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Wealth Before Health

Anthony McIntyre • 26/6/2002

Who these days recalls Connolly’s biting comment on those who would whoop it up for the Liberty of Ireland as they steadfastly continued to punish its people? In a week in which Sinn Fein leaders can dosh out the drivel that Wolfe Tone would have approved the performance of the Irish soccer team no mention was made of whether Connolly would approve the manner in which the cutting edge of British state health policy has grinded its way into the well-being of many Irish people still subject to the administration of British rule.

If, as we are often told there is no alternative, then the absence of one has curbed republicanism so severely that whether she likes it or not Bairbre de Brun now serves as Britain’s Health Minister in the North of Ireland and implements the economic logic of British capitalism against the well-being of Irish citizens. Britain, in pursuit of laissez faire economics, and in its majesty, permits de Brun to don the executioner’s hood and wield the axe.

Having been enabled by the ‘possession’ of state power to do just that the Sinn Fein Health Minister has set about ‘empowering’ the community by slashing at essential facilities. The number of hospitals with acute services are to be reduced from 15 to 9. Although in a bout of de Brunian spin the public is being asked to believe that ‘my proposals are not about reducing acute services’.

According to the Irish News the decision to deny acute services to the Omagh hospital has ‘bitterly divided the two Sinn Fein MPs whose constituencies lie in counties Fermanagh and Tyrone.’ But in a party not known for the willingness of its members to speak out of line, this ‘divide’ may alternatively and plausibly be viewed as an attempt to be all things to all people - a party of votes telling the voters what they want to hear. That they need to hear the exact opposite in Tyrone from what they are being told in Fermanagh is easily overcome by having the Party’s respective MPs speak from different sides of their mouths, while overall the party leadership will speak from both sides at once. Furthermore, would the thought police not be at the doors of these people if their ‘dissent’ was not approved from above?

De Brun gets it rough. All the seepage from Stormont, offline media and some within Sinn Fein is that unlike the performance of her colleague Martin McGuinness, her own as Minister of Health suffers from dangerously impaired efficiency. But this may result more from the advice and services she gets rather than reflect on her individual capabilities.

Defending her attack on health facilities she has suggested that fuelled by an injection of £1.2 billion over the next ten years her approach would ‘deliver a world-class service’. But one need only look back to May to find out how her party colleague Robbie MacGabhann rubbished those pursuing a form of PFI yet who have the audacity to tell us they were offering a world class health service. So just who does Bairbre de Brun think she is fooling? World health service? - Ireland, North and South, is the only part of the European Union without a specialist air ambulance medical service. There is nothing world class about the British health service, not even in Britain. Sweden, Germany and France put it to shame. Why would the British consider allowing us in Ireland to have one? Why would the British commit themselves to giving us a world class health service? And if they were to does it not impact on anyone that they must intend sticking around for quite a bit? Why after all provide a world health service in Fermanagh and a Third World one in Birmingham when in 2016, if Sinn Fein are to be believed, Fermanagh will be part of a united Ireland and Birmingham voters may still bring down governments who under fund public services?

The North of Ireland does not have a decent health service because unlike some other capitalistic economies the particular form of British capitalism does not permit one. And under the present application of the Private Finance Initiative the strategic objective is very much one of killing off social provision. The wealthiest in British society are taking back the ground they felt forced to cede under the welfare state. They are not concerned with my health or yours.

Dr. P. J. Devereaux of McMaster University in Ontario studied, for the purpose of comparative analysis, 26,000 for-profit and non-profit hospitals in the US, which between them treated 38 million patients over a period of 13 years. His findings are published in the May 28th issue of the Canadian Medical Association Journal. He concluded that if Canada were to opt for its own version of PFI there could be an increase of 2,200 in the annual death rate which would be equivalent to the number of Canadians who die from motor vehicle accidents and colon cancer each year. Dr Devereaux, not surprisingly, observed, ‘clearly, those are things that no one would knowingly introduce into society.’ In the case of the first PFI hospitals to open in Cumberland, North Durham and Strathclyde, these were beset by a series of disasters resulting from cost cutting. This allows George Monbiot, who has written extensively on privatisation, to argue that while private managers ‘are extremely efficient at making money, they are rather less efficient at running public services.’

One effect in British society which, thanks to the Good Friday Agreement, we remain an integral part of, is that government consultants estimate that every £200 million of public money used to finance Private Finance Initiative will result in 1000 fewer doctors and nurses.

Yet are we to believe that the Sinn Fein minister is doing all of this unknowingly? A health minister who does not know what is happening or what she is doing can stake little claim to the position. Does she not know that in the Republic, Sinn Fein, in its own words 'is proposing a ten-year strategy to convert the private health insurance system into a single tier public system.' Is the anti-partitionist party now offering the people of Ireland a two tier health service clearly separated by partition?

Joe Byrne of the SDLP has denounced de Brun as the minister for inequality but it is more accurate to see her as the minister implementing British fiscal policy to our health care service - a fiscal policy that is increasingly conservative and profit oriented. George Monbiot claims that the present Labour Government is implementing policies the Conservatives ‘would scarcely have dared to suggest’.

What is the point in being a technocrat at the disposal of the British Government? With no room to do anything other than implement British economic policy can people be faulted for viewing the Stormont government as a mere puppet administration? Why do the bidding of the British on these matters? Why not lead a strategy of ethical resistance to them rather than swing the axe on their behalf?

The eternal optimists assure us it is alright, that the strategy is actually revolutionary, that the ingenuity of it lies in concealing revolutionary practice beneath tactical manoeuvrings. Furthermore, we are advised to take succour from the supposed presence of Marxists in the Republican Movement. Finding one is like meeting a pregnant man. Whatever reservations we may have about the rhetorical strategies of the Socialist Workers’ Party could we envisage any of their Marxists slashing and chopping into our hospitals in the interests of British capitalism?

Only a few years ago the present British Health Minister, Alan Milburn, stated ‘it's PFI or bust’. Why did we roll over and accept it? PFI has busted radical opposition. Why not admit the absolute failure of present republican strategy predicated as it is on the Thatcherite arrogance of ‘There Is No Alternative,‘ and from that point on encourage rather than suppress the search for alternatives which are base driven rather than leadership led?






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Let us free Ireland, says the patriot who won't touch socialism. Let us all join together and crush the brutal Saxon. Let us all join together, says he, all classes and creeds. And, says the town worker, after we have crushed the Saxon and freed Ireland, what will we do? Oh, then you can go back to your slums, same as before.
Whoop it up for Liberty!
- James Connolly

Index: Current Articles

28 June 2002


Other Articles From This Issue:


The Pity of War

Billy Mitchell


Dispute At Dunboyne School

Wealth Before Health

Anthony McIntyre

Belfast: Political Sectarianism and the Left
Davy Carlin


23 June 2002


It Is But Institutionalised Collusion

Davy Carlin


Snarling Down Below
Eoghan O’Suillabhain

Reunion vs Six-County Independence

Paul A. Fitzsimmons

Eire Nua
Sean O Lubaigh



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