Paper short abstract:

This paper demonstrates how universality has become a focal point of health activism in the UK, thus leading to the building of new solidarities and a putative class consciousness.

Paper long abstract:

This paper demonstrates how universality has become a focal point of health activism in the UK, thus leading to the building of new ties between social groups.

The paper is based on ethnographic fieldwork with people campaigning against cuts and privatisation in the NHS, the UK’s public healthcare system. In contrast with countries that do not have pre-existing free, comprehensive healthcare services, UK healthcare activists object to insurance-based schemes, which they see as representative of privatised health systems. Such systems are rendered as inefficient, unfair and low quality, serving as a foil against which to compare the (imagined) goods of the NHS: universal, free and comprehensive.

The Tory government undermined these goods with its “hostile environment” policies, introduced from 2012 onwards. Charges were introduced for people deemed ineligible for free healthcare, officially described as “overseas visitors” and popularly dubbed “healthcare tourists”. As well, a healthcare surcharge was introduced for anyone applying for a UK work visa. This surcharge effectively functioned as an insurance premium, payable on top of any taxes paid by migrants.

These policies formed part of a narrative that the reason the NHS was deteriorating was because of uncontrolled immigration. Thus the Tory government moulded the popularity of free healthcare to a logic of exclusivity. Activists used the NHS value of universality as a rallying point to reject this logic. They defined their campaigns according to a unity of interests between themselves and migrants. Thus they built alliances across occupational groups, ethnicities and nationalities, thus building new solidarities.