Matt tweets sentiments today I’m sure we all can sympathise with:
People still miss the point about the NHS. The point is: should people make a profit from healthcare? Should life and health be a market? No
But whilst sympathy is easy, agreement is not so simple.
Since its creation, and via their hierarchically differentiated salaries, GPs, consultants, surgeons, nurses, cleaners, ambulance drivers, managers and receptionists have all made a profit from the NHS. Many have chosen their roles as vocations: none could have worked for nothing.
And do we really think those who have supplied blood plasma, oxygen, sterile products of all sorts, medicines, bandages, syringes, hospital furniture, light bulbs, signs, telephone and communications infrastructures, sandwiches, food in general and a whole host of other products and services were not, in reality, motivated by the incentive of the market in order to make as fast a buck as possible for their shareholders?
Back to Matt’s tweet, then: “Should people make a profit from healthcare?” he asks. The answer is: “Of course.” And before this awful Coalition government, and maybe before New Labour, we didn’t mind when they did.
So what’s changed?
I think it has something to do with what I alluded to the other day. It has become all too self-evident that government is no longer the caped crusader and protector between naked capitalism and the rest of society. Whilst we trusted that the game between governors and corporate capitalists involved some kind of give and take on both sides, we were prepared to contemplate situations and structures that perhaps were a little unwise and risk-ridden on our part. But that silent social contract between a society which created infrastructures on the one hand and a large corporate base which generated employment on the other has been splintering for more or less a decade now. And when that corporate base showed that – despite all the favours society had paid it – it was manifestly unable any more to fulfil its unwritten social responsibilities, we began to suspect – and understand far more clearly – that we had been much more than a little unwise in our even-handedness; much more than a little risk-ridden in the way we had chosen to keep our eyes wide shut.
As long as key public services remain free at point-of-use, we should not mind that private companies tender competitively for public provision. But when corporations accustomed to engendering and working inside monopolistic markets want to do the same to our public sector, we not only gain nothing from the changeover in terms of efficiency, we also lose a tremendous amount in democratic accountability.
We could easily argue, with the evidence on the table, that the private sector is named thus precisely because it generally attempts to keep its sometimes horrific failings to itself. After all, the light of public day is not generally cast on the boardrooms which take their cold decisions – protected as they are by their legions of lawyerly advice.
Let us, then, understand one point: the truly free market could help our healthcare a thousandfold. But the market proposed by Cameron & Co is not the free market in question.
And the market proposed is not a problem because it allows people to profit from healthcare. We understand that a nurse or GP should want to build a life around their career.
No. In truth, the market proposed is actually a problem because it allows non-human corporations to profit to the ever-increasing exclusion of flesh-and-blood people.
That’s what’s changed.
And that’s why we now find it easy to sympathise with tweets like Matt’s.
The problem isn’t the profit motive, per se.
But, rather, what’s invading our social and emotional landscapes – and taking us over.
It’s not that we shouldn’t make a profit out of our wellbeing but, rather, that – in the future and at our expense - only others will be able to.