Sociological Explanations
Sociology: AQA A Level, topic 5.3.3
Marxist and Pluralist Explanations of Unequal Distribution of Healthcare
Sociologists see the unequal distribution of healthcare provision in different ways and offer different explanations. The three main explanation come from Marxist, pluralist and structuralist perspectives.
Marxist approaches
- Tudor-Hart proposes an ‘inverse care law’, whereby the most advantaged gain the most from healthcare even though the disadvantaged need it most.
- This reflects a pattern of inequality across capitalist societies.
Big business
- Marxists argue that healthcare provision supports big business, in terms of pharmaceuticals (drugs), medical technology and private healthcare at the expense of preventative methods such as health education.
Class struggle
- Healthcare provided via the NHS is viewed as benefitting capitalism by keeping the working classes fit enough to work while giving the impression of fairness and caring in society, disguising the inherit inequalities that capitalism creates and reinforces.
Pluralist approaches
- The distribution and allocation of healthcare resources result from the bargaining actions of competing groups.
- Groups include, groups such as the British Medical Association, GPs, health administrators, the government, private healthcare companies and patient groups.
Structuralist Explanations of Unequal Distribution of Healthcare
Sociologists see the unequal distribution of healthcare provision in different way and offer different explanations. The three main explanation come from Marxist, pluralist and structuralist perspectives.
Structuralist approaches
- Structuralist approaches draw on the Marxist view of social inequality and power distribution in healthcare and structuralist notions of competing interest groups.
Distribution
- How healthcare is distributed depends the outcome of the power struggle between three different and competing interest groups who work within the healthcare system...
Interest groups
- Dominant interests (the final decision-makers).
- Challenging interests (who challenge the interests of the dominant group).
- Repressed interests (whose interests are least likely to have their need met by the existing structure of the healthcare organisation).
Power structure
- Checkland et al. argue that there is little scope for public and patient participation with the NHS structure, and patients are the least powerful group and have the least control over the allocation of healthcare.
Test yourself on Sociological Explanations
Who proposes an ‘inverse care law’, whereby the most advantaged gain the most from healthcare even though the disadvantaged need it most?
Who does Checkland et al. argue has the least control over the allocation of healthcare in the NHS?