Book contents
- Frontmatter
- Dedication
- Contents
- List of tables and figures
- Notes on contributors
- Acknowledgements
- Preface
- Part One Life chances
- Part Two Lifestyle challenges
- Part Three Social and community networks
- Part Four Employment and housing
- Part Five Supporting people at the edge of the community
- Part Six The socio-political environment
- Conclusion
- Index
Twenty-Three - Health and social care in an age of austerity
Published online by Cambridge University Press: 12 April 2022
- Frontmatter
- Dedication
- Contents
- List of tables and figures
- Notes on contributors
- Acknowledgements
- Preface
- Part One Life chances
- Part Two Lifestyle challenges
- Part Three Social and community networks
- Part Four Employment and housing
- Part Five Supporting people at the edge of the community
- Part Six The socio-political environment
- Conclusion
- Index
Summary
Introduction
One of the first lessons I was taught at medical school was that the career we were being trained for was by no means the most important factor in promoting good health or a long life. Clean water, sanitation, nutrition, housing, employment and money are all more important than medical care as factors in the improvement in life expectancy. One might now add to the list social networks (Wilkinson and Marmot, 2003) and equality (Wilkinson and Pickett, 2009).
It remains true, however, that medical care does contribute to improvements in both the quality and duration of life. It is also true that societies generally place a high value on the provision of such care; when we are ill we all want someone to look after us, and, if possible, to make us better. In this chapter, therefore, I shall concentrate on the health care that is provided by health services such as the National Health Service (NHS). In the same way, I shall focus on the social care that is normally paid for, rather than the wider social support provided by family, friends, neighbours or colleagues.
The second point of clarification that I need to make is that austerity is a conscious act of policy. It is not an ‘act of God’. Total government spending is a choice, and I would argue that the policy of austerity as exhibited by the UK government, among others, has deepened and prolonged the economic downturn since 2007:
The austerity arguments focused on deep cutbacks to public policies and shrinking the state as a main way to fix the deficit, calm the markets and revitalize the economy; following this logic, the social welfare state was depicted as unaffordable and burdensome, which ultimately reduced competitiveness and discouraged growth.
Numerous studies have highlighted the fallacious basis of austerity programs. In the short term austerity depresses incomes and jobs, hinders domestic demand and ultimately recovery efforts. Austerity also has negative impacts on employment, economic activity and development over the long term. (Ortiz and Cummins, 2013: 11; see also Chu, 2015; Krugman, 2015; Crescenzi et al, 2016)
The economic case for spending on health and social care
It does nevertheless fall to governments at a time of reduced government revenue to consider carefully what their priorities for spending should be.
- Type
- Chapter
- Information
- Social Determinants of HealthAn Interdisciplinary Approach to Social Inequality and Wellbeing, pp. 325 - 336Publisher: Bristol University PressPrint publication year: 2017