Posts Tagged ‘Private Health Care’

RT Parliamentary Coverage: Nurse and Labour MP Karen Lee on NHS Crisis

September 13, 2017

In this very short clip from RT, Unison nurse and Labour MP for Lincoln, Karen Lee, describes the chronic lack of nursing in the NHS, and the threatened closure of walk-in centres in her constituency.

Hunt stands up, thanks her for her work in the NHS, and then admits that there is a shortage of nurses in the NHS, there was when he began as health secretary, and then declares he will go on to tell her how he means to solve it. This is where the clip ends.

Lee is absolutely right, just as she is right to remind him that the NHS is seriously underfunded while at the same time, the government is cutting corporation tax and has given £1 billion to the DUP. The government cannot rightly talk about austerity when this goes on.

There’s a piece in today’s I by Yasmin Alibhai-Browne, whose headline states that austerity was never about reducing the deficit. It was all about a Tory class war on the poor. Which is what Owen Jones, and very many other bloggers, including Mike over at Vox Political, have been saying for years.

As for Hunt’s plans to get more nurses into the NHS, I am extremely skeptical about this. All the evidence I’ve seen shows doctors and other medical professionals leaving the NHS. As for those nurses that remain in it, they are to be applauded as they’re increasingly treated extremely shabbily. Such as those, who are forced to use food banks, for example.

The threatened closure of the walk-in centre also shows the massive dangers of the Blairite/Tory NHS privatization. The walk-in centres, otherwise known as polyclinics, were part of New Labour’s big idea for NHS restructuring, which including dismantling the NHS and opening it up further to private investment. Again, not a new idea. Like most of Blair’s economic thinking, it was taken over and developed from the Tories, like the Private Finance Initiative generally. These polyclinics were intended to be privately run, hence the interest in them from the usual private healthcare firms, including ‘Beardie’ Branson’s Virgin Health.

Since private companies have taken over hospitals and GPs’ surgeries, we’ve seen one hospital after another go into the red, while Private Eye reported in their ‘In The Back’ column how several surgeries in London were closed down, and their patients thrown out without medical care, by the private firm running them. Private enterprise in the health service doesn’t work, and leads to gross inequalities in healthcare provision and massive profiteering by the companies.

But Hunt, for all his weasel words about getting more nurses into the NHS, doesn’t care about any of that. Indeed, he actually advocates the NHS’ privatization, though he is very loud in denying it in public. As is his mistress, Theresa May. And it’s been the same all the way back to Margaret Thatcher, who really wanted to privatize the NHS under there was a massive cabinet revolt, as well as evidence from her personal private secretary, Patrick Jenkin, who came back from a fact-finding mission to America and informed her how wretched American private healthcare was.

Don’t be taken in by Hunt’s lies. Believe Karen Lee, and kick out the Tories.

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Don’t Let Theresa May Privatise the NHS

June 8, 2017

This is the text of one of the self-published, table-top produced pamphlets I created a few years ago, and which are advertised on one of the other pages of this blog.

As you can see, it was written a year or so ago when David Cameron was in power. Nevertheless, it is still as valid now as it was then. Theresa May has not changed the Tory policy of privatising the NHS one whit.

So, please, read this article, and then vote for Jeremy Corbyn to preserve this most precious of British institutions.

Don’t Let Cameron Privatise the NHS
David Sivier

Visiting our local health centre the other day, my parents, along with the other local people enrolled there, were handed a letter, explaining that due to funding cuts the health centre was having to cut back on services. It also advised its patients that if they wanted to raise their concerns about the restriction in their service they could contact:-

1. NHS England at FAO Linda Prosser, Director of Assurance and Delivery, NHS England South West (BNSSG), 4th floor Plaza, Marlborough Street, Bristol BS1 3NX
2. your local MP at the House of Commons, Westminster, London SW1A 0AA

Unfortunately, this is happening to the NHS and GPs’ services all over the country. It is no accident, and it is certainly not the fault of the many dedicated doctors, nurses and other health professionals working in the NHS.
It is the result of over 30 years of privatisation begun with Margaret Thatcher. Thatcher and her former Chancellor, Nigel Lawson, denied that they wanted to privatise the NHS. They merely stated that they wanted to include more private provision in the NHS. This is a lie. Released cabinet minutes showed that Thatcher and Geoffrey Howe wanted to privatise the NHS along with abolishing the rest of the welfare state. They were only prevented from doing so because the rest of the cabinet realised that this would be the death knell for the Tory party. And a fact-finding mission to the US to see how their private healthcare system worked by Patrick Jenkin showed that it was massively inefficient.

Nevertheless, the amount of private healthcare in the NHS was expanded, and state provision duly cut by successive governments. It was Maggie’s government in 1989 that ended the state support for care for the elderly in nursing homes. As a result, the families of those, who need this kind of care, are forced to fund it themselves, often through selling or remortgaging their homes because of the immense expense. It was also Maggie’s government that ended free eye tests, and picked a feud with the doctors that saw the majority of them leave the NHS.

This privatisation has continued under Tony Blair, Gordon Brown and now David Cameron and Jeremy Hunt. Blair and Brown were deeply impressed with American private healthcare firms such as Kaiser Permanente, and wished to reform the NHS on their model. The ultimate intention was to replace the publicly owned and operated NHS with private healthcare funded by the state, but administered by private health insurance companies. As a result, NHS work has been given to private hospitals and clinics, and private healthcare companies have been given NHS hospitals to manage. Alan Milburn, Blair’s health secretary, wanted the NHS to become merely a kitemark – an advertising logo – on a system of private healthcare companies funded by the government.

This has been carried on the current Conservative government. And they have used the same tactics Margaret Thatcher did to force private healthcare on this nation. The dispute with the doctors over contracts a few years ago was part of this. It has left the majority of NHS GPs wishing to leave. Yet elements within the Conservative networks responsible for foisting these demands have seen this as an opportunity for forcing through further privatisation. Penny Dash, of the National Leadership Network, and one of those responsible for the NHS privatisation, has looked forward to the remaining GPs forming private healthcare companies. Furthermore, an report on the Care Commissioning Groups now in charge of arranging healthcare in the NHS by one of the private healthcare companies also suggested that they could form private healthcare companies, and float shares on the stockmarket.

Further privatisation has come with Andrew Lansley’s Health and Social Care bill of 2012. This exempts the state and the Secretary of State for Health from their statutory duty, as the ultimate leaders of the NHS, to provide state health care. It is carefully worded to disguise its true meaning, but that is what has been intended by the bill. Dr David Owen, one of the founders of the SDP, now part of the Lib Dems, has tabled amendments trying to reverse this despicable bill. He and many others have also written books on the privatisation of the NHS. One of the best of these is NHS SOS, by Jacky Davis and Raymond Tallis, published by Oneworld.
This process cannot be allowed to continue, and I strongly urge everyone to resist the creeping privatisation of the NHS, Britain’s greatest public institution.

In the last government, there were 92 Conservative and Lib Dem ministers, who advocated the privatisation of the Health Service, and who stood personally to gain from it. They included Iain Duncan Smith, the minister for culling the poor, the sick and the old. Andrew Lansley, the health minister, openly stated he is in favour of privatising it. So has Nigel Farage, and the Unterkippergruppenfuhrer, Paul Nuttall.

Farage in particular follows the Tory policy going all the way back to Thatcher of promising to defend it while secretly plotting how to sell it off. Thatcher ‘s review into the NHS and its funding in the 1980s. so alarmed Labour’s Robin Cook, that he wrote a Fabian pamphlet, Life Begins at 40: In Defence of the NHS, attacking possible proposals to privatise the Health Service.

Previous reviews had given the NHS a clean bill of health. The extremely high quality of the NHS and its doctors was recognised by the heads of American healthcare firms: Dr Marvin Goldberg, chief executive of the AMI health group, told a parliamentary select committee that the Health Service Provides ‘outstanding health care and British NHS hospitals are at least as good as those in America while British doctors are better.’

The then Conservative MP for Newbury, Michael McNair-Wilson, also testified to the effectiveness of the NHS. He had suffered kidney failure. He had private health insurance, but it did not cover operations such as the one he needed because of the expense. He said ‘I have cost the NHS tens of thousands of pounds – much more than I could have afforded privately … Had my treatment depended on my ability to pay, I would not be alive today.’

Pre-NHS Britain: Some Areas Completely Without Hospitals

Cook’s pamphlet also graphically described the patchwork state of healthcare in Britain before the NHS. In London, where there were plenty of paying customers, there could be hospitals in neighbouring streets. Out in the poorer British provinces, there were hardly any, and many operations were carried out not by surgeons but by GPs. He cites Julian Tudor Hart’s book, A New Kind of Doctor, to show how bad this could be. Hart described how he joined one of those practices in Kettering. One patient was left under anaesthetic as the London specialist operating on him was called away to continue a stomach operation on a London patient, which the operating GP had been unable to complete.
Cook was deeply concerned that the Tories’ review would not be at all interested in improving quality, only in opening up the NHS to the market and privatisation.

Cook on Private Health Insurance

One of the issues he tackled in the pamphlet was the possibility of the introduction of private health insurance. This covers two pages and a column and a bit in the original pamphlet. This is what he wrote, though emphases and paragraph titles are mine.

The mechanism proposed to square the incompatibility of health care with the market is insurance. All market approaches to the NHS submitted to the Review stress the case for much wider private insurance and almost as frequently propose subsidies to boost it.

Insurance-Based Systems Encourage Expensive Treatment

The first thing to be said is that private insurance does not offer
to health care the alleged benefits of the discipline of the market place. At the point when the individual requires treatment he or she has already paid the premiums and has no incentive not to consume as expensive a treatment as can be reconciled with the policy. The position of the doctor is even more prejudiced in that he or she has every incentive to obtain as much as possible from the insurance company by recommending the most expensive treatment. Both patient and the doctor are in a conspiracy to make the consultation as costly as possible, which is a perverse outcome for a proposal frequently floated by those who claim to be concerned about cost control.

Insurance-Based Systems Encourage Unnecessary Surgery

The compulsion in an insurance-based system to maximise the rate of return is the simple explanation why intervention surgery is so much more often recommended in the United States. For example, the incidence of hysterectomy there is four times the British rate. This is unlikely to reflect higher morbidity rates but much more likely to reflect the greater willingness of doctors on a piece-work basis to recommend it, despite the operative risks and in the case of this particular operation the documented psychological trauma. I can guarantee that an expansion of private insurance will certainly meet the objective on increasing expenditure on health care, but it is not equally clear that the money will be spent effectively.

Insurance-Based Systems Require Expensive bureaucracy to Check Costs

One direct diversion of resources imposed by any insurance-based scheme is the necessity for accountants and clerks and lawyers to assess costs and process claims. The NHS is routinely accused of excessive bureaucracy, frequently I regret to say by the very people who work within it and are in a position to know it is not true. Expenditure in the NHS is lower as a proportion of budget than the health system of any other nation, lower as a proportion of turnover
than the private health sector within Britain, and come to that, lower than the management costs of just about any other major enterprise inside or outside the public sector. I am not myself sure that this is a feature of which we should be proud. ON the contrary it is evidence of a persistent undermanaging of the NHS, which is largely responsible for its failure to exploit new developments in communication, cost control and personnel relations. Nevertheless, there is no more pointless expansion of administrative costs than the dead-weight of those required to police and process and insurance-based system. These costs would be considerable.

Forty per cent of personal bankruptcies in the US are attributable to debts for medical care

Part of this additional cost burden is incurred in the task of hunting down bad debts, which does not contribute in any way to the provision of health care. Forty per cent of personal bankruptcies in the US are attributable to debts for medical care, a salutary reminder of the limitations set to insurance cover. These limitations have three dimensions.

Insurance Cover Excludes Chronic and Long-Term Sick, and the Elderly

First, insurance cover generally excludes those conditions which are chronic and therefore expensive or complicated and therefore expensive. Standard exclusions in British insurance policies are arthritis, renal dialysis, multiple sclerosis or muscular dystrophy. Most people do not require substantial medical care until after retirement. Most insurance cover excludes the very conditions for which they are then most likely to require treatment. Short of retirement, the most expensive health care required by the majority of the population is maternity care, which is also excluded by the majority of insurance policies.

Private Healthcare Limits Amount of Care due to Cost, not Need

Secondly, insurance cover is generally restricted by upper limits which are arbitrary in every sense other than financial. I recently met a psychiatric consultant to a private clinic, who was prepared to discuss candidly the ethical dilemmas of treating patients whose financial cover is fixed at five weeks of residential care, but whose response to treatment may indicate that a longer period of hospitalisation is desirable.

Private Health Care Geared to Selling to Healthy not Sick

Thirdly, insurance cover is further limited by exclusion of those most likely to claim on it. I am often struck at the sheer healthiness of the patients who illustrate the promotional literature of BUPA and PPP who appear in such pink of good cheer and fitness that it is difficult to figure out why they are in a hospital bed. These models are though in a sense most suitable for the purpose as the objective of insurance companies is to attract the healthy. They therefore claim the right to screen for the unhealthy and reject them from cover. This discriminatory approach was defended earlier this month by the managing director of WPA, Britain’s third biggest health insurer, on the principled grounds that it meant ‘essentially healthy people are not penalised by unhealthy people.’ This statement has the advantage of originality in that it perceives healthy people as the vulnerable group and proposes a market remedy that protects them from the inconvenient costs of the unhealthy.
Given this limited character of health insurance in Britain, the private sector is patently not in a position to substitute for the NHS and to be fair most directors of BUPA or PPP would be horrified at the notion of accepting the comprehensive, open-ended liabilities of the NHS. It is therefore perplexing that so much effort in and around the Review appears to be addressed to the issue of how the private sector may be expanded rather than how the public sector may be improved. Two major devices are being canvassed to boost private cover-tax relief on private cover or opt-out from public cover, or for all I know both of them together. Both would be a major mistake.

Tax Relief on Private Healthcare

Tax relief is open to the obvious objection that it targets help most on those who need it least – the healthy who are most likely to be accepted for private cover and the wealthy whose higher tax rates make relief most vulnerable. These are curious priorities for additional health expenditure.

Tax Relief Does Not Create Higher Spending on Health Care

Moreover, even in its own terms of stimulating higher spending on health, tax relief is likely to prove an ineffective mechanism. If for example the average premium is £200 pa the cost of tax relief for 6 million insured persons will be £300 million. The numbers under insurance need to increase by a third before the increased spending on premiums matches the cost of the subsidy and provides any net increase in health spending. Up to that point it will always produce a larger rise in health spending to increase the budget of the NHS by a sum equivalent to the cost of tax relief.

It is apparently being mooted that these objections could be circumvented by limiting the tax relief to the elderly. At this point the proposal moves from the perverse to the eccentric. This restriction targets help for private insurance on the very group for whom private cover is most inappropriate as their most likely health needs are the ones most likely to be excluded from cover. Only a moment’s reflection is required on the multiple ways in which we need to expand our health provision for the elderly to expose the hopeless irrelevance of tax relief as the solution for them.

Opt-Out Penalises those who Remain in the System

Opt-out is even more objectionable. The basic problem with opt-out is that it requires the payment towards the NHS of every individual to be expressed in a manner that gives him or her something to opt-out from. The principal attraction to Leon Brittan of his proposal for an NHS insurance contribution appeared to be precisely that it paved the way for opting out (A New Deal for Health Care, Conservative Political Centre,, 1988). Nor is this inconvenience confined to the need for a whole new element in the tax system. If one in ten of the population chose to opt out, it would be remaining nine out of ten who would have to prove they were not opted-out when they went along to seek treatment. With the new contributions comes a requirement to maintain a record of payment of them, and presumably a mechanism for credits to those not in work but who do not wish to be counted has having opted out of the NHS.

Private Healthcare Undermine NHS as Universal System

The more fundamental objection both these proposals is they explicitly threaten the NHS as universal health service catering for everyone. Moreover, they threaten its universality in the worst possible way, by encouraging those with higher incomes and lower health needs to get out, leaving behind the less affluent and the less fit. In this respect such an approach to the NHS would be a piece with the Government’s strategy of erosion towards the rest of the social services-housing, pensions, and now education, where the Government has encouraged those who could afford it to opt-out of public provision, leaving behind the poor who could be expected to put6 up with a poor service.

This is the reality of the private healthcare system which Cameron, Clegg, Farage and the rest of the Right wish to introduce. It is expensive, bureaucratic, does not stimulating further spending, and excludes those with the most acute and expensive medical need, especially the elderly.
And the Tories and their counterparts in UKIP and the Lib Dems know it. Why else would the Tories spend their time trying to deny what they’re doing? Why does Farage appear to be advocating retaining the NHS, while arguing for an insurance based system, like America? It’s because they know that private medicine does not provide the solutions they claim. It is only source of further enrichment to them and their corporate donors.

And since Cook wrote that pamphlet, more than 20 per cent of all Americans can no longer afford their healthcare. It’s why the firms are trying to get their feet under the table over here. Don’t let them. Ed Miliband and now Jeremy Corbyn have promised to reverse the privatisation of the NHS. Please support them.

My YouTube Video Urging People to Vote Labour to Defend the NHS

April 30, 2017

I’ve had my own YouTube channel for a few years now. I haven’t posted anything on there for quite a while, and most of the stuff I have posted up there is about archaeology, early musical instruments and few home-made space videos. However, today I put up a video urging people to vote for Jeremy Corbyn’s Labour to prevent the Tories privatising the NHS.

I state that it began when Margaret Thatcher came to power as part of her campaign to dismantle the welfare state, but that Thatcher was stopped from doing so by her a cabinet revolt and her Personal Secretary, Patrick Jenkin. The cabinet realised that if she did privatise the NHS, it would immediately result in the Tories losing an election. Also, Jenkin went to America and realised just how bad the American system of private healthcare was. So Maggie settled for trying to expand private healthcare in Britain, aiming to have 25 per cent of the British people take out private health insurance.

A few years later in the 1980s there came a dispute between her and the dentists, which resulted in very many of them leaving the NHS. The result of that is that, while there still are NHS dentists, you need to look for them. And private dental care is not cheap. So people are going without proper dentistry.

After that, Peter Lilley in John Major’s administration introduced the Private Finance Initiative, under which private corporations build and manage hospitals for the NHS. It’s essentially a scheme to keep the costs of construction and management off the books. In practice it’s massively more expensive than simply having them build by the state. Those hospitals, clinics and other medical services built through it also tend to be smaller than through ordinary hospitals built by the state. See the chapter in George Monbiot’s Captive State. This was all done to open up the NHS to private investment.

This programme was expanded by Tony Blair, as he, like the Tories, was approached by private healthcare firms such as Unum, Virgin Health, Circle Health and BUPA to privatise more NHS services. His health secretary, Alan Milburn, wished to reduce the NHS to a kitemark for services provided for the state by private healthcare companies. He split the NHS up and handed its management to CCGs – Community Care Groups. This was supposed to be giving doctors greater freedom and more choice. However, it doesn’t do this as most doctors simply don’t have enough time to spend on administration. The CCGs were given the power to raise money privately, and commission services from private healthcare providers. Again, hospitals and the health centres or polyclinics Blair also built were also to be managed by private companies.

This programme did not stop when David Cameron’s new Conservative government was voted into power in 2010. Cameron had claimed that he going to stop further cuts in the NHS. He didn’t. He expanded the privatisation programme even further. The 2012 healthcare act formulated by his health minister, Andrew Lansley, is a convoluted document, but it removes the Health Secretary from having to provide medical services. Furthermore, the Tories have also passed legislation allowing the NHS to charge for services, even ambulance care. And this is still going ahead under Theresa May.

There is a real danger that the NHS will be abolished, and the country will return to the way it was before the Labour government introduced it. Private healthcare is not more economical and efficient than state healthcare. Private insurance companies and hospitals spend much more on management, including advertising, legal teams and simply trying to raise money from investors, to make sure their shareholders see a profit. There are about 50 million Americans without health insurance. 33,000 Americans die every year from lack of medical care. And it was like that before the NHS, when the charity hospitals, where people were sent if they didn’t have private health insurance, or weren’t covered by the state health insurance scheme, spent much of their time trying to raise money. And millions of people were denied healthcare, because they couldn’t afford it.

Jeremy Corbyn has said that he will renationalise the NHS. Dr. David Owen has also sponsored a bill to renationalise the NHS. They need our support. And so, if you want to keep the NHS, you should vote for Jeremy Corbyn.

For further information, see the following books:
NHS-SOS, edited by Jacky Davis and Raymond Tallis (London: OneWorld 2015)
Dr. Youseff El-Gingihy, How to Privatise the NHS in 10 Easy Steps (Zed Books)
and my own, Privatisation: Killing the NHS, published by Lulu.

Vote Leave’s Lies about the EU and the NHS Funding

June 9, 2016

I just caught a bit of Vote Leave’s referendum broadcast earlier this evening. It was broadcast around about 7 O’clock, just before the One Show. I didn’t see all of it, as I was busy here, putting up article, but just managed to catch a snippet where they claiming that the £350 million they claim we spend every week on Europe could be used to build hospitals in the NHS. They then claimed that the EU therefore was undermining the Health Service.

They then went on to scaremonger about immigration, raising the dire spectre of what might happen when Albania, Macedonia and Turkey all join the EU. There were large, scary arrows from those countries running across Europe to Britain, rather like the diagram of the Nazi advance in the titles of Dad’s Army. Which is actually what I’d much rather be watching, even in the recent film version, than the Brexiteers and their wretched propaganda. But they made, the claim, so let’s filk it.

Who Do You Think You Are Kidding, Mr Farage (and Johnson, Gove and Ms Patel)

First of all, the claim that Britain spends £350 million every week on Europe has been refuted again and again. Yes, we do spend that money, but we get over £100 million or so of it back. So in net terms, no, we certainly don’t spend that amount. See Mike’s articles about this over at Vox Political.

Then there’s that guff about funding the EU diverting money away from the NHS. This is rubbish. What is undermining the NHS is the stealth privatisation carried out by Andrew Lansley’s Health and Social Care bill of 2012. This has opened up the NHS to further privatisation by private health care firms, such as Virgin, which under law must be given contracts. This has frequently gone against the wishes of the patients using the NHS. The reforms included forcing local authorities responsible for some NHS provision to contract out at least 3 medical services from a list of eight sent down by the government. Furthermore, the remaining state-owned and managed sectors of the NHS are being deliberately starved of funds as part of the campaign to privatise the whole shebang. See Jacky Davis’ and Raymond Tallis’ NHS SOS, particularly the chapters ‘1. Breaking the Public Trust’, by John Lister; ‘2. Ready for Market’, by Steward Player, and ‘7. From Cradle to Grave’, by Allyson M. Pollock and David Price.

It’s a lie that the NHS is being starved of funding due to Europe. It’s being starved of funding due to Lansley and the rest of the Conservative party and their purple counterparts in UKIP. If Vote Leave were serious about the funding crisis in the NHS, then Johnson, Gove, Patel and the other xenophobes and Little Englanders would have voted against Lansley’s bill. They didn’t. They supported it.

‘Bloody Foreigners, Comin’ Over ‘Ere!’

Let’s deal with the threat of people from Turkey, Albania and Macedonia all flooding over here in the next few years. This too, is overblown and pretty much a lie. Turkey would like to join the EU, but the chances of it actually qualifying to do so are presently remote. Critics have suggested that it’ll only reach the point where it has developed sufficiently to be admitted in about 30 years’ time. So the Turks are hardly likely to come flooding up from Anatolia in the next few years.

As for Albania and Macedonia, I’m sceptical about the numbers that will come from those nations due to the open borders policies. Mike’s posted up pieces reminding us all how millions of Romanians and Bulgarians were supposed to be ready to inundate Britain, and in the event only a small number arrived. Mark Steel, the left-wing activist and comedian, in one of his newspaper columns, republished in Colin Firth and Anthony Arnove’s The People Speak: Democracy Is Not a Spectator Sport, attacked the inflated claims of the threat of uncontrolled immigration by pointing out that many of the Poles, who were supposed to flood in, had in fact gone back to Poland. So while it’s certainly possible that a vast number of Albanians and Macedonians may want to come to Britain, it’s also possible that few in fact will.

And in any case, why would they all want to come to Britain? The impression given by the Brexit video tonight was that Britain was a tiny island under siege, and that the first country that the Turks, Albanians and Macedonians would all head for was Britain. But why? Britain’s social security system and welfare state – or what remains of them – are much less generous than some parts of the rest of Europe. Britain does have more cache, apparently, than some of the other nations, but Britain is by no means the sole destination for migrants, as we’ve seen.

Vote Leave’s video tonight was little more than right-wing scaremongering. What I saw was mostly speculation, and when it wasn’t speculation, as on the piece on the NHS, it was a distortion compounded with lies. There are problems with Europe and immigration, but leaving the EU isn’t the solution. Indeed, voting for Johnson, Gove, Patel, Farage and their cronies will only make the situation worse. They want to privatise the NHS, just as they want to remove the EU human rights legislation and social charter that protects British workers. The anti-EU campaign is part of this programme to grind down and deprive working people of their hard-won rights at work and for state support in sickness and unemployment. Don’t be taken in.

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.

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.

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.

Public Dissatisfaction with NHS Rising, Report the ‘I’

February 9, 2016

Today’s I newspaper has an article stating that the British public’s satisfaction with the NHS is falling. The article begins

Public dissatisfaction with the NHS is rising according to new data.

IN 2015, overall NHS satisfaction fell to 60 per cent, down from 65 per cent in 2014, the British Social Attitudes survey found. At the same time, dissatisfaction with the NHS rose by 8 per cent to 23 per cent the largest single year increase since 1986.

Dissatisfaction is now back at the same levels reported between 2011 and 2013, the survey, published by The King’s Fund charity found.

The decade of NHS funding growth during the 2000s was accompanied by increasing levels of public satisfaction, it said. This reached a peak of 2010 at 70 per cent and, although satisfaction is still high by historic standards, it is 9 per cent lower than in 2010. The report is entitled, Public Discontent with NHS is Rising, and it’s on p. 4.

This is no accident. It’s a deliberate part of the Tories’ over all long term strategy to sell off the NHS. Remember the meme from Noam Chomsky Mike’s put up at Vox Political on how the right operates to privatise industries by defunding them. And the Tories have vested personal interests in selling it off. 95 of the Tory and Lib Dem MPs in the last parliament had connections to health firms looking to profit from the sale of NHS services. Health Secretary Jeremy Hunt has said that he wants the NHS privatised. And the Tory conference last year was sponsored by private health firms, and included debates on topics like opening up the NHS to private industry.

If you want further proof, consider some of the stuff that gets posted on the right-wing Canadian blog, Five Feet of Fury. This is an ugly little blog that makes absolutely no secret of its hatred for organised labour, immigrants, indigenous Canadians, feminism and socialised medicine. It also has a venomous hatred of Italians. It was urging its readers to send in stories about how awful the British NHS was, and went absolutely berserk at the 2012 London Olympics because it dared to include the NHS in the opening display. Socialist propaganda, it roared. It would be tempting to write this off as just a North American blog, whose readers are safely confined to the other side of the Atlantic. This would be a mistake. It’s part of a network of right-wing blogs which link Conservatives over here with their counterparts in Canada and the Republicans in the US. It says openly what the Tories over here only say amongst themselves, and then start lying when it gets out.

Be warned. Don’t be taken in. Protect the NHS from these profiteers.

The Guardian Adds a Few More Details on Jonathan Stanley’s UKIP Resignation

March 20, 2015

I posted an article yesterday about the resignation from UKIP of Jonathan Stanley, a Scotland-based surgeon. Mr Stanley was their candidate for Westmoreland and Lonsdale. He resigned citing racism and sectarianism in the Scottish party as his reasons for leaving, along with the party’s failure to publish documents he had written about the deaths of eleven babies and a mother in the University Hospitals of the Morecambe Bay NHS Trust.

The Guardian today published an article reporting Mr Stanley’s resignation as one of three blows and scandals to hit the party. The other two were the investigation of Janice Atkinson for fiddling her expenses from the EU, and the suspension of Stephen Howd, a barrister, and their candidate for Scunthorpe, over allegations of harassment at his workplace.

The Guardian’s report says little about this. Most of the article is about Stanley’s resignation and Atkinson’s fraud, adding a few more details about why he resigned. In addition to the sectarianism and culture of bullying, he also strongly objected to the party’s use of ‘the language of English nationalism’. He felt it was damaging and corrosive to the Eurosceptic and Unionist cause.

He also took issue with part of Farage’s plan to exclude migrants from state support for five years after they came here. Along with his other reasons, he stated he could not support the exclusion of migrant children from state education and medical care.

Stanley’s absolutely right. It is totally unacceptable that migrant children, in particular, should be punished and left vulnerable because their parents came here in search of a better life. It’s also a move that is absolutely certain to do immense harm. If you exclude children from state education, and they cannot afford the immense fees of private tuition, then automatically you create an unskilled underclass, who will have no other recourse but crime. Especially if they cannot claim dole or other benefits.

I’ve similarly reblogged material from Vox Political, where Mike has produced the opinions of doctors and social workers that if migrants are excluded from the NHS, then it could lead to more infectious disease going untreated. You think of the chaos and suffering that could arise, if someone contracted Ebola, because they came from or visited West Africa, and were excluded from state medical treatment and couldn’t afford to go privately.

Or more prosaic problems and deaths that could arise from more ordinary problems going untreated, like meningitis or appendicitis. And does anyone really want to see women left to give birth without proper medical care, especially after the rave reviews of the Beeb’s Call The Midwife? That programme showed exactly the problems women faced bearing children in the East End slums in 1950s austerity Britain. No-one should want that privation and poverty to come back.

Except, it seems, Farage, and the rest of the Kipper, Tory and Lib Dem goons, who crave to see the NHS carved up and sold off.

The Guardian’s article is at: http://www.theguardian.com/politics/2015/mar/20/ukip-faces-crisis-two-parliamentary-candidates-suspended-one-resigns

Roy Porter on Rising Cost of American Medicine

March 19, 2015

Blood and Guts Cover

The historian of medicine, Roy Porter, devotes a couple of pages to the development of medicine in America in his book Blood and Guts: A Short History of medicine. He notes that the development of private medical insurance and the fees-for-service system in America caused medicine to become a highly developed and lucrative industry. Competition was at the heart of this system, with doctors and hospitals competing to offer better medical service, such as better tests, a fuller range of elective surgery, more check-ups and so on. However, the costs of these procedures became correspondingly expensive, so that President Truman in 1948 mooted a national health service for America. This came to nothing, however, as the American Medical Association campaigned against it.

Part of the American system of private health care are the HMOs, the Health Maintenance Organisations, which began with the Kaiser Foundation Health Plan in California. These arose as a cheaper alternative to ordinary medical insurance like Blue Cross. Porter states that health costs have continued to rise, not just in terms of medical personnel and equipment itself, but also in the growth of hospital bureaucracy, administrative and marketing teams – including corporate finance, lawyers, medical insurers, public relations firms and accountants. He states ‘Expenditure has continued to rise, quite disproportionately to measurable improvements in health.’ (p. 167). The result is that by 2000 40 million Americans had no medical insurance. That’s almost one in six people under the age of 65.

This is the system that Cameron, Clegg and Farage wish to import over here. Meanwhile in America, Conservatives are attacking the soaring costs of medicare and Medicaid, introduced by Lyndon B. Johnson to allow the state to pay for the medical care of the poor and elderly, who couldn’t afford it.

There are 92 Tories and Lib Dems, who have links and positions on the private health companies waiting to profit from the Tories’ privatisation of the NHS. Andrew Lansley, the current health minister, is a supporter of the privatisation of the health service.

If they win, and get another term, we will not see the NHS survive. The poor will be deprived medicine, but the Tory, Lib Dems and Kippers will profit immensely.

We mustn’t let them.

Labour NHS Privatisation UKIP

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