Views & Reviews Live from London

Why do posh people ignore poverty on their own doorstep?

BMJ 2007; 335 doi: (Published 25 October 2007) Cite this as: BMJ 2007;335:888
  1. Deborah Cohen, features editor, BMJ
  1. dcohen{at}

    Chavs, scallies, townies, neds, hoodies, bindippers, peasants—call them what you want. It looks as if Britain's underclass is here to stay—if the upper echelons of society have their way, that is. Despite Tory leader David Cameron pledging to “make British poverty history” last week, the UK's rich/poor divide is growing and will continue to do so unless there's a seismic shift in attitude. Developing world poverty appeals so much more to the philanthropic and, dare I say it, paternalistic traits of posh people. Helping the poor in Africa makes for jolly decent charity parties, whereas poverty at home is just a bit too close to the bone. We're all a bit to blame.

    As a medical student I went to a conference in my hometown, Liverpool. In a talk about her HIV project in South Africa, the medical student presenter implored: “Africa needs us, we must do something. There are so few opportunities—not like here, where people choose to live the way they do.” She was in Liverpool, a city where 41.2% of people live on the breadline, which, according to the Joseph Rowntree Foundation, leaves them “excluded from participating in the norms of society.”

    But the solutions are complicated, painful and expensive—it may even involve a bit of soul searching. You can't simply lecture the British poor about the error of their ways, and expect them to tug their forelock and hop to it. Despite the nagging post-colonial guilt, certain sections of society still think that they can hector the developing world about the need for culture change to alleviate poverty. It's not really their problem anymore, they're just doing their little bit of charity work, and golly gosh, don't those Africans appreciate it. What's more, doesn't the photo montage look great at dinner parties—there's the well you built; the AIDS orphan to whom you gave some brightly coloured crayons; and oh look, there's the goats you bought your friend for Christmas. What a life-enhancing trip. All admirable stuff, don't get me wrong, but it's just so much easier to “do something” when you're not actually part of the problem. The inequalities in the UK are about class—and certain sections of society simply don't like to admit it.

    But there's an attitude, as my medical student friend espoused, that there's opportunity aplenty and the hoi polloi clearly choose to live the way they do—obese, lazy, unhealthy, ill educated, and tacky. It's Britain, where everyone has a choice and a chance—if you have the cash, connections and class, that is. And this inequality is even more exaggerated for children. Children who grow up poor are more likely to leave school without qualifications, have lower employment chances, restricting their ability to get a good job and financially contribute to society. And so the cycle continues.

    Breaking this cycle is far from easy. It goes straight to the heart of Britain's class ridden society and may involve the redistribution of power, status, and wealth. It's probably a Barbour-wellied step too far for the ruling elite. After all, who really wants to share the spoils, if it spoils the party?

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