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‘Fighting the Five Giants: It’s Time to Renew Our Social Contract’

Every one of us will experience illness, damage, impairment, disability and, inevitably, old age, writes Penny Pepper

A copy of the Beveridge Report. Photo: Sam Stephenson/Alamy

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The concept of a social contract for welfare support and national health, the 1942 Beveridge Report and what this Liberal politician termed the ‘five giants’ – want, disease, ignorance, squalor and idleness – still strikes me as ground-breaking.

Even the old posters used to campaign for its implementation remain as powerful today as they surely were then. In one, the ‘giants’ are portrayed as people. I’m most struck by idleness depicted as a forlorn unemployed man slouching against a lamp post, a factory behind him with a large ‘closed’ sign hanging over it. 

In terms of disabled people today, we’d likely have a ‘scrounger’ or ‘fraudster’ sign, perhaps combined with some representation of disease. But maybe ‘hopelessness’ would be a better term than idleness? 

The idea of the five giants took hold at a time when there was less division in society. When, good or bad, the delineation between classes was more comfortably understood. When Winston Churchill made the much-shared statement: “Rank me and my colleagues as strong partisans of national compulsory insurance for all classes for all purposes from the cradle to the grave.” 

But we now take for granted those measures that led to the founding of our NHS, when political parties cooperated on matters of importance to society as a whole.

The odds were different then. This was in the midst of the Second World War, when a healthy, fighting fit proletariat was required, and there was nothing to take for granted. Those five giants loomed everywhere outside of the gentry and their financial security. My mother remembers the lottery of dentistry during her 1930s childhood – sharing gruesome stories of who could have a filling first in a family of many siblings.

There was pragmatism in the debates back then; an awareness of sickness that was horrifically close to most people’s lives. Now, we have an established narrative, urged on by recent governments – and the overwhelming dross in the mainstream media – which wants to deny the modern equivalents of those five giants as relevant. 

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We are promised so much in our technological age, on the back of a strain of Conservatism that enjoys promoting the idea that we can somehow sidestep poverty, illness and impairment.

I’m fearful that it’s too late. That we’ve taken for granted for so long the notion of state support that we believed would always be there: a reliable NHS hovering in the background, somehow still operating, even as eager politicians score points for its failings or successes and it shatters under the weight of so much pressure.

I’ve lived through my own sociology experiment in social care and NHS support. I’m my own test subject, pushed through various medical departments and services both as an inpatient and outpatient. My experience suggests that the NHS is not only broken but gorged upon by the private sector with a sly side-glancing secrecy, as it sucks up every chance to make profits.

But I refer to myself as an NHS baby. And to think of this in the broadest sense encourages me to puff up with a strange patriotic and perhaps socialist pride. Even a sense of ownership, from all those years lived through a system that worked to keep me well, and more recently alive, brings me hope.

I remember my GP regularly visiting my home from a young age to examine my joints. I remember the touching trust I felt in most of my doctors and health professionals. They were there for me. They knew me over the course of many years. 

Recently, faceless managers and administrators make me feel as though I’m making a fuss, that I don’t understand cost implications, and that I want too much – as if my needs are an outrage. 

I can’t even begin to talk about the attacks on benefits, social care, and the 2005 closure of the much-loved means of choice and control gained by disabled people via the Independent Living Fund.

It’s very difficult to argue that the original principles underpinning the NHS remain. If you have no money you can no longer expect a decent, functioning level of support from systems that are supposedly there to manage your health and ability to thrive. These failures begin, as in my case, within the home. With doctors who don’t visit. Services that aren’t available. Dots on a chart; numbers on a spreadsheet. None of which equates to the delivery of everyday workable healthcare and support.

The problem is every one of us will experience illness, damage, sickness, impairment, disability and, inevitably, old age. And so, if we believe in a fair society that operates with compassion and equity, we need to reformulate our own five giants that are relevant today. 

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A healthy, cared for, society that has few wants at a basic level will surely thrive and, at a personal level, the construction of artificial barriers via attitudes and environment can and should be removed. Very few of today’s politicians have the interest or the humanity to do so.

The pandemic undoubtedly stands as a sombre wake-up call for such disregard. Millions dead and many more living with the ongoing consequences of the Coronavirus. So much for the Brave New World of the unbreakable, never-damaged, uber human! Through my own lived experience, and that of others, I know this is the ultimate lie.

Churchill, as a Conservative, spoke of the ‘cradle to the grave’. William Beveridge was a Liberal politician. And it was a Labour Government that enacted his report to create our welfare state and the NHS. It was an achievement of cross-party cooperation – not perfect, but of a like that we simply no longer see. 

With all its flaws, let’s remember all the years so many of us have reaped its benefits. Not simply because we pay in for ourselves, and feel happy to pay in for those who can’t, but because it is the right thing to do.

There is now a grotesque disconnection between governments and public services, resulting in more than poor communication. We are a nation let down, in poor health, disappointed and baffled. Yet the individuals I meet, who care for me so well in hospital, keep my humanity alive and remind me that, in the end, there is good in people and the world.

Let’s remember the humanity those five giants brought out in our society and politics. And prepare to renew our fight with their latest incarnations again today.


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