38 Degrees Petition against Truss and Coffee’s Running-Down of the NHS

I just go this email message from internet petitioning service 38 Degrees. Their disgusted at the government’s latest ‘reforms’ to the NHS, which in fact consist of telling doctors to try harder. They make the point that it doesn’t do anything to cut waiting lists nor counter the increasing rates of burn-out suffered by doctors because of overwork. They have therefore launched this petition against it, along with a wider campaign to spread the word about the government’s dreadful NHS policies using an ambulance.

‘Dear David,

Yesterday, our fourth Health Secretary since last year, Thérèse Coffey, revealed the Government’s “Plan For Patients”. [1] It turns out, the plan is nothing more than telling GPs to try harder and giving them a new target. [2] Health groups have said it will “make no tangible difference” and have “minimal impact on the care patients receive.” [3]

This is not acceptable. New PM Liz Truss says the NHS is one of her top three priorities. [4] Yet more than six million of us are languishing on waiting lists. More than two million of us are waiting to see GPs. And there are more than 60,000 NHS vacancies across the UK, with doctors at breaking point, suffering burnout. [5]

We needed something big. This wasn’t it.

We should all be furious about this. There is no point giving GPs new targets if there aren’t enough GPs to meet them. How is a new “cloud-based” phone system supposed to put an end to thousands scrambling for appointments first thing in the morning when there aren’t enough appointments to go around?

David, 38 Degrees supporters like you have been campaigning for a better NHS as long as we’ve been around. We can’t let the Government get away with this new lacklustre plan. Will you sign the petition demanding better – then share it with your friends and family so we, the British public, can make clear that we won’t accept anything less than a properly funded NHS?

YES, I’LL SIGN

NO, I DISAGREE

Over the summer, we fought hard to show that the NHS is on a knife edge. That’s why we bought an ambulance, turned it into a mobile advert, and drove it to leadership campaign events across the country. [6] We know Liz Truss heard us, because she said on the steps of Downing Street when she became PM that making sure “people can get doctors’ appointments” was one of her early priorities. [7]

Yet this first step is embarrassingly inadequate compared to the scale of the problem. And while it can feel hopeless at times seeing what’s happening to our beloved NHS, we know we can change things if we work together. That’s why last year we fought hard for NHS staff to get the pay rise they deserve, and after initially offering a 1% pay rise, the Government increased their offer after hundreds of thousands of us spoke out. [8]

The NHS is one of the most important issues to the 38 Degrees community. We’re not prepared to stand by and let this government underfund and understaff it. Millions of people depend on the services it provides, and thousands more will suffer if we don’t speak out.

Will you sign the petition, and get your friends and family to do the same? It only takes a few seconds to add your name, and a few seconds more to ask others to do the same.

YES, I’LL SIGN

NO, I DISAGREE

Thank you for your continued support,

Jonathan, Veronica, Megan, Tash and the 38 Degrees team

NOTES
[1] PoliticsHome: Therese Coffey Sets Out “Expectation” That GPs Will See Patients Within Two Weeks
[2] See note [1]
[3] Royal College of GPs: More expectations without addressing GP workforce shortage not best way forward, says RCGP
British Medical Association: Health Secretary’s new plan brings us closer to the demise of general practice, says BMA
[4] Sky News: The economy, the energy crisis and the NHS – Liz Truss sets out three key priorities in her first speech as PM
[5] Daily Mail: NHS waiting list shoots to ANOTHER record high of 6.8million
Evening Chronicle: ‘Bad health has doubled’ in the last decade across North East – and almost half of people report struggling to get GP appointments
BBC News: NHS in England facing worst staffing crisis in history, MPs warn
The New Statesman: “This is just not safe for anyone”: the NHS doctors at breaking point
[6] Express & Star: Ambulance protest greets Tory Party members at hustings
BirminghamLive: Protestors voice anger at NHS delays and costs crisis outside Truss v Sunak hustings at NEC
[7] 10 Downing Street: Prime Minister Liz Truss’s statement: 6 September 2022
[8] 38 Degrees: NHS Staff Pay Rise Campaign‘

I’ve had absolutely no problems signing it. If you feel the same way about this latest assault on the NHS, please feel free to do so as well.

Cameron Blames Lansley and Lib Dems for His Act Promoting Privatisation of NHS

This fortnight’s issue of Private Eye also has a few choice things to say about David Cameron’s new book, For the Record. This seems to be largely his attempt to justify his wretched tenure of 10 Downing Street and the havoc he caused. The book’s reviewed, and comprehensively and thoroughly trashed, in their ‘Literary Review’ column on page 34 in a piece titled ‘Shed tears’. It’s a long review, which can be summed up by saying that Cameron keeps trying to claim that his government left Britain stronger, more stable, and more prosperous. To which the Eye’s answer – and just about everyone else’s – is Brexit, and a few telling details refuting the Old Eton’s bogus claims.

The magazine’s ‘Medicine Balls’ column also attacks some of Cameron’s claims. It begins by refuting BoJob’s claim that he’ll build 40 new hospitals, before going on to tackle Cameron’s little stories. Including the former PM’s claim that he wasn’t really responsible for the Health and Social Care Act of 2012. This is a nasty little piece of legislation which, behind its convoluted verbiage and tortuous clauses, exempts the Health Secretary from having to provide Brits with universal healthcare which is free at the point of service. It’s a piece preparing for the wholesale privatisation of the NHS, and is duly attacked as such in the book NHS – SOS. As Prime Minister, Cameron is responsible for the Act. Except he claims it’s all the fault of his Health Secretary, Andrew Lansley, and the Lib Dems. The Eye writes

Then there is the small matter of repairing the disastrous Health and Social Care Act, a Trojan horse for outsourcing NHS services to the private sector via an astonishingly wasteful process of repetitive, competitive tendering. David Cameron, in his autobiography, places the blame for the act on his health secretary Andrew Lansley, the Lib Dem coalition partners and the British Medical Association (BMA): “Andrew Lansley … was too submerged in the detail. The jargon he’d use was baffling. I remember sitting in cabinet when he shared his reform white paper. it was like an artist unveiling a piece he’d spent years on, and everyone wondering what on earth it was.” So why did he allow such chaos to progress?

It was the Lib Dems fault, claims Cameron, that he was forced to abandon his pre-election pledge of “no top-down” reorganisation” of the NHS, because they insisted that primary care trusts should be abolished rather than left “wither on the vine”. Then there is the BMA, which Cameron declares “will oppose anything, whether it is a good idea or not.”

(Eye page 17).

From this it’s clear that there was little ideological difference between Cameron and the Lib Dems. Both wanted the primary care trusts to go. It was simply a difference of the means.Cameron wanted them to decay quietly, the Lib Dems wanted abolition.

The column also attacks Comedy Dave’s pledge to support the NHS:

But he also promised to “always support the NHS with the funding it needs”, which he manifestly failed to do. And the promises in his 2015 manifesto – “to make the NHS the safest and most compassionate health service in the world” – were always phoney given the lack of resource, capacity and staff.

The article does admit that Cameron did some things right, such as highlighting the dangers of anti-microbial resistance, but attacks his role in provoking the junior doctor’s strike by demanding they work weekends, based on flawed, decades-old statistics.

From this it’s very clear that, whatever he says about Lansley’s Health and Social Care Act, Cameron was in favour of the privatisation of the NHS. No surprise there, then. He’s a Thatcherite, and Maggie Thatcher wanted to privatise the NHS. She couldn’t, because her Personal Private Secretary, Patrick Jenkin, found out how awful the American, insurance-based system was, and there was a massive cabinet rebellion. But she was determined to open it up to private industry. This was taken over by Peter Lilley and John Major, who introduce the Private Finance Initiative, and then by Tony Blair and Gordon Brown, who expanded it in their turn. It was then taken up, once again, by David Cameron, Nick Clegg and Tweezer. And I’ve no doubt Johnson also wants to privatise it, after he gets through ruining the country with his assaults on the sovereignty of parliament and a ‘no deal’ Brexit.

And the Lib Dems share the Tories’ determination to destroy the NHS. At the last election, Nick Clegg stated that he wanted to open the NHS up to private industry, as those countries, whose healthcare had a mixture of state and private provision had ‘better outcomes’. It’s a flat-out lie, or it was until he and the Tories started their disastrous campaign of trashing the NHS. And Swinson shares his goal of privatising it. She consistently voted for the government’s bills, and supported them far more than some front bench Conservatives.

Despite this, she claims that she and her party are ‘progressive’, solely because it ostensibly supports ‘Remain’. But this is sheer opportunism. When it came to the referendum, she issued a single, lukewarm tweet and was nowhere to be seen, while the Labour leader she reviles was travelling up and down the country. As for her party, the proportion of Lib Dems who support ‘Remain’ is only two per cent higher than that of the Labour party. Her whole pro-Remain stance is a lie, as is just about everything she says.

Don’t be fooled. Both the Tories and Lib Dems want to privatise the NHS. The only person who doesn’t, and will block it, is Jeremy Corbyn.

 

Tories Manufacture Dispute with GPs to Destroy NHS. Again.

Mike over at Vox Political today posted a truly chilling story for everyone who genuinely believes in and supports the NHS. He quotes a former deputy chair of the British Medical Association, Dr. Kailash Chand, as saying that doctors are now so sick and tired of being scapegoated by May and her lickspittle puppet, Jeremy Hunt, that they are considering disaffiliating from the NHS. Doctors are rightly annoyed at being blamed by the Tories for the crisis caused by the underfunding of the NHS. Mike’s article also reports that they are also angered by May’s demands that they run a service from 8 am in the morning to 8 pm at night, seven days a week. If they do not do so, they will losing their funding. Unless they say that there is no demand for it from their patients.

Dr. Chand has said about the attacks on GPs for the gross failure of the Tories

“I think making this particular statement at this minute is essentially scapegoating. [May] has got to find something, she can’t blame [the health secretary] Jeremy Hunt for this, or her own government.

“She’s got to find a scapegoat and GPs are probably the easiest scapegoat in this way because your rival papers, like the Daily Mail, all the time are giving the public the view that GPs don’t work and GPs are working only nine-to-five, which is nonsense.”

Mike in his article makes the point that this is exactly what Theresa May wants and will bring the prospect of a private, for-profit health system like that in America closer. He makes the excellent point that tyrants like May should not be given what they want, and recommends that doctors should set up charities as a way of blocking her plans to foist this on the economy. This isn’t a perfect solution, but it could be an effective stop-gap until a Labour government is elected that will renationalise the NHS.

His article ends

Theresa and her Tories must be defeated here. Much more depends on it than simply the NHS in England (and Wales, Scotland and Northern Ireland, whose funding is dependent on the English service receiving cash).

Let’s have a contingency plan ready, for the moment the worst prime minister in UK history does the worst thing she possibly can. Because I think she will.

See http://voxpoliticalonline.com/2017/01/14/if-gps-disaffiliate-from-the-nhs-how-about-forming-charities-to-thwart-theresa-may/

Right-wing governments, including that of Tony Blair, have wanted to privatise the NHS for a very long time now. Thatcher wanted to do so in the 1980s, but was stopped by a cabinet revolt, and by finding out just how bad the American system. Nevertheless, she still wanted 25 per cent of the British population to take out private health insurance. And she also tried again to moot its privatisation a few years later.

John Major introduced the PFI scheme specifically so privatise enterprise could take over the construction and management of hospitals. It had nothing to do with efficiency or savings, and everything to do with allowing his paymasters in private health the opportunity to profit from this part of the state economy. And after his government was replaced by New Labour, Blair introduced a series of reforms which were further intended to privatise the NHS. Apart from granting more contracts to private firms and hospitals, he also wanted to replace GPs’ surgeries with polyclinics or walk-in centres, which were also supposed to be privately run. He also set up Community Care Groups, of local GPs, to manage doctors’ surgeries in the area. These were intended to have the power to arrange treatment from private healthcare providers. They are also able to opt out of the NHS, and raise money as private healthcare firms, if they so choose.

Now May and Hunt are deliberately stirring up a dispute with doctors, so that many will leave the Service altogether. Many parts of the country, including my own in south Bristol, have trouble finding staff thanks to the contrived departure of many medical professionals due to Tory policies. This is another attempt to force even more out.

This is not something that May’s just dreamed up out of the blue either. She’s taken a leaf from that other great Tory leader, Maggie Thatcher. I can remember thirty years ago when Thatcher contrived a dispute with the dentists, which resulted in them leaving the NHS. She refused to award them a rise in funding, which the dentists claimed was needed because of their use of expensive equipment.

As a result, many left the NHS, so that today those unable to pay privately may have great difficulty finding a dentist willing to treat NHS patients.

May is doing the same now with doctors.

She has to be stopped, before we go back to the conditions of horrifically poor health provision for everyone except the very rich before the establishment of the NHS under Nye Bevan.

The War and Socialist Demands for a National Health Service before the Beveridge Report

This is following a debate I’ve recently had with a critic, who stated that the National Health Service had its origins in the Beveridge Report of 1942, and was endorsed by Winston Churchill and the Conservatives. This is true, up to a point, though Churchill was initially very cautious about the foundation of a National Health Service. After the War he made a radio speech denouncing the Labour party’s plans for a complete reconstruction of Britain as ‘a Gestapo for England’. However, Michael Sullivan in his book, The Development of the British Welfare State (Hemel Hempstead: Prentice Hall/Harvester Wheatsheaf 1996) also points out that before the publication of the Beveridge, there had been a long process of negotiation and demand for some kind of comprehensive, free healthcare for working people, and that this had become official Labour party policy in the 1934. He writes

Discussions about the reform of British health care had, in fact, occurred between the National Government and interested parties during the 1930s (Abel-Smith, 1984, pp. 424-7). The starting point for these discussions was the extension of health insurance rather than the position adopted by the Socialist Medical Association in the early 1930s. These latter proposals, which became Labour party policy in 1934, included the provision of free services to patients, the establishment of a corps of full-time salaried doctors and the introduction of local health centres which would be the hubs of the health care system. The discussions between doctors and government had emphasised the need to cater for the British Medical Association’s preference for the retention of a large private sector in health and the extension of health insurance to cover hitherto uninsured groups. (Leathard, 1991, p. 24).

During the early war years the departmental civil service encouraged the continuation of these discussions and received deputations from the medical profession and the Trades Union Congress. Events, however, overtook these discussions. The formation of the Emergency Hospital Service had, as we have noted earlier, the effect of providing a planned health service, albeit in the conditions of war.

By 1941, civil servants in the ministry of health, perhaps influenced by the running of the EHS, suggested a comprehensive national health system in which general practitioners would be grouped in health centres associated with local hospitals. In October of the same year, the Minister of Health, the Liberal, Ernest Brown, announced that some sort of comprehensive service would be introduced after the war. The organisational and funding arrangements of the service remained unclear, though the minister did suggest that patients ‘would be called on to make a reasonable payment towards cost, whether through contributory schemes or otherwise (Hansard, 10 October 1941). At this time, a survey of hospital provision was also set under way.

At the same time, professional interests were attempting to influence the shape of any future national health system. First, the voluntary hospitals, which had been in financial difficulties before the war, started to plan to avoid the return of financial ill-health after the war. Their suggested framework for a national health system included a closer co-operation between the two existing hospital systems in which local authority hospitals might buy service from the voluntary sector, a call echoed of course in the 1980s, if in a slightly different form and from a different source!

The British Medical Association and the Royall Colleges were also active. Charles Hill, better Known to a generation earlier than that of the author’s as ‘the radio doctor’, and later to become a Conservative Minister of Health, argued that those who planned first would be more likely to influence the final form [of the health service].’ That planning initially included an acceptance of the ideas emerging about General Practitioner (GP) health centres, as well as those of central planning and of a universal and free service. (Pp. 40-1)

He then describes how the BMA later changed its opinion, and became resolutely opposed to the idea of socialised medicine.

Of the contribution of the Conservative Health Minister, Henry Willink, he says

The White Paper, introduced by the then (Conservative) health minister, Henry Willink, conceded very little to the doctors and the voluntary hospitals. Indeed it was, at first sight, almost as radical in intent as the National Health Service came to be seen. Under this plan, a national health service was to be comprehensive and free and financed out of general taxation and local rates. A closer look at the White Paper reveals acknowledgement of some of the doctors’ concerns, however. The planned service would, as far as the ministry was concerned, be free and comprehensive. There would, nonetheless, be no compulsion for doctors or patients to use the planned public service but doctors who opted into the system would be offered the opportunity to become salaried employees of the central or local state. This latter offer, of course, flew in the face of the formal position adopted by the BMA. (p. 41).

He also points out that Willink appears to have retreated from several of his initial positions due to lobbying from the BMA:

In the succeeding months, political lobbying was intense. BMA leaders engaged in secret negotiations with Willink and appeared to have achieved a large degree of success. It seems that the minister colluded with the BMA in dismembering the proposals contained in the White Paper. First the idea of Central Medical Board was dropped to be followed by the demise of plans for a salaried service organised around health centres. Local authorities, it was now decided, would build health centres, but not control them. Instead GPs would rent the buildings, would be remunerated by capitation fee and be entirely free to engage in private practice. (p. 42).

He also argues against the view that the War was ultimately responsible for the creation of the NHS, and that it was the result of an overall consensus in which there was little left for Labour to do but decide the final details. He writes

The war cannot sensibly be regarded as the midwife of the NHS. Some account must also be taken of pressure for change in health policy during the inter-war years.

As we have already seen, the SMA were successful in placing these recommendations for a national health service on the political agenda during the 1930s. These proposals for a free and comprehensive service with a salaried staff formed the basis of Labour party policy as early as 1934. The proposals put forward during this decade by the BMA were, of course, less radical but acknowledged that there were fundamental weaknesses in available medical cover. On two occasions in the 1930s, it published reports which recommended that each citizen should have access to a family doctor and to the services of appropriate specialists. These recommendation, like later proposals from the BMA, fell far short of a national, or nationalised, health service; the financing of the service was seen as best achieved through a system of health insurance. The BMA were even unwilling to accept the recommendations of its own Medical Planning Commission about the scope of a health insurance scheme (Sullivan, 1992). Nonetheless, the BMA during the 1930sa was ready to concede that co-ordination of any post-war service was most satisfactorily located at the national level. (pp. 42-3).

He also notes that even in the 1920s there were calls for some kind of national health service.

There had, of course, been an even earlier call for a national health service. In fact in 1926 the Report of the Royal Commission on National Health Insurance was published. It acknowledged that the insurance system established in 1911 by a reforming Liberal government had become an accepted part of national life. It suggested, however, that ‘… the ultimate solution will lie we think in the direction of divorcing the medical service entirely from the insurance system and recognising it, along with all other public health activities, as a service to be supplied from the general public funds (HMSO, 1926). (p. 43).

Of the supposed consensus produced by the War in favour of an NHS, he says

While it is undoubtedly the case that the experience of war played some part in promoting ideas about changes in the principles and practices of health care (ultimately represented in the 1944 White Paper), it is far from clear that this process represented a new beginning. War may simply have achieved the acceleration of an already established process of policy movement.

Nor should we fall into the trap of seeing the development of war-time health policy as consensual, leaving a Labour government only to decide on the best way to implement agreed policy frameworks. Though many doctors, even in war time, supported the idea of a health system funded from general funds and including a salaried service, there was critical resistance to some of the measures outlined in Willink’s White Paper. that resistance, from the BMA leaderships and, it must be said, from a small majority of doctors responding to the BMA survey, included resistance to the idea of doctors as public servants and, sometimes, to the idea of comprehensive health system itself.

Even among those medical and other interests favouring the establishment of a comprehensives system, there were conflicts about other issues. While the SMA and the Labour Party and Service doctors supported the idea of financing the service from the national Exchequer, most other doctors and certain elements in the Conservative Party favoured a system of health insurance, either publicly or privately administered. While the former grouping favoured control of the health service by central or local government, many doctors opposed government activity that went beyond central planning functions. While the SMA, Service doctors and local medical officers, the Labour Party and some ministers in the Coalition government favoured a salaried service, this found very little support in the wider ranks of the medical profession.

By the end of the war there was agreement of only a limited nature, which masked a wide divergence of opinion amongst interested parties in the health field and in the wider social politics of health. (P. 44).

He concludes

War-time health policy seems, then, to be of less significance than some claim in defining post-war health policy. Though limited agreement on the need for a comprehensive system had emerged, conflict remained over the nature of that system. More than this, inter-war factors seem to be not insignificant in the growth of pressure for a comprehensive health system. War undoubtedly accelerated the acceptance as orthodoxy hitherto contested arguments. Nevertheless, as Aneurin Bevan was to find out, that orthodoxy was still some way short of a national health service.

It’s therefore clear then that sections of the civil service was aware of the defects in existing health provision in the 1920s, and that the Labour Party was demanding something like an NHS from 1934 onwards. The proximate cause of the emergence of the NHS was indeed the emergency health care system set up in the war to treat victims of bombing and evacuees. I concede to my critic the fact that Churchill was, at times, cautiously in favour of an NHS, and that Henry Willink did advocate a free health care system, although his was not ultimately as radical as that set by Bevan.

Nevertheless, ultimately it was Bevan and the Labour party that set up the NHS in 1946. Furthermore, even though there were elements in the Tory party that certainly supported the creation of the NHS and welfare state, there were still many others that opposed it.

Furthermore, the origins of the National Health Service in a fragile war-time and post-war consensus does not, unfortunately, alter the situation today. The Tory party is determined to privatise the NHS by stealth. Jeremy Hunt has said that he wants the NHS broken up and replaced with private health care. Another Tory apparatchik stated that by 2020, if his party had its way, the NHS wouldn’t exist except as a clearing house for health insurance. This was later denied by the Tory spin machine, would claimed that he instead said that the Tories would succeeded in removing unnecessary health regulations and bureaucracy. In the last government, there were 95 Tory and Lib Dem MPs with interests in private health firms, hoping to profit from the NHS’ privatisation.

The only remaining clear champions of the National Health Service as national, free, universal system are the anti-Blairite wing of the Labour party under Jeremy Corbyn.

And that’s my last word on this issue. At least for now.

The Foundation of the NHS: The Conservatives’ Reaction to the Beveridge Report

As I mentioned in my last post, I’ve been discussing the origins of the NHS with a presumably Tory critic, who took issue with my statement that Nye Bevan is the NHS’ founder. Among his other points, he argues that Winston Churchill was in favour of it, and the NHS would have happened regardless of who was in government at the time.

I have argued that Churchill was in fact highly ambivalent about it. Sometimes he was for it, at other times against. G.C. Peden, in his British Economic and Social Policy: Lloyd George to Margaret Thatcher (Oxford: Philip Allan Publishers Limited 1985) has this to say about the public and the government’s response to the report.

The focus for discussion of postwar social planning was the Beveridge Report on Social Insurance and Allied Services (Cmd. 6404). The Report appeared in December 1942, at a time when ultimate victory could be foreseen and when new incentives had to be found to maintain the war effort. Despite this, the Government was cautious, if not openly hostile, to Beveridge’s proposals for universal social insurance, without means test, against interruption of earning due to unemployment, ill health or old age. It was true that the Anglo-American peace aims in the ‘Atlantic Charter’ of 1941 had included a reference to ‘social security’ but Churchill thought that such plans should be substantially left until after the War. As Harris (1977) has shown, the Beveridge Report had been very much Sir William Beveridge’s own handiwork. His committee had been expected to deal with technical questions related to workmen’s compensation for industrial disease or injury, and with anomalies in social insurance, such as the well-known one whereby a man whose earning were interrupted because of unemployment received a higher rate of benefit than if he were sick. Beveridge, however, had gone beyond his terms of reference and had called for an attack on Disease, Ignorance, Squalor and Idleness as well as Want – the five giants on the road of reconstruction, as he called them in Bunyanesque language. In particular, he stated that no satisfactory scheme of social security could be devised unless there were family allowances, comprehensive health and rehabilitation services, and avoidance of mass unemployment. Indeed, the actuarial soundness of Beveridge’s plan depended upon the average rate of unemployment being no higher than the lowest level in the 1930s; that is 10 per cent of interwar insured labour force or 8.5 per cent of the wider body of insured employees in the new scheme (Cmd 6404, pp. 120, 154-65, 185-6). Uncertainty whether unemployment could be controlled, and memories of the political consequences of an actuarially unsound unemployment insurance fund in 1931, no doubt contributed to the Treasury’s critical reception of the Report.

Nevertheless there can be little doubt that the Report was extremely popular with the general public and, following a backbench revolt in parliament, the Government felt compelled to commit itself to Beveridge’s plan, at least in principle. Widespread support for universal social insurance without means test may have been the result of what Titmuss called a ‘war-warmed impulse of people for a more generous society’. On the other hand, the fact that so many people in the armed forces and munitions industries could not but be uncertain about their own post-war employment, in the light of post-1918 experience, must have been a factor. In the interwar years the unemployed had always been a minority of the electorate; in the war those who felt threatened by unemployment may well have been a majority. Moreover, the associated prospect of universal health insurance may well have been attractive to people had been finding the cost of private health insurance a burden.

Key interest groups were also generally in favour of Beveridge’s ideas. The evidence presented to Beveridge’s committee showed that hardly any trade unions opposed extensions of national insurance and even business witnesses generally favoured more intervention by the state in matters relating to national efficiency. The one business group clearly adversely affected by Beveridge’s proposals were the industrial insurance companies which had helped to administer national health insurance since 1912. Beveridge not only recommended their exclusion from this, but he also proposed that national insurance should cover workmen’s compensation and funeral grants, thus taking away business from the companies. These seem, however, no longer to have had the influence they had had in Lloyd George’s time, and the state no longer needed their administrative expertise. Wartime experience had created new attitudes about what the state could achieve. All this does not mean, however, that there was necessarily a consensus in favour of a ‘welfare state’ except in the most general terms. Looking at Beveridge’s five giants in turn, one finds that sometimes proposals were agreed for differing motives, or on an inadequate basis, and that sometimes there were serious disagreements between Conservative and Labour members of the Coalition government.…

For all its reservations on Beveridge’s main proposals, the Government did agree in principle with his assumption that there should be a comprehensive health service available to all, without any conditions of insurance contributions. The trouble was that it proved to be impossible during the war for the details of such a service to be agreed, either between political parties or with the interest groups involved. Certainly war had increased the state’s role. Greatly exaggerated prewar estimates of numbers of casualties in air raids had led to the provision of 80,000 Emergency Hospital Service beds, compared with 78,000 beds in voluntary hospitals and 320,000 in local authority hospitals. Moreover, the Emergency Hospital Service gradually extended its operations from war casualties to treatment of sick people transferred from inner city hospitals and then to other evacuees. In discussions in 1943-45 on a future national health service, however, both Conservative ministers and the British Medical Association showed themselves to be determined to safeguard private practice and the independence of the voluntary hospitals. In particular, there were deep differences between successive Conservative ministers of health, Ernest Brown and Henry Willink, who were responsible for health services in England and Wales, and the Labour Secretary of State for Scotland, Tom Johnson, who was responsible for health services north of the border. For example, Johnson successfully opposed the idea of maintenance charges for patients in hospital. The 1944 White Paper on A National Health Service (Cmd 6502), which was signed by Willink and Johnston, left much undecided and was avowedly only a consultative document. …
(pp 139-40).

The National Health Service Act of 1946, and its implementation on the Appointed Day in 1948, was a considerable achievement of Aneurin Bevan, the Minister of Health. Bevan’s original nation health proposals differed from those of Willink, his Conservative predecessor, chiefly in respect of the degree of the Ministry’s control over hospitals and doctors, and in the emphasis given to group partnerships of doctors in local health centres. Whereas Willink had wished to preserve the independence of voluntary hospitals, Bevan took over all local authority and voluntary hospitals, except those not necessary for the National Health Service (NHS). Bevan’s biggest problem was with the British Medical Association which, as late as February 1948, organised a poll of its members which resulted in a vote of 8:1 against the Act. Bevan was aware of the need to meet the medical profession on some points. In particular, he was willing to allow private beds in NHS hospitals so as to attract the best specialists into the service. He met the general practitioners’ fears for their independence by promising that there would be no wholetime salaried medical service. In the end the doctors and consultants were given a larger place in the administration of the NHS than Willink had envisaged.

(pp. 155-5). Thus, while the Tories did have a role in the creation of the NHS, the government as a whole only reluctantly accepted its necessity after it won a general acceptance amongst the electorate and parliament. Yes, Willink did play his part, but the ultimate creation of the NHS was under Nye Bevan.

There is much, much more I could write on this, but at the moment this ends the discussion.

Jimmy Carter on the Corporate Corruption of Regulatory Authorities

I found this very pertinent piece from former US president, Jimmy Carter, in the collection of pieces by Hunter S. Thompson, The Great Shark Hunt (London: Picador 1980). It’s in Carter’s 1974 Law Day address to the students at Georgia University.

We had an ethics bill in the state legislature this year. Half of it passed – to require an accounting for contributions during a campaign – but the part that applied to people after the campaign failed. We couldn’t get through a requirement for revelation of payments or gifts to office-holders after they are in office.

The largest force against that ethics bill was the lawyers.

Some of you here tried to help get a consumer protection package passed without success.

The regulatory agencies in Washington are made up, not of people to regulate industries, but of representatives of the industries that are regulated. Is that fair and right and equitable? I don’t think so.

I’m only going to serve four years as governor, as you know. I think that’s enough. I enjoy it, but I think I’ve done all I can in the Governor’s office. I see the lobbyists in the State Capitol filling the halls on occasions. Good people, competent people, the most pleasant, personable, extroverted citizens of Georgia. those are the characteristics that are required for a lobbyist. They represent good folks. But I tell you that when a lobbyist goes to represent the Peanut Warehouseman’s Association of the Southeast, which I belong to, which I helped organise, they go there to represent the peanut warehouseman. They don’t go there to represent the customers of the peanut warehouseman.

When the State Chamber of Commerce lobbyists go there, they go there to represent the businessmen of Georgia. They don’t go there to represent the customers of the businessmen of Georgia.

When your own organisation is interested in some legislation there in the Capitol, they’re interested in the welfare or prerogatives or authority of the lawyers. They are not there to represent in any sort of exclusive way the client of the lawyers.

The American Medical Association and its Georgia equivalent – they represent the doctors, who are fine people. But they certainly don’t represent the patients of a doctor.

Obviously, there are some differences between the situation Carter and Thompson describe. I think we do have legislation in this country, which requires gifts to ministers and civil servants to be declared. And some of the most determined opposition to the Tories’ campaign to privatise the NHS has come from the ranks of the British Medical Association.

But the substance of what Carter said is as true today as it was when Carter said it. If you read Private Eye in the 1990s, you saw fortnight after fortnight yet more news of someone from one of the industries getting a job in the body that was set up to regulate it. And it’s gone on. Private Eye are still running stories about banks and the leading accountancy firms, who were most notorious at dodging tax sending senior staff to act as interns or advisors to the Inland Revenue and the financial regulatory authorities. Or else a former managing director or chairman of the board from one these industries him- or herself gets a place there.

As for the lobbyists, Mike over at Vox Political the other year ran many pieces describing the Tory act that was supposed to limit their influence. Except it didn’t. What it did instead was try to cut out the influence of smaller, grass roots activist groups campaigning against some injustice or piece of misgovernment, and try to limit the ability of trade unions to campaign against particular issues. The lobbyists themselves were left largely untouched. As you can expect from a government, whose annual conferences are paid for by the big corporations, and which is headed by a PR spin merchant: David Cameron himself.

Carter was right to attack the corruption of the regulatory bodies by the very corporations they were meant to be overseeing, and his remarks on the pernicious influence of the lobbyists is still very timely. It’s time to clean up politics, and get rid of them and the Tories.

D-Day and the Creation of the NHS

Earlier today I reblogged Mike’s article attacking the censorship of one of the posters to the Labour Forum. This person, agewait, had had their posts repeatedly removed from the Forum and been told that they were ‘very offensive’. They had created the image reproduced here at the top of this very post, showing the courageous D-Day servicemen about to do battle, and linked it to Harry Leslie Smith’s attack on the government’s reform of the NHS. The Forum immediately deleted the posts, and responded to agewait’s inquiry why they were doing this with the statement:

“D-Day and the NHS have nothing to do with each other. Whatsoever. Any photos trying to link today’s political issues with D-Day are offensive and will be deleted immediately.”

Agewait himself gave his account of what happened in a comment to Mike’s article:

Thank you for highlighting this issue. I am the creator and apparent antagonist by posting this and another related post on the so called ‘Labour Forum’. I was angered by their actions and told them so (without swearing) – I asked for them to be reinstated, but I was threatened with a ban – So I told the jumped-up, swaggering b*****d just what I thought about him and his tin-pot political correctness, knowing full well I would be banned. I was extremely angry with them for initially removing the posts and angered more by the explanation which was not only inaccurate but extremely patronising. I am not anti-labour, but it does appear to be anti-working class… It is time it realised the people didn’t leave them, they left us…. disengaged chatterers…. and out of touch with the passion people have for the injustices against so many people who have witnessed a blitzkrieg attack upon their NHS and their Social Security system with so many, too many so called labour MPs standing by whilst others cash in on their financial interest in the Private Health sector…. Thanks again – Injustice Anywhere is a Threat to Justice Everywhere. I feel they should apologise for removing the posts – I don’t expect or wish for a personal apology not after sharing a small section of my anger and disgust with their outrageous tactics. Adrian Wait.

The Labour Forum’s censorship is wrong and completely ahistorical. Mike has already pointed out in his article that the Beveridge Report setting up the NHS was in response to concerns about the victories of the German army at the start of the War, which drove us out of France and back to Britain. The Germans were better nourished and healthier, with the support of old age pensions, unemployment and sickness insurance brought in by Bismarck in the 1870s. When the Liberals first introduced these measures shortly before the First World War, the Germans boasted that the Reich had already had them for over forty years.

Richard Titmuss in his 1950 Problems of Social Policy, which linked the creation of the welfare state very firmly to the experience and necessities of providing for the civilian population during the War. G.C. Peden in his British Economic and Social Policy: Lloyd George to Margaret Thatcher, states

Titumuss argued that the hazards of war were universal and that prewar principles of selectivity could no longer be applied. Bomb victims could not be treated like recipients of poor relief. The Unemployment Assistance Board, which became simply the Assistance Board, was used to pay out hardship allowances, rather than leave these to local Public Assistance Committees, which were associated in the public mind with the Poor Law. When inflation reduced the value of old age pensions, the Assistance Board was empowered to pay supplementary pensions based on need, and by 1941 the Board was dealing with ten times as many pensioners as unemployed men. As Minister of Labour, Bevin insisted on abolishing the household means test, and the Determination of Needs Act of 1941 substituted an assumed contribution from non-dependent members of a family. Titmuss stressed cross-party support for welfare policies. According to him (pp. 506-17), the condition of inner city children evacuated to more prosperous areas shocked public opinion and moved the Government to take ‘positive steps’. Cheap or free school meals and milk were made available to all children and not, as hitherto, only to the ‘necessitous’. Free milk, orange juice and cod liver oil were provided for all expectant mothers and for children under five years. In all these ways, Titmuss argued, the ‘war-warmed impulse of people for a more generous society’ created favourable conditions for planning ‘social reconstruction’ after the war. (pp. 135-6).

Titmuss’ view has now been criticised, as Titmuss was excluded studying plans for post-War policy, and so his view did not necessarily correspond to the government’s actual intentions. Peden notes that the outbreak of the War halted slum clearance, house building, and may have delayed the extension of national insurance to workers’ families and dependence and the introduction of family allowances. The Tories own Research Department had been worried about their own chances of winning elections before the War, and so had suggested including the above measures in their manifesto. On the other hand, the TUC had opposed Family Allowances, as they feared this would allow employers to pay low wages, and there was little support for them from the government. (p. 135).

Peden does state that the War brought a massive expansion of state hospital provision, and that the government agreed with the Beveridge Report’s recommendation that there should be a free health service, while acknowledging that the Tories and the British Medical Association also wished to preserve private practice and the charity hospitals:

For all its reservations on Beveridge’s main proposals, the Government did agree in principle with his assumption that there should be a comprehensive health service available to all, without any conditions of insurance contributions. The trouble was that it proved to be impossible during the war for the details of such a service to be agreed, either between political parties or with the interest groups involved. Certainly was had increased the state’s role. Greatly exaggerated prewar estimates of numbers of casualties in air raids had led to the provision of 80,000 Emergency Hospital beds, compared with 78,000 beds in voluntary hospitals and 320,000 in local authority hospitals. Moreover, the Emergency Hospital Service gradually extended its operations from war causaulties to treatment of sick people transferred from inner city hospitals and then to other evacuees. In discussions in 1943-45 on a future national health service, however, both Conservative ministers and the British Medical Association showed themselves to be determined to safeguard private practice and the independence of the voluntary hospitals. In particular, there were deep differences between successive Conservative ministers of health, Ernest Brown and Henry Willink, who were responsible for health service in England and Wales, and the Labour Secretary of State for Scotland, Tom Johnston, who was responsible for health services north of the border. For example, Johnston successfully opposed the idea of maintenance charges for patients in hospital. The 1944 White Paper on A National Health Service (CMd 6502), which was signed by Willink and Johnston, left much undecided and was avowedly only a consultative document.

Peden then goes on to state that there is little evidence that the War created a lasting consensus in favour of the Welfare State. He does, however, agree that the experience of the war created a more universalist approach to social problems, and that it led to the main political parties meeting on a ‘Butskellite’ centre. (pp. 142-3). He considers instead that the solutions recommended by the Wartime government were merely attempts to deal with temporary insecurity caused by the War.

Nevertheless, the War had led to the demand for the creation of the NHS, and the massive expansion in state hospital provision. And the Labour party played on the desire to create a better society for the servicemen and women, who had fought so hard against Fascism and the Nazi menace, as shown in the poster below.

The Tories too, have had absolutely no qualms about using images from WW2 in their election propaganda. I can remember their 1987 election broadcast being awash with images of dog-fighting Spitfires, ending with an excited voice exclaiming ‘It’s great to be great again’. All while Thatcher was doing her level best to destroy real wages and smash Britain as a manufacturing nation in the interests of the financial sector. The satirist Alan Coren drily remarked that the broadcast showed that the War was won by ‘the Royal Conservative Airforce’, and stated that it was highly ironic that in reality all the servicemen went off and voted Labour.

All this seems to have been lost on Labour Forum, which suggests that the mods in charge actually don’t know much about Socialism or the creation of the NHS. You could even wonder if they were actually Labour at all. If they were, then it certainly looks like a Blairite group, afraid that linking D-Day and the origins of the NHS will disrupt its part privatisation introduced by Blair. Many of the firms involved in this were American, and there is certainly massive hostility to any inclusion of the NHS as one of the great achievements of British history by the transatlantic extreme Right. They were fuming, for example, at Danny Boyle’s inclusion of the NHS in the historical tableaux at the opening ceremony of the 2012 Olympics. The censors over at Labour Forum seem to reflect this mentality, rather than anything genuinely and historically Labour. It’s time the Right-wing censors over at Labour Forum were finally shown the door, and a proper historical perspective and pride taken in the NHS, one of the great legacies left by the people, who fought so bravely to keep Europe free.

Immigration, ID Cards and the Erosion of British Freedom: Part 1

‘The true danger is when liberty is nibbled away, for expedience, and by parts’.

– Edmund Burke.

Edmund Burke is regarded as the founder of modern Conservatism, the defender of tradition, freedom, and gradual change against revolutionary innovation based solely on abstract principle. He was also the 18th century MP, who successfully campaigned for the Canadian provinces to be given self-government on the grounds that, as they paid their taxes, so they had earned their right to government. His defence of tradition came from his observation of the horror of the French Revolution and his ideas regarding their political and social causes, as reflected in his great work, Reflections on the Revolution in France. While his Conservatism may justly be attacked by those on the Left, the statement on the gradual, incremental danger to liberty is still very much true, and should be taken seriously by citizens on both the Left and Right sides of the political spectrum. This should not be a party political issue.

In my last post, I reblogged Mike’s article commenting on recent legislation attempting to cut down on illegal immigration. This essentially devolved the responsibility for checking on the status of immigrants to private individuals and organisations, such as banks and landlords. As with much of what the government does, or claims to do, it essentially consists of the state putting its duties and responsibilities into the private sphere. Among the groups protesting at the proposed new legislation were the BMA, immgrants’ rights groups and the Residential Landlords’ Association. The last were particularly concerned about the possible introduction of identification documents, modelled on the 404 European papers, in order to combat illegal immigration. Such fears are neither new nor unfounded. I remember in the early 1980s Mrs Thatcher’s administration considered introduction ID cards. The plan was dropped as civil liberties groups were afraid that this would create a surveillance society similar to that of Nazi Germany or the Communist states. The schemes were mooted again in the 1990s first by John Major’s administration, and then by Blair’s Labour party, following pressure from the European Union, which apparently considers such documents a great idea. The Conservative papers then, rightly but hypocritically, ran articles attacking the scheme.

There are now a couple of books discussing and criticising the massive expansion of state surveillance in modern Britain and our gradual descent into just such a totalitarian surveillance state portrayed in Moore’s V for Vendetta. One of these is Big Brother: Britain’s Web of Surveillance and the New Technological Order, by Simon Davies, published by Pan in 1996. Davies was the founder of Privacy International, a body set up in 1990 to defend individual liberties from encroachment by the state and private corporations. He was the Visiting Law Fellow at the University of Essex and Chicago’s John Marshall Law School. Davies was suspicious of INSPASS – the Immigration and Naturalisation Service Passenger Accelerated Service System, an automatic system for checking and verifying immigration status using palm-prints and smart cards. It was part of the Blue Lane information exchange system in which information on passengers was transmitted to different countries ahead of the journey. The countries using the system were the US, Canada, Andorra, Austria, Belgium, Bermuda, Denmark, Finland, France, Germany, Ireland, Italy, Japan, Liechstein, Luxembourg, Monaco, the Netherlands, New Zealand, Norway, San Marino, Spain, Sweden and the UK. Davies considered the scheme a danger to liberty through the state’s increasing use of technology to monitor and control the population.

At the time Davies was writing, 90 countries used ID cards including Belgium, France, Germany, Greece, Italy, Luxemburg, the Netherlands, Spain and Portugal. They also included such sterling examples of democracy as Thailand and Singapore. In the latter, the ID card was used as an internal passport and was necessary for every transaction. The Singaporean government under Lee Kwan Yew has regularly harassed and imprisoned political opponents. The longest serving prisoner of conscience isn’t in one of the Arab despotisms or absolute monarchies, nor in Putin’s Russia. They’re in Singapore. A few years ago the country opened its first free speech corner, modelled on Hyde Park’s own Speaker’s Corner. You were free to use it, provided you gave due notice about what you were planning to talk about to the police first for their approval. There weren’t many takers. As for Thailand, each citizen was issued a plastic identity card. The chip in each contained their thumbprint and photograph, as well as details of their ancestry, education, occupation, nationality, religion, and police records and tax details. It also contains their Population Number, which gives access to all their documents, whether public or private. It was the world’s second largest relational database, exceeded in size only by that of the Mormon Church at their headquarters in Salt Lake City. Thailand also has a ‘village information system’, which collates and monitors information at the village level. This is also linked to information on the person’s electoral preferences, public opinion data and information on candidates in local elections. The Bangkok post warned that the system would strengthen the interior ministry and the police. If you needed to be reminded, Thailand has regularly appeared in the pages of the ‘Letter from…’ column in Private Eye as it is a barely disguised military dictatorship.

In 1981 France’s President Mitterand declared that ‘the creation of computerised identity cards contains are real danger for the liberty of individuals’. This did not stop France and the Netherlands passing legislation requiring foreigners to carry identity cards. The European umbrella police organisation, Europol, also wanted all the nations in Europe to force their citizens to carry identity cards. At the global level, the International Monetary Fund routinely included the introduction of ID cards into the criteria of economic, social and political performance for nations in the developing world.

Davies’ own organisation, Privacy International, founded in 1990, reported than in their survey of 50 countries using ID cards, the police in virtually all of them abused the system. The abuses uncovered by the organisation included detention after failure to produce the card, and the beating of juveniles and members of minorities, as well as massive discrimination based on the information the card contained.

In Australia, the financial sector voiced similar concerns about the scheme to those expressed recently by the landlords and immigrants’ rights and welfare organisations. Under the Australian scheme, employees in the financial sector were required by law to report suspicious information or abuse of ID cards to the government. The penalty for neglecting or refusing to do so was gaol. The former chairman of the Pacific nation’s largest bank, Westpar, Sir Noel Foley, attacked the scheme. It was ‘a serious threat to the privacy, liberty and safety of every citizen’. The Australian Financial Review stated in an editorial on the cards that ‘It is simply obscene to use revenue arguments (‘We can make more money out of the Australia Card’) as support for authoritarian impositions rather than take the road of broadening national freedoms’. Dr Bruce Shepherd, the president of the Australian Medical Association stated of the scheme that ‘It’s going to turn Australian against Australian. But given the horrific impact the card will have on Australia, its defeat would almost be worth fighting a civil war for’. To show how bitterly the country that produced folk heroes like Ned Kelly thought of this scheme, cartoons appeared in the Ozzie papers showing the country’s president, Bob Hawke, in Nazi uniform.

For those without ID cards, the penalties were harsh. They could not be legally employed, or, if in work, paid. Farmers, who didn’t have them, could not collect payments from marketing boards. If you didn’t have a card, you also couldn’t access your bank account, cash in any investments, give or receive money from a solicitor, or receive money from unity, property or cash management trusts. You also couldn’t rent or buy a home, receive unemployment benefit, or the benefits for widows, supporting parents, or for old age, sickness and invalidity. There was a A$5,000 fine for deliberate destruction of the card, a A$500 fine if you lost the card but didn’t report it. The penalty for failing to attend a compulsory conference at the ID agency was A$1,000 or six months gaol. The penalty for refusing to produce it to the Inland Revenue when they demanded was A$20,000. About 5 per cent of the cards were estimated to be lost, stolen or deliberately destroyed each year.

The ID Card was too much for the great Australian public to stomach, and the scheme eventually had to be scrapped. It’s a pity that we Poms haven’t learned from our Ozzie cousins and that such ID schemes are still being seriously contemplated over here. It is definitely worth not only whingeing about, but protesting very loudly and strongly indeed.

In Part 2 of this article, I will describe precisely what the scheme does not and cannot do, despite all the inflated claims made by its proponents.