Neoliberalism, Codes of Sensibleness and Therapies of Freedom Governments are led by particular ideologies which can be placed somewhere along the left-right political spectrum. Since about the 1980s, the dominant political ideology in the West has been neoliberalism. Neoliberal governments, such as the recent regimes in the UK, advocate minimal State intervention in key areas of society and rather encourage citizens to take control of their own destinies by acting smartly and responsibly in the marketplace. In short, the State step back, reduces public spending and instead let private companies compete in a free market to give people ‘choices’. We can see the influence that neoliberalism has had on the British healthcare system in recent years. The NHS is now predominantly framed as a drain on public resources and is increasingly being privatised. This moves the UK closer to the situation in the US where falling ill or suffering injury will land someone with a significant bill to pay – some people can afford this while others are severely restricted by such costs. Given how unequal British society is, questions need to be asked about whether this is a fair and sensible way to provide healthcare. Alongside the shift towards private healthcare, the influence of neoliberalism effects the way that health - and the attainment of good health - is understood. Increasingly health is viewed as an outcome of lifestyle: people are viewed as either healthy or unhealthy because of the way they choose to behave. This is not entirely problematic but can become so when this logic is presented in simplistic terms, as it is currently in the UK Governments ‘Change4Life’ campaign. This campaign encourages people, with its prominently promoted slogan, to ‘eat well, move more, live longer’. The slogan is an illustration of the simplistic and individualist logic of neoliberalism: everybody can and should act responsibly by following health advice. It promises good health in exchange for compliance with lifestyle advice but does not account for the fact that the circumstances of somebody’s life influence their freedom to act, e.g., how much money they earn, where they live, etc. As such, this approach frames non-conformity with health advice as irresponsible and morally corrupt which can often lead to victim blaming, e.g., those living in deprived areas, etc. More broadly, this simplistic and individualistic approach is the consequence of neoliberal regimes depoliticising social issues. This is why the simplified strapline of ‘Change4Life’ does not read: redistribute wealth, better fund public services, have a healthier population. Although it might within an alternative political culture. Herrick (2011: 5) argues that past and present governments have been so successful in establishing neoliberal ideology as common-sense that the majority of people now accept that this is just the way it is. She conceptualises common sense understandings of how people should behave in neoliberal societies as ‘codes of sensibleness’. The Change4Life slogan is an excellent illustration of how codes of sensibleness are promoted. People who do not ‘eat well’ and ‘move more’ are framed as not acting sensibly and therefore being irresponsible citizens. We must be critical of this approach as it deflects attention away from the social inequality that influences whether people eat well and exercise regularly. The dominance of neoliberalism has made these codes of sensibleness - and the moral judgements that accompany them – an inescapable part of modern life. This is why Nikolas Rose has argued that we are now ‘obligated to be free’ – what he means by this is that the ‘healthy lifestyle’ is now so closely aligned with notions of freedom and common sense that doing what is considered ‘right’ and ‘healthy’ is now less of a choice and more of an obligation. If people do not make the ‘right’ choices they will face the scrutiny of others. For this reason, Rose argues that things like going to the gym or eating low-fat foods have become ‘therapies of freedom’. I argue for behavioural justice: if these behaviours are going to be moralised in this way then we need to ensure that existing inequalities are addressed so that everybody is realistically able to follow lifestyle advice. Currently people living in less affluent neighbourhoods have many more barriers between them and a healthy lifestyle than people living in more affluent neighbourhoods.
DEADLINE: 29/1/16