1980s >> 1985 >> no-966-february-1985

Running Commentary: Feel the quality

Were the doctors who decided to refuse further kidney dialysis treatment to Derek Sage serious, when they said this was because his “quality of life was not good enough” to justify it?


Perhaps Derek Sage was a difficult, demanding, aggressive patient at the Churchill Hospital. Perhaps his behaviour did tend to disrupt the routine there; such places are at times rather like a huge factory with an overworked labour force where the routine is important, for without it everything might grind to a halt.


But does this case set a precedent? If so, there will be some trembling hands among the port glasses of the stately homes. If medical treatment is to be allocated on the basis of quality of life and on the demands the patient makes on social resources, how will the privileged class in society fare when they need it?


For example what contribution, other than helping to fill the columns of the gutter press, does Prince Andrew make to the quality of life? Is he not, with his unproductive. parasitic existence, an unjustifiable drain on human resources?


Then what about Mark Thatcher? Apart from losing himself in the desert in an exercise based on the assumption that he could find his way through it, and failing to become an accountant, what contribution has he made to the communal good?


These questions can be asked of the ruling class as a whole. In what way is the quality of life improved by the activities of this assortment of leeches and play-people? How do the majority of people, those who do the useful, productive work, benefit from those long, expensive nights in the casinos of the world, from those orgies of killing on the grouse moors, from those massively indulgent feasts which are called eating and drinking?


How do we benefit from any aspect of the existence of the owning, ruling, coercing. capitalist class? The answer to all these questions is that there is no advantage to humanity in any of this; in fact the opposite is true, for society will be a much happier, healthier, more peaceful place when their standing is removed and class society abolished.


But of course until that happens the capitalist class do not need to worry about their chances of getting medical treatment. What really settled the matter for Derek Sage was that he couldn’t afford, at the time, to pay for dialysis. When the money was found for it he was whipped off to another hospital where patients can be as difficult as they like provided the bills are settled easily.


What it comes down to, is that what matters is not the quality of your life but the size of your bank balance — which is roughly how capitalism judges almost everything.


Cause or effect?

The latest issue of Social Trends, the government’s statistical picture of what life is like in Britain today, gives no hope for anyone who waits for such surveys to come to any surprising or original conclusion.


For example, Social Trends finds that those who lost their jobs between 1979 and 1983 recorded higher rates of divorce, alcoholism and notified illness. Anyone with any ability to relate facts to each other will not be surprised at this; indeed, it would be astonishing if it were the other way round.


To the people who rely on selling their working abilities to an employer in order to live, holding a job often has an importance beyond mere physical survival. It is also something to do with status, with self-respect as a person who is usefully contributing towards a home and a family. The sack can bring on a depressive sense of unworthiness, at times leading to suicide.


So it is not unreasonable to expect the unemployed to react to the problems of being on the dole by taking to drink, or falling ill, or having difficulty in their personal relationships. The happy, secure, sunshine-bathed family so beloved of the advertising industry is a cruel myth. The reality of working class life, with its unrelenting struggle for survival, is much less attractive.


But of course, if the statisticians saw it as simply as that they might reason themselves out of a job. So Social Trends also contains some discussion about the sequence in which unemployment and illness are related. Which comes first? Is it more a matter of, say, heavy drinkers being more liable to be sacked when redundancies are in the offing, than teetotallers hitting the bottle as a consolation for being on the dole? Such trivial debating points are the stuff of life for the statisticians, the economists, the sociologists, but how important are they?


The majority of people in capitalist society have to find employment. Naturally, employers prefer to take on workers who are fit and well to those who are persistently on the sick-list or liable to lapse into alcoholism or drug abuse. Workers who suffer from these disabilities are among the most distressed members of their class. Their fate under the pressures of capitalism in the 1980s is a bitter illustration of the relentless degradation of working class poverty.


So whether unemployment and sickness are seen as cause or effect, we are brought back to the basic fact of capitalism’s class relationships and of working class deprivation. These are not social trends, but inevitable social features which can be eradicated only by the abolition of capitalism.


Not guilty

Band Aid’s record about famine-stricken Ethiopia was a shrewd contrast to the usual Christmas mush about presents and children and jolly sleigh rides. It went some way to resurrect, as well as rename, a not-now-so-popular pop group by appealing to the sickened reaction to the sight of wasting, pot-bellied, fly-smothered children.


In turn, this stimulates impatience at the apparent complacency and indolence of officialdom, fuelled by the notion that governments exist to organise away problems like famine with shipments of food, medical supplies and so on. So why don’t they get on with their job. instead of leaving it up to a charitably inclined pop group and their customers?


Then there is the measure of induced guilt, as workers in places like Britain are encouraged to be embarrassed at the level of poverty they are accustomed to while millions of people elsewhere are even worse off, expiring through lack of basic necessities like food. British workers are told that, luckily for them, they live in the “affluence” of the west and that if some of this were transferred to the Third World it would go a long way to eliminating famine, tropical diseases, shanty housing and the like.


There are many faults with these arguments. which get in the way of promoting the idea of a radical social revolution which will really solve these problems. If governments existed to protect human welfare, their priorities would be very different; they would devote a lot less resources to coercion and destruction and a lot more to humane constructiveness.


A society of class ownership is one of privilege, of poverty opposed to riches and of course there must be degrees of both these conditions. There are very rich people in the world and very poor. However poor a worker may be it may be possible, until we reach the very lowest and most degraded, to find someone who is even worse off. But this does not help the argument; the important point is that rich people don’t get caught in a famine; hunger is another symptom of poverty and immunity from it another benefit of riches.


So it is actually a class issue. Throughout the world the majority of people are denied by their class standing full and free access to wealth. The guilt of workers who may be somewhat above the most wretched and doomed of people is a false reaction to the problem; it would be better applied as indignation about the social system which divides humanity into classes, with such catastrophic consequences for most of us.