There’s a problem with vaccine take-up among some BAME communities. But is this an ‘irrational’ lack of trust in Government , or because of the solid reasons they have been given not to?

My next two posts continue with the lessons I think we should learn from the building of a new society after World War 2. But they start from a recognition that society in 2021 is hugely different from that of 1948. Some of that difference lies in the nature of modern society and some in the need for a different form of state policy to meet its needs.  So post COVID-19 both society and state policy will need to change.

Post World War 2 Britain thought of itself as a monoculture. It’s true that in 1948 we were mostly an all-white society, but class had created different cultures. There was a small – much smaller than now – cohort of upper and upper middle classes. There was an exceptionally large majority of working-class people and a small, poor group that had fallen out of the working class.

Beveridge addressed the first group mainly by expecting them to do their duty and pay for the new welfare state, remembering the sacrifices the whole country made during the war.

He addressed the vast majority working-class group by expecting them to make a full contribution to the new services they would receive and recognise the necessity of us all playing a full role in our society.

He addresses the third group rather more sternly – expecting them to keep themselves fit for service and to play a full role in society by joining the working class in a society organised around the world as he saw it. Sometimes he became quite punitive towards this group – indicating that the state expected co-operative behaviour. Beveridge’s policies expected people to join in (as they had been expected to during the war).

The result was that most of those post-war welfare state policies had an edge of compulsion. For part of my career, I worked with the education welfare officers of the Inner London Education Authority (ILEA). Their job was – mainly nicely – to get people to send their children to school. But if the nice approach did not work – there was the law.

Last week I mentioned the expectation that employers, state and employees would play their part by paying for the national insurance stamp and emphasised that the state would use the law to enforce that on employers – and that this created an organised labour market.

But there were some employees who neither wanted to be part of an organised labour market, nor to pay for their stamp.

So for the last 60+ years there has been an tinge of compulsion to our ‘welfare’ state.  It’s ours so long as we do the right thing by it and society.

This was true of some peoples’ experience of the NHS. Some experienced nurses and doctors as having a critical view of them and their lives. Why can’t you be more organised? Why can’t you take better care of your health? Some of my older relatives (and now also younger friends) stayed (stay) away from the NHS because it judged them and the way they lived their lives.

Fast forward to the first decade of this century and I remember meetings with refugees in London where myself and others extolled the virtues of registering with a GP.  For all of my life this process had been nothing but a plus in my life. As I moved around the country, I always registered with a new GP. As I extolled this wonderful 1948-style relationship – “All you have to do is register – It’s free!”, people in the room would start to drift quietly out of the doors and meetings usually ended with very few people ‘signing up’. (I recall – even in A&E –  bringing in registration forms which patients succeeding in leaving without completing). A Bradford GP recently reported that this remains  a problem.

Registration for me – white, middle class and in a secure relationship with the state- was nothing but an upside. Registration for a refugee was full of anxiety which could lead to a wide range of police activities and possible deportation. The price of my receiving health care was nothing. The potential cost of registration with the state for them was huge.

Overlay this experience of NHS registration with the day-to-day experience of the immigration services. Here you were simply trying to get your children or grandparents into the country. Trying to get your family together.  And you have had a different relationship with a state than me. During my 70+ years – however much of a lefty I have been – the state did not spend a lot of time, effort and money trying to create an environment for me that was deliberately hostile.

Yet for decades the British state has spent a lot of imagination and money in creating a hostile environment for some sections of our population, In recent years we have seen the detailed cruelty of this policy in dealing with the Windrush generation. The state has put a lot of effort into making many black and minority people feel unwelcome.

As a consequence many black and minority ethnic people feel mistrustful of the state. This is a direct result of policies that have been created to undermine their trust. Not everyone. Not all of the time. But some people, a lot of the time.

Which brings me back to the title of this post.

A great deal of time and money has gone into making some people in our society anxious and mistrustful of Government. So the fact that now they are anxious and mistrustful about the vaccine is not really a cause for surprise. It is an indication of the success of this policy.

As a nation we need the vaccination programme to reach everyone. This means that the programme has a strong requirement to embrace the principles of equity and universalism. Those principles are critically important for the future of our country so to make them work we I propose,

  • That all of us must try and mend this relationship of mistrust.
  • That whilst doing so we must be clear about why the trust is not there.

Only then might we be able to do something about tackling the problem.

In my next post I’ll be exploring this further.