State Control or Social Initiatives?
by Brian Bamford
LES MAY engaging with Carl Faulkner's comment and considering the founding of the NHS, writes:'As my Libertarian friends endlessly remind me there were other schemes in operation even before the NHS was a gleam in anyone’s eye.
'Bevan
would have been familiar with the Tredegar
Medical Aid Society
as
he was the local MP. In
return for contributions from its members
it provided health care free at the point of use. (my
emphasis)
'This
model of funding was rejected by Bevan.'
Les clearly admires the Attlee government of 1945, which formed the first Labour majority government and in particular he favours its Keynesian approach to economic management aimed to maintain full employment, a mixed economy and a greatly enlarged system of social services provided by the state. This amounts to a supreme faith in what in the 20th century amounted to Fabian managerialism. It is a view that after the Second World War prevailed in which it was considered that as George Orwell observed in 1946: 'For quite fifty years past the general drift has almost certainly been towards oligarchy'* (James Burnham & the Managerial Revolution [1946]).
At that time after the war it must have seemed that big government was onto a winner, and Orwell then felt able to write: 'The ever increasing concentration of industrial and financial power; the diminishing importance of the individual capitalist or shareholder, and the growth of the "managerial" class of scientists, technicians, and bureaucrats; the weakness of the proletariat against the centralized state; the increasing helplessness of small countries against big ones; the decay of representative institutions and the importance of one-party regimes...'
The problem with this approach is that it represented a shift from the capitalist and the dividend grabbers to a 'new boss class' of the technical elite functionaries blessed with cushy jobs and all on a generous state stipend. As Orwell observed above it became 'the weakness of the proletariat against the centralized state'. There was still the spirit of entitlement of the elite and the dependency of the working-class.
The difficulty is still that this analysis is too mechanical as well as managerial and top-down. It lacks an evolutionary grasp of how the concept of social welfare entered and developed inside our culture.
Colin Ward described how the social concepts permeated sociologically: 'Anarchists are frequently told that their antipathy to the state is historically outmoded, since a main function of the modern state is the provision of social welfare. They respond by stressing that social welfare in Britain did not originate from government, nor from the post-war National Insurance laws, nor with the the initiation of the National Health Service in 1948.' **
Rather as Mr Ward argues: 'It evolved from the vast network of friendly societies and mutual aid organizations that sprung up through working-class self-help in the 19th century.'
This is what is implied by Carl Faulkner in his perceptive comment on this Blog: 'It could be argued that is was predictable that the NHS was established by a Labour government due to it being elected in 1945 - when plans for what was to be called the NHS were well advanced but lost in the mists of time.'
Indeed it was 'lost in the midst of time', as the anarchist Mr Ward explains:
'The founding father of the NHS was the then member of parliament for Tredegar in South Wales, Aneurin Bevan, the Labour Government's Minister of Health. His constituency was the home of the Tredegar Medical Aid Society, founded in1870 and surviving until 1995.'
It gave medical care for the local employed workers, who were mostly miners and steelworkers, but also (unlike the pre-1948 National Health Insurance) for the needs of dependents, children, the old, the non-employed: everyone living in the district.
A retired miner told Peter Hennessey that when Bevan initiated the National Health Service, 'We thought he was turning the country into one big Tredegar.' Alas, it was not to be, and as Mr. Ward observes in his brief book: 'In practice the Health Service has been in a state of continuous reorganization ever since its foundation, but has never submitted to a local and federalized approach to medical care.'
More seriously Ward argues 'ever since full employment and the system of PAYE (automatic deduction of tax as a duty of employers) was introduced during the Second World War, the central government's Treasury has creamed off the cash that once supported local initiatives.'
Furthermore, in keeping with the spirit of local spontaneity Colin Ward suggests:
'If the pattern of local self-taxation on the Tredegar model had become the general pattern for health provision, this permanent daily need would not have become the plaything of central government financial policy.'
There is a price to pay for the pattern of State funding medical care applied by Nye Bevan and approved by Les May, and it now being played out as different governments enact various outsourcing schemes promote what Ward called 'the virtues of profit-making private enterprise.'
What follows from this debate is what will be the consequences of the pandemic for the psychology of the general population? Will people look to the state for salvation in fear of a repeat performance of another potential pandemic threat or second wave? If so, I suspect it will represent a reactionary response to the politics of the pandemic.
* Oligarchy, government by the few, especially despotic power exercised by a small and privileged group for corrupt or selfish purposes. Oligarchies in which members of the ruling group are wealthy or exercise their power through their wealth are known as plutocracies.
** 'ANARCHISM: A Very Short Introduction' by Colin Ward (Oxford) 2004.
Les clearly admires the Attlee government of 1945, which formed the first Labour majority government and in particular he favours its Keynesian approach to economic management aimed to maintain full employment, a mixed economy and a greatly enlarged system of social services provided by the state. This amounts to a supreme faith in what in the 20th century amounted to Fabian managerialism. It is a view that after the Second World War prevailed in which it was considered that as George Orwell observed in 1946: 'For quite fifty years past the general drift has almost certainly been towards oligarchy'* (James Burnham & the Managerial Revolution [1946]).
At that time after the war it must have seemed that big government was onto a winner, and Orwell then felt able to write: 'The ever increasing concentration of industrial and financial power; the diminishing importance of the individual capitalist or shareholder, and the growth of the "managerial" class of scientists, technicians, and bureaucrats; the weakness of the proletariat against the centralized state; the increasing helplessness of small countries against big ones; the decay of representative institutions and the importance of one-party regimes...'
The problem with this approach is that it represented a shift from the capitalist and the dividend grabbers to a 'new boss class' of the technical elite functionaries blessed with cushy jobs and all on a generous state stipend. As Orwell observed above it became 'the weakness of the proletariat against the centralized state'. There was still the spirit of entitlement of the elite and the dependency of the working-class.
The difficulty is still that this analysis is too mechanical as well as managerial and top-down. It lacks an evolutionary grasp of how the concept of social welfare entered and developed inside our culture.
Colin Ward described how the social concepts permeated sociologically: 'Anarchists are frequently told that their antipathy to the state is historically outmoded, since a main function of the modern state is the provision of social welfare. They respond by stressing that social welfare in Britain did not originate from government, nor from the post-war National Insurance laws, nor with the the initiation of the National Health Service in 1948.' **
Rather as Mr Ward argues: 'It evolved from the vast network of friendly societies and mutual aid organizations that sprung up through working-class self-help in the 19th century.'
This is what is implied by Carl Faulkner in his perceptive comment on this Blog: 'It could be argued that is was predictable that the NHS was established by a Labour government due to it being elected in 1945 - when plans for what was to be called the NHS were well advanced but lost in the mists of time.'
Indeed it was 'lost in the midst of time', as the anarchist Mr Ward explains:
'The founding father of the NHS was the then member of parliament for Tredegar in South Wales, Aneurin Bevan, the Labour Government's Minister of Health. His constituency was the home of the Tredegar Medical Aid Society, founded in1870 and surviving until 1995.'
It gave medical care for the local employed workers, who were mostly miners and steelworkers, but also (unlike the pre-1948 National Health Insurance) for the needs of dependents, children, the old, the non-employed: everyone living in the district.
A retired miner told Peter Hennessey that when Bevan initiated the National Health Service, 'We thought he was turning the country into one big Tredegar.' Alas, it was not to be, and as Mr. Ward observes in his brief book: 'In practice the Health Service has been in a state of continuous reorganization ever since its foundation, but has never submitted to a local and federalized approach to medical care.'
More seriously Ward argues 'ever since full employment and the system of PAYE (automatic deduction of tax as a duty of employers) was introduced during the Second World War, the central government's Treasury has creamed off the cash that once supported local initiatives.'
Furthermore, in keeping with the spirit of local spontaneity Colin Ward suggests:
'If the pattern of local self-taxation on the Tredegar model had become the general pattern for health provision, this permanent daily need would not have become the plaything of central government financial policy.'
There is a price to pay for the pattern of State funding medical care applied by Nye Bevan and approved by Les May, and it now being played out as different governments enact various outsourcing schemes promote what Ward called 'the virtues of profit-making private enterprise.'
What follows from this debate is what will be the consequences of the pandemic for the psychology of the general population? Will people look to the state for salvation in fear of a repeat performance of another potential pandemic threat or second wave? If so, I suspect it will represent a reactionary response to the politics of the pandemic.
* Oligarchy, government by the few, especially despotic power exercised by a small and privileged group for corrupt or selfish purposes. Oligarchies in which members of the ruling group are wealthy or exercise their power through their wealth are known as plutocracies.
** 'ANARCHISM: A Very Short Introduction' by Colin Ward (Oxford) 2004.
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