SPGB Snippets: Unhealthy Living (2026)

From the Socialist Party of Great Britain website

March 11, 2026

The ONS recently reported that there had been small increases in life expectancy in the UK since the 2019–21 period. However, it also revealed that in 2022–24 there had been decreases in healthy life expectancy (HLE) since the previous period.

HLE is the number of years that people can expect to spend in ‘good’ general health. In the more recent period, HLE at birth was 60.7 years for males and 60.9 years for females. The reductions here are 1.8 and 2.5 years, respectively.

So the chances are that at least a fifth of a person’s life will not be spent in decent health, a situation which is deteriorating. That’s life and health under capitalism!

New Zealand letter (1965)

Letter to the Editors from the March 1965 issue of the Socialist Standard

I recently read a press report on the new BMA booklet Doctors’ Orders.

We in New Zealand have been getting this sort of thing thrown at us for about two or three years. The BMA are only handing these books out in order to get the workers to keep themselves fit for more intensive exploitation.

Think how the military authorities must groan in despair at the number of men who are not in fighting condition at commencement of training! The expense involved in bringing them up to a peak of fitness required for cannon fodder!

The BMA’s little booklet should enable the workers to do their own P.T. at less cost to the master class. Our experience in Australasia has been that as soon as the masters knew they had a good reserve of healthy labour, they increased the pressure on the workers.

Also there has been a coincidental rise in drug trafficking, and, even in Australia, the discovery of several acres of narcotics growing wild on the banks of a big river.

I notice in the BMA’s booklet that people who have to stand up at work are advised to take a few paces every few minutes. The medical reason for this is quite sound, but the trouble is that so many people are unable to put it into effect because of the very nature of their work. Also, where workers do make the effort, other workers who are more fortunately placed, and have healthier jobs, spare nothing in their efforts to ridicule them.

The object, of course, is to get the other bloke to quit or to “keep him down”. This is often encouraged in New Zealand by foremen who find it a convenient way of dealing with workers who “know too much” and are a threat to their own job security.

If you go to a “vocational guidance expert” and tell him your troubles (that you cannot adjust to this sort of thing) he will have the unconscionable gall to tell you that it is in your own attitude to society and life that the trouble lies, and that where there is “competition” of this sort you must simply learn to fight against it and “stick up for yourself.”

This, incidentally, is a favourite one with our psychiatrists, prison psychologists and Bible-bangers at the present time. In the meantime, those worthies are enjoying the best of privileges handed out to them by a grateful capitalist class who find it very convenient to have a large number of trained sophisticates taking care the workers do not get out of hand.

In spite of all the perennial rot they say about us having free speech, if a worker really gets up and has a go at them he is going to get slapped down pretty hard.

Only the Communists can get away with this “free speaking”; they are adept at saying nothing in several sentences and are in any case supporting the system.

I have not yet read the BMA’s little book and I am not especially anxious to do so. When I hear that they have written a book describing the social conditions which give rise to, and help perpetuate, the majority of mental and bodily disorders, and suggesting the means whereby those conditions can be eradicated, then I will be eager to get my copy.

E.W.H., 

Christchurch, NZ.

Blogger's Note:

I'll go out on a limb and say that 'E.W.H.' was Ernie Higdon.

Medical economics (1947)

From the December 1947 issue of the Socialist Standard

The religious racket has, been exploded by Socialists since the days of Marx; but the more scientific racket, the medical “business” has received little attention, in spite of the fact that it is now generally recognised as the strongest and most militant trade (or professional) union in the country.

Millions of pounds are daily spent on therapeutics (curing disease) but scarcely anything is spent in comparison on prophylactics (preventing disease), for the simple economic reason that it is far more profitable to pursue, therapeutics. If too much attention was devoted to prophylactics it might render therapeutics redundant by “killing the goose that laid the golden eggs.” Doctors and hospitals must have sick people, and millions of them, or go out of business.

The workings of the medical profession provide a wonderful example of the economic factor in determining events and culture. Perhaps in this respect it is even more clearly demonstrable than in the case of the spiritual counterpart in religion. In this country there are more doctors and hospitals per head of population than in most countries, and strange to say, there is also a vast and increasing number of sick or ailing people. The same is the case with dentists; in spite of the fact that they are to be seen everywhere, and in spite of the widespread use of the tooth brush and dentifrice, the state of the teeth of the average English person is appalling, when compared to those of many primitive tribes who have no dentists, no tooth brushes and no dentifrice. In fact it would appear superficially that the more dentists, and care of the teeth, the worse is the final result.

Strange to relate with all the efforts of the medical profession and all their scientific research, Cancer, Diabetes, Heart Disease, Nephritis, Rheumatism. Nervous Diseases, Occupational Neurosis, and a host of other complaints, continue to increase yearly, which clearly indicates that something is radically wrong somewhere.

Capitalism regulates, the channel in which medical money goes, and stipulates broadly how it shall be spent; “for the hand that pays the piper, calls the tune.” Surgeons who can get, (or extract from the patient), 100 guineas for a certain operation, are always lurking for possible clients ; and why not, for their success depends very largely upon how many they find. Would anybody pay a surgeon for saving them from an operation? They certainly would not be prepared to pay the same fees.

Drug manufacturers, and patent medicine vendors, make enormous profits on certain chemical preparations, and do not fail to take full advantage of the power of advertising through the medium of those who handle and prescribe the drugs. Only too often quite worthless and harmful drugs are applauded as having health-giving properties, and statements made about them which could never be justified.

The late Lord Trent (formerly Sir Jesse Boot), owner and controller of about 1,000 chemists shops which hears his name, was bed ridden with Rheumatism, and had to be wheeled about in a bath-chair for many years of his life before he died, whilst his shops sold dozens of different chemical preparations for alleviating rheumatism.

A lady who is quite a public figure, owns or used to own, a once much advertised slimming product, and yet she herself regularly tipped the scales at 18 stone. Just imagine this 18 stone of beautiful womanhood ; what about a shovelful of her own slimming mixture for breakfast? But business is business, especially in anything connected with medicine and health, so why worry?

Today certain drugs are making fortunes for the companies behind the medical profession. Just think of the amount of advertising the B.B.C. gives to Penicillin, Streptomycin and Pheno-barbitone. Almost every day the B.B.C. has to announce that some doctor has carelessly mislaid quantities of the latter, thus giving further free advertising to these drugs, incidentally, who says the B.B.C. don’t advertise?

Blood squirting (hypodermic injections of serum), is popular today because apart from their simplicity, and certain medical reasons, these, practises, are enormously profitable, both to doctors and the companies responsible for the serum preparation. An old horse, of little use for its traction power, might fetch about £10 in the cats’ meat market (although horse flesh has many other uses than for cats’ meat). If the horse is deliberately given a dose of a disease resembling smallpox or diphtheria, it can be made capable of producing many times its cats’ meat value by producing suitable serum, at wholesale prices.

The enormous amount of injections done during the war on soldiers—where the men lined up before the doctor who did one after the other just like shelling peas, till the needle got blunt and was thrown away— was not done for nothing, nor even without profit. Manufacturing chemists were reaping thousands out of it.

Medical research under capitalism has got itself into an absurd scientific entanglement. Shaw’s “Doctor’s Dilemma,” and Cronin’s “Citadel,” only touch on aspects of this contradictory muddle. After millions of pounds had been spent on Cancer research (and the figures for cancer mortality steadily rising), the medical profession were instrumental in causing the government to pass the Cancer Laws of 1939, to prevent anybody except a qualified medical man from treating cancer. It would appear that the large amount of criticism they were receiving at this, time had to be silenced, and freedom of action as well as freedom of criticism was debarred to the public.

It is not always those who have the biggest purses who receive the best treatment. Sometimes the more money you have the more operations and specialists’ fees, and subsequently a quicker route to the grave. This was the trouble with the one-time world famous film idol, Rudolph Valentino, who wasted his money on medical attention to no purpose. Doctors are specialists in the art of knowing how to bleed (financially) those who have too much (pecuniary) blood. Kings and presidents, Lords and business magnates have to watch their step where doctors are concerned, as do also the working class. Even Karl Marx was helped to an untimely grave before his life work was completed through advertised chemical dope. Engels observed when Marx was obviously dying, that his body was literally full of patent medicines.

It is regrettable that so many workers have little real interest in health matters, and consequently become such easy victims to medical frauds, and tyranny. Doctors thrive through the advertisements for medicines, cigarettes, alcoholic drinks, doped foods and the health-destroying habits that follow their use. Why should the medical profession endeavour to educate the workers on these topics, and lose them as potential clients as a result? Is there any wonder why the doctors and specialists confine their nomenclature to technical terms derived mostly from the. Latin: or Greek, and pharmaceutical abbreviations that few can understand. It is not easy either to climb into the profession nor to understand its workings; those in it see to that.

“It’s your blood they’re after.” The recent blood transfusion campaign, coming at a time when it is extremely difficult to obtain blood-making foods of the right nature, quality and quantity, is enough to make us sit back and do some thinking. Every day appeals are made on the radio that blood donors are urgently needed, and thousands have responded, to what they consider a humane cause.

At one time in capitalism’s youth, we were told that disease was due to too much blood. When the public were convinced of this doctrine a new line of business was established in removing this surplus. The barber-surgeons were brought into existence for the purpose of taking a pint of blood from all comers who were sick (plus of course a fee for services rendered). The fact that many people treated by these methods were suffering from anaemia and afterwards died, and many others through lack of antiseptic precautions became infected and succumbed, did not worry the barber-surgeons much. Today we can get our blood taken for nothing, and by the latest scientific methods. Tomorrow we might be paid for giving it, but that all depends on how many “blood blacklegs” there are, and also the degree of health consciousness of the masses. No longer is the theory held, “let us take some of your surplus blood and you will get health,” but rather, “let us give you some more blood and you will gain health, or have your life saved.” A curious biological reverse !

Of course there are thousands of street and industrial accidents today that need immediate supplies of blood. But this is not the whole story, there are also many hospital accidents, for modern surgeons, with the aid of anti-septic surgery and anaesthetics, regularly take risks that but a few decades ago they could, or would, never have taken. There is more surgery today than ever before, and there is going to be more tomorrow, especially if a third world war occurs. Consequently a blood donor campaign becomes necessary to capitalist society. Surgery is a very profitable department of science and those that are in it intend that it shall remain so. These strange changes in doctrine become practical politics to the high priests of the medical profession.

Capitalism has long ago converted the cow into a milk producing machine, and the hen into an egg producing apparatus; it now seeks to convert the worker into a blood producing factory, and this has got to be done on a restricted diet.

Horace Jarvis

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

Knock-out drops (1988)

From the October 1988 issue of the Socialist Standard

Nearly two million people in Britain are addicted to drugs prescribed for them by their doctors. But. unlike the 80,000 heroin addicts who are mostly young and male, most tranquilliser addicts are women and predominantly elderly. Pain, misery, addiction or even death have frequently been associated with legitimately prescribed drugs. In the United States 130,000 deaths occur each year from drugs prescribed by medical practitioners; in Britain nearly one in thirty hospital admissions are due to prescribed drugs and about 2,500 people each year approach the charity Action for Victims of Medical Accidents for help.

With hindsight, some of the mistakes with addictive drugs seem incredible; when heroine was extracted from morphine in 1874 it was hailed as the new "miracle drug" for the safe treatment of morphine and opium addiction because it was considered safe and non-addictive. And it was to take over fifty years before the Rolleston Report identified heroin addiction in 1926. More recently, methadone was used extensively between 1971-1978 to treat morphine addiction and as an analgaesic substitute for morphine but, being itself highly addictive, led to a further spread of addiction.

Psychotropic drugs, prescribed for anxiety and depression, alter the patient's moods or mental processes. These drugs are much more likely to be prescribed for women; and extensive study in Oxfordshire found that psychotropic drugs accounted for one-fifth of all prescriptions and that women received more than twice as many tranquillisers and anti-depressant drugs as men. (Skegg et al British Medical Journal, 1977). The frequency of tranquilliser prescriptions increases with age; women over 75 years of age receive more of these than any other group.

In part, the larger quantities of mood altering drugs prescribed for elderly women can be attributed to the higher incidence of dementia in old age and the fact that most of the more common causes of dementia affect women more than men. But the excessive numbers of prescriptions for tranquillisers are not entirely justified on medical grounds alone. In recent years the closure of substantial numbers of hospital beds has led to increasing numbers of mentally and physically infirm elderly people being "cared for" in the community.

Providing safe care for mentally infirm old people in their own homes causes considerable problems for relatives. All too often tranquillisers have to be used to control the old person's behaviour and. even if the drugs are not addictive, the quality of life for the person is impaired. Caring for a demented person in a family home can prove to be a nightmare. Family life disintegrates due to disturbed nights, incontinence, noisy, aggressive behaviour and the need for somebody to be in attendance at all times. For such families there is no respite: holidays and nights out cannot be taken together and friends are deterred from visiting.

For middle aged women, in particular, caring for an elderly mother causes considerable anxiety because the traditional caring role is reversed and the awareness of the possibility of helplessness and insecurity for themselves in the future becomes all to evident. In such situations the temptation to resort to the use (and often the abuse) of tranquillisers is difficult to resist. Indeed, members of the family providing care may take tranquillisers themselves to cope with the difficult social circumstances forced on them by the lack of provision for care of the elderly. But for both the dependent elderly and their, mainly, female carers, tranquillisers are used as substitutes for social remedies which are not forthcoming under capitalism because workers are viewed as economic units.

The Royal Commission on Population put into perspective the disadvantageous position of the elderly under capitalism:

The burden of maintaining the old does not consist in the money paid out as Old Age Pensions. It consists in the excess of the consumption by the old over their production. It is the fact that (with some exceptions) the old consume without producing which differentiates them from the active population which makes them a factor reducing the average standard of living in the community, (pi 13)

This view of the elderly as redundant economic units has led to inferior standards of accommodation in the majority of hospitals for the long-stay elderly and the mentally ill.

The difficulty of attracting staff-in adequate numbers to work in poor conditions and inadequate facilities can lead to over-reliance on tranquillisers to control the patients as too few staff try to cope with relentlessly increasing numbers of admissions in the drive to make hospitals more "efficient" regardless of the social costs. And in private hospitals and nursing homes there is a greater temptation to resort to the use of tranquillisers to control disturbed elderly residents as trained nursing staff are reduced to a minimum in the drive to make profits.

Capitalist governments operate double standards when confronted with problems of drug abuse. In the past dangerous, addictive drugs have been sold abroad: human misery being an acceptable price to pay as long as profits are made. Drugs of doubtful therapeutic value but which have undesirable or even serious side-effects are produced and, where legislation prevents their use in this country, sold in countries which permit their use. Thus the addiction to tranquillisers and the misery that they cause, like addiction to tobacco and alcohol, only become the concern of the state when the efficiency of the workforce, and consequently profits, is threatened.

In 1987 only £500.000 was allocated to help tranquilliser addicts compared with £24.5 million for the much smaller group of heroin addicts. But. unlike heroin addiction, the use of tranquillisers is legitimate, respectable and widespread, with 14 million prescriptions being dispensed in Britain last year. The enormous profits which the drug industry makes has led to general practitioners being the targets of aggressive advertising campaigns to promote tranquillisers as a panacea for their patients' problems. But for patients who are prescribed benzodiazepine tranquillisers (Lorazepam; Oxazepam; Diazepam. Chlordiazepoxide) for periods of longer than four months physical dependency occurs even at therapeutic dose levels.

Withdrawal symptoms include anxiety, apprehension, tremor, insomnia, nausea and vomiting; in fact, many of the problems for which these drugs were prescribed in the first place.

Sexual dysfunction may be caused by both the phenothiazine group of drugs and the benzodiazepines. The phenothiazines, especially Phenergan, have been associated with cot deaths in infancy. The problems of toxicity and unpleasant side-effects of drugs arise because of the hasty and incomplete research carried out by pharmaceutical companies in their attempts to market their products ahead of their rivals. The continued demand for drugs to relieve anxiety is assured because competitiveness causes fear and insecurity. Capitalism's booms and slumps, wars, alienation at work and impoverishment in old age all generate anxiety for workers. And for women, the problems of isolation within the home for housewives or the stress of the "double shift" for working mothers leads to them consulting their doctors for the relief of tension more often than men.

Women's economic dependence on men (who themselves are economically insecure) has served capitalism's interests by providing future generations of workers within the conventional framework of the family.

Patrick Jenkin when he was Secretary of State for Social Services, stated.

I don't think that mothers have the same right to work as fathers. If the good Lord had intended us to have equal rights to go out to work, he wouldn't have created men and women. (Man Alive, October 1979)

The barriers placed in the way of working mothers by such attitudes; relegation to mostly part-time, unskilled, alienating work; low pay — women earned less than three-quarters of the average wages paid to men in 1982 — have all combined to place a greater emotional strain on women. The operation of factories around the clock to maximise profits leads to shift workers being forced to adopt unnatural life-styles. Insomnia causes some workers to resort to taking sleeping tablets to cope with this. Doctors are helpless to remedy the political causes of all these problems and offer tranquillisers to help patients cope with intolerable social circumstances.

Further abuses of tranquillisers occur in prisons where drugs are used to control prisoners who fail to "adjust" to their environment.

Undeniably, tranquillisers can be of value. Used carefully they can help to relieve distress. But it is the application of drugs under capitalism, which fails to heed the lessons of the past while the present is profitable, which is at fault. Medical advances, in common with all forms of technological advances, will be abused until the workers decide to place human needs before profits.

Carl Pinel

World Socialist Radio - Withdrawal Symptoms (2025)

Adapted from the October 2025 issue of the Socialist Standard

Withdrawal Symptoms by The Socialist Party of Great Britain

Even in a socialist society the legacy of capitalism would pose deep challenges—particularly in areas tied to personal behaviour, health and consumption. The episode points to obesity, processed foods, addictions, pollution, synthetic drugs and industrial toxins as examples of harms created under capitalism, and raises the question of how a socialist world would responsibly manage them without exacerbating individual dependency or imposing authoritarian controls. While acknowledging that some “withdrawal symptoms” might result from removing harmful, profit-driven products, a democratic socialist society would not perpetuate illnesses for profit, and would need to find ethical, collective ways to address lifestyle and health issues.

Adapted from the October 2025 issue of The Socialist Standard.

World Socialist Radio is the official podcast of The Socialist Party of Great Britain. We have one single aim: the establishment of a society in which all productive resources – land, water, factories, transport, etc. – are taken into common ownership, and in which the sole motive for production is the fulfilment of human needs and wants.

World Socialist Radio is the official podcast of The Socialist Party of Great Britain. We have one single aim: the establishment of a society in which all productive resources – land, water, factories, transport, etc. – are taken into common ownership, and in which the sole motive for production is the fulfilment of human needs and wants.

RSS Feed for Withdrawal Symptons.

To read more news, views, and analysis please visit: worldsocialism.org/spgb

Pathfinders: Withdrawal symptoms (2025)

The Pathfinders Column from the October 2025 issue of the Socialist Standard

Socialism, a sophisticated global society of cooperative common ownership, would face a number of urgent legacy problems if established today.

One of these is world hunger, with its related diseases, from which around 10,000 children and 15,000 adults die every day. Globally some progress has occurred, but almost one in ten people remain undernourished.

Weirdly though, more children are obese today than underweight. According to a UN report covering 190 countries, whereas in 2000 almost 13 percent were underweight compared to 3 percent obese, today the figures are respectively 9.2 and 9.4 percent.

Global obesity levels have tripled since 1970, with most commentators attributing the problem to the widespread post-war production of cheap and ultra-processed food, though it may have begun even earlier. Diets have become progressively less healthy since the Industrial Revolution, when toxic compounds like red lead and green arsenic were used as factory food colourings.

Profits flow from making us fat, even while obesity is stigmatised. Eight of the ten most obese countries are in the South Pacific, possibly implying a genetic element. But the rest of the world is not far behind. Generally speaking, the only places not obese are those starving.

Modern capitalism is a smorgasbord of high-calorie fast food which, along with sedentary online living, constitutes what are called ‘obesogenic environments’. But personal choice is also involved. Sugar isn’t addictive as such, but does induce a dopamine hit that can be. How would socialism deal with addictions? The need to solve hunger is a no-brainer, but lifestyle choices are more ethically tricky. If our collective behaviour is making us ill, then it places a load on health services. One way to think about a socialist ‘economy’ is to ask, not ‘shall I have X’, but ‘are other people prepared to put in labour so that I can have X?’ Lifestyle isn’t just personal, it’s political.

Nutrition is a difficult subject. We’re not even sure how our own metabolism works. In the 2010s, evolutionary anthropologist Herman Pontzer set out to study metabolism in hunter-gatherers, specifically the Hadza of Tanzania, to see how their active lifestyles burned up calories. His findings rocked the scientific world. It turned out that, though tribal males might walk or run around ten miles a day, or maybe six for women carrying children, they burned off no more calories than a desk-bound clerk in Manhattan or Manchester. Convinced this had to be a mistake, Pontzer repeated the study with other groups, in other countries, and got the same result. The implications for the global diet industry, worth hundreds of billions, and the global sports fitness industry, worth trillions, are devastating. If Pontzer is right, diet and exercise are not linked but independent processes, so you can’t just trade off the one against the other, that is, you can’t run three miles and then allow yourself a doughnut. His ingenious working theory, as explained in a recent Babbage interview for The Economist, is that organisms don’t just go about doing their random daily thing and then pay off the calorie bill afterwards, somewhat like capitalist consumers. Instead they’re more like capitalist investors, looking for a long-term payoff in terms of reproductive success, and ‘fronting up’ the calorie investment in advance. Thus, we have a daily ‘calorie budget’ which we can invest wisely or poorly. We’ll certainly allocate 300 calories, the equivalent of a 5k run, for our large human brains. If we don’t spend our remaining budget on physical activity, it will end up being spent on other internal processes which also use energy, like the endocrine system (hormone production, for example testosterone or cortisol) or the immune system. With excess ‘fuel’ at their disposal, these systems may go into dangerous overdrive, producing auto-immune inflammations, stress-related diseases and cancers prevalent in urban western societies but unknown among the Hadza.

All of which brings new resonance to the phrase ‘armchair socialist’. How exactly a democratic global cooperative society would deal with addiction-related health problems is not really for us to say today. What it wouldn’t do is make the problem worse. In capitalism, all industries exist to make profits, even at the expense of killing us. State governments try to impose legal limitations, but vested interests and regulatory capture make this a permanent arms race.

The food industry is hardly alone in treating your body as a rubbish dump. Other industries have bequeathed us microplastic-polluted brains, ‘forever chemicals’, and the US opioid epidemic, to name just three. To see the ultimate direction of travel for unfettered capitalist markets, just look at organised crime. Take ‘kush’, for instance (or rather, don’t). Kush is a highly addictive and dirt-cheap synthetic opioid several times stronger than fentanyl, and now rampant across West Africa.

Quite apart from causing delirium and psychosis, it suppresses the appetite, lowering the body’s ability to fight off diseases and results in flesh-eating sores, and swollen limbs. It also results in STDs that women get by selling sex to pay for the kush. It involves no expensive opium or cannabis plantations, but instead uses cheap synthetic compounds (sources: China, Netherlands, UK) which you can cook for next to nothing in a garage. It’s also a cinch to transport because it doesn’t smell and just a tiny amount is needed to knock people brainless. The drug producers are no doubt delirious with joy at making such a killing, which they are doing, literally by the thousand: ‘It’s killing so many people that the mayor of Freetown [Sierra Leone] has had to set up a dedicated burial team to pick up abandoned bodies in the streets. These mass burials and cremations have been going on since 2022’ (Economist podcast).

Socialism’s legacy problems might be tricky where personal choice is involved. Without the profit motive though, there’ll simply be no point in producing foods and drugs that kill people, even if that could involve some withdrawal symptoms.

Paddy Shannon

Voice From The Back: Child’s play (2003)

The Voice From The Back Column from the July 2003 issue of the Socialist Standard

Child’s play

It sums up the madness of capitalism’s market system that at a time of falling stock exchange prices and the dismal results of fund market experts, we can learn of the following in the Observer, Business Section (25 May). “Despite falling equity prices, a group of schoolchildren from Oxfordshire put the professionals to shame by reaping a 140 percent profit from shares over seven months. The competition, sponsored by ProShare, shows you don’t have to pay through the nose for advice from experts earning six-figure salaries.” It also shows that we live in a mad house society.

Keep taking the tablets

The government’s medical advisers have agreed to hold an independent inquiry into the risks associated with the antidepressants known as SSRIs, or selective serotonin re-uptake inhibitors. This is the result of reports of suicides among patients taking the medication, as well as users describing nightmares, tremors and feelings of violence. These drugs have been widely prescribed for 10 years, so how come nothing has been done about it? “The Medicine and Healthcare Products Regulatory Authority, which oversees drug safety, has been criticised for not holding a proper investigation into SSRIs. An earlier expert group had to be disbanded last year after it emerged that some members were shareholders in the companies involved.” The Observer (25 May) Perhaps the following sales figures would tend to colour the shareholders’ findings. The manufacturer Glaxo-Smith Kline has more than £100 million sales a year in the UK alone. What’s a few suicides to shareholders compared to those figures? Truly, capitalism is a sick society.

Band aids for poverty

Almost 20 years ago Bob Geldorf organised “Band Aid” concerts in London and Philadelphia to help the starving millions in Ethiopia. So what is happening in that country today? Local musicians are organising similar concerts to aid the starving. “Aid agencies estimate 14 million Ethiopians are at risk of starvation after the worst drought in nearly two decades. The United Nations said Ethiopia needs 1.5 million tonnes of food aid this year.” Herald (26 May) In 1984 Ethiopia was devastated by a famine which killed one million people. In 2003 we have 14 million at risk of starvation. So much for charity, so much for well-intentioned reformers. What we need is a complete transformation of society not an elastoplast on a gaping wound.

Body parts for sale

Inside capitalism even items that are not produced for sale take on the form of commodities. Thus a man’s honour or a woman’s body are bought and sold. Perhaps the nadir of this commodification is the sale of human body parts. “Organ harvesting for the black market is most prevalent in India, Turkey and Central and Eastern Europe. Kidneys, lungs, pieces of liver, even corneas, bones, tendons, heart valves and skin are all available for purchase. A donor will be paid about £1,500 for a kidney, but a “broker” can expect to make £150,000 for the same organ. An auction of a human kidney on eBay in February 2000 drew a bid of $100,000 before the company put a stop to it.” Times (27 May) CONTRASTS The following two quotations illustrate the strange values of capitalism. “6,ooo children a day die from unsafe water and sanitation – equivalent to 20 jumbo jets crashing every day – according to the UN.” Observer (1 June) Contrast that with the fashion writer Lucia Van Post in The Times (6 June) prattling on about designer handbags. “One I lust after is the Asprey “race companion” – and have done so ever since I first saw a prototype some two years ago. It is a slim pochette, made of lizard skin, with a clasp that makes a nice, crisp, closing sort of noise. It holds not only a purse and mirror, but also a tiny notebook and a pen – perfect. … Not cheap at £1,250, but delicious.” Does the “nice, crisp closing sound” drown out the sound of those 20 jumbo jet loads of childish death whimpers?

Gongs for the gormless

The fiftieth anniversary of the Coronation was marked by the usual nauseating sycophantic brown-nosing of the press and TV. There is one exception in the Independent (5 June) by John Walsh that we think is worth recording here, if only to assure future generations that the world was not completely insane in 2003. “Then Her Madge decided to give knighthoods to Prince Andrew and Prince Edward. Along with being a Duke and an Earl, they’re now Knight Commanders of the Royal Victorian Order. Don’t ask what feats of intrepid public service justified these glamorous rewards (getting the wife pregnant? Womanising on yachts? Playing a lot of golf? Going bald?), because answer is there none.”

Tiny Tips (2025)

The Tiny Tips column from the March 2025 issue of the Socialist Standard

Kylie Jenner, the 27-year-old billionaire and car enthusiast, was recently spotted with her sister Kendall Jenner driving her $3 million Bugatti Chiron in Beverly Hills. Known for her impressive car collection, Kylie gave fans a rare glimpse of herself behind the wheel rather than posing next to her fleet. 

(Yahoo)

‘Everything outside the Christian framework — including secular music, television, and books — was discouraged. Just as I signed multiple purity pledges throughout my preteen and teen years, promising to avoid not just sex, but even impure thoughts, we were taught to practice absolute abstinence from dangerous ideas’. 

(AlterNet)

While official data is still somewhat sketchy, it’s estimated that 12,000 illegal transplants are performed annually, about 10% of the total number of transplants conducted each year. The organ trade is immensely profitable, generating between $840 million to $1.7 billion in revenue for a relatively small number of traffickers, according to estimates compiled in 2017. Organ trafficking survives, in part, because the demand from affluent consumers in the advanced capitalist West is so high and the legal supply of organs – primarily (about 80%) kidneys, but also lungs, livers and cornea – barely keeps pace. Many people wait at least two years to qualify to receive an organ transplant legally and thousands die every year – about 25 daily, according to the World Health Organization – because no organ becomes available in time to save them. Where do the illegally harvested organs come from? Primarily from North Africa and South Asia. Organ traffickers prey on poor and vulnerable rural dwellers, offering cash in exchange for an organ, usually a kidney. 

(Counterpunch)

This is about the Arctic. You have Russia that is trying to become king of the Arctic with 60-plus icebreakers, some of them nuclear-powered. Do you know how many we have, Jesse? We have two, and one just caught on fire. This is about critical minerals. This is about natural resources. This is about, as the polar ice caps pull back, the Chinese are now cranking out icebreakers and pushing up there as well. So, it’s oil and gas. It’s our national security. It’s critical minerals. 

(Common Dreams)

The response provided by South Africa’s elected officials has so far been both lacking and sinister. It targets migrants with few political allies in the country’s fractured political scene, increasingly characterized by populism, highlighting problems without solutions. 

(Geopolitical Intelligence Services AG)

As long as the capitalist system continues, we will never be able to escape from the shackles of economic crisis, war and massacre, ecological destruction, and workers’ sacrifice. The only solution is the revolutionary overthrow of the capitalist system and its replacement with communism, a society in which the means of production are no longer in the hands of capitalists or the state, but are socialised, in which production and distribution are in harmony with humanity and nature. 

(Controversies)

(These links are provided for information and don’t necessarily represent our point of view.)

Capitalism and ill-health (1951)

From the March 1951 issue of the Socialist Standard

With all the wonderful knowledge at our disposal, with all the efforts of the National Health Service, and again with all our doctors, dentists, specialists, hospitals and facilities for teaching health and preventing disease—it would appear on the surface that there should be no such thing as ill-health. But what do we find? Sickness is everywhere, and disease rather than health is the order of the day. Can it be that this problem under capitalism has something in common with other factors which are likewise conditioned or controlled by capitalism?

There are the means for producing an abundance of food in the world, and according to a recent issue of “Time” it is costing America over a million dollars a day to store food which they can’t sell, yet there are millions of workers facing starvation in Asia. There is abundance of raw materials for the purpose of building houses, yet there is a shortage of houses. There is an abundance of resources in the world capable of giving leisure and happiness beyond our wildest dreams, if only it was used intelligently. Yet there is poverty, want, misery, insecurity and everything that would appear to indicate an absence of wealth rather than an abundance of it.

But surely critics will say, the workers can’t be worse off under capitalism from a health aspect. With all the modern sanitation methods, doctors, radio propaganda, school instruction in matters of health and hygiene, and factory cleanliness, and a literate race who should know how to look after itself. 

Under feudalism, the health of the people was appalling, chiefly because of filth and lack of rudimentary sanitary knowledge. Capitalism has provided this knowledge, but in addition brought with it other factors which affect the health of the worker. Since the time when children and women were not allowed to work in coal mines, about 150 years ago, there has been a steady improvement in the health of the worker measured in terms of extension of life. But what about the pressure under which so many thousands of workers have to spend their days? What about the sweat shops in the East End of London where even if the worker doesn’t work so long in hours as previously, has nevertheless to keep up a pace with machines which work ever faster. Sewing, cutting, sawing, planing, chiseling, spraying, nailing, packing, etc. And again, there is the enormous amount of van driving which has to be done along streets ever more congested and at speeds which would have frightened our ancestors. Hurrying to work, hurrying all the time at work, hurrying over meals—and the result is, sooner or later, a breakdown in some part of the digestive or nervous system. All this is made very much worse by the precariousness of living and lack of any real economic security.

Then there is the quality of our foods. More adulterated than ever before, for there is profit in food adulteration. More coloured and refined than ever, for the same reason. Is it a wonder that digestive complaints rapidly increase? With all our hospitals packed and a long waiting list for beds, the National health service goes on, but does the health of the people steadily improve?

The plague and cholera have disappeared so far as England is concerned, but their place has been taken by new diseases like neurasthenia and those which arrive later in life. It is an undeniable fact that we live longer (or linger longer) as insurance figures for expectation of life have shewn.

All workers are not engaged in industry and therefore don't suffer directly from the effects of industrialisation. But all workers have to eat food, and so do their wives and children. Food makes blood, builds muscles, nerves and gives health and vigour; but only if it is of the right kind. Poor food lacks essentials for preventing disease, helps to clog the system and lays the foundation for ill-health which can easily and totally incapacitate an individual. Food is consequently an enormous factor in the health of any and every community, yet the control of our food is in private hands and the food services run for profit.

Capitalism is a factor which contributes to ill-health because there are profits to be pursued, and incentives which make the capitalist's role in society ignore the health requirements of the majority. Although health is said to be the first wealth—from the capitalist’s standpoint, profit is the first wealth, in fact the only one they think of. Consequently until the working class can organise the production of food for use, it will always be tampered with by the capitalist for his own ends.

Horace Jarvis

Ours and theirs (1981)

From the September 1981 issue of the Socialist Standard

The main points in the Bank of England Bulletin, which was issued last month, were well covered by television, radio and newspapers. Anyone taking what was said in these reports as what was meant would have been delighted with the good news. Here are some of the ways in which the news was reported: “Recession or no WE are getting richer abroad”; “According to figures assembled by the Bank’s statisticians . . . OUR external wealth was actually £4.3 billion more in 1979 than we thought it was a year ago”; “In 1980, for the first time, OUR assets abroad exceeded £200 billion ...” (Our emphasis).

Great, you might think. You can leave that dreary job, or stop looking for one. You can move out of your cramped home and move into spacious accommodation with pleasant amenities. No longer will your lifestyle be tethered by a meagre and insecure income. No longer will your impulses be repeatedly smothered by your poverty. So you get on the blower to the Bank of England, explain that you have heard the news about our great wealth which is invested abroad and ask how you might go about getting some of your share now.

Waiting for your reply from the other end of the line, the dialling tone, or worse, would be your signal that all is not as it seems. In fact what is described as "our overseas wealth’, if it was being reported from the point of view of the great majority, would be described as "their overseas wealth’. In Britain today, the entire pooled wealth of the poorest 80 per cent of the adult population amounts to less than that which is owned by the wealthiest 1 per cent (Report of Royal Commission on Distribution of Income and Wealth, 1980) and 93 per cent of adults do not own any stocks or shares. (CIS report, The Wealthy).

Meanwhile, in Japan the capitalist minority’s quest for profit continues with its inevitable disregard for the common social good. For many years a drug developed by a Professor Chisato Maruyama to treat terminal cancer has been dispensed at his small clinic in Tokyo. The vaccine seems to be regarded as effectual, at least by the hundreds of people who queue from dawn every day outside the clinic to collect a forty days’ supply for their suffering friends or relatives.

Research conducted at Tohoku University suggests that where the vaccine has been used in conjunction with other medical treatment survival rates in terminal cancer have much improved over treatment with other drugs. However, the small clinic cannot keep up with the demand and at the moment it is the only place allowed to dispense the vaccine. In order for the drug to become generally available it must be licenced by the Pharmaceutical Council of the Health Ministry. The Health Ministry usually rules on new drugs within 18 months but the Pharmaceutical firm making the vaccine first applied for licensing five years ago, and still no decision has been reached.

The issue became publicised after patients’ families petitioned the Ministry with 60,000 signatures, and the clamour could no longer be ignored by the government. The reason for the extraordinary delay in official approval being granted to the drug cannot be certain as deliberations of the decision makers—and this applies across the world under capitalism—are conducted in secret, or privately as they would prefer to call it.

But all of the available evidence suggests that there have been “close relations" between the Health Ministry and major drug companies. It seems that these firms are exerting strong pressure (the Yen variety) on health officials to block the commercial licensing of the Maruyama vaccine, which would present damaging competition to their own anti-cancer drugs already on the market. There is a trend for many senior ministry bureaucrats who are ‘co-operative’ with the representatives of large drug companies to be given highly paid appointments with the companies once they have retired from government employment. The rather well-titled ‘vice-president’ of one of the largest Japanese pharmaceutical companies was Deputy Health Minister a few years ago. Until the power of control and decision-making is withdrawn from the minority who now exercise it all over the world, society will continue to be run by us for them.

Gary Jay

Theatre Review: Nye (2024)

Theatre Review from the July 2024 issue of the Socialist Standard

Nye  by Tim Price (Wales Millennium Centre, Cardiff)

The celebrated Welsh actor, Michael Sheen, takes the lead role in a new play about the celebrated Welsh politician, Aneurin (‘Nye’) Bevan. With a script by Tim Price and under the direction of the National Theatre’s artistic lead Rufus Norris, the scenario has Sheen, dressed in pyjamas and close to death in a hospital bed, going back in memory through the key moments of his life. A series of scenes, sometimes surreal in their framing, show him progress from stammering schoolboy to coal miner, from trade union activist to rebel Labour MP, and finally from the back benches of parliament to government minister overseeing the establishment of the NHS.

The play has already had what can be called ‘rave reviews’. The Times declared that ‘Sheen burns with genuine passion’, the i paper called it ‘a taut and fluid triumph’, and other words used to describe it have been ‘spectacular’ ‘mesmerising’ and ‘unrepeatable’. The full house of around 2,000 at the performance I attended were indeed mesmerised, as was I, by Sheen’s performance and indeed by the performance of the whole cast of actors around him, taking parts such as Bevan’s wife, Jennie Lee, his best and most longstanding friend, Archie Lush, and his bitter political adversary, Winston Churchill. One could not but be powerfully drawn into Bevan’s journey, both mental and political, and in particular into the leading role he played in setting up the ‘welfare state’ immediately following the Second World War as Labour government Minister for Health and Housing. His role in this, and particularly in the NHS, is the play’s main raison d’être, so that even the staunchly conservative Telegraph had only words of praise for Sheen’s performance and went so far as to refer to the production as ‘a valiant and valuable affirmation of the NHS’.

The question of course that a reviewer in the Socialist Standard must ask, even while sharing the widely positive view of the production itself, is to what extent its unmitigated praise of Bevan and his politics is justified. Prior to the formation of the NHS in 1948, workers who could afford it generally contributed to various small insurance policies to provide a form of insurance for medical treatment. But many did not. And this was cumbersome and inefficient, and above all a hindrance to workers’ productivity. It was decided by the wartime coalition government, therefore, in line with the recommendations of the 1942 Beveridge Report, to reorganise the health system under central control. Both main parties, Labour and Tory, committed to such a reform in their 1945 election manifestos, and so when Labour won an overwhelming victory in that election, it fell to that party to put it into operation.

The justification for this and other welfare reforms was summed up in the Beveridge Report:

‘Social insurance and the allied services, as they exist today, are conducted by a complex of disconnected administrative organs, proceeding on different principles, doing invaluable service but at a cost in money and trouble and anomalous treatment of identical problems for which there is no justification.’

In other words, it was going to be more efficient and more cost effective for the services in question to be streamlined and brought directly under state control. So while no one would deny the famous adage of Bevan’s, repeated in the play, that ‘no society can legitimately call itself civilised if a sick person is denied medical aid because of a lack of means’, it has to be borne in mind that the main rationale of this reform was to make the system of workers selling their energies to an employer for a wage or salary more efficient and not first and foremost to benefit those workers.

The Socialist Party’s frequent characterisation of the NHS as ‘a cheap back-to-work service’ or a ‘way of patching up workers’ may seem a little over-cynical, especially as the nation-wide hospital and free medical advice and treatment system that was set up under the supervision of Bevan as Labour health minister in 1948 was clearly of benefit to workers who no longer had to find the money to pay for medical treatment. But, that said, there can be no doubt that it was not introduced with benevolence in mind. Indeed, such an arrangement was soon mirrored in various other countries whatever the professed ideology of the governments in office there. The fact is that ‘welfare’ reforms were necessary to guard against social breakdown, a situation potentially detrimental to capitalism and its profit-making imperative.

Yet of course, as many reforms, the NHS never worked quite as intended. The ‘free’ health service soon became unpredictably ‘expensive’ and certain charges (eg, for prescriptions) were introduced, and it has rarely not been in a state of crisis. Today’s increasing waiting lists, difficulties in securing GP appointments and overwhelmed emergency units show how the economic forces of capitalism constantly beguile the intentions of well-meaning reformers such as Bevan.

There can be little doubt about Bevan’s sincerity, at least in the early and middle part of his life and career, as focused on in this production. He was a spellbinding orator not afraid to be seen as a rebel and to use the strongest terms possible to state his credo (once famously referring to the Tories as ‘lower than vermin’). But, in the end, his was the idealism of someone who threw his energy into political life under the impression that capitalism could be adjusted to work in the interests of the working class. And what, as a celebration of the man, this play fails to convey is that this impression was a mistaken one and indeed that Bevan himself, in later years, moved from expressions of triumphant idealism towards pragmatic acceptance of capitalist politics and its limitations. It was in a private pay-bed in an NHS hospital in fact that he ended his days, the bed from which we are taken in this play through the key moments of his life. But thoroughly recommended as a spectacle.

Howard Moss

Cooking the Books: Bottom line building (2008)

The Cooking the Books column from the January 2008 issue of the Socialist Standard

Like everyone else with an email address we get loads of spam. Most go straight into the trash can, but the subject of one – “Crack Patient Paying Problems with these Helpful Hints” – caught our eye. It turned out to be a plug for an audio-conference in America on “Tried-and-True Ways To Get Chiropractic Patients to Hand Over Their Dues”. The message began:

“Getting patients to pay their bills at your chiropractic office isn’t always the most successful part of the visit. And even a handful of patients who don’t pay their bills can start adding up – and hurting your practice’s bottom line. But you can learn less-stressful way to collect pays, deductibles and co-insurance in this 1-hour session. Your expert speaker, Marty Kotlar, DC, CHCC, CBCS, will provide strategic advice on everything from gathering patient information to forming an office policy explaining the patients’ financial obligations. Don’t miss this bottom-line-building session . . .”

Chiropractics is an “alternative medicine” that is regarded by most conventional doctors as quackery (it is based on the idea that by manipulating the spine you can deal with ailments in other parts of the body, a bit like reflexology claims for manipulating your toes). But that’s not the point since no doubt teleconferences also take place in America about how conventional doctors can boost their bottom lines too – except that it does not fit in with the caring image that “alternative medicines” seek to cultivate as a way of attracting paying customers.

In Britain NHS doctors – and patients – are freed from this stress since the doctor’s fees are paid to them directly by the government. Not a solution, we imagine, that Marty Kotlar will be proposing in his teleconference, even though chiropractors in Britain would dearly like to get in on the act and even though doctors’ practices in Britain are, with government encouragement, going the American way and converting themselves into profit-seeking businesses. Of course to the extent that they take on private patients these medical businesses do face the problem of getting patients to pay up, as do unrecognised “alternative” practitioners and NHS dentists. So perhaps, after all, they could learn something from listening in to Marty Kotlar’s “bottom-line-building session”.

Most people, in Britain at least, find it abhorrent that people should have to pay for medical treatment and health care. And they’re right; if you are ill, you should get treatment whether or not you can afford to pay for it. Socialists go further. We say the same as-of-right access to what you need should apply across the board, to housing, heating, electricity, food, clothes, transport, entertainment.

But this will only be possible once the means for producing these things have become the common property of the community as a whole instead of being, as at present, provided by profit-seeking businesses owned by rich individuals, corporations or states.

Proper Gander: An appetite for profit (2024)

The Proper Gander column from the January 2024 issue of the Socialist Standard

The usual template followed by TV documentaries presents issues in a frustratingly simplistic way, reshaping and reducing them to fit the pattern. The format starts with a speedy summary of what’s to come, which assumes the viewer doesn’t have the patience to see a story unfold. The rest of the programme is still edited in a snappy way which jumps around from one aspect of the topic to another, just at a less fast pace. Scenes of the reporter speaking with victims and experts on the issue are usually short, cutting down their explanations to a minimum in case we lose interest. Statistics aren’t very visual, so evidence of wrongdoing is livened up as shaky footage filmed undercover by the reporter with some personal risk of being rumbled. Bouncing between briefly sketched out aspects of a problem doesn’t give the subject enough depth, nor help the viewer comprehend it. Watching a documentary which keeps to this template is like watching edited highlights of the start of a more substantial programme. Problems are revealed and questions are raised, but any answers suggested never reach the fundamental causes or reasons. The usual implication is that different state regulation will resolve the issue, although why such reforms have never brought about a capitalist paradise isn’t considered. The companies which produce mainstream documentaries are embedded in the system, and so aren’t going to look beyond it.

A recent example of this formula being followed was BBC Three’s The Skinny Jab Uncovered, an investigation into the availability of semaglutide. This is medication which has been developed over recent years to manage type 2 diabetes and which also works as an appetite suppressant. NHS doctors are only likely to prescribe it to help with weight loss for people who are classed as obese. Other people who want to lose weight and can’t afford a private prescription can easily find lots of cheaper traders in semaglutide at beauty salons or online who won’t ask any questions apart from what their payment details are. Most people hear about it on social media such as Facebook, TikTok and Instagram. Demand grown by online promotion and discussion has outstripped supply, leading to a global shortage.

The product is a white powder which buyers mix with a liquid and then inject themselves with. The people attempting this aren’t likely to have had any medical training beforehand, and the packs they receive don’t even tend to come with instructions. Buying semaglutide from a salon can be accompanied by haphazard advice from staff about dosage and administration, as revealed by undercover filming. Some packets are stamped with words like ‘not for human consumption’ or ‘for research purposes only’, intended as a get-out clause for the seller if anyone makes any complaints after using it. Understandably confused buyers have tried to work out what to do for themselves or have turned to social media groups for guidance, with posts such as ‘I’m a bit scared’ and ‘hopefully I don’t die’. Some have experienced unpleasant side effects such as nausea and ended up in hospital. The manufactured desire to be thin makes some people accept or overlook the risks which come with self-administering what’s sold as semaglutide.

Reporter Pria Rai buys 12 packs from various suppliers and sends them off to a laboratory for analysis. Perhaps surprisingly, as many as eight were pure samples, with the others being adulterated with sugar or containing no semaglutide at all. Diluting drugs with cheaper substances is a longstanding tactic by dodgy manufacturers and dealers to maximise how much money they make from each dose. Semaglutide made illicitly is likely to come from producers working outside state regulation, which further saves on costs which come with safeguards and testing. All this means that as well as being unsure how to use the product safely, buyers are unsure what they’re putting into themselves.

When Pria contacts the companies selling packets containing little or no semaglutide, they reply with flat denials or abuse and gloating. These sellers represent the weight loss industry at its most blatant. While semaglutide suppresses the appetite for food, it has fuelled an appetite for profit. Making money by encouraging and preying on insecurity about looks is more important to sellers than acting responsibly about a medical procedure. This has led to dubious tactics to reduce production costs and also unreliable and extravagant claims to promote sales of the product. The documentary doesn’t explain the weight loss industry in this way, though, and just ends with a quick mention that the government’s regulator is investigating.

How would this situation play out in a socialist society? Does the principle of free access to goods and services mean that anyone could have substances such as semaglutide on demand? The practicalities would be for people at the time to decide, but any responsible society would have safeguards around medication which had the potential to be used in a harmful way. Regulation of medication in a socialist society would only be based on the best available knowledge of its properties, a framework to make decisions which wouldn’t have to compete with an obsolete need to make money. This means that the current risks with semaglutide wouldn’t apply, such as the adulteration of black market supplies to minimise costs, and responsible use being linked to what people can afford. There would be no reason to produce or administer it in a way which encouraged harm. And what place would a substance like semaglutide have in a socialist society, apart from its use to treat diabetes? We don’t know to what extent people would crave an appetite suppressant as a dieting technique, but it’s likely to be less than today. Attitudes to weight, attractiveness and health would differ, and wouldn’t be shaped by an economic market, and in particular by industries which profit from manipulating how we want to look.

Mike Foster

Sting in the Tail: Good news, bad news (1995)

The Sting in the Tail column from the December 1995 issue of the Socialist Standard

Good news, bad news

The publication of a 400-page Genome Directory as a supplement to Nature Magazine should be really good news. It is an attempt to provide a map of a large portion of the 100,000 or so human genes. Medical experts believe it could be a step on the road to finding the genetic causes, and eventually the cure, of many killer diseases.

But we live in capitalism, so this good news has a major downside to it. In America where many companies provide their workers with health care insurance as part of their wage, we learn how such advances are being used to cut the capitalists' health care liabilities:

“To avoid hiring people with ‘disease genes' some companies ask job applicants about their family medical histories or ask for samples of blood or cell tissue without revealing that they will be used for genetic tests " (Herald. 19 October).

Job losses inevitable

That proposed merger of Lloyd's bank and the TSB has once again had banking unions complaining about likely job losses. They pointed to the increased profits of the Big Four last year—up £1.5 billion to £5 billion, and Ed Sweeney of BIFU argued that:

“The shareholder will do very nicely and top executives will get fatter pay cheques. The least they can do is ensure staff there will be no sackings ” (Guardian, 11 October).

Those increased profits are mainly due to fewer bad debts and not to any growth in banking activity. Then there is fierce competition for business from building societies and now the insurance companies are entering into banking. Also, new technology means that banks simply don’t need as many workers now, so the pressure is on to cut costs.

Fair enough, unions must protest at job losses, but oh for even a glimmer of recognition from them that their real enemy is capitalism and not mere mergers, executives or shareholders.

Of cops and hookers

Members of the working class have to sell their abilities to work for wages and salaries. Some even have to sell their bodies.

“Prostitution is not legalised, yet in genteel Edinburgh there are about 400 women at work in saunas or massage parlours, earning £2,000 per month, according to a recent survey.

"Trying to stop prostitution is like trying to compress water: all you do is displace it. It will come squeezing out of the sides somewhere else, ’ says Tom Wood, assistant Chief Constable of Lothian and Borders police." (Independent, 26 September).

If the assistant Chief Constable had prefaced his remark with “Inside a buying and selling system like capitalism . . ." no-one could have disagreed. But he didn’t, so let us be quite plain about this matter.

The only way to stop prostitution is the establishment of the classless, private property-less society. Inside that system the 400 hookers and the even more numerous policemen can start doing worthwhile and dignified work for the first time.

Hell drivers

Ever felt a little queasy on the motorway as you passed one of those mammoth heavy lorries and wondered if it was swaying a bit on the road? Well start feeling really queasy for a report in the Observer (22 October) makes frightening reading:

“Lorry drivers forced to work illegal hours by unscrupulous employers are to blame for up to 200 road deaths a year. Haulage firms, prompted by the recession to cut costs to the minimum, are pushing drivers to break the law or face dismissal."

When you read that between 600 and 1,000 people die in accidents involving HGVs every year in Britain; that 20 percent of these are caused by lorry driver fatigue and that up to 40 percent of the drivers have been asked to exceed the legal limit of 10 hours a day, you may come to the conclusion that the sway you detected was because the driver was half-asleep at the wheel.

It is just another example of capitalism lowering costs to boost profits and to hell with people’s lives.

“Support” — Tory style

Last November we mentioned on this page that the Young Conservatives were “set for the chop” because they had become an embarrassment to the Tory Party. This provoked an indignant letter in the January issue from a YC who told us:

“The Young Conservatives are not for the chop; both the Prime Minister and the Party Chairman have pledged their support for the organisation. ”

What this “support” amounts to was revealed in the Guardian (13 October). Tory’ Central Office has closed its youth department and the YCs now have to share the services of “one tenth of a person” at Central Office with Conservative Students.

Often, when the Tories have wanted to kill off some state benefit or allowance but without causing a row, they have left it to, in their own words, “wither on the vine”. The YCs are looking like a bunch of mouldy grapes to us.

Warning — this system is dangerous (1971)

From the December 1971 issue of the Socialist Standard

Peter Simple, the columnist who plugs a consistently comfortable, almost invulnerable, reactionary line in the Daily Telegraph, has often turned his acid pen against the people who sought to prove with their statistics and experiments and surveys that cigarette smoking is a factor in causing death by lung cancer. It was not simply a matter of an individual’s right to puff his way into an early grave if he wanted; to Simple, smoking was part of the slow, feudalistic way of life which he imagines (and it is only imagination) was once lived by the people of this country.

So any fan of the column must have turned to it with trembling hands, after the most recent anti-smoking report from the Royal College of Physicians. Sure enough, there was a passage on the report. But at the end of an unusually mild attack, Peter Simple had to confess himself baffled by it all; why did they attack smoking? Why? Why? It was all rather disappointing, especially as it showed that the columnist had not read even the press reports of the document, some of which quoted the vital reason for it all: 

Government and Parliament must decide between an easy source of revenue and the preservation of the lives, health and productive capacity of the people they serve. 

Now what this quotation from the report indicates is that we have here a case just like many which have gone before. “Productive capacity” is vital to industry, to employers; since it depends upon the lives and health of the producers then any employer who keeps the most casual eye on his profits must start to worry if he has reason to think that the lives and health of his employees are being threatened.

The only chance of a large, official campaign against smoking was that there would be enough evidence that it was damaging the profits of the employers. The evidence about the possible effects of it on health has been there for a long time; the crucial point is when it is likely that there are also effects on productive capacity, or profits, or some other aspect of the worker/employee relationship. It was the same with the Clean Air Acts and with the measures aimed against noise, pollution and the like. It is the same, still, with the countless combined eyesores and threats to safety such as the coal tips in South Wales, where the “economic” case for removal is not officially considered to have been made out four years after Aberfan.

We can approach this point from another direction, by looking at one of the report’s ideas to persuade people to stop smoking. This was to print on all packets a warning of the possible effect of smoking. This has already been put into practice and nobody can now draw out a cigarette without being confronted with the awful words "Warning — smoking can damage your health”. This may or may not be an effective idea; there is a case that the words of warning might only go to make the smoke more enjoyable, spicing it with thrills of guilt and danger.

But the main point is that it is surprising that this technique should be confined to cigarettes. An average of something like twenty people are killed on the roads every day, but nobody has yet suggested daubing the doors of all road vehicles with the words “Caution — this machine is potentially lethal.” And while we are on the subject of death, what are they doing, allowing all those advertisements for the armed forces and none of them with a warning that the forces’ job is to train killers to protect the interests of their master class?

And what about the other, innumerable, ways in which capitalism, in the name of profit and the rights of a privileged society, simply murders people? We are thinking here not so much of the quick, easily identifiable death like the road accident and the battle but the slow erosion of life — the coal miner with his lungs gradually filling up with dust; the asbestos worker with a horrible death in prospect; and all of us, whoever we are and wherever we live or work, who are subject to the atmosphere which is foully polluted because at present capitalism thinks it is cheaper to pump its muck into the air than to find other ways of dealing with it.

Every factory, then, every mine, every aircraft, almost everything which capitalism uses in the march of its profit-based activity, should have some sort of warning on it, shouting out the damage which it does to us — and the reason it happens. Food which is devitalised and adulterated to make it more easily marketable should carry a label telling us what has happened to it and what is likely to happen to us if we consume it. The homes we live in should have a notice on their door, telling us that they are inferior buildings which are uncomfortable and cramped and are full of dangers to health and life (the home is at present the biggest killer of all — it is all done, they say, by “accident”.)

Then there are the health hazards which are even less identifiable, which are insidious but none the less deadly. These are often matters of pressure upon us, matters of the sheer struggle to live, to survive, to get to and from work, to keep out of debt, to raise children, to hold a job. Sometimes it is even a matter of finding somewhere to live. Not so long ago, there was a case in the Appeal Court in which nine homeless families who were squatting in some houses owned by the Southwark Borough Council were ordered to move out. There was no doubt about the desperate plight of these people; the council’s man in court said their conditions were “heart rending”. But the judges did their job; one of them summed it up with the words:

It must be in the interests of law and order to protect the title of property such as these.

Yet at the same time the judges were also saying how sorry they were for the squatters. They were using words like “deepest sympathy” and “deep depression and oppression”. Unusual perhaps for words like that to come down from the bench; but if that was how the judges felt, how did the situation affect the squatters? How much of their health, their life, was simply worn away by a desperate plight which had to stay like that to protect the title of property?

But of course such situations can only be known to a certain social type. The inferior standards of living, the life without privilege, without security, without comfort, is the life of the worker. He is the person who has to struggle and who is never far from the razor edge, if not actually balanced on it or indeed toppled off it. He is the person whose health and life suffer because he is simply not permitted, by his social station, to live free. He must be suppressed and degraded; he must accept second, third, fourth best. And it makes no difference, that he is in the majority and that he makes up all the socially useful people in society.

What it amounts to is that capitalism should wear one great big label, warning everyone of what it is doing to them. It should tell them that it is a system in which only a few have the opportunity to live like human beings and they do this on the backs of the many. It should tell them that it is a society where everything we need is made so that a minority can profit by it, which means that all our welfares and lives are under continual assault and in constant danger. It should tell us that all the health hazards and all the tensions can be ascribed to the basic inhumanity and craziness of capitalism.

All members of the working class should have these labels, and they should have them from the day they are born because it is from then that the assault of capitalism upon them begins in earnest. And it carries on until they are in their graves.

Ivan