Extract

The British welfare state is a behemoth, particularly in terms of historiography, with recurring sources and recognisable debates. However, using something as diminutive as a single bureaucratic object—the Med 1 form, or sick note—Gareth Millward’s book delves inside the web of relations between government, medicine, the public and their health which have shaped the welfare state in Britain between 1948 and 2010. Its six empirical chapters are chronological, each built around a case study, but Millward does not simply reproduce the teleological rise and retreat of the welfare state, nor focus on iterations of top-down policy implementation. Instead, he interrogates the sick note as a contested medical testimony, one signifying competing meanings across the different parties that financed, consumed and gained from them over time. The resulting narrative hinges on exploring the fluid boundaries between medicine, social security and social policy which centre on individual economic productivity, fitness and employment.

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