The reality of the Good State

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Some readers of this blog might think that I’m labouring the question of nationalisation and state ownership and its identification with socialism. While I believe it is a question of fundamental political importance its practical significance has been vividly illustrated in the last few days.

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In Britain the report from the fifth investigation into Stafford hospital has been delivered, prompting David Cameron to say that he was”truly sorry” for what had happened, which was “not just wrong, it was truly dreadful.” Previous investigations had already established in harrowing detail the abuse and neglect that took place from 2005 to 2008.

Between 400 and 1,200 more deaths took place than would have been expected between these years, although it is stated that it is impossible to say whether all of these patients would have survived had they received better treatment. Receptionists were left to decide which patients to treat, inexperienced doctors were put in charge of critically ill patients and nurses were not trained how to use vital equipment.

The National Health Service, so beloved of the British nation that it featured in the opening ceremony of the Olympics, has been damned from top to bottom.

Trust management ignored patients’ complaints while local GPs and MPs also failed to speak up, the inquiry said.

The local primary care trust and regional health authority were too quick to trust the hospital’s management and national regulators were not challenging enough.

Meanwhile, the Royal College of Nursing was highlighted for not doing enough to support its members who were trying to raise concerns.

The Department of Health was also criticised for being too “remote” and embarking on “counterproductive” reorganisations.

The findings of the report cannot be regarded as an aberration as it follows repeated damning judgments of care provided in Britain, especially care of the elderly, and news that five other hospitals are to be investigated following Stafford.

Yet the NHS is the crown jewels of the social democratic state.

The inquiry’s head said that patients “were failed by a system which ignored the warning signs and put corporate self-interest and cost control ahead of patients and their safety.”

Many on the left speak and act as if the only problem with the health service is a lack of cash but this is much less than the full story and money will not deal with what has been referred to as the cultural changes that are required.

Working class people in Britain and Ireland are all too aware of the shortcomings of the health services. While those in Ireland may wish for their own NHS those in the UK know its limitations and going to hospital is more and more regarded as something you really don’t want to do unless you have to.

Those with elderly relatives in care are all too aware of the possibility of mistreatment.

Only yesterday Channel 4 news reported on the death of an elderly person left with no domiciliary care for 9 days when the service she was receiving was closed by immigration police, who had raided the office of the private organisation providing the care. When the care provided by this organisation stopped the council never picked up on the elderly woman who had no relatives. She went without her medication and died hungry, thirsty and alone.

Two days ago the illegal charging by the Irish State of people in long-term care again became news. As early as 1976 the State, through the Department of Health, knew its charges were illegal. In 2005 the Government attempted to make them legal retrospectively although this was stopped by the Supreme Court.

The Government knew exactly what it was doing. The Minister of Health Mary Harney said that “more than 300,000 people were charged illegally during 28 years. This was entirely wrong. They were old, they were poor, they suffered from mental illness, they had intellectual disabilities, they were physically disabled. As vulnerable people, they were especially entitled to the protection of the law and to legal clarity about their situation.”

And yesterday the report on the Magdalene Laundries was released, which revealed some of the State’s role in the incarceration of thousands of women in institutions run by Catholic religious orders, compelled to work for nothing and stigmatised as ‘fallen women.’ “A very Irish form of slavery” as the Sinn Fein TD Mary Lou McDonald put it. Over one quarter of the women were put there by the State. The last laundry only closed in 1996.

The State again attempted to cover up and lie over its role.

In 2009 the Minister of Education Batt O’Keefe said that “the Magdalene laundries were privately owned and operated establishments which did not come within the responsibility of the State. The State did not refer individuals to the Magdalene laundries nor was it complicit in referring individuals to them.” Not true.

In 2011 Sean Aylward, secretary general of the Department of Justice, speaking in Geneva at the UN Committee Against Torture said “the vast majority of women who went to these institutions went there voluntarily or, if they were minors, with the consent of their parents or guardians.” He knew this because he had met some of these women.

Yet not one of the five women he had met had entered the laundries voluntarily or with the consent of their parents or guardians. Over eighty three per cent who entered the laundries were put there.

What all these examples demonstrate is that the capitalist state cannot be relied upon to provide services that working people, especially the most vulnerable, require. Some, like the Magdalene laundries, are now easy to denounce but none are models of socialism. Far from uncritically defending these services socialists must educate and agitate for a workers’ alternative to how they are currently organised and managed. The very last thing we want to do is proclaim these services as exemplars of socialism and the state that runs them as the font of this socialism.

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