Thursday 9 May 2024

The paradoxes of public health

 First published in LibDemVoice.

The promotion of public health is a liberal policy. It is an effective tool in the development of fairness and equality, it contributes notably to health and happiness (thereby reducing the need for, and the expense of, medical care; and reducing the cost to businesses of time off work), it enables people to have much more effective control over their own lives, and many of the activities associated with it resist financialisation, which is one reason why it is so unpopular in right wing circles.

It is also a wide ranging field. Healthy populations need good quality, warm, dry housing; good education; good food; good opportunities for both rest and exercise. On the other hand, reduction of social housing, the obsession with reducing education to league tables, corporate control over food prices and ingredients, the selling off of parks and playing fields, all contribute to reductions in public health.

Fundamentally, good public health reduces the impact of poverty, ignorance and conformity in people’s lives.

Public health requires a community based rather than an individualistic response. This again is a liberal value. While we champion the freedom of individuals, we also champion the notion that we live together in communities, and that we affect, and must support, each other. It is an effective sphere for government to do what we cannot do so well ourselves. It utilises “the power of government to change conditions that are constraining people’s freedom”.

As a country we allow the debate to be dominated by advocacy of a freedom that takes no responsibility, by far too much misinformation, and far too little information. (A very clear example at the moment is when both government and media notice that the number of people off sick has notably increased recently, and wonder why. Without ever mentioning Covid, which we know has severe long term consequences for many who have had it.) As a party we allow ourselves too often to be trapped within those terms rather than campaigning to change them.

The party currently has very creditable policies on public health: well thought out, detailed and workable. (I encourage you to go and read them.) I doubt that they will gain much prominence in a LibDem manifesto in the near future, any more than any other party’s. (I understand the reasons for this; the bandwidth in an election campaign is severely limited.) But perhaps we, as the foot soldiers of liberalism, should be making a much more concerted noise about the benefits of public health as well as the possibilities for local as well as national action in that sphere.