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

A Pill For The Public (1938)

Book Review from the July 1938 issue of the Socialist Standard

“ Patent Medicines,” by Professor A. J. Clark (Fact, May, 1938).

The select committee set up by H.M. Government in 1914 to "consider and enquire into the question of the sale of patent and proprietary medicines” expressed the hope that the National Insurance Act would curtail the business in secret remedies. Their optimism has been far from justified, and the N.H.I. Act, having failed to put an end to illness, fanned the belief, already widespread, that health could be obtained from a bottle. A number of capitalists, more perspicacious than H.M. Commissioners, were well aware of this. They sank money in the production of patent medicines, and by one device or another encouraged the belief. The sick public, uninformed and receptive, swallowed thousands of panaceas from almost plain water to poisonous drugs, and paid well for the privilege. The proprietors, on the other hand, waxed prosperous.

Prof. A. J. Clark has set out the details in the Fact for May. Let us say here that the monograph is not written from a working-class angle, and that this entails a certain criticism, to which we shall allude later. But, subject to these limits, practically every aspect is covered in a simple and straightforward manner. We think that Prof. Clark might have detailed some of the huge profits made in the trade—for instance, Beecham’s Pills, Ltd., which markets many well-known proprietaries, such as Germolene, Iron Jelloids, Veno’s, Amami shampoos and the like, and has a capital of about two and a half million pounds, declared this year a profit of over £600,000 and a dividend of 85 per cent.

All sections of the community take patent medicines (the expression “Patent Medicine” only strictly applies to those registered under letters patent, of which there are actually very few). The volume of retail trade is, therefore, very large — possibly between £20 and £30 millions annually. The Government takes a rake-off in the shape of medicine stamp duty, which amounted in 1928-9 to one and one-third million pounds, since when it has declined by 44 per cent. Manufacturers found that by slightly altering the composition and printing on the package a pseudo-scientific formula, meaningless to the man in the street, they were legally exempt from paying the duty and pocketed the difference. We know of no case in which the price to the public was afterwards reduced. The law relating to patent medicines is, in fact, a confused jumble of statutes and regulations dating from 1787. It is still possible to use bogus testimonials from fictitious physicians, and perhaps even real physicians! There is a law of the most severe character against the supply of abortifacients; but under cover of wording which is well understood a loophole exists for the business to go on, a business for the most part in either useless or dangerous and always expensive drugs.

Various committees of enquiry have been set up, notably that of 1914, referred to above. Their report was devastating in its revelations and indictment of the patent medicine trade. “Naturally, however, it attracted no attention whatever at the time of its appearance and was allowed rapidly to pass out of print and is now very difficult to obtain. The reasons for its rapid disappearance are unknown” (page 29). The publications of certain analyses carried out by the British Medical Association vanished in an equally mysterious manner. The interests concerned were quite averse to anything being done, and it was pot until 1920 that a “Proprietary Measures Bill" based on the 1914 report, was introduced into the Lords, but “was allowed to perish for lack of Parliamentary facilities.” There' were further Acts in 1931 and 1936, both of which failed to become law. In 1936, however, the Government became alarmed at the decline in revenue, and a committee was set up to. consider this aspect alone. Their report, published in 1937, suggested a much wider basis of taxation, and “a Bill was promptly prepared in accordance with the recommendations of the select committee of 1937; it did not attempt any reform of the secret remedies fraud, but was simply designed to increase revenue by extending the scope of the incidence of the Medicine Duties. . . . The Bill perished chiefly because it proposed to tax cosmetics, a reasonable but highly unpopular proposal” (page 2$). As a matter of fact, there was much internal opposition to the bill, in particular from chemists, who would have lost certain privileges by its provisions and been placed on the same footing as grocers and other traders. No attempt whatever was made to protect the consumer at any stage.

Patent medicine proprietors are able to exercise a considerable pull over the Press, as the biggest single group of advertisers. One firm stated that it spent one-quarter million pounds in 1937 on publicity, largely in the Press. One of the effects of this expenditure is a virtual censorship of anything likely to endanger the patent medicine interests. Millions of people every year, who from malnutrition, bad housing, and overwork fall ill, succumb readily to the clever propaganda of the big advertising, often handled by firms which specialise in this work. And the more readily since the occasional exposures of danger and fraud rarely creep into the popular Press. These dangers and fraud are very real. A certain check is provided by recent poison regulations, but only this year 73 people in the U.S.A. were killed by a preparation before supplies were stopped. And there would have been no legal restriction on its sale in Great Britain. There is no account, of course, of those drugs which only kill if taken in time, or of the false inducement of security and hope. It is also certain that many workers afford patent remedies by cutting the purchase of vital necessities.

Prof. Clark suggests measures for dealing with the problem. It may be that for a variety of reasons a Government will one day be persuaded to frame new laws. They may even be operated. But the real trouble is that people are ill, and the problem one of preventing it—an impossibility while capitalism lasts. The patent medicine proprietors are in business for profit and indifferent to the harm and suffering they may inflict. Capitalist governments have already had 24 years since the first commission’s report to demonstrate their care for the working class. And the last Bill presented to the House was an attempt to increase revenue from the industry! Is it unlikely that any advantage to the workers from future enactments will only be incidental? There can be few grosser instances of the evil workings of the profit system than the patent medicine industry.

Kilner.

Hi-tech births (1986)

From the May 1986 issue of the Socialist Standard

The profession of obstetrics has received a great deal of public attention as a result of an inquiry which began in February into the professional competence of Wendy Savage, a consultant obstetrician at the London Hospital. Savage was suspended in April of 1985 by her employers, the Tower Hamlets Health Authority, after complaints surrounding her handling of five pregnancies. Following her suspension a campaign was mounted for her reinstatement by local midwives, mothers and GPs.

During the inquiry a number of criticisms were made of the type of approach to childbirth and pregnancy that has come to dominate maternity care in recent years. According to Savage and her supporters the excessive use of high-technology in modern obstetrics has deprived women of the freedom to choose where and how to have their babies. The process of giving birth has become dehumanised because current obstetric practices have succeeded in shifting the focus of interest from the mother to the machine. Women, argue critics, are regarded as mere objects on a conveyor belt. Wendy Savage and her supporters would like to see this depersonalised system of obstetric care replaced by an approach which emphasises both the naturalness of every birth and the individual medical needs of the women concerned.

While socialists sympathise with these objectives we also point out the limitations which present-day society places on their achievement.

First of all, isn't it surprising that the controversy arose within an NHS hospital providing health care to a particularly deprived working-class area in the east end of London? Not at all. Under capitalism there are two quite distinct standards of health care. For the rich — the capitalist class — there are the Harley Street Clinics and the private hospitals which provide the best maternity treatment money can buy. Consequently they suffer none of the degradations associated with current obstetric practices.

For the poor, on the other hand — the working class — there is the NHS.

Contrary to what politicians tell us the NHS is not in the business of providing an all-embracing caring service, free at the point of delivery and run in the interests of everyone. Its real intention is to serve the economic interests of the capitalist class by placing at their disposal a steady supply of fit and healthy wage slaves. In meeting this requirement of the exploiting class, the NHS contributes enormously to the overall profitability of British capitalism. However, it also represents expenditure and as such the provision of its services must be cost-effective to ensure that the capitalist class get value for their money. In economists' jargon this means that resources must be used effectively. services must be rationalised, financial targets must be met, and wages must be minimised — the NHS is big business and it must be run accordingly. Under capitalism even the most basic of our health needs play second fiddle to the managerial and accounting practices associated with production for profit.

So how do these practices relate to the provision of maternity care? The maternity services operate within a context of scarce resources, shortages of expert consultants and midwives and expenditure cuts. Everything possible is done to cheapen the cost of childbirth and this economic fact determines the quality of care and the practices adopted by obstetricians.

In the early years of the twentieth century maternity care was exclusively handled by untrained mid wives, known as "handywomen". Apart from a few difficult cases, which were handled by doctors or GPs. more babies were delivered at home. Today, however, these functions are controlled by professional obstetricians working from maternity units in large district hospitals. Community midwives have been gradually reduced and as a result the number of hospital deliveries has risen from 15 per cent in 1927 to 97 per cent in 1976, with the intention that home delivery be phased out further (Short Report on Perinatal and Neonatal Mortality, 1980).

With the professionalisation and hospitalisation of maternity care there has been an increased reliance on high-tech medicine. One practice which has increased tremendously in recent times is that of inducing labour artificially by using modern technology. Some obstetricians have argued that inductions are carried out only when the life of the baby or mother is threatened but some experts have pointed out that inductions are not always carried out for medical reasons:

Technology is now being used in some hospitals to induce labour routinely, not primarily for the baby's safety or the safety of the mother, but in order to create a production line system where women have their babies by clockwork during daylight hours. (O. Gillie & L. Gillie, Sunday Times. 1974.)

Given the priorities of the NHS it is easy to see why the rate of inductions increased (from 13.7 per cent in 1963 to 38.9 per cent in 1974). Inductions help to speed up the process of childbirth, ensure that hospital beds are used more intensively and shorten the length of time women stay in hospital. Often inductions are laid down as hospital policy — as was the case in the hospital where Wendy Savage worked — in order to meet a planned throughput of births, perhaps 1.000 babies delivered each year. In a study of inductions, A. Cartwright (The Dignity of Labour) reports that more than half the obstetricians questioned said they would recommend inductions where there were staff shortages or a restricted access to anaesthetics. After giving birth by this method, which often has negative psychological and emotional repercussions, women are ushered out of care to be looked after by a much depleted and hard-pressed community midwife service.

Economic considerations can also be observed behind the startling increase in caesarian sections. The use of this method of delivery was central to the case against Wendy Savage. Tower Hamlets Health Authority claimed that she had performed a caesarian "too late", resulting in the death of a baby eight days after delivery by an emergency caesarian. Although the merits of this particular case are unclear, recent figures released by the Office of Population Censuses and Surveys suggest non-medical reasons for this type of operation. The figures show that much depends on how busy the ward is on a particular day. On Fridays, the busiest day for deliveries, there was a 43 per cent increase in the number of elective caesarians (those not performed in an emergency) but on Sundays, the quietest day, elective caesarians were 62 per cent below average. An interesting figure is that the caesarian rate for private hospitals (19.6 per cent) was twice that for NHS hospitals. The explanation here is that most insurance policies cover caesarians, while patients have to pay cash for spontaneous births. Given the choice it is hardly surprising that working class mothers choose the former, less expensive method of payment.

As with all services provided by the NHS for members of the working class, maternity care offers women little choice over the kind of treatment they would prefer. In a study of NHS hospitals in York and London (H. Graham & A. Oakley: Medical & Maternal Perspectives on Pregnancy in Women) most women complained that there were very few areas in which they were allowed any say in their maternity care. They had practically no explanation from the doctors about what was being done to them; they saw too many doctors to receive any kind of personal attention and the whole experience left them feeling like battery hens.

This kind of treatment cannot be blamed entirely on the attitudes of consultants, who are as much victims of the situation as are the pregnant women. Over-worked consultants have little time to discuss alternative options of delivery and for the sake of convenience are likely to make decisions for those in their care. They require a passive rather than a questioning attitude from their patients and this is fostered by the sense of vulnerability and helplessness felt by pregnant women — especially when they are delivered into the hands of experts who, they believe, ought to know best and surrounded by a bewildering array of sophisticated equipment.

So what's the solution? Both the best and the worst aspects of the use of technology are represented in modern obstetrics. On the one hand the risks to mother and child associated with child-birth and pregnancy have fallen dramatically, as evident in the reduction in the perinatal mortality rate (still births and deaths during the first week of birth) from 38.5 per cent in 1948 to 17 per cent in 1977. But on the other hand modern obstetric methods have left women feeling degraded and brutalised. Under capitalism this situation will never be resolved; technological advances can only be used for the enrichment of the tiny few and the consequent enslavement of the vast majority. A truly civilised standard of medical care can flourish only in a truly human society and judging by current obstetric practices, it is perfectly obvious that we clearly do not live in one.

G. Davidson

Trial and Error (1959)

Book Review from the June 1959 issue of the Socialist Standard

Call The Doctor. By E. S. Turner, (Michael Joseph, 21s.)

In an age of X-rays and artificial kidneys, there is no excuse for anybody thinking that the stomach is an oven where food is cooked by heat from the liver. No doctor now prescribes the gall of a bull mixed with vinegar, or wine made from six live vipers. Yet this, apparently, once passed for medical science. At this distance, it seems incredible that the patients stood for it; we can only hope that we are less gullible today.

Quacks

The book starts as it intends to go on, shocking us with the Salerno rules for the mediaeval physicians; (“When feeling the patient’s pulse, allow for the fact that he may be disturbed by your arrival and by the thought of the fee you are going to charge him"). It tells of the vogue for revolting medicines and antidotes, one of which—the bezoar stone—was discredited by trying it on a criminal after giving him a large dose of corrosive. The wretched man was found crawling like an animal around his cell, with blood streaming from every orifice of his body. There is the story of the quacks, (“The cheapest and safest Way of bringing forth ye Venom of ye Secret Disease .. . Sold by J. Sherwood, Bookseller") and the bodysnatchers, who supplied the doctors of the 18th and 19th centuries with their subjects for dissection. For hundreds of years, the physicians fought the over-indulgence of the well-to-do by drawing off rivers of their blood and administering tons of violent purgatives, and probably committing vast slaughter in the process.

Mr. Turner has a lot of surprises for us. Who knew that The Lancet was founded as a truculent rebel journal, which earned the disapproval of the Royal College of Surgeons by revealing the substance of medical lectures and reporting horribly bungled operations? Or that, before the day of anaesthetics, surgeons worked so fast that some could amputate a leg in the time taken to sprint a hundred yards? The operations were particularly gruesome—as late as the 1890's, the surgeon wore a frock coat which he kept behind his theatre door and which was sometimes so stiff with blood and filth that it could have stood up on its own. Equally sickening is to read about the ignorance of the sources of infection. About the doctor who carried in his pocket some remains from the abdomen of a woman lately dead of childbirth fever—and wore the same clothes when attending later confinements. Sometimes the doctors were reluctant to change their ideas. Here is plenty of ammunition for those who think the medical profession has always been an obstinate, unprogressive lot.

Disappointment

Yet when we have recovered from our disgust and surprise, what is there in this book? A little disappointment; the subtitle—A Social History of Medical Men—is hardly justified. There is no suggestion that the medical and surgical advances of the 18th and 19th centuries were related to the achievements of the Industrial Revolution. The 1914-18 war, one of the great disruptive social influences of the 20th century, gets a couple of paragraphs. Could it be that too much—over 500 years—is crammed into too little—just over 300 pages?

To satisfy Socialists, Call The Doctor must have pointed out that medical science cannot be excepted from the principle that our knowledge expands with the development of society's wealth-producing capabilities. That modern medical research and techniques reflect —and are made feasible by—the advance of modern industry. Anaesthetics could not have happened without the Industrial Revolution and it is hardly necessary to say that machines like the iron lung can only be made in a factory. The introduction says that the book is limited to an examination of the doctor as a member of society. Yet it ignores the influences which make society what it is.

Doctors and Patients

What position does the doctor hold in society? Although most of them would not concede it, they are members of the working class, compelled at times to defend their material interests. Twice during the past 50 years—in the National Insurance Bill of 1911 and the National Health Bill of 1948—the government has imposed changes on the doctors' working conditions. On each occasion, amongst the clouds of nonsense which they talked, the medical men could be descried resisting anything which they thought would lower their standards. Mr. Turner recalls the words of one doctor who opposed the 1911 Bill: “. . . we have a commodity . . . and we are practically monopolists of that commodity . . . are we going to demand a fair price for our services?” No shop steward could have put it better.

And the patients? Mr. Turner says, on the old Poor Law days,

  Among these were consumptives in crowded dwellings or sunless valleys, and workmen discarded by the industrial machine with their inner economy wrecked. What they needed was what no doctor could supply: food, fresh air, decent houses. All the practitioners could do was palliate their lot or give them illusory hope with bottles of cheap medicine.

Nowadays we are all on the National Health and some of the diseases which took their toll in the Poor Law times have been suppressed. But others have taken their place and always the effort to cure them is complicated by the fact that the majority of patients are compelled to work for their living.

Overwhelming Question

If, after the centuries of trials and spectacular errors which this book relates, the medical men are at last getting to grips witth their problems, we are leftivith one overwhelming question. How much more effective would they be, in a world free from social disease? ,

Ivan

Thalidomide Crime (1968)

From the August 1968 issue of the Socialist Standard

Every so often capitalism commits one of its more colossal crimes against mankind. A recent example is that of the Thalidomide Babies.

The Sunday Times of 19 May discussed this matter fully under the headline of “The Thalidomide File”. The public first knew of this in 1961. Nine men from the firm of Chemie Grünenthal in the little town of Stolberg are at this moment on trial charged with placing on the market a drug which even when taken as instructed caused the human body an unacceptable degree of harm, for advertising the drug as completely safe when they could give no such guarantee, and for brushing aside and then deliberately suppressing the adverse reports from doctors that it caused those who took it to itch, shake, vomit and lose the power to stand. The charge is made that this same drug, which the sales department called “the apple of our eye” because it was so profitable, caused a large number of monstrously deformed babies. The trial is expected to last some ten years. It is obviously in the interests of the defendants to spin it out as much as possible so that some of the hot feeling may have died down.

The drug was exported to about 11 European, 7 African, 17 Asian and 11 American states. There are in Germany alone thousands of victims and roughly five thousand babies have been born there with appalling deformities. The discoverer of K17, as he named it, was a qualified chemist and doctor who had served at the Institute for Typhus and Virus Research at Cracow in Poland which was under the control of the German Army High Command during the war. His name was Dr. Heinrich Muckter. His precise role at the Institute was not clear but no charges were made against him at the Nuremberg Nazi doctors’ trial. We can anticipate that — especially in view of his past — many people will blame Muckter for this crime.

Socialists, however, whatever the outcome of the trial, will not give Muckter and his associates the sole blame for this incident in medical history. This does not mean we condone the actions of the men concerned.

Under capitalism some people are capable of doing anything for personal gain; others are not. Our view is that, given certain conditions, society will produce people with no scruples who will do whatever suits them no matter what the cost in human life and welfare.

The “business mind” is well illustrated by this extract from a letter written by the Sales Director of the firm which marketed Thalidomide to a sales manager in Essen :

  “We must realise above all else that such a quick rise in the turnover of a sedative must lead to certain apprehensions in the minds of doctors and chemists. Not all members of this clientele can keep their ethical attitudes within the limits of the market economy. There will certainly be doctors conscious of their responsibility, who in view of this trend, will start speaking about addiction.”

And a report from the Sales Office in 1960:

    “Unfortunately, we are now receiving increasingly strong reports on the side of this preparation, as well as letters from doctors and chemists who want it put on prescription. From our side, everything must be done to avoid putting it on prescription, since already a substantial amount of our turnover comes from over-the-counter sales.”

Even the Sunday Times was prompted to ask “Was the fault that of society, of a set of attitudes to profit and the responsibility that it entails?” They use the word “society”. We would say rather “capitalist society”. Our answer to their question is: yes, it is the fault of society, capitalist society.

Capitalism is an obsolete system of society; it long ago outlived its usefulness. It fetters production; it distorts production so that hitherto unimaginable horrors like this become realities. The “set of attitudes to profit” is thus the reaction of men to the relations of production in which they find themselves. When men convert the privately owned means of production into the common property of all, classes will disappear. Wealth will be produced simply as products to be distributed according to wants and needs, and not as now as commodities to be exchanged on a market with a view to profit. Socialist production and distribution would mean that technical development would hold no threats to human welfare, as it does now, with its sales propaganda nuclear “deterrents” and so on.

J. MCL