Is the NHS now about treating 'shi t life syndrome'?

[mids2019]

https://www.theguardian.com/commentisfree/2025/jul/03/the-guardian-view-on-labours-nhs-plan-it-is-right-to-celebrate-medical-science-but-delivery-is-the-hard-part

A Guardian article but it seems like this push to reduce health inequality is making the NHS look like part of our benefits system. While I agree with good health for all is this strategy going to appeal to a middle class tax payer base who are a lot of their tax going to a struggling NHS with the money ultimately flowing from their pockets to more deprived areas? It seems like the poorer the area the more snazzier and funded your health service will be and I just wonder if ultimately this may too the balance towards a more health insurance based syatem?

I agree it's not sustainable. The housing situation is a big problem and is ironically something that goes hand in hand with prosperity/growth (recently growth has been very slow but the economy has grown in the last 50 years.) increased prosperity ironically always leads to a rise in grievance/identity politics because it is very rarely shared equally - those at the very top get more. The grievance isn't just unreasonable sour grapes - when people get more wealth they tend to spend a chunk of it on land/concrete assets. The amount of land we have doesn't grow. So land/house prices go up as more land gets concentrated in fewer hands. In the UK you also saw the rise in available credit to buy houses increase considerably since the 1960s. House prices went up to match this. Banks therefore own a much greater share of people's houses than they did 50 years ago.
This leads to a wealth transfer which is worsened by the fact that people who can never afford to buy a house see their rent go up. Leading to a decline in their living conditions and an increased need for housing benefit etc - which comes out of your pocket if you are a high earner. And some goes into the BTL landlords pocket but a lot goes into the pockets of the banks themselves.

And that's before you even think about the 2008 bailout and austerity.

So yes, a lot of your own money as a net contributer is being siphoned of and it isn't sustainable. It's not the lower paid that are at fault. There has been a transfer in real wealth from the middle classes to the very rich and corporations. Fixing it would take political ambition I don't think Labour have (and I don't think there would be broad public support either). But putting money into comparatively lower cost preventative health care is a good thing in itself - even if the wider issues remain. Waiting to not do this even if not doing so costs tax payers more money long term is illogical.

Also most of the reform leaders and the owners of newspapers come from a hedge fund/banking background. And all have benefited from increased property prices. So it's not really in their interests to fix the problem.

I don't hate the rich by the way. I would point out that while taxing income can scare away high earners (and therefore mean the UK loses their tax), taxing real wealth (eg land/inheritance) doesn't because you can't take it with you. So we could try that. But we won't so the only option is to muddle through.

I was not complaining about it, I noted that at 65 it becomes tiring.

I'm also fed up of the feckless poor and hearing about how their poor health impacts them. If they were so poor as people claim, they might be a little thinner.

I'm sorry that you don't like a view that is opposed to yours but I fail to understand why you think upskilling and facilitating better choices is an issue. I think it's essential, even if it costs taxpayers more in the short to medium term. Clearly you prefer them not be supported to make better choices for their health and well being.

Your not talking about upskilling you’re talking about tokens and vouchers and ‘pocket money’

Whilst implying that people who are struggling financially are all fat so cant possibly be struggling and bandying the word ‘choice’.

I lived in poverty after being abandoned with a 6 year old - no roof, no belongings. I was neither fat nor unskilled, and I can assure you that all those skills meant nothing as the bare truth was that I simply didn’t have enough money for the basics and frequently had to choose calories over healthy choices (or be accused of starving my child). Not to mention the fact that because I had an incredibly limited budget I also frequently couldn’t take advantage of offers, and because I didn’t have a car had to make small frequent trips to the supermarket so I could manage to get the food home.

And those barriers are just the tip of the iceberg.

You’ve zero idea

I really do not believe that anyone that shares these views genuinely believes what they are saying. Otherwise we would all be advising our DC to claim benefits. Why make their lives harder than it needs to be? Anything that makes you feel superior though eh?

Are you the elected spokesperson for the entire middle class? Do you consider the middle class to be a homogenous blob with one view?

There are members of every class who hold the view that improved health across the whole population makes the nation stronger, the economy stronger and society more successful.

So wouldn't it have been better to get a nutritious parcel of food every couple of days, rather than having to make choices about good and bad calories?

If they were so poor as people claim, they might be a little thinner. This is a deeply ignorant comment.

Go to a supermarket and look at which foods are cheapest

Why is it always people who don't have a bloody clue that feel entitled to call others feckless!

But the regions of deprivation are often also the places that those middle class people want to live when they are older/visit on holiday
You would be the first to complain if you took sick on hollibobs in Cornwall and waited hours for treatment at the local hospital because it was filled with local riff raff who couldn't get a GP appointment because local services are so poor. The UK is comparitively small and what affects one area affects a wide range of people.

@verycloakanddaggers sorry I quoted the wrong person. I agree with you!

So wouldn't it have been better to get a nutritious parcel of food every couple of days, rather than having to make choices about good and bad calories?

I’m sure it would have been better to have secure housing, reasonable utility costs to cook said food, the ability to chose and plan her own meals from reasonably priced supermarkets and no ancillary financial pressures that forced cheap, but filling, food choices.

Well said 👏🏻
Yes it's true that the better off pay more tax, but that's because they are the ones with the money!
That doesn't mean they are the ones who do most of the work.
Most of the work that needs to be done to keep society functioning is low status, unpleasant, boring low-paid work. This work is done by people who have been pushed to the bottom and have no other options.

Problem is, often smaller and less prestigious offers the most opportunities.

an outstanding dr in those regions are more likely to be able to effect change, implement new programmes, and actively improve things.

if you join a “good” programme you’re a cog in the wheel and have to do things their way. No option to improve as things are already good. It’s also easier to build relationships with other departments and do joint work.

there’s an a&e dr in Bradford for example who was able to implement and show bipap was a better option than ventilation in Covid patients. I’m going back years but there was a plastic surgeon in Middlesbrough doing amazing things with burn victims. Another small town northern hospital I knew was near an Army base and many of the dr’s there were combat trained and experts in violent injuries.

a big fish in a small sea often has more opportunities to be extraordinary than a small fish in a shoal where only the big fish are listened to.

to assume a “northern town” will not be a good medical education is ridiculous and arrogant.

It would be better if people were given the means to look after themselves by being given decent access to: food, exercise, healthcare, education, transport, housing, cooking facilities, childcare, reasonably priced utilities.

Wanting a group of people with ignorant ideals such as yourselves merrily deciding what food I should have had (not to mention the r insane cost of having several parcels delivered to me at mg home - that’s a good one) wouldn’t have helped much. In fact it didn’t - they're called food bank parcels and the few I did receive were mainly exactly the kind of food you’re bleating in about being unhealthy - white pasta, ready oats, tinned fatty processed meat, tinned tomato soup…..most of which my autistic child wouldn’t touch.

The problems affecting those living in deprivation are far more complex than you clearly can imagine. And if doesn’t start with a couple of naive cookery classes delivered by clueless and inadequate ‘services’ and having choices further restricted via voucher schemes.

I wonder if the pp complaining about "the working class" actually see these low paid workers round about them, or do they just block them out ?

I don’t really think the food tokens, parcels or whatever is very different in spirit to when the good folks of the town used to administer the poor law. It gave them satisfaction that they were worthy even when their own success was a matter of birth. Not much has changed, only that the morality police has been replaced by actual law, and that’s better for human dignity.

I didn't assume anything a Northern town btw. I'm not a medic so I have no idea why a dr might choose where they want to work. But if you try to tell people where they must work, not all of them will like it. Some people don't want to live in Northern towns. Some people don't want to live in London. And some people would rather go to Australia than be told to live somewhere they don't want to live. Bright people with options aren't all going to accept being told where to go. We don't demand it of any other career do we?

Because there the ones mainly paying for everything….🤷‍♀️

I think I've supported everything in your first paragraph.

I'm certainly not suggesting food is delivered to those without work, I'm suggesting they collect it, just as they would have to go out to shop. The entitlement that it would be delivered is mind-blowing. I'm also suggesting that the food supplied is healthy and in season. Presumably you would have an issue with fresh chicken, vegetables, fruit, wholemeal bread and rice, etc. Possibly a bigger issue with a starter pack of seasoning, oil, dried herbs, etc.

I'd also support work skill and job seeking workshops, parenting classes, budgeting, etc. All things that would be helpful. If people agreed to attend and did so then I think they should be entitled to enhanced benefits and hopefully the period of time on benefits would be shorter.

Where I live many volunteers litter pick at weekends. Perhaps their time would be better spent supporting the more vulnerable, and the more vulnerable could litter pick at the weekends instead.

As far as I am concerned the cycle if entitlement needs to broken and we need to look at why it arose and address it for the good of all. What has been done for the last few generations has simply not worked.

However, Jeremy has set up a new left wing labour party and I imagine will support benefits being doubled. I hope those who disagree with me will be out voluntarily campaigning for Jeremy and will be putting their money where their mouths are to change things for the way they perceive to be better.

Ah, a now we’re going down the ‘entitled’ route.

Lets face it - you’ve had the gall to dehumanise people living with disadvantage by suggesting they have any kind of choice over what they eat taken from them (because they’re too stupid or feckless to make choices) and have also suggested that peopld living with disadvantage are fat (whilst musing how they’re not thinner given their disadvantage)

You've not walked a couple of metres in their shoes. You’ve shown an incredible lack of understanding of the complexities of disadvantage and how that plays out and how health inequality is a part of that (again with the presumption that it all revolves around feckless food choices/poor people can’t be trusted because they fritter their money away blah blah)

Perhaps you may consider actually listening to them - if you are able to even view them as human.

@cloudyblueglass perhaps you would like to set out some viable alternatives. That would be far more constructive than dissing suggestions you don't agree with.

What do you do personally from a voluntary perspective?

What I do has no bearing on the fact that removing any kind of choice from people who already have limited choices on the basis that you have this deluded belief that they're all just feckless and make bad choices and so need to be shown the right way is short sighted and naive- health inequality is multi-faceted - is wrong.

Treating the disadvantaged like naughty little ungrateful children is dehumanising.

And I’ve already set out the viable alternatives - but I did miss one out: make work pay, the minimum wage is a disgrace.

Apart from the fact that living with poor health is miserable and it is much more pleasant to be healthy.

So what do you think should be done? You gave a rather long list of things you think people need to be given, it would interesting to hear how you think it should all be implemented. Just saying "give people things" isn't exactly helpful when you poopoo the methods suggested.

Written by George Orwell in the road to Wigan Peer in 1936