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Where the NHS is going: they’ll give you a diagnosis – but no treatment
Yesterday I followed the advice of my local hospital’s Audiology Department (they fix hearing aid problems) and tried to book an appointment at the GP surgery to get my ears syringed. I wear two hearing aids. This increases the likelihood of a build-up of wax in the ears. Recently, this has made it difficult for me to use the phone and by yesterday it was impossible for me to understand the recorded voice on my local surgery’s answering system telling me to press this, that or some other key for this, that or some other service that I also, unfortunately, wouldn’t be able to decipher. But no problem: I went into the medical centre to make an appointment. They found me a slot in three weeks’ time. But the receptionist said it will be “for assessment only”. She repeated this as she booked the appointment — “it’s for assessment only, you understand, not treatment. We’ll be able to tell you where you can get treatment if it’s necessary.” In other words, at most surgeries, ear syringing is no longer available on the NHS.
I knew this already as it happens. Audiology had told me it would cost between £50 and £70. So I suppose I’ll get to choose which private outfit I fancy to do it. I suddenly had this memory of a friend of mine in the 1980s who did a pretty good impersonation of Margaret Thatcher haughtily explaining her vision for us all in the new world she was creating: “Choice — choice — we must have choice!”
So I’ve got an appointment in three weeks. Audiology said there might be an infection developing in one ear. If they do find one, I have to assume they’ll still be treating infections on the NHS then, although three weeks is a long time in politics, as the Labour prime minister Harold Wilson once told us (he didn’t actually — he said one week). Whether I’ll submit to private syringing is another matter. Perhaps it’ll be done in the little corner shop down the road that used to be a newsagent’s. Thatcher again: “We want to encourage small businesses.” It probably won’t be done there though. It’s more likely to be done by some big outfit, like a bank. Or Marks & Spencer’s. “Can I have Tesco’s Finest?”, I’ll ask.
No ifs, no buts – Labour must support free movement
At a jamboree of the G7 interior ministers this week, the French minister, Christophe Castaner, took his chance to attack the non-governmental organisations (NGOs) saving migrants from their sinking vessels in the Mediterranean. The NGOs, said M. Castaner, were “complicit” with the people traffickers.[1] This was in line with his president’s view of the matter: last summer Macron declared that the NGOs were “playing the game of the smugglers”. In saying what he did at the end of this week’s conference, Castaner joined forces with his far-right Italian counterpart, Matteo Salvini, who had also said, during the conference, that there was “collusion” between the NGOs and the traffickers. Salvini’s contribution seemed to be a reassertion of the Italian far right’s earlier campaign against the rescue ships, calling them “the taxis of the sea”.
There is no mention here of our own home secretary, Savid Javid, who has just been forced to apologise for the Home Office’s treatment of the Windrush generation, an affair which also resulted in death for some of its victims. Javid said it was all a terrible mistake, and that it will never happen again. He then popped back to the office where his officials are continuing to steal, and keep, the UK passports of up to 6,000 British-Iraqi citizens on the spurious ground of finding discrepancies in their dates of birth. The Home Office knows full well that many Iraqi Kurds (and most of these people are Kurdish) are uncertain about their dates of birth. Historically, records were not kept in the same way as in the West. The Home Office knows this, yet, cruelly, it persists. The hostile environment continues.
But back to Christophe and Matteo. The “let them drown” brigade in Europe began its campaign some time ago. The UK was complicit.[2] The far right is getting its act together across the world. Will we continue to be complicit? Nothing suggests that the Tory Party will suddenly become migrant-friendly. Its leadership after May will become more right-wing, its home secretary (Javid or otherwise) will become more migrant-hostile.
That’s not where the Labour Party wants to go. Its 2017 election manifesto made this clear:
Labour will not scapegoat migrants nor blame them for economic failures … We will not discriminate between people of different races or creeds. We will end indefinite detentions … Labour will protect those already working here, whatever their ethnicity … Labour values the economic and social contributions of immigrants. Both public and private sector employers depend on immigrants. We will not denigrate those workers. We value their contributions, including their tax contributions … Labour will restore the rights of migrant domestic workers, and end this form of modern slavery … Refugees are not migrants. They have been forced from their homes, by war, famine or other disasters. Unlike the Tories, we will uphold the proud British tradition of honouring the spirit of international law and our moral obligations by taking our fair share of refugees. The current arrangements for housing and dispersing refugees are not fit for purpose. They are not fair to refugees or to our communities. We will review these arrangements.[3]
But if Labour doesn’t want to go down the same road as the Tories, it now has to change its stance on freedom of movement – for its current position, also set out in the manifesto, undermines these commitments. “Freedom of movement will end”, says the manifesto, “when we leave the European Union.” The reason for this was suggested by Emily Thornberry in an interview, apparently citing voters’ concerns about immigration:
As for the single market, you know and I know that it’s very difficult for us to remain in the single market as it currently is because nobody can pretend that the referendum didn’t include a debate on immigration and we want to have fair rules and managed migration when it comes to immigration so we need to negotiate something.[4]
But we are on dangerous ground here. Conceding to voters’ concerns and fears is no substitute for facing them honestly and allaying them. So what are the concerns that voters have about immigration? One of them is the idea that immigrants take jobs from the native population and depress wages. Liberal leader Vince Cable has summarised some of the arguments on this:
At the heart of the politics of immigration is the belief, repeated by Theresa May as a fact, that immigrants, especially unskilled immigrants, depress wages. At first sight the argument seems plausible – and undeniably there is low-wage competition in some places. But there is no evidence that this is a general problem. [In 2013, during the coalition government] I commissioned a range of reviews and studies to establish the facts. They showed that the impact on wages was very small (and only in recession conditions). By and large, immigrants were doing jobs that British people didn’t want to do (or highly skilled jobs that helped to generate work for others). This research was inconvenient to the Home Office, which vetoed the publication of its results.[5]
In 2016, Paul Johnson of the Institute for Fiscal Studies produced a report and asked:
But aren’t all these foreigners taking our jobs? That’s true in the Premier League. The more foreign footballers there are playing for the top clubs, the fewer English players there will be. There’s only room for 11 players in a starting XI.
Yet there is not a fixed number of jobs in the economy. There are seven million more people in work in the UK than there were 40 years ago. Astonishingly, there are nearly two million more than immediately before the recession in 2008. Employment rates among the UK-born are close to record levels. More people means more jobs, not more unemployment. There is absolutely no evidence that higher levels of immigration have increased unemployment among native-born Brits.[6]
On wage levels he wrote:
Evidence on wage impacts is a bit less conclusive. While many studies do not find any evidence of immigration depressing wages, a recent Bank of England paper suggests that the impact of migration on UK-born lower-skilled workers might have been to reduce wages by 1 per cent over a period of eight years. Thus it may have played a part, though only a minor one, in recent experience of low or negative pay growth.[7]
In fact, instead of seeing the fears and concerns of people as a reason for declaring an end to free movement, Thornberry could have argued those points and others in order to allay them and embrace free movement. Labour’s failure to do this had its impact on the Labour manifesto itself. First, the Tory White Paper on immigration post-Brexit included an income threshold of £30,000 p.a. which migrants would have to meet before they could have the right to work.[8] This would keep the poor out, and because of the way poverty is structured it would discriminate by race and ethnicity too. Labour’s response was:
We will replace income thresholds with a prohibition on recourse to public funds. New rules will be equally informed by negotiations with the EU and other partners, including the Commonwealth.[9]
This suggests that the “no recourse to public funds” rule would apply to EU and Commonwealth citizens alike, and it has the same effect as the Tory proposal: it discriminates against the poor and in the end it also discriminates by race and ethnicity.
Secondly, Tory policy matches this exclusion of the poor with “a new, skills-based immigration system”. Such a system “will mean we can reduce the number of people coming to this country, as we promised”.[10] On this, Labour’s manifesto (p. 28) says a Labour government would work
with businesses, trade unions, devolved governments and others to identify specific labour and skill shortages. Working together we will institute a new system which is based on our economic needs, balancing controls and existing entitlements.
This sounds no different to a Tory skills-based system.
The failure to defend immigration also led to the fiasco of Labour’s front bench at first whipping to abstain on the government’s Immigration and Social Security Bill a few weeks ago. There were many reasons to vote against the Bill. As David Lammy MP described it:
It will force our NHS and other vital services into an even deeper staffing crisis. There are already 41,000 nursing vacancies in England. The salary threshold still under consideration would exclude many skilled medical staff, including nurses, paramedics and midwives.
It continues the inhumane practice of indefinite detention. We remain the only European country which does not set a time limit for detained migrants. This sullies our international reputation and undermines complaints we make about human rights abuses abroad.
The 1.2 million [UK citizens in Europe] will inevitably see their own rights eroded too. Overnight they could lose their ability to live and work freely in Europe. Young people who overwhelmingly want the chance to live across the continent are having their horizons permanently narrowed.[11]
But Diane Abbott argued at the time:
The Labour [P]arty is clear that when Britain leaves the single market, freedom of movement ends, and we set this out in our 2017 manifesto. I am a slavish devotee of that magnificent document: so on that basis, the frontbench of the Labour [P]arty will not be opposing this bill this evening.[12]
In the event, the Labour front bench changed its mind and whipped MPs to vote against the Bill, rather than abstain, after protests by several MPs and an immediate on-line and email protest from Labour activists and others. But it took the front bench 90 minutes to do this, after MPs had originally been told they could go home as their votes were not required. Many of them did. Only 178 out of 256 Labour MPs were present to vote.[13]
Labour, under its present leadership, and with its expanded membership, is better than this. At a time when far-right forces are getting their act together, Labour should do so too, giving not an inch of ground to racism and xenophobia, whether it comes from politicians in France, Italy, Brazil, or the United States, or whether it is home-grown. In the Brexit arguments we should be fully in favour of the right to travel, to move from anywhere to anywhere, and for whatever reason: we should be in favour of the right to free movement.
[1]« Castaner accuse les ONG d’être complices des passeurs » Le Monde, 6 April 2019: https://www.lemonde.fr/international/article/2019/04/06/castaner-accuse-les-ong-d-etre-complices-des-passeurs_5446576_3210.html
[2] “Mediterranean Massacre”: https://bobmouncerblog.wordpress.com/2015/04/22/mediterranean-massacre-job-done/
[3] For The Many Not The Few: The Labour Party Manifesto 2017, pp. 28-29: https://labour.org.uk/wp-content/uploads/2017/10/labour-manifesto-2017.pdf
[4] “Labour signals that Britain should remain in customs union”, Irish Times, 18 February 2018: https://www.irishtimes.com/news/world/uk/labour-signals-that-britain-should-remain-in-customs-union-1.3396757
[5] “The Tory fallacy: that migrants are taking British jobs and driving down wages”:
[6] Immigration limits won’t lift Britain: https://www.ifs.org.uk/publications/8317
[7] Ibid.
[8] White Paper: “The UK’s future skills-based immigration system”: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/766465/The-UKs-future-skills-based-immigration-system-print-ready.pdf, p. 3.
[9]For The Many Not The Few: The Labour Party Manifesto 2017, p. 28: https://labour.org.uk/wp-content/uploads/2017/10/labour-manifesto-2017.pdf
[10] White Paper: “The UK’s future skills-based immigration system”: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/766465/The-UKs-future-skills-based-immigration-system-print-ready.pdf, p. 3.
[11] In a series of three tweets on 28 January 2019, before the front bench change of mind, declaring his intention to vote against the Bill.
[12] House of Commons debate, 28 January 2019: https://www.theguardian.com/politics/2019/jan/28/labour-in-embarrassing-u-turn-over-immigration-bill-vote
[13] By my calculation, since the government won the vote by 297 votes to 234 (a majority of 63), if the full quota of Labour MPs had turned up to vote against them (another 78), the government would have lost the vote on the Bill.
Freedom of Movement II
What will immigration policy be after Brexit?
The Tories were clear about their intentions from the beginning. In the Foreword to their White Paper on post-Brexit immigration policy May declared, “As we leave the European Union, free movement will end.”[1] But she also added: “For the first time in decades, it will be the democratically elected representatives of the British people who choose who comes into our country.” This promotes the claim that for the last few decades there was “uncontrolled immigration” – which, as we saw in the previous blog, was not true. Given this bad start, there should be no surprise at the criticisms that quickly emerged. May had said that the government would
introduce a new, skills-based immigration system. This will be a system where it is workers’ skills that matter, not which country they come from.
It will be a single system that welcomes talent, hard work, and the skills we need as a country. It will attract the brightest and best to a United Kingdom that is open for business.
Migrants have made a huge contribution to our country over our history – and they will continue to in the future. But it will also be an immigration system that is fair to working people here at home. It will mean we can reduce the number of people coming to this country, as we promised, and it will give British business an incentive to train our own young people.[2]
The White Paper also announced that skilled workers would have to be earning £30,000 if they were to qualify for entry. In this way, preference was to be given to high earners while low earners would be much less welcome. Sabrina Huck of Labour Against Racism and Fascism summarised much of this approach when she pointed out that
“low skilled” workers from “low risk” countries (countries whose citizens are deemed less likely to commit immigration offences such as overstaying or coming under false premises)[3] can apply to work in the UK for up to 12 months, with no ability to bring family members, access different visa schemes or extend their stay, and without access to public benefits during their time. When the 12 months are up, the person is not allowed to re-apply for this visa until a “cooling off” period of a year has passed, effectively banning them from re-entering for work purposes in this time.[4]
Problems with Labour’s response to the White Paper and the Immigration and Social Security Bill
In her response to the White Paper, Shadow Home Secretary Diane Abbott was right to point out that the £30,000 salary threshold for skilled workers does not reflect a skills-based immigration system, because skill levels don’t always reflect salary levels. But, as Sabrina Huck noted, “Abbott is not challenging the basic assumption that a person’s ability to enter the country, and to live a life with full citizen’s rights, is determined by their material contribution to the needs of British capital.”[5] She added:
This is a dangerous line for the left to take, as it concedes to the right’s political argument that immigration in itself is not a right, and that people’s worth is determined by their (narrowly defined) value for the economic system. This argument underpins much of the Conservative’s [sic] austerity agenda, the demonisation of the working class, poor and disabled, as undeserving, because they do not “contribute” their “fair share” to society.[6]
Abbott’s response to the Bill itself increased these worries: “The Labour [P]arty is clear”, she said,
that when Britain leaves the single market, freedom of movement ends, and we set this out in our 2017 manifesto. I am a slavish devotee of that magnificent document: so on that basis, the frontbench of the Labour [P]arty will not be opposing this bill this evening.[7]
In the event, the Labour front bench changed its mind and whipped MPs to vote against the Bill, rather than abstain, after protests by several MPs and an immediate on-line and email protest from Labour activists and others. But it took the front bench 90 minutes to do this, after MPs had originally been told they could go home as their votes were not required. Many of them did. Only 178 out of 256 Labour MPs were present to vote.[8]
It is, of course, true that the Labour manifesto appeared indistinguishable from the Tory White Paper and the Bill when it came to freedom of movement: “Freedom of movement will end when we leave the European Union. Britain’s immigration system will change …” it said.[9] It is also true that assurances were given that Labour would not “scapegoat migrants nor blame them for economic failures” and that Labour “will develop and implement fair immigration rules” and “not discriminate between people of different races or creeds.”[10] But how fragile are these assurances in the light of Labour’s incomprehensible original decision to abstain? Such a possibility should not even have crossed the leadership’s minds. For there were overwhelmingly more important reasons to vote against the Bill. In the words of David Lammy, MP for Tottenham:
It will force our NHS and other vital services into an even deeper staffing crisis. There are already 41,000 nursing vacancies in England. The salary threshold still under consideration would exclude many skilled medical staff, including nurses, paramedics and midwives.
It continues the inhumane practice of indefinite detention. We remain the only European country which does not set a time limit for detained migrants. This sullies our international reputation and undermines complaints we make about human rights abuses abroad.
The 1.2 million [UK citizens in Europe] will inevitably see their own rights eroded too. Overnight they could lose their ability to live and work freely in Europe. Young people who overwhelmingly want the chance to live across the continent are having their horizons permanently narrowed.[11]
The Labour Campaign for Free Movement couldn’t understand abstention either:
The Bill would end free movement for EU citizens and subject them to UK immigration control. Rather than having parliament specify what the new regime will be, it would hand over a blank cheque to Ministers who will be able to write and re-write the law themselves – so-called “Henry VIII powers”. The Government’s White Paper last month signalled some of their intentions – a brutal attack on the rights and security of migrants, especially working-class migrants.[12]
It was impossible not to be reminded of the fiasco of the Labour abstention during the Tories’ Welfare Bill debate in 2015, at the height of the first Labour leadership elections. The Bill was set to impose measures under which the most vulnerable in society would have to bear the heaviest burden: measures proposed in the Bill meant that, for the first time, tax credits and family benefits under Universal Credit would be limited to the first two children and that most working age benefits would be frozen for four years from 2016.[13] People claiming the working element of the Employment and Support Allowance (ESA) would have their payments reduced to match the Job Seeker’s Allowance (JSA),[14] and the benefit cap was to be reduced from £26,000 a year to £23,000 in London, and £20,000 in the rest of the country.[15] Moreover, many young people between the ages of 18 and 21 would no longer be able to claim Housing Benefit.[16] Most people expected Labour to vote against such measures, which impacted so negatively on the poor. But the party’s Acting Leader, Harriet Harman, decided otherwise. She told Andrew Neil on The Sunday Politics:
We won’t oppose the Welfare Bill, we won’t oppose the household benefit cap. [We won’t oppose] what they brought forward in relation to restricting benefits and tax credits for people with three or more children … We’ve got to recognise why the Tories are in government and not us, not because [voters] love the Tories but because they didn’t trust us on the economy and on benefits.[17]
Harman went on to instruct Labour MPs to abstain in the Commons vote on the Bill.[18] This caused much dissent among MPs, and Harman tried to defuse the crisis by tabling a “reasoned amendment” to the Bill, an amendment which changed nothing since it still supported controls on the overall costs of social security and backed proposals such as the lower benefits cap, the removal of tax credits from families with more than two children and the replacing of mortgage interest support with loans. Among the leadership candidates, only Corbyn voted against the Bill.
On that occasion, Corbyn was the hero, together with John McDonnell. They refused to pander to the prejudices and misperceptions about benefits that some voters entertained. Instead they tried to counter and dispel them. John McDonnell made a powerful speech:
I would swim through vomit to vote against the Bill, and listening to some of the nauseating speeches tonight, I think we might have to.
Poverty in my constituency is not a lifestyle choice; it is imposed on people. We hear lots about how high the welfare bill is, but let us understand why that is the case. The housing benefit bill is so high because for generations we have failed to build council houses, we have failed to control rents and we have done nothing about the 300,000 properties that stand empty in this country. Tax credits are so high because pay is so low. The reason pay is so low is that employers have exploited workers and we have removed the trade union rights that enabled people to be protected at work. Fewer than a third of our workers are now covered by collective bargaining agreements. Unemployment is so high because we have failed to invest in our economy, and we have allowed the deindustrialisation of the north, Scotland and elsewhere. That is why the welfare bill is so high, and the Bill does as all other welfare reform Bills in recent years have done and blames the poor for their own poverty, not the system … We need a proper debate about how we go forward investing in housing, lifting wages, restoring trade union rights and ensuring that we get people back to work and do not have high pockets of deprivation in areas such as mine and around the country … I say to Labour Members that people out there do not understand reasoned amendments; they want to know whether we voted for or against the Bill. Tonight I will vote against it.[19]
In the debate on the Immigration and Social Security Bill this week he could have stood ready to counter and dispel the current prejudices and misperceptions about immigration and migrants. Instead he, Corbyn, Abbott and the rest of the front bench stood ready to give in to them. It took a rebellion to stop that happening.
What fears do people have? One of them is the notion that immigrants take jobs from the native population and depress wages. Liberal leader Vince Cable has summarised some of the arguments on this:
At the heart of the politics of immigration is the belief, repeated by Theresa May as a fact, that immigrants, especially unskilled immigrants, depress wages. At first sight the argument seems plausible – and undeniably there is low-wage competition in some places. But there is no evidence that this is a general problem. [In 2013, during the coalition government] I commissioned a range of reviews and studies to establish the facts. They showed that the impact on wages was very small (and only in recession conditions). By and large, immigrants were doing jobs that British people didn’t want to do (or highly skilled jobs that helped to generate work for others). This research was inconvenient to the Home Office, which vetoed the publication of its results.[20]
In 2016, Paul Johnson of the Institute for Fiscal Studies produced a report and asked:
But aren’t all these foreigners taking our jobs? That’s true in the Premier League. The more foreign footballers there are playing for the top clubs, the fewer English players there will be. There’s only room for 11 players in a starting XI.
Yet there is not a fixed number of jobs in the economy. There are seven million more people in work in the UK than there were 40 years ago. Astonishingly, there are nearly two million more than immediately before the recession in 2008. Employment rates among the UK-born are close to record levels. More people means more jobs, not more unemployment. There is absolutely no evidence that higher levels of immigration have increased unemployment among native-born Brits.[21]
On wage levels he wrote:
Evidence on wage impacts is a bit less conclusive. While many studies do not find any evidence of immigration depressing wages, a recent Bank of England paper suggests that the impact of migration on UK-born lower-skilled workers might have been to reduce wages by 1 per cent over a period of eight years. Thus it may have played a part, though only a minor one, in recent experience of low or negative pay growth.[22]
So, just as Harriet Harman should have argued against benefit cuts and voted them down in 2015 instead of pressing the panic button, Corbyn and the Labour front bench should have argued against immigration myths and should never have tried to press the abstain button. They must never do this again.
Corbyn says that after Brexit we will have a new immigration policy. But for some of us our confidence has been shaken by this episode. We need to know what the new policy will be. It should be spelt out now. At a conference last year, the journalist Gary Younge argued that, while the promises and plans of the Labour leadership under Corbyn are welcome news, we still have to hold these politicians to account. In that context, Sabrina Huck has some good advice for us all:
Anti-racism campaigners have a duty to oppose the toxic hostile environment through engaging the public in a positive debate about immigration, challenge the arguments that a person’s value for society can be determined purely based on their economic contribution and by effectively lobbying parliamentarians to oppose legislation enforcing these immigration policies.[23]
[1] White Paper: “The UK’s future skills-based immigration system”: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/766465/The-UKs-future-skills-based-immigration-system-print-ready.pdf, p. 3.
[2] Ibid.
[3] The White Paper counts, among others, Australia, the US, New Zealand, Japan, South Korea and Singapore as “low risk” countries. Poorer countries (e.g. African and Arab countries) are likely to be classified as “high risk”. Thus, for all the talk of more opportunities for people from outside the EU to come and work in Britain, workers from the global south will be virtually excluded.
[4] “The Immigration White Paper represents a massive attack on migrants’ rights”, Labour Against Racism and Fascism: https://laraflondon.wordpress.com/2019/01/04/the-immigration-white-paper-represents-a-massive-attack-on-migrants-rights/
[5] Ibid.
[6] Ibid.
[7] House of Commons debate, 28 January 2019: https://www.theguardian.com/politics/2019/jan/28/labour-in-embarrassing-u-turn-over-immigration-bill-vote
[8] By my calculation, since the government won the vote by 297 votes to 234 (a majority of 63), if the full quota of Labour MPs had turned up to vote against them (another 78), the government would have lost the vote on the Bill.
[9] Labour Manifesto 2017, p. 28: https://labour.org.uk/wp-content/uploads/2017/10/labour-manifesto-2017.pdf
[10] Ibid.
[11] In a series of three tweets on 28 January 2019, before the front bench change of mind, declaring his intention to vote against the Bill.
[12] Labour Campaign for Free Movement email, 29 January 2019.
[13] “Benefit changes: Who will be affected?”, BBC News, 8 July 2015: http://www.bbc.co.uk/news/business-33429390 (accessed 29/3/2017).
[14] Ibid.
[15] Ibid.
[16] Ibid.
[17] “Labour won’t oppose Welfare Bill”, BBC News, 12 July 2015: http://www.bbc.co.uk/news/av/uk-33498110/labour-won-t-oppose-welfare-bill (accessed 2/1/2018).
[19] Commons Hansard, 20/7/2015, House of Commons, London: https://hansard.parliament.uk/commons/2015-07-20/debates/1507206000001/WelfareReformAndWorkBill (accessed 29/3/2017).
[20] “The Tory fallacy: that migrants are taking British jobs and driving down wages”:
[21] Immigration limits won’t lift Britain: https://www.ifs.org.uk/publications/8317
[22] Ibid.
[23] “The Immigration White Paper represents a massive attack on migrants’ rights”, Labour Against Racism and Fascism: https://laraflondon.wordpress.com/2019/01/04/the-immigration-white-paper-represents-a-massive-attack-on-migrants-rights/
I will do no harm or injustice to them
There’s a thing called the Hippocratic oath, taken by medical students when they end their studies and set out on their careers. It’s 2,500 years old now, so it’s a bit out of date. For one thing, the medic declares, “I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses” to keep the oath; for another, aspiring doctors say, “In purity and according to divine law will I carry out my life and my art.” Mind you, leaving aside the divine law, the purity promise may be less out of date when coupled with the promise to avoid “any voluntary act of impropriety or corruption, including the seduction of women or men, whether they are free men or slaves.” (We may once have thought slavery was out of date after Toussaint L’Ouverture and Wilberforce, but not any more.) It may also be encouraging to know that your GP has sworn, “I will not use the knife, even upon those suffering from stones, but I will leave this to those who are trained in this craft.” But much is out of date – the prohibition of abortion for example. But there is one promise that’s right up to date, even to today’s headlines, and it’s one we all need to be sure of. Speaking of their patients, doctors promise: “I will do no harm or injustice to them.”
Both those things were done to Esayas Welday, an Eritrean asylum seeker in the UK. He was diagnosed with leukaemia and started a course of chemotherapy. But suddenly the treatment was stopped and he was told that, because he couldn’t afford the £33,000 needed to pay for the treatment, that was it. He had already been homeless. Now he was homeless again, turfed out of Northwick Park Hospital in West London, with a few bits of medication in a plastic bag. Read his story below. The hospital trust apparently treated him in this way because they thought the government had instructed them to do so. They said: “Mr Welday is not eligible for NHS treatment … he is homeless with refugee status.” They were wrong. He was eligible although he was homeless. They were wrong again because with refugee status he would have been eligible. They were wrong yet again because he didn’t have refugee status, he was simply an asylum seeker asking for refugee status. And as such he was eligible because his treatment was urgent. How did they get all this wrong? I would guess it’s because these particular rules, part of the government’s hostile environment towards migrants since 2017, are complicated, strict and presented in such a way that the pressure is on staff to err on the side of refusal rather than follow their instinct to care.
Happily, another hospital interpreted the rules in a different way. Whittington Hospital in North London looked at their patient, looked at the rules, and refused to be panicked or pressured into doing “harm or injustice” to him. His treatment continued.
My point is this: capitalism corrupts everything, It has no respect for human decency. It even tricks people sworn to a duty of care into thinking that they now have no need to care. It demands what this article describes as payment “upfront for many forms of hospital-based medical care, even though such patients are usually penniless and often destitute, like Welday.” Complicated and hard-to-interpret government rules imposing a hostile environment seemed to lock the NHS bureaucracy and then its staff into a scenario that would have ended in Esayas’s death (at 29) if another solution had not been found by other staff.
We definitely need a general election. But we need more than that. We need to overturn a system of markets and money and profits and a culture of xenophobia and racism that insists that “they” are not equal to “us”. Are our alternative leaders up to the job? I hope so. But I don’t know.
The article:
Is no news good news?
I have hardly watched any news since just before Christmas. And you know how it is when you’ve been on holiday and when you come back it takes time to understand that you are back and that you will have to adjust to what is called normality, as opposed to the beach, or the mountains, or the Metropolitan Museum? Well, I’ve been away from the news for two weeks (apart from an accidental, careless sight of the Home Secretary telling the nation that asylum seekers are only genuine if they make their applications in the first safe country they cross on their journey and not bother us here; at that point I fumbled for the off-switch, rushed out of the room, and went back into news-blocking mode. Oh, but before I found the off-switch I caught a glance of a newly inaugurated Brazilian president, and then I was really desperate for the off-switch.
Anyway, yesterday morning I watched the Andrew Marr Show and found I didn’t understand much of what was being said. There was Theresa May repeating the words of her old recordings. When she felt that perhaps they had lost some of the impact they once had she reverted to that real old-time-religion favourite: “On the 29th of March we will leave the European Union, take back control of our borders, control of our laws, and control of our waters with a deal that is in the interests of all the British people”, she sang. Her voice took on a slight Thatcher intonation, and the whole performance, with the accompanying jangly necklace, was obviously designed to bring the likes of Boris Johnson and Jacob Rees-Mogg to a premature orgasm. As a matter of fact, I never really did understand what “control of our waters” actually meant, but now, since my news-blocking effort, I don’t understand what any of it means. Still, life goes on and I must try to revise my Brexit vocab.
Then there was Labour Shadow Health Secretary Jonathan Ashworth, who also repeated a lot of old songs, though without the jangly necklace, about the damage Tory policies were doing. The songs all spoke the truth (and I cheered up a bit) but then he seemed unable to answer any of the really interesting questions, like what Labour’s own policy on social care and the NHS would actually be. From his first words, I think he was saying something like “We’ll look to see what the Tories are offering and then we’ll …” and I felt the urge to block the news again. Then he was asked whether his plan for the NHS would be full public ownership like in the old days. He muttered something about “there will always be a role for the private sector”. This sounded like a kind of partnership – a public-private partnership even. This has usually been code for “private”, both under Tory and Labour governments. These schemes are ones where private calls the shots, makes everything more expensive and rakes in the profit. That’s its purpose. So Jonathan’s words were worrying. Because many of us thought those days would be over under the new politics. Not that we want to go back to the old days, far from it. We thought we would go forward to a democratically accountable public ownership, in which workers and users of services would call the shots. That was never the case in the old days. The old nationalised industries and public services were run by more or less the same people who ran them when they were private. And they ran them on the same lines. At the end of the day they were supposed to make a profit, like their capitalist predecessors. And they mostly did.
It’s time to tell a story. Long years ago, when Sir Keith Joseph was Education Secretary, I interviewed him for an audio magazine for the blind. We touched on the private versus public question. He agreed that publicly owned outfits make a profit: “Oh, yes, they make a profit, of course, but – well, look at that splendid jumper you’re wearing. I don’t know where you got it, where did you buy it?”
“I don’t remember,” I replied nervously. “Marks & Spencer’s probably.”
“Very well, then. What do you want us to do? Nationalise Marks and Spencer’s? And what would happen then? They’d say, ‘You can’t have the colour you want – we’ll choose it for you; you can’t have the pattern you want – we’ll choose it for you; you can’t have the style you want – we’ll choose it for you.’ Is that want you want?”
I can’t remember my answer, but anyway he slowly calmed down. Of course, he wasn’t really worried about my rights, or customer satisfaction, or the service provided. His real concern was that in a publicly owned operation the profits would go to the wrong people: instead of going into the pockets and coffers of his friends they would go to the state, where they might be spent on improving the service. Of course, in “the old days” governments often spent the money on things that, if we’d been asked, we would have vetoed. But we weren’t asked. That’s why now, after Corbyn’s election, the eyes of some of us lit up when we heard the words “democratically accountable” attached to the words “public ownership”. And that’s why my eyes glazed over and I was tempted to head for the news-blocker when Ashworth mentioned “a role for the private sector”. But I thought, No, I’ve closed that door behind me. I must now find my way back to being a responsible citizen. It’s difficult though. There aren’t that many role models.
The other thing I noticed yesterday was that America is in lockdown. That sounds uncomfortable. Like when, during the dockers’ strike in the 1970s the Heath government said they would “sequestrate” the union’s funds. “By heck,” said union leader Hugh Scanlon, “We’re going to be sequestrated – that sounds painful!” But Trump clearly doesn’t understand how workers, even those in government departments, feel when they’re sent home or have to work without pay. “They’re 100% behind me,” declared Trump. Yes, and hopefully they’re all armed to the teeth!
We must ensure that nobody will ever again be afraid to ask for medical treatment
We really do have to get rid of this Tory government and replace it with a Labour government different from any other. This story (see link below) about asylum seekers being afraid to get NHS treatment is just one of many reasons. Asylum seekers are afraid of being presented with a bill they have no means of paying, and they are afraid of the Home Office. The groundwork was laid for such fears a good number of years ago by governments of all stripes. A Labour Health Secretary was one who helped. At the end of my research into the treatment of asylum seekers, which I finished in 2010,[1] I wrote this in the wake of the news that an asylum seeker had been refused cancer treatment:
On 30 March 2009 the UK Court of Appeal ruled that failed asylum seekers were not entitled to free National Health Service treatment in England, overruling an earlier High Court ruling that they were. One exception was allowed: if an asylum seeker cannot return home and cannot pay in advance hospitals must consider treatment, but they were at the mercy of the discretion of the hospital. Lord Justice Ward expressed his views on failed asylum seekers clearly: they should not be here and should never have come in the first place. Health Secretary Alan Johnson was “pleased with the Court of Appeal’s judgment that asylum seekers cannot acquire ordinary resident status which would entitle them to treatment and a range of other services.”
When Jeremy Corbyn protests about a Tory statement or policy, the reply often comes back “Labour did the same thing.” Those of us in the Labour Party should always acknowledge the fact when it’s true and we will all have to make sure things are different next time by constantly holding Labour ministers to account. Shadow Home Secretary Diane Abbott has said clearly, when speaking of the Windrush scandal, “This will not happen when I am Home Secretary.” She will face strong opposition from Home Office officials who are currently enjoying the implementation of the “hostile environment”. We will have to support her, and support asylum seekers, in every way possible, against the pressures, not only of the Home Office establishment, but also of the Tories and their media. And it must never be the case again that vulnerable people are bullied so that they are afraid to ask for medical help. That, among many other reasons, is why I and thousands of other people joined or rejoined the Labour Party when Jeremy Corbyn was elected leader in 2015. We saw a different future.
Asylum seekers ‘too afraid’ to seek NHS care, report says
https://www.theguardian.com/uk-news/2018/nov/28/asylum-seekers-too-afraid-to-seek-nhs-care-report-says?CMP=Share_iOSApp_Other
[1] Dealt with on their Merits: https://hydra.hull.ac.uk/resources/hull:2678
Happy birthday NHS – and we should remember it was a difficult birth
Polly Toynbee reminded us in yesterday’s Guardian to beware of Tory claims to love the NHS:
The Tories voted 22 times against the creation of the NHS, warning it was “Hitlerian” and it would “sap the very foundations on which our national character has been built. It is another link in the chain that is binding us all to the machine of state.” The British Medical Association, then mostly Tory doctors, said it was “a dagger blow to personal freedom” that would “enslave the medical profession”. Ever since, a strong core of the Tory party has kept calling for NHS “reform” that would end its founding principles. Their newspapers and thinktanks bristle with bright ideas for top-up fees or personal insurance. It’s insufferable to them that the state, not the market, should run such a mighty enterprise efficiently, even when underfunded.
No one should let the NHS birthday celebrations go by without reading Michael Foot’s account of the founding of the NHS. It’s in Foot’s biography of its founder, Aneurin Bevan. It is now in a single volume but was originally published in two vast tomes somehow befitting the image of the founder himself. The account is in Chapter 12 of the single volume.[1]
At the beginning of the chapter Foot tells how, at the Annual Meeting of the British Medical Association (BMA) on the day after the 1945 general election, delegates cheered when they heard that Sir William Beveridge had lost his seat as Liberal MP for Berwick. The famous Beveridge Report during the Second World War had proposed a welfare state, including a national health service. The BMA were delighted to see him go. But they didn’t cheer when they realised Labour had won the election. Foot wrote:
… the doctors felt themselves impelled across strange frontiers into an unknown land. “I have spent a lot of time,” said one eminent Harley Street surgeon, “seeing doctors with bleeding duodenal ulcers caused by worry about being under the State.” The scene illustrated the collective neurosis afflicting the most articulate section of the British Medical Association even before it was confronted with the apparition of Aneurin Bevan at the Ministry of Health.
So remember, the child had enemies even before it was born. It still has.
Polly Toynbee’s article:
https://www.theguardian.com/commentisfree/2018/jul/03/nhs-religion-tories-health-service
[1] Foot, M. (1999), Aneurin Bevan, Indigo, London, pp. 286-361.
Amsterdam 1 – Milan 0
London is losing the European Medicines Agency to Amsterdam now that we’re leaving the EU. Brexit has led to a scramble for agencies – so far, the Medicines Agency and the Banking Agency. It was all a bit of a gamble, rather like greyhounds or horses. Or, in the case of the Medicines Agency, a cross between football and the way they choose who goes first in Snooker championships. According to The Guardian:
“Italy’s Europe minister Sandro Gozi said Milan’s loss to Amsterdam in a tie-breaker was like losing the World Cup on the toss of a coin.”
The European Medicines Agency sounds like an important institution to me, yet the language describing its fate would be familiar in the betting shop down the road in any European city. There were “fancied contenders”, says the Guardian report, and “outsiders”; the result was “very tight”, said Dutch minister Halbe Zijlstra; French minister Natalie Loiseau was saddened that Lille had “lost out in the race” (we are, I think, back to horses); Malta, Zagreb and Dublin are said to have “dropped out of the race” for the Medicines Agency, with Ireland hoping to “boost its chances of winning” the Banking Agency.
I suspect this is not good for any of us, and Daniel Zeichner argues, in a separate article, that “losing the European Medicines Agency is bad news for patients, jobs – and the NHS”, which reminds me: it’s not just about the Medicines Agency – it’s about health care in general. Our free-at-the-point-of-use NHS is very expensive at the point of purchase, with all kinds of outfits vying to become its “private partners”, its “providers”; faceless drug companies foisting their goods on to our doctors, with pressure to persuade all patients to take this or that medication whether they need it or not; and has the medical centre chosen the right computer system? Or have they been sold a pup and need to look for another “provider” next year? And will this year’s flu jab work?
It’s all a bit of a gamble.
London loses EU agencies to Paris and Amsterdam in Brexit relocation
Why losing the European Medicines Agency is bad news for patients, jobs – and the NHS
Passport to health
The government has plans for us. If it thinks a pilot scheme in Peterborough, Stamford and St George’s Hospital in Tooting is successful it may be rolled out across the country, and coming to a health centre near you.
Will that be good? No.
If the scheme gets the go-ahead, we won’t just have to show our passports when we go abroad and come back. We’ll have to show them before we go into hospital for operations. No passport, no operation; no ID, no treatment. Go home and wait to die.
The Guardian explains: “Patients could be told to bring two forms of identification including a passport to hospital to prove they are eligible for free treatment under new rules to stop so-called health tourism.”
Why?
Well, apparently, “the government paid out £674m to other European countries for the treatment of Britons abroad, but received only £49m in return for the NHS treatment of European citizens.”
Chris Wormald, Permanent Secretary at the Department of Health (the Department’s “Sir Humphrey”) explained his thinking to the Commons Public Accounts Committee today and told MPs that the results so far are encouraging:
“Individual trusts like Peterborough are doing that and it is making a big difference – they are saying please come with two forms of identity, your passport and your address, and they use that to check whether people are eligible.”
He realised that such a practice might be criticised but then confirmed that, like Credit, it would be Universal: “It is quite a controversial thing to do, to say to the entire population you’ve got to prove your identity.”
No decision has yet been made, of course. It’s not clear whether Chris just blurted out this information under pressure from the committee (some members of these committees can be quite pushy once they’ve got the bit between their teeth) or whether he was floating the idea to test the water.
Well, I’ll tell you what I intend to do. If the scheme comes in, and I’m asked for my passport, I will refuse to produce it, or any other proof of my identity. And I’ll see what they do. That’ll be me testing the water, like Chris.
Listen, I’m 74, and, so far, healthy. A nurse at my medical centre, explaining why they stop automatic over-60s medical checks at 74 (I’m due for my last one) said, “Well, the checks are preventative – but when you reach about 90 there’s not much we can prevent!” Point taken, although that still makes 74 a bit early, but I’ll let that pass. However, at some point or other I’m likely to need some of the “passport-required-before-access” treatment they’re talking about. But I was born half a dozen years before Nye Bevan’s great struggle with the doctors to create the NHS, free at the point of use, no questions asked, no passports required, and I started benefiting from it immediately. I’m buggered if I’m going to provide ID to get hospital treatment at this late stage. It’s against my principles.
So is the suggestion by “a source close to the Health Secretary”, Jeremy Hunt: the scheme “might only be applied in areas with shifting populations and large influxes of immigrants.”
That’s called racism, Secretary of State. But what more can we expect?
Here’s the Guardian article:
On the eve of a referendum …
Several friends have told me that they are voting Remain in the EU referendum – but with a heavy heart.
I’m voting Remain too, in spite of France tear-gassing protesting workers who are resisting their government’s, and the EU’s, plans to ditch their rights (Jeremy, don’t imagine the EU is on your side here) and tear-gassing (again by France) of refugees in Calais (ditto, Jeremy) and its refusal to allow aid through to Calais. I’m voting Remain because I don’t want Johnsonism and Goveism to have the whip hand in government and I also want to save Jeremy from the Blairites and the assorted Gawd-knows-whatites waiting to get rid of him if there’s a No vote. It’s not the right time to vote Leave.
If we get a Labour government committed to rolling back NHS privatisation, rejecting TTIP, bringing the rail network and the energy companies into public ownership, restoring the trade union rights that have been eroded since Thatcher and getting rid, amongst other noxious things, of zero-hour contracts, that would be several major steps forward. A Corbyn-led government could do that, and it could reaffirm the principles of the Refugee Convention rather than bolster the profits of the tear-gas manufacturers. The EU would certainly oppose such a Labour programme, since much of it would break EU rules, laws and protocols. Then we could oppose the EU, and then, if change proves impossible, vote to leave – and defend policies worth defending.
Will any of that happen?
Don’t know.
But if we vote Leave now, we are playing into the hands of the Right, including the very nasty Right.
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