Introduction

As Chapters3 and 4 have argued, the challenges facing health and social care are the result of discursive and structural changes at the global and national level, namely globalisation, neoliberalisation and austerity. A shift from active to precarious ageing, alongside growing fragmentation, complexity, marketisation and intersecting inequalities, is illustrated in the empirical data in Chapter 5. The health and social care system have been in ‘crisis’ for many years; thus, the COVID-19 pandemic did not cause the ‘crisis’ in health and social care, but rather exacerbated it. Nevertheless, since COVID-19 hit in March 2020, the NHS has gone through the most challenging set of circumstances since its inception in 1948. Furthermore, it occurred at a time when health and social care institutions were underfunded, understaffed, fragmented and poorly coordinated with each other. The result of the pandemic was devastating for older people in the UK (particularly the tragedy of numerous deaths in care and residential homes) and this chapter provides an initial discussion of what went wrong. What follows is a comparative analysis of the respective COVID-19 health and social care policies of Sweden and Germany. Here, I revisit the two case studies detailed in Chapter 3, where Germany's and Sweden's health and social care systems were summarised. Finally, I discuss the impact of the COVID-19 and Brexit nexus on health and social care, and the ways forward the government is indicating it might take. Some of the policies offered by the Conservative government since taking power and securing a majority in 2015 related to integrating health and social care. These will also be critically examined considering the UK government's handling of the COVID-19 pandemic.

The impact of COVID-19 on the UK

Analysis of the empirical data in Chapter 5 has already established that health and social care services were not consistently providing good quality care or dignity to older people. Chapter 3 argued that neoliberalisation, together with the resulting privatisation of health and social care services, shifted responsibility for health and social care from the state to the individual, thereby re-establishing the very class inequalities that the welfare state was originally constructed to eradicate.