UK ministers are claiming ill health is over-medicalised in the UK. It isn't. It's under-politicised instead. It's neoliberalism that is making us ill, but they refuse to recognise that fact.
This is the audio version:
This is the transcript:
Medicine is under-politicised in the UK at present.
I think many people will be surprised to hear me say that because what they're used to hearing is Wes Streeting, our Health Secretary, saying that medicine is over-medicalised at present, particularly when it comes to mental ill health.
Well, he's right to an extent and again, I think most people will be surprised to hear me say that. But the reason why he's right is for reasons that he does not understand.
Like most Labour ministers, he's out of his depth when he talks about medicine.
The fact is that the reason why we have so much mental ill health at present, is that we are not talking about the politics that is creating that ill health. And that's what I mean when I say that we are under medicalising medicine at present. We live in a country where ill health is being created by the choices that politicians are making.
Just look at the recent example of the government deciding that it's going to cut benefits for the most disabled people in our society.
Is that going to reduce depression?
Is that going to reduce anxiety?
Is that going to put people into a position of work because suddenly they're liberated - as the minister's claim - to go out there and do a job that they never realised they could do before?
No, of course it isn't going to do any of those things.
It is going to increase stress.
It's going to increase anxiety.
It is actually going to increase disability, and it's going to remove the right of many people to get to work because they will not have the funding that they need to do so. Everything is almost the opposite of what Wes Streeting says when it comes to health, and this is true more generally.
We have a massive medical problem with obesity in the UK. I'm old enough to remember when people were smaller than they are now. Let's be quite blunt about this. Average waist sizes in the UK have increased by three or four inches over the last 40 or so years. My memory that people were slimmer when I was younger is not false. It's absolutely true. We are simply bigger now, and there is no genetic explanation for this.
There is an argument in medicine, of course, about nature versus nurture. The neoliberals want us to think that it's all about nature. They say every problem that we have with regard to medicine simply requires us to examine the genome in ever greater depth until we find the answer to the problem that they're looking for, which will be another drug.
And look, we can see that with regard to obesity - ozempic, and wegovy - they are the answers apparently to the problem of obesity, but actually they aren't.
They suppress the desire to eat. They actually also suppress the desire to live. They suppress the desire for sex. They suppress the desire to go to work. They are creating mental ill health in their own rights because that's what they do. They suppress. So, therefore they are not an answer to anything in the long term, except they do make a lot of profit for the medical industry. It's already thought that one in ten people in the UK might be on one of these drugs, many of them privately prescribed.
And this is not an answer to our medical problem. Our medical problem is caused by the failure of our government to ensure that we have safe food to eat.
We are fed with ultra-processed food, which is so packed with sugars that are so addictive that we so overconsume those foods that we end up overweight as a consequence.
But not just overweight, because the same sugars that create the addiction also create pain in our bodies because we are too big as a consequence of eating them.
They create problems with regard to our mental ill health because they give us short term dopamine hits and then deep crashes. They create further problems.
And yet our government is doing nothing to stop this because they will not stop the pursuit of profit. They won't deal with the problem of obesity because it is about profit making in the first case, by selling ultra processed foods, and in the second case by selling drugs to tackle it, which in the end will create more problems all of their own.
There's a fentanyl problem in the USA. We thankfully don't have anything like that in the UK. My prediction is we will have an ozempic and a wegovy problem in due course because they in turn are drugs prescribed in the first instance for good reason, but with long-term and deeply dangerous effects.
I suspect, and I'm deeply worried about this, that there's another dimension as well. I am well aware of the problems of neurodivergence that about 30% of people in the UK suffer from. They just are simply not fitting into the expectation of what normality is, as is defined by our politicians, as is defined by the 70% of the population who are neurotypical, and as is also defined by our economic philosophy.
Remember, neoliberal economics assumes that we are homogenous human beings. It says there is nothing different between you and me, and I promise you there is. I'm not saying that's a problem. I don't want to be you, and you don't want to be me. What we want is to be ourselves with all those little idiosyncrasies that make us up and I hope make us appealing to those who know us and maybe even love us.
But the point about it is, that is not what the government assumes we are. We can see it in their policy. We can see that they think we are one and the same. All of us are, for example, they say willing and able, whatever our circumstances, to go out to get work because apparently we all get our dignity through work, even though very clearly that's not true and very clearly, it's not true that we are all able to work.
So, this assumption of homogeneity is fundamental to the problem that we face with medicine because we are simply different. We don't want to be forced into boxes.
Ask most people with neurodivergence whether they want to be neurotypical, and they'll say no, because they enjoy being who they are. But that is not acceptable to a medical system, which is seeking to put people in boxes.
This is where the danger lies in almost everything that we are looking at.
And it is reinforced again by the world around us. We are told what we must want. Advertising does that all the time.
We are told what is typical by that advertising, even though quite clearly a lot of the advertising will completely miss the point with us.
And we recognise that we are not typical.
We recognise that we are not wanting to be one and the same as everyone else.
And this comes down to the curse of neoliberal economics. We are simply seen as economic units. We are not even seen as functioning human beings.
And again, this is so clear from what Labour is talking about when it talks about disability.
They don't talk about the fact that we need to care for people. They talk about the fact we need to get people back into the workplace. We only exist if we work according to Labour.
They say they exist for the sake of working people, but the majority of people in the UK don't work. They're young, they're old, they're carers, they're sick, or whatever else it might be.
Why should we assume there is this complete uniformity of you and that as a result of this uniformity being imposed upon us by our politicians, by our economists, by our companies in the UK, that we should all be the same because we must all consume the same products and look alike?
This pressure to be uniform is making us anxious, depressed, and ill in a world that is not made for people to be stereotypes, but instead to be individuals.
And this is where Wes Streeting is wrong. If he wants to take medicine forward - if he wants to actually de-medicalise so many of these conditions - he has to change the political environment around them by recognising that some people can't work in the same way as others and some people don't want the same thing as other people might.
We have differing skills.
We have differing opportunities.
We have different strengths.
We have different weaknesses.
All of those things are real Wes Streeting.
When you build a medical system that recognises that there is no one such thing as a standard human being then you will build a medical system that reflects the fact that that is the reality of the people we are. And then you'll treat us as individuals, and then you'll find a cure to our problems. But so long as the economy treats us as this homogenous being, we're in deep trouble.
What can you do about this? I think that's a really good question and one I like to ask often.
Well first of all, learn about this. Understand that advertising is forcing you into a box in which you don't want to be put.
Understand that you may not be neurotypical. You might have ADHD; you could be autistic. You may have issues with regard to mental ill health, which are not of your choosing, but which have been imposed upon you.
And don't blame your parents or people around you because they didn't nurture you wrongly.
The economy nurtured you incorrectly.
So again, let's take this out of a blame game, except for the fact that profit is what is destroying mental ill health in this country.
Instead, let's begin to talk about how it is that we can think about ourselves as individuals, as people who are different and value those differences and respect them.
This is a task we can all undertake because it's about us and it's about how we relate to other people and how we look at other people and how we understand them.
And that is really key.
I don't want to be you.
You shouldn't want to be me.
We should respect our differences and actually nourish and cherish them.
But we don't live in a world that does that. And that's why we live in a world where there's far too much mental ill health, and as a consequence, too much physical ill health.
Wes Streeting is a million miles away from realising that this is the case. He thinks that there's a problem with the over-medicalisation of health in the UK. No, there isn't. There's a problem with the under-politicisation of health in the UK, because politics has not recognized the cause of the ill health we have. When we do that, we'll all get a lot better.
Thanks for reading this post.
You can share this post on social media of your choice by clicking these icons:
There are links to this blog's glossary in the above post that explain technical terms used in it. Follow them for more explanations.
You can subscribe to this blog's daily email here.
And if you would like to support this blog you can, here:
Buy me a coffee!
Definitely under-politicised as I found out with my recent blood. Only interested in prescribing me statins, no interest in any preventative tests.
Precisely
There is no profit in preventing you getting ill
Yes I’ve had that, both with having to refuse statins (my cholesterol is in normal limits in your test, “but age”), then wanting to decrease BP meds (Ramipril 2.5mg) as the increase caused by illness in 2024 has disappeared, and post run will drop to 100/60. Trying to get a blood test ir see a GP? Ha.
So true
My wife’s advice as a retired GP is avoid them if you do not want to rattle with drugs
Some years ago Carlsberg (a lager brand) ran an advert with the idea ‘what would holidays be like of Carlsberg ran them’
Now following on from that, and we will probably all have our brand of choice, but Japanese and Korean car makers have a reputation for reliability, so my question might be what might social policy and healthcare look like if we put the teams who designed, building & maintained the slightly work stained but still reliable17 year old car with 160000 miles on the clock thats sitting on my drive right now in charge?
On this theme, I recommend the book “Sedated: How Modern Capitalism Created our Mental Health Crisis” by Dr James Davies PhD
In this book, building on his earlier criticisms of the pharmaceutical industry in ‘Cracked: Why Psychiatry is Doing More Harm Than Good’ (2013), Davies shows how the pharmaceutic industry has had influence on the definitions and classifications of mental illnesses (through the Diagnostic and Statistical Manual of Mental Disorders) which had defined the narrative of mental health to be a matter of personal “health” and so of individual responsibility, resilience and coping strategies, rather than consequence of social systems and structures.
The book is not a simple criticism of the pharmaceutical industry, but recognises that the work of the drugs industry is but a part of a wider political narrative and neoliberal ideology which shifts responsibility onto the individual, while concealing the social pressures that ought to be addressed. Hence a rise in mental “health” issues can be seen to be a product of a target-driven attainment culture in society, in schools, etc. The proposed solutions have been commodified too, in anti-depressants and anti-psychotic medications, the long term value of which are questioned, and in back-to-work therapy, for example, which offer strategies for “resilience” while failing to address questions of meaningful and valued employment.
Readers who have absorbed ‘The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity, and Improve Everyone’s Well-Being’ (2019) by Richard Wilkinson and Kate Picket (authors of the earlier and more widely read ‘Spirit Level’), will not be too surprised at the arguments.
For those reflecting on the social pressures in society and church, whether in social theology or pastoral reflection, this work helpfully connects so-called mental health issues with contemporary social issues.
When politicians talk about work, they usually mean paid work. If you volunteer your help with socially or environmentally useful projects, that isn’t work according to politicians. If you are the sole carer for a friend or neighbour, not exactly voluntarily but because there isn’t anyone else to do it, that isn’t work according to politicians. Now there may be good reasons why a politician may sometimes refer to work in this way, but they should be open about what they really mean.
Agreed
I’ve brought up 4 children. I was mostly a stay-at-home mother; I was not “working” because I wasn’t paid. In reality, I was working incredibly hard, available 24/7, no way of having scheduled breaks with babies or toddlers. Being told I wasn’t working made me very angry. And, of course, my human status was downgraded because I wasn’t paid. People act as if they think bringing up children is just unnecessary self-indulgence, and mothers should get out there and earn money. And as this has happened, young people have had more problems in all areas of their lives.
Much to agree with
@ Christopher Pipe
And how criminal it is that MMT shows the benefits to the economy of actually treating those “unpaid occupations”, done for others, as work deserving remuneration.
The State is not restrained when paying for an obviously-available resource – labour – that is needed in the economy.
This is a truly solid point. Spot on.
For the roots of decent medical treatment go deep into government – the economics of it, the regulation of it, the quality of it, the fair allocation of it.
The blind spot in this poxy Thatcherite infected LABOUR government – in fact most if not all governments since ‘it from Grantham’ came on the political scene – is that when one is sick, one is not being ‘productive’ or ‘earning one’s keep’ for King and country. One is a burden to society apparently if one is sick. That is what the attitude is. Being in hospital or at home poorly is not unlike being a guest at one of his majesty’s penal institutions – no rights!
Thatcherite Britain is all about making money, not spending it, and if you’re not making huge amounts, you are not worth worrying about.
And, if you are not spending money on stuff that validates and reinforces that attitude – certain marques of cars, big houses, yachts, 2nd, 3rd homes, holidays and other conspicuous consumption to be worshipped then you just haven’t made it yet baby.
Yes, a superb post, remanding me why I keep coming here.
It is being massively under-watched compared to usual
Why, do you think?
And thank you
Richard, I think that it may be that you seem more pessimistic than usual in this post? I totally agree with your pessimism, but my guess is many people will just give up in the first few minutes. Sorry, don’t mean to be a downer!
On a happier front, here’s my song to go with this post… Seems to me to cover the healing happiness that music can bring even when “Everybody’s desperate trying to make ends meet. Work all day and still can’t pay the price of gasoline or meat. Alas, their lives are incomplete”.
Mahommed’s Radio – which always makes me think of Radio Caroline, and hunkering down under the bedclothes (so hopefully parents wouldn’t hear!) with my transister radio when I was about 16 – it was so much better than the crackly and often lost Radio Luxembourg that I’d been forced to listen to for pop/rock music before the pirate radios arrived! Better music too, it really turned the UK music industry around.
https://music.youtube.com/watch?v=REYBMks2q3w
I am more down than usual right now.
I am finding this world hard right now
Why not?
Why under watched? It’s a good question.
Well, no one wants to feel unwell or think about being so and also think about going into hospital – a fear that has worsened recently because of the collapse of the NHS which I fear has become normalised, and which I have personal experience of. Added to that, fear over having to rely on help with disability which like me, will prevent me from having disability recognised (that’s how it feels – that I should keep it to myself and solider on). So fear keeps people away or not engaged. Being ill is you see being close to, well, death – there is an association. So, its also a social issue that is cynically exploited by bad actors in the media and politics. Only the ill know what it is like in the NHS and they have had no choice but know about it.
But the media is mixed and confusing isn’t it – we have the 24hrs in the NHS or A&E sort of thing going on on TV, documentaries about certain hospitals all putting on a good show of the worth of the service.
Then there are the big issues now over things like the Lucy Letby case (is she a murderer or was it poor management or was it the strangle hold on government funding or was it all of them?) and other cases that relate to maladministration here and there – all making the NHS look dangerous and incompetent and ripe for change – any change, including more private ownership.
Maybe A&E will always be free but the idea is to use other areas of medicine to maintain the poorly (not make them better) as an income stream?
The other night, C4 news hold a special about the shortage of staff in the NHS and its consequences. In my housing background, I know for a fact that when Thatcher got rid of rent controls, students nurses – who relied heavily on a cheap private sector property – declined steeply in number back then, never mind now. It makes me realise that the Thatcherite trajectory is alive and well.
I’m convinced though, that in this world being sick is the making of you invisible, in-valid (not invalid, but non-valid) as an economic unit, so the only way to make you ‘valid’ is to enable someone to make money out of your illness.
You have to be exploitable you see – or like the elephant before it becomes ivory or the rain forest before it is used to grow palm oil, you simply just don’t exist or count – you are a unit of nothing unless you can be turned and extracted into ‘value for money’ or ‘shareholder value’.
These changes are coming, and are already here – this is why Andrew Lansley tried to disassociate the government from responsibility of patient safety etc., because the Tories intended to break the NHS for good in order to manufacture consent to privatise and virtue signal for funding your own care. And Wes Streeting and Labour have accepted this under the false flag of ‘change’.
It’s nothing short of betrayal by our political class.
Agreed
Yeah, I’d noticed that on the like boxes (& indicator of people through the site).
My guess? many people are down, due to USMango/Ukraine/UK situation/feeling of powerlessness/feeling that nothing will change/feeling that nothing can change….etc
Societal atomisation, Peter Seeger sang about it back in the early 1960s “Little Boxes” – by 8 it was my favourite song and thoroughly politicised me. If society is atmonised then it prevents collective action – apart from via well controlled political parties. Change thus slows down and stops – apart from change in favour of those in control. & if those nominally in control have their strings pulled by those truly in control then you have what you have. Corbyn offered a possible change – but would have been prevented implmenting it.
Blog traffic is at a record high this month – heading for 150,000 above any previous month
The best ever month on YouTube
But there may be a weariness creeping in.
I think that what we are seeing now is the result of Margaret Thatcher’s fairly successful attempt to destroy the working class. Did it ever occur to her and her cronies, I wonder, that replacing the working class with a non-working class would have such effects? If it did, would they care? I’d suggest not.
[…] By Richard Murphy, Professor of Accounting Practice at Sheffield University Management School and a director of the Corporate Accountability Network. Originally published at Funding the Future […]
It’s your economic arguments that initially impressed me ,eg the one today on government debt ‘crisis’,but also this wonderful article demonstrates a clear insight into people’s thoughts and needs.
This blog is an antidote to the horrid world of Thatcherism/neoliberalism and should be prescribed reading , especially for Labour MPs.
I’m a retired Health Visitor, I’d like to remind people that the money when you’re on Benefits to cover the cost of your rent has been cut so that claimants had to use money from what they had to live on to pay the rent. I retired 15 years ago and it was in place for about 10 years before that. So claimants have very little money, must move to find somewhere they can afford too often to build up a supportive community around them, children have to move school. All of this affects the families mental and physical health. A basic human right removed because of the lack of social housing and enough money to pay basic bills.
Agreed
It is meant to penalise, and it does.
The issue of ‘difference’ is fundamental. Medicine is developing in the direction of personalised care which acknowledges and operates on the basis of diagnosing specific causes and characteristics of an individual’s condition (while government makes sure only the rich can get to experience a holistic health approach). Similarly in education, recognising that each of us has differing approaches, backgrounds, ways of learning, and so on (while government corrals children into standardised groups and encourages exclusion of those that don’t fit). Local authority housing policy promotes a variety of housing arrangements including intergenerational, disabled, and so on (while the larger housing companies continue to churn out standardised nuclear family models). Each of us is different. But crucially, we share our fundamental humanity.
Neolibs designate *everyone over here* as the same and *everyone over there* as different and alien in order to promote their divisive, antagonistic, oppressive, genocidal, fascistic self-serving ideology – self-serving for the profits of the ultra-rich, the international corporations, the insurance industry who now control so many countries.
Agreed