By Daniel Margrain

Ever since the Red-Tory government of Tony Blair stepped up the Thatcherite ethos of the British state as purchaser rather than direct provider of services, the outsourcing of these services has continued apace. This neoliberal ideology has, in turn, increased the proletarianization of not just traditional blue collar roles but white collar middle class professions as well.

The intensification of work and the insecurity of working life, short-term and part-time contracts, flexible shift patterns, mushrooming ranks of middle managers and supervisory staff, constant testing and assessments, punitive disciplinary codes, long working hours, short holidays and relentless ‘downsizing’ have materially and dramatically worsened the experience of going to work for many people.

Whereas forty years ago working as teacher or health professional was widely regarded as a stimulating and well paid job that offered a great deal of autonomy, they are now roles that provide a diminishing social and economic status in which the workers concerned have little or no control in their day to day activities.

As the experience of work has become increasingly harsh and coarse for the vast majority, life for the minority of the ruling class and upper ranks of the middle class has taken a completely different trajectory. Just as we entered the 21st century, government figures revealed that Britain’s biggest earners were enjoying their largest share of national income since the Thatcher years.

Within the space of about ten years, the multiple of chief executive pay to average pay for FTSE companies, has moved from 69 times, to 149 times. And that’s just a comparison with average pay, not those paid at the very bottom of the scale which also does not reflect company performance. The New Economics Foundation (NEF) has argued that unless the pay discrepancies are tackled, “by 2030 the UK will have returned to Victorian levels of inequality.”

With Victorian levels of inequality comes a Victorian paternalistic ideology that dominates the governing classes in which the ‘socially excluded’ must be helped to help themselves. Those who refuse to ‘modernise’ must be swept aside. But the maligned are not just the poorest but increasingly extend to enemies of ‘reform’ among the less well off sections of the middle classes.

These are the kinds of people who cannot rely wholly or mainly on private provision for such essentials as health care, pensions, education, care of the environment and transport. They too depend on the welfare state. The scientific work measurement practices of Taylorism traditionally associated with blue collar occupations are becoming a feature of white collar jobs too.

Although some heads of department and heads in schools, lecturers, middle ranking civil servants, managers in local councils and health professionals regret the passing of the public sector ethos even as they preside over its destruction, others like Dr Rob Galloway are beginning to make a political stand against the top down reorganization of the National Health Service (NHS) and the kinds of changes to working conditions that Taylorism implies.

This feeds into the attitudes of the wider public who recognize the connection between the deteriorating working conditions of health professionals, the downward spiral of the NHS in general (both of which are politically and ideologically driven) and their own working conditions and experiences.

The deliberate running down of the NHS is predicated on its eventual privatization related to the fact that 70 MPs have financial links to private healthcare firms. The carving open of the NHS for exploitation by private interests undermines the longstanding obligation of the UK government to provide universal health care free at the point of delivery. The creeping implementation of the former will ensure the ditching of the latter.

On March 20, 2012, MPs passed the Health and Social Care Bill despite the fact that it was not mentioned anywhere in the 2010 Conservative election manifesto, or that nearly every professional medical body fought against it. It was clear that the reason why the Tories were silent on the issue was because to highlight it would have been electoral suicide.

The coalition agreement between the Tories and the Lib Dems of May 2010 had promised: “We will stop the top-down reorganisation of the NHS.” That promise has been well and truly smashed. The NHS bill was opposed by 27 professional medical bodies, including the Royal College of GPs, the BMA and the Royal College of Nurses: that’s all but one of the relevant medical bodies.

Researcher Éoin Clarke has produced a map of England showing the areas affected so far by the NHS carve-up. One of the major corporate players is Virgin Care who won a £500 million contract to provide community services across Surrey and began running these services, as well as the county’s prison healthcare. Hundreds of donations from private healthcare firms to Tory coffers can be viewed here.

Moreover, the website Social Investigations has compiled an extensive list of the financial and vested interests of MPs and Lords in private healthcare. This list, says the site, “represents the dire state of our democracy”. Andrew Robertson, the blog’s founder observes that more than one in four Conservative peers – 62 out of the total of 216 – and many other members of the House of Lords “have a direct financial interest in the radical re-shaping of the NHS in England.” 

These unelected peers – with personal interests in insurance companies, private healthcare and private equity groups – were able to help push through a bill from which they will now profit. If they had been elected local councillors, such personal interests would have debarred them from voting. The Tory top down reorganization of the service while spun as a necessary precondition for its survival as a free at the point of delivery service, is in reality the precursor to its demise.

The Tories’ privatization objectives will be made smoother following the introduction of the proposed Transatlantic Trade and Investment Partnership (TTIP) agreement, the purpose of which, if finalized, will be to grant big business the right to sue governments which try to defend their citizens. It would allow a secret panel of corporate lawyers to overrule the will of parliament and destroy our legal protections.

The mechanism through which this is achieved is known as investor-state dispute settlement. It’s already being used in many parts of the world to kill regulations protecting people and the living planet. It could also be used to smash any attempt to re-regulate the banks, to renationalize the railways, to leave fossil fuels in the ground and to save the NHS from the kind of corporate control envisaged by the Tories.

Just as the government attempted to hide from the public their intentions for the NHS prior to the 2010 general election and then subsequently spin their way out of the reality faced by junior NHS doctors, they are also maintaining their silence over the proposed undemocratic TTIP agreement which will be used to further their privatization agenda.