Our social system, based on Private Ownership, encourages and glorifies this spirit of gain, and cripples and thwarts the spirit of service. You need but have your eyes once opened to its influence, and thereafter you will never cease to see how the needs and imperatives of property taint the honour and dignity of human life. Just where life should flower most freely into splendour, this chill, malign obsession most nips and cripples. The law that makes getting and keeping an imperative necessity poisons and destroys the freedom of men and women in love, in art and in every concern in which spiritual or physical beauty should be the inspiring and determining factor. Behind all the handsome professions of romantic natures the gaunt facts of monetary necessity remain the rulers of life. Every youth who must sell his art and capacity for gain, every girl who must sell herself for money, is one more sacrifice to the Minotaur of Private Ownership—before the Theseus of Socialism comes.
Opponents of Socialism, ignoring all these things and inventing with that profusion which is so remarkable a trait of the anti-Socialist campaign, are wont to declare that we, whose first and last thought is the honour and betterment of life, seek to destroy all beauty and freedom in love, accuse us of aiming at some “human stud farm.” The reader will measure the justice of that by the next chapter, but here I would say that just as the private ownership of all that is necessary to humanity, except the air and sunlight and a few things that it has been difficult to appropriate, debases work and all the common services of life, so also it taints and thwarts the emotions, and degrades the intimate physical and emotional existence of an innumerable multitude of people.
All this amounts to a huge impoverishment of life, a loss of beauty and discrimination of rich and subtle values. Human existence to-day is a mere tantalizing intimation of what it might be. It is frostbitten and dwarfed from palace to slum. It is not only that a great mass of our population is deprived of space, beauty and pleasure, but that a large proportion of such space, beauty and pleasure as there are in the world must necessarily have a meretricious taint and be in the nature of things bought and made for pay.
§ 3.
If there is one profession more than another in which devotion is implied and assumed, it is that of the doctor. It happens that on the morning when this chapter was drafted, I came upon the paragraph that follows; it seemed to me to supply just one striking concrete instance of how life is degraded by our present system, and to offer me a convenient text for a word or so more upon this question between gain and service. It is a little vague in its reference to Mr. Tompkins “of Birmingham,” and I should not be surprised if it were a considerable exaggeration of what really happened. But it is true enough to life in this, that it is a common practice, a necessity with doctors in poor neighbourhoods to insist inexorably upon a fee before attendance.
“A case of medical inhumanity is reported from Birmingham. A poor man named Tompkins was taken seriously ill early on Christmas morning, and although snow was falling and the atmosphere was terribly raw, his wife left the house in search of a doctor. The nearest practitioner declined to leave the house without being paid his fee; a second imposed the same condition, and the woman then went to the police station. As the horse ambulance was out, they could not help her, and she tried other doctors. In all the poor woman called on eight, and the only one who did not decline to get up without his fee was down with influenza. Eventually a local chemist was persuaded to see the man, and he ordered his removal to the hospital.”
That is the story. You note the charge of “inhumanity” in the very first line, and in much subsequent press comment there was the same note. Apparently every one expects a doctor to be ready at any point in the day or night to attend anybody for nothing. Most Socialists are disposed to agree with the spirit of that expectation. A practising doctor should be in lifelong perpetual war against pain and disease, just as a campaigning soldier is continually alert and serving. But existing conditions will not permit that. Existing conditions require the doctor to get his fee at any cost; if he goes about doing work for nothing, they punish him with shabbiness and incapacitating need, they forbid his marriage or doom his wife and children to poverty and unhappiness. A doctor must make money whatever else he does or does not do; he must secure his fees. He is a private adventurer, competing in a crowded market for gain, and keeping his energies perforce for those who can pay best for them. To expect him to behave like a public servant whose income and outlook are secure, or like a priest whose church will never let him want or starve, is ridiculous. If you put him on a footing with the greengrocer and coal merchant, you must expect him to behave like a tradesman. Why should the press blame the poor doctor of a poor neighbourhood because a moneyless man goes short of medical attendance, when it does not for one moment blame Mr. J. D. Rockefeller because a poor man goes short of oil, or the Duke of Devonshire because tramps need lodgings in Eastbourne? One never reads this sort of paragraph:—
“A case of commercial inhumanity is reported from Birmingham. A poor man named Tompkins was seriously hungry early on Christmas morning, and although snow was falling and the atmosphere was terribly raw, his wife left the house in search of food. The nearest grocer declined to supply provisions without being paid his price; a second imposed the same condition, and the woman then went to the police station. As that is not a soup-kitchen, they could not help her, and she tried other grocers and bread-shops. In all the poor woman called on eight, and the only one who did not decline to supply food without payment was for some reason bankrupt and out of stock. Eventually a local overseer was persuaded to see the man, and he ordered his removal to the workhouse, where, after considerable hardship, he was partly appeased with skilly.”
I, myself, have known an overworked, financially worried doctor at his bedroom window call out, “Have you brought the fee?” and have pitied and understood his ugly alternatives. “Once I began that sort of thing,” he explained to me a little apologetically, “they’d none of them pay—none.”
The Socialist’s remedy for this squalid state of affairs is plain and simple. Medicine is a public service, an honourable devotion; it should no more be a matter of profit-making than the food-supply service or the house-supply service—or salvation. It should be a part of the organization of a civilized State to have a Public Health service of well-paid, highly-educated men distributed over the country and closely correlated with public research departments and a reserve of specialists, who would be as ready and eager to face dangers and to sacrifice themselves for honour and social necessity as soldiers or sailors. I believe every honourable man in the medical profession under forty now would rather it were so. It is, indeed, a transition from private enterprise to public organization that is already beginning. We have the first intimation of the change in the appearance of the medical officer of health, underpaid, overworked and powerless though he is at the present time. It cannot be long before the manifest absurdity of our present conditions begins a process of socialization of the medical profession entirely analogous to that which has changed three-fourths of the teachers in Great Britain from private adventurers to public servants in the last forty years.