Welfare for all, at the same cost

In his writings in the 1950s and 1960s on the British Welfare State the eminent social scientist, Richard Titmuss, argued that…

In his writings in the 1950s and 1960s on the British Welfare State the eminent social scientist, Richard Titmuss, argued that it was inevitable that if state services, whether education, health or income support, were provided only for the poor, they would be poor services.

His insights have much to tell us about our own crisis-ridden health and education systems, and his conclusions, derided by the Taoiseach in his recent broadsides against Labour as inefficient and wasteful of scarce resources, are nevertheless worth considering seriously.

With among others Anthony Crosland, Titmuss was one of the foremost advocates of the idea, latterly somewhat tarnished, of "universalism" which underpins the rationale of both the British and the Nordic models of welfare states. In essence, this is the idea that the state should provide a service in such vital areas as health, education and pensions to which all citizens would be entitled, irrespective of income, and which would be of sufficient standard that the middle classes would not feel the need to make alternative provision for themselves.

Most importantly, such a system, they argued, would help shape more cohesive, united communities by doing away with the social apartheid that two-tier provision for the rich and poor entails, exacerbating class divisions and social tensions.

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Sharing in the experience of state schooling or hospitals those middle-class taxpayers, or so the argument went, would insist on a quality of provision acceptable to their nearest and dearest, and hence an acceptable standard for the poor. In return the middle classes would agree to be taxed at a level necessary to pay for such provisions. And, for some time, that compact worked.

Nearly 30 years since I left London, where I grew I up in a middle-class community, I still have a vivid memory of the remarkable depth of support for those universal principles, almost taken for granted, and even of the pride with which many in that community viewed the NHS and the state school system. I recall then, too, in the 1970s the growing disappointment many felt as they saw services deteriorate through dwindling investment and the realisation they had no choice but to sign up to private provision. The compact had broken down.

Today New Labour has little truck with such a "utopian" notion. Selectivity and targeting are the order of the day, driven by an almost Thatcherite sense of the deserving and undeserving poor.

Tony Blair has warned that "to participate in benefits, there has to be give as well as take." David Marquand, a leading New Labour theorist, has attacked the Crosland/Titmuss vision: "If rights are not balanced by duties why should the rich make sacrifices for the poor? If collective provision is not a means of moral improvement why should those who are not in need pay taxes to pay for it?"

And the former minister, Frank Field, has bluntly explained the retreat from universalism: "Altruisn alone is not a strong enough motivational force to sustain the sheer size of the welfare edifice as proposed by Titmuss."

But to see and make the case for universal provision purely in terms of altruism, or a charitable concern for the poor, is profoundly to misunderstand Titmuss's radical vision. His purpose was to co-opt the middle classes into support for universalism as a form of social organisation that was intrinsically in their interests as much as the interests of the poor.

Just as the objective of social cohesion and the desire to be part of a sharing community in which divisions of class and wealth are muted and in which two-tier provision is seen as unnecessary are embedded in the political culture of the Nordic countries, so, the universalists argue, the middle classes can be sold a concept that goes far beyond a technical debate about the efficiency of university fees versus free places and is about a vision of society.

Yet to articulate such a radical perspective is, admittedly, difficult for the left in these tax-cutting days. As Sir Humphrey would tell the quintessentially cautious Jim Hacker in an effort to steer him away from a particular course: "That, Minister, is a very brave policy indeed!"

Bertie Ahern realised as much and successfully laid a trap for Labour in the recent debate on university fees. Having defined the parameters of the debate - a tax-neutral solution to the university funding crisis - Mr Ahern taunted Labour, successfully wrongfooting it in the debate, with the reality that its option was a socially regressive subsidy to the middle class and a betrayal of its claim to concern for the poor.

But for Labour, dangerous as it may appear, there is no real alternative to pitching a radical universalist case to middle-class voters if the party wants both to expand its base and genuinely put the health and education systems on a sound basis. That means explicitly making the case for spending more and taxing more.

And appeals to altruism will not be enough. A case must be made, particularly in health, that can enlist the enlightened self-interest of voters, a case for a new universalist compact.