Giving away NHS to profiteers
It costs Cuba £100 per person per year to provide a free medical service to its people, and life expectancy in Cuba is similar to that in the UK and the US.
The NHS in Britain provides a service that in 1997 cost £650 per person per year, and which we are constantly told the government cannot really afford, the conclusion being that the only way of keeping the NHS is increasingly to involve the private sector. It is this involvement, however, that makes Britain's health provision so much more expensive than Cuba's, while being no more effective. Millions of pounds are being poured into the pockets of private pharmaceuticals companies and service and equipment providers.
As successive Tory and Labour governments have introduced privatisation measures such as the 'internal market' and forced hospitals to pay market 'rents' for the use of their premises, thus driving hospitals into the arms of multinational banking loan sharks, the proportion of the NHS budget that actually goes to providing medical services has got smaller and smaller.
Government spending on the NHS might have increased substantially, but an increasingly large part of that spending goes straight to profiteers, as well as to supporting the army of non-clinical administrative staff needed to deal with the whole process of competitive tendering, drawing up complex contracts, complicated accountancy, etc, etc.
The old NHS
The old NHS came about because, on the one hand, the communist Soviet Union had demonstrated how easy it was to provide a comprehensive and universal health service to the masses once capitalism was overthrown and, on the other hand, because the bourgeoisie that rules this capitalist country did not want the British working class to think that the only way they were ever going to get decent health provision was by following the Soviet example and making Britain communist too.
Moreover, as an imperialist country whose banks and multinational corporations make billions in profits from the superexploitation of countries in the exploited world, it was an 'affordable' crumb to throw at the British working masses to keep them from turning to thoughts of revolution.
A number of things have changed since those times, however, namely, competition among capitalists has sharpened, so profit margins are acutely threatened; there are decreasing opportunities for profitable investment, so private capital is desperate to move into areas of 'captive' markets - the principal ones being utilities and public services (such as education and medicine); and the Soviet Union has collapsed, making it easier for the moneybags to convince workers, quite wrongly, that they should not look to communism for their salvation and must abandon all thought of overthrowing capitalism.
Both Tory and Labour governments therefore began to make cuts in the NHS.
After 20 years of this process, which began gradually, we now see hospital cleaning, catering, building maintenance and construction, etc in private hands, allowing a goodly proportion of the public money earmarked for the health service to find its way into the private pockets of the super-rich.
All this privatisation is making the NHS more and more expensive. While the government uses ‘expense’ as an excuse for yet more privatisation, it funds expensive PFI schemes by cutting services (medicines, operations, A&E departments, wards, nurses and entire hospitals, along with care for the elderly and mentally ill) that are already seriously deteriorated.
To facilitate privatisation, the NHS system has been broken down into separate individual hospital trusts, health centres etc, making it no longer possible to plan for the efficient distribution of services throughout the country. Thus we see a 'post-code' lottery for treatment and medications, alongside increasing pressure to turn to private health insurances schemes.
In the year 2000, the US spent more on health than any other country - an average of $4,500 per person - but US life expectancy is only 27th in the world. Cuba is 28th, although its health expenditure is only a fifth of the US's. If, however, one were to deduct from US spending all the money that goes in profit and additional administrative and management costs necessitated by market mechanisms, US expenditure per head might be as low as Cuba's.
Fight for free health care
To save our NHS, to establish ideals of the best possible health care from cradle to grave provided free to the entire population, it is pointless to beg and plead with the parties that represent the interests of capitalism, be they Tory, Labour or LibDem. The interests of the bourgeoisie nowadays militate strongly against those ideals.
What is happening to the NHS shows in microcosm how capitalism is damaging the whole of human society all over the world, holding back the exponential progress we might otherwise be making in our ability to provide for the needs of the whole of humanity - including the millions living in the oppressed countries of the world, who under capitalism are starving and have no medical care at all.
The living experience of doctors, nurses, health workers and patients points in one direction only - the need to overthrow capitalism and establish socialism; the replacement of the market economy by the planned economy, the replacement of profit as the motivator of production by the motivator of satisfaction of human material and spiritual need.
This can, however, only happen if the working class, the people most affected by the absurdities of the capitalist system, actually get together and organise to make it happen. This is why we urge you: join our party - join the fight!