Yesterday, I wrote about why I had turned down a COVID Jab, not because I have some objection to such jabs, quite the contrary, but because of the reckless way in which the NHS is administering them. Its only as I later considered what had transpired that I realised the full absurdity of the situation.
My GP is part of a consortium of five surgeries, each within close proximity of one another. Some in the same village are only half a mile apart. One of my complaints about the way NHS hospitals have acted is that they have failed to establish isolation hospitals or wings for COVID patients, so that such patients have been in the same wards as other patients, which is no doubt the reason that the NHS is the biggest single superspreader of COVID in the country. Of all the patients being treated for COVID in NHS hospitals, 25% of them contracted the virus AFTER they had gone into hospital or some other cause. In a six week period over Christmas, the NHS infected 11,000 people with COVID that it then had to treat in hospital, The total number it infected would be larger than that still. Last year, early on, the comedian Eddie Large was a prominent victim of such blatant neglect by the NHS, and, this year, Captain Tom Moore became another prominent victim. The NHS seems singularly incompetent and unable to learn basic lessons, even for something so serious, and even over the period of a year, when most other organisations would have addressed those issues. Instead, it spent large amounts on creating the Nightingale Hospitals, most of which did not see a single patient cross their doors.
My GP practice, has indeed taken advantage of the fact that there are five surgeries within its group, and has set aside one of those surgeries to give the jabs. Great. But, why then not have that surgery dedicated solely to that, at least for certain days of the week? Instead, that surgery is continuing to function as a general surgery, in the same way that NHS hospitals are continuing to put COVID patients into wards alongside other patients!
As I set out, yesterday, I asked whether, as when I had my flu jab, it could be given to me outside the surgery, while I sat in my car. To be fair, the receptionist who called me understood my concern that, having avoided contact with anyone for nearly a year, it was reasonable of me not to want to sit in a surgery with a load of other people, who might be carrying the virus, for an unknown length of time, in an enclosed space. She said she would ask if someone could come out to administer the jab to me and my wife, in the surgery car park, but she thought it was not likely. Why it would be unlikely, however, she didn't say. No one has contacted me to say that it would be possible.
Now, I find this extraordinary. On a couple of occasions when we have had to take the dog to the vets, they have a procedure in place, where you ring them when you are on their car park. You tie the dog to a post, and they come to get him, administer the jabs, and then return him to the post. You put the dog in the car, and off you go, paying, by phone. On a couple of occasions, we have needed things from Screw-Fix, you order online, and if they can't deliver it to your door, you go to the warehouse, again phone them to say you are there, and only one customer at a time is allowed in. Your goods are on the counter, and you pick them up, confirming with your payment card.
So, why is it that a private veterinary practice, and a DIY retailer, can put in place sensible and effective measures to prevent its customers from being at risk from contracting the virus, but the NHS can't? One reason, of course, is that both the vets and Screw-Fix need customers, or they have no sales, and no money coming in to pay staff, or provide profits. They have a direct incentive to operate as efficiently as possible, and to meet the needs of customers, including the need not to be infected with the virus, whereas the NHS does not. The top bureaucrats of the NHS continue to draw their large salaries, no matter how bad the NHS is, how inefficiently it operates, no matter how much it puts the lives of patients and others at risk, and that applies all the way down the NHS hierarchy.
If the NHS operated as a private business then that would not be true, as with the vets or the Screw-Fix. As with the rest of the capitalist economy, the inefficient providers, including those that did not meet patients needs would be weeded out, and their capital taken over by others who did not suffer those deficiencies. That is how capitalism has massively improved efficiency within the economy, and increasingly produced a range of commodities that meet consumers needs. But, going back to such provision would now be a step back, even if it was more efficient and provided a better service. The solution to the deficiencies of the state capitalist NHS reside in moving forward, not moving back.
In a worker-owned co-operative, the incentives for efficiency and good service exist, as each co-operative unit must meet the needs of its customers/patients as well as attempting to do so by the most efficient means, in the same way that any other capitalist enterprise must do. The workers in such a co-operative will seek to use the most efficient means, and the latest techniques, because not only does that raise the profits of the co-operative allowing it to expand, but it lightens the workload of the workers themselves. But, in a worker co-operative, a further incentive operates, which is that as workers, the producers/workers have an incentive to produce in a way that meets the needs of their fellow workers in society. It goes a way to reducing the alienation of labour that exists in all commodity production and exchange. But, to compete with the largest capitalist enterprises, co-operatives too must operate on a large-scale, which is why they each have to join together in a large co-operative federation, pooling their profits, and know-how. Turning the NHS into such a large, national worker-owned co-operative, would be a massive step forward, but, of course, the capitalist state is not going to allow that.
Another means of countering the kind of rent-seeking activity that exists within the NHS, where there is no incentive for anyone to produce efficiently, or to produce in a way that meets patients needs, is for there to be some form of democratic control over the enterprise. No such democratic control has ever existed for the NHS. Years ago, there were "elected" Health Boards, and there were District Health Authorities whose members comprised elected local councillors and so on, but they never exerted any real democratic control over the NHS. The Community Health Councils, were even more toothless watchdogs of NHS activities.
The truth is that the capitalist state is never going to allow any kind of real democratic control over the NHS, which swallows up huge amounts of the state's revenues, and forms a central part of its control over the economy, and over the production and reproduction of labour-power. The current pandemic would have been a perfect opportunity for health unions to have demanded the introduction of such democracy, and to have instituted measures of workers' control and workers' inspection in NHS facilities, but they have completely failed to do so.
Like the teachers unions, they have been far more concerned with trying to promote the idea of large scale lockdowns, which, of themselves, preclude direct workers action, and self-management. It is a sign of the degeneration of the labour movement, and its infatuation with statism, and economism.
With private veterinary practices, and retailers able to institute measures to protect the health of their customers, whilst the NHS, whose job it is to protect the health of the people, cannot do so, its no wonder that the government has things arse over end with its demands that rather than the NHS protecting us, we should "protect the NHS"!
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