2 - Disease: An Evolving Giant

Summary

Hælth – From WHOLE, a being whole, sound, or well.

The first duty of Beveridge's committee was to survey existing national schemes of social insurance and allied services; the second was to make recommendations. Such a survey cannot have been an easy undertaking, but can you imagine conducting a similar one today? Consider, for example, the sheer complexity of welfare provision exposed through the chaos of universal credit introduced in 2013. Somehow, in seeking to simplify benefit payments and streamline six separate schemes into one, the system became even more complex. Or imagine trying to unpack exactly why, during a global health crisis, one set of benefit recipients would be deemed in need of a temporary uplift to their payments while others would not. And that is just those services that, supposedly, safeguard against want. But what would a survey of the services and schemes of today actually conclude? What would Beveridge recommend now? It is tempting, in a discussion such as this, to reel off the latest questionable decisions on service provision; or perhaps to spend time dissecting decisions that seem to have been motivated by short-term budgetary constraints rather than long-term planning. A biography of such changes to welfare and service provision is not, however, our task in this book. Instead, we are surveying progress in tackling Beveridge's giant of Disease given the foundations he laid for our welfare state, and making recommendations to tackle that giant, which is somehow more monstrous today. To begin, we need a picture of the contemporary giant of Disease, tracing its evolution from the infections, emerging chronic diseases and relatively short lifespans of 1942 to the behemoth of today.

MORE THAN THE ABSENCE OF DISEASE

In general, how would you rate your health? In the UK, this may sound a familiar question, at least to anyone who has completed the decennial census. In the census, you are encouraged to consider any aspect of your health that you think is relevant. So, what is relevant? The criteria you use to evaluate your health in the last year might be different from that which you would have used five years ago, or as a child, or as you might in the final stages of your life. But the criteria you probably use to evaluate your own health doesn't just change as you age, it will also change depending on when you are aging.