Jeremy Corbyn stood for election as the leader of the UK Labour party on the pledge of a new “kinder politics and a more caring society”. Taken at face value it seems difficult to see how anyone can argue, or be seen to argue, against this. But what are the implications of this new politics for health, both at system and population levels? And what is the likelihood that the rhetoric will be given the chance to make a difference?
The link between politics, inequality and health is well established and has been made by many different people posting on this site over the past 3 years. Only last week Danny Dorling highlighted the data showing rising health and income inequalities and falling health outcomes. Before that Ted Schrecker and Carol Bambra highlighted the four neo-liberal epidemics of austerity, obesity, stress and inequality. They concluded that “A looming public health crisis can still be avoided, but it will require a different set of political choices, which recognise that public finance is a public health issue and the Conservative project of shrinking the state comes with a body count.” It is to this end that the election of Corbyn brings hope.
In his speeches Jeremy Corbyn talks about a new type of politics and outlines a new set of choices that the public can make. Choices that provide an alternative to the neo-liberal, small state ideology that has predominated over the past 4 decades. The pledges he has made tackle health inequalities at all levels, addressing the provision of health care, wider social determinants and political determinants. In relation to direct provision Corbyn has outlined the plan to remove all elements of privatization from the NHS, making it completely publicly run and publicly accountable. He has also created a shadow minister for mental health and reiterated, amongst other things, the need to increase both the budget and the workforce attached to mental health care and to tackle the growing mental health problems experienced by children in the UK.
In addition to the above there are a raft of pledges that will directly tackle the social determinants of health, including both a maximum wage to cap the wages of those at the very top and the introduction of a minimum living wage which bears little resemblance to that offered in name only by Osborne in the last budget. The link between poor housing and poor health has again been highlighted recently and rent controls along with a social housing building programme are planned to address this. Reversing the closure of domestic violence centres, the provision of universal childcare and 50/50 representation of women in parliament are all major steps towards reducing the inequalities faced by women, who will also benefit most from the ending of austerity by which they have been disproportionately affected.
These policy proposals are the first step to challenging the neo-liberal political system and reintroducing the social contract between the state and the people. This begins to address what Schrecker and Bambra refer to as the political determinants of health, the ideological, political and quasi bureaucratic wings of the system of financial capital which allows negative social determinants to fester. On the face of it then Corbyn’s policies are a good starting point for building/rebuilding a healthier, more equal society. Addressing the gap between the richest and the poorest is the first major step towards tackling inequality and the political/ideological causes of the social determinants of health.
These ideas have been around for a long time; they are not new. The challenge is not coming up with the ideas but getting them heard.
As Aditya Chakroborty argued in a recent article in the Guardian, there is no level playing field in politics. Zombie ideas, that have been shown to be false and should have died with the 2008 crash, remain in the public arena as if they are natural laws rather than ideology. These include: “the sanctity of the City; the rightness of austerity; the law of political gravity that says tax rates must only ever go down”. The media machine, the mouthpiece of the 0.01%, the core of rentiers, CEOs and Directors of large companies and financiers that Scambler terms the ‘governing oligarchy’, work to protect the lies they want us to believe. Financiers and City bankers are brought in as experts to advise us on what to do about the financial crisis, just as manufacturers of junk food are brought in to advise us on healthy eating. And the media report their advice as neutral expert opinion.
Social media offers an opportunity to start to level the playing field and engage and organize in less traditional ways, and is particularly effective in reaching younger people. But this remains a marginal platform up against the might, money and power of the traditional media and its paymasters. It is, therefore, not just the zombie ideas that Corbyn and his team are fighting against, but the means through which they are spread. To slay the zombies is to fatally wound those that protect them. In the meantime the fact that there is even mention of a quest for a kinder and more caring society offers a glimmer of hope.