Except for its greater prevalence amongst older people, cancer isn’t a discriminatory disease. It affects men and women, all ethnic groups and all social classes. Forms of the disease are gender-specific or more prevalent amongst certain ethnic groups. And some are life-style related, with certain cancers more likely amongst poorer people, and others more likely amongst better off people. You don’t get a full sense of this in a ward of cancer patients, as I was at The Christie. There was a wide cross-section of ages, characters, and variations of the disease. There was, I suspect, a wide income variation amongst us, but missing was a stratum or two of social class – those with private health insurance or who could afford private care. I can’t imagine these people get any better treatment or more professional care, though no doubt they get a lot of frills and more privacy for their money (thus missing out on the comradeship that existed amongst us as we came and went through our various operations and recovery).
All of this leads not so neatly onto some reflections on social and economic inequality. This won’t be a particularly well-researched academic discourse: there are better places to go for that. It’s an attempt to set out some my thoughts and feelings on what is, alongside climate change, the biggest issue facing us today. As we bow at the altar of economic growth, we fail dismally to address adequately either of these issues.
Despite Boris Johnson’s recent intervention I sense a slowly developing recognition that our growing economic inequality isn’t a good thing. Indeed, this developing recognition could have been a major factor behind Johnson’s “in praise of elitism” speech! Robert Shiller, one of this year’s of the Nobel Prize winners for economics, acknowledges inequality to be the most important problem that we are facing today, and in this country support for the living wage is growing amongst politicians and employers. Tax avoidance by the rich, though of course still widespread, is frowned upon now more than for many years. And in Switzerland enough citizens were concerned about economic inequality recently to force a referendum on it.
But debates amongst our politicians about fairness and inequality rarely acknowledge that we must address incomes at the higher end of the scale as well as at the lower, and that we need to look beyond just incomes. Governments over the years – here and abroad – see economic growth as the answer to all problems, still holding to the misguided belief that somehow we will all benefit from burgeoning incomes higher up the scale.
For some time now I’ve followed the work of Richard Wilkinson and Kate Picket. Wilkinson’s The Impact of Inequality: How to Make Sick Societies Healthier presented evidence that however rich a country is, it will be a more dysfunctional, sick and unhappy society if the gap between social classes grows too wide. He showed that poorer countries with fairer wealth distribution are healthier and happier than richer, more unequal nations. The Spirit Level[i] takes this further. There’s not space here to go through all their arguments and evidence, but they make a strong and coherent case that more unequal societies are bad for everyone, rich and poor. The Equality Trust[ii] has been set up in its wake to provide further research and promotion.
To me, this debate is about what sort of society we want to live in, what values we think are important. It’s a debate that the political leaders of the major parties are reluctant to hold except within narrow parameters that serve their particular interests at the time. Yet what would be the answer if people in this country were asked if it is right and fair that some people – CEOs of companies, entertainers, people who buy and sell money, footballers – earn millions of pounds a year, whilst other people – who clean hospital wards, serve us in restaurants, look after our under-fives – earn less than £15,000 per year? I suspect that the vast majority would answer an emphatic no. What would be the answer if people were asked if it was fair that women’s pay for full-time work is on average £5k less than men’s? No again I suspect.
Inequality is more than just about salaries “earned”. Inherited wealth does much more than maintain the status quo: it exacerbates the problem (just 20% of inheritors receive 76% of the total inheritance given), and is conveniently ignored by those (like John Major and David Cameron recently) who bemoan the lack of “upward mobility”. Inequalities are also maintained and enhanced by pensions that give more to those that already have, and by the two-tier services we run in health, education and housing. It’s unlikely (yet) that private health care provides better treatment, but it does enable people to jump waiting lists for certain treatments. The two-tier education system ensures that more resources go into educating the children of the wealthy, thus enabling parents to “buy” their children into better higher education and jobs. In housing the recent subsidies to owner-occupation through help to buy is just the latest in a long line of initiatives that assists and promotes the owner-occupied sector, yet at the same time the myth is perpetuated that social housing soaks up tax-payers’ money. The richest richest 10% in this country have five times as many rooms per person as the poorest 10%, putting the bedroom tax into perspective. Evening this out a bit would go some way towards solving the housing crisis.
I’m not going to pretend I have immediate solutions to these issues. Yes, the tax system could be made more progressive. Yes, more employers could take up the living wage. Yes, we could stop private schools gaining tax benefits through charitable status and yes, we could equalise subsidies across the housing sectors. All this would help, but overall won’t have much impact other than perhaps slowing down the rate of growing inequality. And politicians aren’t going to make even these changes unless they think a significant proportion of the population support them. Yet we feel helpless, that there’s nothing we can do about it, it’s just the way things are.
Somehow we need to create the conditions by which people in power will seriously take up the issue of inequlaity. The living wage campaign provides an interesting example. This didn’t become popular through policy papers, academic research or political speeches. It began with working people in the East End of London finding they struggled to have a decent life even with more than one minimum wage coming into the household. So, with support, they organised and campaigned and raised the issue. Work by the Centre for Research in Social Policy, funded by Joseph Rowntree Foundation, set out calculations for a Minimum Income Standard, and gradually local campaigns sprang up throughout the UK resulting in a national movement for change. This was a specific campaign with clear, well thought-out, very reasonable, demands. And it’s been very successful.
A campaign for greater equality is more nebulous, so perhaps needs more specific targets. The Swiss referendum was to create a law to make it illegal for any company to pay anyone in a month more than the lowest earn in a year – in other words no company could have a low to high salary ratio more than 1:12. Not surprisingly the referendum proposal was voted down, but at least they had a debate, and focused attention on what in some companies is a 1:250 ratio. Maybe as a start in this country we should campaign for all companies to publish their ratios, and for no public-funded organisations to surpass a particular ratio. I don’t know what a reasonable ratio would be. The TUC argue for a maximum of 1:20 which would mean a company could pay the lowest paid worker £12,500a year with a top earner taking home £250,000. It’s hardly socialism, but it would be a start!
We’ve a general election in about 18 months. The election will be fought on who can best manage the economy, reduce the deficit and achieve economic growth, even though that growth is founded on consumerism and encouragement of greater personal debt. I like to think that we can change that debate, not to how we can bash the rich but to one about what sort of society we really want to live in. Greater income equality is crucial to this: but I’d hope we can take the debate further even than one about wealth, economics, welfare, service delivery, to encompass a range of things that might help create a more contented society. (There isn’t time to develop this part of the theme now, but I was struck by a recent report on city living that those who walk or cycle to work are much more contented than those who drive, particularly those who drive some distance. Let’s throw that into the discussion how we make our cities and towns better places. Hey, we may be able to do a bit towards reducing CO2 emissions at the same time; a win/win for all!)
I don’t have any confidence in any of the major parties going into the election with fairness and greater equality at the very core of its policies. But maybe, just maybe – with some campaigning, questioning and social media noise – we can at least use the occasion to start developing and promoting a value-based vision of a fairer society.