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.
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