Big Society, NHS

The “Big Society” and the “small folks”

The Big Society has signified and evoked various meanings in history ranging from Max Weber’s “gemeinschaft” (community), social consciousness and solidarity to totalitarianism and repression of public opinion under the name of a “greater good”. However, in today’s socio-economic and political context, the Big Society seems to be more of a vacuous concept which only serves the political exigencies of the day.  

In spite of the pronounced aspirations of greater solidarity and social cohesion under the umbrella of the Big Society, the different policies, reforms, reports and responses by various officials reflect a profound contradiction in government’s intent.

Take for instance the latest report from Low Pay Commission released last week, which indicates that social care staff are among the lowest paid groups in the economy, with approximately 1 in 10 of the 1.5m workforce earning less than the minimum wage of £5.93 an hour. That is nearly 150,000 people doing an emotionally, and often physically, taxing job without much appreciation and without even minimum wage. The response by the Department of Health only adds insult to injury, as its spokesperson stated that “Recent surveys have shown that the main reason people work in social care isn’t the level of pay but the high satisfaction they obtain from caring for people with needs.”

Andrew-Lansley -

Smiles and appreciation are all good and well, however, hopefully we all realise that people cannot pay for food, clothing or rent with smiles and goodwill. Social care staff, like the rest of us, need to use their hard earned cash to pay for these and other necessities.

Another example of the divergence between government’s pronouncements and intent is the Health and Social Care Bill. The proposed GP Consortia are supposed to bring about cost efficiencies and greater choice. However, this will eventually reduce the NHS to nothing more than a “Big Society” business franchise. In presenting parliamentary evidence for the bill, Dr Hamish Meldrum, chairman of the British Medical Association, stated: “We will quickly see failed consortia bought up on the cheap by foreign companies and see bits of the NHS run from abroad.” While Sir Richard Thompson, president of the Royal College of Physicians, indicated that: “The fragmentation of services would have detrimental impacts on the various areas the reforms seek to improve”.

Unfortunately, the government continues to ignore the fact that choice is the luxury of the haves, and that the proposed Health and Social Care Bill will eventually lead to greater marginalisation and social exclusion of have nots, a factual outcome that runs counter to the proclaimed objectives and spirit of the Big Society.

The need for reforms is evident and undisputed by the many. However, it is a question of whether they are for the better or the worse. The increasing socio-economic rift in our society runs counter to any notion of social responsibility or civility and reforms such as the Health and Social Care Bill only serve to exacerbate that situation.

The efficacy or any possible positive outcomes from the Big Society in general and these reforms in particular, hinge on the government’s ability to go beyond hype and begin to take on board the views of those who actually engage with these services; be it providers, operators, practitioners or service users. It is through an open debate and collaborative multi-lateral partnership that any idea or conception of TBS can begin to find practical positive relevance and significance.

We must realise that the Big Society would not be all that “Big” without genuine regard for and engagement of the “small folks”.



One thought on “The “Big Society” and the “small folks”

  1. This is a really insightful analysis of the contradictions between the rhetoric of “Big Society” debate that Cameron has espoused and the government’s policies which are about the marketisation of society where the rich and powerful will thrive and the devil takes the hindmost. This is the start of the UK’s version of the Wisconsin experiment. Reduce taxes, the public services are bad, big business can do no wrong, people pay for the services they need or use and tough luck on those who cannot survive in this harsh environment.

    Posted by Anthony Robinson | April 18, 2011, 5:37 am

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