Val Hudson has recently written a brilliant article called “Wither the Socialist Health Association”, which was recently knocked off the front page by a sudden flurry of other blogposts, curiously by the Director, Chair and Vice-Chair of the SHA. However, Val’s post is as relevant today, as it was a few days ago when it was first published.
Recent discussions here and beyond have confirmed an unofficial sentiment amongst some members of the Socialist Health Association that the Association does not appear to be advocating socialist principles for the NHS, currently. This would not be a problem of course if the Association were merely a group hoping to provide useful and relevant input to the Labour Party on health, but it has the word “Socialist” in its title and claims to espouse socialist values:
for example on the homepage
A longstanding member of the SHA even opined recently:
“there is precious little socialism in the day to day workings of SHA. This needs to change.”
In talking about Mid Staffs, Richard Bourne, Chair of the SHA, recently remarked that, “The situation … must be seen as an opportunity, not a response to “failure”. ” But the problem, arguably, comes from a comment made by Martin Rathfelder, Director of the SHA: “If socialism only means nationalisation then we are sunk.” A sensible response therefore is for there to be an accountable Committee within SHA, with card-carrying Socialists participating, which can oversee on behalf of the senior members of the SHA that the implementation of all policy strands is consistent with a reasonable interpretation of ‘socialism’ in relation to the NHS. Any exceptions deviation from this standard could be discussed as exceptions or issues in a coherent, mature and balanced way, within an acceptable band of tolerances. This would also help to restore the trust, reputation and confidence in the leadership of the SHA that the conduct of the SHA is taking place in a way which reflects the views of its socialist members.
There is no escaping from Martin Rathfelder’s view, that entire state ownership of the NHS is impossible, given how many contracts of the services ‘in the name of’ the NHS are being awarded to entities in the private sector, including social enterprises in the private sector. However, there has been concern by Colin Leys and others that the ultimate outcome of progression of activities into the private sector is that the NHS is left with the difficult, ‘unprofitable’ cases, with the private sector having ‘cherrypicked’ the more lucrative business (see for example Colin Leys’ article from merely 3 days ago.) The existence of a hybrid ‘mixed economy’ may be consistent with a ‘third way’ definition popularised under Tony Blair and Prof Tony Giddens (as described in Wikipedia today):
Major Third Way social democratic proponent Tony Blair claimed that the socialism he advocated was different than traditional conception of socialism, and referred to it as “social-ism” that involves politics that recognized individuals as socially interdependent, and advocated social justice, social cohesion, equal worth of each citizen, and equal opportunity.
However, this is not a definition of true Socialism, and this ‘mixed economy’ poses substantial problems not only from a professional perspective but also from a macroeconomic one. Prior to the parliamentary debates about the Health and Social Care Bill, Sunder Katwala reported on ‘Next Left’: “”We are all socialists in a funny way when it comes to the NHS”, Tory MP David Ruffley told Newsnight, explaining why Tory MPs are so nervous about Andrew Lansley’s proposed health reforms.” However, the concern with the ‘mixed economy’ is that you end up ‘privatising profits, and socialising losses‘ a saying attributed to Andrew Jackson as long ago as 1834.
Members of this Society have indeed warned relentlessly about the dangers of embracing privatisation in any form, regardless of any abandonment of socialism. Michael Moore could not put any more graphically than this why the US healthcare system is a disaster:
“The case for a free, high-quality national health service in the USA is absolutely clear. The United States spends twice as much on healthcare compared to any other advanced industrialised country yet 47 million Americans are without health insurance. For those fortunate enough to have coverage, they are slowly being crushed beneath exorbitant monthly premiums. For all this Americans have a lower life expectancy and higher infant mortality rates than any other advanced industrialised country.
The US healthcare system is a monumental testament to the lies of pro-capitalist ideologues who preach that private industry is more efficient than publicly-run programmes.”
So, Richard Bourne is right. Treat this as an opportunity for those of us in the Socialist Health Association who wish to discuss how socialism can be implemented across all SHA policy strands. One assumes that most managers in the NHS have some sort of basic training in organisational culture (one hopes, but one cannot be certain): in management speak, this involves ‘breakdown the explicit and implicit barriers’, i.e. making the ethos and language of socialism one which should be pervasive in all the Society does. If it cannot do this, the Socialist Health Association in my mind has certainly failed, and cannot be relied upon by the UK Labour Party to provide reliable advice while called ‘the Socialist Health Association’.
Finally, I remember, shortly after chatting with Shamik Das (@shamikdas) outside ‘Starbucks’ during Manchester for the Labour Party Conference in 2010, I was greeting by a very pleasant lady in her 80s, who handed me this badge:
She was an activist in Labour, and I do not wish there to be a ideological schism between the “Socialist” Health Association and the contemporary views of actual members of Labour (and of the leadership of the UK Labour Party itself, for all I know). There is a lot of grassroots support for the NHS, as this nurse who attended the rally today showed (ht: @marcuschown).