The future of health, wellbeing and sustainability

Any take on sustainability that doesn’t have health and social care close to its heart probably isn’t worth taking seriously.

Any take on sustainability that doesn’t have health and social care close to its heart probably isn’t worth worrying about any further. But you’d be astonished at how many people just don’t get that.

A bit of history. Labour set up the Sustainable Development Commission back in 2000. It took a while to persuade the Cabinet Office that we should operate across the whole of government but, by 2004, we’d already started to work closely with the Department of Health on a whole range of different initiatives within the NHS. The redoubtable Anna Coote joined the Commission, and we quickly developed a fantastic health team within the Secretariat.

It was a fruitful period. Synergies began to flow around public health issues (e.g. food and nutrition), health inequalities (e.g. food poverty), transport (cycling, walking, air pollution etc.), planning and housing, greening the NHS itself, and, of course, climate change. There was extensive engagement with Strategic Health Authorities (long gone), Primary Care Trusts (duly re-engineered), and Directors of Public Health through Regional Assemblies (again, long gone).

During that time, the Department of Health got more and more involved, as did key people within the NHS. A Sustainable Development Unit in the NHS was created in April 2008, and the Department launched its own Carbon Management Strategy in January 2009. Of all the relationships the SDC had across government at that time – advising, supporting, monitoring, challenging – this was one of the best.

Which mattered not a jot to the incoming quango-crushing Coalition Government. It wasn’t just the Sustainable Development Commission itself which was unceremoniously brushed aside. Bit by bit, with clear intent, not by accident, almost every element in the "SD infrastructure" of the outgoing government, built up over a decade (Departmental Action Plans, procurement, audited performance reports, improved policy-making and so on) was rooted out or simply allowed to die.

But not completely, thank heavens, in the Department of Health – despite yet another mega-restructuring. And the best possible proof-point for this was the launch last week of a seriously impressive Sustainable Development Strategy not just for the NHS itself, but for Public Health England (which now falls under the remit of local government) and social care (which has never been part of this agenda before).

I know that all sounds remarkably geeky – yet another strategy, clunky, departmental integration, boring old support units, and so on. But dismiss all that at your peril. When it comes to actually delivering more sustainable outcomes on the ground, institutional strength and continuity matter at least as much as smart policy-making.

By and large, institutions work because of the people in them. Right from its inception, the NHS Sustainable Development Unit has been run by two extraordinary individuals: David Pencheon and Sonia Roschnik, with huge encouragement and vision from Sir Neil McKay. It’s a formidable team, which has somehow managed to navigate its way through the chaos of the last few years – and to bring together a quite extraordinary coalition of organisations across the wider health system which are all now committed to playing a much bigger role in putting sustainability at the heart of that system.

I acknowledge I may be making a bit too much of this – the Sustainable Development Unit’s budget, for instance, is laughably inadequate. But right now, if you scan across the whole of Whitehall, sustainable development is mostly invisible. Michael Gove killed it in the Department of Education; BIS meddles a bit with various aspects of the "green economy", but has no strategic overview; DEFRA’s a basket case; DCLG has gone backwards on sustainability issues from the first moment that Eric Pickles crossed its threshold; the treasury is a pit of very smart, ideologically hostile vipers; the Foreign Office and DFID do good stuff, but are desperate to ensure that the Daily Mail never hears of it. It’s a grim picture.

So against that backdrop, what the Department of Health is doing is really quite special – and the new strategy is very special, too.

David Cameron on a hospital visit in 2013. Photograph: Getty Images.
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Theresa May’s stage-managed election campaign keeps the public at bay

Jeremy Corbyn’s approach may be chaotic, but at least it’s more authentic.

The worst part about running an election campaign for a politician? Having to meet the general public. Those ordinary folk can be a tricky lot, with their lack of regard for being on-message, and their pesky real-life concerns.

But it looks like Theresa May has decided to avoid this inconvenience altogether during this snap general election campaign, as it turns out her visit to Leeds last night was so stage-managed that she barely had to face the public.

Accusations have been whizzing around online that at a campaign event at the Shine building in Leeds, the Prime Minister spoke to a room full of guests invited by the party, rather than local people or people who work in the building’s office space.

The Telegraph’s Chris Hope tweeted a picture of the room in which May was addressing her audience yesterday evening a little before 7pm. He pointed out that, being in Leeds, she was in “Labour territory”:

But a few locals who spied this picture online claimed that the audience did not look like who you’d expect to see congregated at Shine – a grade II-listed Victorian school that has been renovated into a community project housing office space and meeting rooms.

“Ask why she didn’t meet any of the people at the business who work in that beautiful building. Everyone there was an invite-only Tory,” tweeted Rik Kendell, a Leeds-based developer and designer who says he works in the Shine building. “She didn’t arrive until we’d all left for the day. Everyone in the building past 6pm was invite-only . . . They seemed to seek out the most clinical corner for their PR photos. Such a beautiful building to work in.”

Other tweeters also found the snapshot jarring:

Shine’s founders have pointed out that they didn’t host or invite Theresa May – rather the party hired out the space for a private event: “All visitors pay for meeting space in Shine and we do not seek out, bid for, or otherwise host any political parties,” wrote managing director Dawn O'Keefe. The guestlist was not down to Shine, but to the Tory party.

The audience consisted of journalists and around 150 Tory activists, according to the Guardian. This was instead of employees from the 16 offices housed in the building. I have asked the Conservative Party for clarification of who was in the audience and whether it was invite-only and am awaiting its response.

Jeremy Corbyn accused May of “hiding from the public”, and local Labour MP Richard Burgon commented that, “like a medieval monarch, she simply briefly relocated her travelling court of admirers to town and then moved on without so much as a nod to the people she considers to be her lowly subjects”.

But it doesn’t look like the Tories’ painstaking stage-management is a fool-proof plan. Having uniform audiences of the party faithful on the campaign trail seems to be confusing the Prime Minister somewhat. During a visit to a (rather sparsely populated) factory in Clay Cross, Derbyshire, yesterday, she appeared to forget where exactly on the campaign trail she was:

The management of Corbyn’s campaign has also resulted in gaffes – but for opposite reasons. A slightly more chaotic approach has led to him facing the wrong way, with his back to the cameras.

Corbyn’s blunder is born out of his instinct to address the crowd rather than the cameras – May’s problem is the other way round. Both, however, seem far more comfortable talking to the party faithful, even if they are venturing out of safe seat territory.

Anoosh Chakelian is senior writer at the New Statesman.

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