Let us not mince words. The crisis engulfing the NHS is neither a political nor economic issue, it is an issue of class.
What we are witnessing is a concerted and planned campaign oby the Tories and their supporters to destroy one the last redoubts of social solidarity in the country, and the last repository of collectivist ideas, making it anathema to a class for whom there is no such thing as society, only a vast conglomeration of individual self-interest, wherein everything and anything of value comes with a price tag attached. The NHS stands in direct contravention to this ideological worldview, which is why it must be destroyed in service to entrenching the values of individualism and completing the process of social atomisation begun by Thatcher and continued by successive governments since.
The crucial point to bear in mind is that the economic crash of 2007/08, leading directly to the election of the Tory-led coalition government in 2010, was their economic and political 9/11 - in other words a pretext for unleashing, under the rubric of austerity, a final assault on those national institutions that provide the social bonds upon which working class people and communities depend. The Tories, aided by their right wing media acolytes, succeeded in turning what was an economic crisis caused by private greed into a crisis of public spending, managing to persuade enough of us that savage cuts were not only economically necessary but also morally just. The result has been millions of poor and powerless people being blamed and punished for the misdeeds of the rich and powerful.
Another factor is the role that the NHS, along with those of the welfare state in sum, has played in retaining a class identity with the potential to deliver an earth shattering blow to the hegemony of Tory ideas and nostrums that continue to predominate in Britain, and have done for over a generation.
Nye Bevan, the driving force behind the creation of the NHS after the Second World War, understood this more than anyone. When he famously opined that "No amount of cajolery can eradicate from my heart a deep burning hatred for the Tory Party ... So far as I am concerned they are lower than vermin," Bevan gave voice to the suffering and despair endured by previous generations of working class communities at the hands of a Tory Party that exists to wage war against them in the interests of those for whom wealth is the only true measure of human worth.
These are wretched human beings who couldn't give a damn about people dying on trolleys in hospitals that have been sytematically starved of investment and resources. In this they are conditioning the public to accept that the NHS is no longer sustainable and must be replaced with a 21st century alternative - i.e. a system of private healthcare provision under which healthcare is no longer a right of citizenship but a privilege of individual wealth. As for those who cannot afford to pay, they are human detritus and should be viewed and treated accordingly.
Allyson Pollack, Professor of Public Health Research and Policy at Queen Mary University in London, has been among the most vocal in warning of the creeping privatisation of the NHS over the past few years. In a 2015 article, she wrote:
The NHS had solid foundations. Its system was based on fairness of funding through income taxes and designed to maximise redistribution of resources and services.
An efficient public bureaucracy ensured that administration costs were no more than 5 per cent of the total budget and health expenditure didn't rise much above 4 per cent of gross domestic product.
However, since 1990, under Conservative and Labour administrations, market incrementalism has been a hallmark of NHS legislation with the introduction of the purchaser-provider split. The Labour government in 1997 accelerated market-driven measures giving trusts new powers to generate private income and enter into exorbitant private finance initiative (PFI) debt obligations and commercial contracts for clinical care.
The main political parties are wrangling over public expenditure but have said nothing about the high costs of marketised healthcare. We have little time left. By 2020 the NHS as we know it will have disappeared, not with a bang but with a whimper. It is in terminal decline.
The argument that we can no longer afford the fund the NHS is bunkum. At the time it was originally founded the country was on its knees economically after the ravages of the Second World War, emerging with an astronomical national debt of 200 percent of GDP. In 2017 there is more than enough money to fund the NHS. What is lacking is not money but political will. In this, as in all things, the issue is rooted in ideology not economics, which is merely how ideologically driven political decisions manifest.
If the formation of the NHS by Nye Bevan and his colleagues was revolutionary, what we are living through now is the counterrevolution, unleashed by the forces of political reaction that are as strong in Britain now as the left was after the Second World War. Austerity, Brexit, attacks on the poor, the disabled, benefit claimants, migrants, and the NHS - taken together they describe a class war in which one side is throwing all the punches and the other taking all the blows.
"The NHS will last as long as there are folk left with faith to fight for it," Bevan said in 1948. Seventy years later responsibility for taking on this fight devolves to us. If we do not fight, or do not fight with sufficient passion and fire to defend the one institution that allows us to boast that we are living in a civilised society, then we shall rightly stand disgraced in the estimation of future generations.