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GPs go forth

A society should be judged by how it cares for those who are most vulnerable

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The Old Testament book of Leviticus may seem an unusual source for guidance to inform social policy, but there is wisdom in this ancient Hebrew book of the law that we would do well to consider, whatever our religious views. Hidden in the middle of the 19th chapter are the following two verses:

‘When you reap the harvest of your land, do not reap to the very edges of your field or gather the gleanings of your harvest. Do not go over your vineyard a second time or pick up the grapes that have fallen. Leave them for the poor and the foreigner.’

This was a clear instruction to the Jewish people that they were to live with a social conscience: that those with plenty should leave behind something for those in need, which includes both the poor and the foreigner.

In stark contrast, the political arguments from our Government are increasingly about taking the harvest right up to the edge of the field. There is an ideological fear that someone, somewhere might be getting a free ride, which leads to picking over the vineyard again and again to make sure that nothing is left for ‘free-loaders’, while the dual spectres of the benefits scrounger and the health tourist are used to stoke the political debate.

There are many formal policies already in place, such as the huge cuts to legal aid or the cap on welfare payments. Most obvious to GPs are the changes to Employment Support Allowance, with patients frequently left bewildered and desperate after an assessment by ATOS and the sudden cessation of their benefits.

Now we hear that there are to be changes to Job Seekers’ Allowance. Claimants will have to sign on weekly rather than fortnightly, and will have to wait seven days rather than three before their first claim - four days without income when you are already gleaning what you can from the edges of society. The poor are being squeezed.

As for the foreigner, families are being split by increasingly harsh immigration laws, the spectre of a two-tier NHS was first floated by the Immigration Minister Mark Harper, who seeks to deny healthcare to migrants from Romania and Bulgaria, and now the Health Secretary intends to make it a reality with his proposals to dramatically reduce access to healthcare for migrants.

Austerity, of course, is the justification in every case - epitomised by the plight of the idealised ‘hard-working family’ - but there are times when society has to decide what is right, and what is wrong. For many of these policies the financial gain to the Treasury is small, but the political will makes them appear a necessity. Do we want to live in a society that squeezes the margins so tightly that we ensure no-one ever takes us for a ride? Or might we just be willing to risk being taken for granted, leaving something at the edges for those who are in genuine need?

A society should be judged by how it cares for those who are most vulnerable. At first it might seem more expensive, but there are wider costs to bear when society gets tough on the poor. Poverty is closely linked with poor health, and increasing poverty with worsening health, while the health problems of the most vulnerable will have impact on us all.

When I look at these verses in the book of Leviticus, I can’t help feeling that the thinking behind them is as pragmatic as it is moral - if you marginalise the poor and the foreigner there will be a greater price to pay in the end.

Dr Martin Brunet is a GP in Guildford and programme director of the Guildford GPVTS. You can tweet him @DocMartin68

Readers' comments (4)

  • What I would like to see squeezed is not the marginalised but the fat cats in banking and central and local government, in quangos and the numerous non-jobs known as "outreach" and "policy planning" etc etc.

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  • What a well- illustrated response to a dire situation; one that is fast leading into paranoia about our fellow human beings. Only blinkered thinking would exclude our guests in the UK, often those who do jobs others don’t want – and do them better – as well as those who, due very largely to circumstances engendered by the greed of those who are insensitive about those they exploit, fail to cope with being outsiders. Doctors were once encouraged to explore the physical, mental, emotional and psychological quirks of their patients, and families. But that was before the kind of ragged relief provided by surgery meetings lasting no longer than ten minutes. Such consultations lead inevitably to quick, often imperfectly researched drug referrals to quieten the symptoms, not the cause of their patients’ problems. Only the drug business is healthy in such circumstances. Sadly, it’s rare to find a doctor who has the capacity to objectively consider what his or her patients – or potential patients - are really experiencing and, therefore, guide them in the right direction. Thank you for giving me back a measure of faith in the medical profession.

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  • The Legal Migrants who are paying NI and Tax are being asked to pay £200 person per household annually more:-)

    Gordon Brown Hiked visa fees to 800-1000 pounds saying it would pay for extra pressure on health and education due to migrants.

    New Migrants are being singled out by Tories for political point scoring to appease xenophobes from abandoning them.

    We thought people on temporary visit visas from
    non-EU countries were supposed to be Policed now they are after legal migrants as well.What is the justification of squeezing full income tax and NI from them if they have to pay a Health Levy any way?

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  • 'But that was before the kind of ragged relief provided by surgery meetings lasting no longer than ten minutes'
    Anon 8.11, good comments. Your faith in the profession should hold but the reality of the pressures of the job make it an unpleasant way of working. It is fire fighting rather than managing the forest! That isn't the professions doing, it is the lack of coherant government and the ever increasing demand on a limited workforce.
    Also most of us feel 20m+ is better for the patient but it isn't an easy job emotionally to cope with without rest. We're already at 50 hours + a week and our health secretary is spinning out of control with politically correct pandering to people and health companies. The aim is to force the demand to a point where we fail. Ripe for privatising and the NHS falls as a public body, NHS is no more than a trademark to be sold and franchised.

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