How long do you expect to live for? Babies born when Beveridge was outlining his system of social security, as we saw in Chapter 2, could expect to celebrate around 60 birthdays. That is if the mortality rates that existed at their birth remained the same throughout their lifetime. Of course, with the advent of the NHS, those babies enjoyed substantial improvements to mortality rates. In fact, by the time they reached their sixtieth birthday in 2002, increases in life expectancy had risen so that they might enjoy another 20 or so years of life (Office for National Statistics 2021a). At the population level, the benefits of Beveridge's welfare state, particularly the NHS, are truly remarkable. Even for individuals, the extent of provision for welfare established by Beveridge was unprecedented. Improving living conditions through better housing, expanding education and the full-scale attack mounted on poverty stood alongside better and growing access to ever-developing medical interventions. That we now tend to live longer than our great-grandparents is no surprise. But the gains heralded by Beveridge's vision are in danger, while some have already been lost. The collective participation and shared sense of responsibility fanned by the shared trauma of two successive world wars weakened as the neoliberal, capitalist ideologies of contemporary society came to regard welfare as a costly burden. The system has, to invoke Hilary Cottam's (2021) arguments on welfare reform, always been designed with humans imagined as self-interested, self-maximizing individuals. But this has now overtaken any sense of a shared fate in the creation of the system of social security, which is now hollowed out, overburdened and in peril. For some the consequences are severe, whereas for others high incomes, high wealth and high self-esteem are sufficient buffers. To understand the scale of work needed to now launch a new attack on our contemporary and more monstrous giant of Disease, we must understand its uneven pursuit of the population.

UNEQUAL HEALTH

In 2021 a baby boy born in south-east England might live to be 80, but if they were born in Scotland they may not live past 77. What is so different about the experiences of that boy in south-east England from those of that boy in Scotland? It isn't just between countries and regions of the UK that such differences emerge. They also play out between postcodes within cities and regions, often to an astonishing degree.