The Politics of Health

The Politics of Health

By Mr Ghaz, November 9, 2009

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The Politics of Health

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The politics of health is about these sorts of questions. We looked at some of these causes of health and illness in our society; we suggested ways in which you as an individual might change them through your own action or by collective action in group. Here we take a wider look at the causes of ill-health in our community and the ways in which we might tackle them.

Change in the Pattern of Health and Illness

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Many people do not realize that the major contributions to better health we enjoy in this century are social and environmental. Investment in better housing, sewage disposal schemes, legislation about purer food, pensions, education and higher income, have led to the improved standard of health we have today.

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When the National Health Service was set up, many people believed that more spending would mean better health. And that in due coarse there would be less and less need for a health service. Yet today we are spending more money on health.

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The reason for this is that, as our patterns of living have changed, the diseases we suffer from have also changed. Heart disease, strokes and cancer that you are have replaced infectious diseases as the main causes of death. Most of today’s diseases are due to environmental causes or to what are called ‘self-imposed’ risks of life. Some of these risks are chosen (eg. climbing mountains). But many risks, such as those arising from doing a very inactive job, are dictated by the kind of society we live in.

Ways in which our Society Creates Illness

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By inequality: If you are an unskilled worker, you are not only twice as likely to suffer from chronic illness, but your life is likely to be shorter than that of professionals or managers. Your child has less chance of surviving to its first birthday than the child in a professional family. Unfortunately this doesn’t mean that you are more likely to get good medical care. In fact, there seems to be an unwritten law that the more you need health care the less likely you are to get it. The reasons for this could be: a) the social gap between doctor and patient, causing difficulties b) the greater difficulties working class people have in getting access to medical services. For example, they are more likely to work unsocial hours, live further from doctors’ surgeries, have to rely on public transport and so on.

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By the way we live: We drive fast cars, causing accidents, we eat sweets which rot our teeth, we drink too much alcohol and smoke cigarettes. We have to make a positive choice not to live like this. And it’s difficult because these are the images of the good life pushed at us every day by newspapers, magazines and TV.

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By the way work is organized: The work we do may severely affect our health and the by-products of the things we produce may pollute our neighbors’ environment.

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By the time span we live: By living longer more of us encounter the infirmities and chronic diseases of old age.

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By changed patterns of living: The fact that people move around the country to live and work has destroyed the old patterns of care in the community. Now people are more likely to look for health care in institutions rather than turn to their own friend and relatives.

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So the diseases we suffer from today are mainly those caused by the way society is organized. Faced with this, what can a healthcare system do? Some people say we have a National Disease Service, a salvaging service. The National Health Service doctor has been compared with a man on a riverbank who sees a drowning man in the river. He dives in and rescues him, but just as he gets one man out, he sees another man drowning and has to dive in again, and then again and again. He never seems to have time to go upstream and see who is pushing them in.

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‘So there we are, spending more each year on health but not getting rid of illness. Recently governments have been promoting campaigns to persuade people to look after themselves, to eat wisely, and to take more exercise. This approach implies that the individual is wholly responsible for his or her own illness, and fastened their seats belts they wouldn’t be ill. As we have seen, illness is not always caused by an individual person’s ‘bad’ habits, and the solutions to ill-health are not always in the hands of the patient. A government which really wanted to reduce lung-cancer would change the situation we have now where it spends little on health education yet condones the tobacco industry spending many millions a year on advertising.

If You Were Minister of Health

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We talked about what individuals can do. In this activity we’d like you to consider what you think the government should do about the health of the nation.

Imagine you are Minister of Health in a new government which is eager to reorganize its departments;

a)   Would you limit your health service to the job of curing disease, or would you change its responsibility to include things like housing provision of school milk, health and safety legislation?

b)   Would you spend money on services for those who are most in need, like the elderly, the mentally ill and the young? Or on those who live productive working lives and are most useful to the economy?

c)   Whose priorities would you consider? The patient’s needs and preferences? The doctor’s desire to work where it is convenient for him to work? The administrator’s need to keep down costs? Or the community’s need to keep friends and relatives close by them when sick and not send them to hospital?

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Each decision, whether it is about providing meals on wheels for old folk, or intensive care for heart patients involves a range of different opinions.