Month: March 2013

Students who acquire large amounts of debt putting themselves through school are unlikely to think about changing society

“Students who acquire large amounts of debt putting themselves through school are unlikely to think about changing society. When you trap people in a system of debt, they can’t afford the time to think. Tuition fees increases are a disciplinary technique and by the time students graduate they are not only loaded with debt but have also internalised the disciplinary culture.  This makes them efficient components of the consumer economy”.


(attributed to Noam Chomsky).


University tuition fees, and the student’s preoccupation with ‘occupation’ as the defining goal of higher education, reflect the realities of current education provision within modern capitalist societies. Societies have to reproduce themselves and education is part of that process. Getting students and society to accept this version of education requires an ideological straightjacket underpinned and reinforced by a disciplinary practice, e.g. debt or fear of unemployment, or fear of exclusion from desired goods and services, or fear of poverty in a post welfare state economy.  This fear is reinforced by the globalisation of labour power in which vast reserve armies of labour have been drafted into the relations of production in a competitive race to the bottom. A race which requires ‘flexible’ labour markets. Students, and their parents, are increasingly aware that skills and knowledge is being ‘outsourced’ to the emerging economies in a competitive globalised market. Those who cannot compete will be relegated to the poor prospects, low wage, part time, zero hours contract economy, to become the ‘precariat‘.




Thus, Higher Education is increasingly a commodity to be sold in a market aimed at the reproduction of the relations of production in a global competitive marketplace. This how the Corporate Class Executive and the Political Power Elite (CCE/PPE) under financial capitalism requires it to be. They inhabit, own and run this market place and compete to reap the rewards that they enjoy. To continue to do so, their vested interests in the current system has to be supported by reproducing the current conditions of production.




In ‘On Ideology’ Louis Althusser outlined a theory of the reproduction of labour power through a mechanism of ideology, as well as repression when required.  This operates in the following way:


As stated above there is a requirement to reproduce the ‘conditions of production’:  every social formation arises from a dominant mode of production and in doing so, and to survive, that social formation must reproduce the productive forces and the social relations of production. These sound very technical. What this means is that society has to ensure the next generation engages in the world of work and the social relationships that make up how we work together. So far, so what? Hunter gatherer societies had a very sustainable ‘mode of production’ – they hunted and gathered! Their conditions of production were their small group kin relationships and the natural environment they found themselves in, with property rights, if they had them, manifested in their cultural practices. The next generation had to learn the skills and knowledge required to reproduce the conditions of production they grew up in. Or die. However, even in these so called ‘primitive’ societies there was room for art, as expressed in the cave paintings that survive to this die. All their educational practices were not only to reproduce the way of life and the goods and services they required. As far as we know, early human groups also seemed to engage in ‘art for art’s sake’.


So, a mode of production is the way a society organises the provision of goods and services (hunter-gather, feudal, mercantile/industrial/financial/state capitalism). This ‘mode’ describes how we go about making things, growing things, distributing and exchanging things that we all want. This of course involves social relationships, which includes in the modern era communities or workers all focused on producing certain goods. This also involves the relationships these workers have with the owners of any land they work on. Another social relationship is that of ‘contract’, we promise each other to do or provide something and the terms that surround that promise. Productive forces might include the availability and bringing together infrastructures such as railways or information technologies to those with goods or services to sell. Together the forces and social relations of production are the ‘conditions of production’. The ‘means of production’ include land, capital, factories, call centres, railways, the internet.


Productive forces must reproduce the means of production and reproduce labour power. In order to smoothly reproduce labour power, Labour (workers/students) must learn the skills needed in the economy, and the rules that govern Labour’s place in the social relationships of production.


This where higher, and other forms, of education and training comes in. To ensure the smooth running of the capitalist system, Labour must accept its place and preferably not question the social relations of production. Education that focuses only on providing skills and knowledge for a job will not equip students with critical tools. The system of rewards and incentives can then be reproduced without query. In a capitalist mode of production, wages must also reproduce labour power otherwise the next generation can’t pay their bills to eat and pay rent. Competence also reproduces labour power otherwise the next generation can’t undertake the work that is required. Ideology also reproduces labour power, the work ethic must be passed on while the system of rewards for work has to be seen as legitimate and as serving the needs of all fairly rather than serving the needs of the few unfairly. Not to do this will lead to a ‘crisis of legitimation’ in which the citizenry cry ‘enough!”


So, the reproduction of labour power also requires the reproduction of it’s submission to the rules of the established order, to the ruling ideology, and a reproduction of the ability to manipulate the ruling ideology for the benefit of the agents of exploitation and repression so that they too will provide for the domination of the ruling class in words.


Ruling class interests requires that labour/students submit to the dominant rules, and that this submission is reproduced. Ruling class ideology must be seen as being the ‘normal rules’ which are required to ensure the system functions efficiently for all and not just for the ruling class. Class interests must be covered up by an ideology that masks the exploitative social relationships of production. Ruling ideas must become ‘common sense’ that everyone in society accepts.


Thus it is becoming common sense that one is required to pay for education on the basis that she or he who pays also is the one who benefits from education. Common sense argues that middle class beneficiaries of education must not benefit from the tax contributions of working class people who do not go to University. It is also common sense that if one has to pay for education then this should lead to paid employment, that the course above all other objectives must lead to skills for the workplace. Currently this means a focus on STEM subjects in order to prepare the UK workforce to compete in a global marketplace. Why waste an education on the Arts and Humanities when what is required is skills in the sciences, maths and technology?


Philosophy and Critical Sociology are luxuries we can longer afford.


Thus for the current system of capital to continue as a mode of production, the CCE/PPE need to ensure that Labour (students) accepts the tenets of this brand (neoliberalism) as serving not only or just the ruling elite or class but also that it serves Labour’s own interest.


To do that it needs an ideological apparatus, backed up by a repressive apparatus when required, i.e. when labour/students no longer accepts the ideology. The disciplinary techniques mentioned above are part of the repressive apparatus used to keep students in line. The paradox is that the more repression is required over and above the ideological, the less acceptance of the ideology there is. Repression may actually highlight that ‘the rules’ are not legitimate, but are self serving rules for the ruling class. This is evidenced by the Occupy movement, the ‘Indignados’ and what Paul Mason has called the ‘graduate with no future’ who increasingly argue that the current system is unjust.


The ideology supporting tuition fees is that of neoliberalism: Unfettered markets, deregulation of capital, the withering away and de-legitimisation of state provision, control of Labour and its immasculation as a force in politics, and the primacy of individualism. This is supported by a materialist culture that values consumption as an end in itself. Other social goals are relegated as useless in meeting the demands of markets and consumption. Globalisation backs this up through threats of undercutting wages and moving production to where Labour is weaker.


This ideology supported the development of Finance Capital as it replaces Industrial capital as a dominant mode of production in developed countries. Finance capital provides fabulous rewards for those that access and control financial assets, but it produces nothing concrete. It may provide capital for investment for actual production of goods and services but even this base function has been overshadowed by its overreach into speculation, trading on credit default swaps, hedging and betting on futures markets.


The promise of material rewards, the manufacture of demand for consumer products, fear of precarious work, the collapse of the structure of opportunities, fear of migrant workers, the powerlessness of social democratic control, and the loss of collective social solidarity in a liquid modern world, leads many students to accept fees and experience its disciplinary nature.


Students therefore get trapped into a higher education system that reproduces the social relationship of production that suits the needs of the CCE/PPE. Unless there are liberated territories for critical thinking that are not linked to ‘getting a job’, a generation of students will find it hard to articulate against power, to organise against power, to speak truth to power and will resort to credit fuelled consumption locked onto the treadmill of mortgages they can neither afford, or not to afford to have. They’ll be damned if they do, and damned if they don’t. Not getting into mortgage debt means facing a lifetime of rent and that could take an increasing share of their income. Getting into mortgage debt, on top of the fees debt, ensures they keep compliant or lose risking their home as well as the loss of their critical faculties as disciplined consumers. The other way to ‘escape’ fees debt is not too earn too much and wait for 30 years.


Finally, there is a small group of ‘elite’ universities who are particularly complicit in all of this. Supported by long established histories, nobel prize winners, wealthy benefactors and  huge corporate and state funding for research they provide the instrumentally based education that supplies and supports the next generation of the CCE/PPE. They get prestige, power and funding, they provide a compliant uncritical graduate whose only goals are their ‘discipline’ and naked self aggrandisement as members of an ‘elite’ group. Their failure to forecast economic collapse indicates the level of their paradigm bound understanding. Just at a time when the modern university should have been critiquing ideological policies, they capitulated, unable to analyse the systemic risk that resulted in the collapse of Lehmann’s and nearly the entire global financial system, an error that students are now also paying for.


The riposte to this is that the system is inevitable, that society has to reproduce a workforce that can do the ‘work’ and that someone has to pay for that education. This misses the point. It is a given that this is so, but it is the form of that education and the nature of work itself as well as the social relationships which direct reward and incentives that can be critiqued. However, while education trains for skills for the workplace it cannot focus on the ideological reasons that underpin the current system.


It does not have to be this way.  For the student working in a burger bar who will graduate to a precariat ‘non job’, they have little choice and little voice, in this Hobbesian educational and social environment.




Can you eat well for £25 per week?

I remembered a conversation with a friend a few months ago regarding eating on a low income, and I thought could I do that? The challenge was £25 per week for two people. One issue was the sustainability of that challenge, if I could pull it off for a week, could I do it for a month, 6 months, a year? Issues to consider are meat eating and wine. Meat eating will be affected but that is no bad thing. We already know eating less meat is healthy and environmentally required. Wine? Will £25 stretch to include a bottle of Chateau Lafitte? (No)… so that issue needs to be cracked or, horror of horrors, go without! My friend is quicker off the mark and is now embarking on the challenge, you can read some very interesting tips on her blog. Well worth a read. if you are considering it, then you will need to plan the week’s menu and think very differently about how, where and when you shop. Watch this space. Visit our facebook page for all things ‘sustainability’.

More greedy bastards

The Greedy Bastards Hypothesis (GBH).


Since the financial crash of 2008, populations became aware of what a certain class of people were up to. The word class itself however had fallen out of fashion as many commentators had pronounced the death of class politics preferring instead to think of us all being concerned with various ‘identities’. So, although many people understood that ‘rich’ people had advantages this did not lead to a ‘crisis of legitimation’ – many people either agreed with Peter Mandelson’s quip ‘“We are intensely relaxed about people getting filthy rich as long as they pay their taxes.” ,  or at least ignored it as the consumer and housing bubble kept inflating. People forgot that class relations still operate whether one ignores it or not.

Graham Scambler (2012a) has not forgotten.

The hypothesis asserts that there are:  “strategic behaviours at the core of the country’s capitalist-executive and power elite. The ‘capitalist-executive’ are a core ‘cabal’ of financiers, CEOs and Directors of large and largely transnational companies, and rentiers. These individuals were perfectly capable of ‘conspiring’ but despite being involved in fierce competition rarely had a need to do so in the post-1970s neo-liberal era of financial capitalism. This cabal has come to dominate the political class”.

As it turns out, the filthy rich are not even paying their fair share of taxes. Tax cuts have not reduced deficits, the GB’s have stashed them away. The banking ‘elite’ enjoy lifestyles beyond the dreams of avarice and threaten to leave the country if we cap bonuses.

So, in effect, democratic politics has been hijacked to serve the interests of a very select few.

Scambler also listed individuals who make up this cabal in 2009.

While Liam Fox calls for a freeze on public spending for three years and a reduction in capital gains tax to 0%, and while Osborne and Ian Duncan Smith continue to take money away from poorly paid working people, the richest 1000 people in the UK have increased their wealth in the last three years by £155bn, and the global elite sit on £13 trillion in offshore accounts. Austerity is only for the ‘little people’.

Scambler (2012b) also cites how private companies will be profiting from the re commodifying of the NHS and health care, as a result of the Health and Social care Act 2012. This he says is evidence of policy based evidence rather than evidence based policy and comes about as a result of corporate interests coming before individual health. This is what Lansley meant when he talked about taking responsibility for health…i.e. take out insurance. The current ConDem coalition is pushing through ideologically driven agendas while Labour sleeps. Maybe Miliband and co. know just how complicit Blair and Brown were in furthering class interests.

GB’s are what Scambler calls ‘Focused Autonomous Reflexives’ (FAR). That is to say that the ‘inner conversations’ these people have concerning social action tend to be self-referential, the inner conversation requires no confirmation by others, they are self-sustained. They have a ‘lone inner dialogue’ which then leads to action. If this is dominant then the person will not need to seek or require the involvement of others, he knows that the correct course of action does not need others to confirm that it is so.

Scambler (2013) has developed an ideal type of the FAR whose ‘mode of reflexivity’ has various 6 characteristics:

Firstly there is total commitment. The FAR’s overriding aim in life is increasing capital accumulation and personal wealth. Nothing less will do and any drift from that commitment is relative failure. Secondly there is a Nietzschian instinct based on Hobbesian view of human nature as nasty, brutish and short in a dog eat dog world, that does not quibble about cutting corners in a ruthless determination to succeed and gain advantage. Thirdly a fundamentalist ideology underpins action, there is no room for compromise “there is no alternative”; it is a standpoint born of vested interests. Fourthly there is cognitive insurance which nullifies any cognitive dissonance that might arise. Criticism that greed and responsibility for others suffering will not be internalized, for to admit that this might be the case would otherwise begin to sow the seeds of doubt that arise from cognitive dissonance.  Fifthly there is tunnel vision; the commitment to making money sidelines other matters often in gendered delegation of these matters to others. Finally what is known as lifeworld detachment. The ‘lifeworld’ is that area of everyday life where taken for granted day to day decisions are taken. For the FAR there is simply no time for the ordinary business of day to day decision making.

This is an ideal type and in the real world men will vary in their modes of thinking which direct their action. Those who rub shoulders of the GB’s can draw their own conclusions, however their ideological bias may prevent critical self-reflection of the results of their actions as they seek to shift the blame for financial collapse and budget deficits onto the ‘feckless poor’, the benefit cheats and the skivers.

Warren Buffet once stated “There’s class warfare, all right….but it’s my class, the rich class, that’s making war, and we’re winning.”



Scambler. G. (2012b)  The Assault on ‘our’ NHS ! November 30th 2012

Scambler, G. (2012a) GBH Greedy Bastards and Health Inequalities November 4th

Scambler, G. (2013) Resistance in unjust times: archer, structured agency and the Sociology of health inequalities. Sociology. 47 (1) 142-156

How responsible am I for my health?

To answer this question, we need to understand what determines health and to focus on the social determinants. There are of course biological determinants, for example familial hyperlipidaemia which may have genetic antecedents, however to discuss biology is to make the original question redundant. To move on to personal responsibility for health I take the position of the ‘social determinants of health’ approach which argues:


“The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries” :


Inherent in that description is the idea that the society in which you grow up ‘acts’ upon you and thus determines your health. Emile Durkhiem (1895) wrote about what we might think of as ‘social forces’ acting upon us; the sociologist, he suggested, is to  ‘treat social facts as things’ which are


“a category of facts which present very special characteristics: they consist of manners of acting, thinking, and feeling external to the individual, which are invested with a coercive power by virtue of which they exercise control over him” (p52).


Note the use of the word coercive power, which suggests that society coerces us into a particular manner of thoughts, feelings and behaviours. We are, in this view,  crudely determined by the society we grow up in. It is fair to say that social theory has moved on from crude determinism.


What however is still being discussed is the degree to which we exercise our own ‘agency’; our ability to act upon our own autonomous thinking, feeling, manners, customs and norms as free ‘agents’. To that we also consider the degree to which social ‘structures’,  family, schools, occupations, socio-economic status, gender and ethnicity, act upon us and constrain social and individual action. This sets up the agency-structure dichotomy. Many sociologists tend to emphasise social structure as guiding behaviour while historians emphasise agency in human affairs. We need to come to an understanding that gets away from crude models of the either/or of structure or agency.




To take the position that we are 100% responsible for one’s health status requires the ability to make choices free from external constraints…to act and behave in a manner that enhances our health status unencumbered by external forces, such as lack of clean water or the advertising and availability of certain products, that would ‘act’ upon us. We must, in this view, be free agents, indeed in this view, we are free agents, able to make autonomous decisions. It also requires us to be able to be critically self reflective of internal thought processes (our ‘inner conversations’) and subconscious desires that lead us into unhealthy behaviours. Not only must we be critically self reflective so that we come to understand our inner motives but we must also be able to act upon that knowledge. When we reach for a bottle of sugared water in a supermarket which is packaged to appeal to a particular lifestyle, but which has no health benefit whatsoever and indeed is linked to dental caries if consumed in place of plain old water, we do so in the full knowledge of its health effects and we do so as uncoerced free agents.  To be 100% responsible we need to be 100% free agents of our destinies. This is the agency end of the argument.





On the other hand we note that social inequalities are linked to distinct patterns of mortality and morbidity that often follows socio-economic status. These patterns are what we call ‘health inequalities’,  and so we come to think that society is working upon us to create patterns of health and illness. This is the crude ‘structure’ approach, which draws from material deprivation theories of ill health. It is if being of a lower social class acts upon us as a social force. Danny Dorling (2013) certainly suggests that health and social inequalities are not two separate entities but ought to be seen as one phenomenon, that is not to say however that Dorling adheres to structural determinism.





Graham Scambler (2013) asks us to consider ‘agency’ as well in a more nuanced understanding of our responsibility for health and to do this he refers to the work of Margaret Archer and the idea of ‘inner conversations’.


Scambler argues:


“Humans…are simultaneously the products of biological, psychological and social mechanisms while retaining their agency…socially structured without being structurally determined” (p147).


Who, and what, we are arises socially, as well as from our physical biological selves and as well as from our psychological thinking and motivations. Society structures who we are without determining who we are. Your family life structures you – it gave you language, culture, hopes and aspirations but does not determine these aspects of your self. There is room for agency.


We need to consider how our ‘inner conversations’ shape our responses to how we see and feel the way external social structures such as our families, and cultural powers, such as occupational positions or the food industry, act upon us. These responses then result in our social behaviours and values. That is why similar social structures produce similar patterns of behaviour but does not determine them. As an example, take dialect and accent. Social structures ‘determine’ whether you will grow up speaking with a particular accent but does not make it fixed. A child does not actively choose to speak certain words in a certain way, but as with many in their peer group, it almost looks as if they were determined to do so. The same goes with later health choices.


Added to that is the structure of opportunities a society provides children with. In a social world where cigarettes are seen to be the norm, and also are imbued with notions of adulthood, it is not surprising that many children ‘choose’ to smoke. Agency however means that some children are free not to smoke and choose not to. Some will cite trying it and being put off by taste, but not all. Their ‘inner conversation’ tells them to get past that barrier. The social structure of norms and expectation around smoking is tempered by agency, the freedom not to act in this case. So why and
how do we exercise agency in social circumstances? This is a question to return to below, first another example.


In ‘Oranges are not the only fruit’ – a coming of age novel, Jeanette Winterson describes how growing up a lesbian in a strict religious family acted upon her choices and feelings without determining the outcome, she did not grow up to be a member of her family’s Pentecostal church and to renounce her sexuality. Her ‘inner conversation’ resulted in a rejection of the strict religious lifestyle and belief system. In her case her behaviours and values were socially structured but not determined. Of course in many other families children do acquire the religion of their parents, their inner conversations lead them in what looks like a deterministic way.


So we need to see that agency works within a context, e.g. a religious family, in which the social outcome is structured by that family but not determined by it. How does happen? Lets consider the structure of family.


  1. The family provides the external, objective, situation and context which the free agent is then confronted with. The agent does not have a choice about this. The family provides situations of constraint and opportunities for the ‘agent’.  Lets change that term ’agent’ for ‘child’. This objective situation operates in relation to…
  2. …the child who has their own internal, subjective, concerns in relation to physical nature, social realities and cultural practices. In Winterson’s case this subjective concern involved her awaking sexuality which ran counter to the family’s religious teaching. Her inner conversations told her something, and of course this is where biology might intervene.
  3. The action undertaken by Winterson was partly produced by her ‘reflexive deliberations’, i.e. her internal thinking about the situation and her own concerns. Children determine their choices of practical action in relation to their objective circumstances. Some choices will require quite deep reflexive thinking and commitment, especially if the inner conversation is saying something like “I feel sexual attraction to girls” in the face of objective situations, i.e. the family, which says “same sex attraction is sinful’.


In Wintersons’ case her agency trumped social structure.



Let’s consider a health example using the same steps:



  1. The family buys mainly processed foods from supermarkets, they do not use local organic farmer’s markets as they are viewed as expensive and require a drive that is further away. In addition the parents buy sugared water as it is cheap and not seen as unhealthy. This is the objective context that structures the child’s responses.
  2. The child’s own inner subjective concerns do not entail a detailed analysis of the food production, manufacturing, distribution and marketing process. The child experiences tasty, often sweet and satisfyingly available foods. The inner conversation says “I like this” and takes note of what peers and family say and do.
  3. The child’s action does not involve a rejection of the food choices but actively embraces them. In this case the inner reflexive deliberations do not run counter to either family values or social values and requires little in the way of critical reflection.


Social structure in this case provides the contexts for agency not to challenge it.



These two very short examples, illustrate the interplay between structure and agency and how behaviour is ‘structured but not determined’. However, one may understand how forceful structures may appear to be in shaping the individual responses. I think this is what is meant by the use of the word ‘social determinants’ in the ‘SD of health’ approach.


So far, this is not so complex to understand. We know that social structures do not determine behaviour otherwise there would not be any social change. However we also recognise the power that certain social ‘forces’ have in reproducing cultural practices such as religious observance or eating habits.


Modes of reflexivity


We need to then consider the interplay between structure and agency and consider why in one case agency ran counter to social pressures, but not only ran counter it overcame them. Is the inner conversation that is driven by sexuality particularly powerful? Scambler’s point regarding the interplay of biology, psychology and social structures is important to remember when considering this.


Margaret Archer (in Scambler 2013) argues that the interplay between our internal concerns and our social and environmental contexts is shaped what she calls a ‘mode of reflexivity’. A ‘mode of reflexivity’ is the manner in which we think about our thinking, our ‘inner conversations’ that then shape our actions. Archer outlines 4 ‘ideal types’ of modes of reflexivity which she drew from empirical studies:


  1. Communicative reflexivity: our inner conversations require confirmation and communication with others before we act. We all do this but for some people this is the dominant mode and it requires that we must pay attention to what others are thinking and take this into account,  and action will be based on what those others are thinking. These others may be peers, family and the local people, hence the tendency to social immobility. A student nurse who is dominated by communicative reflexivity will consider what their peers and mentors are thinking and will want to act in such a way as to fit in. Consensus is sought after.
  2. Autonomous reflexivity: our inner conservation requires no confirmation with others, they are self sustained and lead directly to action. Here we have a ‘lone inner dialogue’  which then leads to action. If this is dominant then the person will not seek or require the involvement of others. Autonomous reflexives might use communicative reflexivity but it is not strictly necessary. A student nurse thinking in this way will act upon their own deliberations and not always require consultation or considering others’ thinking. Outcome rather than consensus is important. Was Winterson, in relation to her sexuality, exercising autonomous reflexivity?
  3. Meta reflexivity: our inner conversation is subjected to criticism and we critique whether effective action in society is possible before we act. This is about self monitoring, our thinking about how we think, and when dominant results in self questioning such as ‘why did I say that?’, ‘why am I so reticent to say what I think?’. We may be self critical and concern ourselves with the moral worth of what we do. Values more than consensus or outcome is important. Students nurses are introduced to the idea of critical reflection but it is debatable whether they are skilled at this by the end of a three year programme.
  4. Fractured reflexivity: our internal conversation intensify the disorientation and distress we already feel and this leads to inaction. Some children, brought up in abusive and neglectful homes, may only develop fractured reflexivity and thus turn in on themselves and withdraw.



This typology delves further into the nature of agency and explains how society and its structures might provide a framework for action but the inner conversation indicate how that structure ‘determines’ action. In the example above we might hypothesis that Winterson was an autonomous reflexive, perhaps driven by nascent sexuality that was so at odds with her family socialisation. It is a moot point to consider that if Winterson was a dominant communicative reflexive, whether her resistance would have been quite so forceful.


The child who eats junk food sitting in front of the TV who is also a communicative reflexive may be ‘determined’ to be obese. Their inner conversation engages with the voices and thinking of their peers who may all be doing the same thing and who consider that this diet is typical and ‘normal’. Children of course may not have developed meta reflexivity, they may not have been taught to do so either by family or school. They may therefore lack critical self reflection. Indeed some child rearing practices may see critical self reflection as self indulgent and not helpful to learning the skills and knowledge needed to make one’s way in the world. Children who are fractured reflexives may be so because of fractured and disorientating childhood experiences and thus be in too fragile a psychological state to consider their own abilities to take action.


The life chances, and thus health choices, that result from choices do so from within people’s social position in which they exercise Autonomous, Communicative, Meta and Fractured reflexivity. Given an abusive childhood, lived in material deprivation, and without the benefit of escape via public school and University education, a child’s life chances are in this sense determined. If that child was an autonomous reflexive early in life they might grow to be to fight against disadvantage, however it might be the case that very early childhood development experiences are linked to certain modes of reflexivity. We don’t know. However, even an autonomous reflexive will struggle against damaging patterns of life they have no option but to choose from.


So to explain why people act differently in similar social situations may be partly down to the inner dominant mode of reflexivity. Their choices however are still structured. A child cannot choose to go to Eton and thus up their chances of becoming Prime Minister. A Duchess does not have to choose between paying a utility bill or buying food for her children. Neither can she ‘choose’ to become a prostitute. Her structure of opportunities however make it far easier  to make healthier life choices in terms of diet and exercise but perhaps, not when it comes to eating disorders. A different social structure provides a very different context for those decisions.


We still do not know why a person, however, ‘chooses’ a mode of reflexivity. What makes one child an autonomous reflexive and others communicative? Social structures provide the context in which these modes operate and so offer objectives choices in which to exercise them. As we do not know the relationship between the physical material brain and consciousness it is no surprise that we can’t yet determine in the last instance why people develop a certain cognitive structure of thinking. However, Susan Gerhardt in ‘The Selfish Society’ outlines the importance of early childhood development and the development of empathy which seems to link with communicative reflexivity as it takes account of others thoughts and feelings. Autonomous reflexives may develop out of a different childhood experience.


So, are we 100% responsible for our health? Of course not. Ask a child in Syria right now. The external social world has force, and sometimes that comes armed.









Dorling, D. (2013) Unequal health. Policy Press. University of Bristol


Durkheim, E. (1895) The Rules of Sociological Method. New York. Free Press.


Scambler, G. (2013) Resistance in unjust times: Archer, Structured Agency and the Sociology of Health Inequalities. Sociology. 47 (1): 142-156.

The Rich List

The Rich List.


Micheal Meacher posted the following on his blog site:

“The Sunday Times Rich List, published today and compulsory reading for anybody who wants to understand Britain’s power structure today, holds three extremely significant conclusions.   One is that the 1,000 richest persons in the UK have increased their wealth by so much in the last 3 years – £155bn – that they themselves alone could pay off the entire UK budget deficit and still leave themselves with £30bn to spare which should be enough to keep the wolf from the door.   The second, even more staggering, is that whilst the rest of the country is being crippled by the biggest public expenditure and benefits squeeze for a century, these 1,000 persons, containing many of the bankers and hedge fund and private equity operators who caused the financial crash in the first place, have not been made subject to any tax payback whatever commensurate to their gains.   This is truly a government of the rich, by the rich, and for the rich.

The third is that despite the biggest slump for nearly a century, the slowest and most anaemic recovery, and prolonged austerity stretching to a decade or more, this ultra-rich clique are now sitting on wealth even greater than what they had amassed at the height of the boom just before the crash.   Their combined wealth is now estimated at more than £414bn, equivalent to more than a third of Britain’s entire GDP.    They include 77 billionaires and 23 others whose wealth exceeds £750m.  

Despite these massive repositories of wealth, these are some of the very people to whom Osborne gifted £3bn in his recent budget by cutting the 50p tax rate.   That measure alone gave 40,000 UK millionaires an extra average £14,000 a week, at the same time as those on very low incomes in receipt of working tax credits who couldn’t find an employer to increase their hours of work from 16 to 24 a week were being deprived in the same budget of £77 a week, around a third of their income, through their tax credits being withdrawn.

In 1997 the wealth of the richest 1,000 amounted to £99bn.   The increase in their wealth over the last 15 years has therefore been £315bn.   If this increase in wealth were subject to capital gains tax at the current 28% rate, it would yield £88bn, and that alone would pay off more than 70% of the total budget deficit.   However Osborne seems to share the notorious view of the New York heiress, Leonora Helmsley: “taxes are only for the little people”.”


Now, to make the conclusion that all we need to do is tax the rich to solve the deficit problem is misguided and is not actually the point of this article. Meacher well knows the difference between the annual deficit (about £125 bn) and the national debt which he says is about £1tn. The main point to draw from this is to illustrate just how staggeringly wealthy the top 1000 people are. The trend is an ever increasing wealth gap and rising inequalities in the UK which Danny Dorling so clearly outlines. Does this matter? Well, yes. Inequalities on this scale directly lead to health inequalities and that means a social gradient in death to you and me.

Coupled with ‘where do I stand’ data and this ‘UK pay: winners and Losers’  published by the Resolution Foundation, the ‘rich list’ paints a sorry picture indeed.

So, you can justify this position by arguing that the risk deserve their wealth because they are risk takers, wealth creators, gifted, very intelligent, talented and hard working people. However, even if you accept this line of reasoning (and it has more than just a whiff of self justificatory ideology about it), does that still justify the ever increasing gap and the huge amounts of wealth they accumulate?

There are two reasons for thinking not. One is the political threat of social unrest and the other is the unequal patterns of the distribution of disease and death that result.

Danny Dorling argues that democracy works when the gap is acceptable by the people and also when they have hope of betterment themselves. I think the gap is increasingly being seen to be unacceptable and, for far too many in the UK, hope for a better and secure future is also vanishing. Inequality on this scale threatens democracy because it distorts our political system as men of wealth are buying men of power.

Inequality is also directly linked to health inequalities. The ‘little people’ are literally paying with their lives and ill health, as the WHO recognises:

The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries”  The World Health Organisation. 

The British are said to have a sense of fair play which if true will be sorely tested by this sort of information. The public may have been hoodwinked into believing that the last Labour government was responsible for the current plight of public finances, and indeed in not challenging or restructuring the neo-liberal experiment, they are culpable. However, let us not forget that it was the economic policies adopted by Thatcher/Reagan which gave free rein to finance capital to wreck the global financial system for which ‘the little people’ are paying in lost jobs, benefit cuts, pay freezes and dashed hopes.

Given the trillions of dollars that financial and economic mismanagement, no lets call it ‘gambling’,  has caused the global economy, remind me how many of those responsible are languishing in prisons rather than merely resigning/hiding with their pensions and payoffs intact? Where is ‘Fred the Shred’ now? What price at the bookies for seeing him in the queue for a pay day loan?  Well in 2010 it was reported that he was back in the UK paying £3.5m for a home. Back in 2009 the Royal Bank of Scotland (RBS) stated that following negotiation an agreement was reached to reduce his pension to £342,500 a year from the £555,000 and after he took out an estimated £2.7 million tax-free lump sum. It is should be pointed out that The RBS undertook an internal inquiry into Goodwin’s conduct, which found no wrongdoing. Remind me, who now owns RBS and why?

The, understandably, financially illiterate British public prior to 2008 were sold a pup. The British economy was built upon cheap credit and a housing boom financed by the ‘Masters of the Universe’ hedge fund managers in the City of London. British families in the period running up to the finacial crash did not earn enough to buy the goods and services that also provided the jobs. Henry Ford, certainly no Marxist, understood that he needed to pay his workers enough so that they could buy the cars they produced.   Those who ran our politics and financial institutions either forgot this maxim or recklessly ignored it preferring instead to ensure the gap between income and expenditures was filled by easy come easy go credit. While the champagne kept flowing,  no one cared.

The system stinks and people should know it.

Cameron today again said there is no alternative.


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