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NHS Funding Bill 2019-20:
"Mandatory" Funding Obscures How the NHS Should be Funded and Pursues a Corporate-Led Direction
The Queen's Speech on December 19 at the end of last year set out the government's agenda for the new parliamentary session. Amongst the policies and proposed legislation, it announced: "A Constitution, Democracy and Rights Commission will be established. Work will be taken forward to repeal the Fixed-term Parliaments Act." This announcement was immediately followed with declaration of further pro-war government.
No further details have been given, but it is partially elaborated in the Conservatives' election manifesto, which said:
"After Brexit we also need to look at the broader aspects of our constitution: the relationship between the Government, Parliament and the courts; the functioning of the Royal Prerogative; the role of the House of Lords; and access to justice for ordinary people. The ability of our security services to defend us against terrorism and organised crime is critical. We will update the Human Rights Act and administrative law to ensure that there is a proper balance between the rights of individuals, our vital national security and effective Government. We will ensure that judicial review is available to protect the rights of the individuals against an overbearing state, while ensuring that it is not abused to conduct politics by another means or to create needless delays. In our first year we will set up a Constitution, Democracy and Rights Commission that will examine these issues in depth, and come up with proposals to restore trust in our institutions and in how our democracy operates."
This is the Conservative Party's take on what it, together essentially with all of the factions of the ruling elite, calls "the necessary task of restoring public trust in Government and politics" after the fiasco and shenanigans of the last Parliament. It is an attempt to square the circle of appearing to stay within the existing constitutional norms, while casting those norms aside for self-serving purposes and to rule through arbitrary power alone. It is an attempt to deprive the population of an outlook, confining the debate to how to defend and reform the outdated unwritten constitution, rather than renew democracy itself.
The manifesto and Queen's Speech therefore declared that the Government will repeal the Fixed Term Parliaments Act, which it claims "has led to paralysis at a time the country needed decisive action". What will replace this Act has not been stated, but the implication is that this Prerogative power will simply return to the Prime Minister.
The theme of "effective government", "decisive action", "getting things done" and preventing "needless delays" runs throughout.
The rule of law under existing arrangements involves the outdated notion of balancing "the rights of individuals", as the manifesto puts it, civil rights, against "national security", meaning the security of the person of state. This conception of rights as a matter of balance, rather than what people possess by virtue of being human, has increasingly been used to negate the rights of the people, criminalise conscience and strengthen the police powers of the state. Yet the government's proposals go further, offsetting even this balance against the need for "effective government". This amounts to overthrowing the rule of law and is a further move towards overt government by police powers.
Reviewing "the relationship between the Government, Parliament and the courts" will therefore mean further strengthening of and removing the impediments to executive power. The Prime Minister wishes no repeat of the blocking of his exercise of the Royal Prerogative by the Supreme Court. Hence the government is planning to restrict the arrangement of judicial review to ensure it is not used "to conduct politics by another means or to create needless delays". The reference to the role of the House of Lords should also be understood in this light.
Not present in the Speech, but featuring in the manifesto, are plans to redraw again the Parliamentary boundaries - thought likely to follow the 2018 proposals of the Boundary Commissions, will cut the number of MPs from 650 to 600 in a manner that will significantly favour the Conservatives - as well as to introduce voter identification at polling stations. The manifesto also reiterates continued support for the First Past the Post electoral system.
The problem of empowerment posed by modern conditions is the objective need for all citizens to be able to meaningfully participate in decision-making over the direction of the economy and politics and any other questions facing society. Moreover, the need is for new mechanisms through which people speak and act in their own name - in other words, exercise power directly - rather than authorise some other figure to exercise power on their behalf via the mediation of the cartel parties that block people from power.
The reform required is that the electoral process guarantee that all citizens have the same right to elect and be elected, regardless of status, wealth or any other consideration.
Specifically, neither the fielding of candidates nor the constituting of the government should be done on a party basis. Rather, candidates should be selected on the basis of elections in the workplaces, universities, and other places defined by the productive, social and cultural activities in which people are engaged in a particular location. Such a selection process should be used to form the list of candidates for a constituency, which are at present defined on a party basis. The entire expense of such a selection process should be funded by the state, while any state funding of parties either directly or indirectly should be ended.
Further, the division of parliamentary politics into parties in power and opposition is out of date. Instead, once elected, the parliament should elect the government and then support it in carrying out its programme while holding it to account.
The role, then, of parties should be to raise the level of politics by putting forward their thinking and solutions to the problems faced by society, encouraging people to field candidates for selection and ensuring that the government remains on track.
The proposals of the Conservative Party do nothing to address any of these concerns, but rather manipulate the sharpening consciousness over the need for democratic renewal for self-serving ends. This needs to be borne in mind by those fighting to block the neo-liberal direction within the Labour Party, as well as fighting for new arrangements. Nor will they sort out anything amongst the ruling elite. They do nothing to address the underlying problem that governments wield political power on behalf of private interests. Instead, they raise the spectre of "foreign interference" in elections to justify the expansion of police powers and serve to further criminalise conscience.
1. For the full text of the Queen's Speech, see:
2. The Government will continue to "honour the NATO commitment to spend at least two per cent of national income on defence." It "will work to promote and expand the United Kingdom's influence in the world. An Integrated Security, Defence and Foreign Policy Review will be undertaken to reassess the nation's place in the world, covering all aspects of international policy from defence to diplomacy and development"; "It will stand firm against those who threaten the values of the United Kingdom"; etc.
3. The Conservative Party election manifesto can be downloaded from https://vote.conservatives.com/our-plan
4. For example, see: "Boris Johnson would have 104-seat majority under
boundary change plans, exclusive study reveals", The Telegraph, December
Continuing on from the General Election where all discussion was used to obscure how the NHS should be funded, on January 15 the government introduced its "mandatory" NHS Funding Bill 2019-20. The government has clearly stated that the additional funding will be spent by NHS England in the "NHS Long-Term Plan", which is a corporate-led direction that is wrecking the NHS and jeopardising its future.
The Bill, which was previously announced under Theresa May, states that the government commits to increase investment in the NHS in the years up to and including 2024. This will result in a £33.9 billion increase in cash terms by 2023/24, with total NHS England spending rising to £148.5 billion in 2024. The Bill was given its formal First Reading on January 15, and MPs will debate the Bill on its Second Reading on Monday, January 27.
The King's Fund, the Nuffield Trust and the Health Foundation have already responded that an annual increase of the NHS funding should be at least 4% a year rather than the average of 3.4% a year proposed by the government. This line of argument has been taken up by the Opposition in Parliament as well.
This may or may not be the case, but it does not address the present chronic lack of trained medical and nursing staff and the loss of NHS services going back over decades, as many critics have pointed out. Nor does it challenge the direction in which the NHS is being taken, its privatisation, the contracting out of services, and even more fundamentally whether the government's approach resolves the crisis in NHS funding.
What is being obscured is that health care is a claim of all on the economy which the people must make. Health workers provide vital and accessible health services to all and in doing so create value in the socialised economy by curing people when sick and injured and keeping healthy the human resources of society and all those who live and work in it. This value is consumed by big corporations in employing the labour power of a healthy workforce. This is value which should not be expropriated by these corporations but should be claimed by the government and their health services as value that can then be used to resource a fully-funded NHS. The Bill does not raise this vital question of the role the NHS plays in a human-centred economy where the NHS should become a human-centred system paid for at least out of the value it creates in the economy so that any extra funding contributes to meeting the needs of health care for all.
This Bill will not safeguard the future of the NHS and neither is it intended to. Even the claim that a "mandatory" funding by government gives some funding "security" to the NHS is false when it is combined with a a neo-liberal corporate direction that the "NHS Long-Term Plan" represents. The "NHS Long-Term Plan" is already reducing safe access to vital emergency, children, maternity and mental health services for whole swathes of the population. It is being further pursued in the present deconstruction of local District Hospital acute services with a massive loss of acute and long term care hospital beds and local GP services across England. This is the "long-term plan" to switch funding into an "integrated" Care Providers and systems that government intends to be predominately dominated by the private sector companies.
The conclusion to be drawn is that those big corporations that purchase the capacity to work of a healthy workforce must be obliged to pay for the value of that capacity added by the health service. Ultimately, decision-making power of the working people is required over society and its economy to create a human-centred health care system based on the right of all to health care.
 Obscuring How Wealth Is Created in the Economy
 For more details of the Bill, see the briefing paper in the House of
Pension strikes and demonstrations in France
Working people of France have been on the move for well over a year since the Gilets Jaunes movement kicked off towards the end of 2018. Organised workers have joined the poor, the unorganised workers and low-skilled, the unemployed and the rural poor despite the police brutality on the one hand and attempts at concessions from the Macron government which have not satisfied the workers' demands on the other.
Mass strikes began some two months ago as the Yellow Vest movement itself underwent a resurgence. The transport strikes on the railways and metros became the longest for over 50 years as workers took action to oppose and say No! to President Macron's so-called "pension reforms".
On January 18, the Gilets Jaunes once more took to the streets in their thousands. And once more they were subjected to police brutality. Earlier in the month, millions had held demonstrations, while nearly 50 consecutive days of strike action had blocked ports and disrupted power production.
President Emmanuel Macron's proposed neo-liberal reform to France's pension schemes is central to his ambition to make France competitive in the global market. But working people have rightly not accepted that "making France competitive" serves the general interests of society or the interests of the workers, but only business while the workers bear the brunt of the austerity offensive.
The government's proposals are for the retirement age for a full pension to be progressively raised to reach 64 "for the 1965 generation who will retire from 2027". Under the proposal, the legal retirement age will remain 62 but workers who leave at that point will not receive their maximum pension.
There has been practically a media blackout in Britain on these very determined actions by the working people of France, demonstrating the way the monopoly-controlled media have their own vantage point which is not that of the working class, while they emphasise actions inspired or organised by imperialism, such as those against the progressive forces in Latin America.
Indeed the actions have given the lie to suggestions that the discontent is against the foundations of a modern state, but that the working people are acting not out of narrow interests but out of social responsibility. It is the pension "reforms" that strike against the responsibility of a modern state to care for its members and treat with dignity the seniors and others who have contributed to the social wealth.
Those in action have covered all walks of life, from lawyers to transport workers to the young and the unemployed. Under the guise of equalising pensions for all, the government is in fact hitting at the pensions which working people have fought for and are determined to defend. As one lawyer put it: "We don't have a choice - we have to fight now or die later. If we don't make it to the end, what's the point of all this?"
Although it is reported that the Paris Metro was returning to normal after the suspension of 46 days of strikes, following temporary concessions by Prime Minister Edouard Philippe to the strikers, it was seen as a brief respite following Philippe's presentation of the new plan instituting a "universal system" of point-based pensions to the cabinet on Friday, before it is sent to the National Assembly, France's lower house, where debates are scheduled to begin on February 17. This prompted the workers' unions to call for further nation-wide protests. "Our determination remains intact," Yves Veyrier, head of the Force Ouvrière union, told reporters ahead of a street march in Paris. "We have weeks, months, of protest ahead of us." It was reported that on Thursday evening, demonstrators held torch-lit protests in Paris ahead of a "Black Friday" of strikes and shutdowns.
The government's pretext that its only aim is to simplify 42 pension regimes into a single universal system will not wash. Workers are showing that they will fight to defend their rights and interests. As in Britain, where the system of "Universal Credit", far from simplifying the system has had the vindictive aim of penalising the vulnerable and forcing them to shoulder the burden of the all-round crisis, the universal system proposed by the French government is also meant to force working people to shoulder the burden of the chaos and crisis of the anti-social offensive. Meanwhile, the oligarchs and financial elites enrich themselves at the workers' expense. President Macron and his government have been ruling by exception to give the police powers in France free rein to keep the people in check. It has been made clear over the past 15 months or more that this has not been able to stem the tide of protest against the anti-social offensive, which has in fact escalated and broadened.
Macron himself gave the game away in saying that the present system of pensions and benefits deters job mobility and that changes are necessary to create a "more flexible labour market". In other words, it is the working people who are going to be forced to suffer the consequences of the crisis, which is a manifestation of a direction for the economy and society which has had its day and only serves the interests of the oligarchs who would trample the rights of the people underfoot. The old order is to engage in cut-throat competition in the global marketplace, competition between competing sets of oligarchs, while the workers share a common interest of safeguarding the future of society through becoming the decision-makers.
The mobilisation of the working people of France is objectively against the old order and demands something different which does not make the working people the targets of attack. The actions have also underlined the enormous power of the working people organised in defence of their collective interests and the interests of society as a whole, and that they are the power to be reckoned with in how society functions and whom it should serve. As the third decade of the 21st century dawns, the French people can be seen to be taking their stand as part of the world-wide movement for empowerment and taking responsibility for the fate of society.
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