Posts Tagged ‘Health Insurance’

Pamphlets Written Against NHS Privatisation and Austerity

July 26, 2016

Yesterday I added a new page to this blog giving a few brief details about five pamphlets I’ve written on various subjects. I wrote them to get the information about some of the most pressing issues I’ve discussed on this blog out to a wider readership. I wanted to have something I could physically give to people if they asked for information, such as at demonstrations. They’re only short leaflets, produced on the computer and printer at home, and folded over, but I hope they do the job. They are the following:

Medieval Science Pamplet Pic

The Advancement of Learning: Science in the Middle Ages, A5, 14 pp.
This is based on a talk I gave at Uni, and an article I put up on this blog, to show that, contrary to the received wisdom, the Middle Ages was also a period of great scientific and technical discovery, and that from the 12th century onwards scholars took a positive interest and delight in the scientific endeavour.

Anti-Academy Pamphlet Pic

Academies: Failing Schools for Corporate Profits, A5, 14pp.

This traces the history of academy schools right back to their origins as City Technology Colleges, a Thatcherite policy set up under Kenneth Baker, which was terminated because it was a failure. It was then revived as City Academies by Tony Blair in 2000, before being renamed as just ‘academies’. It argues that they’re a form of educational privatisation, they don’t raise standards, and are taking the country back to a period before the 1944 Education Act that made universal secondary education free and universal.

Anti-NHS Privatisation Pamphlet pic

Don’t Let Cameron Privatise the NHS, A5, 10pp.

This gives a brief history of the governments’ attempts to privatise the NHS gradually from Maggie Thatcher onwards, culminating in Andrew Lansley’s Health and Social Care Act, which threatens to completely privatise it. It also reproduces the arguments against the private healthcare system that Thatcher and Tony Blair wanted to introduce made by Robin Cook in a Fabian pamphlet published in the 1980s. A longer pamphlet on the same subject is also in preparation.

Anti-Work Test Pamphlet pic

Stop the Work Capability Test – Before More People Die, A5, 6pp.

Short leaflet describing the introduction of the Work Capability Test, the flawed models of sickness on which it’s based, and the assumption behind it that most people claiming long term sickness or disability benefit are malingerers. It attacks the commercial interests behind it – it was drawn up on the advice of Unum, an American insurance company that was prosecuted in the Land of the Free for not paying out on its insurance schemes, and was labelled a ‘disability denier’ by the American authorities. This scheme is scientific nonsense, designed to enrich corrupt private corporations and has led to suffering and deaths of the people, who have been thrown off their benefits as a result.

Empowering Precariat Pamphlet pic

This briefly discusses Guy Standing’s idea that a new class has arisen, the precariat, and his recommendations for ending their poverty. The precariat are those people, who have become less than citizens, through having the rights taken away through punitive employment legislation and welfare cuts. They are often highly educated individuals, forced to accept work below their educational qualifications, simply to make ends meet. They are trapped in a series of low paid jobs, interspersed with periods of unemployment. This is a result of flexible employment policies, such as zero hours and short term contracts. They are forced into poverty through welfare cuts, benefits sanctions, and workfare. This class also includes migrant workers, who travel around the world in search of work, and find themselves similarly trapped in poverty without the rights of their host nation’s citizens. Standing’s recommendations for ending their poverty include restoring citizenship, giving migrants and the unemployed the same rights as fully employed citizens, and ending the sanctions system, workfare and the work capability tests.

If you’d like any of these pamphlets, go to the page for them and use the contact form there. Or simply get in touch using the comments below, and I’ll get back to you. If you only want a single issue of any of these pamphlets, let me know, and I’ll post it to you free of charge.

Hitler, Mussolini, Trump and Rhetorical and Political Inconsistency

March 9, 2016

A number of media commenters have pointed out the inconsistencies and contradiction in Donald Trump’s speeches as he tries to drum up support for his presidential campaign. Kyle Kulinski over at Secular Talk, for example, has pointed out how Trump has argued for separate, and opposite positions on the Middle East, healthcare and the economy. For example, on the Middle East he has at one moment declared that America should go in much harder to carpet bomb whole cities, and torture and kill not just terrorists, but also their families. At other moments, sometimes just after he has argued passionately for the preceding policy, he has completely reversed his position. Instead of renewing America’s campaign in the Middle East, he has argued instead that America should not get involved, and instead leave Vladimir Putin to sort out ISIS.

His position on healthcare is similarly muddled. At one point he appeared to be arguing for something like the socialised medical service advocated by the Democrat, Bernie Sanders. He has then immediately reversed his position, and stated instead that he intends to repeal Obamacare, and increase competition and free enterprise. He has since been forced to clarify his position, and has since released a detailed description of his policy. This makes it clear that his policy is based very much on increasing competition, and allowing the insurance companies to deny or increase charges for people with severe and difficult to treat forms of illness. And by the way – this is exactly one of the reasons why supporters of the NHS in England actively oppose the introduction of insurance based health care. It actively denies care to those most in need, the chronically sick.

Trump’s stance on industry and the economy is also unclear. He has said at various points that if he got into power, he would prevent corporations leaving America to keep jobs in the country. At other moments, he’s stated that he intends to keep wages low. The two positions aren’t quite contradictory. Corporations are moving abroad to take advantage of the cheap labour available in the Developing World. So keeping wages low would encourage some companies to stay in America. This would, however, keep blue-collar workers in the in-work poverty into which they’ve been plunged by the Neo-Lib policies of successive administrations.

Hitler’s own policies, as stated in his speeches, were also a mixture of contradictory attitudes and positions. He at once appeared to be anti-capitalist and the defender of capitalism, and tailored his rhetoric to suit the differing audiences in the places where he was speaking. In rural areas with a strong tradition of anti-Semitism, he’d concentrate on stirring up hatred and resentment against the Jews. In industrial areas with a strong background of working class politics, either Socialist or Communist, he’d instead focus on the ‘Socialist’, anti-capitalist elements of the Nazi programme. And in 1929, speaking to a meeting of leading German businessmen, he claimed to be the defender to German private industry against the forces of Marxist Socialism.

Mussolini too changed his position frequently. Denis Mack Smith, in his biography of the Duce, Mussolini (London: Paladin 1983) describes how Mussolini’s frequent changes of position, and adoption of extreme views, came from his attempts to drum up excitement and interest amongst his audience. On page 39 he writes

Mussolini’s journalistic style prompted him to take an extreme position whenever possible. Extremism was always dramatic and eye-catching. He was far more concerned with tactics than with ideas, and his violent changeability was bound to seem confused it measured by strict logic; but he had discovered that readers liked extreme views and rarely bothered much about inconsistency. If he appeared successively as the champion of the League [of nations] and then nationalist, as socialist and then conservative, as monarchist and then republican, this was less out of muddle-headedness than out of a search for striking headlines and a wish to become all things to all men.

And on page 40 he notes that Mussolini

called himself a man for all seasons, ‘an adventurer for all roads’. As he said, ‘I put my finger on the pulse of the masses and suddenly discovered in the general mood of disorientation that a public opinion was waiting for me, and I just had to make it recognise me through me newspaper.

This sounds very much like Trump. And like Mussolini, Trump is also fiercely nationalistic and xenophobic, attacking Mexicans and Muslims, and encouraging the violent expulsion of protestors from his rallies. Trump probably wouldn’t be a ruthless butcher like Hitler or Musso, but he would turn America into a much less free, much more authoritarian and brutal place.

G.D.H. Cole on the Demand for Welfare Reform and Its Use by the Tories

March 8, 2016

I found this piece by the radical Socialist G.D.H. Cole on the rising demand for the introduction of increased welfare provision in his 1942 book, Great Britain in the Post-War World (London: Victor Gollancz 1942).

Social reformers naturally echo this mood. The greater part of the progressive legislation of recent years has had to do with the removal or mitigation of the terrible insecurity which besets the lives of men; and programmes of progressive parties follow the same trend. Old age pensions, workmen’s pensions, health insurance, unemployment insurance, widow’s pensions, the assistance board, and many more specialised reforms are examples of the growth of what is sometimes called ‘eleemosynary’ legislation; and the demands for family allowances, guaranteed minimum wages, a national medical service, and a general tuning up of the existing social services figure largely in the reconstruction programmes of advanced parties, and seem likely to appeal to conservative opinion as well, as still the best way of foiling demands for more radical social change. it is widely felt that as long as capitalism can continue to make the concessions in the direction of social security, a large part of the electorate will rest content with the general structure of things as they are, and the more fundamental proposals for social change will meet with no great response among the main body of the people. (pp. 136-7).

Cole was writing while Beveridge was still working on his Report, and that passage shows the great demand there was from working people for what became the Welfare State. He’s also right in that the left wing of the Tory party did support it, although there was still opposition to it within Tory ranks. And Owen Jones made much the same point as Cole in his book Chavs: The Demonisation of the Working Class, when he described how a Tory MP visiting Oxford confessed that his party hung on to power by conceding ‘just enough’ to satisfy the working class hunger for change.

Since then, the Tories have found, following Thatcher, that they were able to repeal all the reforms that have benefited the working class over the past half-century and more, and since Thatcher have been trying to privatise the health service. It stands in the way of corporate profit, and they have learned that they can roll back welfare provision if they maintain the illusion that they are somehow retaining or reforming it at the same time.

And so they’re destroying not just the health service and the welfare state, and plunging millions into poverty, in order to restore the corporate order and social hierarchy.

Secular Talk on Trump’s Vagueness as Successful Rhetorical Strategy

February 20, 2016

This is a very interesting piece from Secular Talk, in which Kyle Kulinski discusses a piece in Reuters analysing the immense appeal of what looks like Trump’s poor rhetorical ability. Trump contradicts himself, he cuts himself off early, and he uses vague words instead of better, more descriptive vocabulary. The article cites as an example a sentence from Trump’s speech demanding that Muslims should be stopped from entering America. He stated ‘We need to do something, because something’s going on’. Or something like that.

Now instead of being the mark of a poor speaker, it’s actually a very persuasive rhetorical tactic with its own technical term: enthememe. It’s convincing because it makes the orators hearers persuade themselves by filling in the blanks in the speech with what they want to hear. And Trump throws contradictory statements about policy issues out willy-nilly. At one point, Trump will state he supports a single-payer healthcare system, or some form which supports the poorest in society. He will then go on to say that he wants more capitalism in healthcare, and for people to be able to buy health insurance over state boundaries. Complete contradiction.

It’s the same in Iraq. At one point he’s for going into the country and killing not only ISIS, but their wives and children. It’s a completely criminal attitude, as Kulinski points out. Then he says something completely contradictory, like America should Putin handle the situation, and America should concentrate on infrastructure.

Everyone listening to him comes away convinced that he stands for what they want. If they want single payer health care, they’re convinced that Trump wants it too. If they want free enterprise capitalism, they’re convinced Trump will give cheaper health care through free enterprise. And the same with Iraq.

Additionally, Trump convinces because he is aggressive, confident, and claims to be outside the system. He isn’t. He tried to get funding from the same corporate donors as the rest of the Republicans, and it was only when they turned him down that he resorted to funding himself. But it’s been an immense boost to his appeal.

Kulinski points out that this marks a change in what the public wants from politicians and their rhetoric. Trump and Sanders, although polar opposites, are winning over large numbers of the American public, because they both speak as if they’re off-script. Which to an extent they are. Kulinski states that he doesn’t know where this preference comes from, but he finds it more interesting on his programme when he’s speaking ex tempore on the show, and not from a piece he’s written earlier. This contrasts with some of the Republican candidates, like the Marcobot, Marco Rubio, where their speech is so scripted they may as well be reading it off a screen in their contact lenses. Their delivery is so scripted and stereotypically that of a politician, that it repels voters.

And now back to Hitler and Godwin’s Law. I’ve been saying all along that Trump’s vagueness and his multiple contradictions on policy are the same rhetorical strategies that Hitler used to appeal to different groups in Germany. In rural areas, where there was a hatred of Jews, he played up the anti-Semitism. In industrial areas, he stressed anti-capitalism. And when he was courting big business, he claimed that Nazism was also pro-business, and would defend the big combines from Socialism and Communism.

Also, Hitler continued to speak in the tones of someone from the Austrian lower middle classes. He didn’t use the polished, educated register of the upper classes. And so it gave the impression that he truly was ‘a man of the people’. As for his rhetoric, it’s been criticised for being convoluted, verbose and muddled. Yet he used striking imagery and very carefully noted what went down well and what didn’t with his audience. Vagueness and an apparently poor rhetorical style – though definitely not poor delivery – were part of Hitler’s appeal.

Just as they’re part of Trump’s. And like Hitler, Trump is another Fascist, who aims at further persecution and marginalisation of America’s ethnic minorities. His attacks on Mexicans and Muslims come dangerously close to Hitler’s policies at the start of the Third Reich, before he launched the Holocaust. For the sake of human life and decency, he must be stopped.

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

February 18, 2016

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.

Nye Bevan and Nostalgia for the Era Before the NHS: My Response to a Critic

February 15, 2016

Last week I received a comment from Billellson criticising me for stating that Aneurin Bevan was the architect of the NHS. He also stated that we did not have a private healthcare system before the NHS, and although some charges were made, they were in his words, not so much that people would lose their house.

Here’s what he wrote.

“Nye Bevan, the architect of the NHS, was also acutely aware of the way ordinary women suffered under the private health care system that put medicine out of the reach of the poor.”
Aneurin Bevan was not the architect of the National Health Service. The NHS was a wartime coalition policy, for the end of hostilities, agreed across parties. The concept was set out in the Beveridge Report published in December 1942, endorsed by Winston Churchill in a national broadcast in 1943 and practical proposals, including those the things the public value re the NHS today, set out in a white paper by Minister of Health Conservative Henry Willink in March 1944. It would have been established whoever was Minister of Health after the war / whichever party won the 1945 general election. The UK did not have a ‘private health care system’ before the NHS. Most hospitals in England and Wales were local government owned and run, the remainder voluntary (charitable). Those who could afford to pay for treatment were required to do so, or at least make a contribution, but nobody was expected to sell their house. The poor were treated in hospitals free of charge. c11 million workers were covered for GP consultations by the National Health Insurance Scheme which had been established in 1911. In many places, particularly mining areas, there were mutual aid societies that established health facilities including dispensaries. Scotland had a greater degree of state health provision and Northern Ireland had greater faith based provision before their NHSs were established, starting on the same day as Bevan’s English and Welsh service, but always separate established under separate legislation.

So I checked this with what Pauline Gregg says about the creation of the NHS in her The Welfare State: An Economic and Social History of Great Britain from 1945 to the Present Day (London: George G. Harrap & Co 1967).

She states

In 1942, during the War, the scope of health insurance had been considerably widened by the raising of the income limit for participation to £420 a year. But it still covered only about half the population and included neither specialist nor hospital service, neither dental, optical, nor hearing aid. Mental deficiency was isolated from other forms of illness. Medical practitioners were unevenly spread over the country – they had been before the War, but now their war-time service had too often disrupted their practices and left their surgeries to run down or suffer bomb damage.

Hospitals were at all stages of development. There were more than a thousand voluntary hospitals in England and Wales, varying from large general or specialist hospitals with first-class modern equipment and with medical schools attended by distinguished consultants, down to small local cottage hospitals. There were some 2000 more which had been founded by the local authorities or had developed from the sick ward of the old workhouse, ranging again through all types and degrees of excellence. Waiting-lists were long; most hospitals came out of the War under-equipped with staff and resources of all kinds; all needed painting, repairing, reorganising; some were cleaning up after bomb damage; most needed to reorient themselves before they turned from war casualties to peace-time commitments; all needed new equipment and new buildings. Other medical services were only too clearly the result of haphazard development. There were Medical Officers of Health employed by the local authorities, sanitary inspectors concerned with environmental health, medical inspectors of factories, nearly 2000 doctors on call to industry, as well as doctors privately appointed by firms to treat their staff. A school medical service provided for regular inspection of all children in public elementary and secondary schools; local authorities provided maternity and child care, health visiting, tuberculosis treatment, and other services for the poor, which varied widely from district to district. How many people there were of all ages and classes who were needing treatment but not getting it could only be guessed at.

Since it was clear that ad hoc improvement would no longer serve, a complete reshaping of the health and medical service marked the only line of advance. The general pattern it would take was indicated by Sir William Beveridge, who laid down his Report in 1942 the axiom that a health service must be universal, that the needs of the rich and poor are alike and should be met by the same means: ” restoration of a sick person to health is a duty of the state … prior to any other,” a “comprehensive national health service will ensure that for every citizen there is available whatever medical treatment he requires, in whatever form he requires it, domiciliary or institutional, general, specialist or consultant, and will ensure also the provision of dental, ophthalmic and surgical appliances, nursing and midwifery and rehabilitation after accidents.”

The Coalition Government accepted the Health Service Proposals of the Beveridge Report and prepared a White Paper, which it presented to Parliament in February 1944, saying the same thing as Beveridge in different words: “The government .. intend to establish a comprehensive health service for everybody in this country. They want to ensure that in future every man and woman and child can rely on getting all the advice and treatment and care which they may need in matters of personal health; that what they get shall be the best medical and other facilities available; that their getting these shall not depend on whether they can pay for them, or any other factor irrelevant to the real need – the real need being to bring the country’s full resources to bear upon reducing ill-health and promoting good health in all its citizens.” The Health Service, it said, should be a water, as the highways, available to all and all should pay through rates, taxes and social insurance.

Ernest Brown, a Liberal National, Minister of Health in the Coalition Government, was responsible for a first plan for a National Health Service which subordinated the general practitioner to the Medical Officer of Health and the local authorities, It was abandoned amid a professional storm. The scheme of Henry Willink, a later Minister of Health, was modelled on the White Paper, but was set aside with the defeat of Churchill’s Government in the 1945 Election. In the Labour Government the role of Minister of Health fell to Aneurin Bevan, who produced a scheme within a few months of Labour’s victory.

Pp. 39-51.

Churchill’s own attitude to the nascent NHS and the emergence of the later welfare state was ambivalent. In March 1943, for example, he gave a speech endorsing it. Gregg again says

He was “very much attracted to the idea” of a Four Year Plan of his own which included “national compulsory insurance for all classes for all purposes from the cradle to the grave”, a national health service, a policy for full employment in which private and public enterprise both had a part to play, the rebuilding of towns and a housing programme, and a new Education Act. He envisaged “five or six large measures of a practical character”, but did not specify them, … (p. 25).

However, two years later after the Beveridge Report had become the official policy of the Labour party, Churchill’s tone was markedly hostile.

Coming to the microphone on June 4, 1945, he said: “My friends, I must tell you that a Socialist policy is abhorrent to British ideas of freedom … Socialism is in its essence an attack not only upon British enterprise, but upon the right of an ordinary man or woman to breathe freely without having a harsh, clumsy, tyrannical hand clapped across their mouths and nostrils. A free Parliament – look at that – a free Parliament is odious to the Socialist doctrinaire.” The Daily Express followed the next day with banner headlines: “Gestapo in Britain if Socialists Win”. (pp. 32-3)

So Mr Ellson is partly right, but only partly. There was some state and municipal healthcare provision, but it was a patchy and did not cover about half the population. It was a Coalition policy, which was sort of endorse by Churchill. However, its wholehearted embrace and execution was by the Labour party under Aneurin Bevan.

And its immense benefit and desirability was recognised by many traditionally staunch Tories at the time. One of my mother’s friends was herself a pillar of the local Conservative party, and the daughter of a pharmacist. She told my mother that at the 1945 elections her father gather his family together and told them that he had always voted Tory, but this time he was going to vote Labour, because the country needed the NHS. He explained that he served too many people, giving them their drugs on credit, because they couldn’t pay, not to vote for Labour and the NHS.

Now I think the Tories would like to roll state healthcare provision back to that of the pre-NHS level, where there is some minimal state provision, but much is carried out by private industry. The Daily Heil a few years ago was moaning about how the friendly societies were excluded from a role in the NHS. Like them, I think Mr Ellson has far too rosy a view of the situation before the NHS. I’ve blogged on here already accounts from doctors of that period on how badly much of the population were served before the NHS, especially those without health insurance.

Britain needed the NHS, and the party that was most passionately in favour of it was Labour. That some Tories were in favour of it, including Churchill on occasions, is true. But there were others in the party that were very firmly against, and it was ultimately Rab Butler in the Tories who reconciled them to the NHS. But that reconciliation is breaking down, and they are determined to privatise it anyway they can.

Secular Talk on Donald Trump’s Confused Position on Healthcare

February 11, 2016

This is an interesting piece. Kyle Kulinski takes apart The Donald’s weird and confused answer on the question of healthcare in the Republican presidential debates. The moderator notes that Trump has said that he wants to repeal Obamacare, and opposes the introduction of universal healthcare, because it would lead to massive tax rises across America. So she asks the obvious question: What would he replace it with?

At which point, Trump starts humming and ha-ing, stating that there are a lots of examples of what could be done. He would repeal Obamacare, but make sure everyone was covered. He would introduce greater competition, and go back to free enterprise. He states he would repeal the arbitrary red line about insurance, and then criticises the insurance companies for pushing up the cost of healthcare to unaffordable levels, and profiting from it. He then states that the costs would come down if they were forced to compete, and praises the excellent saving schemes for medical care. He then talks about people dying in the street from lack of healthcare, and states it’s a disgrace.

Kulinski states that he’s arguing for two different things here at the same time. He’s arguing for universal healthcare coverage, which would be Obamacare. And then he talks about free enterprise and repealing the existing system. Kulinski points out that despite Obamacare, the American healthcare system is still free enterprise. And 40-45,000 Americans die each year because they can’t afford medical treatment.

Kulinski also points out that it’s the same tactic Trump has used regarding the situation in Syria. He has stated that America should not get involved, and Putin should be allowed to go to sort out ISIS and the other terrorists. Then, a little while later, he demands America should go in and stop Putin. It appeals to do different sets of voters, who just hear the pieces they want to hear, and don’t think about the contradictions.

As for repealing the artificial red line about insurance, that means he wants to allow the citizens of one state to buy insurance in another. This means that eventually all the insurance companies will go to the state with lowest tax rates. But it appeals to the same people, whose complete absence of reason and logic makes them cheer at signs saying ‘Get government out of my medicare’, despite the fact that medicare is a government system.

This is another important piece to watch, as it has implications beyond the Tyrant of Trump Tower. Insurance costs have spiralled out of control immensely in America, and 20 per cent of Americans can no longer afford their medical care. This is why Obamacare was brought in, and why Bernie Sanders is extremely popular with his proposal for universal healthcare.

The libertarian Right, on the other hand, really can’t accept that there’s anything wrong with a private healthcare system, or that it’s made healthcare unaffordable. They’re recommending instead ending insurance coverage, convinced that this will make healthcare cheaper. This conveniently forgets that the reason why the insurance companies moved into healthcare, was because Americans could not afford their medical bills.

Remember: this is the kind of system the Tories wish to introduce into England. Jeremy Hunt wishes to sell off the Health Service. One of the other Tories drones said that if they were re-elected, then it wouldn’t last another five years. They’d just reduce it to a central clearing house for insurance. Maggie Thatcher was looking into privatising it, but realised that it would be extremely ‘courageous’. Wasserman, one of the two apparatchiks involved in the proposal, is now a member of Cameron’s task force looking into it.

What is going on in America will come to Britain if the Tories have their way. It will mean that 20 per cent or more of Britain’s won’t be able to afford healthcare coverage, and will die in the street.

Don’t take it. Vote them out before it happens.

American David Pakman on Britain’s Excellent State Healthcare

April 10, 2015

NHS-privatisation

This is another video from the alternative, left-wing or progressive American news media. This time it’s David Pakman, who’s interviewing Wendell Potter. Potter is a former VP of Corporate Communications at Cigna, and the author of the books Deadly Spin and Obamacare: What’s In It for Me.

In his books and other writings, Potter examined the reality behind the comments and the negative depiction of Britain’s NHS in America to show the truth: Britain’s health service is excellent, and far and away much better than that of America.

He states that the stories of long waiting times and poor care trotted out by advocates of private healthcare are anecdotal. He also spoke to Brits living in America, and Americans with dual citizenship with Britain, who had experience of both British and American healthcare. He states that they all stated that British health care was better. It was much cheaper, for a start.

American healthcare is much more expensive than those in the other countries. Thirty per cent of American costs are wasted in bureaucracy.

It is also not true that the tax burden in Britain and other countries with similar systems is higher than America. Americans are also paying significantly for the healthcare in taxes at a comparable level, but this is hidden.

He notes that in the statistics compiled of 11 countries in the developed world by international authorities, Britain’s NHS is no.1, while America is right at the bottom at 11.

British health outcomes are better, as indeed are those in the other countries, which have state regulated or single payer healthcare. The infant mortality rates in America is much higher, for example.

Mr Potter also points out that because healthcare is immensely profitable, the insurance companies and medical industries are actively promoting their system as the best, which he attempted to expose in his book, Deadly Spin.

Pakman and Potter also discuss the fact that American healthcare 100 years ago was moving towards something like state healthcare. However, as this became massively unpopular and there was a campaign against because it was the system used by the Germans, who were the first country to have a state healthcare system.

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This is an important corrective to some of the lies told about the NHS by the Republicans in America and the Tories and Kipper over here. The Conservatives and their Lib Dem enablers are actively privatising the health service. 92 Tory and Lib Dem MPs have connections to private healthcare companies seeking to profit from its dismantlement. A few years ago Boris Johnson even wrote a piece in the Spectator demanding that Britain’s NHS be abolished in favour of the American model. Nigel Farage and his chief gauleiter, Paul Nuttall, have both advocated its privatisation, as have other Kippers.

This must not be allowed. andtThis video shows the reality behind the Right-wing propaganda.

Nigel Farage Interviewed by Evan Davies on Thatcher, NHS and Gay Kissing

February 14, 2015

Farage Drawing

Yesterday I blogged on a piece by Jon Stone in the Independent reporting that Nigel Farage was in favour of introducing the American healthcare system, where it was funded by insurance into the NHS. It looks as though Stone partly based his piece on this interview Farage gave to the Beeb’s Evan Davies on Newsnight a few nights ago.

In summary, Farage talks about how he had been a follower of Mrs Thatcher in the 1980s, and agreed with her about rolling back the state and cutting down the power of the trade unions. He also states that he’s been a lot of other things besides, like a Churchillian. He states he stands for a small state, deregulation and removing taxes.

On the subject of the NHS, he denies that he’s in favour of its privatisation. In answer to careful questioning for Davies, he states that everyone in the 1990s, even Tony Blair, was in favour of finding private solutions to the problem of the NHS. These have not worked. The outsourcing only accounts for 6 per cent of NHS work, and the health service has been saddled with massive debt through the Private Finance Initiative. He wishes to abolish this. He then goes on to say that the state and private enterprise should be kept separate, as mixing them in the NHS has not worked. He does, however, also state that as the population grows to 80, 90, 100 million, we will have to find new ways of financing it, including looking at an insurance-funded system. ‘Nothing should be set in stone’, says the Fuhrer.

On the subject of gay men kissing, Farage himself denies that he personally has any problem with it. On the other hand, many people do have a problem with it, and they shouldn’t be treated with the harsh disapproval that some give them now.

Slippery Farage

This interview actually shows just how slippery and specious Farage is. Much of what he said in this interview makes him and his party look benign and reasonable. He is absolutely right about the Private Finance Initiative. It hasn’t worked. All it has done is make the shareholders of the private contractors extremely rich while saddling them with massive debt. Even George Osborne recognised this. And made exactly the same promise.

Which is why you can’t trust him on this point.

Before the 2010 election, Osborne stated very clearly that the Private Finance Initiative was a disaster and said he would get rid of it. He hasn’t, and it’s gone on regardless, as has the Tories’ privatisation of the NHS.

Fool me once, shame on you; fool me twice … etc.

As for Margaret Thatcher, Farage has said repeatedly that his is a Thatcherite party. Of course, he doesn’t want to say this outright and unqualified on Newsnight, as it means that some of the Labour voters, who he hopes to win over, will immediately drop UKIP like a hot rock. So it’s heavily qualified with flannel about other people he respects, like Winston Churchill, whom he hopes have universal respect.

As for introducing an insurance based system into the NHS, he states that it’s partly done in France and the Netherlands to some extent. In fact, it’s the basis for the health care systems in much of Europe. A Swiss lady I know explained that in her country, medical care was funded partly by the state and partly through insurance contributions. Most people had a mixture of state/ private insurance. Only the very rich had completely private insurance, and only the poorest had completely state care. I think there was a similar system introduced in one of the American states on the East Coast, to the sneers and derision of much of the rest of America.

Now, if Farage wishes to introduce funding through insurance contributions, as in France and the Netherlands, then he still wants to privatise the NHS by opening it up to private health insurance companies.

Despite what Farage believes, or appears to believe, this will make treatment even more expensive. One fifth of Americans cannot afford their healthcare, because of the way insurance premiums have ballooned over the past decade. Farage clearly wants to introduce that into the UK.

And while he says he doesn’t want to privatise the NHS, he also made comments to the contrary. As has his deputy, Paul ‘Eddie Hitler’ Nuttall.

So I simply don’t believe him when he says he doesn’t want to privatise the NHS. It’s exactly what the Tories have said, even when they are doing their level best to sell it off.

As for gay men kissing, while he’s right that there are many people, who would feel uncomfortable about, Farage’s party goes far beyond simple disapproval. Much of the party is bitterly anti-gay, just as the party is also vehemently racist, despite what Farage claims. UKIP’s opponents have attacked the party because, despite it’s ostensibly softer, more reasonable approach, it threatens to legitimise bigotry and intolerance against ethnic minorities. And from this interview, it would also seem gays.

In short, don’t be taken in by the weasel words Farage has made in this interview. His is still a very intolerant party, and he still stands for the privatisation of the NHS, whatever he says.