Mary Ward argues why communists must take an holistic approach to health and health care.
In socialist circles, when you talk about campaigning around health issues, comrades, understandably, turn their thoughts to fighting to defend the NHS.
The cuts in provision, introduction of the mysterious internal market, the quangos that run our local health services, waiting lists, cuts and more cuts. The list goes on and we can understand why these considerations are uppermost in comrades minds.
Next we think of the horrendous figures relating to the physical health of those who live in this country. Premature deaths due to heart disease, smoking induced cancers or due to consumption of that other legal drug alcohol. Poverty takes its toll physically on so many people that we know, and postcode prescribing ensures that the working class are always at the end of the queue when it comes to diagnosis and treatments.
Yet we need to move our thinking forward. We cannot stay in an economistic mindset. As socialists we need to learn a holistic approach to health. I am not suggesting for one second that we ignore campaigning around traditional health issues – far from it. I pride myself as being a long-standing activist against cuts and closures. I mean that we need to define health in such a way that we demand not just what the capitalist system thinks we barely deserve but what is absolutely necessary to be fully human.
Eradicate the artificial divide
For a start, we need to stop thinking of health as an absence of illness but in terms of well-being. The artificial divide between physical, social and emotional health needs to be eradicated and questions relating to mental health and sexual health should not be seen as marginal but central to all our lives.
Whoa! I can hear it now. What is all this middle class namby pamby psycho-babble? Working class people need their illness treated and the waiting lists reduced. We need to fight PPP and hospital closures not indulge in peripheral nonsense.
Comrades, these issues are not peripheral, but integral, to a struggle to bring about a society where people are truly valued. That is about how we feel in emotional, as well as physical, terms and it’s about being able to express our sexuality and sexual needs openly and honestly. And mental health issues are class issues. Those living in poverty are three times as likely to be admitted to hospital for depression and three times more likely to commit suicide. Suicide rates in Scotland are among the highest in Europe, particularly for young men.
Let us consider the interconnection between the physical social and emotional. We all recognise that some illnesses can bring on depression; at a very basic level if we have flu we can feel down and easily upset. It also has an obvious effect on our ability to engage with others and to fully socially integrate. Imagine this effect extended to someone having HIV. Discrimination can make us socially isolated and depressed. This can have an effect on our immune system. Social isolation can exacerbate our feelings and who is in a position to say whether it is the physical affecting the emotional or the social affecting the physical etc. The three are, so clearly, inextricably linked.
Mental health issues have been to the fore lately in the media. Thanks to the very brave and open stance of Rosie Kane SSP MSP a dialogue about mental ill health has started even amongst macho (not just the men, by the way) socialists.
I an delighted to see two resolutions to SSP annual conference on mental health and the understanding that this is not about other people but about all of us.
The numbers of young people who exhibit self-harm from cutting themselves, to binge drinking, to eating disorders, to suicide is growing daily and the age at which this behaviour starts is getting younger. We must take these issues on board not just from the point of view of treatment but also from the perspective of prevention. An understanding of mental health and mental illness (two different but related things) is essential.
A nurturing environment is needed
The very adversarial nature of politics as practised in this country can have an extremely detrimental effect on people’s health. The capitalist ‘democracy’, we live under, values structures not families, and human relationships are daily sacrificed while trying to play the game. No wonder so many people are alienated from the political process. To take part in it is to subject ourselves and our families to a form of abuse.
We need to define what we expect from our politicians and undoubtedly people will make sacrifices but we need to construct a nurturing environment which supports out comrades not one which is prepared to see them fall by the wayside. Our elected representatives are our responsibility. We need to take on the role of boosting their resilience while they are working inside the enemy camp. Otherwise, we will be destined to have only a certain type of elected representative. We want healthy politicians who do not deny their emotional needs but who can understand the emotional needs of our class.
All aspects of health matter
Sexual health is an area many comrades simply refuse to discuss beyond the alarming rise in Chlamydia rates. Under the guise of privacy, questions of sexual liberation and orientation are glossed over. The extent of our conditioning in these areas is rarely discussed in any depth and many working class people feel that this part of their life bears no relation to politics. Well, for socialists that is rubbish. Every aspect of our being is affected by capitalism. It distorts our relationships and creates a barrier between men and women, which affects our lives in every area. A lack of understanding about our own bodies and our own desires leads on to a lack of understanding between partners and a lack of respect. The culture of our personal relationships is for me a reflection of our political culture. That is why we cannot turn a blind eye if comrades are involved in domestic violence or abuse (verbal, physical and emotional). We cannot ignore bullying or intimidating behaviour in political debates. We need to constantly work on creating structures and an environment of open democracy where minorities are heard and where people feel safe to express their ideas. It is bad enough out there without our political organisation simply mirroring the macho culture of capitalism.
Comrades, our health, in all its aspects, matters. We can lead the way in innovative social policies but we need to make sure we do not just stick to the parameters capitalism says are valid. We need to be considering education programmes for schools, which help build resilience, and self esteem. We need to promote positive mental health and we need to change behaviour, which has a bad effect on health. Physical emotional and social are all parts of the whole.
I passionately believe that health is a subject not just to be left to the health professionals. It is an area in which our practice has to be as robust as our theory. We need to educate ourselves and support one another while we strive for better health – physical, emotional and social. Remembering, however, that although politics can be bad for your health, taking control of your life, being part of the struggle and establishing close relationships with comrades can act as the best form of immunisation you can get.