Thursday 25 March 2021

Tory Greed, Nationalism and The NHS

Boris Johnson has praised greed. No surprise there. He did so in justification of UK Vaccine Nationalism. The reason that the UK had lots of vaccines, and the EU and elsewhere did not, is down to the fact that greedy Tory Ministers got their snouts into the vaccine trough early, to snuffle up the available potential supply at the expense of everyone else. Of course, they did the same kind of thing with PPE, throwing around taxpayers money like confetti, in the direction of Tory benefactors, friends and family, for contracts to provide what often turned out to be defective or inadequate equipment. The same could easily have happened with vaccines, in which case the news stories, today, would be quite different.

The reality is that, with vaccines, the Tories were lucky, whereas, when it came to their feckless use of public money in relation to the creation of Nightingale Hospitals, provision of PPE, or the £12 billion spent on a useless Test and Trace system, they were not. When it came to Nightingale Hospitals they relied on their friends in a top heavy, NHS bureaucracy, always willing to spend taxpayers money on prestige projects, to expand their empires, rather than on more effective use of resources for primary care and prevention strategies. The news stories in recent days that the common cold coronavirus could provide some immunity against COVID itself calls into question the vast amounts spent on developing new vaccines.  No wonder the Nightingale Hospitals turned out as huge expensive white elephants. When it came to the provision of PPE, the Tories threw public money around to their friends, knowing they were under little scrutiny, and the deficiencies and corruption would not become apparent until later.

The £12 billion spent on the useless Test and Trace system combined the two. It relied on the usual channels of the Medical-Industrial Complex. On the one hand it produced the idea that COVID could be stopped in its tracks by such extensive testing and tracing, when, in fact, nothing of the sort was ever possible in a country like Britain. The idea that all would have been well had the system been put in the hands of the NHS, which has been so appalling, itself, throughout the pandemic is laughable. As an example, let me give a small personal anecdote. Me and my wife had our COVID jab more than three weeks ago. Yet, we are both still getting letters, texts, and e-mails from the NHS telling us to go and book our first jabs! There is no tie up between the NHS, and GP's, it appears. Does anyone seriously believe this bureaucratic dinosaur would have been any more efficient if it had come to trying to trace millions of unknown people?

When it came to vaccines, life was much simpler for the Tories and their NHS. Because, be under no illusion, it is their NHS, not our NHS. They are the government, they are the ones that have the control over it, not us, as the 1% pay offer to NHS staff demonstrates. For vaccines, it was the giant multinational pharmaceutical corporations that played the leading role. Those corporations that have an incentive in getting their vaccines out quickly, to take advantage of a huge captive global market, in the midst of a pandemic, so as to capitalise on the potential for huge profits, were in the driving seat.

The reality is that the Tories were saved by three things their ideology abhors. Firstly, they were saved by multinational corporations, which, by definition, are founded upon capital having burst through the fetter of the constraints of the nation state. That is inimical to the Tories ideology based upon the primary role of small scale capital and unrestrained competition. Secondly, those corporations are based on an international division of labour, and the cooperation that goes with it, quite inimical to the nationalistic ideology of the Tories, particular the Brexit Tories. Thirdly, they were saved by the professionalism of the scientists and other workers, in those corporations, the collective owners of those businesses, who, on a daily basis, get on with the job of running them without need for private capitalists standing over them, capitalists who now fulfil a role purely of parasites drawing revenues from these companies in the form of the dividends on their shares, and interest on their bonds, while they sit back on their yachts, leaving others to do the work.

The Tories have, of course, been shamelessly hypocritical when it comes to the expression of their greed via vaccine nationalism. In trying to take credit for the fact that Britain was able to roll out large numbers of vaccines – and for them this was crucial propaganda, as their decision to suspend second doses, in order to maximise the number of first doses, illustrated – they ignored the fact that, the first vaccine was, in fact, developed in the EU, by a US multinational, Pfizer, conjointly with Turkish scientists at Biontech, using EU based resources, which, in turn, also depends upon the shared knowledge of scientists in the EU, and across the world. The development of the Astra-Zeneca vaccine also cannot be divorced from this international effort, and division of scientific labour, which all scientists draw on, in their own work. Moreover, now that the EU has responded to the fact that, whilst companies based in the EU have shipped 11 million does of vaccine to Britain, UK based companies have shipped none in the other direction, by threatening to place restrictions on EU exports, the Tories have themselves become alive to the reality of such international division of labour.

The Tories, now, rightly, point out that, if the EU were to block exports of vaccines to other countries, this would be short-sighted, because pharma companies depend upon components supplied to them by companies outside the EU, which might, in turn, be blocked. But, the Tories only point out this international dependency when it suits them, and not when they want to claim sole credit for the production and roll-out of vaccines in Britain. Of course, even here, the truth is always concrete. If we take the fact that the EU is seven times bigger than the UK, if the UK tried to block components going to EU based pharma companies, it would be the one that suffered. The EU would source supplies from elsewhere, including new companies and supply developed inside the EU itself. That is the picture that is developing with Brexit overall, as UK based companies see their exports to the EU fall by 60%, and many have decided to relocate to the EU, to avoid all of the additional costs and hassle that Brexit has brought with it.

The Tories greed, of course, has manifested itself in the 1% pay offer to NHS workers in England. Only naïve liberals and social-democrats could be surprised by this development, despite all of the weekly dose of clap for the NHS that the Tories led for their NHS during the height of the panic. The NHS, as an organisation, as opposed to the majority of its workers, has been appalling throughout the pandemic, as I have set out in previous posts. Be it its failure to protect the vulnerable in its care, the failure to create isolation hospitals, the waste on Nightingale Hospitals, the criminal act of knowingly sending infected people back to care homes, and so on, a greater catalogue of negligence is hard to imagine, and, of course, as all the previous NHS scandals show, its not the first time.

The NHS is a huge, Stalinoid, bureaucratic, hierarchical and failing dinosaur. The apologists for it are like George Bernard Shaw and other Fabians and statists, who went to Stalin's Russia, in the 1930's, and returned singing its praises. They apparently saw nothing of the show trials, of the mass murders, the rampant economic waste and mismanagement and attendant corruption, nor the famine and starvation that led to the deaths of millions of peasants. The apologists have made a fetish of the NHS in a misguided, statist, Fabian belief that it, in some way, has socialist credentials, when, in fact, it has none. It was created by and for the benefit of large-scale capitalism, in the era of imperialism.

The apologists often respond that its deficiencies are not the fault of the NHS itself, but of the role of the Tory government – though the same failings have occurred under Labour governments too. But, that is to fail to recognise that this goes with the territory of what the NHS is, as an organisation, and property form. Control over it by the government, and in the end the state, is integral to it as a state capitalist enterprise. That is why Marx and Engels always opposed such forms. Marx set out his objections to them at length in The Critique of the Gotha Programme. Engels in his Critique of the Erfurt Programme continued the opposition saying.

“Here I want to draw attention to the following: These points demand that the following should be taken over by the state: (1) the bar, (2) medical services, (3) pharmaceutics, dentistry, midwifery, nursing, etc., etc., and later the demand is advanced that workers’ insurance become a state concern. Can all this be entrusted to Mr. von Caprivi? And is it compatible with the rejection of all state socialism, as stated above?”

Kautsky himself noted, in relation to these state capitalist forms and nationalised industries,

“If the modern state nationalizes certain industries, it does not do so for the purpose of restricting capitalist exploitation, but for the purpose of protecting the capitalist system and establishing it upon a firmer basis, or for the purpose of itself taking a hand in the exploitation of labour, increasing its own revenues, and thereby reducing the contributions for its own support which it would otherwise have to impose upon the capitalist class. As an exploiter of labour, the state is superior to any private capitalist. Besides the economic power of the capitalists, it can also bring to bear upon the exploited classes the political power which it already wields.

The state has never carried on the nationalizing of industries further than the interests of the ruling classes demanded, nor will it ever go further than that. So long as the property-holding classes are the ruling ones, the nationalization of industries and capitalist functions will never be carried so far as to injure the capitalists and landlords or to restrict their opportunities for exploiting the proletariat.”


So, no socialist, certainly no Marxist, should have any illusion in the nature, and purpose of the NHS as such a state capitalist enterprise, or the fact that, the government, as “superior to any private capitalist”, as an exploiter of labour, uses its superior power to impose a 1% pay rise on NHS workers, in a way that private capitalists would not be able to do. Apologists for the NHS often fall back on the fact that its “socialist” content resides in the fact that it provides healthcare “free at the point of need”. But, that is nonsense for many reasons. Firstly, many people simply do not get the healthcare they require at all. A look at the variations of provision across the country illustrates that point clearly. But, the fact of “free at the point of need” does not convey anything “socialist” about this provision, only that capitalism, long ago, recognised the greater efficiency, for a range of commodities, of providing them, when required, via insurance schemes.

Businesses take out insurance so that, for example, a shipping company that sees one of its ships sink, is able to claim against the insurance for its replacement, and other costs. The cost of a replacement ship is, for the company, “free at the point of need”, but there is nothing socialist about it. It is just a sensible, efficient, capitalist means of dealing with such unforeseeable events. The provision of the replacement ship, whilst “free at the point of need”, of course, does not mean that the provision of the ship, itself, comes free. The company has to pay insurance premiums, each year, in order to avail itself of this ability to obtain a replacement “free at the point of need”, in the eventuality of an accident occurring.

All insurance works on this basis, as a more efficient, capitalistic basis of provision of commodities whose consumption is not predictable for any given individual, household, or company, but whose aggregate requirement for all can be accurately estimated, by actuaries. That is true whether these commodities are ships, buildings, cars, or the requirement for services such as healthcare, education, social care, or the risk of unemployment. If each individual had to assess their risk of any of these things, they would have to work on the basis of the greatest potential risk, and so would have to set aside large amounts of their income to cover that risk, and potential cost. That is economically grossly inefficient, because all of that income, held as unproductive savings, is not being used productively, and so slows capital accumulation and economic growth. Insurance overcomes that problem, and simply enables each individual to pay an insurance premium based upon the average risk, not the maximum risk. That frees huge amounts of money, which can now be used for consumption, and as money-capital to fund productive investment to produce the commodities consumed. In short there is nothing socialist about “free at the point of need”; it is an inevitable product of the development of capitalist production on a large scale.

Apologists will no doubt point to the fact that the SNP government in Scotland is proposing to pay Scottish health workers a pay rise of 4%. But, what does this show? It shows precisely the degree to which the control resides with the government. Moreover, what it shows is the other deficiency within nationalised or state capitalist provision. The nature of the problem is contained within the term “nationalised” itself, i.e. the “national” bit. What the pay offer to Scottish NHS workers, as against the pay offer to English NHS workers shows is that, even within the UK “national economy”, the role of nationalism, here a direct consequence of devolution, is pernicious in dividing the working class. It creates a two-tier working class, divided and fragmented, with Scottish and English workers facing different conditions, and the basis of a united class struggle, thereby, being undermined. Such division is the inevitable consequence of Brexit, in dividing British workers from their comrades in the rest of Europe, but it is also the inevitable consequence of Scottish nationalism, and the separation of Scottish workers from other British workers.

The future for, and road ahead for, workers – all workers – cannot be found in the path of Tory greed, which is simply a manifestation of capitalist greed in its most reactionary form, and so of nationalistic greed, or by placing faith in capitalistic forms simply on the basis of their state ownership and control. The road ahead resides in the greatest possible unity of workers across all borders, and the most rapid dismantling of those borders; it resides in united class struggle of all workers immediately for common standards on wages and conditions, and for the reform of corporate governance laws to put control of companies where it belongs in the hands of the workers, who are the collective owners of those companies; it resides in the cooperation of workers in all these companies, which themselves already exist as multinational companies, to build a cooperative, regulated and planned economy. Its manifestation will be the creation of a United States of Europe, and its transition to a Workers Europe, and ultimately a Socialist United States of Europe.

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