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.
Shaun Botterill/Getty Images
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All the Premiership teams are competing to see who’s got the biggest stadium

It’s not just a financial, but a macho thing – the big clubs want to show off that they have a whopper.

Here in NW5, where we live noisily and fashionably, we are roughly equidistant from Arsenal and Spurs. We bought the house in 1963 for £5,000, which I mention constantly, to make everyone in the street pig sick. Back in 1963, we lived quietly and unfashionably; in fact, we could easily have been living in Loughton, Essex. Now it’s all changed. As have White Hart Lane and Highbury.

Both grounds are a few metres further away from us than they once were, or they will be when White Hart Lane is finished. The new stadium is a few metres to the north, while the Emirates is a few metres to the east.

Why am I saying metres? Like all football fans, I say a near-miss on goal was inches wide, a slow striker is a yard off his pace, and a ball player can turn on a sixpence. That’s more like it.

White Hart Lane, when finished, will hold 61,000 – a thousand more than the Emirates, har har. Meanwhile, Man City is still expanding, and will also hold about 60,000 by the time Pep Guardiola is into his stride. Chelsea will be next, when they get themselves sorted. So will Liverpool.

Man United’s Old Trafford can now hold over 75,000. Fair makes you proud to be alive at this time and enjoying the wonders of the Prem.

Then, of course, we have the New Wembley, architecturally wonderful, striking and stunning, a beacon of beauty for miles around. As they all are, these brave new stadiums. (No one says “stadia” in real life.)

The old stadiums, built between the wars, many of them by the Scottish architect Archibald Leitch (1865-1939), were also seen as wonders of the time, and all of them held far more than their modern counterparts. The record crowd at White Hart Lane was in 1938, when 75,038 came to see Spurs play Sunderland. Arsenal’s record at Highbury was also against Sunderland – in 1935, with 73,295. Wembley, which today can hold 90,000, had an official figure of 126,000 for the first Cup Final in 1923, but the true figure was at least 150,000, because so many broke in.

Back in 1901, when the Cup Final was held at Crystal Palace between Spurs and Sheffield United, there was a crowd of 110,820. Looking at old photos of the Crystal Palace finals, a lot of the ground seems to have been a grassy mound. Hard to believe fans could see.

Between the wars, thanks to Leitch, big clubs did have proper covered stands. Most fans stood on huge open concrete terraces, which remained till the 1990s. There were metal barriers, which were supposed to hold back sudden surges, but rarely did, so if you were caught in a surge, you were swept away or you fell over. Kids were hoisted over the adults’ heads and plonked at the front.

Getting refreshments was almost impossible, unless you caught the eye of a peanut seller who’d lob you a paper bag of Percy Dalton’s. Getting out for a pee was just as hard. You often came home with the back of your trousers soaked.

I used to be an expert on crowds as a lad. Rubbish on identifying a Spitfire from a Hurricane, but shit hot on match gates at Hampden Park and Ibrox. Answer: well over 100,000. Today’s new stadiums will never hold as many, but will cost trillions more. The money is coming from the £8bn that the Prem is getting from TV for three years.

You’d imagine that, with all this money flooding in, the clubs would be kinder to their fans, but no, they’re lashing out, and not just on new stadiums, but players and wages, directors and agents. Hence, so they say, they are having to put up ticket prices, causing protest campaigns at Arsenal and Liverpool. Arsène at Arsenal has admitted that he couldn’t afford to buy while the Emirates was being built. Pochettino is saying much the same at Spurs.

It’s not just a financial, but a macho thing – the big clubs want to show off that they have a whopper. In the end, only rich fans will be able to attend these supergrounds. Chelsea plans to have a private swimming pool under each new box, plus a wine cellar. Just like our street, really . . . 

Hunter Davies is a journalist, broadcaster and profilic author perhaps best known for writing about the Beatles. He is an ardent Tottenham fan and writes a regular column on football for the New Statesman.

This article first appeared in the 11 February 2016 issue of the New Statesman, The legacy of Europe's worst battle