Tag: nicolai bukharin

How the establishment have engineered the NHS crisis

By Daniel Margrain​

A century or so ago, the Russian Marxist Nicolai Bukharin understood that the growth of international corporations and their close association with national states was symptomatic of how both aspects hollow out the parliamentary system. It is now widely recognized that the power of private lobbying money draws power upwards into the executive and non-elected parts of the state dominated by corporations. Consequently this leads to a reduction in democratic accountability and public transparency.

Internal markets, market testing, contracting out, privatization, encouraging private pensions and all the rest, are mechanisms that are intended to depoliticise the process of social provision, so making it easier to refuse it to those deemed not to deserve it on the one hand, and to clamp down on the workers in the welfare sector on the other. This ethos became established in the late 1980s under Margaret Thatcher during her third term in office.

Removing the foundations of the welfare state

Following the advice of the then chief executive of Sainsbury’s, Sir Roy Griffiths in 1987, the Thatcher government set about removing the foundations upon which the welfare state had been built. Camouflaged in the language of ‘public-private partnerships’, Tony Blair’s New Labour took this one stage further as a result of his envisaging the state as the purchaser rather than direct provider of services. Whole entities within the public sector have increasingly been outsourced, health and social care services privatized and competition and the business ethos introduced into public services in the form of managerialism and New Public Management.

Thus, within residential care, patients have been recast as customers. The aim is to ensure the domination of the market by a small number of very powerful multinational corporations whose primary concern is not the welfare of the residents in care homes which they own or patients in hospitals but with maximizing profits.

The carving up of the NHS opens up one of the worlds biggest investment opportunities. Indeed, its exploitation by private interests is proceeding at a pace. This is hardly surprising given the 2014 revelation that 70 MPs have financial links to private healthcare firms while hundreds of private healthcare corporations have donated to Tory coffers.

There exists a symbiotic relationship between privatization and what Noam Chomsky refers to as a policy strategy of “defunding”. In line with Chomsky’s notion, the aim over the last three decades has been to shrink the NHS and bring it to the point of collapse as the basis for then claiming the only solution is more privatization. In Orwellian terms, health under-funding is portrayed in the media as “unprecedented levels of overspending by hospitals and NHS trusts.” 

Health and Social Care Act

The 2012 Health and Social Care Act removes the duty on the Secretary of State for Health to provide a comprehensive health service and requires that up to 49 percent of services can be tendered out to “any qualified provider.” As early as 2013, between a quarter and a half of all community services were run by Virgin Care. Three years later, the corporation had won £700m worth of NHS and social service contracts.

The retreating by the state from the principle of universal health care provision, free at the point of delivery, can be pin-pointed to 1988 when Tory politician, Oliver Letwin, wrote a ‘blueprint’ document called ‘Britain’s Biggest Enterprise’ where he set out the stages governments’ would have to go through to achieve a US model of health care without the public noticing. The New Labour government under Tony Blair adopted Letwin’s principles. But prior to the 1997 General Election, Blair had to disguise the strategy by using dissembling language in order to get elected.

Once in power, Blair took several steps towards privatization. For example, he broke up the hospital network into foundation trusts which are essentially separate business entities. He also deliberately saddled hospitals with Private Finance Initiative (PFI) liabilities which involved the government borrowing £11 billion from private banks and financiers in order to justify the sale and breakdown of the NHS further down the line.

This culminated with the New Labour government introducing in 2009 what was termed the “unsustainable provider regime” which is a fake bankruptcy framework to justify closing hospitals. The £11 billion of PFI public money borrowed from the banks and injected into the NHS is, in the words of ‘Save Our NHS’ activist Dr Bob Gill, intended to “set up the infrastructure for the whole scale hand-over of our NHS to American corporations.”

Simon Stevens

Arguably, the most influential individual currently working in the NHS is former Labour councillor, Simon Stevens, chief executive of NHS England. After having served under the Blair government, Stevens went on to work for the US private health care provider, United Health, where he campaigned against Obama Care prior to campaigning for the Transatlantic Trade and Investment Partnership (TTIP) to be included within the UK health care remit. Those encouraged by the election of Jeremy Corbyn are still waiting to hear something from the shadow health team about this troubling development.

Controversially, Stevens introduced NHS England’s ‘Sustainability and Transformation Plans’ which form part of the annual HHS Planning Guidance. ‘Sustainability and transformation’ is Orwellian-speak for the move towards the total reorganization of the NHS predicated on more privatizations and cuts.

Two years ago this month, Dr Bob Gill attended a meeting to get some insight into what the position of the then Shadow Secretary of State for Health, Heidi Alexander, was in relation to the direction NHS England was moving in under Stevens. What he heard were narratives that fitted into the ongoing privatization agenda. According to Gill, Alexander expressed support for Simon Stevens, despite his appalling track record. There is no indication that neither the Labour leader, nor current Shadow Health minister, Jon Ashworth, intend to take Stevens to task.

This is extremely worrying given that Stevens appears to be less committed to ethics and patient care, and more concerned with perpetuating the notion that medicine is a profit-based ‘conveyor belt’ service. Could it be the case that Corbyn has underestimated the extent to which the corrupting influence of corporations and the power of lobbying money have hollowed out the parliamentary system as outlined by Bukharin a century ago?

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The Scorpion & the Frog

By Daniel Margrain

Image result for scorpion and the frog, pics

In the famous anti-capitalist fable, a scorpion, eager to get to the other side of a stream and unable to swim, pleads with a frog to allow him to ride on his back, across the stream.“Certainly not,” said the frog. “You would kill me.”

“Preposterous!,” replied the scorpion. “If I stung you, it would kill the both of us.”

Thus assured, the frog invited the scorpion to climb aboard, and halfway across, sure enough, the scorpion delivered the fatal sting.

“Now why did you do that,” said the frog, “you’ve killed us both.”

“I am a scorpion,” he replied, “this is what I do.”

A century ago, the Russian Nicolai Bukharin argued that the growth of international corporations and their close association with national states hollows-out parliaments. The power of private lobbying money draws power upwards into the executive and non-elected parts of the state dominated by corporations.

The growing concentration and internationalization of capital causes economic rivalries among firms to spill over national borders and to become geopolitical contests in which the combatants call on the support of their respective states. As professor Alex Callinicos put it:

“The… system embraces geopolitics as well as economics, and…the competitive processes….involve not merely the economic struggle for markets, but military and diplomatic rivalries among states.”

In refining Bukharin’s classical theory, Callinicos argues that capitalist imperialism is constituted by the intersection of economic and geopolitical competition which, if left unchallenged, will lead to the death of democracy and, ultimately, the capitalist system itself.

What corporations do is strive to maximize the returns on the investments of their shareholders. As Milton Friedman put it, “The social responsibility of business is to increase profits.” Unfortunately, if corporations are unconstrained by law or regulation, they can, by simply “doing what they do”, suck the life out of the economy that sustains them. Like cancer cells, lethal parasites, and the scorpion, unconstrained corporations can destroy their “hosts,” without which they cannot survive, much less flourish.

Society and the environment to the corporations and complicit actions of governments, is what the frog is to the scorpion. The CEOs of the giant corporations, together with governments, compete against each other, globally, for the limited resources of the planet. While the actions of the corporations are beneficial to their CEOs and shareholders, they have detrimental impacts for humanity and society as a whole.

Karl Marx

In his analysis of the capitalist system over a century-and-a half ago, Karl Marx in The Communist Manifesto articulated the processes that were to lead to the growth of the corporations: “The need of a constantly expanding market for its products chases the bourgeoisie over the whole surface of the globe. It must nestle everywhere, settle everywhere, establish connections everywhere” he said. Marx describes, powerfully, the workings, impulses and aggressive dynamism of an economic system in which the units of production increase in size and where their ownership becomes increasingly concentrated.

It takes an effort on the reader’s part to remember that the passage quoted above was written before the search for oil absorbed the Middle East transforming it into a contemporary battlefield, or that globalization began stamping its mark on a thousand different cultures. The accuracy of Marx’s analysis exemplified in the exponential growth of the corporation in the century following his death, is a testament to his magnificent intellectual vigor and groundbreaking dialectical insight.

Where Marx’s analysis has yet to be realized is in terms of his expectation that the working class would become increasingly radical and ultimately revolutionary. What was impossible for him to predict was the emergence of broadcast media and, by extension, the capacity by which it has been able to disorientate the masses by redirecting revolutionary impulses into identity politics, passivity and leisure pursuits.

Also Marx’s analysis has not been borne out in terms of the extent to which workers have been coerced into an acceptance of capitalism by their economic dependence on employment and the repression of revolutionary movements that sought to overthrow the capitalist system. These workers have also been incorporated through their organizations into the political structures of capitalist societies, and are seduced by the flood of inexpensive imported goods often created by sweated labour, that capitalist production has provided.

As bad as the suffering is for many who endure poverty within the countries of the advanced capitalist states today, it is not sufficient enough in scale – as was the case in the 1930s, for example – to threaten the capitalist economic system. But although its true to say Marx’s expectation that oppressed and exploited workers would overthrow capitalism has not been borne out by events, this does not invalidate his analysis. Marx wasn’t deterministic. He viewed the working class from a position of what he perceived they were potentially capable of becoming in the right socioeconomic circumstances.

Contradictions of capitalism

In The Communist Manifesto, Marx describes capitalism at its beginnings as a revolutionary system, because it creates, for the first time in human history, the potential for liberation from want. Through the development of industrial production, it became possible for every human being to be fed, clothed and housed. But as Marx recognized, even in his time, capitalism would never achieve this society of plenty for all, because of the way production is organized, with the means of production controlled by a tiny minority of society – the ruling class – more widely known today as “the one per cent”.

Marx described the ruling class as a “band of warring brothers” in constant competition with each other – giving the system a relentless drive to expand. As Marx wrote in Capital: “Fanatically bent on making value expand itself, he (the capitalist) ruthlessly forces the human race to produce for production’s sake.” Capitalism’s insatiable drive, embodied in the growth of the corporation, has brought us in the 21st century to the edge of climate chaos and environmental destruction. This is the systems Achilles heel.

Marx’s dialectical understanding of how the capitalist system works, therefore, has contemporary relevance both in terms of explaining the growth of the corporation and its competitive drive to extract resources within the context of an environmentally finite planet. Left to it’s own devices, in the absence of any revolutionary struggle, the corporation, like the scorpion, will ultimately end up destroying its host – in the case of the former, humanity and society. In such a scenario, the contradictions of the system couldn’t be more stark.

Prisoner’s Dilemma, altruism & game theory

It should be noted that the frog/scorpion fable that is a metaphor for the propensity of capitalism to destroy the conditions upon which human life depends, does not portray a Prisoner’s DilemmaIn international political theory, the Prisoner’s Dilemma is often used to demonstrate the coherence of strategic realism, which holds that in international relations, all states (regardless of their internal policies or professed ideology), will act in their rational self-interest given international anarchy. A classic example is an arms race like the Cold War and similar conflicts.

During the Cold War the opposing alliances of NATO and the Warsaw Pact both had the choice to arm or disarm. From each side’s point of view, disarming whilst their opponent continued to arm would have led to military inferiority and possible annihilation. Conversely, arming whilst their opponent disarmed would have led to superiority. If both sides chose to arm, neither could afford to attack the other, but at the high cost of developing and maintaining a nuclear arsenal. If both sides chose to disarm, war would be avoided and there would be no costs.

In the frog/scorpion fable, the former had absolutely nothing to gain by carrying the scorpion to safety. From the perspective of the cynical outsider, the frog’s altruism is foolish because he would have lived had he not assisted the scorpion. Similarly, society, the environment and, indeed, the planet have nothing to gain by being accommodating to the corporation. To some, altruistic acts are consistent with the adage, “No good deed goes unpunished.”

But of course this cynical perspective is predicated on their being no mutual trust between two parties. Because the frog believed the scorpion when he said it was irrational to kill him, any intention to find a way to deflect earlier than the scorpion, hadn’t formed a part of the frogs reasoning. The frog’s actions were based purely on good faith and the acceptance of basic norms of behaviour. A rational approach in which both parties were set to benefit was understood by the frog to be a given. The frog hadn’t accounted for the fact that the scorpion was compelled to act in the way he did.

Similarly, corporate capitalists are compelled to ‘externalize’ environmental costs in order to maximize profits. It is the corporation, like the scorpion, that pulls humanity down. This kind of reasoning applies to other related areas. In the field of international relations, for example, the concept of the Responsibility to Protect (R2P) doctrine of ‘pre-emptive retaliation’, expresses nothing other than a strategy based on defecting early and decisively, even though such an action is highly irrational.

The rationale appears to be that any attempts at cooperative actions are, at some point, doomed to be beset by the actions that pertain to that of the scorpion. This presupposes that all potential and/or perceived foes act in a highly irrational manner akin to the pathological actions of psychopaths that lead to unnecessary harmful deflections instead of mutual cooperation that is beneficial to the greater good.

Game theory, on the other hand, does not really take scorpions into account. It holds that people will defect because the future has no shadow and it is in their best interest to do so. Game theory fails as a tool when we are dealing with sociopathology or extreme denial.

The human dilemma is that all progress ultimately fails or at least slides back, that anything once proven must be proven again a myriad of times; that there is nothing so well established that a fundamentalist (of any religious or political stripe) cannot be found to deny it, and suffer the consequences, and then deny that he suffered the consequences.

Theresa May’s authoritarianism and her insistence on putting the short-term narrow self-interests of her party above the wider interests of the country, reflect a psychopathy, narcissism and sense of entitlement. She seems compelled to want to bring society down on its knees in order to satisfy both her own and her parties vanity. Her propensity to fiddle while Rome burns, is comparable to the actions of the scorpion. The British public can only hope she is put out of her misery before sinking the country entirely.

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