Thatcher'sLessons

We are now in the era of 'rethinking'. It is the newbuzzword. Some think there is nothing to rethink.

Others see it as little more than adapting toThatcherism. Stuart Hall argues a radically

different view

'Ten lessons from Madame LaZonga;She does the rhumba, and she does

the conga'

T he process of 'rethinking' hasbegun - many would say, notbefore time. Admittedly, it istaking some peculiar forms -

the 'Labour Listens' campaign beingone of the most bizarre. Is it reallyuseful to listen to all and sundry aboutthe future of socialism without, at least,first formulating some themes or prop-ositions of your own? Are there nopolicy directions or tendencies alreadyemerging inside Walworth Road? Nomatter. Even this muddled exerciseshould be seen as part of a widerprocess - painful, contorted, but anabsolute prerequisite to any possiblerenewal of the project of the Left.The issue, now, is not whether but how

to rethink. The temptations for the Leftwill be either to fall back on The Faithas we know it or to race forward toembrace the new Thatcherite 'consen-sus'. Another, more radical, proposal isthat we could do worse than to start theprocess of rethinking with a littlethought. What the 'Thatcher revolution'suggests is that good ideas, or what thepolitical commentators were calling, inthe aftermath of the election, some 'BigThemes', don't fall off the shelf withoutan ideological framework to give thoseideas coherence. By framework, wemean a perspective on what is happen-ing to society now, a vision of thefuture, a capacity to articulate thesevividly through a few clearly-enunciated themes or principles, a newconception of politics. In short, apolitical strategy. In this, as in muchelse, the Left could do worse than beginby 'Learning From Thatcherism'.Now, nothing is more calculated to

drive the Left into a tizzy than thisscandalous proposition - especiallywhen advanced by MT. The very idea ofThatcherism is anathema to the Left.Decent people everywhere hate andrevile it. Where Thatcherism is, therethe Left cannot be. They inhabit two,not only different and hostile, but

mutually-exclusive worlds. What onearth could the Left possibly learn?Besides (shades of 'Gouldism') isn'tthis slogan simply a cover-up for theattempt to shift Labour irrevocably tothe right - an injunction to cuddle up tothe 'enterprise culture', on the if-you-can't-beat-them-join-them principle?It is a sign both of the defensiveness

and the residual sectarianism afflictingmany parts of the Left that it mis-readsan injunction to analyse 'Thatcherism'for a recommendation to swallow itwhole. It is time to correct this fatalconfusion, most of all because it is nowso politically disabling. Unless the Leftcan understand Thatcherism - what itis, why it arose, what its historicalspecificity is, the reasons for its suc-cess in redrawing the political map anddisorganising the Left - it cannot renewitself because it cannot understand theworld it must live in if it is not to be'disappeared' into permanent marginal-ity. It is time, therefore, in the contextof rethinking, to make clear exactlywhat is meant by 'learning fromThatcherism'. And we can do this, notonly in general terms, but in relation toa concrete example: the current crisissurrounding the NHS.

The first thing Thatcherism teaches usabout the NHS is that crises alwayspresent opportunities as well as prob-lems. The problem here is not only howto reorganise the NHS but how to turnthe crisis to our political advantage. Itis not only a chance to defend the NHSbut an opportunity to construct amajoritarian politics of the Left. If theLeft cannot develop an alternativelong-term political strategy it cannotsave the NHS. What most distinguishesThatcherism's wide-ranging conduct ofideological politics from Labour's nar-row, tactical parliamentarianism, isexactly this unremitting attention tothe long-term, strategic, political 'pay-off of apparently short-term crises.The present uproar around the NHS

is, after all, the most protracted crisisaffecting the welfare state of MrsThatcher's reign. We always knew -and she always knew - that it was her

Achilles heel: the area where popularopinion would be most stubbornlyresistant to the project (to which,despite tactical retreats and statementslike 'the NHS is safe in our hands' (sick)she remained steadfastly committed):that of 'breaking the spell of thewelfare state'. Such a goal has been theconsistent motor of the Thatcheriterevolution in welfare, and was pre-viewed by the Institute of EconomicAffairs as long ago as 1981 (Anderson,Tait and Marsland, the Social AffairsUnit, 1981. I give the reference anddate for the benefit of those politicalcommentators, like Peter Kellner, whocomfort themselves - and us - by theludicrous proposition that, becauseThatcherism is tactically adept, it hasno consistent ideological driving forceapart from that so beloved of psepho-logists - the lust for power). So, whatwe have now is a crisis that refuses togo away, unremitting (and often critic-al) media coverage, widespread andvaried popular support for a change,and the government temporarily on theropes. How could the Left and theLabour Party fail to profit, politically,from such a conjuncture?And yet, the more the crisis unfolds,

the more the Left's political andideological gains seem, at best, 'pas-sive' ones. Mrs Thatcher has personallytaken charge of the crisis - always anominous sign. 'The impression whichthe prime minister was trying to createwas that she was pleased that talk ofcrisis by the opposition and healthprofessionals had opened up the NHS toher radicalism. Her spokesmen coun-tered the impression of governmentpanic by stressing that she was "seizingthe tide of public perception"' (TheGuardian Jan 27). The talk is nowexclusively about 'alternative ways offunding' (which every post-Thatcheritechild of nine knows is a code-phrase forthe massive expansion of private medi-cine and privatisation within the NHS)and 'breaking the barriers to greaterefficiency' (which we know is a code-phrase for destroying COHSE andNUPE).

aven't we been here be-fore? A great, thunderingcrisis - and then, inexor-ably, as it unfolds, the tide

beginning to turn, the ideologicaladvantage shifting to the other side,victory snatched from the jaws ofdefeat ...? Politics, waged by Thatch-erism as a relentless 'war of positions'?Crisis as a God-sent opportunity toradically restructure society (or, asGramsci put it, 'reconstruction alreadyunder way in the very moment ofdestruction')? Why do we still find itimpossible to believe that this couldhappen, when it has been happening tous, steadily, since 1979?

There are several reasons for this reluc-tance. The Left keeps telling itself that'the postwar settlement is over': but westill find it difficult to think politicallyin a world where its terms can no

20 MARXISM TODAY MARCH 1988

MARXISM TODAY MARCH 1988

longer be taken for granted. We find iteasier to be righteously moralisticabout Thatcherism ('isn't she a cow?'):harder to grasp its logic as a politicalstrategy. Another reason is the Left'sdefensiveness. It is as though themoment we stray, even for a moment,from the straight-and-narrow path ofconventional left wisdom, the big, badwolf of Thatcherite revisionism iswaiting to gobble us up. Our sectarian-ism is often a product of fear - thechanging world is seen as a strange andthreatening place without signposts. Itis also symptomatic of the way ourthinking has become stuck in a particu-lar historic groove, of how our agendasare fixed by the circumstances (the1930s, 1945) in which they were origi-nally formed.

I t is also due to a certain notion ofpolitics, inhabited not so much astheory, more as a habit of mind.We go on thinking a unilinear

and irreversible political logic, drivenby some abstract entity we call 'theeconomic' or 'capital', unfolding to itspreordained end. Whereas, as Thatch-erism clearly shows, politics actuallyworks more like the logic of language:you can always put it another way if youtry hard enough. Current campaigningon cuts in the NHS could lead to a leapin public spending. Alternatively, itcould lead to the argument that - sincethe NHS is underfunded but the de-mand is potentially limitless, taxpayersare looking to pay less in taxation andthere is money swilling around in theprivate sector - the only solution isvalue-for-money and privatisation. Thedifference between the first and thesecond scenarios is not determined bysome inexorable 'law of history' but bythe effectiveness of our political-ideological intervention, above all inthe 'theatre' of popular politics andpopular conceptions.Let us stay with the question of

'popular conceptions' for a moment.The popular defence of the NHS isgenuine. But so is the demand for lowertaxation. (In the same way, the commit-ment to the state education system iswidespread. But so is the sense that, insome places, it is beginning to fallapart). These interests genuinely con-flict. They collide inside the heads andhearts of many ordinary folk whoaren't hundred-and-one-per-cent, com-mitted 'Thatcherites' - people whowe will have to win over if theprinciples underlying the NHS or stateeducation are ever to prevail again in anew form. This conflict of loyalties anddesires is what precipitates chaos andunpredictability in the ideological field:precisely the rupture on which Thatch-erism capitalises.

So, the balance of ideological advan-tage slowly turns Thatcherism's way,because the specific issue of the NHS issecured for the Right by a deeper set ofarticulations which the Left has notbegun to shift. These include suchpropositions as: the public sector isbureaucratic and inefficient; the pri-

21 MARXISM TODAY MARCH 1988

vate sector is efficient and gives'value-for-money'; efficiency is inex-tricably linked with 'competition' and'market forces'; the 'dependency cul-ture' makes growing demands on thestate - unless ruthlessly disciplined - a'bottomless pit' (the spectre of theendlessly desiring consumer); publicsector institutions, protected by publicsector unions, are always 'overmanned'(sic).; 'freedom' would be enhanced bygiving the money back to the puntersand letting them choose the form andlevel of health care they want; if thereis money to spare, it is the direct resultof Thatcherite 'prosperity'; and so on.In short, the familiar Thatcherite litanywhich is indelibly imprinted on thepublic mind and imposed on public andprivate discourse everywhere.

T he unpalatable fact is that,despite the crisis, Thatcher-ism continues to hold thehigh ground because, among

large sections of the population (includ-ing Labour voters) the political-ideological thematics of Thatcherismremain in place.So, one thing we can learn from

Thatcherism is that, in this day and age,in our kind of society, politics is eitherconducted ideologically, or not at all.Thatcherism has put in play a range ofdifferent social and economicstrategies. But it has never for amoment neglected the ideologicaldimension. Privatisation, for example,has many economic and social pay-offs.But it is never advanced by Thatcher-ism without also being constructedideologically ('Sid', the 'share-owningdemocracy' etc). There is no pointgiving people tax cuts unless you alsosell it to them as part of the 'freedom'package. In this sense, Thatcherism isalways, and consistently, multi-faceted.It always moves on several fronts atonce. It moulds people's conceptions asit restructures their lives as it shiftsthe disposition of forces to its side.This is what is sometimes called a

'hegemonic political project'. A simplerway of putting it would be thinking andacting strategically. This word is con-stantly bandied about by the Left. Butdo we know what it means in practice?In his recent pamphlet on The PoliticsOf Prosperity, Charlie Leadbeaterargued that 'thinking strategically'implied 'recognising the enormity andsignificance of the changes which havetaken place in the last decade. It mustnot simply modernise past policies . . .There must be some vision of what kindof society this strategy would create...It must be built up from the founda-tions of the cultural identities andlifestyles it sanctions and approves . . .through the institutional mechanismswhich promote and maintain these . . .to the higher political ideology.' Theseaspects need to be spelt out more.

The 'enormity and significance of change'does not only refer to the consequencesof Thatcherite cuts and restructuring.There are deep-seated underlying, eco-

nomic, sociological and cultural trendswhich are profoundly reshaping Bri-tain. Thatcherism did not create these,though it appropriates them politicallyand harnesses them to its ownstrategies. But any left-of-centre gov-ernment will have to deal with themtoo. In that sense, whether we like it ornot, we exist in the same universe, andare subject to some of the sameconditions of existence. This is not theplace to elaborate on what these trendsare. But broadly speaking, organisedcapitalism, the industrial proletariat,the labour movement and the very ideaof socialism itself were all brought totheir mature modern forms alongsideand in conditions (around the turn ofthe century) associated with the 'For-dist revolution' in the organisation ofmodern production. 'Fordism' standsfor the large-scale, flow-processes ofthe modern factory, the skilled factoryproletariat, the intensification of man-agement, the rise of the corporategiants, the spread of mass consump-tion, the concentration of capital, theforward march of the technical divisionof labour, the intensification of worldcompetition and the further spread ofcapitalism as a 'global system'. Thiswas never only an 'economic' revolu-tion. It was always a cultural and socialrevolution as well (as Gramsci, whodiscussed the connection of 'Fordism'with the reorganisation of sexual life inhis classic essay, Americanism andFordism, perfectly understood).

ow we are beginning, in theusual highly uneven andcontradictory way, to moveinto a 'post-Fordist' society

- what some theorists call disorganisedcapitalism, the era of 'flexible spe-cialisation' (See Robin Murray, 'Benet-ton Britain', MT Nov 1985). One way ofreading present developments is that'privatisation' is Thatcherism's way ofharnessing and appropriating thisunderlying movement within a specificeconomic and political strategy andconstructing it within the terms of aspecific philosophy. It has succeeded,to some degree, in aligning its historic-al, political, cultural and sexual 'logics'with some of the most powerful tenden-cies in the contemporary logics ofcapitalist development. And this, inpart, is what gives it its supremeconfidence, its air of ideological com-placency: what makes it appear to'have history on its side', to be cotermi-nous with the inevitable course of thefuture. The Left, however, instead ofrethinking its economic, political andcultural strategies in the light of thisdeeper, underlying 'logic' of dispersaland diversification (which, after all,need not necessarily be an enemy ofgreater democratisation), simply re-sists it. If Thatcherism can lay claim toit, then we must have nothing to do withit. Is there any more certain way ofrendering yourself historicallyanachronistic?

'The significance of change' also has amore practical meaning in relation to

' The postwarsettlement isover: but westill find itdifficult to

think politi-cally in a

world whereits terms canno longer be

taken forgranted'

this crisis. We cannot simply defendthe NHS as it is, as if nothing hadhappened since it was first introducedin 1947. In practice, the Left can onlyseize the political advantage by mount-ing its own critique of the NHS - since,as everybody quietly recognises, thingswere not hunky-dory in the NHS longbefore the advent of Thatcherism; andnot all the problems are of Thatcher-ism's making. Steve Iliffe long agoconvincingly argued in these pages(MT Oct 1986) that, in fact, there is notone, but 'two interconnected criseswithin the health service. One is adirect consequence of the economicrecession and Conservative attempts toescape from it' (coupled, we would add,with Thatcherism's project to restruc-ture the welfare state). 'The second is along-term structural crisis of medicineitself running over decades and com-mon to the industrialised world.'There is a deeper side to this as well.

We may have to acknowledge that thereis often a rational core to Thatcher-ism's critique, which reflects some realsubstantive issues, which Thatcherismdid not create but addresses in its ownway. And since, in this sense, we bothinhabit the same world, the Left willhave to address them too. However,squaring up to them means confrontingsome extremely awkward issues. Oneexample is the fiscal crisis of thewelfare state - the ever-rising relativecosts in the NHS as the average age ofthe population rises, medical technolo-gy leaps ahead, health needs diversify,the awareness of environmental fac-tors and preventive medicine deepensand the patterns of disease shift. Thefiscal crisis of the welfare state is notsimply a Thatcherite plot, though ofcourse Thatcherism exaggerates it forits own political ends.The Left's answer is that there is more

to spend if we choose; and this iscertainly correct, given Britain's piti-ful comparative showing in terms ofthe proportion of GDP spent on healthamongst the industrialised countries.But only up to a point. At the end of thisroad, there are limits, which are notthose set by Thatcherism's artificial'cap' on spending but those limits set bythe productivity of the economy itself.What the Right argues is that, once thislimit is reached (even at the USA's10.7% rather than the UK's miserable5.9%) there is then not much to choosebetween rationing by price (which theywould prefer) and rationing by queue(which is what has been going on in theNHS for decades). Naturally, theyprefer rationing by price, since itincreases the incentive to the patient tosave on costs and puts pressure on the'health market' to become moreefficient. We have rooted objections tothis path: but this must be because wehave a different game-plan, not be-cause we are playing in a differentball-park. But have we spelt it out? Doour supporters and the public knowwhat it is?One thing, for certain then, that we

23 MARXISM TODAY MARCH 1988

'Thatcherismmoulds peo-ple's concep-

tions as itrestructurestheir lives asit shifts the

disposition ofpolitical

forces to itsside'

mean by 'strategic' is thinking in asustained, interconnected way - rightthrough to that painful point where onepolicy cross-cuts another. The point,for example, on the one side, wheresimply 'spending more on the NHS'comes up against the barrier of thefailure of the Left so far to elaborate astrategy for an expanding economy. Onthe other hand, where it hits the roadblock of the unpopularity of highertaxation in the form of that entrenchedfigure (which, at the moment, belongsexclusively to the Right) - the'sovereign taxpayer'. Thatcherism isalso held in place by this ideologicalfigure of 'economic man', the measureof all things, who only understandscash-in-hand, readies-in-the - pocket,and who apparently never gets ill,doesn't need his streets cleaned or hischildren educated or to breathe oxygenoccasionally. Clearly, the NHS issuecannot be won in terms of the NHSalone. If Thatcherism wins the argu-ment about 'wealth creation', 'prosper-ity' and 'taxpayer freedom', it will,sooner or later, win the argument aboutprivatising the NHS.

Of course, you only get a clear sense ofstrategy going among the people youare trying to win over to your side, ifthey can see clearly how it is counter-posed to the strategy of the other side,what are the underlying organisingprinciples, the perspective, the 'philo-sophical themes', which distinguishthem. Successive encounters at thedispatch box are small beer whencompared with a systematic form ofideological contestation, which pola-rises every topic between 'their' way ofconceptualising it, and 'ours', anddrives home in popular consciousnessthe clear, distinction of principle be-tween them. (Mrs Thatcher 'set thescene' for her ascendancy in exactlythis way in the late 1970s, remorseless-ly punctuating the world into a series ofvividly contrasting images - Labour's'statism' against her 'freedom', makingthe flat earth of consensus politics intoa contested battle-zone.) We have tofind ways of dramatising the differencebetween the public and the privatedefinition of social need, betweenmedical care by income or by need,between a first-rate service for the fewand a second-rate one for the majority,between paying for health by universalstandard contribution and paying for itby privatised insurance. These areorganising principles, pertinent to butnot restricted to the NHS (they apply,pari passu to education) because theyare the bare bones of a social philoso-phy we are attempting to unfold byarticulating it.

Contestation, however, is not enough,because by itself it is too negative.Thatcherism did not simply mount aprincipled critique of 'statism'. It un-folded a positive conception of the'enterprise culture', which has takenroot, despite the Left's scepticism, to anastonishing degree. This suggests that,

whilst much of it is political hype, someof it connects with real issues in thepopular mind (its 'rational core'?). Forexample, Britain's relative 'backward-ness', its sluggish performance even ascompared with other capitalist coun-tries, its suffocating traditionalism,which is linked with one of MrsThatcher's favourite targets - thepower of entrenched vested interest.

To develop this more positive perspective,means thematising the NHS crisis interms of wider ideological debates: forexample, around 'the politics of choice'or the question of the market versusthe state. The popular theme of 'choice'has no 'necessary belongingness' toThatcherism. It can just as well beunderstood as belonging to lan older,deeper, complex of attitudes: 'Whyshouldn't ordinary people have a pieceof the action too?' Put this way, 'choice'is as much part of the political reper-toire of popular radicalism as it is ofthe populist radical Right. The problemis that Thatcherism articulated thispopular desire to the 'free market' andthe very powerful idea of 'freedom' -which in reality can only satisfy it in acertain form, at a certain price: and theLeft, having accepted this linkage(secured, not by Nature but by thepolitics of Thatcherism) consequentlyabandoned choice. It nevertheless re-mains possible to reconstruct the ideaof 'choice' in relation to such themes asthe growing diversity of society, thewidening of access, the empowermentof ordinary people through their 'rightto choose' (even if it is only, to startwith, choosing their GP, or having awider range of therapies and commun-ity support services available at healthcentres or simply the right to knowwhat is wrong with you or see your ownmedical records); or in terms of thecontrast between negative and positivefreedom. In short, dramatising theNHS crisis in relation to the conceptsThatcherism has not managed toappropriate: democratisation, rightsand the expansion of social citizenship,

owever, the Left shouldnot expect to get very faron this issue until it hasclarified its mind on the

underlying issue of strategic principle- that of 'market or state'. The Left hada critique of 'statism' - whether of theStalinist or fabianist varieties - longbefore the neo-libertariansim of thenew Right. But, in part because ofLabourism's complicity with the lattervariant, we never pushed that thinkingpast the point where the free-marketeers could hijack it. The so-called 'rediscovery of the market' is nota phenomenon exclusively of the Right(as any Hungarian, Soviet or Chineseeconomist will soon tell you). And thegreater flexibility, flow of information,the maximisation of choice which themarket signals is part of that 'dynamicsof change' which we identified earlier.However, 'the market' in this generic

sense, is quite different from the 'free

play of capitalist market forces'(another Thatcherite elision). And bothare different again from the 'religion ofthe market' - 'value-for-money' as thesole criterion of the good life or ofsocial need. In their unregulated forms,'market forces', now as always, createwealth and dynamic at one end, andgross inequalities and deprivation atthe other. As for value for money as theonly measure of the social good, andMrs Thatcher's 'New Benthamites' who'take the modern shopkeeper, especial-ly the English shopkeeper, as thenormal man' and apply 'this yard-measure to past, present and future',surely Marx said the last word on MrTebbit, Mr Baker, Lord Young, MrRidley and this tribe of philistines:'geniuses in the way of bourgeoisstupidity'. In a proper conception ofmodernity, they are cultural primi-tives. They have hardly come downfrom the trees.

J ust as we have not thoughtthrough what the Left 'approp-riation' of the market means -what forms it can take, how far

it should go, what are its necessarylimits - so our critique of 'statism'remains at an extremely primitivelevel. If 'the state' is no longer to be themonolithic caretaker of socialism, whatis it? What are the institutional forms ofa responsive (rather than a prescrip-tive) state? Of a regulative (rather thana centralising) state? Of a state whosefunction is not to curtail but to expandcivil society and the democratic char-acter of social life? And (the joker inthe pack) how, if not through the statein some form, is the 'social interest' tobe formulated and represented? Canthe Left abandon the ideas of therational planning of resources and therational choice between priorities in asociety of scarcity, together with the'grand narratives' of Reason and Prog-ress? Can we combine a greater use ofthe market mechanism with greaterregulation (rather than with 'deregula-tion')? We raise these awkwardthoughts to drive home the point that aLeft in quest of a strategic position inpolitical life must launch this debate,take command of this agenda, itself,rather than being dragged along in theslipstream of the Adam Smith Institute.The move from a monolithic 'state',

the omnipresent provider, to a plural-ised 'civil society' also entails givingvalue in our thinking to areas of sociallife and arenas where we put in playnew social identities which classicallythe Left has much neglected. Forexample, in relation to the NHS, therole of consumers of health care indefining needs and how they are met; orour 'rights' as citizens of an increasing-ly 'well' society, alongside our place asproducers and suppliers. This marksthe coming into play, within the dis-courses of a contemporary socialism,of the politics of the private as well asthe public; of domestic, familial andsexual life as well as the life of therepublic; 'the personal as political'.

25 MARXISM TODAY MARCH 1988

Where better to see how, in modernsociety, these so-called 'separatespheres' increasingly interpenetratethan by looking at the arena of health,medical care, illness and the body?Where better to open up the excitingchallenge of trying, in the context ofthe NHS debate, to think themtogether? This is one of the elementswhich anyone who has listened atten-tively to the radio phone-ins on the NHSwill have heard being enunciated withremarkable clarity.

T his shift in the postwarperiod from the ever-expanding state to a morediverse, democratised 'civil

society' state (and a 'withering' state) isone of the most profound advances tohave taken place in the thinking of theLeft this century. It transforms thevery meaning and image of socialism.It is to begin to think socialism anewfrom the perspective of some of themajor themes of the agenda of femin-ism and sexual politics. (Is anybody inWalworth Road ready for that?) And itis startingly new (allowing us thereforeto appropriate many themes which ourcommitment to 'statism' precluded)because it has taken on and beentransformed by the modern experienceof contemporary society. The whole'experience' of the deformations ofboth Stalinism and fabian social demo-cracy are inscribed in that shift.

We have been concentrating, so far, onquestion of 'popular conceptions'.However, 'strategy' cannot be a matterof ideological politics alone. It is also aquestion of how to construct aroundthose conceptions, a popular politics or,to put it more simply, the difficultbusiness of constructing alliances. TheLeft needs to build a majority aroundthe NHS, not passively reflect thefragile consensus which is alreadythere. Since this is composed of suchheterogeneous social interests as arethose represented by the BMA, seniorconsultants, junior doctors, nurses andancillary health workers, it is anextremely unlikely alliance, destined tofall apart at the first touch of Thatcher-ism's magic wand if not consolidatedaround some common points of unity,welded into a 'bloc'. Any broaderalliance in favour of some form of free,universal health care will have to beconstructed across classes. That is, itwill have self-consciously to be theresult of a politics dedicated to speak-ing to people in quite different socialpositions. The great majorities of thedispossessed, for whom a publicly-funded NHS is a life-line; the low-wage,unemployed and single-parent familieswho could not manage without it; theoverwhelming bulk of working people,whom Edwina Currie recently invitedto forego their fortnight's holiday inorder to be able to afford 'adequate'private health insurance; but alsoteachers and public sector workers andpeople in the service economy andthose in the middle class, who might be

able to afford some sort of medicalpremium (especially if Mr Brittan hashis way and those moving to the privatesector got rebated) but who value aservice within the 'enterprise culture'where the best goes to those who needit most rather than to those who earn orpossess the most. This is a politicswhich is at last face-to-face with, andknows how to address, the greatdiversity of contemporary society.The idea of using the crisis to

construct a majority means giving upthe illusion of a built-in, permanent,automatic majority for the welfarestate. It is better to start by assumingthat there are no 'natural majorities'for anything. Class, the great back-stopof the Left, has certainly not dis-appeared. Indeed, nowhere is it sopowerfully etched as in the classdistribution of illness, types of healthcare, and death which, for example, theHorizon programme, Death Of TheWorking Classes, so perfectly demons-trated. But the underlying social, eco-nomic and cultural forces which arebringing the era of 'organised capital-ism' to a close, coupled with the vigourof Thatcherite restructuring, have de-composed and fragmented class as aunified political force, fracturing anyso-called automatic linkages betweeneconomics and politics: if, indeed, anysuch 'unity' or 'automatic linkage' everexisted (which I beg leave to doubt).The multiplication of new points ofantagonism, which is also characteris-tic of our emerging 'post-industrial'societies, while making available newpotential sites of intervention, furtherfragments the political field, dispersingrather than unifying the differentsocial constituencies. These processeshave unpacked the old majorities(which were, of course, never 'natural'but politically constructed) and erodedthe old agendas of the Left.

T he stubborn truth is thatsocial interests are contra-dictory. There is no automa-tic correspondence between

class location, political position andideological inclination. Majorities haveto be 'made' and 'won' - not passivelyreflected. They will be composed ofheterogeneous social interests, repre-sented through conflicting social identi-ties - like the ones emerging around theNHS. Unless they are unified by somelarger political project which over-rides, without obliterating, their realdifferences, they will fall apart (morelikely, Mrs Thatcher, who does knowhow to recognise and exploit differ-ences, will blow them apart).As well as trying to unify the existing

social interests and identities, the Leftalso has to put itself 'on the side of thenew constituencies. For example, thegreater involvement of mothers in thehospital care of children; the socialmovements for a healthier diet, for abetter care of the body, for greatercontrol by women over their fertilityand reproduction; for a less unequalrelationship between patients and the

'This shift toa more di-

verse, demo-cratised

"civil socie-ty" state isone of themost pro-found adv-ances in thethinking of

the Left thiscentury'

medical profession; for more preven-tive medicine, a healthier environment,a programme of health education thatis not at the mercy of the industriallobbies, the pharmaceutical companiesor the homophobic and anti-abortionistbigots of the 'moral minority'. If itknew how to articulate these newforces within the great levelling ex-perience of illness, which hits everyonesooner or later irrespective of wealthor class, it would soon discover thatsociety, looked at this in a morediversified way, not at all 'passive'about new needs in the field of healthand medical care. People think the NHSneeds more funds. But they are alsowilling to do something about it, as thepublic health movement and 'HealthAlert' suggest. The link, so often forgedwilly-nilly by the Left, between welfareand passivity has been disastrous. Butit is not inevitable.

If this is to be part of a wider, popularpolitical strategy, it has to be fought inthe end as 'a struggle for popularidentities'. That is, it must draw toitself the widest range of popularaspirations about health, enable diffe-rent sorts of people to see themselvesreflected in this emerging conceptionof health and thus come increasingly toidentify with it. Once you give up theidea of an automatic identification withthe welfare state which is guaranteedby class position, you are obliged toaddress the subjective moment inpolitics because, unless people identifywith and become the subjects of a newconception of society, it cannot mater-ialise. Thatcherism has a perfectlyfocused conception of who its idealsubjects are, who best personify itssacred values. It has used its moralagenda as one of the principal areaswhere these identities are defined - therespectable normal folk who people thefantasies of the new Right in relation tocurrent debates around abortion, childabuse, sex education, gay rights andAids. It is above all through this moralagenda that the new Right has becomea cultural force. Significantly, all theseissues of 'moral hygiene' explodedirectly into an expanded definition ofsocial health.Labour has no moral agenda of its own

except an inherited conservative one.Consequently, it is not a force that isactively shaping the culture, educatingdesire. The paradox is that, banished bythe front door, the politics of identityand desire returns by the back door toexact a terrible, regressive revenge('the London effect').It should, by now, be crystal clear that

'learning from Thatcherism' is neitheran easy nor simple task and is lightyears away from trying to do whatThatcherism does, only with a bit more'caring'. It is a painful exercise since itplainly involves the Left squaring up toits own past in a radical way andconfronting head-on the forces whichare undermining the very ground onwhich it has traditionally stood.

27 MARXISM TODAY MARCH 1988