When a new Scottish Conservative health policy lands on my desk, I flick through it expecting to see the usual marketisation, ignoring health inequalities and blaming the poor for their unhealthy lifestyles.
However, this new paper, ‘Healthy Lifestyle Strategy’ from Brian Whittle MSP is somewhat different. It aims to set out a long term alternative strategy for health, welling being and sport.
So, why is it different?
For starters, the first chapter is entitled ‘Health inequality in Scotland’, and describes the difference in health inequality across Scotland and between income groups. Admittedly there is more emphasis on geography than income inequality, but this is real progress. I can remember the last Tory Chair of Greater Glasgow Health Board denying any link between inequality and health – well after the Black report had been published!
The next chapter describes two pillars of a healthy lifestyle, activity and nutrition. These are of course important and the paper argues for investment in early intervention - preventative spending as we would call it. It also recognises the importance of using procurement as lever to achieve change. Again something UNISON has long argued for.
As you might expect from a former athlete, Brian Whittle argues that activity should be at the core of health and education. He is right, although the emphasis should be on activity, not just sport. The health benefits are undeniable, but what’s different about this policy is that it recognises at least some of the barriers to participation – not just blaming the poor. It also recognises the importance of early years childcare and learning to achieving change and the need to invest in these services. Most policies in this field focus solely on teachers, but this policy also recognises the role of early years practitioners, which is very welcome.
Somewhat surprisingly the paper highlights the difference in participation opportunities between state and private education, and even highlights the fact that a third of the British Olympic Team was made up from 7% of the population that was privately educated. It also quotes extensively from the CPAG Scotland report on the hidden costs that hamper participation in extra-curricular activity. It is similarly opposed to some council charges, which have been caused by the council tax freeze.
It is of course true that many school facilities are closed out of school hours. However, some recognition that this is often caused by PFI contracts would have been welcome. UNISON Scotland’s ‘Combating Austerity’ toolkit shows how we could tackle this.
The chapter of the importance of good nutrition emphasises the role of procurement in ensuring food in our schools and hospitals is of high quality and locally sourced. Almost word for word from UNISON Scotland’s Food for Good Charter - even quoting the groundbreaking work of our members in East Ayrshire Council. No ‘nanny state’ lectures here, just maybe as Stephen Jardine argues in the Scotsman – the tide has turned in this debate.
The paper concludes with a long series of recommendations. These are very practical ideas, almost all of which we would have very little problem with. Several are not the sort of policy proposals you would expect to find in a Conservative policy paper.
It would be a fair criticism to say that the paper would have benefited from greater context on the impact of inequality on health and measures to address this including the importance of progressive taxation to create a more equal society. Practical programmes that ignore this reality are going to struggle.
So, this isn’t the ‘Spirit Level’ recognition that more equal societies are also healthier societies, but that was probably a step too far! However, it is a real step forward in Conservative thinking on this issue and should be welcomed for that.