Surely, it's really about upbringing...
The chavs who won't work, who sponge off of the state, who have no manners or consideration for other people etc are like that because they've learned that type of behaviour from their parents, who think that the world owes them a living, it's a vicious circle that they can't break because
a. They don't know that there's another way of doing things and they think that their way is right
b. Everyone in their family and friends group is exactly the same.
Occasionally, people can change. My better half took on a young man of 24 who had never worked, had hardly ever attended school and who was resigned to living on benefits because he had no hope of ever getting a job even if he wanted one. He came to her on a Jobcentre scheme for long term unemployed, basically she got a grant (no longer available) for taking on people like him for 6 months, and he still got his benefits. He was the only one of the group who was worth the trouble, most of the others didn't even turn up for work, or skived off every chance they got, but he stuck at it.
When the scheme ended she pushed casual work his way, and let him see that there was another way of living. Anyway, to cut a long story short, he now has a job, a future, self respect and has learned a lot of new skills. His family though think that he's a complete muppet for working when he could get almost as much money for nothing, but they will never change.
The 'permanent claimant' class do have their problems though - they tend to be treated like dirt by everyone else, they are always at the back of any waiting list, they generally can't get a bank account, and they end up on council estates with people of the same type, so they suffer from noisy and unpleasant neighbours so that standard of life becomes normal to them, in short they're trapped. And of course they breed, because having kids gets them more benefits, and perhaps because they're too disorganised to avoid unwanted pregnancy.
As for hospital care, even that is different according to my eldest daughter, who is a midwife. Possible problems and 'respectable' people get experienced, qualified midwives. Chavs get student or newly qualified midwives, unless something goes wrong.