Why has Britain's state run health system been so much more successful than the state education system? The answer lies in the success of the NHS in creating an effective cross-class institution which has survived the rise of the new "superclass"by Andrew Adonis / October 20, 1997 / Leave a comment
Britain’s national health Service is widely seen as an international model of its kind. By contrast, the state education system in England and Wales (Scotland and Northern Ireland are different) is almost universally decried. Little attempt is made to explain this dichotomy; rarely, indeed, is it even pointed out, so compartmentalised is public discussion of the welfare state. Yet it demands explanation if reformers are to learn from experience.
Class dynamics lie at the heart of the health/education dichotomy, an argument I elaborate on in my book with Stephen Pollard A Class Act: The Myth of Britain’s Classless Society. We reached this conclusion after, typically, completing separate studies of the health and education systems. Only when we came to consider the two in tandem did it strike us, forcibly, how much the success of the NHS flows from its success, since its inception in 1948, in reconciling the principles of equal access and state provision with the reality of entrenched class divisions; and how much the failure of the education system lies in its failure, over the same decades, to reconcile equal access, state provision and the class system.
A word first about “success” and “failure.” We are not dealing in black and white. Both sectors are about equally afflicted by the rationing of public funding for staff and investment. And while England boasts many good state schools, the NHS has emphatically not succeeded in equalising the health of the nation. Indeed, our study of the health system is a graphic account of class inequalities. A child from an unskilled social class is twice as likely to die before the age of 15 as a child from a professional family, while the life expectancy of a child with parents in the unskilled manual class is more than seven years shorter than for a child with parents from the professional class. Of the 67 “major list” causes of death among men, 62 are more common in the Registrar General’s bottom two social classes than in the others; of the 70 major causes for women, 64 are more common in those classes. By some measures health inequality is now greater than in the 1950s.
As for education, there has been unambiguous progress since the Butler Act of 1944, the ambitious end-of-war reform which stands alongside Aneurin Bevan’s creation of the NHS in 1948. Compulsory schooling extended to 11 years; a huge…