The "Free Health Scheme" Myth (1976)

From the September 1976 issue of the Socialist Standard 

It was all worked out so that sick people in Britain could be looked after and seek treatment undeterred by the financial disaster it previously entailed. So they were told — but it didn’t work out that way. In capitalist society you get nothing for nothing and the politicians (outright callous Tory or two-faced hypocritical Labour) make no bones about their ‘need’ to modify workers’ wages for (and limit the benefits of) a health scheme which fails to satisfy the “cheap healthy work force” expedient of those who planned it.

For let there be no mistake about the motive of those who devised the idea of a National Health Service, telling the world it was to ensure unfettered medical attention for all who needed it. It was (as many publications inadvertently disclose) to cut the cost to British capitalism in working hours lost to their businesses through workers’ sickness.

Now, these Capitalist interests are not happy with their own deal. They feel that British doctors are not doing their bit in the cheap maintenance of healthy wage slaves, but are spending too much capitalist money in the process by “overprescribing” for the sick who turn to them for help. A “free” health scheme (in fact it costs 20p per item on each prescription and there’s a lot of Parliamentary agitation to make it more) is all very well in the interests of the country’s employers — but if general practitioners take the thing too far they will have to be pulled into line. Thus Mr. Mike Thomas, Labour MP for Newcastle, has introduced a Bill demanding that registered medical practitioners be limited in the drugs they may prescribe to a small list and that their surgery treatment notes be made available to a panel who may have to “discuss” with them the treatment they arc making available to patients on the “National Health”.

Quote, from the doctors’ periodical Pulse 10.7.76: —

‘‘The Government may be forced into taking more radical action to reduce the level of prescribing, both within general practice and the hospital service in order to peg the rising drugs bill. Minister of State for Health, Dr. David Owen has called for ‘better prescribing overall’ and has reminded the profession, yet again, that it is now having to make economic decisions within the context of tightly reined resources. Unfortunately both Dr. Owen and Social Services Minister, Mr. David Ennals have reached that stage where they are issuing repeated warnings on the need for constraint in each sector of the Health Service, but no one knows precisely how the Government intends to cut back costs or what level of toughness it is prepared to use. The Department of Health circular issued last week, for example, was supposed to represent ‘Guidelines’ on the much-vaunted review of NHS management costs . . . Dodging the perfectly justifiable suggestions from one Tory questioner that there was need for a realistic uprating of prescription charges which still remain at their pre-inflation rate, Dr. Owen replied: “What is needed is better prescribing overall and a recognition by patients that not every ailment is cured by pills . . . The medical profession must recognize that it has to make economic decisions. At present the prescription Bill has no cash limit and is open-ended . . . But if the medical profession is not able to show some form of economic restraint in its budget, any Government would be forced to look at other measures ... At the moment we prefer to rely on education and we hope to keep the drugs bill within reasonable bounds by that method.’ ”

The article in Pulse continues:

The drugs bill to which Dr. Owen was referring amounted to £379 million during the last financial year in England. At £7.00 a year per person, was that not good value for money? Dr. Owen took this opportunity, replying to Labour back-bencher Dr. Maurice Miller, to confirm that the pharmaceutical industry was not guilty of drawing any excess profits — and that any blame for the escalating drugs bill lay with an over-demanding public and over-generous profession.

In other words, Dr. Owen has the gall to represent himself as unaware of how notorious drug firms are for their enormous profits, and upset by patient’s demands for adequate treatment and doctor’s desires to provide it!

Health at a Price

Quoting from the doctors’ periodical General Practitioner, 16.7.76, on page 8 we read:

A blunt warning that the National Health Service must ‘live within its means’ was given by the Prime Minister last week. Only 24 hours after the Cabinet began a series of meetings to prepare for public spending cuts totalling about £1,000 million next year, Mr. Callaghan made it clear that the NHS would not escape the treasury act. He told members of the Royal College of Surgeons at a dinner in London that ‘difficult choices and unwelcome decisions’ lay ahead in many areas of public expenditure. Doctors would be faced in their everyday work with a difficult period of adjustment from a fairly rapid rise in the amount of resources available in recent years to more stringent conditions.

This, of course, is a typical politician’s mealy-mouthed way of avoiding saying that National Health Service patients will have to suffer neglect by being denied benefits once promised by the British capitalist class. But to add insult to injury, listen to the sheer two-faced double-talk the Labour Leader follows it up with. Quote: “At a time when the ordinary wage earner is voluntarily cutting his own standards, the health service too must live within its means.”

In other words, Mr. Callaghan feels that if workers are being deprived in one way it is only fair that they also be deprived in another! This is the depth to which opportunist politicians will sink and a measure of the contempt they have for their wage slaves’ discernment.

This is but one of the many degrading aspects of life under capitalism, where men can dictate how much medical attention and care their fellows are “entitled to.” In a Socialist society such inhuman parsimony would be impossible. There would be no leaders able to hoodwink anyone, and not just  health care but all goods and services would be free to every one.

R. B. Gill

The Passing Show: Cheddington—The Reckoning (1964)

The Passing Show Column from the June 1964 issue of the Socialist Standard

Cheddington—The Reckoning

In just thirty-two minutes during the morning of April 16th, twelve men were sentenced to a total of 307 years imprisonment for their part in the great train robbery. Seven of the unfortunates received thirty years apiece and even the lowest sentence—on John Wheater the solicitor—was three years. Well might The Guardian describe the sentences next day as “a break from tradition", and point out that even in murder cases, a long term is only occasionally given.

It is no part of our business to argue for either side in the case, or to fall in with the idiocy of Methodist Dr. Donald Soper, who condemned the severity of the penalties but wanted Anglicans and Methodists to co-operate in working out a “Christian punishment". Justice Edmund Davies anyway would have had his reply — “A grave crime calls for a grave punishment"—and could probably quote plenty of Bible references and Christian ethics to support him. Probably, too, the majority of people would agree with him, although not without a sneaking admiration for the sheer daring and ingenuity of the whole plot.

Most of those sentenced said they would appeal, but whatever the outcome of this, it is worth repeating the point we made at the time. Those who practice armed robbery are just as much supporters of private property as any capitalist. The robbers of the Cheddington train, did on a much smaller scale of course, what whole groups of capitalist powers do when they go to war from time to time. There is no basic difference, even down to the detail of carving up the spoils afterwards.

In pronouncing sentence, the judge admitted that the crime in its enormity was the first of its kind in the country, and said “I propose to do all within my power to ensure that it will be the last". Which brings us face to face with the old question: does punishment prevent crime? The judge talked earnestly of deterring others “similarly tempted" but clearly failed to face up to the fallacy in his own argument. The thought of punishment obviously did not deter the men who did the robbery. It is too much to imagine that most of them at least had not weighed the possibility of arrest as one of the risks of the game, and carried on planning it just the same. In fact it has been seriously suggested that the Cheddington venture was financed from the proceeds of previous robberies, and if this is true, the deterrent power of punishment has obviously been sadly overrated 

No, crime is just one of the many facets of capitalist society and neither punishment nor a police force can stop it. For the modern criminal has merely responded to the conditions of a scientific and technological age, himself becoming a technician, mastering the know-how of oxyacetylene cutters, explosives, electrical gear and many other gadgets in the practice of his work. So that most of the time it is a see-saw battle between the police with all their modern means of detection and the boys who seek to outwit them. A battle, after all, between those who already own private property and those who want to take some of it from them. How can this sort of problem be solved by one set of robbers punishing another? The conditions of robbery of any sort must go, and that means the end of capitalism.

Health Charges and Hypocrisy

Perhaps one thing about being a member of H.M. Opposition in The Commons is that you can get away with just that bit more hypocrisy than H.M. Government. After all, the electors won’t blame you for things which go wrong while the other lot are in power and workers’ political memories are notoriously short. Anyway, it is about thirteen years since the last Labour government.

And thirteen years is a long enough time to forget the indignities of Labour rule, to forget that quite a number of present Tory policies had their origins in the years of Labour government, and that the Tories have been no more successful in solving working class problems.

Maybe then you would have missed the point of the statement made in the Commons on April 20th by Mr. Kenneth Robinson, Labour M.P. for St. Pancras North and Shadow Minister of Health. The next Labour government would, he said with a flourish, end prescription charges without making cuts anywhere else in the health service to make way for it. Now does your memory stretch back far enough to recall that the very first charges of this sort were imposed by the 1950 Labour government ? But not a whisper of this from Mr. Robinson.

Such a pledge will of course go down well with pensioners and others, whose plight forces them lo count every penny they spend. At the same lime it gives us an inkling of the contempt in which Labourites as well as Tories hold those who vote for them, the assumption being that a miserable few shillingsworth of pep pills and potions mark the limits of working class ambitions. Ironically and tragically, though, this is pretty near the truth, because working class ignorance means that arguments over crumbs like this can often cause a heated election tussle, while a terrifying problem like nuclear war can be all forgotten.

But health charges or H-bombs, the one thing which does not occur to workers is that they have their origin in the Capitalist system. Stubborn in their political ignorance, they hope to eliminate these problems and leave the cause intact—and that perhaps is the supreme irony of all.

Good Grivas

It’s funny how in the field of statesmanship, supposed enemies of yesterday can become friends of today, and vice versa, depending on the needs of the various ruling groups at the time. History is full of such instances. Stalin after 1945 for example. That was a right-about-turn if ever you saw one. Forgotten were the days when he was a comrade in arms of Churchill and Roosevelt, as the cold war got under way, and more than once the world was pushed perilously close to the brink of another major war. Now the pendulum could be swinging the other way as China develops and Mao becomes the bogyman of the Russian rulers. Then there is President de Gaulle with whom the British government must on many occasions have sworn eternal friendship, but who has been cutting up rough against British interests in Europe and pursuing his own semi-isolationist policies. Will he be the villain of the piece at some future date?

Take a look as the struggle in Cyprus. A few years ago, Makarios was interned in the Seychelles, only to come back later and shake hands over a peace agreement. But the peace was short lived and the British press rediscovers the blood-stained hands of the Cypriot president. Then into the news steps Grivas, another former enemy of earlier years, described by The Guardian of April 13th as “the brains of terrorism”.

General George Grivas was prominent for his direction of the campaign against the British from 1955 to 1959, and waged a ruthless struggle against an equally ruthless enemy, with murderous attacks against soldier and civilian alike. So in your innocence you might be astounded to see The Guardian editorial, again of April 13th, saying this about him:

. . . Whether we like it or not, Grivas is a man of influence, purpose, and decision, and ex-enemies with these qualities have helped us mightily in the past. . . If the General does go back . . . it might not be the worst thing that has happened to the Cypriots lately. The combination of a strong general and a weak president is not usually desirable, but in a country as lawless as Cyprus it can often bring peace more quickly, even if it does not bring justice.

A few years ago no name was too bad for this Grivas as British troops hunted (but never caught) him from one place to another. But times are changing, and with them the whole balance of strategy in the Mediterranean. What’s the betting they'll he pinning a medal on his chest yet?

Status Symbols

The world is full of them, and workers are among their most ardent supporters. What are we talking about? Status symbols of course. In a sane world where things were produced for use, you would expect an outlook in keeping with it. People would have a pride in producing the best at any given time because this would be the only way to give satisfaction to anyone, either in producing or using a particular article. Within Socialism, therefore, we would take great pride in producing things and in using them but not in owning them.

For pride of ownership is one of the false values that arise from capitalist society, where the forces of production are geared to the profit motive, and social approbation for a person is usually in direct ratio to the amount of wealth he owns, not to his usefulness to society as a whole. It is not surprising then that the status symbol has such a firm place in working class affections, and is encouraged by the advertising blurbs with words like ". . . You can be the proud owner of a . . . " But more than that, for many the status symbol is the pie thin crust that conceals the poverty beneath. This is the explanation for the paradox of enormous (mainly second-hand) cars often parked outside the slummiest dwellings, in Windsor a few years ago, over two hundred houses were checked by the G.P.O. and found to have T.V. aerials— but no sets.

Since then, the T.V. craze has slowed down, and people arc beginning to discover that cars are not an unmixed blessing in present frantic road conditions. Anyway, a status symbol loses its purpose if everyone has it so when this happens, the seekers must turn their eyes elsewhere. One certainty is that they will never stop looking. According to The News of the World recently, sun tans are now much sought after, and for as little as thirty shillings you can get your neighbour thinking you’ve just come back from a spell in the south of France. A travel agency in London's West End has started a sun bathing salon with ultra-violet lamps, to acclimatise their clients before they go abroad. Now they find that the majority of those using the salon are not going abroad anyway.

Pitiful, you might think? Tragic would be a better word, and as damning an indictment of capitalism as any. This is the system which never lets us really be ourselves, untrammelled and unashamed, but subjects us all the time to the strain of pretence. For many workers self-delusion plays a part in all this—the vain hope that maybe the pretence will one day be transformed into reality if they can only keep it going long enough and strong enough. Socialism, if it did nothing else, would release us from that sort of indignity at least. 

Eddie Critchfield

The N.H.S.—Was it worth it? (1975)

From the May 1975 issue of the Socialist Standard

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

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

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

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

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

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

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

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

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

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

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

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

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

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

R. B. Gill

Labour and the health charges (1961)

From the May 1961 issue of the Socialist Standard

It is evident that the Labour Party see in the new health service charges a much needed political "shot in the arm" for themselves. Amid much hullabaloo and many late night sittings, the advocates of a "controlled economy" have let it be known that at last they have found something in the Conservative Party's running of capitalism with which they disagree. The trouble the Labour Party now seem to be faced with is to get the different factions within the Party to recognise that a united Labour Party, “championing the cause of the poor and needy", is likely to pay far better political dividends than anything in the nuclear armament or disarmament range. Hence the recent almost frantic attempts to patch up the differences that exist within the party on these issues.

More and more it becomes obvious that far from being the vehicle of socialist ideas, either now or ultimately, the Labour Party has no ideas on the running of capitalism that differ fundamentally from those of the more generally recognised parties of the system. Thus, instead of being able to make a concentrated attack on the government-imposed charges on the health service, Mr. Gaitskell and Co. have been forced to defend the last Labour Government who set the example by themselves imposing such charges.

The capitalist press, who regard a lively opposition party (so long as it does not oppose capitalism) as a necessity of “democracy", rejoiced when for the first time since Suez the Labour Party found something in government policy about which to wax indignant.

Not satisfied with the impact of the “health" charges, the Daily Herald and later Mr. George Brown, Labour' deputy leader, in a party political broadcast, have attempted to blow the affair up as the beginning of a major attack on what they call the social services. This view is given some support by the demand of a group of Conservatives for a charge to be put on State education. The debates which have followed the introduction of the "health" bills have been given wide coverage in the press and read like the script of a farce—though a farce with grim undertones for the working class. Once again Labour Party spokesmen exposed their pathetic lack of understanding of the economics of capitalism and the basic hypocrisy of a party which, while claiming working class sympathies, seeks to administer the system which enslaves them.

Using the Korean War as the excuse for the Labour government's own health service charges, Mr. Brown merely demonstrated how the stresses and strains of capitalism’s economic and military rivalries always seem to thwart the upholders of the “planned economy" from easing the burden of wage slavery.

While the call for a curb on the profits of drug manufacturers may bring support to the Labour Party from any capitalists who see benefit to themselves from such a move, workers should remember that these profits have been made ever since the health service started. It was not noticeably Labour policy when in office to relate profit to the plight of workers in the way they now seek to do. Unfortunately for the Labour Party, workers are liable to remember Sir Stafford Cripps' wage freezing policies, and the Labour government’s support of a “ reasonable " rate of profit as necessary to the interests of the “controlled economy".

Socialists have never supported these so-called social services, seeing in them nothing but an endeavour on the part of capitalism's administrators to give the master class the cheapest and most efficient labour force possible, under the conditions prevailing at the time.

Eric Coffey

50 Years Ago: Labour and the Health Charges (2018)

The 50 Years Ago column from the March 2018 issue of the Socialist Standard

Anthony Greenwood, now a Cabinet Minister, told Labour’s 1963 Conference, on behalf of the Executive:

  “I repeat . . . the pledge we have given you before this, that we shall remove the existing charges in the National Health Service.”

Again, for the 1964 election The New Britain read:

  “The most serious attack on the Health Service made by Conservative Ministers has been the increasing burden of prescription charges imposed by them on those least able to pay. These charges will be abolished. Labour emphatically rejects recent proposals to introduce new charges for General Practitioner services; our aim is to restore as rapidly as possible a completely free Health Service.”

This time they were lucky. Wilson became Prime Minister and Kenneth Robinson Minister of Health. Sure enough, in a few months Labour redeemed part of its pledge. On 17 December Robinson announced the ending of prescription charges “which, since 1952, have created a financial barrier between the patient and the treatment he needs”. He went on to state that in time they would also redeem the other part of their pledge:

   “There will remain charges for dental treatment and appliances and those for spectacles. It is our aim to abolish these charges also.”

He did not say that for teeth and spectacles the financial barrier had existed since Gaitskell erected it in 1951.

In 1966, with Time For Decision, Labour faced the electorate, with the declaration that there were some principles they would not jettison “whatever the pressures”. One of those principles was that “even in times of economic crisis those in need should be helped by the state”. They brought forward their abolition of prescription charges as proof.

Less than two years later this principle is jettisoned. Wilson announced the restoration of prescription charges for many people at a rate of 2/6 an item. Far from abolishing the dental treatment charges, as Robinson promised, Labour raises them by 10/-. Charges for teeth and spectacles remain.

(from Socialist Standard, March 1968)

Labour and the Health Charges (1968)

From the March 1968 issue of the Socialist Standard

“The principle of the free, health service has been breached, and I dread to think how much that breach might be widened in future years”, said the President of the Board of Trade when he resigned from the Labour government in April 1951. He was objecting to 'imposing charges for National Health teeth and spectacles to raise money to spend on arms. His name was Harold Wilson.

Wilson was right. The new Tory government, elected in October of the same year announced within six months that it was to bring in prescription charges. The Labour Party was up in arms playing on its image as builder and defender of the welfare state. In Parliament they did all they could to oppose the measure. Former Minister of Health Hilary Marquand declared on 1 May 1952:

On behalf of my right hon. and hon. Friends I say when we are returned to power we shall take steps, as soon as Parliamentary opportunity permits, to bring all these charges— charges for drugs, medicines, appliances, dentures, dental treatment and spectacles—to an end.

This pledge was written into the 1955 election manifesto, Forward with Labour:

In order to restore a free Health Service, we shall abolish all charges, including those on teeth, spectacles and prescriptions.

In 1959 the manifesto, Britain Belongs to You, repeated:

We shall also restore the free Health Service by abolishing all charges, starting with the prescription charge.

When in 1961 the Tories increased the prescription charge to 2/- Labour MPs again opposed the measure. Anthony Greenwood, now a Cabinet Minister, told Labour’s 1963 Conference, on behalf of the Executive:

I repeat . . .  the pledge we have given you before this, that we shall remove the existing charges in the National Health Service.

Again, for the 1964 election The New Britain read:

The most serious attack on the Health Service made by Conservative Ministers has been the increasing burden of prescription charges imposed by them on those least able to pay. These charges will be abolished. Labour emphatically rejects recent proposals to introduce new charges for General Practitioner services; our aim is to restore as rapidly as possible a completely free Health Service.

This time they were lucky. Wilson became Prime Minister and Kenneth Robinson Minister of Health. Sure enough, in a few months Labour redeemed part of its pledge. On 17 December Robinson announced the ending of prescription charges “which, since 1952, have created a financial barrier between the patient and the treatment he needs”. He went on to state that in time they would also redeem the other part of their pledge:

There will remain charges for dental treatment and appliances and those for spectacles. It is our aim to abolish these charges also.

He did not say that for teeth and spectacles the financial barrier had existed since Gaitskell erected it in 1951.

In 1966, with Time For Decision, Labour faced the electorate, with the declaration that there were some principles they would not jettison “whatever the pressures”. One of those principles was that “even in times of economic crisis those in need should be helped by the state”. They brought forward their abolition of prescription charges as proof.

Less than two years later this principle is jettisoned, Wilson announced the restoration of prescription charges for many people at a rate of 2/6 an item. Far from abolishing the dental treatment charges, as Robinson promised, Labour raises them by 10/-. Charges for teeth and spectacles remain. After Wilson’s announcement a Labour MP, Laurie Pavitt, confronted him with Marquand’s pledge of May 1952. The official Hansard (daily) for 16 January quotes Wilson:

   The statement by Mr. Marquand on February 1, 1952, was a pledge to remove the charges which had been introduced in 1951, and it is only fair to say to my hon. Friend that such has been the problem that we have faced that we have not ourselves removed those Charges which were made on teeth and spectacles in 1951. I do not see how my hon. Friend can say that today’s announcement represents a fatal breach of principle.

This won’t do. If Marquand pledged Labour in 1952 to abolish the charges they themselves imposed in 1951, and Labour has failed to do this, then, by any standard, this is a breach of principle.

Wilson obviously found Pavitt’s reminder highly embarrassing. The parliamentary report of The Times of 17 January exposes Wilson's confusion. According to this report, what Wilson said was:

  The statement made by Mr. Marquand on May 1, 1952, was a pledge to restore the charges introduced in 1951. We have not restored those charges for teeth and spectacles, so I do not see how he can say that what I have announced reflects a breach in the principle

Another reporter, recorded in the Financial Times of the same date, confirms that Wilson said “we have not restored these charges on teeth and spectacles”. This, in his embarrassment, Wilson mistakenly has Marquand pledging Labour to restore the charges! But his remark about there being no breach of principle only makes sense if he really meant to say that Labour had not restored teeth and spectacle charges. Perhaps Wilson thought that Labour had ended these charges along with those for prescriptions in 1965. In any event, he was dodging the issue. Marquand pledged Labour to abolish all health charges and bringing back those on prescriptions is a breach of that pledge. Wilson seems to have had Hansard doctored to cover up his confusion, but despite this, his illogical argument comes out. Putting into Hansard something different from what was said is not uncommon, but it is nice to know that even Wilson has a guilty conscience over some of the pledges capitalism has forced him to break.

Aneurin Bevan called the National Health Service “pure Socialism” as it took buying and selling out of the treatment of the sick. True, Socialism does mean the ending of buying and selling, but Socialism is a social system that must replace capitalism; you cannot have bits of Socialism within capitalist society. In Socialism class ownership, the barrier to the community’s free use of the means of wealth production, will have been removed. All will have free access to what they need. But the NHS is not even free in the sense that Bevan meant. Part of the insurance stamp that is, deducted from wages and salaries is technically a “contribution” to the service. Wilson’s announcement that this deduction is to go up by 6d. will remind people of this.

So-called free services under capitalism are only so in appearance. Capitalism is based on the exclusion of the great majority of society from the ownership of the means of production. Consequently, they must find an employer to live; they must enter the labour market to sell their mental and physical energies for a wage. The value of human labour-power is fixed in the same way as that of other commodities: by the amount of socially necessary labour needed to produce and reproduce it. Thus, wages never amount to much more than enough to keep a man (and his family) fit to work at his particular job. If the working class has to pay little or nothing for medical treatment or housing, then their cost of living is subsidised and employers do not have to pay so high a wage. Employers do not have to make allowance for what their workers might have to spend on their health or housing. Since “free services” are paid out of taxation and taxation, in the end, falls only on those who own property, such schemes are really a way of spreading the cost of maintaining the working class in a fit state to work, over the capitalist class as a whole. The NHS has been correctly dubbed the back-to-work service. Except perhaps for minor ailments, the rich do not use it; they prefer to pay doctors and nursing homes for a better service. The aim of the NHS is to patch up workers as cheaply and quickly as possible. And it cannot even do even this minimum task adequately.

It is not because Socialists think highly of the NHS that we have produced Labour's past pledges on health charges. We do not think that Labour has betrayed us. They have, however, betrayed the millions of workers who voted Labour in the past four general elections. If you were amongst these millions, it is your duty to find out why Labour has betrayed you. Was it because Labour ministers are incompetent? Did they deliberately mislead you? Or, is it just that politics is corrupt? Labour leaders may or may not be incompetent, cynical or insincere. It matters little. Labour has been forced to break its word not because of the personal failings of its leaders, but because of the nature of the social system which they imagined they could control. Labour has always claimed that it could impose human and social priorities on capitalism. The NHS has always been given as a shining example. So it is poetic justice that Labour should be the agent of capitalism’s profit priority getting its own back.

Capitalism cannot be made to work in the interests of the whole community. It is a class system that runs on profits and so any government that tries to improve social conditions at the expense of profits, within the framework of capitalism, is bound to fail. The economic forces of capitalism will in the end dictate priorities to the government, as Labour now knows. Since they got power in 1964 capitalism has not given them a chance and, of course, it never will, despite the pathetic pleas of Wilson and Jenkins for another two years to put things right.

We are here fighting Labour on its own ground. It is they who made defence of the welfare state one of their principles, and used it as a means to win support. Socialists do not accept that the welfare state was the exclusive work of the Labour Party. Welfare services are a must at a certain stage of capitalist development. If free medicines and free prescriptions are something to do with Socialism, how explain that the Health Insurance Act of 1911 provided this for workers insured under it? The then Liberal government has no socialist pretensions. Quite the contrary, it was as anti-working class as the present Labour government. The last recorded case of striking workers being killed by troops occurred under Asquith.

The imposition of health charges is a further Labour attack on the living standards of the working class. No doubt workers will to resist by stepping up the trade union struggle. But this is only a defensive action. We advise workers to recognise that capitalism cannot work for them, whether run by Labour, Tories or Liberals: and to withdraw their support from these and other capitalist parties and join and support a genuine Socialist Party dedicated to replacing capitalism with Socialism.

Adam Buick