfully naive message that if only we’d all take our clothes off, spend most of the day sunning ourselves and generally “get back to nature,” the problems of the world would be solved.

The story starts with a young man winning about £26,000 on the pools. He and his wife chuck up their jobs in London and go to live with a few chosen friends on a quiet Mediterranean island. “We’ll get away for good from the rat race. We’ll be completely self-supporting,” enthuses our young man, fingering the pools cheque in his pocket. So off they go. There is even the political hint in another of his reasons when he talks of “some maniac pressing the H Bomb button and blowing us all to hell.” Someone ought to have reminded the producers that the Mediterranean would hardly go unscathed in such an event.

Never mind. They settle on the island in their birthday suits, dividing their time between sleeping, eating, some work and a great deal of sunbathing. The sun always shines—someone seems to have forgotten that the weather can often be cold and wet even in those parts—and presumably we are to believe they all live happily ever after. The scenery is .beautiful, the direction and acting embarrassingly poor (you often find yourself laughing in the wrong places), and the pathetic naivete of the whole proposition glaringly apparent.

We have never thought much of the idea that you can buy yourself out of the rat race, although a few thousand pounds can of course make things a lot easier for you. But the effects of the scramble are all around you, and the notion of an oasis of self-sufficiency in a desert of capitalism is a non-starter. Even the film has to concede this in part when one of the characters, a painter, runs out of canvas, and gets fresh supplies by sailing to the mainland and selling some of his pictures.

Gaspers

“The new strategy demands a great increase in fertilizer production, which can only be achieved if foreign capital can be induced to invest heavily and quickly." (The Times correspondent on Indian food production, 19.9.66).

Dr. Seretse Khama, who was exiled from his homeland by the last Labour government after his marriage to a white woman, was yesterday created a Knight Commander of the British Empire.” (Guardian, 21.9.66).

“This is our socialism: assertion of social responsibility for our economic welfare and for the welfare of the individual family." (Harold Wilson Purpose in Power, quoted in Nova magazine interview, Sept., 1966).

“The Prime Minister, I understand, has no intention of involving himself in doctrinal arguments about the true meaning of socialism which he believes has done enough harm to the party already. (Nora Beloff in The Observer, 2.10.66).

“Sir Isaac Wolfson reports that because of the freeze, dividends which could have been 36½ per cent will be held at 32½ per cent, the same as last year.” (Daily Express, 11.10.66).

There is nothing in Mr. Wilson’s present policy which a Tory Prime Minister, faced by a comparable crisis, would necessarily reject. (Peregrine Worsthorne—Conservatism Today).

Eddie Critchfield

Party News (1966)

Party News from the November 1966 issue of the Socialist Standard

Socialism V the Rest

About 40 people attended a lively meeting at our Head Office on September 19. The meeting, to which our political opponents were invited, was part of our Seven Days for Socialism campaign. On the platform were George Kiloh, national chairman of the Young Liberals, Chris Parkinson, Tory councillor for Streatham South, and our comrade Baldwin. The Labour Party speaker failed to attend and the Communist Party, which had also been invited, did not send anybody.

The meeting opened with each speaker briefly outlining his party's case. Comrade Baldwin explained that all his opponents (including the absent Labourite) were “tarred with the same brush” because they all stood for capitalism. Only the Socialist Party stood for Socialism. Councillor Parkinson admitted that his party was an avowedly capitalist party but declared that Tory policy was to move everyone up the social ladder by a general improvement in living standards The Young Liberal declared that capitalism was “unjust and immoral” and that Socialism was state capitalism. He went on, however, to outline YL plans, such as “joint-management” and “worker’ control in the nationalised concerns,” which, he claimed, would be a first step in producing industrial efficiency.

Southend

Southend Group maintained vigorous and lively activity through the summer with regular group meetings and canvassing. Members of London and Mid-Herts branches helped to run outdoor meetings on the seafront from time to time. It is intended to make these meetings weekly next year.

Sales of the Socialist Standard locally, through canvassing, have been good — 22 dozen of the August issue were sold. Further canvassing and other literature sales are planned for the autumn. Sympathisers should get on our mailing lists for details of indoor meetings and the like. Details from Secretary, Southend Group (write or call), 19 Kingswood Chase, Leigh-on-Sea.

Brighton

A brief report on the work of the Literature Sales Committee’s work at the Labour Party Conference. Five members covered the conference throughout the week. Three hundred and seventy-eight copies of the October Socialise Standard were sold, in addition to pamphlets. An excellent effort. It is hoped that even more comrades will be available for such sales in future, as the more sellers, the more sales.

Black Muslims

On September 7 Michael X, a leader of the Black Muslims in Britain, spoke “In Favour of the Separation of the Races” at our Paddington branch. He claimed that “the black man’s greatest problem was the white man”. White men had shipped black men to the West Indies; they had deprived them of their names, their language, their religion and their culture. Christianity was a slave religion. That was why people like him returned to Islam, the religion of their forefathers. He was president of an organisation that admitted no whites. This was because if they did the whites would help the organisation to death; the “white liberals” would do all the work so that black people would never learn to act for themselves. Black people from the West Indies were basically agricultural; they were unused to the disciplines of industrial society. They had to learn these “to catch up with the whites". But they could only do this, Michael X said, through “separate development”; by keeping away from, and not trusting, white people and by learning on their own.

In discussion it was pointed out that Socialists did not see themselves as white people or black people or as British or any other nationality, they knew they were members of a world-wide working class without any country. They knew that the only solutions to our troubles as workers was, whatever our skin pigmentation or what not, through the establishment of a world Socialist community. Members of the Socialist Party of Great Britain had come from all kinds of religious backgrounds—Christian, Jewish, even Muslim, had seen through all this mumbo-jumbo. When the Black Muslims had "caught up", what then? They would only be ordinary wage slaves like the rest of us. Was this all they wanted? 

In reply Michael X said that Socialism was a "white man's theory".

New pamphlet on Racism (1966)

Party News from the November 1966 issue of the Socialist Standard

A new Socialist Party pamphlet, entitled The Problem of Racism, is available. The previous pamphlet on this subject, The Racial Problem, published in 1947 has been out of print for some time. The Problem of Racism is not just a revision; it is a completely new pamphlet. In 1947 it was the Jewish Question that was prominent. Today it is the Colour Question. This change is taken into account in the new pamphlet which examines the colour question in Britain, America, South Africa and Rhodesia. There are chapters too on the scientific theory of race, the historical origins of racist theories and on African nationalism.

There is one unfortunate error. The reference on page 41 to Guyana should, of course, be to Guinea.

Pamphlet obtainable from Socialist Party, (Dept. SR), 52 Clapham High St, London. SW4. Price 1/6.

50 Years Ago: The War Office and the Socialist Standard (1966)

The 50 Years Ago column from the November 1966 issue of the Socialist Standard

When those in authority over us determined that no newspaper or books should be sent out of the country without the permission of the War Office, we made application to mail this journal to the Colonies and neutral countries. We have now been favoured with a reply the tenor of which b that the War Office has been compelled to stop our organ on some occasions in the past for the reason that a portion of its contents might be used by the enemy powers for “their propaganda". And we are further informed that, in consequence of this, instructions have been issued to stop in future all copies of the Socialist Standard addressed to places outside the United Kingdom.

Nothing that we publish can be used by our masters' enemies without being stripped from its context, for the simple reason that our criticism applies with just as much force to the German and Austrian capitalists as to British.  Our internationalism is so real a thing that we refuse to set national bounds even to our enemies. Not British capitalists or German capitalists are the foe, but capitalism and the capitalist class of the world.

[From the Socialist Standard, November, 1916].

SPGB Meetings (1966)

Party News from the November 1966 issue of the Socialist Standard

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