David Cameron talks to Professor of Neurology Nick Fox during a visit to the National Hospital for Neurology and Neurosurgery. Photograph: Getty Images.
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To tackle our mental health crisis we need to reduce inequality

The government still prefers to spend money on expensive and complicated solutions, rather than cost-effectively addressing causes.

It was recently reported that poor mental health costs the UK economy £70bn a year, a sum equivalent to 4.5 per cent of our GDP. This is nothing short of a national disaster, primarily in terms of ruined lives but also in terms of lost productivity and economic inefficiency. 

It is also, most infuriatingly, an avoidable disaster. We know that mental health correlates strongly with income inequality, and that a reduction in inequality could significantly reduce mental health problems across the UK. But as with many of the economic and social problems associated with our high level of inequality, we seem to prefer to spend money on expensive and complicated solutions, rather than cost-effectively addressing causes. The cost of inequality can be seen measured in the billions we spend on our welfare state: on the nurses, doctors, police, probation officers, prison staff, psychologists and psychiatrists and all the physical buildings and equipment that we provide for these professionals to do their work. Poor mental health drives up the demand for all of these services and the people and assets that deliver them.

This sticking-plaster-on-a-dam approach is also creeping into more and more areas of our economy, not just the public sector. At the lower end of the income spectrum, people are being crow-barred back into work that many are not fit to take on and, once in their new jobs, they are then struggling to stay in them. Further up the income ladder, more and more employees are being urged to be more resilient and a whole industry has now been spawned to help people cope with workplace stress and perform better. Some employers, in a quest to give their staff mental toughness and "edge" even seek to introduce the benefits of sports or military training into their workplaces, despite their businesses bearing no relation whatsoever to a sports arena or a battlefield.

The probable context for all this is the so-called "global race" in which many of our politicians seem to believe we are engaged. Even if we are tempted to accept this rather depressing rats-in-a-sack worldview, our chances of success will surely be far greater if we reduce inequality and thereby tackle the major cause of the various health and social ills that hold back our individual and collective economic performance. In our increasingly insecure, under-employed, low-paid and long-hours economy it would seem fanciful that success will be achieved by simply telling everyone to pull themselves together, "lean in" and work harder.  

Carrying on as we are clearly entails massive and sustained threats to our health and well-being. We have a choice: we will either succeed together as part of a fair, robust and supportive economy - or we will each strive individually to gain a short-lived and illusory edge in the unfair, jagged and rickety Heath Robinson-esque economic model we have now. Economics and compassion both strongly suggest that rather than forever patching people up when they fall, we should be doing more to prevent them falling in the first place.

Bill Kerry is a co-founder of The Equality Trust

Photo: Getty
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Scotland's vast deficit remains an obstacle to independence

Though the country's financial position has improved, independence would still risk severe austerity. 

For the SNP, the annual Scottish public spending figures bring good and bad news. The good news, such as it is, is that Scotland's deficit fell by £1.3bn in 2016/17. The bad news is that it remains £13.3bn or 8.3 per cent of GDP – three times the UK figure of 2.4 per cent (£46.2bn) and vastly higher than the white paper's worst case scenario of £5.5bn. 

These figures, it's important to note, include Scotland's geographic share of North Sea oil and gas revenue. The "oil bonus" that the SNP once boasted of has withered since the collapse in commodity prices. Though revenue rose from £56m the previous year to £208m, this remains a fraction of the £8bn recorded in 2011/12. Total public sector revenue was £312 per person below the UK average, while expenditure was £1,437 higher. Though the SNP is playing down the figures as "a snapshot", the white paper unambiguously stated: "GERS [Government Expenditure and Revenue Scotland] is the authoritative publication on Scotland’s public finances". 

As before, Nicola Sturgeon has warned of the threat posed by Brexit to the Scottish economy. But the country's black hole means the risks of independence remain immense. As a new state, Scotland would be forced to pay a premium on its debt, resulting in an even greater fiscal gap. Were it to use the pound without permission, with no independent central bank and no lender of last resort, borrowing costs would rise still further. To offset a Greek-style crisis, Scotland would be forced to impose dramatic austerity. 

Sturgeon is undoubtedly right to warn of the risks of Brexit (particularly of the "hard" variety). But for a large number of Scots, this is merely cause to avoid the added turmoil of independence. Though eventual EU membership would benefit Scotland, its UK trade is worth four times as much as that with Europe. 

Of course, for a true nationalist, economics is irrelevant. Independence is a good in itself and sovereignty always trumps prosperity (a point on which Scottish nationalists align with English Brexiteers). But if Scotland is to ever depart the UK, the SNP will need to win over pragmatists, too. In that quest, Scotland's deficit remains a vast obstacle. 

George Eaton is political editor of the New Statesman.