The NHS, Ozzy Osbourne and universal welfare reform

When rejecting universal welfare reforms, we need to consider the impact on solidarity between citizens, writes the Fabian Society's James Gregory.

James Gregory is a Senior Research Fellow at the Fabian Society

This week was the 63rd anniversary of founding of the National Health Service – an event marked by a personal tribute from that other national treasure, Ozzy Osbourne. In voicing his admiration of the NHS, Ozzy was expressing a very British love of a very British institution.

But in some respects this is a confusing anomaly. It would be a stretch to say that this broad admiration was extended to the other cornerstones of our welfare state. We certainly don’t see such sentiment applied to benefits or social housing.

Instead we see a resentment of benefit ‘scroungers’. All too often this also comes with the sense that immigrants are the prime suspect in a great welfare scam; ‘jumping queues’ and taking out what they never put in.

When this happens it is easy to think that diversity can only erode the trust and common bonds which have underpinned the post-war welfare state. Some commentators have gone so far as to suggest there is an inevitable trade-off here; difference and diversity undermine the sense that we are, in the phrase of the day, all in this together.

And without this sense of solidarity we can’t have a strong welfare state.

But this begs the question: why is it that the NHS remains so enduringly popular – with Ozzy and the general public – despite decades of immigration? This is the question I seek to answer in a new Runnymede Trust report on welfare and ethnic diversity, ‘Diversity and Solidarity: Crisis, What Crisis?’

If the NHS is so central to our national identity, why is it that other welfare institutions create such resentment of an apparently dependent and ‘undeserving poor’, either immigrant or from a long line of British families?

The answer to this question has important implications for welfare reform and the division or solidarity that reform can create.

That answer, put simply, is that universal welfare institutions tend to create common bonds of citizenship, whereas narrowly targeted welfare services tend to divide us as a population, characterising some as needy and dependent, and others as virtuous and independent.

An exemplar of such a process is to be found in the way some describe much failed social housing as ‘sink-estates’; estates of outsiders very much ‘not like us’. By contrast, the evidence suggests more inclusive and collective welfare provision (such as the NHS, universal benefits, or well planned social housing and schools) can have the opposite effect.

Collective welfare institutions that bring people into contact through common needs and services can retain strong support in diverse societies – and indeed help provide the glue of common citizenship.

For some this claim will strike a deep chord. It would indeed seem counter-intuitive to assert, for instance, that our society must choose between a strong NHS or increasing diversity, given a popular understanding that the NHS has depended on its diverse workforce.

But the deeper point behind the continued popularity of this institution is that it serves us regardless of our social or ethnic differences – and in doing so sends out a very strong signal about our common identity as British citizens.

This is one of the great lessons we should take form the NHS on its 63rd birthday. When making decisions about welfare reforms and rejecting the universal, we ought to consider the impact such changes can have on solidarity between citizens.

Like this article? Sign up to Left Foot Forward's weekday email for the latest progressive news and comment - and support campaigning journalism by making a donation today.