In the dying days of the ill fated Labour government in the late 1970’s, a report was commissioned from Sir Douglas Black into the causes and potential solutions to the inequalities in the health of the people of Britain.
This report, known as the Black report has become infamous amongst political and social scientists.
By the time the report had been completed, Thatcher had been swept into power on a platform of promises to break the power of the Unions, and to cut and control public expenditure. The report must have landed on her desk like an old kipper The Government wanted to bury it, but eventually released it on a bank holiday Monday, with a minimum of publicity. The report was never published- instead 260 photocopies were made available.
What was so controversial?
Black provided convincing figures that showed what many suspected—that the poorest had the highest rates of ill health and death. He argued that these rates could not be explained solely by income, education, mobility, or lifestyle, but were also caused by a lack of a coordinated policy that would ensure uniform delivery of services. He recommended health goals, tax changes, benefit increases, and restrictions on the sale and advertising of tobacco. Patrick Jenkin, the social services secretary, estimated with a shudder that Black’s proposals, which he hinted were little short of outrageous, would cost an unthinkable £2bn a year.
Excerpt from Sir Douglas Black’s obituary in the BMJ- here.
Leaving aside the economic questions raised by the cost of Trident nuclear weapons systems, or a war in the Falklands, the real political dynamite of this report was simply this- poverty makes people ill, and many of them die young.
This report was not talking about people who living marginal existences in sub-Saharan Africa- it was describing families living in one of the richest countries in the world- the worlds first industrialised country- Great Britain.
The Black report was not alone in reaching this conclusion. 28 years later World Health Organisation figures record a gap of 10 years between affluent Kensington and Chelsea, and post industrial Glasgow. Check out this article from the BBC.
This hides the real issues though- the figures represent areas, not individuals at risk. For example, if you are a homeless rough sleeper, your life expectancy is 42 years.
There have been many discussions about how poverty leads to poor health in Britain. Poor diets, obesity, poor education, poor housing, unequal access to health services, stress- all these no doubt play a part- but the common issue that even the New Labour administration are not happy to dwell on is… poverty.
I do not intend to get into a discussion about how we define poverty- the whole relative or absolute thing. Poverty, once seen, is recognised by most of us. It is easy to blame. It is easy to be repelled and repulsed by squalid living.
Because poverty brutalises.
I have worked as a social worker for all my adult life. I have seen people living in conditions that are hard to believe. A man who lived in a house with a broken overflowing toilet for 15 years. A young woman whose body was broken by drug use and prostitution to the extent that she simply forgot to eat. A woman who was so caught up in her need to escape that she drinks the alcohol based handwashes in the hospital. And many many people who live in fear of a loss of benefit, because life is so marginal- with choices to be made over whether to feed the electricity meter, or the cat, or sometimes- the kids.
These people are not described as poor. We now talk about ‘social exclusion’. Almost as if we stopped inviting them to parties.
There are no easy answers. This, I think, is the reason that Jesus said the the poor would always be with us– and why the early church seemed to have at it’s very heart a desire to serve the poor. Strange then to hear these words of Jesus spoken as justification for inaction.
There are some national policy decisions that will always impact the poor. Progressive taxation, as opposed to the imposition of tax on food or fuel. Public transport, good social housing, employment opportunities and support, adequate benefits- particularly to single parents or vulnerable older people. These things are all good- and we might raise our collective voices in support… but for me there is also a personal dimension.
Because those of us who are paid to try to make a difference soon realise that all we do is administrate. We may have some small success- and this keeps us trying- but ultimately, we bring only sticking plaster to road traffic accidents.
But I believe in redemption and renewal, and lives transformed. And for this to happen- this brings humanity and hope to my own brokenness- and richness to my own poverty. As Jean Vanier put it
Jesus came to bring good news to the poor, not those who serve the poor! … The healing power in us will not come from our capacities and our riches, but in and through our poverty. We are called to discover that God can bring peace, compassion and love through our wounds.
Some more links to poverty issues in the UK