The Cuts in the NHS and its Future

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The Cuts in the NHS and its Future

When the government and the health authorities speak of "saving" millions of pounds, what are they talking about? For example, when the government urges people to "save" for their retirement, they are speaking of putting aside a section of their wages or salaries in a savings account. It is true that the government and the monopolies which have robbed surplus value from working people should guarantee them a livelihood. But the issue is that from produced values, something is put aside. The "savings" in the NHS are of a different quality. Nothing is being put aside. The budget is not decided on the basis of need or safeguarding for the future. It is declared by the government, and the health authorities then have a legal obligation to "balance the books".

The whole issue of the "money" which is funding the NHS and the source of this funding is obscured, and this goes from the top to the bottom. The issue of funding local hospital trusts is posed as though hospitals were a productive force, creating added value, a healthcare product which the Primary Care Trusts have a budget to purchase. Similarly the budgets of the hospitals are described as though the hospital trusts put into motion constant and variable capital, which is either used up or produces added value. The issue of "privatisation" comes naturally into this scenario as the question then is raised about the "productivity" and efficiency of the enterprise and its workforce. The fraud that in fact the private enterprises simply siphon off the wealth which society has generated and which has been allocated to health services is therefore doubly obscured.

For health workers and those involved in the campaigns against cutbacks and hospital closures, to arm themselves with this understanding opens a space for fighting to safeguard the future of the NHS. It helps build the resistance to the programme that the ruling elite are carrying forward with regard to social programmes, encapsulated in the government’s outlook of "investment with reform", i.e. cutbacks and delivering social programmes to the rich, channelling funds to the monopolies and the private sector. It takes off the pressure of a hysteria that it is all or nothing now, that the juggernaut of privatisation is coming, and it is crushing the people and their social programmes beneath its wheels.

The important thing about building resistance to the cuts in funding of the health service is not to compile the longest list of dangers to the NHS and predict its demise. It is the future of our health service, hospitals and health care that we are fighting for, in which health care is a right, and ill people are not consumers but human beings who have claims on society. Now is a critical time in this struggle. A coherent resistance with a vision and programme of a health service of the future must be built with the conscious participation of health workers and society.