Labour in sickness and health (2025)

From the July 2025 issue of the Socialist Standard

We are told the NHS is a ‘national treasure.’ That it was built by socialists. That it belongs to us. That if we just had the right funding and the right managers, it could be restored to its former glory.

But we know better. The NHS is often cited, especially by those still enthralled by the Labour Party, as an example of ‘socialist’ legislation passed during the 1945–1951 Attlee government. Even people who now admit Labour is not socialist cling to the NHS as proof that it once was.

Let’s be clear: the NHS was never socialist. It wasn’t created to empower workers or take profit out of care. It was built to keep the workforce functional – to patch us up and send us back to work. A healthy worker is a productive worker – and a productive worker generates value for the boss. That’s why the capitalist class signed off on it. Not out of compassion. Out of calculation.

Sure, there was high-minded rhetoric at the time. Aneurin Bevan, considered the founder of the NHS, said: ‘No society can call itself civilised if a sick person is denied medical aid because of lack of means’. And William Beveridge, architect of the welfare state, said: ‘A revolutionary moment in the world’s history is a time for revolution, not for patching’. Later he stormed the barricades of the House of Lords as he became a Liberal peer.

The real context was fear. The ruling class had just dragged us through mass unemployment and a world war, and it now faced an angry, armed working class returning home. It saw what had happened in Italy. Reforms were made not to end capitalism but to save it from social and industrial unrest.

Bevan once asked: ‘How can wealth persuade poverty to use its political power to keep wealth in power?’ He blamed the Conservatives, calling them ‘vermin’. But take the party labels off, and the question becomes sharper. The problem isn’t just the Tories. It’s a system that ensures poverty exists in the first place.

Bevan couldn’t see that. For him, the enemy wore a blue rosette. For us, the enemy is the wages system, the class system, the profit system. That’s what’s killing the NHS. That’s what’s killing us.

Now, 75 years on, they’re not even pretending. The NHS has become a marketplace. Drugs are bought from profit-hungry pharmaceutical firms. Cleaning is outsourced to contractors who cut wages and corners. Just this month, a scandal was revealed over botched cataract operations performed by private clinics cashing in on NHS contracts.

We used to joke the NHS was held together with duct tape and goodwill – now they’ve outsourced the duct tape and privatised the goodwill. They say this is a Tory problem. But what has Labour done?

Wes Streeting – dubbed ‘Wes the Rat’ by campaigners – is Health Secretary and says he’s ‘not ideological,’ which is odd for a politician. He wants to ‘use spare capacity in the private sector’. He calls patients ‘customers.’ He says the NHS is no longer ‘the envy of the world’ – not because it’s been gutted, but because it hasn’t been modernised. That’s code for markets, contracts, fragmentation. The same failed model, just rebranded.

Starmer campaigned in 2020 on ending NHS outsourcing. That pledge disappeared like a junior doctor’s lunch break. Now it’s all about ‘outcomes,’ ‘efficiency,’ and ‘value for money’. In his worldview, health is a product, not a right.

He’s cited NHS England as an example of excessive bureaucracy, duplications, and inefficiency. NHS England’s functions are now being absorbed into the Department of Health and Social Care. The transition will take about two years – less time than it takes many trans people to get a first appointment on the NHS waiting list.

Around 9,000 jobs are being axed in the process, as AI systems take over. One of the main tech firms involved is Palantir, a data analytics and armaments contractor with deep ties to the American MAGA state.

Palantir’s NHS involvement began with a £1 (one pound) trial contract in March 2020, part of the pandemic response. Then came:

• July 2020: £1 million contract
• December 2020: £23 million, two-year deal
• June 2023: £25 million contract
• November 2023: £480 million for the Federated Data Platform (FDP)

Now, the NHS is locked in.

Palantir was co-founded by billionaire Peter Thiel, a Trump backer who once called the NHS a ‘monstrosity’. The company built software for the US Immigration and Customs Enforcement agency (ICE), the CIA, and for predictive policing systems. Its platforms – Gotham and Foundry – have been used for deportations, drone strikes, and surveillance. The CEO, Alex Karp, bizarrely refers to himself as a ‘socialist’ and a ‘neo-Marxist,’ despite running a firm helping military and police forces worldwide. He studied the Frankfurt School and Marxian philosophy but now says Western tech should serve national power and defence. In his book The Technological Republic, Karp argues that declining interest in Western civilisation has left tech without ‘patriotic duty’. Palantir, in contrast, builds tools for ICE and the US military – showing where its duty lies.

This company now runs NHS data infrastructure. There was no public debate. No vote. Just a quiet, technocratic handover, sold as ‘integration’ and ‘efficiency’. It sounds like an IT upgrade. In reality, it’s a power shift – from public stewardship to corporate control.

Palantir claims it doesn’t own the data. Maybe not. But it owns the system. The architecture. The infrastructure. That’s vendor lock-in – like getting a free coffee machine and finding the pods cost £12 each and are only sold in Texas.

This isn’t reform. It’s enclosure. The same old privatisation, dressed up as innovation. And the outcome? A two-tier system. A burnt-out workforce. A public service run like a business where care takes a backseat to cost-cutting.

They say the NHS is free. But people pay for it – with taxes when they pay them, with our labour and with our time. It’s not free. We are. Free to wait. Free to suffer. Free to die while shareholders get dividends and algorithms determine care.

The Socialist Party stands for more than better management or fresh branding. We advocate the abolition of the wages system. The end of profit in care. A world where there are no customers, no contracts, no markets – just people, meeting each other’s needs.

Health is not a service. It’s a condition of freedom. The NHS can’t be saved. It must be superseded – by a system where care is not rationed, outsourced, or monetised. Where no one waits, no one pays, and no one profits. That’s not utopian. That’s socialism. And we’re not asking for it. We’re organising for it.

A.T.

Managerial Politics (2022)

From the August 2022 issue of the Socialist Standard

Politics is currently infested with a breed of managerialism. We can see the sort of thing on social media, with people crying out for the Speaker of the House of Commons, Lindsay Hoyle, to ‘make Boris stop lying’ as if he were some sort of manager that could compel Johnson to speak the truth.

This reflects people’s experience of living in a society where ‘calling someone’s manager’ is a way to get satisfaction as a consumer, or to resolve a dispute between colleagues at work. Everything can be fixed by an appeal to authority.

The role of such managers, by definition, is to keep the shop, restaurant or office running smoothly and performing its function. Their intervention is meant to stop disputes getting in the way of the mission of the organisation.

For workers who find themselves trapped in these workplaces, it means grievance processes, investigations and the whole soul-sapping rigmarole of official-ese whenever they fall out with someone they can’t simply get away from, because they are also stuck in the same office.

Grievance procedures were legislated for by New Labour under the Blair government, and are part and parcel of how they view the world and politics: about fairness and process. There’s no intrinsic harm in them, but they are a part of the system that’s meant to slot humans into precise functions of a working machine, rather than promote human happiness, and are more about keeping a lid on relations, rather than making people happy or resolving the underlying problems.

This is the problem with managerialism as politics, it is about containing or smoothing over disputes as part of a permanent hegemony, rather than taking sides. The reality of politics is precisely about taking sides and picking winners in disputes. The only political question is: who rules? In managerialism, that question is effaced, there’s no dispute about taking sides, no deliberate picking of winners, only the continuation of the management is on the table, with no capacity to re-write the rules or relationships being allowed.

For example, Wes Streeting (seen as a rising star of the Labour Party right) got in trouble for stating that if he were in the RMT he would vote to strike, but if he were in government, he would be about trying to avert the strikes and bringing the two sides together, as a neutral. The trouble he got in was for going as far as saying if he were a union member he’d support strikes, but in the latter half of his comment he was clearly annunciating the Labour Party’s ideological position: they will not take sides, and will try to manage the dispute to stop it causing trouble in the overall mission of the organisation.

The problem is, in the world, there are sides to disputes, and any resolution will inevitably mean one side has won and one side has lost, refusing to take sides and ‘representing everyone’s interest’ means, objectively, that when they are not siding with tenants versus landlords, employees versus employers, the weak against the powerful, they are actually batting for the other side.

This leaves Labour trying to win the election through the appearance of competence and responsibility, avoiding any big picture or ideological discussion. They cannot oppose the Tories on any major point of principle, just on personal integrity and ethics. Hence why they are focussing on the Prime Minister’s personal behaviour (as reprehensible as it is: it does not fundamentally question the structures of our society or government).

Whether by design or coincidence, the press are able to effectively reward them for this decision to not question the structures and relations of power in our society, by suddenly discovering a string of apolitical scandals that they have known about for ages, to give an alternative management the chance to show that they can run the machinery of state just as well. Even if they don’t go so far as to actively campaign against the Tories, they can use the threat of Labour to discipline them, and keep them in line as well, on behalf of their wealthy friends and backers.

Labour, for their part, are hoping that the Tories will lose the election through their in-fighting. For their own part, they are quietly using managerial/bureaucratic techniques to sideline people associated with the leadership of Corbyn and quietly crush any rival internal factions: again, had this happened under the previous leader, the press would have been in full cry, but as the cause is bringing the machinery of the Labour Party to heel, their silence is now deafening.

As with the Wakefield by-election, they seem to be preferring that people don’t turn out for the Tories, and they can win by default, rather than trying, as Corbyn did, to activate new voters and build a new electoral coalition. If some of the Tory vote goes to the Liberal Democrats, then the managerialists will achieve their Nirvana, of ensuring that a change of government can occur without any appreciable change in society.

How long such an approach can keep a lid on things is anyone’s guess. But over the Channel, in France, Emmanuel Macron has been trying something similar for five years, using the threat of the old Front National as a means of disciplining the voters into accepting his managerialist bloc, and there are signs that that may be beginning to backfire, with the successor of the FN getting its highest ever number of Parliamentary seats.

Pik Smeet