Health Service | Reaping the bitter fruit

As increased “lockdown” measures by the Government are on the horizon again, it appears that the extent of the bourgeois state’s ingenuity as regards battling the novel-coronavirus pandemic remains to repeat the same failed tactic over and over again: more vaccines and restrictions, no capital investment, no infrastructure, no sickness pay, and no new jobs.

It is vital now that we consider critically whether the vaccination and lockdown programme has been successful, and whether other strategies might be more effective in dealing with the situation. To do so properly it is useful to examine the wider context in which all this has taken place.

Globally, over the past twenty months the ruling class and their clerks in government have facilitated the greatest upward transfer of wealth in human history, while more than 5 million people have died. Workers have been impoverished, laid off, undersold and exploited while multi-billionaires blast into space on vanity projects in between lecturing us on how we need to change our behaviour to protect the planet.

Domestically, we have reaped the bitter fruit of a shamefully neglected and underfunded health system, subject to privatisation, overcrowding, over-reliance on pharmaceutical treatment, and a generally reactive, short-termist and non-holistic approach to medicine: in other words, a capitalist health system.

Fig. 1. Hospital bed capacity in the 26 Counties, 2000–2019

Successive capitalist governments have relied on “current” spending to paper over the cracks of much deeper social problems. Consider the housing crisis and the ever-increasing reliance on HAP payments to landlords; the use of hotel accommodation to temporarily shelter the homeless; the rental of private hospital space at the outset of the covid-19 pandemic; contracting private businesses to provide public transport—the list is practically endless.

Two things these tactics have in common:

(1) they avoid sensible, long-term solutions, mostly requiring capital investment, in favour of costly continuous pay-outs to private business interests, and

(2) they ultimately prolong and exacerbate the problem they claim they are intended to solve.

The tactic as regards covid has been vaccination-uber-alles, bought at a premium, with the occasional lockdown. There has been no regard for significant capital investment in increasing hospital and ICU capacity (both of which are a small fraction of what they were twenty years ago, with a greatly increased population in the meantime), the provision of statutory entitlement to sickness pay, the development of virus-proofed public infrastructure, retrofitting buildings for proper ventilation, radically increasing the frequency and capacity of public transport, and making quality health services free and accessible to all. The tactic, needless to say, has failed.

Or perhaps it has succeeded, if we consider that the objective of those in power has been to maintain a state of perpetual crisis on a number of fronts while ensuring that the upward flow of wealth continues unabated, facilitated by the state taking on enormous debt, which will, of course, be undersigned by the working class.

Fig. 2. Hospital beds per 1,000 people, 26 Counties, 2000–2018

There are many otherwise conscientious people who have been cowed into tacit support for the government’s anti-human policies because they consider any and all opposition to these to be the realm of “anti-vaxers” or similar. It is vital that we recognise this sleight of hand for what it is: a naked attempt to smuggle reactionary policies into public acceptance under the banner of the necessary and only possible measures to address a pandemic.

In this country, as in many others, the government has erected a conservative, neurotic public morality around the coronavirus, necessary for the maintenance of retrograde measures such as “lockdowns,” curfews, covid passports, etc., in place of any real structural solutions to the problems we face with a now endemic virus.

The working class must put an end to the endless cycles of demonisation of our fellow-workers that has characterised the past two years. Let the reactionaries fixate on restrictions and people “breaking rules”—dead ends that lead nowhere but to a feedback loop of the same failed measures that got us to this point in the first instance.

We must advance our concrete, transformative demands for a greatly expanded, free and universal 32-county health service that treats its workers fairly, with a public infrastructure that is built to cope with the pressures of an endemic respiratory virus, with a statutory entitlement to sickness pay for all. Everything else is just window-dressing.

Fig. 3: Ireland’s ICU capacity is less than half the OECD average per head of population