“The Biscuit of Socialism”: The NHS comes to Northern Ireland

“Once they start nibbling the biscuit of socialism, before they knew where they were their children would be tied hand and foot”. 

Northern Ireland Prime Minister Basil Brooke on voters during 1945 election campaign

The National Health Service is the most comprehensive, fair and efficient health service in the world.  Today however, it is in crisis. In Northern Ireland waiting lists are longer than ever, and acute hospitals and GP surgeries in rural areas are closing down.

A fightback has begun. Staff have voted to take strike action for decent pay and the local community in Fermanagh and Tyrone have mobilised to defend the South-West Acute Hospital outside Enniskillen. The struggle for higher wages and better conditions, central to the retention of staff, and the defence of local services, depends on the united action of working people.

By Ciaran Mulholland, Chairperson of Cross-community Labour

The Privatisation threat

We cannot rely on the five parties which have governed the North over the last two decades All of the main parties support the Bengoa Report which justifies the closure of rural services, and none stands squarely for the just demands of NHS staff. We need a mass political party which gives a voice to working class and young people who are fighting for a better life. Such a party must stand resolutely against sectarianism and all forms of discrimination and put forward arguments for the socialist re-organisation of society, including a re-vitalised health service.

To understand the present, we must examine the past.  The NHS was not an overnight creation but the end result of decades of campaigning and agitation. It came into being at a time of profound social change. In the last analysis, as argued by the US socialist writer on health Vincente Navarro, “class struggle was indeed the main force behind the development of state health care”.

NHS: won through class struggle

Understanding the rhythm of the class struggle is key to understanding the roots of the NHS.  When those who control society sit down to discuss their options, they do not do so in a social vacuum.  They must calculate the degree of pressure from the working class, expressed through the trade union movement and working-class political parties.  This pressure means that at times the ruling class concedes temporary measures to buy social peace.

The social and economic forces that shaped our National Health Service in its early days hold powerful lessons for today. The most important is this: we cannot rely on unionism or nationalism to defend our interests we can only rely on our strength. We must build united community campaigns, combative trade unions, and a political party for all working-class people. This is the only way to defend our NHS from repeated attacks.

Introduction

Northern Ireland was not immune from the intense desire for change that swept Europe as World War 2 came to a close. This mood was summed up by a prominent Presbyterian minister as early as 1942: “If something is not done now to remedy this rank inequality there will be a revolution after the war” (Dr JB Woodburn, Chair of Presbyterian General Assembly, Belfast Newsletter, 3rd June 1942). The Unionist Party, which had governed the North since partition, was under pressure early in the war years and lost the constituency of North Down to an independent Unionist and Belfast Willowfield to the Northern Ireland Labour Party (NILP) in by elections in 1942.

“The Five Giants”

In December 1942 what became known as the Beveridge Report (its official title was “Social Insurance and Allied Services”), was published.  Queues formed overnight such was the enthusiasm to get hold of a copy and the first 60,000 copies sold out within days.  Over 100,000 copies were sold within a month and more than 200,000 full versions and 400,000 summary versions by the end of 1944.

In his report Beveridge declared war on what the “five giants” of Want, Disease, Ignorance, Squalor and Idleness, and stated that “a revolutionary moment in the world’s history is a time for revolutions, not patching”. Importantly the report recommended “a health service providing full preventative and curative treatment to every kind of citizen … without an economic barrier at any point…”

The Unionist Party were not blind to the mass social pressure for change and struggled to find ways to resist it. Dampening expectations was one strategy: the NI Prime Minister, John Andrews, wrote to the Chancellor of the Exchequer to complain that “In numerous public utterances of responsible people the minds of our people have been directed more than ever before towards what is called a “new order” or a “fair deal”, the “scandal that property should exist” and the “horrors associated with the slums”.  Other unionists could see which way the wind was blowing, however. Two MPs, Brian Maginess and Sir A Wilson Hungerford, wrote to Andrews arguing for “far reaching social reforms” and warned that “if this Government does not carry widespread reforms some other government will”, and William Grant, Minister of Health and Local Government worried that “if Unionism was to become Conservatism then support from the working class may be lost”.

Under pressure Andrews did commit to post-war improvements, including slum clearance and a housing programme, and educational expansion, but in words only.  More right-wing members of his cabinet warned against “premature action” however and Tory government ministers in London attacked Beveridge for putting forward proposals which “came mostly from socialists”. Andrews’ promises did little to cut across increasing support for those who were more committed to social change and in February 1943 a Labour candidate took the West Belfast Stormont seat in another by-election.

Andrews became increasingly isolated and within months was replaced as Prime Minister by the more right-wing Sir Basil Brooke who promised a traditional and financially “sound” approach. Brooke was tied inextricably to the interests of big business in general and linen manufacturers in particular, who “provided the backbone of opposition to proposals involving extravagance” (Bew et al, p88) but even he recognized that his government might have to introduce some reforms “on account of the financial relationship between Northern Ireland and Great Britain”, including those which he dubbed “more socialistic measures” and “unacceptable”.

Trade Union Militancy and Growth of Left Parties

During these years the working class was becoming increasingly radicalised.  In 1942 there was a major strike at Shorts aircraft plant which spread to other engineering works and resulted in the formation of a Belfast-wide shop stewards committee.  Strikes continued through 1943 and in 1944 20,000 workers were out in a major confrontation between capital and labour. The government jailed five of the strike leaders but had to back down in the face of a possible general strike (Hadden, p20).  There were 279 walkouts in total between 1941 and 1946, and 877,749 days were lost through strike action.

The increase in industrial militancy was matched by spectacular growth in support for left-wing parties.  In the 1938 Stormont General Election the left had won a total of 18,775 votes, with a further 5480 cast for Nationalist or Republican candidates standing on left-wing platforms.  In the 1945 election support mushroomed to 106,588 for the left and 19,281 for the Nationalist/Republican left, against 196,459 votes for Unionist candidates and 32,546 for Nationalist candidates.

The voting pattern in Belfast in the 1945 Stormont election portrays even more starkly the processes which were well underway.  In 1945 96,273 votes were cast for Unionists in the city, 66,506 for left- wing parties, 14,361 for the Nationalist/Republican left and 2,766 for Nationalists.  The left-wing vote was shared between the NILP, the Commonwealth Labour Party (a split to the right and to a more unionist position from the NILP) and the Communist Party of Northern Ireland (CPNI) which gained a credible 12,456 votes. These parties had major weaknesses and confused policies, but nevertheless working-class people were expressing their intense desire for a better future by breaking from the Unionist and Nationalist parties at the ballot box.

Socialist Medical Association

Both the NILP and the CPNI were strongly influenced by the Socialist Medical Association (SMA) which by 1945 was at its peak in terms of size and influence.  It had 2500 members across Northern Ireland and Great Britain and played a major role in ensuring that the NHS became a reality.  Its most active Branch was in Belfast.  The group there was large enough to produce its own monthly newsletter and in 1945 it produced a short pamphlet “Health in Belfast”, published on its behalf by the NILP.  This pamphlet helped to shape the future health services of Northern Ireland.

“Health in Belfast” provided a snapshot of the situation as it was in the days before planning and co-ordination.  Belfast’s health service was provided by a patchwork of hospitals, large and small. Most were “voluntary” (financed in part by charity, and in part by the “philanthropy” of the business class), one was provided by a religious order, and one was an old Poor Law or workhouse hospital (today’s Belfast City Hospital).  The latter accounted for the largest  number of beds, 1866 out of a total of 3754.The SMA pointed out that there were not enough hospital beds to meet need, that waiting lists were rising and that services varied greatly in quality.  The voluntary sector was in crisis.  The Royal Victoria Hospital had a deficit of £50,000 on its revenue account and its expenditure had exceeded its annual income by £5000 for the previous five years.

Maternity and child welfare services were entirely inadequate and alongside endemic poverty this helped keep Belfast near the top of the infant mortality table.  Tuberculosis (TB) services were also in disarray.  TB remained the greatest single cause of death for those aged between 10 and 40 years: in 1937 1200 died from TB in NI and the death rate increased during the war years. TB was essentially a social disease, thriving on malnutrition, bad housing, over-crowding, poor ventilation and lack of natural light, and overwork.

Unionism and Nationalism United

The Unionist Party fought the 1945 elections on a strongly anti-socialist programme, warning of the “biscuit of socialism”, but in fear of a losing Protestant working class support it simultaneously committed to adopting whatever social reforms were passed in Britain.

The position of the main political party of nationalism in the 1940s, the Nationalist Party, was confused. The Nationalist Party was not an organized political party in the commonly understood sense but a network of individual politicians and their local supporters. Its more prominent representatives were ultra-conservative on social issues and instinctively spoke out against the NHS legislation. They were eventually instructed to support the creation of the NHS by the hierarchy of the Catholic Church, which was concerned that Catholic working-class voters were moving to the left. A true indication of the political position of nationalism in this period came when the “Mother and Child Scheme” was introduced in the South in 1950. Its modest proposals would have given free health care to all mothers and all children up to the age of sixteen, regardless of income, The nationalist parties in the South rowed in behind the bishops, and the legislation was defeated. Without the pressure of a vibrant workers movement, growing in strength and moving to the left, the Catholic bishops and the nationalist parties were making no concessions (nor was the Church of Ireland which described the Mother and Child Scheme as “communistic”).

The NHS Arrives: Vesting Day, 5th July 1948

On July 5th, 1948, Labour Health Secretary Aneurin Bevan symbolically handed over the keys to the NHS at Park Hospital in Trafford, Manchester. 3100 hospitals with a total of 550,000 beds were organized into a new comprehensive service. There was controversy on Vesting Day over a speech Bevan had made the previous night describing the Tories as “lower than vermin”.  He was forced to withdraw the remark but the emotions that sparked his outburst, given the horror of the 1930’s and the Tories’ venomous opposition to the NHS, were shared by most working people.

The advent of the NHS revealed very high levels of untreated ill health.  One GP later commented on “the colossal amount of very real unmet need that just poured in needing treatment… they were all like that because they couldn’t afford to have it done.  They couldn’t afford to consult a doctor, let alone have an operation” (Timmins,  p131).

Stormont passed the necessary legislation to create the NHS in Northern Ireland.  There were differences in organisation compared to the rest of the NHS. Hospital property was transferred to the Hospitals Authority rather than the state, and hospitals were allowed to keep their individual endowments rather than having them pooled for general distribution.  The Mater Hospital kept its independence. Nevertheless, the NHS had arrived.

In the decades since it has saved countless lives and helped improve the health of the population on every indicator. As is all too obvious this does not mean that it has been safe from attack. And over the last seventy-five years and today, its only true defenders have remained the organised working class.

References

  • Bew P, Gibbon P, Patterson H.  Northern Ireland 1921-1996: Political Forces and Social Classes.  Serif, 1996.
  • Hadden P.  Beyond the Troubles? Herald Books, 1994.
  • Navarro V.  Crisis, Health and Medicine.  A social critique.  Tavistock Publications, London 1986.
  • Socialist Medical Association, Belfast Branch.  Health in Belfast, Northern Ireland Labour Party, Belfast, c1945.
  • Timmins N.  The Five Giants.  A Biography of the Welfare State.  Fontant Press, 1996.

We call for an end to intimidation and violent attacks. 

Cross-Community Labour Candidate for Fermanagh and South Tyrone Donal O’Cofaigh has condemned recent attacks on the right to politically campaign. 

“The 2022 Assembly Election campaign has been marred by attacks on the democratic right to campaign and seek the support of the voters. There have been dozens of reports of posters being torn down, across every constituency and affecting every party. Candidates have been intimidated on-line and on the streets. Candidates have faced state interference in their campaigns. On more than one occasion candidates and their campaign teams have suffered violent attacks. 

“We all know that elections are a reflection of society at large. The sectarianism, repression and intimidation that mar everyday life in many working-class communities remains a massive problem during elections.

“The right to free speech, the right to political organisation and the right to vote were hard won, with the labour and trade union movement leading the way. We will continue to defend the right to democratic expression now and in future elections”.

Stormont must deliver domestic violence refuges and emergency accommodation

Cross-Community Labour Councillor Donal O’Cofaigh today pledged that as a MLA for Fermanagh-South Tyrone in May he would demand Stormont provide proper resourcing of refuges for victims and survivors of domestic violence.

He explained his experience on this issue to date:

“As a councillor I was able to attend a presentation by Women’s Aid on the current problems they were facing. I was both shocked and dismayed to find out that due to Stormont cuts, there were no longer any dedicated domestic violence refuge units anywhere in Fermanagh.
“Subsequently I raised this issue publicly and repeatedly at council meetings and succeeded in getting the council to write to the Communities Minister demanding action. In response, a commitment was made to provide three domestic violence accommodation units in Enniskillen – which was a success.

“That said, even this provision is completely inadequate. It’s widely known that the number of reported incidents of domestic violence has skyrocketed since the start of the pandemic but there is literally nowhere for those living in fear to go. This can be a life or death situation. Three or four emergency units are just not enough.”

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A Cross Community Labour Alternative comes to Dungannon

Donal O’Cofaigh the Cross Community Labour assembly candidate for Fermanagh South Tyrone in the upcoming Stormont election met with Gerry Cullen in Dungannon to formulate a cross-community labour alliance.

The Enniskillen-based councillor and full-time Unite the union official Donal O’Cofaigh was endorsed by the well-known and highly respected socialist politician and ex-councillor Gerry Cullen from Dungannon Town. Gerry Cullen welcomed Donal to Dungannon on Saturday last to agree and endorse his election campaign. Donal will be standing for election to Stormont as the candidate for Cross Community Labour. Gerry Cullen commented that “there is a strong and historic cross community vote in the Dungannon region. Looking back through the history of the Dungannon region there has always been a strong labour vote, it is now more important than ever that a candidate can put forward a political agenda based on cross community values and solid policies that will appeal to an electorate long starved of political representation based on traditional labour values.”

Donal O’Cofaigh stated that now more than ever a cross community labour candidate is needed at Stormont “to offer effective representation on critical issues facing the electorate, the cost of living crisis, the crisis in health and social welfare, the destruction and exploitation of the environment by multinational financiers and the denigration of a once strong and well resourced social and community based infrastructure”.

Both Gerry Cullen and Donal O’Cofaigh agreed that there is a mood among the electorate of Fermanagh and South Tyrone to move away from the old worn out politics of the past. “It is important that we as a community look to the future with a different perspective. We must take on board the need for community based political values that incorporate a wish for social and community based initiatives which will benefit all of the community of Fermanagh and South Tyrone, not just a fortunate or privileged few. The political system at present has failed this constituency. It is time to offer the electorate an effective and forward thinking socialist and labour based alternative.”

Workers unity must become the watch word for every trade union militant

The shock of the devastating Covid 19 crisis, and a new phase of economic turbulence has unleashed a wave of dislocation, uncertainty, and desperation across the globe. The impact is compounded by the grind of the previous 10 years of austerity that had brought many individuals and communities to the edge of impoverishment. In such circumstances where people see that we can no longer go on as before, significant struggles in society are inevitable.

Across every continent we already see the early stages of a fight back against austerity, job losses and attacks on workers’ rights, oppression, repression, racism, and environmental destruction. But alongside these positive developments a crisis of this scale and depth also inevitably means that the desperation of sections of society are reflected as well. The political detritus and poison of populism that already exists in various guises such as religious fundamentalism, national interest, racism, xenophobia, war mongering and of course locally sectarianism are now likely to re-emerge strengthened and renewed. These reactionary ideas are no longer just the bailiwick of wings of the mainstream right-wing political parties, isolated cranks, and fascist groups on the fringes of society they are also increasingly reflected in so called mainstream media and public discussion.

For trade unions this poses serious challenges. Naturally, they are not immune from either positive or negative developments. On the one hand the trade unions can grow and become increasingly militant and determined to fight for a better society. On the other hand they are also susceptible to pressure from the ideology of populism. Populism in the unions is likely to initially appear in the form of a Trojan Horse wrapped in the national flag demanding defend ‘our’ jobs and our industry against the interests of workers in other places. If left unchallenged defending ‘our’ jobs can become the worker in another country city or parish is my enemy and my boss is my friend. These ideas, if unchecked, will inevitably create division, setting worker against worker and weakening the fighting capacity of the union movement to the point where even defence of the most basic achievements of the working class on pay and terms and conditions is made more difficult.

The signs of populism are already evident in the unions today, we must take this issue on now. Workers unity must become the watch word for every trade union militant. This does not mean that the trade unions do not deal with hard and potentially divisive issues, but it does mean dealing with them on our own terms. We have nothing in common with the bosses or the ruling class, their political mouth pieces or the myriad groups advocating national interest, racist, or sectarian solutions to the problems facing workers. Our solutions are based on the interests of the working class and as such can never align with theirs.

We take our stand on the ground of the struggle for workers unity. Our aim is to build powerful trade unions and new political parties of the working class that can play their role in advancing the struggle to change society for the better.

Seeds for future growth sown by anti-austerity, labour and trade union candidate

The launch of Caroline Wheeler’s election campaign in Fermanagh-South Tyrone

Caroline Wheeler, a prominent anti-cuts activist and trade unionist, was the only candidate standing on a genuine cross-community, labour and trade union platform in the recent Westminster election in Northern Ireland, in the Fermanagh and South Tyrone constituency.

Caroline received the full support of local activists and her candidacy was proposed by our councillor in the area, Donal O’Cofaigh. Caroline’s campaign secured a creditable 754 votes in what was a very sharply polarised and closely contested ‘headcount’ poll between the two communities, Protestant and Catholic.

Parliamentary elections in the constituency of Fermanagh-South Tyrone have been highly contested since the constituency was established in 1950. Because of the first-past-the-post system used, Westminster elections are traditionally a sectarian headcount, with the relatively well-balanced and stable demographic balance meaning every election is closely fought.

In 1981, the constituency famously elected IRA prison hunger striker, Bobby Sands, who died only weeks after winning the seat. The victory demonstrated the Republican movement’s potential to score political success and was highly influential in the subsequent thinking and trajectory of Sinn Fein’s leadership. The seat reverted back to the unionists when Sands’ successor went on the run after he was caught transporting guns. Due to the split nationalist vote, that remained the situation for almost twenty years before the seat fell to current Sinn Féin incumbent, Michelle Gildernew, in 2001, signalling the party’s road to dominance as the largest nationalist party in the aftermath of the Good Friday Agreement. Tom Elliott, the United Unionist candidate, retook the seat in 2015 but lost it again to Gildernew, in 2017, with the collapse of the bourgeois-nationalist Social Democratic Labour Party (SDLP) vote.

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Campaign mounts over historic sexual-abuse allegations cover-up in Fermanagh

Sex abuse victims protest publicly demanding justice

Northern Ireland is a society scarred by its history. The legacy of the conflict over the national question is everywhere apparent; painted flags, kerbstones and murals mark territories and promote narratives. But just as the history of the working-class has been excluded consciously from these ‘green’ and ‘orange’ narratives so too is the hidden legacy of sexual abuse of children which until now has largely been left unexplored.

Fermanagh journalist, Rodney Edwards, deputy editor of the local newspaper, The Impartial Reporter, was investigating reports of a paedophile ring operating in the county when he started to receive more and more reports of sexual abuse spanning decades into the past. A common feature was that the victims had reported the incidents to the police but there was an apparent failure to investigate or see the cases through.

The cases were predominantly reported during the period of the long armed conflict, known as the ‘Troubles’.

Those whose names have been made public span the breadth of society. One alleged prominent abuser, David Sullivan, worked as a bus driver and was reportedly responsible for a range of abuses of children (sometimes on school buses) in the 1980s and 1990s. Some of those abused by Sullivan claim that he abused them in conjunction with unnamed prominent businessmen. Sullivan’s dismembered body was found in the early 2000s and the culprit for the killing has never been found.

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