by Daphna Whitmore

Dunedin hospital’s substandard food has come in for some well deserved criticism. At a protest outside the hospital Andrew Tait of the International Socialist Organisation argued that the public hospital was socialism in action, and he went on to call Britain’s National Health Service socialist:

There’s a lot that is good about the public health system in New Zealand, (excluding the hospital meals) but socialist it is not. Nor could it be. While we have a relatively well-funded public health system it follows a capitalist model adopted by most western countries.

First World countries maintain a centralised government-regulated and funded health-care system at the insistence of the public. It is also out of pragmatism. A public health system is more cost effective than America’s relatively decentralised private-sector system where hundreds of millions of dollars go on health lobbying rather than providing services. New Zealand, like many other western countries, has a large private health sector too, and it is in the business of making money. But that doesn’t make the public sector socialist; even the best health system in a capitalist country will not be socialist.

For a start the public system does not meet the needs of the population. Funding is substantial but limited, and the health care system is constrained by these limits. That’s typical of public services in a capitalist society. It comes down to how the rationed resources will be allocated.

Andrew Tait implies that because hospitals are funded from taxation that makes it socialist. (“This is my hospital, I pay for it”). Just because something is funded from taxes doesn’t make it socialist, otherwise the prisons could be held up as bastions of socialism.

Public services in capitalist society are funded out of the exploitation of the working class. Much of that exploitation takes place in the Global South – that’s where over 80 percent of the world’s industrial workers live. NZ has only 10 percent of GDP from manufacturing, and enjoys relatively cheap goods being made in cheap-labour countries. From t-shirts, to whiteware, NZ manufacturing has, since the 1980s, moved offshore to where there is cheap labour and superprofits. Workers in the west have a relatively high standard of living thanks to the sweated labour of those workers. To get a detailed picture of this reality check out John Smith’s book Imperialism in the Twenty-First Century.

Marxists favour public health over private, but don’t confuse that with socialism. What a socialist society will look like isn’t something that can be forecast. The first wave of socialism has been and gone. The next wave will be in a different era.  Maybe it will resemble aspects of Cuba’s health system, where the health of the whole society is the focus, where preventive measures are given priority, where doctors are part of the community they live in and put medicine before personal wealth. Institutions reflect the societies they are created in, the public hospitals are no exception.

See also: Is Dunedin hospital red? How (not) to propagandise for socialism

Further reading: Capitalism, the state and the NZ left

  1. Thomas R says:

    I will never understand Socialists like Andrew here to appeal to what people are familiar with to try to argue that something is “socialist”. It doesn’t connect people more closely with socialism, it just confuses what “socialism” is. And I suspect Andrew Tait knows that, he’s well aware that the NHS isn’t a beacon socialist institution. So what is the point of this approach? Connect socialism with the interests of workers, by misleading workers about what socialists are for? Is it opportunism? If it is it seems misguided.

    • daphna says:

      Yes, it’s strange that desire to call publicly funded things socialist. Even the example he gives reveals lots of unsocialist aspects. For instance he talks about the CEO being paid $500k. Plus, anyone who has worked in a hospital knows they are hierarchical, bureaucratic, with wide pay differentials and lots of features that just wouldn’t be part of a hospital in a socialist society, you’d hope!

  2. Phil F says:

    I think it’s also strange that Andrew would say Cuba was capitalist and its hospitals would therefore be capitalist, but in NZ the hospitals are socialist?!

    The stuff about the NHS is incredible too. The NHA was about creating as cheaply as possible a health service which would ensure that labour-power was fit and well enough to be exploited because, after the depression, a chunk of the working class had very poor health – actually, the British ruling class freaked out in the Boer War because so many of their working class soldiers were not fit enough to effectively fight much fitter Afrikaner farmers. That was when the ruling class decided that simply leaving the health of the working class up to fate was not a wise decision.

    What Andrew says is very odd when one also takes into account the state-capitalist theory that ISO upholds. This theory *should* actually innoculate ISO against illusions in stuff owned and run by the capitalist state. Unfortunately it hasn’t. They supported the businesses owned by the state at the time of the partial sale of some of those businesses – even though they were actually the creation of Roger Douglas and the commodification programme of the fourth Labour government.

    I think Andrew may have watched Ken Loach’s romanticisation of the post-WW2 British Labour government. On the other hand, Andrew is a very smart and genuine guy – so he really should know better!

    Moreover, re the funding of the NHS – it didn’t come out of capitalist profits. Our friend Tony Norfield has written a few good little pieces on this. See Origins of the UK welfare state and Labour’s colonial policy

    The ‘tax the rich’ obsession is an odd one too. Parts of the IS tradition these days seem really addicted to it. In Ireland, the SWP’s electoral front, People Before Profit, and their friends from the SP’s electoral front (the Anti-Austerity Alliance) want to “make corporations pay their fair share of tax”, whatever a “fair share” might be.

    The notion of a whole heap of expropriation has been eclipsed by the notion of a bit more taxation.

    Why tell workers things that are not Marxism and are not true? The working class can’t be tricked into socialism!

    Phil F

    • Thomas R says:

      They’re under the mistaken notion that a nationalist populism of “Tax the Rich” will rally workers to their cause. Funnily enough – it generally doesn’t. When we look at the Left in this country, ISO being the largest Marxist organisation – even then the basis of their unity seems confused, the politics are unclear, and they seem to have a distinct difference between “behind closed doors” politics, and “in front of a crowd” politics.

      To me, this constitutes lying to the class as far as I can tell. And for what? ISO is the largest, maybe 50 members I suspect (less active, though perhaps 50 dues-paying is a close approximation). That’s not nothing, but considering the looseness of the politics it does seem to me that the kind of ‘broad’ and vague articulations of “tax the rich” etc. are actually building a broad grouping at all.

      This is how I think of a lot of the Left today – stuck in a kind of ultimate limbo – we have “broad Party” politics with “narrow Party” numbers. The political unity, if it exists, is relatively opaque and probably only really exists with the senior members of ISO with the younger recruits mostly just talking about the various ‘ideas’ while knowing very little about the organisation in which they participate.