It might reasonably be argued that in the UK in the early part of the 21st century we are facing a ‘perfect storm’ in the guise of climate change, Brexit, COVID, a cost of living crisis and a relativised or post- truth culture. While it is important not to be too hasty in our judgements on live topical issues such as COVID, enough is already known to make certain conclusions incontrovertible. Moreover, it provides wholesome support not only for the class/ command dynamic but for the ‘greedy bastards hypothesis’ (GBH). COVID revealed, if any doubt remained, just how iniquitous the fissures and cleavages in the fractured society had become. As far as health is concerned, it did so via COVID-enhanced morbidity and mortality rates for those disadvantaged by structural relations of class and race in long- deprived regions, communities and neighbourhoods. At the same time, it shone the harshest of spotlights on a decade of NHS and welfare underfunding and the resultant worsening of public access to over- stretched and understaffed NHS and welfare services. Bright (2023: 230– 231) has summarised some of the relevant data. From 2009 to 2015/ 16 local government spending was cut by 60 per cent in real terms; and the Department for Work and Pensions’ budget, which administers benefits on behalf of some of society's poorest citizens, fell by just under 60 per cent. The UK's child poverty rate soared as a result of these cuts from 15.5 per cent in 2016– 17 to 19.3 per cent in 2019/ 20 (an increase of 24.5 per cent); and the suicide rate in England and Wales increased from 9.3 to 11 per 100,000 from 2010 to 2019. The cuts placed intolerable burdens on already overworked doctors, nurses and allied health and social workers and community and residential care workers, culminating in high rates of job stress, burnout and people leaving their jobs.

However, the pandemic illustrated just how expediently and promptly a government can detect a ‘magic money tree’ when a potential crisis of state legitimacy is in the offing. Unsurprisingly, it afforded ready cover too for the government's longstanding agenda of involving for- profit companies in the provision of health care services, under the rhetoric of ‘meeting the COVID challenge’.