Saturday 21 January 2023

The Tory Politics of NHS Charges

The Tories aren't about to introduce a charge for going to see the doctor or a call out fee for ambulances, but that doesn't stop some from wishing this was the case. Take Sajid Javid, for example. Having announced his departure before Christmas and with the bright lights of the front bench in his rear view mirror, he can now say what he really thinks. And among the very important opinions he's been repressing is that something has to be done about NHS waiting lists, and that would be making people pay for treatment. Seemingly unaware people already pay via taxation and National Insurance, Javid is arguing the best way for getting the waiting lists down is by denying treatment. What a lovely chap.

For a lot of Tories, the NHS has always represented a socialist Trojan horse in the British body politic. Free at the point of use on the basis of need? How grotesque. If health care is decommodified, what else might be next? But even more outrageous is the fact the idea of the NHS has remained stubbornly popular. It's no accident that The Tories, from its inception, have sought to hobble it. This has especially been the case since 1979 when the Tories declared open warfare on everything and anything that smacked of "socialism". Their governments have worn it down by denying funding, introducing internal markets, holding down staff pay, and conceding conditionalities around the NHS's margins. The aim, consistent with how the Tories have remodelled social security and public housing, is not the introduction of charges but its residualisation. It suits capital more to have one consumer of medicine underwritten by bottomless pockets of state money than the uncertainty of competition. Though driving more affluent people into private medical insurance is a bonus.

For the likes of Javid, there are other concerns. For most Tories having the state do anything is anathema. Indeed, Rishi Sunak has almost transformed it into performance art. Run institutions down, pretend everything is out of your hands, no one will look to the government to do anything and the Tories can pretty much do what they like. It's a strategy whose desired outcome is a depoliticisation of politics. As long as the NHS exists, however, there is an expectation on the state that it be funded properly. And when it doesn't work, like now, it becomes an axis of accountability the Tories would rather do without.

Despite his weird foray into anti-austerity politics, we know Javid is an avowed disciple of Ayn Rand and her "objectivist" horse shit. Which, like all right wing libertarianism is capital's collective whinge about having any responsibility for the people they exploit. Getting shot of the NHS is attractive because as soon as charges are introduced, the case for reducing National Insurance makes itself. And as NI payments fall on employers as well as employees, in the Javid/Randian imagination another burden on capital accumulation can be whittled away.

A day's worth of media about an exit-bound senior Tory wanting to do the NHS won't win the government points with anybody, including the eroding base. But there's still over a year of Conservative administration to run, and plenty of more opportunities for them to damage the institutions we depend on and, ultimately, us.

Image Credit


Old Trot said...

All very true, Phil, re the collection of corrupt Ayn Randist sociopaths who people the Tory benches . But what can we expect from an incoming Labour government ? Unless one is naive enough to believe the current risible 'line' being propagated across numerous Guardian opinion pieces , ie, that Starmer and co are pulling a fast one on the Tory mass media and will actually refund our now near collapse NHS, and be a genuine 'social democratic' government of some hue, the future is grim.

The Nulabour2 leading lights like Starmer, Cooper, Streeting, etc are avid recipients of largess from exactly the same Healthcare privatisers as the Tories nowadays. And the ex Tory Big Ticket funders are reported to be climbing on board NuLabour as the prospects of a future Tory government fade away. Sadly, the next Labour government will be a collective 'Philip Snowden' administration, keen only to balance the books no matter what harm this does to the most vulnerable in our society. And they will NOT do that vital thing to raise the £billions needed to undo the systemic damage done in the post 2010 period by Tory austerity, ie, close the tax havens and effectively tax the rich and big corporations.

They just won't . The ideologically rootless left liberal UK 'Left' are simply engaging in self-deluding magical thinking that Starmer and co will offer a way out of our collapsing civil society, whether on the NHS, benefits or the collapsing local government services fronts . Face it, The Labour Right destroyed the 'Corbyn Insurgency, with ruthless efficiency, in cahoots with the entire mass media, as pure lackeys of their current and hoped for future capitalist paymasters , re jobs on those future comfy sinecure banking boards that ALL the Blair era Front Benchers went to .

Like the useless ( for the poorer citizens) terms in office by Obama and Biden in the US, a future Nulabour collaborationist government will totally discredit Labour , forever, as having anything to offer the majority of us. What comes next, as it has across Europe, (and will again in the US with TRUMP 2), will be a massive surge in pseudo radical Right populism. Dark times ahead, and no amount of justified glee at the stinking pile of corruption the Tories are now engulfed in, will change that harsh future reality. NuLabour's actual priorities are perfectly demostrated by the recent grovelling trip by Starmer and co to Davos to bend the knee to the superrich, and the circa 3 to 4 £million that Starmer and co are reportedly spending to pursue those former 5 Leaders Office Corbynites they think leaked that report on the systematic sabotage by the Labour Party machine creatures during the Corbyn Leadership period, even though the Information Commissioners office has ruled there is no case to answer !.

Blissex said...

«Seemingly unaware people already pay via taxation and National Insurance»

The conceit that most people pay for treatment via tax and NI is quite wrong, because the average cost per household in England is around £8,000 per year, but many if not most household pay a lot less than that (many households pay significantly less than £8,000 per year in tax for example) and a large minority pay a lot more than that. Most of the payment of the latter is not to pay for treatment but for lifetime insurance against becoming too poor to pay for treatment.

«the Tories declared open warfare on everything and anything that smacked of "socialism" [...] For most Tories having the state do anything is anathema.»

I still can't believe that our blogger keeps repeating cartoonish views of Conservative thinking, despite the Conservatives having a sterling record of massive intervention in the markets and huge spending in favour of their "sponsors" and supporters, from the hundreds of billions spent over the years to make property in the south-east more valuable with better infrastructure and access to better jobs, to trillions to bail out the City and again the property sector whenever their losses threaten the system, plus the laws against strikes, against freedom of building, against freedom of assembly, etc.

David Lindsay said...

Sajid Javid can call openly for charges for GP appointments and for visits to A&E, because Wes Streeting has given permission for such proposals to the people who have been itching to make them for 50 years. There is no suggestion that, as Health Secretary, Streeting would abolish such charges if they were already in place. NHS privatisation would now face no Official Opposition. Last Sunday, Keir Starmer endorsed Streeting's views, effectively naming Streeting as his successor as Prime Minister in the course of the next Parliament, at the end of which Starmer will be 67 to Streeting's 46.

Blissex said...

«cartoonish views of Conservative thinking, despite the Conservatives having a sterling record of massive intervention in the markets and huge spending»

Two of the other common cartoonish view of the Conservatives is that they are the 1% instead of the 20-40%, and that they have imposed "austerity" instead of massive redistribution upwards from the 60-80% to that 20-40%.

Perhaps up to 100 years ago and maybe even up to 80 years ago the Conservatives represented the interests of a small number of cartoon-style Capitalists smoking big cigars in top hats, morning coats and white overshoes, but at least since Thatcher that has changed a lot.

That New New Labour's core constituency is now again "Sierra man"/"50yo man with mortgage" should make clear we live in the era of mass rentierism, not that of victorian liberal ironmasters, and that the Conservatives have been for decades an (uneasy) coalition between "whig" financiers and "tory" urban property speculators ("Sierra man"/"50yo man with mortgage"). Or perhaps it is me who is deluded and the cartoonish 19th century view of Capitalists is still right.