Chris Bem Talk to Taking Soundings

HEALTH, THE ECONOMY AND TODAY’S NHS
Talk, Leeds Taking Soundings, 19th January 2011

Outline – themes – the dismantling of a public health service through

COMMODIFICATION OF THE LIFE WORLD
BUREAUCRATISATION OF SYSTEMS OF CONTROL
PROLETARIANISATION OF HEALTH CARE WORKERS

Theories for resistance

REFRAMING PHILOSOPHIES OF BIOLOGY
HEALTHY ECONOMY – HEALTHY SOCIETY
HOMO SOCIALIS – SOCIAL GOVERNANCE – RE-MAKING THE PUBLIC SPHERE

New political openings – opportunities for action and involvement

Utililizing those existing opportunities for participation in governance and health care design that exist both to campaign against the reforms and to subvert the reforms. Membership of local health care organisaions, involvement in health scrutiny panels
Health care institutions as centres for an economy of care and cooperation (in opposition to the economy of profit and exploitation) with social facilities, art, education, well-being, social enterprises e.g. Bromley by Bow Centre, Tower Hamlets, East London
Community media/newspapers/journals (media divorced from consumer advertising) distributed through health care facilities waiting rooms

EXPLORING THE MEANING OF A HEALTHY ECONOMY

The word “economy” is derived from two ancient Greek words, “oikos” meaning “home”, and “nomos” meaning “rule” or “law”. The word, economy, therefore in its original sense concerns “the rules pertaining to household management”. Economics is therefore primarily not about money, but how we seek to live with each other. Whilst proper financial accounting is important to ensure that we live within our means, money is a poor substitute for meaningful work and supportive relationships. Money is a lubricant for human development but it cannot be the motor otherwise it turns people into instruments and human activities into commodities. It subverts economic life into a form of financial slavery and encourages us to seek personal material gain in all human relationships.
The word “health” derives from an old English word “hail” meaning “whole”. In medical care we recognise the importance of a holistic approach. Likewise, a healthy economy needs to respond not only to the physical realities of life but also to the need to foster appropriate personal and communal values and a healthy ecology of living. A healthy economy cannot be measured in dollars, pounds or euros, but can be felt in how it how promotes supportive human relationships which in turn help people to live out their talents and develop as human beings. Many studies have shown that affluent societies, especially those that are egocentric, self-willing and consumerist have lower parameters for health, contentment and social cohesion than middle income, socially cooperative societies.

It is a paradox that the easiest way to increase financial turnover and increase the sum of necessary work is to cause problems that must then be solved – problems such as waste production, crime, environmental degradation, illness-provoking life-styles and violence. Add to these the subtle generation of psychic insecurity and a sustained promotion of material needs, then an economy can be created in which financial turnover is enormous but in which healthy economic relations are distorted. The armaments industry, tobacco, alcohol, the automobile industry each contributes some 4% to the gross national product. Each has their consequences for health and well-being. Economic theory has also to deal with problems generated by a motivation for surplus profit in which it pays financially to deny health and social rights to workers and to ignore the environmental and social consequences of economic activity.

There is a need to move to the third paradigm of health philosophy. Progress in health care began some 300 years ago with the scientific revolution. Some 30-40 years ago, health carers began to become aware of the need for personhood of the patient before them. It is now necessary to fully understand the social aspects of health, aspects that are determined by the economic rules of an societyOrganisations working against the NHS reforms
Keep our NHS public (KONP)
BMA (half hearted)
NHS Consultants Association – (made up of consultants who support the NHS)
Socialist Medical Association – excellent and informative web site
Medact (challenging the barriers to health from poverty, violence and climate change)
The campaign for greener health care

Some reading/background

NHS, economy, governance and health
Allyson M Pollock; “NHS plc”, Verso 2004
Pat Devine: The Political Economy of Twentieth First Century Socialism, Soundings, issue 37, 1997
Anna Coote, Jane Franklin: “Green Well Fair: three economies for social justice” New Economic Foundation, 2009 (pamphlet)
Fair Societies, Healthy Lives, the Marmot Review, 2010
The Spirit Level: Why Equality is Better for Everyone: Richard Wilkinson, Kate Pickett, Allen Lane, London, 2009
Three Dimensions of Modern Social Governance: Markets, Hierarchies and Kinships, Vladimír Benácek: http://www1.ceses.cuni.cz/benacek/3D-Nov05-short_version.pdf (accessed 3rd October, 2010)
Felix Guattari: “The Three Ecologies”
(Guattari, a Marxist psychoanalyst, “The three ecologies”, an essay published in 1989 and available on the web)
Lewis Hyde: “The Gift”, Vintage Books 1983
Richard Titmus “The Gift Relationship: from human blood to social policy”, 1970, re-issued 1997
Global Health Report 2: an Alternative World Health Report, Zed Books 2008

Philosophy and Biology
Joost van Loon: “Risk and Technological Culture: towards a sociology of virulence”, Routledge 2002
(especially Chapter 4: Assemblages and deviations: biophilosophical reflections on risk)
Noel Castree: “Nature”, Routledge, 2005
(although a book of the philosophy of geography, opens up perspectives on the philosophy of the biology of health)
Iain McGilchrist: “The Mastery and the Emissary: the divided brain and the making of the modern world”, Yale 2009
(author is a psychiatrist, neurophysiologist and one-time lecturer in English at Oxford University who offers a critique of the narrow bounds of technical reason)
William Engdahl: “Seeds of Destruction: the hidden agenda of genetic manipulation”, Global Research, 2007
Steven Rose, Hilary Rose: “Darwin and After”, New Left Review 63, May-June 2010, pp 91-113 (downloadable from New Left Review Website)
(a critique of Darwinian and genetic determinacy with an introduction to epigenetics – emerging theories showing that the dna of the nucleus is not the master molecule but influenced, and changed, by its cellular environment and ecological habitat)

Philosophers worth (in my view) looking at
Jean Baudrillard
Alain Badiou e.g
Jurgen Habermas
Maurice Merleau-Ponty

chrisbem@btinternet.com