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Health Service NHS doesn’t just need defending – it needs developing for the future

THE scale of the NHS 70th anniversary demonstrations over the weekend shows the huge level of support among the British people for what is truly a national institution, and their determination to protect it from the ravages of Tory cuts and marketisation. 

The principle of a National Health Service, providing healthcare as a form of collective solidarity from which no-one is turned away on the basis of what they can afford, is one which trade unions, campaigners and even those who consider themselves to be “apolitical” have shown themselves willing to defend, on the streets and at the ballot boxes.

Defence of our NHS, and reversing the funding cuts and partial privatisation implemented by Tory and Tory-Liberal governments, will be a crucial part of Labour’s electoral strategy at the next election. 

However, as Labour Party leader Jeremy Corbyn argued in this paper at the weekend, defence of the NHS alone is not enough. 
Aneurin Bevan, founder of the NHS, envisaged that it would be progressively developed by successive governments, as public endeavour proved to be both more efficient and more egalitarian than private profit-making.

A future Labour government must not only commit to reversing the attacks on the NHS but to further developing its capacity to provide for all the healthcare needs of the people of Britain.

This vision will involve further developing both the national co-ordination and the local responsiveness of NHS structures, ensuring that decision-making operates according to a national plan based on need, while incorporating an element of local democratic control, so that those working at the chalk-face and citizens in each local area, have control over their NHS and its responsiveness to local needs.

This could replace the current system of quasi-market mechanisms which introduce perverse incentives into the system, and the thorough lack of democratic accountability at a local level, to staff or to people who use the service.

But the NHS is not the only area where this approach of national co-ordination combined with local democratic accountability is desperately necessary. Following the reforms of the Blair era and the Tory-led governments which followed it, our education system has been left in a weakened and fragmented state. 

While schools are subject to an “accountability” system which has massively increased pointless workload and driven teachers out of the classroom in droves, there seems little genuine accountability to local parents, students or to any kind of national plan for education.

Multi-academy companies and national academy chains, run on business lines, are free to pay their CEOs extortionate salaries while a lack of strategic planning and democratic oversight means such companies can collapse overnight or neglect schools to the point that they collapse. 

At the heart of this, our children are being failed while the usual suspects make a tidy profit off the backs of working people.
That is why Labour’s plans for a national education service are so important. This must be a truly national service, guided by a national plan but developed at local level, through strong forms of local democratic accountability. 

Schools, colleges and other education institutions, including universities, must once again be part of a national strategy to deliver the liberatory potential for the people of Britain, but must draw in the expertise of those that work in them and be truly accountable to the communities that they serve.

A government that could deliver such a national education service would both be advancing the current needs of our society and building the foundations on which a similar approach could be extended much more broadly across the economy under socialism.


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