I’m often asked to give talks on ‘Health’ by which people usually mean the NHS. However, the NHS doesn’t create health, it helps to manage and control illness. It could more accurately be called the National Illness Service but that would sound far too dismal. Rather, good health is influenced significantly by factors outwith the health service such as housing, nutrition and pollution control.
What is Wellbeing?
Good health or ‘wellbeing’ is also more than just an absence of illness. It is a holistic approach which considers quality-of-life and encompasses five main components. This includes both physical and mental health, to which the NHS contributes, but also economic security, social inclusion and a healthy environment. A ‘Wellbeing Economy’ is one which values the health and wellbeing of people and the planet. Rather than allowing workers to be exploited for profit, through low wages and insecure contracts, it promotes investment in their development. Instead of the profligate consumption of raw materials, it supports a circular economy with the sustainable use of natural resources. While some consider a wellbeing approach to be unrealistic, many large businesses are coming round to the idea that, to improve productivity, they must look after their staff and reduce their environmental impact.
Unique Scottish Government wellbeing policies
The foundation of good health in later life is laid down in our earliest years which is why the SNP Government invests so strongly in children, our next generation. This includes policies such as the Baby Box, extended Early Learning; Childcare and the game-changing Scottish Child Payment (SCP), established to directly tackle the destructive scourge of child poverty. The latter is already contributing to Scotland being the only UK nation with falling child poverty rates. However, it doesn’t just support children but helps ease the financial stress of the whole family. Of course, Scotland’s wellbeing policies are not just limited to childhood but benefit us all at different stages of our lives. Free college or university tuition provides opportunities for young people to grow and develop, while free personal care helps our elderly maintain their dignity and independence.
Those of working age, along with their families, benefit from free prescriptions, the recent removal of peak rail fares and Scotland’s more progressive tax system, which means those on lower incomes pay less tax than elsewhere in the UK. With mortgage payments or rent being the largest financial outlay of most families, Scotland’s higher provision of affordable housing is a major contributor to our lower poverty levels. However, while Scotland has built 47% more affordable homes per capita than England and 73% more than Labour-run Wales, real-terms cuts to the Scottish block grant and the lack of borrowing powers under devolution have restricted the investment needed to meet housing demand.
A normal independent country would be able to borrow to invest capital in housing and improving national infrastructure. Within the UK, most of these wellbeing policies are unique to the Scotland which was one of the founders of the ‘Wellbeing Economy Governments Group’ in 2018. However, there is currently little political or public discussion of the topic, or its relevance to the need for Scottish Independence.
A failed economic system – the limitations of GDP
While the Scottish Government has tried to utilise the powers of devolution to tackle poverty and promote wellbeing, mitigating Westminster austerity takes money from its limited budget for devolved services and doesn’t tackle the underlying problem of a broken economic system. Under the current economic model, and with Rachael Reeves’ obsession with endless ‘growth’ in Gross Domestic Product (GDP), the ‘Economy’ is treated as an immutable law of physics or a deity to which people’s health and wellbeing must be sacrificed. Everything is reduced to the measure of ‘Profit’ without considering the true ‘Value’ of anything.
While profits from the tobacco, alcohol, gambling and arms industries are considered as positive contributors to GDP, public services which provide free healthcare, education, cheap public transport or active travel are not. Similarly, while patients do benefit from improved drug therapies, the excessive profits of some pharmaceutical firms contribute to GDP while public health and prevention services are considered a drain on the public purse. It was the greed of successive governments, for economic activity and cigarette duty, that delayed effective tobacco controls for decades, even though medical research already showed the cost in lives and the burden on health services. Using growth in GDP as the main yardstick to make comparisons over time or between countries attempts to reduce the worth of a nation to a simple digit. Intangibles, such as access to nature or the richness of our culture, score nothing – unless they can turn a profit.
Poverty, inequality & austerity
GDP tells us nothing about wealth distribution and, according to the Organisation for Economic Co-operation and Development (OECD), the UK is one of the most unequal developed nations. Since the 2008 crash, the rich have trebled their wealth while the poor have been made poorer by UK Government austerity – both Tory and Labour. Repeated cuts to benefits over the last 15 years have created a head wind which has made it much harder for the Scottish Government to tackle poverty, particularly child poverty. Child poverty levels in the UK are significantly driven by the appalling two child benefit cap, introduced by the Tories in 2016 but indefensibly kept by the Labour government.
Poverty is the biggest scourge of our society and impacts all aspects of life. Young people who grow up in poverty and deprivation tend not to achieve their full educational potential and are more likely to become unemployed, suffer from addiction or end up in the criminal justice system. Picking up the pieces of such blighted lives is expensive, so it makes more sense to invest in children in the first place.
After the financial crash, when interest rates were at rock bottom, the Scottish Government pushed for investment in infrastructure, such as the renewal of schools and hospitals, improved transport links and digital connectivity. As well as providing jobs, modernised infrastructure would have provided a strong platform for economic recovery. Instead, UK Governments of every colour have followed the same disastrous path of public spending cuts and austerity. In addition to the individual suffering caused by financial hardship, austerity is utterly self-defeating. Social security cuts and public-sector pay freezes starve local economies of money, leading to dead High Streets, job losses and eventually a reduced tax-take to the Treasury. With the full powers of independence Scotland could tackle the underlying drivers of poverty and inequality through the development of a wellbeing economy which is fairer, greener and more sustainable.
Protecting the Environment
The obsession with growth in GDP leads governments to short- term thinking rather than investing in future resilience, particularly with regards Climate Change. For example, the profits made from clearing up an environmental disaster such as an oil spill, are counted in GDP while protecting the environment in the first place scores nothing. In addition, the current uncontrolled consumption of limited natural resources takes no consideration of future generations and, even now, increases the risk of territorial conflict in the hunt for rare earth minerals.
The need for change has never been more evident. With floods, droughts and wildfires raging across the world, even in Scotland, we can see that the climate crisis is not a threat in the distant future but is happening right now. Despite this, the Tories merrily issued new oil licences, Labour ditched its £28 billion ‘green’ industry investment strategy and Farage’s Reform plan to abandon ‘Net Zero’ altogether. Such politicians moan about the cost of tackling climate change but don’t appear to have considered the price of doing nothing. The costs of trying to mitigate the climate collapse resulting from ‘NOT Zero’ are simply incalculable!
Independence
While the Scottish Government has delivered many ‘Wellbeing’ policies, changing the underlying economic model to eliminate exploitation requires the full powers of independence. This would include setting the genuine ‘Living Wage’ as the minimum, rather than people having to struggle with low pay and job insecurity while still having to depend on benefits. In-work benefits are designed to protect low-income families but are often simply subsidising businesses who won’t pay a fair wage. It is important for businesses to realise that their staff are also their potential customers!
Instead of the UK’s miserable State Pension, which is less than 30% of average earnings, Scotland could establish a ‘Living Pension’ similar to those in Europe which range from 70-90%. This would reduce pensioner poverty and the associated poor health which causes individual suffering and puts pressure on the NHS. The ability to set wealth taxes could allow additional investment in infrastructure and public services such as our NHS. The power to utilise Scotland’s immense energy resources for the benefit of those who live here, would allow fairer pricing to reduce the cost-of-living and ease the financial stress faced by families and individuals.
Significantly, with Independence, Scotland would be free to choose its own future direction, including a return to the EU. This would benefit our businesses, through easier exports, and our young people would regain the educational and work opportunities which come with Freedom of Movement. Discussion of the Wellbeing Economy approach, and its benefits for ordinary people, can help highlight the work of the SNP Scottish Government under devolution, while also helping us promote the ‘Why’ of Independence. The Wellbeing Economy provides a positive vision of Independence and the better Scotland we all hope to build for our children and their children.
Photo Credit: M J Richardson / Welcome to NHS Lanarkshire / CC BY-SA 2.0