The planned strike is off, but we all know that the assault on the NHS will continue. The corporate incursions into the NHS that Hunt and his ilk are encouraging are because of neoliberal ideology, not a desire to provide the best healthcare. Can there be anyone on the left or right who doesn’t appreciate this, whether they voice it or not? Once politicians have decided that the corporate route is best for economic growth, profit and international competitiveness, then it’s very difficult to ascertain whether people like Hunt do what they do for personal reward from the corporate sector, or because they truly believe that the quest for perpetual growth, profit and international competitiveness is good for us. It may be, of course, that their hands are tied and that they have to take a certain line within the current political system. I can see that this may be true, but it doesn’t seem to me that Hunt is particularly upset about his attacks on junior doctors, or attempts to slowly sell the NHS to the corporate sector. On the contrary, he appears to take pleasure in his work.
The corporate system makes us sick
But the quest for perpetual growth, profit and international competitiveness is far from good for us. There are other things that the corporate mentality damages – most importantly the biosphere and democracy, but it also just makes everywhere ugly, bland and unhealthy. If we just focus on health – the corporate system damages nature and produces a constant stream of processed food, cigarettes, alcohol, boring, stressful jobs, toxic cleaning products, pesticides, fracking (involves pumping toxic chemicals underground), industrial waste, vehicle exhausts, toxins in clothes, furniture, building materials, household goods etc. So is it any wonder that we’re living through an epidemic of stress-related diseases, obesity, allergies, diabetes, cancer, asthma, mental illness and infertility? Ultimately, we need a new system.
Corporate frustration with the existence of the NHS
What’s happening to the NHS is pretty clear isn’t it? The corporate sector can see a source of profit that they can’t access, which they must find very frustrating, and so they are putting pressure on politicians to allow them to make profit from it. These are politicians whose parties are funded by the corporate sector, who have personal friendships with corporate CEOs, who spend more time meeting corporate lobbyists than they do constituents, who own shares in corporations and who are looking forward to well-paid jobs on the board of a corporation when they leave office (and possibly before). Of course they are going to toe the corporate line. It would be much more surprising if they didn’t.
Funding for the NHS has more-or-less flatlined since 2010, and George Osborne has made it clear that on his watch, he intends to reduce public spending as a percentage of GDP, as part of his neoliberal ‘small state’ project. The Health and Social Care Act 2012 was a way to open up more of the NHS to corporations, as responsibility for provision of universal health care was transferred to NHS England, with a remit to open up services to competitive tender. The chief executive of NHS England is Simon Stevens, formerly executive vice president of the UnitedHealth Group – no. 14 on the Fortune 500, worth around $80 billion. Is it really difficult to guess where his priorities lie?
Heading towards the US system
I know doctors who believe that it can’t be stopped. It will be a campaign of attrition by the corporate / state coalition until the NHS is privatised, and pharmaceutical and insurance corporations run our health service. NHS hospitals are crawling with corporate pharmaceutical sales reps, Coca-Cola vending machines and Costa Coffee outlets already, but we have to look to the US to see where healthcare in the UK is really headed. In the US there is a totally superfluous sector of healthcare provision – insurance companies – who need to pay shareholders and staff and advertise, which wastes money and makes healthcare more expensive. In the US, around 18% of GDP is spent on healthcare – twice as much as in the UK, but resulting in an inferior product. Around 20 million Americans have no access to healthcare – in the richest country in the world. Here’s an even more surprising statistic – the US has a higher public expenditure on health care than the UK – around 8% of GDP compared to 7.6%. This means that around 10% of GDP that is spent privately on health care in the US is for nothing at all – apart from corporate profits. If they had an NHS, they could have better health care for half the cost.
And then of course, there’s TTIP, a trade deal that will throw open public services across Europe to unprecedented and unrestricted competition from transnational corporations. More on this here.
So then, the direction that we’re moving in will result in a corporate system that makes us sick, but profits from our sickness by selling us liposuction, cosmetic surgery and most importantly, drugs, in a health service that costs twice as much for an inferior service.
What’s the alternative?
Clearly, the state is desperate to help the corporate sector take over the NHS, but they have to do it slowly because of public opposition. But it’s happening. Is there another way to ensure that health provision is run by and for the people, instead of for corporate profit? Is there a way, in other words, to provide healthcare free at the point of use, but without the state (so that we don’t have people of the quality of Jeremy Hunt making the decisions)?
The Mondragon co-operative federation, in the Basque Country, have one such system. 10% of profits are ploughed into social care, including health and education. It’s possible to imagine a system whereby co-operative groups like Mondragon (and the Co-op?) can provide healthcare to members and to local people who could be allowed to opt out of national health care taxation and pay into a co-operative fund instead. The anarchists in the Spanish Civil War had another – funded by local municipalities (anarchism doesn’t mean that local people can’t pool their resources to fund things that everyone needs, such as education and healthcare, so that it’s free at the point of use). Other systems are not beyond our intelligence.
In the meantime, let’s support the junior doctors, because having healthcare free at the point of use, to everybody, paid for from progressive taxation is by far the most humane way to look after each other within the current system, and people like Hunt know it. Hunt got a first from Oxford, so I’m not questioning his intelligence. So what’s left – compassion and integrity? Yes, I am questioning his compassion and his integrity. Unfortunately, in our party-political system, in an age of fear, where we don’t get to meet our political representatives, it’s relatively easy for people who don’t score well in terms of compassion or integrity (and in some cases, intelligence) to achieve high office. I think I might have mentioned this before, but we need a new political system. This one is unhealthy, as well as unsustainable, undemocratic and unfit for purpose.
