Words by Hannah Yeager and Lara Thomas
Access to healthcare is a fraught topic worldwide and it often becomes politicised as well–the UK being no exception. In an effort to nuance the topic of access to healthcare in the UK, this blog compares different political perspectives on the issue and analyses the effect that region, class, race and ethnicity have on this access.
First to consider are the platforms of the Labour Party, where the approach is to increase access to health care through social welfare schemes such as the NHS. The Labour Party created the NHS, but in a changing world, it has recognised the need to adapt its approaches to access to healthcare by modernising it. As of 2017, the Labour Party put forth a 10 year plan aimed at modernising the NHS by ensuring ‘fewer patients need to go to hospital, shifting resources to social care, GPs, care at home and mental health services, reducing the cost of hospital care in the long-term’. In a January 2022 speech, Keir Starmer, the Leader of the Labour Party, commented on the necessity of addressing the reality of the UK as an ageing population, long queues and wait lists at NHS institutions, the widening health gap between the rich and the poor, stalled life expectancy across the population, and staff shortages as realities needing to be addressed in policy. Overall, the Labour perspective highlights the many positives that the NHS affords the UK-wide population while also being keenly observant of the necessary changes that need to be made to it in order for it to reach its full capacity, including individuals’ access to its services.
Second, there are more conservative approaches. These tend to be more economy-focused and aimed at funnelling more financial resources into the NHS, including upgrading hospitals and healthcare buildings. These are undoubtedly important issues, but upgrading NHS facilities can only go so far and only affects those with preexisting access. Perhaps in adopting a more economy-driven approach, resources could be invested more so into creating access to healthcare services and facilities for those with no or little preexisting access. This could take the form of a shuttle service, more efficient roads and highways connecting rural areas with healthcare centres, and even better internet services in rural areas to provide those communities a mechanism by which to access telemedicine.
One way of shaping this approach to be more aligned with enhancing access is to funnel resources towards making the NHS more accessible, particularly to those in rural areas and marginalised groups. According to a 2020 Southern Medical Association article, it was found that those in urban areas are generally more proximate to a GP than their rural counterparts. Surprisingly though, those in rural areas tended to live on average two years longer than those in urban areas. This is especially noteworthy, consider that there is a systematic issue in recruiting GPs and other health professionals to work in rural areas. This creates what has been called ‘distance decay’: the farther away a person is from a GP the less likely they are to use them; however, telemedicine has revolutionised this in many ways. Similar disparities are also seen across economic classes, race and ethnicity.
Aside from politics, aspects like region, class, race and ethnicity also influence how individuals’ access to healthcare is shaped. This is not to say that these are the only factors affecting healthcare access, but they were the focus of this study. There seems to be recruitment issues with getting GPs and other healthcare professionals to work in rural areas, which further contributes to the ‘distance decay’ described above. Telemedicine has transformed this in many ways, but it only works if the individuals affected have internet access. Moreover, those living in deprived areas (urban or rural) generally have a significantly worse experience with the NHS than those in the least deprived areas, highlighting a key socio-economic issue. According to a 2021 census, males living in the most deprived areas have a decreased life expectancy of seven years and females six years.
Welfare and social spending cuts coupled with the COVID-19 pandemic have only enhanced this gap. By another token, one’s religious identity can also impact their healthcare access; for example, a BMJ study indicated that individuals identifying as Muslim reported that their religious affiliation negatively impacted the quality of healthcare they received in the US and UK, largely due to the larger socio-political context shaped in part by Islamophobia. This is certainly not the only religious group that experiences negative impacts in healthcare because of problematic social ideologies, but it does highlight an important problem spanning across the UK as well as the US.
In regards to COVID-19, ethnic minorities were found to be at a higher rate of testing positive, and as we are well aware the pandemic has had a disproportionate impact upon ethnic minorities in comparison to those of white ethnic backgrounds. Black women also statistically have a higher mortality rate during childbirth in the UK, a fact likely caused by systemic racism, and further exacerbates how there is an inequality of access to quality health care in the UK and elsewhere, like the US. This racism was caused by a belief that originated after the horrific treatment of the Black community during the time of the Transatlantic Slave Trade wherein the treatment of this community was purported to be justified by medical professionals who perpetuated the statement that people of colour have higher pain tolerances.
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