US health care row spreads to UK

By Julie Hyland
19 August 2009

The row in the US over President Barack Obama’s health care proposals crossed into UK political life in the last week. For the most part, it is motivated just as much by prejudice, political posturing and outright deception as its transatlantic counterpart.

Much of the UK’s attention has focussed on groups such as Conservatives for Patients Rights, who charge the Obama administration with seeking to introduce a “socialist” health care regime along the lines of the National Health Service in Britain. 

The accusations made in several advertisements and articles run in the US are grave. They charge the NHS, and by dint the British establishment, of setting an “Orwellian” cap on the value of human life. The British system, they contend, routinely rationalises health provision, condemning many to painful waits for treatment, denying medicine and even operating “death panels” discriminating against the elderly and disabled.

The Investor’s Business Daily suggested that leading physicist Professor Stephen Hawking, who suffers from Lou Gehrig’s disease, “wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.” Hawking, who is a British citizen, repudiated the claim, stating, “I wouldn’t be here today if it were not for the NHS.”

Despite the severity of the allegations, they were initially met with silence. Finally Prime Minister Gordon Brown broke cover—on Twitter. A bland message stated, “PM: NHS often makes the difference between pain and comfort, despair and hope, life and death. Thanks for always being there.” Another Twitter posted on behalf of Health Secretary Andy Burnham stated, “Over the moon about strong support for NHS,” which was second only to his football team in his affections. 

Conservative leader David Cameron followed. The thousands who had added a message to the Twitter campaign “We love the NHS” was “a reminder—if one were needed—of how proud we in Britain are of the NHS.” 

Even Rupert Murdoch’s press in the UK, whose Fox News in the US has run many of the allegations slamming Britain’s health care, adopted a seemingly conciliatory tone. Writing in the Times, Janice Turner opined that “free healthcare is the mark of a civilised society. It is the one principle that unites British politicians across the spectrum.”

This claim was blown apart by the comments of Conservative Member for the European Parliament (MEP) Daniel Hannan, who told US television that the NHS was a “60-year mistake,” and he “wouldn't wish it on anyone.”

Conservative attempts to dismiss Hannan as an eccentric were undermined when a second Tory MEP, Roger Helmer, told the BBC, “If the Americans came to me and said, ‘Would you recommend us taking up a system just like the British NHS?’ I think I would have to say ‘No.’”

Pro-Labour newspapers have pointed up the links between leading Tories and Republicans denouncing the NHS. In addition, the Observer noted that prominent Tory MPs had contributed, along with Hannan, to several recent publications arguing that the NHS is “no longer relevant in the 21st Century” and arguing for its replacement.

With the Tories apparently on the back foot, Brown broke off from his holiday to announce that his government would make health care the central issue in the campaign for next year’s general election.

This is a nauseating charade on a number of levels. Opposition to the NHS by the Tory right is hardly a revelation. Hannan’s condemnation of it as the “relic of an era in Britain when the state was considered all-powerful and benign” is pro-forma in the party that, under Margaret Thatcher, declared its intention to “roll back” the welfare state established in 1945.

What they despise is not the all too real inadequacies of the NHS, a product in large part of its systematic underfunding, but the socialist aspirations out of which it was born. 

At the end of the Second World War, working people in Britain—as across Europe—were determined not to allow a return to the conditions of depression, poverty and military devastation that had blighted much of the first part of the century. They demanded major curbs in the power of big capital, whose predatory interests were rightly blamed for these conditions. In the British General Election of May 1945, Labour won a landslide victory because it pledged that state provision would protect every Briton “from the cradle to the grave.”

At the centre of this was a health care system, free to all at the point of use, which millions rightly recognised as a progressive and hugely beneficial advance.

Notwithstanding working class hopes, the NHS—like all the measures enacted by the Attlee government—was never a “socialist” system. Largely funded by working people themselves, it did not require any major intrusions against capital. In particular, the major drug companies were not nationalised. Not only have they profited massively from the NHS, but this has played a major role in the “extortionate” costs of medical treatment routinely cited by opponents of the NHS.

In addition, in the last three decades, all aspects of welfare provision have come under systematic assault as part of a generalised offensive against the gains and conditions of the working class.

The Labour Party has played the politically decisive role in this. Having repudiated its former connections with the working class, it is no less hostile to any semblance of social equality than its Tory counterpart.

During its 12 years in power, Labour has significantly expanded the “internal market” first introduced into the NHS by Thatcher in the 1980s. In addition to strict budgeting and the closure of “surplus” facilities, the privatisation of health care provision under Labour has developed unabated.

Under the Private Finance Initiative and other measures, entire sectors of the NHS have been farmed out to major healthcare management consortiums, such as Care UK and the US-firm United Health, amongst others, while the London Ambulance Service is currently up for privatisation.

The introduction of fee-per-service measures has significantly expanded costs, paving the way for hospital insolvencies. As a consequence, it was recently announced that Hinchingbrooke Hospital could soon become the first to be run by the private sector.

Writing in the Guardian, GP Kailash Chand described the introduction of the market “as a cancer eating away at the NHS.” Under Labour, “the private sector had metastasised to virtually every organ of the NHS,” he wrote.

Only in April the Treasury demanded that the health service make cuts of £2.3 billion by reducing the duration of in-patient treatment. At the same time, the government is establishing a £20 million network of “commercial managers” in the NHS, whose task is to introduce “private-sector competition” in further areas of health care.

Across the media and the official political spectrum, there are shrill demands for deep cuts in public spending in order to offset the billions of pounds spent bailing out Britain’s major banks. 

All agree this must include health care. The Sun newspaper rebuked Cameron for implying “he will carry on pouring money into the NHS without seeking better value for taxpayers,” while the Independent complained that “the shouted defence” of the NHS was preventing a “serious discussion” as to “how the cuts in public spending, widely accepted as inevitable, will be applied to the health service.”

That people endure long waiting times on the NHS, and even die because the necessary resources are not available, is not due to UK health care being “socialised” but because it has become increasingly marketised. 

In Britain, no less than the US, the provision of free universal, state-of the art, health care requires the abolition of the capitalist market and the nationalisation of the banks and major companies as part of the re-organisation of the economic life according to social need, not private profit.