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