Mon. Nov 28th, 2022

Today I want to use my voice, and encourage you to use yours, to begin to campaign, if you haven’t already, or to step up your campaign if you have, to protect an NHS that is free at point of use: the NHS Aneurin Bevan created in 1948, the NHS of which this country has always been so proud, and which has seen so many of us lovingly from cradle to grave.

Today, I want to focus on two things that need to be done: to campaign against privatisation of the NHS, and specifically against the appointment of Dido Harding as head of the NHS, and to campaign for an inclusive NHS, one which recognises and welcomes the support and care of people of any and all nationalities as workers in it.

Today, I want to use my voice, and encourage you to use yours, to protect an inclusive NHS –  the NHS which is staffed, with care and pride, by so many of the “foreigners” that Dido Harding, currently front runner to lead the NHS, and writing in the Times and the Daily Mail this weekend, has said she wants to get rid of to “make the NHS less reliant on foreigners.”

We do not need or want Harding. We do not need or want, Harding’s attitude. It is bad enough that nurses and doctors and support staff who are identifiably “not-white-British” have been increasingly targeted, post Brexit, by racist and xenophobic patients: they are subjected to abuse even as they care for their abusers. Harding’s comments only add fuel to that particular fire. We need to make it clear that we stand neither with Harding, nor with her supporters, nor with the abusers.

So there are two issues here.

The first is that the NHS must be protected from further privatisation, American-style, by a government that wants to cream off profit to benefit its friends – Harding being one of them.

The second is that we must recognise that we have been incredibly privileged to have the services of people of so many nationalities to care for us from cradle to grave. We need – and want – this to continue.

We should remind ourselves, in fact, that we have benefited from the services of those “foreigners” often to the detriment of their own nations, although in some cases – Spain, for example – a country does produce a genuine surplus of nursing staff. But that is another issue: not to be dismissed, but to be considered. What we must focus on here and now is the vile ingratitude displayed by the likes of Harding, and her dog-whistling to the far-right and their rampant xenophobia, to win cheap votes and to further her agenda.

Let’s also remind ourselves of the history of the NHS.

When Clement Attlee’s Labour Party won the 1945 election he appointed Aneurin Bevan as Health Minister. Bevan then embarked upon what the official historian of the NHS, Charles Webster, called an “audacious campaign” to take charge of the form the NHS finally took.

Bevan’s National Health Service was proposed in Westminster legislation for England and Wales from 1946 and Scotland from 1947, and the Northern Ireland Parliament’s Public Health Services Act 1947.

(Webster wrote in 2002 that “the Luftwaffe achieved in months what had defeated politicians and planners for at least two decades.” There had been discussions about a National Health Service in some form from 1909, when the Minority Report of the Royal Commission on the Poor Law called for a “unified medical service.”  In 1934, Somerville Hastings, President of the Socialist Medical Association, successfully proposed a resolution at the Labour Party Conference that the party should be committed to the establishment of a State Health Service, and following the 1942 Beveridge Report’s recommendation to create “comprehensive health and rehabilitation services for prevention and cure of disease”, cross-party consensus emerged on introducing a National Health Service of some description. Conservative MP and Health Minister, Henry Willink later advanced this notion of a National Health Service in 1944 with his consultative White Paper “A National Health Service.”)

The NHS was born out of the ideal that good healthcare should be available to all, regardless of wealth. At its launch by Bevan on 5 July 1948 it had at its heart three core principles: That it meet the needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay. And Bevan specifically did NOT exclude visitors to these islands from using NHS care.

From the very beginning, however, the NHS as originally conceived was under threat. Unfortunately, it wasn’t just under threat from the Tories, as one might expect.

When the NHS Bill was voted on, Conservative MPs had voted in favour of their amendment to Bevan’s Bill to maintain local control and ownership of hospitals and against Bevan’s plan for national ownership of all hospitals. The Labour government defeated Conservative amendments and went ahead with the NHS as it remains today; a single large national organisation (with devolved equivalents) which forced the transfer of ownership of hospitals from local authorities and charities to the new NHS.

And three years after the founding of the NHS, Bevan resigned from the Labour government in opposition to the introduction of charges for the provision of dentures, dentists and glasses. The following year, Winston Churchill’s Tory government introduced prescription fees.

So Bevan’s vision has, throughout NHS’s history, been substantially diluted – not just by the Tories, although we must not forget that they have always been ideologically opposed to free health care. Never forget that Harding’s husband, John Penrose, sits on the 1828 board. The 1828 Board? According to its website it,  

“was founded to champion freedom. Why are we needed today? Because practically anything that’s perceived as remotely negative is blamed on capitalism, economic freedom or neoliberalism. There is also an urgent need to challenge socialism’s grip on the young and to make the case for free market-conservatism.”  

In other words, it is a rich people’s club that doesn’t believe in socialism. Any form of socialism, including the NHS: despite saying that it’s

“championing the noble principle of universal healthcare,”

the kicker is in the ending of that sentence from its website:

“but at the same time promoting innovative ways to improve outcomes.”

(AKA, according to one of 1828’s founders’ articles, arguing that  Britain should be “bold and progressive” – scrapping the NHS in favour of a system where people pay for insurance either through private firms or a government scheme, and saying that with a social health insurance system, you don’t need the state to own or subsidise hospitals, or to control policy from the centre; you simply need it to regulate the system to a satisfactory degree.)

It’s like wolves arguing that sheep don’t need protecting from wolves, they need protecting from themselves . . .

Long story short: the NHS is, as we know, more under threat than ever before.

And yes, it was under a Labour government that much of the threat materialised. As a 2007 article by Polly Toynbee, writing for the BMJ summarised,

“This has been a decade of turmoil, with zigzag reforms dictated from the top, only to be countermanded again from the top. The history of his (Blair’s)  “reforms” hardly bears repeating. First he dismantled general practice fundholding and some aspects of the Tory internal market. He set up primary care groups, remade them into primary care trusts, and then merged them again into half the number. Demolished regional health authorities were resurrected as 28 strategic health authorities and then merged again back into the original 10 regions. The public health director for the south west region provides one graphic example of what has happened on the ground in this breathless deckchair shuffling. He has held the same job since 1994, but has had to reapply for it seven times since then because of reorganisations.

With each turn of the screw, Tony Blair became more convinced that only a fiercely competitive market could jolt the NHS into better productivity. He castigated Bevan’s “monolithic” state driven model and trusted the magic of Adam Smith’s “hidden hand” to drive greater efficiency. But he made a fundamental error by putting the power in the hands of the providers and not the purchasers. He built up mighty foundation hospitals and independent treatment centres first, neglecting weak and feeble primary care trusts without the managerial clout to power his great market machine. Instead, the hospitals sucked money out of the pockets of the primary care trusts’ inexperienced finance directors.”

Adam Smith, let us not forget, was, and still is, the darling of free market capitalism: working, as its website says to “promote neoliberal and free market ideas through research, publishing, media commentary, and educational programmes” and believing that “free markets work best for the poor. No system has raised people out of poverty and given them the freedom to live their lives as they wish like free markets have.”

(People actually living in poverty at the mercy of the “free markets” might beg to differ. Isn’t it interesting how these grandiloquent statements about free markets benefiting the poor are so often made by people who have never themselves had to try and drag themselves out of poverty after an impoverished and disadvantaged childhood, an inadequate and poorly funded education, health issues which access to high quality nutrition might have prevented and living standards well above simply dragging out a wretched existence in a cramped, mould-ridden flat in a polluted city? Most of these “free-market enthusiasts probably went to private schools, and did PPE at Oxford. Men of the people – sorry, persons of the people: looking at you, here, Harding –  they most definitely are not: they are the privileged preaching to the proletariat.)

So we can’t just point the finger at the Tories here: Labour under Blair (who apparently is looking for a political comeback: perish the thought) also played its part in undermining the institution that, according to an opinion poll in 2016, 70% of people in the UK were willing to protect to the extent that they were also willing to pay an extra penny in the pound in income tax if the money were ringfenced and guaranteed for the NHS.

Now, however, it is not just right-wing think tanks, rogue Labour politicians, and inevitably free-market capitalist far-right Tories from whom the NHS is under threat, it is the whole apparatus of the new Tory/Brexit party in power: the ideologically Trumpian, monumentally incompetent, constitutionally corrupt chumocracy of Johnson and his coterie.

Johnson’s gang hasn’t just sold us down the river (an interesting phrase, that, derived from the slave-holding American South, where “being sold down the river” implied being sold from a bad situation on one plantation to a worse situation on one further south).

It has encouraged a sizeable group of this country’s population to collude in their own selling by appealing to their worst instincts, in the pursuit of which, that group, as it preens, and puffs itself up, and prides itself on its pure white “Britishness,” has not just rejected the European hand that fed it, but is busily, now, engaged in biting the hand that heals it.

Rejecting the diversity of the NHS, rejecting the diversity of its healers, they are rejecting their own safety, their own futures and the futures of their own families – as well, of course of ours: those of us who do not consent to nor collude in their xenophobia. Nursing is hard, unremittingly difficult, and often painful work. It’s poorly paid, and “pure white British” people have often chosen not to do it: hence, we have a health service which relies on the “foreigners” whom Harding wants to reject. (Although I suppose if she kills off a few more people because of inadequate health care, that might at least mitigate the social care crisis.)

So the NHS is more under threat than ever before. Harding, if she gets in, will privatise it: that goes without saying. If she excludes “foreigners” it will fail: we cannot staff it to our level of need without importing staff – and we should be damn grateful they are prepared to come, although fewer and fewer are, now, given the hostile environment they face.

What can we do? (I have removed live links here, but if you copy and paste the whole link into a browser window, you will get there.)

I urge you to write to your MP – useless as many of them are, we still need to keep up the pressure. (Mine is the worse than useless John Penrose, Harding’s husband, presiding over the county with one of the worst hospitals (Weston Super Mare) in England.) Write to neighbouring MPs if you think it will have more of an effect. Askthem to advocate for you, since your elected representative won’t.

Support EveryDoctorUK; which is campaigning for reversing privatisation and an inclusive NHS that welcomes foreign staff.  Sign their letter here:

Look at the NHS Support Federation here at actions you can take to support the NHS locally and nationally.

Go here to be informed, and to help you inform other people.

The trade union UNISON is fighting privatisation in the NHS

Even if you take only one action, and persuade one other person to take one too, you are sending two powerful messages to the government. The first is that we stand for the NHS as Nye Bevan first conceived it with its three core principles: that it meet the needs of everyone, that it be free at the point of delivery, and that it be based on clinical need, not ability to pay.

The second is that you recognise and value the contribution made to our NHS by nurses, doctors, other health professionals and all support staff, of every nation in the world, that you stand against Harding’s xenophobia, and that you continue to welcome people not born in this country to work for us in our healthcare.

The NHS: care for it, support it, love it – or else lose it! The time to act is now.

“NHS” by Edmond Wells is licensed under CC BY-ND 2.0

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