Anarchism by Alex Prichard

Author:Alex Prichard [Prichard, Alex]
Language: eng
Format: epub
ISBN: 9780192547590
Publisher: OUP Oxford
Published: 2022-07-07T00:00:00+00:00

Public health

You don’t have to be an anarchist to see that the history of the provision of socialized healthcare is a history of state appropriation of working-class, non-state, provision of public goods. In the late 19th and early 20th centuries, states began to mimic and appropriate the public goods and mutual aid the labouring classes provided for themselves, by what were called ‘friendly societies’, guilds, and unions. For example, the German Chancellor, Otto von Bismarck, introduced a pension or social security in 1889, and did so unashamedly and strategically to mimic and co-opt the initiatives of pre-existing institutions. Not every attempt was so cynical. Aneurin Bevan, the founder of the UK’s National Health Service in 1948, was then member of parliament for Tredegar in South Wales, and the Labour government’s Minister of Health. His constituency was the home of the Tredegar Medical Society, founded in 1870 and closed in 1995, which at its height in the 1920s provided medical care for 95 per cent of the community, paid for by subscriptions. After the Second World War, with so many and so much having been sacrificed in the fight against fascism, Bevan fought tooth and nail for the scaling up of the Tredegar Medical Society into the National Health Service, to provide for the country what had been provided for by his community for one another for decades.

Most anarchists, if asked, would no doubt want free universal healthcare at the point of access. Good health is central to individual and communal flourishing. The question is how should it be organized, to what ends and by whom, and how should it be paid for? There is little public engagement in this question in the UK, other than through periodic voting in elections for whoever claims to be on the side of the NHS. Anarchists object to centralization, hierarchical bureaucracies, and the profit motive, which counter the professed egalitarianism of universal healthcare, and make nimble, bottom-up responses to local public health crises difficult. Anarchists also object to the high opportunity costs of training to become a doctor and the class structures this professionalization (like so many others) entrenches.

The example of the Peckham Health Centre illustrates this. The Peckham Health Centre in south London was an anarchist health centre in operation from the 1930s to the 1950s, closing only as a precautionary measure during the Blitz because part of the health centre had a glass roof. It was formally structured around families and local membership, paid for by direct subscriptions, with the building an integral part of the community, consisting of a creche and social centre, as well as a surgery. It prided itself on its autonomy, but when the NHS was founded, this autonomy was unacceptable for at least two reasons: first, the health centre’s autonomy ran counter to the universality of the NHS’s founding ethos. Secondly, the avowed horizontality and anarchistic ethos of the centre undercut the professional hierarchy doctors were trying to defend, mainly against Bevan himself. As the administrator of

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