The Medical-Industrial Complex - Part 3 of 3

Part of the problem is that the Left has turned the NHS into a fetish. 

“The basic source of left orthodoxy is not hard to trace, It lies in the widespread over-romanticised attachment to the NHS on the left, which derives from a belief that the 'principles of 1948', under which it was set up, form the basis for a socialist health care service.” 

(Left Orthodoxy and the Politics of Health, in Capital & Class 11, Summer 1980) 

But, of course they don't. The NHS was established to meet the needs of capital not labour. As Carpenter says, the Left seemed to have more difficulty understanding this with the NHS than it did even with other elements of the welfare state, such as education. Most of the Left could understand that education is geared to the needs of capital; it concentrates on the kind of education and training required by capital to provide the kinds of workers in demand at the particular time. In truth, large sections of the Left have lost even this understanding. The kind of statism that dogged the Left for a century, based upon the ideas of Lassalle and the Fabians, and promoted by Left social democrats and Stalinists, but which had begun to weaken in the 1960's and 70's, has grown ever stronger since the 1980's, and for much the same reason that Carpenter identifies here. The Left lost the ability to think critically. It became obsessed with fighting immediate battles over cuts, austerity, privatisation, job losses and so on, and did so simply on the basis of placing a minus sign wherever their enemies placed a plus sign. The obvious manifestation of that was to defend existing state capitalist institutions, to defend the existing capitalist state itself, including, as can be seen today, defending institutions like the BBC, which acts as the propaganda organ of the capitalist state. It completely failed to present, as an alternative, any independent working-class analysis or solution. 

“Let us take for granted that the NHS is different. Nevertheless, if we accept the 'socialist' character of the NHS at face value, it leads to the acceptance of a particular kind of socialism, obscures the way in which the NHS serves fundamentally conservative purposes. It has led socialists in this country to think of health services as the 'natural' means of tackling the ill-health effects of capitalism, and it has on the whole led them to accept the medical mandate to define health and ill-health even when criticising aspects of doctor's practice.” 

(ibid) 

As Carpenter says, any Left critique of the NHS has amounted only to a criticism of its failure to live up to the socialist principles of 1948, not to question whether those principles were themselves socialist in any case. The more the NHS came under attack from, particularly, Tory governments, though the Labour government of the 1970's inflicted cuts on the NHS too, the more the critique has become not of the NHS itself, as a state capitalist institution, but merely of the failure of Tory governments to provide adequate financing of it. 

“In capitalism... health and ill-health are both made to serve the needs of capital accumulation.” 

(ibid) 

Capitalism sought healthy workers to facilitate capital accumulation, but in so far as capital made workers ill, resulted in accidents and so on, a section of capital profited from this too via the provision of drugs, surgical treatment, the provision of devices and so on. The NHS fulfils a useful ideological role in presenting a fiction that everyone is provided with free healthcare on an equal basis, and on the basis of need. But, it never has. Its not free, but paid for out of the wages fund, as healthcare is a component of the value of labour-power. Workers buy it collectively from their wages in the form of an insurance payment, or tax.

In the process, by enabling healthcare to be undertaken on massive Fordist lines, they also reduced the cost of healthcare for the bourgeoisie too, who benefit from the production of new drugs and so on at much reduced costs, because of economies of scale. Every survey also shows that the provision of healthcare is neither provided equally across the country nor on demand. There is greater provision in more affluent areas, and many of the workers who require treatment for their particular complaints do not get it. The current decisions to deny treatment to many workers, for cancer or many other life-threatening conditions, in preference to providing treatment for COVID patients, is a case in point. But, it also assumes that every individual starts from an equal position of health, whereas it is always the case that the bourgeoisie, or even just the more affluent, tend to start with better health than do workers. 

“Of course, in reality, working class people have sickness problems which the NHS does not deal with at source, or even adequately after the event...” 

(ibid) 

As Carpenter says, illness is a “profoundly decollectivising experience”. In many ways, its a bit like the way people turn to God when they suffer bereavement, or some other tragedy, because such events always appear as individual, personal events, and lead to a desire for some form of succour, for events that are outside our own individual control. Its no wonder that, in all those decayed urban areas, a similar attachment to the capitalist state, as benefactor, provider of doles and even minimum security, and a paternalistic, more or less feudal, relation of dependency is created from it. Its no wonder that its in those areas that this semi-feudal relationship of dependency to the capitalist nation state manifests itself in the form of a nationalistic desire to keep its bounty for the preserve of the natives, and deny it to foreigners, and leads to reactionary ideas such as Brexit. 

Left orthodoxy, 

“... helps to foster 'the NHS illusion' that the problem of ill-health in our society can be largely dealt with by more and 'better' health services, the 'better' meaning to a considerable extent 'whatever doctors decide'.” 

(ibid) 

And, this feeds directly into the mechanisms of the medical-industrial complex, because individual doctors are under tremendous pressure from those medical-industrial companies to prescribe the latest drug etc.; they are under pressure to conform with the orthodoxy within the medical-industrial complex itself, which has been obvious in relation to responses to COVID, and to the demonisation of any medial scientists or practitioners, such as those that have signed the Great Barrington Declaration, who dared to point out that the Emperor had no clothes on, when it came to the claims about the existential threat posed by the virus, or the requirements for lockdowns as a means of responding to it. 

The proponents of lockdown have tried to use the old Stalinist tactic of the amalgam to defame those scientists that have signed the Great Barrington Declaration, and who argue for focused protection of the elderly and vulnerable, not by dealing with their arguments, but by talking about the libertarian ideals of some of its backers. Yet, no one points to the actual medical-industrial complex that channels millions of pounds into universities like those listed in the FT article cited above, such as Imperial, Cambridge, and UCL, in research grants that, in turn, results in the development of very expensive drugs that produce billions of pounds of revenue for those drug companies, paid for by the capitalist state, out of the NHS budget! 

As described above, the current test and trace scheme is useless. It would be useless even if the tests were reliable, and the computer systems to identify contacts, and to trace them worked perfectly. In Germany, which has as close as can be considered to such a system, it has seen the same surge recently in infections that have been seen in Britain, France, Spain and Italy.  But, the tests are not reliable. Around 30% of positive infections are missed by the tests, whilst a significant number of false positive tests have been shown up by the fact that people on holiday who had the virus weeks ago, are still showing up as positive, because the tests cannot distinguish between the DNA of dead viruses and those of live viruses.

But, it is useless anyway, because around 90% of the population who have the virus are not tested. They are asymptomatic or not ill enough to seek testing. So, the vast majority of people who are infected are walking the streets infecting others anyway. Testing and tracing would require testing everyone every day, even if the tests were reliable. It is simply a diversion and means of giving a false impression. Yet, the focus put on testing and tracing alongside the idiotic lockdowns has pumped £12 billion directly into the pockets of the tech companies, and consultants responsible for developing the app, on top of that it has pumped billions more into those drug companies that produce the test kits, and those that analyse the tests.  The only tests that make sense are those that identify existing immunity, but it is those tests that no priority is being given to. 

All of the emphasis is on expensive medical solutions, be it testing, hospital treatment, or the production of a vaccine or other drugs to deal with the symptoms of the virus. All of that channels money into the medical-industrial complex on a vast scale, pumping up the profits of the drug companies and other medical services providers, swelling the personal empires of the health bureaucracies in the department of Health and NHS. Yet, a sensible approach would instead start from the perspective of simply isolating that minority of the population actually at risk from the virus. Compared to the billions of pounds already spent, on useless testing systems, the state could have simply told those over 60, or in vulnerable categories to self isolate, and could have financed that at much less cost. But, it would have provided no revenues to the medical-industrial complex, no addition to the profits of those big companies. 

The policy of focused protection immediately protects the elderly and vulnerable, who are being culled in their tens of thousands by the current lockdowns, which have not even provided effective protection for the elderly and vulnerable in hospitals and care homes. And, by allowing everyone else to go about their business normally, it means that not only is the economy not destroyed, but these millions of people develop herd immunity safely at no cost. It is this herd immunity at no cost that the medical-industrial complex, of course, is most concerned about, because no cost means no profits for the big drug and medical supplies companies, no bigger empire for the health bureaucrats, and so on. Not to mention no funding for the university epidemiologists that, time and again, have told us that there was going to be some existential threat that, in fact, turns out to be nothing of the kind. 

Instead, we have huge sums being pumped into the development of vaccines, with government already ordering tens of millions of them from the drug companies, at a cost of billions of pounds, even without knowing whether they are safe, or will work. In Russia, we have seen that resulting in vaccines being rushed out without proper testing, we have seen vaccine tests stopped in the US and UK, due to the development of illness by trial participants. In order to develop vaccines quickly, genetic modifications are being used, which normally would require extensive testing before any new vaccine was released generally, but governments know they cannot keep populations locked down forever, both because there would be increasing rebellions against it, and because the existing lockdowns are destroying economies, and so they are placing all their eggs in the basket of a vaccine saving their bacon. Even, so the reality is that a vaccine is not going to be ready for at least six months, and it is no wonder that, with all the pressure for it to be rushed out, there are many who will be reluctant to take it for fear of being used as guinea pigs. 

We can bet that the first people its tested on will be the old, the vulnerable and the poor. If a successful vaccine is produced that is safe, then, of course, that will be great, but will it be worth all of the death and destruction that lockdown has caused as the necessary consequence of relying on its development, rather than the development of cost-free natural immunity in the intervening period? Once again, we see the consequences of health policy being determined by the interests of the medical-industrial complex rather than the interests of workers and their health.

Back To Part 2

The Medical-Industrial Complex - Part 2 of 3

A medical-industrial complex operates on the same principles as the military-industrial complex. It ties together powerful vested interests within the Department of Health bureaucracy, the NHS, University medical science departments, and large-scale pharmaceutical, biotechnology and medical technology industry. Huge monopolies and bureaucracies and elites exist, in each, with overlapping interests. The Department of Health channels huge amounts of money into the drug companies and other medical equipment industries, via the the NHS purchasing budgets. Last year the DHSC spent £70 billion on procurement, up from £68.3 billion the previous year. To give an example of current spending with these private companies, £12 billion has already been spent on test and trace, equivalent to about 16% of the procurement budget. Yet, it has been completely useless, whilst no penalty clauses were even put into the contracts for its provision! Its no wonder powerful interests from within the medical-industrial complex have kept insisting that only large-scale testing and tracing can provide a solution, when clearly it has not, and cannot. 

The state also channels large amounts of funding to universities to engage in pure research, as well as targeted research in a range of areas including health sciences. But, the research work done by universities also feeds directly into the large health sciences industries, who frequently do the commercial development of the products first created in university labs. Since the 1990's, and the development of large science parks on the campuses of most universities, that has become increasingly important. Many of the new biotechnology, gene technology and other such cutting edge firms have come out of such science parks, with academics bleeding over into the creation of these new firms. Often, these firms are then bought up for billions of pounds by large pharmaceutical companies. But, in the same way that the large defence contractors funded scientific research in universities that led to the development of new weapons systems, so the huge pharmaceutical and medical equipment producers also fund university research, with the resultant products then being commercially developed by the big companies. A lot of the funding, for research in these spheres comes from the big companies.  

In the 1970's, local, “cottage hospitals” were closed, and attention focused on the development of large hospitals that patients now had to travel to. 

“It was argued that effective treatment required a high level of skilled manpower and the best in technological hardware that was available, Only a large hospital could support the skilled workers – and by skilled workers, consultants are generally meant – by giving them enough cases to be fully occupied without having to waste their expensive time travelling from hospital to hospital. Similarly, the high technology machines – generally even less mobile than consultants – needed frequent use to justify their high cost.” 

(Health Policy and the Cuts, by Tom Manson in Capital & Class 7, Spring 1979) 

Even for things like laundry services in these large district hospitals this argument applied, providing a market for private machine producers in that area too. Manson describes the way this focus on high cost systems had resulted in other areas of medicine being denied funds, for example in geriatrics and mental health. It resulted in patients on a production line being pushed out of hospital early, placing greater stress on other elements of health and social care. But he also notes another critique. 

“This critique is based on the fact that in societal terms, all the successes in medicine have not made much difference to the health of the population. Instead of spending money on heart transplants (for instance) money should be spent on those social factors that affect the health of the whole population, such as environmental factors and indeed the distribution of wealth.” 

(ibid) 

Huge amounts of health spending goes to deal with the consequences of obesity, for example, a factor that is also involved in susceptibility to COVID19. But, instead of dealing with the causes of obesity to begin with, which requires education and intervention not even at the level of Primary Care, but in schools, and as part of a programme of health education and monitoring, the NHS seeks to cure the problems arising from the obesity after it has arisen. Drug companies make huge sums from selling people slimming aids, or medicine for high blood pressure, for Type II diabetes, and so on. The NHS spends large amounts treating the consequences of the diabetes, performing heart operations, as well as surgery to implant gastric bands and so on. 

The introduction of large socialised healthcare systems was designed to ensure that healthcare was provided efficiently, so as to reduce the costs of reproducing labour-power for capital as a whole, but the existence of the medical-industrial complex means that it does not even do that, because the monopolies and bureaucracies that it generates result in policy and expenditure being skewed into channels that benefit the individual interests of the drug companies and other medical supplies companies, and that facilitate the development of large bureaucratic empires within the NHS and Health Departments, and which, thereby, leads to unnecessarily high costs compared to health outcomes. The last Labour government trebled spending on the NHS, for example, but its own performance monitoring showed that it did not even double the health outcomes resulting from it, meaning that instead of economies of scale, it resulted in diminishing returns. 

Of course, its not just the vast bureaucracies within the Department of Health, or in the hospitals where this applies. Go to any GP's surgery and you will notice the steady flow of salespeople from the drug companies that tread their path to the doctor's office. GP's are bombarded with a barrage of advertising from drug companies, in particular, but also other medical supply companies, all out to increase their sales. With the NHS paying for all of these prescription drugs, the pressure is always on for hard pressed GP's to get patients through their waiting rooms by prescribing them the latest pill for this that or the other. Its why we have seen the growing resistance to antibiotics that have been grossly overprescribed, not to mention the level of over-prescription for anti-depressants and so on. All of this is symptomatic of a health service based not upon wellness, but on treating illness. Talking about the discussions inside the Politics of Health Group, of the Conference of Socialist Economists, Mick Carpenter wrote, 

“In particular those concerned about work hazards, and the relationship between health and anti-imperialist struggles in the Third World, looked beyond health services. The former saw the need to remove the fundamental cause of ill-health in the places where people wok, rather than to patch them up in shiny new citadels of technological medicine; the latter knew that the export of western models of medicine had proved patently inadequate to deal with the health problems caused by neocolonial economic and social relations – indeed were a significant feature of them. Finally, the group contained radical epidemiologists who were able to show that the improvements in health made in the last century had more to do with improvements in social conditions than health services.” 

(Left Orthodoxy and the Politics of Health, in Capital & Class 11, Summer 1980) 

Carpenter was writing at a time when the NHS was under right-wing attacks from Tories seeking to make public spending cuts. But, he rightly states that some of the Right's critique of the health service was justified. If we allow our politics to be defined by the Right, but simply place a minus sign where they place a plus sign, then it becomes impossible for our own analysis and politics to advance. In that case, it would mean simply defining yourself only in terms of opposition to health cuts. The modern equivalent is the idea that any kind of sustainable unity or progress can be achieved simply on the basis of opposition to “austerity”. 

“Instead we allow the right to make all the running, and at best fight a rearguard action.” 

(ibid)

Back To Part 1

Forward To Part 3

The Medical-Industrial Complex - Part 1 of 3

In January 1961, President Eisenhower popularised the term, the Military-Industrial Complex. It refers to the close relations that existed between the US military, and the huge armaments companies that supplied it. Analysis showed the extent to which military personnel, and politicians involved in the area of defence, moved seamlessly into lucrative posts with the big industrial companies whose businesses relied on being able to continue to sell ever more, and ever more expensive armaments to the US state. The top generals, and the civilian top brass at the Department of Defence, built bigger personal empires, and increased their status by enlarging the military and its budgets, and the defence contractors made ever larger profits in supplying them with the weapons systems that enabled them to build those personal empires. It required that the US citizens continually felt themselves to be in imminent danger of attack. The expenditure put no value back into the US economy, whilst representing a huge drain of value from it. A similar situation exists with healthcare, and the huge pharmaceutical and medical equipment companies that supply it. It represents a Medical-Industrial Complex. It similarly requires a belief by citizens that they are faced with some existential threat that requires the building of huge hospitals, stuffed to the gills with the latest, most expensive machines, and the provision of the latest, most expensive medicines. COVID19, has been a perfect example of it, and how it distorts public policy making, in the same way as the military-industrial complex has done for the last 60 years. 

Capitalism always seeks the most efficient means of producing, so as to lower the cost of production, and, thereby, raise the rate of profit. It seeks to reduce the cost of the provision of the commodities required for the reproduction of labour-power, so as to reduce the proportion of necessary labour to surplus labour, so as to raise relative surplus value, the rate of surplus value, and, thereby, the mass and rate of profit. For some things, that has meant that the capitalist state must take on functions on behalf of capital as a whole. There are various reasons for that. For some things, like the development of space technology, the amounts of capital required were so large, and the rate of turnover so long, that no private capitals would undertake it. Of course, in the US, although NASA itself was a state entity, the companies that provided it with equipment were non-state owned, but relied on the state paying them huge amounts of money both to develop technologies, and to buy them when turned into actual equipment. That was really just an extension of the military-industrial complex. 

Capital soon realised that to produce the labour-power it required, it had to have workers educated at least to a minimum standard to operate machinery, to read and write, and to be able to function in a society, which increasingly also produced commodities that were technological in nature. So, the idea of the state taking over that function, so as to do it on a large, Fordist mass production basis soon arose. It also meant that the capitalist state could keep control of the ideas being fed directly into young workers heads, rather than them getting dangerous ideas as a result of workers organising education for themselves. And, in much of the advanced capitalist economies, in Europe, it also became obvious that a similar approach was required with healthcare. The state was able to organise healthcare on the kind of large scale that is required for Fordist production lines, standardisation, and economies of scale. In the US, the persistence of a huge number of small producers meant that it was reluctant to follow, because those small producers saw it as only increasing their costs. If their workers got sick, they could easily replace them. Not so for the huge US industries that arose, and which found themselves at a competitive disadvantage to their European competitors, as the US companies found themselves having to contribute to ever more costly private health insurance schemes for their workers. In the 1960's, the US itself introduced socialised healthcare via Medicare and Medicaid, and the battle for its extension continues to this day. 

The development of these huge state healthcare systems was intended to produce all of these benefits of Fordism, and of economies of scale, and indeed, they do. But, as with all such monopolies they also have their downsides. In Capital III, Marx demonstrates the way in which monopolies can drain surplus value from elsewhere, in the form of rent. The classic example, of course, is landed property. Marx shows how, landed property is able to prevent competition in the production of primary products from driving down the market price to the price of production. Primary products are then sold at the individual value of the least efficient producer. Even where primary products are sold at their market value, this results in a surplus profit (profit above the average profit), which is the basis of absolute rent, but with primary products actually sold at the individual value of the least efficient producer, this means that the more efficient producers make additional surplus profits that are the basis of differential rent. 

But, this ability to extract rent, and so to appropriate a portion of surplus profits, by preventing competition from eliminating them applies to all monopolies. For many commodities, competition ensures still that surplus profits are eradicated. For example, car companies are huge oligopolies, with just five companies dominating global production. But, they all have to compete for market share from consumers. Consumers are free to choose which car they buy. The big car companies now try not to compete on prices, because that is destructive of their profits. Instead they compete by trying to convince consumers that their brand is better than the others, which occurs via a combination of actual continual improvement in the product, along with clever advertising and marketing. They try to increase their profits, by continually trying to reduce their costs of production. This monopolistic competition means that their market prices are driven down to the price of production, and any surplus profits arising from technological improvements by one producer, quickly disappear, as others adopt the same technologies. 

But, when it comes to things like the military industrial-complex or the medical-industrial complex, this does not apply. Its not citizens buying military equipment or healthcare (other than on a small scale, such as the purchase of guns, or private healthcare), but the state. Even where the citizen does buy their own gun or private healthcare, they still have to pay taxes to the state towards the cost of the state's expenditure on those things. The citizen is not free to say I will provide for myself, than you very much, and, thereby to seek out the best deal for their needs. And that means that those in the state that have a monopoly over this expenditure then have clear incentives to form an alliance with those that have a monopoly in the provision of goods and services to the state in those areas. They have vast sums of other people's money to spend, and their powerful positions mean that they can use that money to further their own interests, and expand their own personal empires. 

In the case of the military-industrial complex it requires that citizens be scared witless into a belief that Armageddon is at hand, that there are reds under the bed, Islamist terrorists in every mosque, and so there is a need for a huge surveillance state, for extensive, uncontrolled security services using the latest spying and surveillance equipment, and, of course, huge armies, navies and air forces, spread across the globe to provide protection against these threats. And, as each economic bloc produces these things, it becomes a self-fulfilling prophecy, because if NATO armies are on the borders of Russia and China, then the Russian and Chinese elites say, look what a threat we are under, and so justify their own expenditure on these things, sending their armies, navies and air forces to the borders of NATO. And, most ludicrous of all is vast expenditures on nuclear weapons which could never be used without causing the mutual destruction of those on either side. 

Instead, therefore, of this military-industrial complex minimising the necessary costs for the state, and so for capital, it creates an ever expanding cost to the state, and an ever expanding drain of value and surplus value out of the economy. It represents increasing waste of resources. It is not a production of means of production, but means of destruction. As Bukharin describes it, in place of Marx's expanded reproduction, it represents expanded negative reproduction. 

In the case of the medical-industrial complex, it requires a similar belief amongst citizens that they face some kind of existential threat, whereas in fact, nearly all of the actual existential threats to life and health were dealt with long ago. It wasn't expensive drugs and treatments that dealt with those threats. The big killers of the 19th century, such as cholera and typhoid were dealt with simply by environmental health measures to provide clean drinking water and sanitation. The biggest contributor to improved health and life expectancy in the 20th century, came from improved diets and living conditions for workers, as living standards rose. The other major contributors came not from astronomically expensive drugs and other treatments but from the fact that understanding of bacteria meant that simple hygiene and sterilisation meant that you were no longer likely to die from any treatment as a result of infection, and the discovery of penicillin, meant that if you did develop a bacterial infection, it could now be treated. 

The expansion of the medical-industrial complex has come on the basis of the idea that what has to be provided is not good health, but expensive means of treating ill-health that has been allowed to develop, in just the same way that the military-industrial complex develops, because instead of seeking means of reducing the causes of war, it seeks to provide ever more expensive means of winning a war should one arise.

Forward To Part 2

Russian Documents?

Last week, Labour produced extensive documents showing the plans of the Tories to enable US pharmaceutical companies to be able to charge much higher prices to the NHS, in part by being able to keep drugs on patent for much longer periods.  It is a starting point for what would inevitably be a gradual process of opening up healthcare in Britain to private competition, so that, as in the US, the NHS would be reduced to a rump used only by those who cannot pay.  When Trump says, he would not want the NHS even if it was offered to him on a platter, what he means is that he abhors everything the NHS stands for.  He does not want the NHS, he wants his billionaire friends to be able to provide private healthcare in place of it!  It would be the same argument that is used with private schools - "What you want people to be banned from buying private healthcare?"

Everyone knows that Trump wants to get his grubby little hands on the UK healthcare market for him and his billionaire friends.  This is the same man who wanted to buy Greenland for goodness sake.  And, we know that the Tories will fall over themselves to help Trump to get what he wants.  Some of them will see their own personal opportunity to get their snouts in the trough, but more importantly, having dragged Britain into the disaster that will be Brexit, they now have to prostitute the UK economy to others like Trump, or the Saudi Royal Family, in order to get the trade deals that they will be desperate for to prevent the economy disappearing completely into the toilet.

Trump will know that he has all the cards in his hand, if the UK wants a trade deal, and so whatever lies he comes out with now, it is obvious that one of the demands will be what he has said all along, which is that Britain will have to pay much higher prices for US drugs, and the UK healthcare market will have to be opened up to giant US corporations.  Labour had, in fact, provided documents to that effect some time ago, but they had been heavily redacted by the government.  Now, Labour has produced unredacted copies of those documents.

The government not only failed to deny that these documents were genuine, but has even agreed that they are.  They initially tried to minimise the importance of them, claiming that they did not prove what Labour had been saying.  That was not washing.  So, now, a week latter the Tory gutter press have come up with another tack.  They now claim that the documents had been leaked by the Russians, and in one version were supposed to be part of a disinformation campaign - despite the fact that Tory Ministers have affirmed that the documents are genuine!

But, the implication behind these Tory claims is that the Russians are interfering in the election on behalf of Corbyn.  This is all part of the actual disinformation campaign that the Tory gutter press has waged against Corbyn since he became Leader.  The truth is, of course, that the Russians are interfering in this election, just as they interfered in the 2016 EU referendum, but they are certainly not interfering on behalf of Corbyn and the Labour Party.  A labour victory is the last thing the Russian oligarchs around Putin would want to see.  Its Corbyn and McDonnell that championed the Magnitsky Act, for example, that acts against the wealth of those oligarchs; its Corbyn and McDonnell whose economic policies would hit at the Russian billionaires, and the use of London as a tax haven for their ill-gotten gains.

The Russians have been interfering not in support of Corbyn but in support of Johnson and the Tories.  It is Putin's cronies that have financed the Brexit campaign of Farage and co., just as they have financed others of that ilk such as Le Pen.  The Russians channelled thousands of pounds into a Northern Irish Tory group, which then found its way back into Britain to finance the Brexit campaign.  They are closely tied to Cambridge Analytica and its various manifestations, as well as to right-wing nationalist groups such as Breitbart that backs Trump, Johnson's buddy.  It is Putin's cronies, living in London, that have paid thousands of Pounds to play tennis with Boris Johnson, and who have contributed hundreds of thousands of Pounds directly into Tory coffers.

Its no wonder that Johnson and the Tories refused to publish the parliamentary report into Russian interference in British politics before the election.  They know their hands are dirty, from the dirty Russian money they have been taking.  The suggestion that the documents showing the extent to which the Tories plan to sell off bits of UK healthcare to the US is somehow Russia acting to support Corbyn is ludicrous.  It is the equivalent of Trump's claims that the Russian interference in the 2016 US election was actually undertaken by Ukrainians, and was designed to help Clinton!

Putin's kleptocratic regime is closely tied to other kleptocrats such as Trump.  The Russians intervened in the US elections to help Trump get elected.  The same forces intervened to help Trump's allies in Britain, like Farage and Johnson, to get Brexit passed.  They are intervening again now to try to get Johnson elected.  So much for "taking back control".  

Newsnight's Blackhole

Last night's Newsnight, argued that, according to Treasury figures, even if the Government succeeded with its austerity measures, the UK would be bankrupt by around 2050. That would be because an ageing population, and shrinking number of young workers, would mean that it would be impossible to pay for all the additional costs of health and social care that this population would need. Of course its nonsense. Paul Mason should know better. Its nonsense for the same kinds of reasons that the Reverend Thomas Malthus was wrong when he put forward similar ideas at the beginning of the 19th Century.

It is wrong because it unjustifiably extrapolates from current data and trends into the distant future. Let's just look at a few of the reasons why that is wrong.

The main argument for these kind of scare stories is in relation to Health Spending. There are several reasons why the idea that Health spending will simply continue to spiral upwards is wrong.

One argument for putting forward this idea is that people are living longer. That is true, but does that necessarily mean that they will require more, and more expensive health care? Part of the reason that people are living longer, is because general levels of health have improved. If general levels of health improve further due to people quitting smoking, adopting healthier lifestyles, suffering less from physical industrial diseases and so on, then it is quite possible that demands on the Health Service could reduce rather than increase. They could live to a decent age, before dying quickly rather than their demise dragging out over a period of illness. It is often suggested that people are living longer, because of the introduction of the NHS, but numerous studies have shown that the main cause of improved health, and longer lifespans has in fact been general improvements in housing, food and other living and lifestyle changes. There is no reason that should not continue. In fact, one of the criticisms that Marxists have of the NHS is that it provides Health as a commodity, as something that is essentially sold to workers (even if it is paid for by a collective payment of taxes out of their wages and consumption), to repair their health, rather than that it addresses the causes of workers' ill health in the first place, whose origins lie in the nature of capitalist society. (See: Why The NHS Cannot Protect Our Health.) Once again, many studies show that a focus on “wellness”, on primary care and prevention are far more effective than the current focus on the provision of mega hospitals, with all of their very expensive equipment, specialists and so on. But, of course, the latter better meet the needs of Health bureaucrats seeking to develop their own empires, and of high paid Consultants, not to mention the Big Capitalists who make billions from providings medicines, medical equipment, computer systems and so on.

Moreover, as I have pointed out elsewhere, although there is now some talk of merging Health and Social Care, particularly in relation to Old People, very little currently exists in this respect. From my own experience, I know that very little is done, with elderly people in Residential and Care Homes, to ensure that they are kept physically and mentally active, which would be a good way of reducing their potential health problems. Still less is done in terms of preventive treatments through physiotherapy etc. to prevent problems arising. Some small steps are taking place in that regard in the joint ventures between the NHS and Local Authorities to create Retirement Villages, but the UK seems way behind even the US in such developments. In the US, a quite considerable number of people retire to places like Florida, where they can enjoy the health benefits of the climate. It would make sense, as part of the UK's membership of the EU, for elderly people here too, to be able to make similar arrangements, by moving to Spain, the South of France etc. Of course, many do, but here, unlike in the US, such a move is more likely to provoke the ire of the gutter press, complaining about people taking their benefit entitlements from the UK, whilst living elsewhere in the EU!

The other argument put forward is that because new discoveries and treatments are being developed all the time, not only can people be kept alive longer, but more things can be treated, and therefore, the demands for treatment keep expanding. But, this is no different from other parts of the economy. New commodities are being developed all the time, and new demand for these commodities is stimulated, but, at the same time, the time required, and the costs involved, in producing the older commodities, continues to fall. At any one time there will be far more existing commodities whose costs are falling than there are new commodities whose costs are high. In fact, it is because of these new discoveries that there is considerable hope that future costs will not continue to rise. Take genetics, and the possibilities it opens up for targeted treatment of a wide range of illnesses. Less than a decade ago, it looked like it would take decades to decode the human genome. But, the continued advances in computing power meant that, in fact it was accomplished in around 18 months, and now the genetic code of many viruses, cancers etc. is being unravelled on a daily basis. Not only has the cost of doing that tumbled, but the treatments it opens up, mean that the costs of these treatments is also likely to be slashed compared with the previous development of medicines whose effectiveness was not so great.

And, of course, that is not just true of medicines. The same rapid increases in productivity that have slashed the prices of many consumer goods mean that the prices of things such as CT and Body Scanners should be significantly reduced too, and used on a large scale, as part of a programme of preventative medicine, they could significantly reduce the instances of illness, and the costs of treating it. If workers themselves directly owned and controlled the Health Service it is likely that they would already be directing resources in this direction, rather than into the big vanity projects developed by the bureaucrats and top Consultants.

This ties into another idea of why Health costs do not, and should not, simply continue to rise. The Health Service, like the Education System, was developed to meet the needs of Capital, for the reproduction of Labour Power. To do that it was developed along the same lines as Fordist mass production. Hospitals and Schools were established as large factories. Schools took in children at one end, and passed them along a conveyor belt until they came out at the other end as Proletarians, produced to operate as a cog in the Capitalist machine. Hospitals helped to ensure that these young workers were brought into the world at least cost, reducing the costs to Capital that previously arose from Infant and Child Mortality, and then acted to repair those workers when they were damaged.

These kinds of mass production were efficient up to a point, but for the same reasons that Fordism came up against limits around 30 years ago, so its application to the provision of Health and other services has met similar limits. Capital searched around for solutions to its problem in relation to other aspects of consumer goods production, and came up with a series of answers. It reduced functions down to core operations, farming out other activities to a range of external suppliers; new technology and robotisation made it possible to replace the conveyor belt with more modular forms of production based around work groups, and flexible specialisation. The same “neo-fordist” solutions have been applied to other service industries, such as Banking, they are now, as Aglietta argued, likely to be introduced into the provision of Health, Social Care, Education etc. and as with its application elsewhere, it is likely to result in an explosion of increased choice, and reduction in costs.

Similarly, the kinds of processes that led to skilled jobs being replaced by machines elsewhere can be introduced. Computer Expert Systems, can for example, replace expensive Consultants diagnosis. In fact, a Computer system is likely to be able to have a database of possible illnesses far greater than any medical professional can store in their head, and be able to simply match symptoms with causes. The application of other technology is already allowing medical specialists to provide their services over long distances, via the Internet and teleconferencing. The development of computing power, and the advance in mobile technology means that everyone could now be monitored 24 hours a day via small implants, or by a mobile device embedded in a graphene strip used as a multi-functional device on the wrist, picking up signs of any problems - in the same way that computer chips in cars now monitor for any defects and report them - and notifying the appropriate medical services instantly.  In the same way that robots are able to replace skilled workers in many areas of manufacture, so surgical robots will be able to undertake many surgical tasks to a far greater degree of precision and consistency than any human.

Finally, we are only just beginning to see the revolutionary transformation of healthcare that the combination of computing power with biology, chemistry and genetics is about to bring about. That applies over a huge range of areas, from the ability to generate replacement organs via stem cells, to the use of new materials being made possible through nanotechnology, to the introduction of new drug delivery systems. In effect, Healthcare is still at the stage of the Model T Ford, and as happened with motor car production, the period ahead is likely to see not just a vast and rapid transformation of quantity and quality of what is available, but a massive reduction in the costs of what is provided.

But, in part these same factors are the other side of what is wrong with the argument put forward by Newsnight. As I've argued in the past, The Big Pensions Lie, the argument that workers have to work longer because they are living longer is a myth, because workers' productivity has increased hugely since the time that Pensions were first introduced, and in fact, even just since WWII. That means that fewer workers are needed to produce the goods and services consumed by those who have retired. We can easily allow people to retire earlier, and enjoy a higher living standard, even with a smaller working population to support them. The reason Capital seeks to make people work longer is because a smaller working population, means it has to pay higher wages, and, therefore, accept lower profits.

But, although productivity has risen sharply, the truth is that the UK economy, even during the period of the Post War Boom has not performed as well as it could have done. Rather like the US, during the 1980's, when much manufacturing went to China and other parts of Asia, Capital, instead of moving into high value areas of production, went into retailing, and into other forms of services. As a consequence productivity did not rise as much as it could have done. But, with the Financial Meltdown, and its aftermath, that model of the economy based around continually expanding retail outlets is no longer possible. Capital will be forced to restructure in these economies, or be destroyed. Assuming the latter is avoided, then the UK economy could see rises in productivity far in excess of what it has experienced since WWII, and that will finance the costs of the Welfare State, and a rising old population.

And, although I have argued that there is no need for workers to have to retire later, the chances are that as people live longer, they may CHOOSE to undertake work of some form or another. Many of the people I worked with, who took early retirement, from the Council, during the 1990's, topped up their pensions by working a few hours a week at B&Q, and other such jobs. Provided, employers are prepared to make it worth their while, and provided Governments do not tax away the benefits of doing so, many workers are likely to adopt such a strategy. And, of course, many retired workers already do work that is not counted in the economic data, because they work in the domestic sector, providing childcare etc. looking after grandchildren and so on.

Malthus made the mistake that he believed that the population would grow geometrically (2,4,8,16) whilst production would only expand arithmetically (2,4,6,8), and so population growth would outstrip the capacity to meet its needs, leading to starvation and so on. The same catastrophist ideas are put forward today by the environmentalists, who not only make the same warnings about resources running out, but who continually talk about the damage to the environment, but who do not seem to have noticed that in many old industrial countries the environment has been substantially improved in the last 50 years! Newsnight make the same mistake.

Malthus was wrong, as Marx pointed out, because like Ricardo, he assumed that agricultural production was already being conducted on the most fertile land, and because he failed to understand that the productiveness of the land itself could be transformed by the application of Capital to it. As I wrote some time ago, The Great Food Flim Flam, all of these ideas are false. As I set out in my blog Food, Population and development, back in 1953, Colin Clark showed that even with the technology available then it was possible to provide a standard of food consumption equal to that of the Netherlands for a global population of 12 billion. As I write there, that figure is likely to be around 30 billion today. The same argument applies in relation to providing for the needs of an ageing population.

Occupy The Care Homes

According to Channel 4 News, tonight, the announcement of 3,000 redundancies by private Care Home provider, Southern Cross, is symptomatic of a much wider financial problem, which is already having an effect on the quality of care provided.

Meanwhile UNISON, also quoted in the report says,

“Four Seasons, the second biggest care provider is also in severe financial difficulties. If both Southern Cross and Four Seasons were to collapse, around 1,150 nursing and residential care homes would be at risk of closure, affecting nearly 50,000 vulnerable people and their families and hitting over 60,000 staff.”

According to documents seen by Channel 4,

“Headed "draft for agreement - not government policy", the paper sets out how local authorities will have to manage the transfer of residents to alternative care homes.

The industry watchdog, the Care Quality Commission, will "provide intelligence" about the location and quality of any alternative centres.

And central government, along with other responsibilities, should consider setting up a "national helpline" for those worried about family caught up in the crisis.

A Department of Health spokesperson confirmed to Channel 4 News that the government had prepared the document in order to properly plan for every eventuality.”

But, as they point out this is not Government policy, but only a draft for agreement. Given the incompetence this Government has shown from Day 1, and given its propensity to change policy by endless U-Turns, whenever it faces some kind of pressure, this is not very comforting for those worried about their relatives in these care Homes.

But, for that reason alone, we cannot simply wait, and ask the State to intervene as Dave Prentice suggests.

The Liberal-Tory Government that he wants to intervene to save the Care Homes, is the same Government whose Cuts programme is partly to blame for the problems those homes face! It has reduced the amount paid in grant to Local Authorities, who now are passing that on in reduced Social Care budgets, and payments for Residential Care. Asking the Liberal-Tory Government to intervene to stop Care Home closures is like asking Hitler to intervene to stop the Brown Shirts attacking Jewish property!


Now is the time for the Labour Movement, and those unions like UNISON most responsible for the provision of Health and Social Care to intervene themselves.

Already, we have seen workers prepared to act rather than wait, as in the case of the New Cross Library occupation, along with all of the University Occupations organised by Students and their supporters amongst staff.

The Labour Movement should begin to occupy the Care Homes now to ensure that they are not closed, jobs are not lost, and residents do not face life threatening disruptions.

Immediately, they have been occupied, staff should organise meetings with the relatives of residents to organise Support Committees, and Joint Management Boards to discuss how provision can be maintained and improved. The Public Sector unions have a vital role to play in helping to organise such occupations, and providing all of the immediate back-up and support that will be required, and in extending the action to bring in the support of workers in ancillary services, and supplying firms.

Local Trades Councils have an important role to play in establishing Support Committees that can link up the Occupations with local Anti-Cuts Campaigns, with Tenants and Residents Associations, and other such bodies to build a widespread network of support.

Having occupied the establishments, a campaign needs to be built to ensure that the Government rubber stamps the workers ownership and control of all the facilities, in the same way that workers in Argentina in places such as Zanon, were able to get the ownership of businesses legally transferred to them.

These Care Homes constitute a sizeable industry, and the Public Sector unions can again play an important role in ensuring that once the workers have taken them over, they can be brought together into one large Worker Owned Care Co-operative operating throughout the country, and able to benefit from economies of scale.

The lesson that has to be learned from the experience of Upper Clyde Shipbuilders is that once in the workers ownership and control, these businesses must not be handed over to the Capitalist State. All experience of such nationalisation is that the Capitalist State will use it to bring about a large scale rationalisation, resulting in mass redundancies and speed-up, ahead of the business eventually being sold-off again to private Capital, once it has been rationalised, and made profitable.

This should mark the beginning of the fightback against the Cuts, against privatisation, and against the Liberal-Tory attacks. A successful campaign of occupations, and the establishment of worker-owned and controlled Care Co-operatives can show how workers in the private and State capitalist sectors can effectively oppose attempts at closures, and reductions in provision. It can show how another, better socialistic, method of running society can be established here and now, without the need for bosses or State bureaucrats.

OCCUPY, ORGANISE, KICK THE BOSSES AND BUREAUCRATS OUT!!!

Capitalism & Care

The last few days have shown once again that Capitalism cannot be relied upon to provide even basic standards of Care for workers. Coming on top of the many revelations about appalling conditions and treatment of patients at Stafford Hospital and elsewhere, there have been further similar revelations about Redditch Hospital, and Panorama has produced film evidence of atrocious treatment of residents at a private Care Home, Winterbourne View, in Bristol.

On top of that, Southern Cross, the biggest provider of private residential Care in Britain, is facing a financial crisis, partly due to its model of selling its homes to Landlords and renting them back (a version of PFI), and because of limitations on payments by the State to cover costs.

The fact, that these problems extend to both private and State capitalism demonstrates that this is not a question of whether care is provided by private companies or by the State, but is a result of the fact this provision in both cases is CAPITALIST, i.e. it is ultimately determined by the needs of Capital, not of ordinary workers. In fact, even in the case of the private provision, the Capitalist State is also culpable. The reason that private companies such as Southern Cross and BUPA are resorted to by Local Authorities, is that the scale of operation of these companies means that they can achieve efficiencies that the Local Capitalist State cannot, and usually can do so whilst still providing higher quality facilities than the local Council is capable of.

But, although these private care homes do have a considerable number of residents who pay the full cost of their places, in order to meet their legal responsibilities, and to operate on a large enough scale, they also have to take residents sent by the Local Authority, and they are, therefore, at the mercy of what the Local Authority is prepared to pay, and as the Cuts imposed by the Liberal-Tories bite, that is passed on.

This shows the lunacy of attempting to provide something like Care on the basis of profit. At least in the case of Southern Cross, and BUPA and other large scale providers there is not a question about the quality of Care provided. In fact, this is really a mirror of what is seen elsewhere. Particularly, since WWII, we have seen the development of a small number of very large companies in most sectors of production. These companies compete, mostly not on price, but on quality, in order to expand their market share.

This has driven the marked improvement in the quality of most consumer goods seen during that period. At the same time, in order to increase their rate of profit, these companies have also been vigorous in finding new methods of production, new techniques etc. in order to raise productivity and reduce costs. This has acted ultimately, to ensure that higher quality has been accompanied by lower prices, as these new methods become standard. In Europe, where socialised healthcare is achieved via State run National Insurance schemes, which commission services from often large private or not-for profit companies, this has also acted in the same way to raise quality, and reduce costs.

But, this assumes that the care needs of the population will be met by the National Insurance funds collected by the State. In the event that does not happen, then the companies providing the services will make losses, and eventually withdraw provision or close down.

If workers had full control over this, then they would ensure that, if necessary, the insurance premiums required to meet the costs were increased. But, this is precisely the problem with Capitalist provision of Care, be it private or State Capitalist. Workers do not have any control over the provision, either in terms of how much of their wages are devoted to it (let alone how much of society's resources are devoted to it), or over what or how provision is made. In the case of Redditch Hospital, it had only recently been given a clean bill of health by the Care Quality Commission, the Capitalist State body set up to inspect such establishments.

In fact, as the Patients Association have reported in the past, it is not the first hospital that has been given such a clean bill of health, but been found to be wanting in its provision. Similarly, the CQC was responsible for the inspection of Winterbourne View, and despite having been warned by a former member of staff about what was going on there, failed to take any action.

But, anyone who has worked in the State capitalist sector can understand why this is. In reality, the whole culture breeds an attitude of complacency. Frequently, those doing the inspecting – this applies to external audits amongst other things – move in and out of doing the very functions they are inspecting. They belong to the same profession as those they are checking up on, and so on. In addition, the bureaucratic mindset developed is one of box ticking. You have a job to do like any other, for which you get a pay check at the end of the month, and like most other workers your attempt is to maximise the pay check, whilst minimising the effort you need to put in to get it. Again, any one who has worked in the State capitalist sector knows that not only do people who rock the boat not get promoted, but they are likely to face hostility from both superiors and peers alike. But, more than that there is no imperative for an Inspector sent in by the Capitalist State to have any immediate reason to make their own life more difficult. It is not their parents or children who are in the home after all.

When it comes to buying a new car, there is lots of information, including the information given by people you know, and your previous experience. That means you have a good chance of being able to make the right decision, and, if there is a problem with it, of complaining and getting it sorted out by the dealer. That is even true if you are going into a hospital yourself. But, it is largely not true about care for your children or parents. What is more, they are frequently not in a position to complain, or to tell you if there is a problem. You rely, on the State Inspectors to do their job properly in that regard. But, why should we be surprised that this does not happen.

Although, we have had Factory Acts for 150 years, and a Factory Inspectorate, and now a Health and Safety Executive, workers do not rely on them to ensure their safety, they know that these things provided by the Capitalist State are a facade, and that we have to continue to appoint our own Health and Safety Reps, and undertake our own direct Trade Union action to try to protect workers health and safety. If we really want to ensure that the existing provision of health, care and education even minimally goes to meet our needs, we cannot rely on the Capitalist State to do that. Just as we have our own Health and Safety Reps, we need our own Committees of Workers Inspection to go into hospitals, schools and care homes to ensure that our needs are being met.

But, just inspection alone is not enough. As a County Councillor, sitting on the Social Services Committee, both myself and the Chair of the committee, month after month complained about the terrible level of education provided to children in the Council's care. But, we found that we were effectively impotent to do anything about it. Real control rested with the Permanent State bureaucracy, and when eventually some action was taken by them, it was to appoint yet another high paid bureaucrat to be responsible for improving the situation.

Of course, month after month, despite that, the situation did not improve. My Mother spent the last three years of her life, bed-ridden in a Private Nursing Home, paid for by the Council. The quality of the home was good, better than the Council, Residential Home she had been in previously. Many of the staff, lived near to me, and so I knew them personally, which helps. A number of them came to my Mother's Funeral. Yet, if I had had any complaints, it would have been difficult to raise them individually, because, ultimately I was not paying for my Mother's stay there, and even if I was, it would still have left me relating to the Home on an individual basis.

If ordinary workers are to have any real power in such relationships they have to be able to act collectively, and that means that they must be responsible for Commissioning that Care themselves on a collective basis from within their Community, rather than the Commissioning being done by a Health Authority, Primary Care Trust, or Doctor's Collective. Only if workers through a Commissioning Co-operative, have control of the funds, and use it to buy in the care they need, will they have any hope of exercising any power in such relationships.

That would also mean that workers through such a process could also exercise direct supervision over the care provided to avoid the kind of problems seen at Winterbourne View, Stafford Hospital, and elsewhere. That could be done by workers, through such a Commissioning Co-op, placing one or more of its members into each establishment on a full-time basis, and providing regular reports back. This duty should be done on a rotational basis to prevent any relationship developing between the Monitor and the establishment, and like Jury Service, the time taken from their usual work to carry out this function should be met by their employer, and guaranteed in law.

That would be a start in ensuring some degree of democratic and workers control over provision. But, such control is only effective if the Commissioning Co-op, also has control of the purse strings in a wider sense. If the State continues to determine how much money shall be allocated to each activity, then workers will only exercise partial control. The quality and quantity of provision will remain under the control of the Capitalist State. In other words, workers will need to move to a situation, in which the taxes and other payments that are currently absorbed by the Capitalist State, and its bureaucracy, go directly to them to cover the commissioning of these services.

In that way, as Marx described we will also be better able to see how much of our taxes go to pay for these services, and how much is actually siphoned off by the Capitalist State for its own purposes, including the maintenance of its vast and controlling bureaucratic apparatus.

“Because indirect taxes conceal from an individual what he is paying to the state, whereas a direct tax is undisguised, unsophisticated, and not to be misunderstood by the meanest capacity. Direct taxation prompts therefore every individual to control the governing powers while indirect taxation destroys all tendency to self-government.”

(Marx - Programme of the First International)


Already in Britain, we have some move towards the establishment of worker co-operatives in health and social care provision. That is far more developed in Europe and other parts of the world. It is the rational extension of Worker Owned and controlled commissioning of services. In the first instance it is likely that such Co-operatives will continue to compete against each other, private Capitalist and State Capitalist providers.

We should not be afraid of that situation, but be confident that a Co-operative, socialistic model is more efficient, and will win out in the end, due to its superiority, even if there are inevitably some failures along the way. Even whilst they compete on quality, and, to begin with, price, we should encourage these Co-operatives to join together in a national Co-operative Federation, in order to obtain the benefits of economies of scale. As part of that Co-operative model we would expect a continual expansion of planned production in conjunction with the needs expressed by the Commissioning Co-ops, and a general sharing of best practice, new techniques and so on, so that the Worker Co-operative sector as a whole could rapidly develop at the expense of the private and State Capitalist sector.

In Left-Wing Communism, Lenin wrote,

"We must work to accomplish practical tasks, ever more varied and ever more closely connected with all branches of social life, winning branch after branch, and sphere after sphere from the bourgeoisie.”

Given that Lenin here recognised that bourgeois democracy was a sham, and that it was impossible to control the Capitalist State through it, it is clear that what he means is that these practical tasks, and this winning over of branch after branch means workers doing that outside Parliament, in their daily life. As Trotsky puts it,

“It would of course be a disastrous error, an outright deception, to assert that the road to socialism passes, not through the proletarian revolution, but through nationalization by the bourgeois state of various branches of industry and their transfer into the hands of the workers’ organizations.”

Nationalised Industry And Workers Control Of Production

It is a reatatement of the ideas of Marx and Engels who rejected the idea that workers should rely on or promote the development of the Capitalist State in all forms including Welfarism. Instead they argued that workers if they were to make themselves fit to become the ruling class had to increasingly establish their own forms of property, democracy, and state in opposition to the Capitalist State. Marx and the First International called this "self-Government". Engels himself remarked,

“It seems that the most advanced workers in Germany are demanding the emancipation of the workers from the capitalists by the transfer of state capital to associations of workers, so that production can be organised, without capitalists, for general account; and as a means to the achievement of this end: the conquest of political power by universal direct suffrage.”

If we want to avoid the kind of abuse, and catastrophes we have seen in the last few days, then workers have to begin to take control and ownership into their own hands, rather than simply expecting the Capitalist State to do it for us.