Dunedin hospital: no, it's not socialism in action

Dunedin hospital: no, it’s not socialism in action

Admin note: the reason we have run two articles on this issue is not because we are trying to doubly blast ISO but because, due to a misunderstanding via email, two Redline contributors, unbeknownst to each other, wrote pieces on the subject.  We hope ISO will take this as a comradely critique.

by Don Franks

At last month’s Stop the Slop rally, protesting outsourcing of Dunedin Hospital food services, Andrew Tait said for the International Socialists:

“This is our hospital and this is about way more than food, Carole Heatley (Hospital CEO).

“This is about philosophy and this is about socialism vs capitalism. This hospital is socialism in action right here. It is the biggest employer in Dunedin. And this, practical socialism, is love, love for your neighbour in the most simple way and in the most real way.”

Socialism is seldom advocated at New Zealand protests, so it’s a good thing that Andrew put it on the agenda.

It’s not so good that he included false advertising.

Hospitals in New Zealand are not enclaves of socialism; they are creations of workers controlled by the capitalist state. Like all such creations they are affected by the ups and downs of class struggle, but its those at the top who call the shots when it counts.

New Zealand hospitals arrived in the 1880s as part and parcel of European colonisation. From the outset, some free care was offered to the destitute, but those who could pay for treatment were required to do so. Since their foundation, New Zealand hospitals have attracted the idea of free public health care, as well as the idea that the user should pay, a clash of ideas which continues to this day.

In the late 1980s the fourth Labour government held office and Helen Clark held the Health portfolio for part of that time. She sacked the elected health boards and closed down around twenty hospitals.

The fourth National government then came into office and continued Labour’s privatisation and commodification programme. They comprehensively overhauled the public health system. The system of democratically-elected Area Health Boards was abolished and replaced with Crown Health Enterprises (CHEs), run according to the prevailing new public management ethos that required the CHEs to make a profit. Thirty-eight public hospitals were closed down during the term of that National government.

National was eventually voted out, but it remained business as usual.

These various hospital closures were very unpopular with the public, particularly because of their bad effect on small communities. But despite several energetic mass protests, the cuts remained, because New Zealand was not a socialist country and its workers had no decisive power over the fate of the hospitals.

Inside New Zealand hospitals, workers don’t rule, big money does.

A 2012 report by the Herald’s Martin Johnson pointed out: “Some Auckland surgeons are being paid more than $6,000 for a day’s work at a public hospital.

“The Waitemata District Health Board scheme has divided doctors over concerns that the surgeons involved can earn nearly four times as much as general physicians and psychiatrists on their collective agreement’s top step.”

Socialism recognizes the need to reward skill and experience. It also recognizes the value of essential ‘unskilled’ work and seeks pay equity.

As of March 2016, the  average pay for a hospital cleaner is $15.36 per hour, or $122.88 for a day’s work.

No socialism worthy of the name would tolerate those levels of pay differential. Neither would it tolerate the inflated salaries of today’s hospital administrators.

In a socialist system, free quality public health care would be universal. This is not the case in New Zealand. The hospital system treats citizens or permanent residents free of charge.

However, costly or difficult operations often require long waiting list delays. Because of this, a secondary market of health insurance schemes exists which fund operations and treatments for their members privately.

Southern Cross Health is the largest of these at about 60% of the health insurance market and covering almost a quarter of all New Zealanders in 2007, even operating its own chain of  private, pay-as-you-go hospitals.

I agree with Andrew Tait that socialism is about love for your neighbour. There is little love lost inside the halls of today’s hospitals.

Hospital’s training accreditation because of bullying and harassment is further evidence that the corporatisation of health management has failed, according to Democrats for Social Credit Party health spokesman David Tranter.

He notes, “Added to Dunedin Hospital’s loss of its intensive care training facility status and orthopaedic training accreditation it is time to stop playing political games with health and face the fact that the supplanting of the practical expertise of health professionals by empire-building, career ladder-climbing bureaucrats and the irrelevant theories of money-grubbing ‘consultants’ has had disastrous consequences for New Zealand’s public health system which was previously the envy of many far more wealthy countries.
Annette King’s crocodile tears over what she calls ‘The culture of bullying’ in the health system conveniently overlooks the fact that while health management corporatisation may have been kicked off by National in the early 1990s, Mrs. King’s setting up of DHB boards in 2001 – allegedly to make health issues more ‘open and accountable’ – simply added a meaningless veneer of democracy while in fact establishing the total power of secretive bureaucrats over health professionals.”

Well, that’s one bloke’s political opinion, but Tranter’s claim resonates with the constant complaints from hospital staff of bullying and harassment. (Google subject search shows 435,000 entries.)

Ever since hospitals were first begun in this country there have been countless heroic efforts to make them serve the interests of the people. Capitalism has continually thwarted that goal and we need a socialist solution.

Pretending capitalist hospitals are “socialism in action” the way they are now doesn’t help.

See also: Sloppy food and politics

Further reading: Capitalism, the state and the NZ left

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