Sample Answer
Health, Social Care and the Body: Neoliberalism, Public Health and Control
Question 1: Consequences of the Neoliberal Shift from Collectivism to Individualism in Health and Social Care
Since the late 1970s, the neoliberal agenda has reshaped welfare provision in the UK and beyond, fundamentally shifting health and social care from collectivist principles of shared responsibility to an individualist ethos centred on personal choice, responsibility and market mechanisms. This transformation has had far-reaching consequences.
One of the most significant outcomes has been the erosion of the welfare state as a collective safety net. Under collectivist frameworks, particularly evident in the establishment of the NHS in 1948, healthcare was conceived as a universal right, underpinned by taxation and state responsibility. Neoliberalism reframed this model, introducing ideas of efficiency, competition and consumer choice (Harvey, 2005). Health services became increasingly marketised through policies such as the purchaser-provider split in the 1990s and the expansion of private-sector partnerships. As a result, services are often evaluated through cost-effectiveness metrics rather than broader social value, leading to concerns about inequality of provision.
Another consequence has been the individualisation of risk and responsibility. Where collectivism emphasised structural determinants of health such as poverty, housing, or employment, neoliberalism foregrounds individual lifestyle choices. Citizens are encouraged to manage their own health through diet, exercise, and screening, with less emphasis on state intervention to address underlying inequalities (Petersen & Lupton, 1996). This has widened disparities: while affluent groups often have the resources to engage in healthy practices, those in deprived communities face structural barriers that individualist narratives fail to address.
Additionally, neoliberal reforms have led to growing health inequalities. Research shows that income-related disparities in health outcomes have widened since the 1980s (Marmot, 2010). Neoliberalism’s reduction of welfare provision and introduction of austerity policies in the 2010s further exacerbated the vulnerability of marginalised groups. The COVID-19 pandemic revealed how unequal access to healthcare and secure living conditions amplified risks for low-income and minority groups, underscoring the dangers of over-reliance on individual responsibility in public health.
From the perspective of health and social care professionals, neoliberalism has also reshaped work cultures. The emphasis on managerialism, performance targets and accountability frameworks has placed strain on practitioners, sometimes leading to reduced autonomy and job satisfaction (Clarke & Newman, 1997). Care itself risks becoming fragmented and transactional, with clients treated as service consumers rather than participants in a collective endeavour.
In summary, the neoliberal shift from collectivism to individualism has produced profound consequences: marketisation of health systems, the privatisation of responsibility, widening inequalities, and pressures on practitioners. While it has introduced efficiencies and innovations in some areas, the long-term effect has been to undermine the collectivist ethos that once defined UK health and social care.
Question 2: New Public Health, Prevention and Societal Reactions to Medical Deviants – Case Study: Obesity
The emergence of the New Public Health in the late 20th century has placed prevention and lifestyle at the centre of policy, moving beyond curative medicine towards holistic strategies addressing risk factors. While this shift has brought advances in population health, it has also reshaped societal perceptions of so-called medical deviants, particularly obese individuals.
The New Public Health emphasises modifiable behaviours, such as diet, exercise, smoking and alcohol consumption, as key determinants of health. Obesity, framed as a preventable condition, has become a focus of campaigns encouraging personal responsibility. Government strategies, such as Healthy Lives, Healthy People (Department of Health, 2010), highlight the importance of self-regulation in diet and activity. This discourse has produced significant societal consequences, particularly in the form of stigmatisation.
