The socialist rule is “from each according to their ability, to each according to their needs”.
The capitalist rule is “from each according to what the hours and effort they’re forced to put in, to get a living; to each according to their wealth”.
Under capitalism, the system where the economy is run for private profit, it is possible to win socialist-type bridgeheads.
The NHS is one of them. You get health care according to your needs, instead of being denied it if you’re badly-off and getting lots if you’re rich.
Since 2010 the Tories (and the Lib-Dems, to 2015) have systematically undermined the NHS.
As people live longer, and can be treated successfully for chronic diseases from which we would earlier have died quickly, NHS budgets need to rise faster than inflation.
Since 2009/10, NHS budgets have been almost frozen, rising by only 1.5% each year. That’s far below the average over the 70 years since the NHS was set up, 3.7% per year.
The Health Campaigns Together group has summed up the results since 2010:
• 1,400% increase in hospital “trolley waits” in A&E
• 372-fold increase in 12 hour waits for a hospital bed since 2010
• 8,779 fewer frontline “general and acute” beds now than 2010
• 22% reduction in mental health beds since 2010
• 4.52 million patients in England now on waiting lists for treatment
• NHS pay has been largely frozen, leading to big staff shortages.
Also, since a law that the Tories and Lib-Dems passed in 2012, the NHS has been pushed to contract out work to private firms. In 2018/19 NHS commissioners spent £9.2 billion on services delivered by the private-profit firms.
Mostly that’s been small contracts. One whole hospital, Hinchingbrooke Hospital, was franchised to a private-profit firm.
After a few years, the firm handed back the hospital to the NHS because it had been put into “special measures” for faults in its running, and they weren’t making enough money from it.
But the push to contract-out continues. And with it an increase in managerial costs.
That increase was already underway, with the NHS “internal market”. The number of NHS managers in England rose 37 per cent between 1997 and 2010. Lots of time and energy is spent on box-ticking for performance measures; endless staff and patient surveys; and contracting-out.
The NHS is also burdened with huge debt from the “private finance” schemes used instead of straightforward public funding, mainly by the Blair government, to build new facilities.
Labour has pledged to restore NHS funding, to reverse privatisation in the NHS, and to repeal the 2012 law which pushes the NHS towards contracting-out to private firms.
The left within Labour pushes for the full-scale restoration of the NHS as a public service under democratic control, without “internal markets”.