Notes From the Margins…

Walter White, Aneurin Bevan, and the end of the NHS

  • July 11, 2014
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There can’t be many fans of tv crime drama who are unaware of the grim trajectory of Walter White in the hit series Breaking Bad.     To those who don’t know, White begins the series as a humble chemistry teacher diagnosed with cancer who resorts to cooking crystal meth in order to pay his medical bills and leave something to his family.   These aspirations set White on a bleak and savage odyssey through America’s narco-hell, which transforms him into a callous mass murderer.

I thought of Walter White last Sunday, when I went to a screening of Ken Loach’s The Spirit of ’45 in my local town, as part of an anti-NHS privatisation event put on by SOS NHS South Derbyshire.   It was a memorable evening for various reasons.     First of all there was a brilliant speech from Professor Raymond Tallis, poet, philosopher, former geriatrician and anti-privatisation campaigner.

Tallis was passionate, lucid, urbane, and very funny, as he guided   the audience through the lies, deceptions and sleights-of-hand that the Coalition government has employed into order to drive through the privatisation of the National Health Service.

Loach’s film was a moving and powerful tribute to the post-war egalitarian spirit that brought a Labour majority to power for the first time in 1945.     It paid particular attention to Aneurin Bevan’s creation of the National Health Service. Various interviewees testified to the patchy and minimal health care available to the poor and working classes before the war, when the quality of medical treatment was always dependent on income.

All that was changed through the establishment of a taxpayer-funded system offering free medical treatment to the whole population. That system has been in place for so long that many people have forgotten what a radical transformation in attitudes it represented.     Bevan’s reforms were based on the very simple principle that health care is not a marketable commodity, but a human right to which the whole British population was entitled.

Sixty-six years later, that essential idea   continues to form the basis of   a health system that provides free medical treatment to more than sixty million people.   The NHS is not perfect or beyond criticism or improvement.   But it   remains the most enduring of all the social reforms introduced by the Attlee government, a magnicent symbol of human solidarity and an essential marker of our progress towards a humane and civilised society.

There are few people in this country who have not or will not come into contact with it at some point in their lives, either because their relatives, their friends, or they themselves will be ill.   And unlike Walter White, at present they don’t need to sell their homes or resort to crime in order to pay for even the most prolonged and expensive cancer treatments.

Solidarity, it goes without saying, is not a Tory idea.   Thatcher dreamed of the marketisation of the NHS, but recognized that it was politically impossible.     Until recently therefore, NHS privatisation was a piecemeal process, to which both Tory and Labour governments contributed in various ways under the banner of public sector ‘reform.’

The Coaltion has taken advantage of the crisis to take a giant leap towards full marketisation.   Before his election, David Cameron frequently praised the NHS and promised that his government would not attempt to privatise it, and would cease the top down reforms begun by his predecessors.

As Tallis reminded his audience, these promises have been rendered hollow by the 2012 Health and Social Care Act, which allows the National Health Service Commissioning Board and clinical commissioning groups (CCGs), to   impose ‘ the competitive tendering for the provision of services’ and offer these services to ‘Any Qualified Providers’ (AQPs).

Since 2013 more than £5 billion of contracts to run or manage clinicaly-related NHS services have been advertised, of which 70 percent have been awarded to private companies.     Under the terms of the Transatlantic Trade and Investment Partnership (TRIP), which Lord Snooty and His Pals are currently negotiating, the NHS will be included with Free Trade Agreements (FTAs), that will allow transnational corporations to sue the government if it introduces legislation restricting or curtailing private investment or profit-making activities within the NHS

The dismantling of the NHS is partly the result of an ideological Tory aversion to state-funded public services, which Tory politicians like to present as inherently inefficent, expensive and undemocratic.     But only last month the Washington-based Commonwealth Fund rated the NHS the best service out of 11 countries that it examined, in terms of quality, access and efficiency, and the provision of of effective,safe, co-ordinated and patient-centred care.

The US, needless to say,   ranked bottom, in terms of value for money, the denial of care to patients without health insurance and saving the lives of people who fall ill.

In other words, efficiency and patient ’empowerment’ are not really the issues here.   What Lord Snooty and His Pals really want to do is cruder, simpler and nastier – they want to marketize healthcare so that it can become a source of profit to private healthcare companies who are itching to get stuck into the NHS, and who have been lobbying for some years for greater access.

These aspirations are not limited to Tories, it must be said.   A number of former Labour ministers and MPs, most notably Alan Milburn and Patricia Hewitt, have also made money from private healthcare companies.   But Andrew Lansley and Jeremy Hunt have accelerated the tempo of privatisation beyond Margaret Thatcher’s dreams.

It’s an indication of the total cynicism and amorality of this government that it has coolly and unproblematically gone pursued this agenda, while simultaneously fanning the myth of largescale ‘benefit tourism’ to suggest that the NHS is under threat from immigrants, rather than itself.

Tragically, these efforts have worked, and there has been more furore about the foreigners who are supposedly taking ‘our’ national health service than there has been about the implications of the Health and Social Care Act.   Too many people in this country have forgotten how to fight or lost the will to do so.   Too many of the gains of the ‘spirit of ’45 have been given up too easily.

That mustn’t be allowed to happen to the NHS.   At last Sunday’s meeting, most of the audience were over 50.     But the young will one day get old and sick, even if they don’t believe it now, and their parents and their grandparents will go to hospitals and doctors.

And if we don’t act now, there will be nothing left of Bevan’s legacy and they will be paying the likes of Serco to do what the NHS is already doing – and doing much better.     And even though the government still insists that services will be ‘free at the point of need’, there are already plans to make patients pay to see GPs.

All this will only get worse, unless it is stopped.       Otherwise the next generation of patients may find themselves forced,   like Walter White, to consider exceptional and unorthodox means of funding expensive treatment, and they may look back on the ‘spirit of ’45’ and wish that they had done something to prevent its disappearance when they still had the chance.






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  1. Nigel Baldwin

    12th Jul 2014 - 11:04 am

    5 years ago I had a heart problem which made the insertion of two stents into my arteries necessary. After the procedure had been done (in Southampton’s state of the art General Hospital), I asked the Ward Sister how much the operation cost. Off the top of her head, £6000, she answered. There’s no way I could have afforded this or the insurance to cover my situation in the land of the ‘free’ market that the Tories love so much.

    • Matt

      12th Jul 2014 - 7:27 pm

      Hope you’re better now Nigel. And yes, what you’ve said applies for many of us.

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About Me

I’m a writer, campaigner and journalist.  My latest book is The Savage Frontier: The Pyrenees in History and the Imagination (New Press/Hurst, 2018).  The Infernal Machine is where I write on politics, history, cinema and other things that interest me.

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