The NHS/National Health Serice and Me

i always find my contact with the nhs/national health service not only healing,but educative and a deeply emotional and affecting process.

it remains the flagship,i believe for most people living in britain of what is best here.it is not without its faults and difficulties but other than being made insecure as the compromised but key element of the welfare state,the social democratic socialcontract following world war ii,none of those probles are either fundamental or terminal.

it is extraordinbary the loyalty of most people to the national health service-branded as free at the point of need.only the political class and the hardest of hearst and heads have it in for the national health service,who do want to turn it into a tatterred flag rather than the (flag)ship.

as i get older ive now reached the age where i collect illnesses and conditions.i fidn that difficult and dont like admitting it to myself.over the last fave years approximately ive been admitted in an emergency or pretty serious circumstances.

ive just come out of hospital(last evening)after the latest.one of the ways i distract myself,is trying to be observant.

on this occassion,again i was dealt with by a variety of people from all iinds of backgrounds,trained in all kinds of skills.i do not doubt that even in goodf times,or notionally easier times(oh yeah,who am i kidding)these people work hard,long hours and the vast majority for significantly less remunaration than they need,or deserve orf by any standard are worth.and these are not those times.these are hard and oppresiuve times,when any and all jobs in public service inclduing the nhs are under threat.5,000 staff in the mental health sector have probably already gone in advance of this governments slash and burn apoproach to their crisis.

let me be clear.these people are not saints-the ntion of canonisation is problematic,and in seeting up others as somehow perfect,distances ordinary human decency and further alienates and distorts tyat notion.

we are all as workers under capitalism alienated and exploitedas both features go with the very nature of the system,but still these people do and deal with every day the difficulties of people in often extrreme need that most of us might never experienbce.i do not dobt they go home anxious,angry,focused on other things like the rest of us but it is all of apiceand all of it that makes both the service and the thousands of workers in it so extraordinary.

i was asked to wait up to hour for an ambulace,as the situation whilst serious was not an emregency.it came in 10 minutes.the staff were friendly,caring and proficient.i was admitted to a busy accident and emergecncy department and carefully,thoughtfully processed and assessed for several hours before being taken to another ward where i was met with a similar reception.they were busy but calm,placed under cionstant demands,but i never felt like meat or a parcel but a man in distress and quite ill.im sure managers arent labelled but id did not see any,the clockwork machine operated with the best that is human.everyone knew what thyey were about,and fitted in with each other.no-one needed telling,everyone knew what to do.in a veryt real sense i was happy to give my life into the hands of these strangers,as they were caring for many more starngers like me.and i was not at my best,nor always "present".i was certainly not in control but felt no demnand that i should be.this is arare experince of being taken as i/.we are.last time it really was my life in their hands.this time as last time,i told some of them i would trust them with my life but i would trust our common matsres(government,the state with nothing).

and thats the key,the turning point i want to come back to in part 2.

meantime there can never be enough times we salute such,as these our fellow workers.whilst gthe structures within which they operate may devalue them,here is one fellow worker who firmly values their help and service.

i look forward to a time when we dont just defend the nhs,but collaborate to build something even better that really can take a wholistic approach to positive health.whilst the revolution may not simply take over the state,we have some fine buildiung material in the nhs,mthe first and last of which is the workers and their labour within aqnd beyond it.

i salute you!

lost
17/04/2011

The NHS in britain is now actively under threat comparable to what is the usa is called-"clear and present danger"-and i dont jest in the use of that comparison.

despite the huge gains from the nhs for the capitalists-the state still seems dead set on a "slash and burn"rather than"root and branch reform".i do not doubt that the con-dem regime,who only seem able to condemn do have a mandate from a ruthless ruling capitalist class,for instripping away any welfare from the state they hope to enable an increase in profit,rate of profit and accumulation,although this is increasingly difficult in decadent if not actually decaying capitalism.i also do not doubt that the particular virulent demands of a section of that class within within and without the tory party have particular intentions.

i acknowledge that the compromise that is the nhs was developed and built at a particular conjucture in the class struggle and that in some senses these are different times.it might have been very difficult in the late 1940s for anyone to predict the health and needs of the population in 2010 or further forward.it might have been diffficult even for a committed revolutionary workers decision making structure.but if this is a failing in the nhs it is a failing of its own success,considered warts and all.life expectancy is considerably increased over that time,and the age and demographic structure of the population and its social expectations are different.prediction of changes in ill health and disease are themselves very difficult to predict,not least i suspect because the so called natural processes remain to be further explored and are themselves changed by sociasl conditions and class struggle.i suggest that in social relations not driven by profit and the extraction of value from labour,the amount and types of industrial ill health and accidents and disease would be lower.the nature of the ageing population is such that aging itself will raise new issues to be addressed.i would guess that cancer,diabetes type 2 and many other conditions reflect more about class society than of individual choice.yet i suuggest that a genuine socialist society would have done more planning and innovation,for it is categorically not true that capitalism is the best of all options that generates the best of all choices.what is (most)profitable is not what is best.

yet this situation is used as a stick with which the careless(they dont care)critics beat the nhs.

it is also said to be the largets employer in europe,which amkes it an inevitably vast sprawling organisation.i would argue that its overbureaucratisation is indicatative that it is part of the capitalist state,and that it could be a different way under different sociasl relqations.if british capitalism privaties it or changes the dynamics and dimensions under capital,nothing truly psoitive in the interests of workers will happen.we dont need or want more say,more choice as consumers,we want more control as workers who generate all wealth and value.as the anarchists would say,"we don't just want more bread,we want the whole bloodyuy bakery".

having said the con-dems have a mnandate for this attack,they dont have the one that should count.and they dont have a mandate.it is undoutedly primarilly a tory initiative,though it was not in either manifesto,and if it is in the con-dem "stitch-up"then the only pay off for the "social defectives"lib dems)is gerymandering with the voting system.that is a fools gold that could easily slip through their fingers in the referendum on 05/05/2011.whatever,the dems are facillitating this arbitrary,opportunist,ideaologically driven class attack.the dems should never be seen to the left of anything.to the genuine left they are "tories with velvet toe caps"who will like the associates of a bully will join in the thugs attack,and then run ansd hide with their feeble excuses.

the bais of this hi-jacking is that all the problems can be solved if consortia of gps(general practitioners)will gain control to commision services.this is privatisation which forces the nhs into the market.the market in capitalism is not comparable with the bazarre or street market where thers is some coming together of those who choose to buy and sell(this is only and entirely free process in abstraction,but in the real world the stret market is comparably freer that wage-labour set against capital itself in an inevitably combative and compuksoiry relationship).some,indeed most of the gps see if only from aprofessional perspective where this is going and do not want to get on the bus.

i suspect and hope that most of the service users,who will be more of less the same as most workers as most of the labour force(a theoretical abstraction explicitly to slice up reality,so that it appears not to be reality)are likely to be opposed to it.even some of the dems.see it as a disproportionate approach-that what is proposed is not the right one for the problems identified and it will literally be a haqmmerf to crfack nuts.it is in direct contradiction to the cuts in public service.how can either the referendum on gerry mandering(the trade off)or such a vast reform itself come free.the only way is by resorting to the tommy cooper style of economics(a now decesaed comedian and magician)

many people here used to and probably still do believe that the nhs was the best health service in the world.this may or may not be an objective fact,but in a sense even if it is only idealogical fact,as seen by louis althusser it doesnt matter-its about how a social order presents and sees itself.ideaology does however raise other problems.what does matter is that some and proably major fractions of capitalist,inclduing fiance capital which is always particvularly greedy and irresponsible,and the extreme libertarian free marketeers have broken rank.

so the ideaolical self image moves down one or more notches.at worst the service is decsribed as not fit for purpose,a failure in terminal condition,or the claim is modified,so that the usa susytem is seen as highly generative of innovation because it is entirely free,and soable to deal with the leading edges of health care,the rarities and extremities,whilst the uk is seen as a mass health service with the implication that mass is somehow of itself inferior.

we cannot allow the capitalist lie that its own tricks will resolve this difficulty,nor to attack the whole system at root.only a service designed to meet need and not profit could innovate to find that solution.

its interesting that in britain my own family experience shows me that at last 3 members of mhy family have benefitted from social medicine.had they not done so the quality of my family life would have been drastically reduced oif not different.when i lived in the usa,i saw and knew people whose life conditiions and choices were seversly limited alongside their improverishment and/or redundancy.i do not know anything about the libyan health service but notice that injured resistance fighters and civilans run to hospitals for help,only considering whether they would be handed over to the quaddafi gang.i also notice hospital staff from bombed facilities heading towards the front line!i suspect in the usa doctors are directly constrained by insurance asnd profit driven medicine away from the critical experiences of working people and towards the rich and priveleged.when i lived innthe usa during the clinto era,many ordinary americans seemed mystified by nhs,whicdh somehow was seen as literally free,rather than paid for by taxes.if the clintons understtod the realities they entirely failed to explain it,as their early health care plans became afailed illusion.iam equally horrified that apparent popular resistance to social medicine in the usa wasa portrayed as virulent communism,which weaked the already soemwhat llusory provison of the obama presidency.

the nhs is not without difficulty,but these tend to be in some senses limited rather than fundamentally undrmining flaws.some reflect the nature of the compromise which allows international drug conglomerates to milk and suck out vast resources from the system.the power structure and bureacracy provides this with a cover.there was a compromise with the power of the professions which again might be refought out in the current plans which would be destabilising for workers and expensive,risky and positively destructive elswhere in the health system.

the con-dems are also building key elements of their reforms in advance of legislation and will undoutedly build on this before testing any pilots.this is both an erosion of democracy and is already creating further practical problems for inevitably competitive commsioning.one hospital closure/development is put on hold because of adamaging report aboiut another where reform development has aready begun.outside the realm of competition-which i view as destructive-no one can win,any and every result would be destructive.

a brief period of reflection has been granted.if this is anything other than vacuous we have to work towards halting all these plans.to build maximum unity for the defence of a health service which we can defend and develop-that meets our needs and not their profits,political or financial.

there are also local needs and issues to which there is almost an inevitability.even a workers health system would have toadapt,change and grow,but is hiughly unlikly to be threate3nding or destabilising.,there is also human error,and problems at the extremes-extreme cases and at the frontiers of medicine or development.

some research indicates form example that huamn error is soem kindf of constant,wher new ways or new staff pose risks because they are untried or untested.the counter to this is the greater care and vigilance applied.on the other hand experienced staff,using tested qand proven systems and procedures can make mistakjes through over familiarity.

workers coulld however put further procedures in place when not distracted bhy their own alienation and exploitation on the one hand or profit motive on another.i know that the same system that appoints managers as a control mechanism also attacks management and support services when cutting and shaving and looking for efficiency.this is an easy but illusory target,and actually think that in a workers health care system managers might be exactly the staff to bring together,seek out,encourage,monior and develop exactly the growth and innovation neccessaqry,and which does not simply jand instructions down by builds on the very real and obvious skills available in the health service,from cleaing,catering,compouters,potering and administratiion,through the specialist services and facilities right along to the medical and nursing staff.failures at any level is damaging to all.workers are usually very eager and willing tokiin together not just in their own defence but in developing gthe success and satisfaction of their work.mangers could easily be the cordinating,generalising glue in a collective process here.

for it strikes me that revolutionary change could result in some relatively easy and speedy changes in the health service.job security and developoment within a service clearly and only directed at human need would grow in confidence and competence.i do not doubt theiur abilities to innovate and serve because they do not currently work in a system that doe encourage those things qand they still serve us generally well.they are after all engaged in some of the nastiest,basic,demanding actvities in the service of people largely unknow to them(ot colleagues,friends or family)

it is not entirely an aside to end with the following:i carried a book into hospital with me-an edition of the journal historical materialism,which started at least 3 conversations.it was a good advert for the journal,which i recommend highly.but i also had brief discussions with ambulance staff who talked about targets and systems in their jobs,whilst demonstrating and giving me a high quality of service,sensitive to my needs.later i spoke with a doctor who was gently reassuring and helpful in his manner,and began to express concerns about management.i also spoke with a "leading nurse",whose rank i do not know but worked with warm authority and treated me like a person.

all of them and many others presented as highly committed,caring an competent people,working effectively under qa loyt of relentless pressure.patients are oen thing,systems another.once again i want to reapeat that i felt safe in their hands.all of them qand me sharfe a concern for the life blood of the nhs,not just central to the lives of each individual patient and worker but to the health of britain in the literal and political sense.i salute threm all.

i am happy to stand with them in the defe3nce of a health service which should be fully ours and beyond the grasp of those who think they are or really are in power.

defend the health service,dedicated to human need not systemic greed!

lost
17/04/2011


in a sense with all its problems

i think it is to be hoped that the current pause in pressing so called reform of the nhs is a sign of weakness and that the overall strategy is high risk.i hope the strategy collapses,the bill falls apart and that nothing less than full blooded socialist workers organisations can dare to touch the service at all,until workers democracy replaces decadent decaying capitalism.

this is not russia in 1917,nor is it libya 2011,where state support of health care is probably skeletal and what doe exist is now actively faced by shortage due to the barbarism of the regimes attack on its own people.

britain in 2011 has a vast pool of an extremely capable and experienced working class,who could easily take over not only the nhs but along with the workforce of currently semi or wholly privatised medicine and transform it.a fighting unity across the working class could quickly impact on the high profits within the pharmaceuticals to similarly pour resources intyo health services and divert dividends and profits into creating a vast array of generic industry made available across the world,and most cheaply to the most needy.

london is particularly well placed as it remains a mnajor hub of so many things,and its cosmopolitan nature means the world and the international working class is on our doorstep.

i have indicated that i am optimistic that the outlook of most ordinary,working people is to be generous in their outlook if not most of the time,then when given an opportunity and/or placed in a crisis.staff in the nhs demonstrate that everyday.indeed locally i find it paricularly striking.

too often the racist stereotypes we carry about in our heads,attitudes and sometimes our actions play themselves out to poison the ambience of living,in alow key way.irish people,though physically white can remain victims of such stereotypes and yet...and yet many work in the health service.both here and in ireland i am aware that there are alternative and positive images,that often irish medical staff also volunteer and quite frequently takwe time out,unpaid to volunteer elsewhere in the world,as if on abusmans holiday.and then of course there are the thousands of workers from around the world brought to britain to escape or in the belief that it is better here(of qwhich i have serious doubts about the limitations of how it is better).alongside some intellectual grasp on how and why,i remain neveretheless amazed that so many of the poor from elsewhere come to britain to work on low wages to sustain our services,especially indeed the nhs.but actually that exactly one of the reasons the nhs is so good-that they come here and work inside the nhs.some of course might be high powered consultants or specialists but many more are the hardworking cleaners and porters and nursing staff.

despite it all,and however oppressive capitalist becomes that still makes living in the global village in greater london such a rich experience.the rACIST Abuse that tghis makes us a mongrel race is so wrong.thinking that makes such crude comparisons between human and the rest of the animal world is simply wrong but were it true,the conclusions the racist drawer should be exactly reversed,for it is the very diversity that makes us so rich and strong as a class.

we need to realise that power,and relying on all our shared talent build that world we have to win.and begin to do it now within,alongside and beyond the struggles to defend the crums they leave us.nothing short of the best is best for the best-the working class!

lost
18/04/2011