Private profit takes a bite

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city areas, "the healthiest The best way to judge the part of Britain appears to be health of any society is by the the southern belt below a death rate (the number of line drawn across the country deaths per thousand of the from the Wash to the Bristol population). In most of the Channel. " (p.57).

Western world the death rate For once women get the has been falling for well over best deal - men are twice as 100 years, and that is the case likely to die at any age. Workwhether you're a miner or the ing class women, though, have that means is that more people Chairman of the NCB. What and make less use of post- and more unwanted pregnancies are living longer lives. ante-natal care.

But the death rate for The Report goes on in lawyers, accountants, manag- horrendous detail to show how ing directors, etc., has been working class adults are much falling much faster than the more likely to suffer from rate for skilled and unskilled serious illnesses such as workers.

In real terms this means that and also how they get less out cancer, heart and lung disease the child of an unskilled of the NHS to cope with disworker is three times more ease: "'Higher income groups ukely to die before its first know how to make better use birthday than the child of a of the Service: they tend to "ELTE| B MARLEY CANC poverty as the cause of this inequality.

Death rates in Europe have reached their lowest point in the history of human society, and this is mainly due to an increase in standards of living and improvements in public hygiene. The separation of drinking water supplies from sewage systems has probably done a lot more than the BCG vaccination could ever do to eliminate disease.

But this doesn't explain the big inequalities that still exist. Part of the answer is that standards of living may have gone up, but we still have boring, low-paid jobs and increasing unemployment, both of which cause stress which has a major effect on health.

gu nulgo TURE NO * TS millions in the first year and more in the following years.

Apart from big increases in the level of state benefits, it proposed free school meals, full nursery provision, sheltered housing for the disabled, screening programmes for cancer and heart disease, accident prevention programmes, and an anti-smoking campaign.

A special action programme would take in the ten areas with the highest death rate.

Within the NHS budget emphasis would move from cure to prevention.

Patrick Jenkins' response to the Black Report was, predictably, that this level of spending was "quite unrealistic" • He was not interested in making life longer and healthier for the working class - why should he when capitalism has a massive reservoir of unemployed labour to draw on, picking and choosing the healthiest specimens and dumping the rest into the dustbin of the welfare state?

The proposals contained in the Black Report are detailed and wide-ranging. They touch on areas such as mental illness, physical and mental handicap and so on which I have not dealt with because they deserve separate discussion. Hopefully we can begin that discussion in Socialist Organiser and broaden it to take in areas such as prevention versus cure, alternative medicine, subjects which have appeared briefly in the Science Column.

Our response as socialists to Tory and Labour spending cuts in the NHS has been far too negative. If we are to convince people that the NHS is worth defending we need to go beyond what we already have and fight for what we need -i socialist health service.

DISTRICT Health Authorities are obliged to submit plans for privatising cleaning, catering and laundry services by the end of the month.

Implementing those plans will take time. But the government has instructed health authorities that they must hive off these services if the private tenders are cheaper than having the work done by NHS staff.

Private contractors will offer cheaper work - by imposing worse pay and conditions on their employees.

In Medway Health Authority, for example, Exclusive Cleaning has won contracts for four hospitals already.

They will employ different staff for weekends, to avoid paying higher rates for weekend work. They'll give four weeks' sick pay instead of six months under the NHS. Holidays will be shorter. It is not clear whether the union will be recognised. The hours in which to do the job will be cut by 53%!

Such methods will also mean a worse service for patients.

Cheltenham Health District did a survey on its privatised laundry services. 84% of pillows were rejected as inadequately cleaned, and 73% of sheets!

As a next stage, the government proposes to contract out specialised operations to private hospitals.

But there are already many ways in which private profit loots the NHS.

Consultants use NHS facilities for private practice. The private medical insurance schemes have had some difficulties lately, but their general trend is certainly upwards. By 1983, 65% of managers British companies were getting private medical insurance as a fringe benefit with their jobs, as against 44% in 1978.

Drug companies make about £300 million profit each yuar from the NHS.

And the principle of • free health service is also undercut by increasing health charges. The Tories have increased prescription charges from 20p to £1.40 and in October 1982 they introduced charges for 'overseas' patients.

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Socialist Organiser no. 167 February 2: 195: P=s-