Wednesday, 16 September 2015

The possibility of anarchist healthcare

John Desmond
LES May asks eight questions in his response to my post. I hope that he doesn’t mind if I confine myself to answering only seven questions that are answerable in this blog. The question that isn’t answerable is whether a model for the provision of healthcare that is based upon local organizations would provide better healthcare than the NHS model.  Unfortunately, this question isn’t answerable because it implies too many variables. In short, it is too complex. That said; I am genuinely grateful to Les May for raising his questions because answering them has required me to test robustly my ideas.  
The first question is: ‘What advantages did the Tredegar Medical Aid Society have for the people of Tredegar?’  I think that the observation by Paddy French (1999) that I quoted in my previous post affords an answer to this question:  
‘In five decades more and more of Tredegar’s medical services are provided further and further away from the town while control becomes ever more remote.’  
The second, third, fourth and fifth questions are: 
2. ‘Will [the solution of the Tredegar Medical Aid Society] “scale”?’ 
3. ‘does this solution still work when the problem gets larger?’
4. ‘What might it look like here?’
5. ‘What would a network look like?’
Answers to these questions can be drawn from many publications, the large majority of which, predictably enough, appear to relate to Spanish revolutionary anarchism. Two books by a contemporary observer, Gaston Leval (1990, originally 1952: 122-127) and (1975: 268-273), the respected French anarcho-syndicalist, are a useful starting point. In his books, Leval was able to describe only in very broad terms the provision of healthcare for Catalonia, the population for which was then 2.5 million. However, fortunately, Xavier Ferrandis (2014) describes in detail the provision of healthcare in Valencia during the first months of the civil war in his lengthy article (which is available online and translatable with Google Translate). 

The sixth and seventh questions are:
6. ‘Would an organisation like TMAS be able to adapt to our era of “Big Medicine”?’ 
7. ‘Would a network of TMAS be able to provide [scans and knee replacements]?’
Two references about these questions might be helpful. First, Leval (1975) mentioned that ‘the cantonal Comités on the federal principle, had ramifications in Barcelona which had greater technical facilities and specialised establishments, [than the nine large sectors of the region]’ (op. cit.: 269). Second, Iain McKay (2012: 918-920) examines in Volume Two of his encyclopedic ‘An Anarchist FAQ’ the issue about whether technological advance should be seen as anti-anarchistic. By ‘technological advance’, he includes that which relates to medical technology. His examination of the issue elaborates his answer ‘Not necessarily’.  
Of course, my answers would be insufficient without an acknowledgement of the need for a critical mass of people who can be confidently relied upon to organize the provision of anarchist healthcare. Unfortunately, in Britain not only does such a critical mass not exist but also there is no indication of its likely emergence. (So much for the supposed existence of a movement.)  However, the absence of a critical mass need not induce paralyzing pessimism.  Instead, it can afford an opportunity to reflect upon why this negative situation exists, which will require a demanding examination of the past.     

John Desmond

Ferrandis, Xavier García. 2014. Anarcosindicalismo y sanidad en la retaguardia y en el Frente. Los casos de Valencia y de la Columna de Hierro en la guerra civil Española (1936-1937). Asclepius. 66 (2): PO63, doi:
French, Paddy. 1999. Raiders of the Lost Ark. Planet The Welsh Internationalist. April/May (134). 35-39.
Leval, Gaston. 1990. The socialisation of health services. In Chapter 7 of ‘The anarchist collectives’. Edited by Sam Dolgoff. Montréal: Black Rose Books.
Leval, Gaston. 1975. Collectives in the Spanish Revolution. Translated from the French by Vernon Richards. London: Freedom Press. 
McKay, Iain. 2012. An Anarchist FAQ: Volume Two. Edinburgh: AK Press.

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