Al-round Attack on Workers' Health

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Fisher's call is months overdue - as demonstrated by the closed for Strikes The Callaghan government's determination to make further cuts in public spending will have a devastating impact on a whole range of social services -so wide-reaching that simply the defence of individual sectors of the social services is now insufficient to defend the working class.

This is particularly clear in the case of the Health Service. The standard slogan on this is "Stop the Cuts - Defend the NHS" and at face value this is all that is needed.

But in fact, not only do the ragbag of 'lefts' rally verbally to support the NHS but so (also in words) do the august bodies, the British Medical and Dental Associations (BMA and BDA) -strange bedfellows indeed.

SLOGAN

Why is this slogan so attractive to such diverse groups? More important - what exactly do the Medical associations defend?

A historical perspective on the medical services might clarify some of the issues. The inception of the NHS was a victory won by the working class as part of the struggle for better living standards and these legitimate claims for a decent standard of life and health must be defended.

The NHS, however, was from the start a compromise designed by a Liberal, Beveridge, who claimed that better health would come with simply more medical treatment.

He assumed that a lot of money would need to be spent on getting us healthy and that then the cost of the NHS would fall.

This has obviously not happened. The medical profession has gone on devising more and more sophisticated and expensive types of treatment, many of dubious value to patients, but the NHS remains in real terms a repair service - a cover up.

HEALTHIER?

Are people healthier as a result of all this doctoring? If we examine the evidence it would. seem not!

The vast explosion in medical expenditure over the last 20 years has not resulted in an increase in life expectancy. In fact for the first time this century life expectancy for men has fallen over the last few years.

One of the major claims of modern medicine is that it controlled infectious diseases during this century - but there is evidence to show that these diseases were not actually controlled by medical intervention.

Tuberculosis (TB) for example, was the major cause of death in young adults but was already declining before the introduction of drug therapy. Scarlet fever, the most common cause of death in 1-5 year olds, was a reducing threat even before the use of antibiotics.

MEASURES

These and many other diseases were in fact more controlled by other public health measures such as better sanitation and education on hygiene and diet.

Improvements in living standards and less crowded housing condit ions also contributed to the reduc tion in the prevalence of these diseases.

But of course none of these *ems are commonly found on doctors prescription pads. Doctors ¡prefer the individualistic bourgeois approach.

They patch up individual porters hadies to make them healthy enough to go on producing profits - without attacking the underlying social causes of ill health.

Today the major killers are road accidents, heart disease, strokes, bronchitis and lung cancer. These too can be traced to lifestyle -unhealthy unsafe working conditions, stress, " industria? pollutants and poor diets. Real changes in health can only be achieved by workers winning control over their working and living conditions.

But of course the medical anc dental professions, almost exclusively middle class, do not push for these demands which challenge their class interest and the capitalist system. Instead they devise new, admittedly very clever, tricks, gadgets and drugs which cost more and more.

These things are often available at the doctors whim, varying from the exotic - heart transplants for the rich who eat, drink and smoke too much - to the mundane - drugs to numb the grinding pressure of Measured Day Work, night work. overtime, and the drudgery of housework.

They may stop the working class worrying about low wages and rotten housing, but do they really make you healthier?

The doctors and dentists, the tip of the million-strong workforce, clamour only for safeguards for their NHS where their right to have private patients is defended; where middle class patients get more than their fair share of attention from middle class doctors (A Report just published shows that nearly 50% тоге money is spent on every middle class patient than on one from the working class); where Doctor Kildares dispense or ration the miracles in jargon which only the specialist can understand (after all it is onlv vour hodv)

They are defending only the present hierarchical system. This has reached the point where 70% of the NHS budget was spent just on hospital services last year.

Of course we do need medical expertise and hospitals, but health is too important to be left in the divert the legitimate demands of the working class. Medicine alone cannot alter health significantly and this movement should not endorse this deception.

BEYOND

All workers, not just those involved in the NHS must develop a policy on health which goes beyond the present disease service.

Preventive actions must be taken inside and outside the NHS. This can only be done by controlling the the vested interests of capital which exploits workers' and their families" health and pollutes the environment Health in other words should not be defined as 'fit for work'. . The NHS must be defended but this Oxford's The call from Alan Fisher, General Secretary of the National Union of Public demonstrations to oppose the cuts is a sign of the pressure from NUPE members.

Only two days earlier the NUPE executive had announced only another lame round of propaganda against the cuts - printing 35,000 posters and 250,000 leatlets, holding meetings leading up to a lobby of Parliament.

While this would provide much-needed work to the printing industry it is certain that if not tied to a programme of sustained strike action the propaganda will not save a single job or threatened sector of the social services.

The new additional call is to mount a series of "short strikes and mass demonstrations" at critical times, along with workingto-rule; non-cooperation with management; unilateral re-arrangement of work schedules by members to offset the effects of the cuts; and refusal to accept additional work loads. Radcliffe Infirmary nUPE calls These forms of action, while important as a starting point of resistance, have the weakness that they all isolate action to the individual workplace - with no perspective of coordinated national action which can actually defeat the cuts Indeed Fisher specifically rules out. the fight for "extensive and prolonged strikes" , ensuring as best he can that his members actions are reduced to inconvenient irritations for axe-wielding social service managements.

We support every, even partial, action taken by workers to stop the cuts - but as a part of the fight for all-out national strike action.

Fisher has made only a gesture to head off the militancy of his members - NUPE branches must press for the real fight to be taken up. This must begin by NUPE repudiating the 42% TUC wage-cutting plan, and leading an offensive against Callaghan's programme of spending cuts and hand-outs to big búsiness.

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Employees, for "guerrilla tactics". , including strikes and