The Canary is excited to share the latest edition of our letters page. This is where we publish people’s responses to the news and politics, or anything else they want to get off their chest. We’ve now opened the letters page up so anyone can submit a contribution. As always, if you’d like to subscribe to the Canary – starting from £5 a month – to support truly radical and independent media, then you can do that here:
This week’s letters
This week we have people’s thoughts on it being a general election year, and a lot of responses to a Canary article on a think tank’s proposed NHS reforms.
I remember the character assassination carried out against Labour politicians in the 1980’s to keep Thatcher in power beyond her best before. This was nothing compared to what was done to Jeremy Corbyn in the 2015, 2017 and 2019 election campaigns.
We have to get rid of the Tories because they have stopped hiding their corruption and Fascist views (just like Trump in the US has done) and want to destroy the working classes having any power to force changes. 2024 is probably going to be the last chance to destroy the Tories and I think we need to work together to do this.
I don’t think Starmer will make a good PM but he is the best chance we have to destroy the Tories before they continue their mass destruction of the poor.
Dave Barclay, via email
Responses to a think tank’s NHS reform plans
We’ve had a large response to the Social Market Foundation’s plans to reform the NHS. You can read the article here.
The Social Market Foundation’s proposals to replace the traditional general hospital model are very interesting and worthy of further exploration (hospitals, after all, easily push us towards the dependency of what sociologists like to call “the sick role”), but they could easily be used as an excuse by the right to avoid providing adequate care which sometimes simply has to be carried out in hospitals — remember what “care in the community” often amounted to.
There is also the counter-suggestion that energy and resources could best be expended making the existing structure work well, as it’s capable of doing when properly supported, rather than tweaking it. (The same thinking, incidentally, could well be applied to education too — make what we have run well for all, and stop messing about with nonsense about baccalaureates and so on.)
Above all, it seems to me that what we need for our NHS are two things; firstly, to not have a government in power which wants to destroy it (and I include Starmer in this, not just the literal Tories), and secondly, to rid it completely of the private sector.
The NHS, hospitals and all, ran beautifully in the decades after its inception when all governments agreed that publicly-owned healthcare for all was a basic right, and taxed the rich enough to make that possible.
David Revill, via email
I’d like to share my initial thoughts with regards to this proposal.
My first thought is that these proposals do not address the deliberate underfunding of the NHS.
Secondly, they only consider NHS funding micro-economically rather than macro-economically.
At a macro level, NHS spending is part of the overall size of the economy, spend more and the economy overall is bigger, since spending equates to wages (and also govt spending isn’t funded via taxes, the state can always spend more and occupy a larger space in the overall economy).
In this way, how the money the NHS gets is spent, with a focus on value for money, efficiency and so on, become an economic smokescreen for a deeper, political/ideological issue (how many people and how much time do we devote to healthcare).
This is the left captured by the frame of the right. The authors note also that patterns of illness are changing and mention “respiratory, cardiac, diabetes and anxiety/depression set to rise from 5.3 million in 2020 to 9.1 million in 2040”. There is no question of why here, as though these things will just somehow increase, even though none of these conditions are contagious.
These are all conditions linked to the social, economic and political conditions in which we live (and their underlying ideologies). These cannot be prevented through individual intervention via “neighbourhood teams” and “dynamo centres”. My view here is that the myth of public services being financed by taxes when people make and flog widgets (a kind of sponsored walk version of how governments fund themselves and a complete inversion of reality – money comes from states, and the private sector only gathers money from others, it never makes it) is getting in the way of demanding more money for health, social care and so on, which will ultimately become (better) wages for people and provide meaningful occupations for many more.
There are those who say that there are limits to what can be spent on healthcare, but that limit is not actually financial, it is a question of people – how many would work in healthcare in some way. The government can always pay for that number of people. However, the private sector would be crowded out, hence the lies that get told about money, by the Tories and the other Tories in the Labour Party.
Linking this article to another recent Canary article, much of what the private sector produces is harmful and/or unnecessary junk. David Graeber has also addressed the issue of how many people are involved in useless activities in what we call work.
The suggestions made for how to reconfigure the NHS may be helpful, however, my view is that, the only way to resolve the problem would be via a different politics, one in which highly local, regional and national assemblies of citizens, collectively decided their priorities, and allocated funding accordingly, rather than think-tanks and elected representatives of the status quo.
To return to the statistic I quoted earlier, of a rise in a number of conditions from 5.3 to 9.1 million. That this isn’t treated as a massive and catastrophic scandal, and a gargantuan failure of state tells us much about the Social Market Foundation (SMF).
Also, somehow, seemingly without cause, a set of non-contagious conditions is set to increase at a phenomenal rate (almost doubling) within 20 years, conditions that are life limiting/threatening, affecting over 15% of the population. That this hasn’t led to a societal level panic and has led the SMF to simply suggest closing hospitals and offer peripatetic care instead is simply staggering.
In the face of a seemingly species-wide looming existential threat growing inexorably within us by virtue simply of being human, to suggest that we need to provide services more efficiently within insufficient budgets tells us that the authors know what the causes of these conditions really are – they’re the result of poverty, of domination and disempowerment.
They’re the result of extraction and exploitation, of unhealthy food systems and burning fossil fuels, of sitting at a desk all day in soul crushing and meaningless monotony, of living a life in which spontaneity has been all but removed in favour of endlessly repeating robotic actions for an economic system that grinds most of us to dust.
Related to this is a question of who benefits. If 9 million people, rather than 5 million, are ill and need treatment, that’s more work for medics and allied professionals. Even better if those conditions are long term and can’t be corroborated medically (anxiety/depression). Changing society isn’t in their interests.
No wonder the recommendations are about tinkering. Treating long term conditions caused by conditions of living, isn’t the same as addressing the conditions of living, and represents a failure.
If implemented, which I doubt, I don’t think it would achieve what’s claimed.
Kind regards,
David, via email
A new political party would:
- Recruit at least half a million medical professionals, trained and experienced, from abroad, to staff public NHS. With zero Visa costs to the staffing, old and new. Including the severe shortage of GPs, which makes Bosanquet and Haldenby’s ideas unworkable.
- Rebuild all shut down NHS public hospitals and accident and emergency units. Heart and stroke deaths have increased not less mortality rates, as the A and Es are just not able to help people, even after a lengthy wait for an ambulance, we are told by the staff about to leave to go and work abroad.
- A lot of early screening to save funds and lives.
- Requisition all private hospitals, equipment and staff, into public NHS for length of parliament. The firms could use European private hospital firms.
- End privatisation, saving the high cost inflicted on NHS.
- Including bringing back in-house the feeding of patients.
- Patient Charter, starting with right to food and water / hydration.
- Bringing Liverpool Care Pathway/Canadian system into common law murder as a joint enterprise.
- End the discrimination against age and women in their medical complaints (either solely or majority). For swift diagnosis and proper treatment. Ending medical schools calling us the ‘whiney women’ and not believing our description of our ailments
- Have operations in all NHS public hospitals and not just in a few areas.
And so much more.
Main NHS manifesto page, with links to other pages of NHS policy pledges, is here.
We’re seeking a volunteer admin, please, to bring our new political party into existence by getting it registered. This would be the top new political party in UK history to gain the vital Grey Vote, that is the last age group sufficiently turning out to vote, and by doing so get us Corbyn’s (actually Clement Attlee’s) legacy, with focus as Gandhi observed, that people’s politics are their daily bread.
First manifesto written by us, the people.
Christine Williams, via email
First, I live in Scotland, so the model used by the researchers is not directly applicable. Nevertheless, most proposals can be adapted in various ways to fit the different and differing conditions, where population density is much different, with high concentrations in the Central Belt between Glasgow and Edinburgh and much lower densities in the Highlands and Islands which also include quite difficult terrains.
Given these population densities and the distances involved – and remember, Scotland’s land area is not much smaller than England’s, but the distance between Edinburgh and Shetland, for example, is greater than the distance between Edinburgh and London – a much more localised system is required and one which is locally empowered, but with relatively rapid access to specialised centres in place like Aberdeen, Inverness, Dumfries, Galashiels as well as Glasgow and Edinburgh.
Low population densities leads to issues in recruitment and retention of staff in low density areas. While many people positively choose to live in such areas and have over the years contributed significantly to the communities, longer term, there is a drift of people from them to the cities, largely due to the costs of affordable housing, lack of public transport and employment prospects.
So, for much of Scotland reorganisation of health care services is just a part of a wider political issue of devolution of powers and funds from the larger centres of population to the more sparsely populated. However, in the urban areas, as the report indicates for England, there are significant resource disparities between affluent and less affluent areas which are often cheek by jowl. So, within the urban areas there is a need for a redistribution of resources and power from the more affluent to the les affluent.
One of the lessons from the pandemic was the value of the local community in supporting others within the community. It was heartening to se how spontaneously this assistance was given. If we can develop empowered local communities, in towns and cities, too, then we can create an ethos for the kind of community based NHS which the article envisages.
Alasdair, via the site
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By The Canary
This post was originally published on Canary.
