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Raymond Challinor

Tory Attack on National Health Service

(April 1961)

From Socialist Review, April 1961.
Transcribed by Christian Hogsbjerg, with thanks to Ian Birchall.
Marked up by Einde O’ Callaghan for the Encyclopaedia of Trotskyism On-Line (ETOL).

FOR the overwhelming majority of the working people the recent Tory Government measures – increased Health Service charges, increased National Insurance contributions and, thanks to dear Mr Brooke, increased rents – are all part of a definite pattern, an attempt to whittle down the Welfare State and to attack workers’ standards.

However, in a deeper sense, these measures accord with fundamental Tory philosophy. One of its bedrock principles is that people should be made to pay, as far as possible for everything they receive, whether they be luxury goods or the necessities of life; they should never (except, conveniently, through inheritance and “sound financial investment”) get something for nothing. Those unable to pay their way, the victims of this highly competitive society, are regarded as social cripples. They should be pitied, charitably helped – but kept on the bare minimum. Lest they grow indolent, the State should make their lot remain difficult; perhaps a bed of thorns will prick them into doing something for themselves. It is this idea, a guiding principle for workhouse administrators in the 19th century, that pervades all Tory social legislation.

But just as the ability to pay his own way, the amount of money in his pocket, is the criterion of an individual’s worth, so must an industrial project be judged solely by its returns in hard cash. And when we look, in terms of hard cash, at exactly who is benefiting from the Welfare State it is certainly not the working class; and when the working class are losers it can only be big business that gains.

In fact, when we look at the eighteen largest drug companies in England (nine of them American subsidiaries) we see that their aggregate profits jumped from £35m to £46m from 1959 to 1960 – this increase mark year being more than the increase in the NHS drug bill which the Government are imposing. To quote from the Civil Appropriation Accounts report published early this year:

“the profits of these companies, expressed as percentages of capital employed, had been above those of general industry throughout the period, examined and had lately tended to increase whereas the rate for general industry had been falling. While the position, varied greatly, between individual manufacturers and groups of manufacturers, it was noticeable that the profit rates of the British subsidiaries of American concerns had consistently been much higher than, those of general industry.”

Of course the drug firms argue that their profits are justified because of the tremendous amount of medical research they have to undertake. However, according to the Times Review of Industry, only £6.2m is spent annually on research by the industry. Also we can only guess how much of this ‘research’ is merely finding out what other firms know in order to prepare another version of the same thing.

“On the other hand advertising expenditure is beyond all reason. The cost of total advertising of ‘medical products’ in the press and on TV alone was around £10 million in 1960. But this does not include the flood of glossy, five-colour advertising material together with samples sent direct through the post to general practitioners and others in the medical profession, which, as every doctor can testify, involves quite a problem in refuse disposal, though figures of the cost involved are not available.”

All this racketeering on the part of big business is, as can be expected, aided and abetted by the Tory Government. In December last year some minor modifications to the NH scheme revised the definition of new drugs, which are free from price control during their first three years, to exclude drugs which owe nothing to fresh research.

“A decision which shows how right those critics were who suggested that much of the so-called ‘research’ was not research at all.”

As well as directly assisting the big drug combines the Government have clamped down on the doctor and the individual trying to escape the pernicious and unnecessarily high cost of inscription charges.

“The first result of the levy of 1s. per item in 1956 was that doctors tried to counteract the price increase to the patient by prescribing larger quantities at a time; indeed the Hinchliffe Committee found that the new charge was one of the main causes of waste and extravagance in prescribing. The Government has tried to tackle this with seemingly more energy than they have tried to tackle drug firms; at the beginning of 1960 a circular was sent to doctors telling them to limit the quantities prescribed to a week’s supply except where larger quantities are clearly justified and steps have been taken to ‘carpet’ doctors who go in for ‘excessive’ prescribing. Thus the charges themselves have produced irresistible incentives to over-prescribing, and, their own bit of machinery for trying to curb it.”

Some argue that, while the Health Service charges will increase ill-health in the community, it might restore the Parliamentary Labour Party to fighting fitness. For here at last is an issue which they can get their teeth – or rather dentures – into.

Alas! this is extremely improbable. So far, all we have seen is a verbal battle, carried out strictly within the parliamentary framework. Whilst making Cabinet Ministers lose their sleep is highly commendable – their consciences should have done that long ago – it still doesn’t alter things one iota. The Bill still goes through.

The Gaitskellites, in any case, are themselves too compromised to lead any principled opposition. For it was Hughie, our lad, who first introduced prescription charges. How can we expect him to point out that had the Government pegged the arms bill at last year’s figure, almost all the money to be raised by Health charges could have come from that source? Being as much an apostle of the Cold War as Macmillan, Gaitskell has hamstrung himself. With, his own behaviour when Chancellor of the Exchequer still fresh in people’s minds he cannot even hint that to spend £1,655 million each year on ‘defence’, that gives us four minutes warning of annihilation, might be a trifle too expensive, or that the money could be better spent improving old age pensions, the Health Service and the other social services.

Similarly, the Gaitskellites, by their own behaviour, have made it impossible to conduct a vigorous opposition to the increased National Insurance contributions. They were largely responsible for foisting on to the Labour Party the National Superannuation Plan, a plan which was the first to moot the idea of differential contributions. Instead of arguing workers should have an adequate pension as a right, the Plan tied it to the size of the insurance contribution.

Instead of paying for old age out of taxation, where the super-taxpayer would fork out the most, the Plan wanted to be self-financing. Using the same principles as embodied in Labour’s official Plan, the Tory Government have, with a subtle twist, enacted, a vicious piece of legislation, with regressive taxation in the form, of a poll tax.

But of all the ways in which the Gaitskellites retard the struggle the most important is by perpetuating the myth of the clear division between political and industrial activity. As even the most simple-minded worker knows, although a shadow Cabinet Minister may not, the effect of the Tory Government’s increased charges is to lessen his wages, the amount he takes home. It is tantamount to a wage cut. And, as such, the only effective countermove is to greet these measures as one would a wage cut.

The Derbyshire Miners have pointed the way, by their suggestion of strike action. If the Labour Movement stood united, prepared to meet any attack on the Welfare State with, in the last resort, a general-strike, then MacMillan and his colleagues would lose more sleep over that than they ever will through all-night sittings.

All quotations and statistical information from Labour Research, March1961.

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