Universalism, diversity and norms: Gratitude, healthcare and welfare chauvinism

Hannah Bradby, Rachel Humphris, Beatriz Padilla

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Access to universal healthcare is a normative expectation of citizens in European welfare states. As part of a comparative study of healthcare in diverse European neighbourhoods, we met women who described failures of the public healthcare system, together with gratitude for that system. Challenges to European welfare states of ageing populations, the retraction of resources available for healthcare and globalised migration streams have been linked to xenophobic ‘welfarist’ attempts to restrict access to services for new arrivals and those seen as failing to contribute sufficiently. Stories of healthcare systems’ failure to treat symptoms, pain and suffering in a timely and caring fashion came from eight women of non-European migrant backgrounds as part of a wider interview study in four European cities (Birmingham, Uppsala, Lisbon, Bremen). These accounts suggest that a normative aspect of welfare provision has been reproduced – that is, the expression of gratitude – despite inadequate services. Where welfarist attitudes to migration meet normative aspects of health care, suffering may be compounded by an expectation of gratitude. The regrettable unmet healthcare need of the eight women whose cases are presented suggests that other marginalized healthcare users may also be under-served in apparently universal healthcare systems.
Original languageEnglish
Number of pages20
JournalCritical Public Health
Early online date2 Oct 2018
Publication statusE-pub ahead of print - 2 Oct 2018


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