Labour and the Health Charges
“The principle of the free, health service has been breached, and I dread to think how much that breach might be widened in future years”, said the President of the Board of Trade when he resigned from the Labour government in April 1951. He was objecting to ‘imposing charges for National Health teeth and spectacles to raise money to spend on arms. His name was Harold Wilson.
Wilson was right. The new Tory government, elected in October of the same year announced within six months that it was to bring in prescription charges. The Labour Party was up in arms playing on its image as builder and defender of the welfare state. In Parliament they did all they could to oppose the measure. Former Minister of Health Hilary Marquand declared on 1 May 1952:
On behalf of my right hon. and hon. Friends I say when we are returned to power we shall take steps, as soon as Parliamentary opportunity permits, to bring all these charges— charges for drugs, medicines, appliances, dentures, dental treatment and spectacles—to an end.
This pledge was written into the 1955 election manifesto, Forward with Labour:
In order to restore a free Health Service, we shall abolish all charges, including those on teeth, spectacles and prescriptions.
In 1959 the manifesto, Britain Belongs to You, repeated:
We shall also restore the free Health Service by abolishing all charges, starting with the prescription charge.
When in 1961 the Tories increased the prescription charge to 2/- Labour MPs again opposed the measure. Anthony Greenwood, now a Cabinet Minister, told Labour’s 1963 Conference, on behalf of the Executive:
I repeat . . . the pledge we have given you before this, that we shall remove the existing charges in the National Health Service.
Again, for the 1964 election The New Britain read:
The most serious attack on the Health Service made by Conservative Ministers has been the increasing burden of prescription charges imposed by them on those least able to pay. These charges will be abolished. Labour emphatically rejects recent proposals to introduce new charges for General Practitioner services; our aim is to restore as rapidly as possible a completely free Health Service.
This time they were lucky. Wilson became Prime Minister and Kenneth Robinson Minister of Health. Sure enough, in a few months Labour redeemed part of its pledge. On 17 December Robinson announced the ending of prescription charges “which, since 1952, have created a financial barrier between the patient and the treatment he needs”. He went on to state that in time they would also redeem the other part of their pledge:
There will remain charges for dental treatment and appliances and those for spectacles. It is our aim to abolish these charges also.
He did not say that for teeth and spectacles the financial barrier had existed since Gaitskell erected it in 1951.
In 1966, with Time For Decision, Labour faced the electorate, with the declaration that there were some principles they would not jettison “whatever the pressures”. One of those principles was that “even in times of economic crisis those in need should be helped by the state”. They brought forward their abolition of prescription charges as proof.
Less than two years later this principle is jettisoned, Wilson announced the restoration of prescription charges for many people at a rate of 2/6 an item. Far from abolishing the dental treatment charges, as Robinson promised, Labour raises them by 10/-. Charges for teeth and spectacles remain. After Wilson’s announcement a Labour MP, Laurie Pavitt, confronted him with Marquand’s pledge of May 1952. The official Hansard (daily) for 16 January quotes Wilson:
The statement by Mr. Marquand on February 1, 1952, was a pledge to remove the charges which had been introduced in 1951, and it is only fair to say to my hon. Friend that such has been the problem that we have faced that we have not ourselves removed those Charges which were made on teeth and spectacles in 1951. I do not see how my hon. Friend can say that today’s announcement represents a fatal breach of principle.
This won’t do. If Marquand pledged Labour in 1952 to abolish the charges they themselves imposed in 1951, and Labour has failed to do this, then, by any standard, this is a breach of principle.
Wilson obviously found Pavitt’s reminder highly embarrassing. The parliamentary report of The Times of 17 January exposes Wilson’s confusion. According to this report, what Wilson said was:
The statement made by Mr. Marquand on May 1, 1952, was a pledge to restore the charges introduced in 1951. We have not restored those charges for teeth and spectacles, so I do not see how he can say that what I have announced reflects a breach in the principle
Another reporter, recorded in the Financial Times of the same date, confirms that Wilson said “we have not restored these charges on teeth and spectacles”. This, in his embarrassment, Wilson mistakenly has Marquand pledging Labour to restore the charges! But his remark about there being no breach of principle only makes sense if he really meant to say that Labour had not restored teeth and spectacle charges. Perhaps Wilson thought that Labour had ended these charges along with those for prescriptions in 1965. In any event, he was dodging the issue. Marquand pledged Labour to abolish all health charges and bringing back those on prescriptions is a breach of that pledge. Wilson seems to have had Hansard doctored to cover up his confusion, but despite this, his illogical argument comes out. Putting into Hansard something different from what was said is not uncommon, but it is nice to know that even Wilson has a guilty conscience over some of the pledges capitalism has forced him to break.
Aneurin Bevan called the National Health Service “pure Socialism” as it took buying and selling out of the treatment of the sick. True, Socialism does mean the ending of buying and selling, but Socialism is a social system that must replace capitalism; you cannot have bits of Socialism within capitalist society. In Socialism class ownership, the barrier to the community’s free use of the means of wealth production, will have been removed. All will have free access to what they need. But the NHS is not even free in the sense that Bevan meant. Part of the insurance stamp that is, deducted from wages and salaries is technically a “contribution” to the service. Wilson’s announcement that this deduction is to go up by 6d. will remind people of this.
So-called free services under capitalism are only so in appearance. Capitalism is based on the exclusion of the great majority of society from the ownership of the means of production. Consequently, they must find an employer to live; they must enter the labour market to sell their mental and physical energies for a wage. The value of human labour-power is fixed in the same way as that of other commodities: by the amount of socially necessary labour needed to produce and reproduce it. Thus, wages never amount to much more than enough to keep a man (and his family) fit to work at his particular job. If the working class has to pay little or nothing for medical treatment or housing, then their cost of living is subsidised and employers do not have to pay so high a wage. Employers do not have to make allowance for what their workers might have to spend on their health or housing. Since “free services” are paid out of taxation and taxation, in the end, falls only on those who own property, such schemes are really a way of spreading the cost of maintaining the working class in a fit state to work, over the capitalist class as a whole. The NHS has been correctly dubbed the back-to-work service. Except perhaps for minor ailments, the rich do not use it; they prefer to pay doctors and nursing homes for a better service. The aim of the NHS is to patch up workers as cheaply and quickly as possible. And it cannot even do even this minimum task adequately.
It is not because Socialists think highly of the NHS that we have produced Labour’s past pledges on health charges. We do not think that Labour has betrayed us. They have, however, betrayed the millions of workers who voted Labour in the past four general elections. If you were amongst these millions, it is your duty to find out why Labour has betrayed you. Was it because Labour ministers are incompetent? Did they deliberately mislead you? Or, is it just that politics is corrupt? Labour leaders may or may not be incompetent, cynical or insincere. It matters little. Labour has been forced to break its word not because of the personal failings of its leaders, but because of the nature of the social system which they imagined they could control. Labour has always claimed that it could impose human and social priorities on capitalism. The NHS has always been given as a shining example. So it is poetic justice that Labour should be the agent of capitalism’s profit priority getting its own back.
Capitalism cannot be made to work in the interests of the whole community. It is a class system that runs on profits and so any government that tries to improve social conditions at the expense of profits, within the framework of capitalism, is bound to fail. The economic forces of capitalism will in the end dictate priorities to the government, as Labour now knows. Since they got power in 1964 capitalism has not given them a chance and, of course, it never will, despite the pathetic pleas of Wilson and Jenkins for another two years to put things right.
We are here fighting Labour on its own ground. It is they who made defence of the welfare state one of their principles, and used it as a means to win support. Socialists do not accept that the welfare state was the exclusive work of the Labour Party. Welfare services are a must at a certain stage of capitalist development. If free medicines and free prescriptions are something to do with Socialism, how explain that the Health Insurance Act of 1911 provided this for workers insured under it? The then Liberal government has no socialist pretensions. Quite the contrary, it was as anti-working class as the present Labour government. The last recorded case of striking workers being killed by troops occurred under Asquith.
The imposition of health charges is a further Labour attack on the living standards of the working class. No doubt workers will to resist by stepping up the trade union struggle. But this is only a defensive action. We advise workers to recognise that capitalism cannot work for them, whether run by Labour, Tories or Liberals: and to withdraw their support from these and other capitalist parties and join and support a genuine Socialist Party dedicated to replacing capitalism with Socialism.
Adam Buick