Well-being — House of Lords, 2020-03-12
Topic: Social Welfare
Sarah Virginia Brinton (Liberal Democrats, Centre to centre-left): My Lords, I too congratulate my noble friend Lady Tyler on securing this important and interesting debate. I thank her for her introduction to the enormously wide-ranging debate we have had over the past two and a half hours. Noble Lords who are not Liberal Democrats might want to know that she practises what she preaches. She led a policy working group inside the party a few years ago to make sure that all our party policies looked at well-being and social inequality. That is why as a party we stand full square behind her My noble friend made a number of points. For me, the most important was what she said at the start that this debate: that this debate is timely and not new. Over the years, many people have tried to grapple with the difficulties that the right reverend Prelate the Bishop of Portsmouth described: hard and soft data, the outcomes and how we manage that. I am grateful to the noble Lord, Lord Skidelsky, for challenging us on some of our thinking. Professional economists can see things much more clearly than the rest of us who are struggling to make things add up and work out. Today’s debate has demonstrated that across all parties and none in this House we see that well-being is critical to the success and future of our people and our country It was a pleasure to hear the noble Lord, Lord Layard. Like many colleagues, I am in awe of his expertise on this. I will come back to QALYs later on, because I have a particular issue about them. He is right that it is all about the quality of relationships, whether in your community, at work or between Governments and other people. The moment we start to think about well-being in them and all the issues that make it up, it becomes extremely important My noble friend Lord Addington talked about sport and the reduction in children’s happiness, and he spoke a little about education. It is interesting that the reduction in children’s happiness shown in the Children’s Society’s regular survey coincided with Governments’ focus on STEM and the reduction and removal of arts, music and dance from the curriculum. They were the spaces in our school system where children learned about well-being with each other and about how to practise it outside and as they grew up. Speaking for colleagues who are passionate about the creative and sports worlds, I regret that those subjects are sadly lacking in our schools at the moment The noble Lord, Lord Stone, talked about yoga, which was interesting. Before I was wheelchair-bound, I used to take part in T’ai Chi for people with disabilities. It combines physical and mental abilities. I always felt better mentally after a session of T’ai Chi. I look forward to the day when I can do it again My noble friend Lady Burt outlined her introduction to mindfulness in Parliament seven years ago, which was encouraged by Jo Swinson, who was then an MP. Many people have talked about mindfulness today. It is understood and followed by many people across the country. The noble Lord, Lord Bilimoria, talked about Bhutan and its gross national happiness. Then, in his typical style, he immediately linked it to styles of working and employers. It is extremely useful to have businessmen who see so clearly the benefits of mindfulness and happiness in the economy The noble Lord, Lord Bird, spoke about how poverty and well-being are distant bedfellows. I wish him well with his Private Member's Bill, which starts its progress tomorrow. There may be ways in which we can start to mark this through legislation, and it is very useful to look at that The right reverend Prelate the Bishop of Portsmouth highlighted the importance of good physical and mental health. For people living with long-term conditions, as I do, depression can be all too common and until fairly recently it was ignored by clinicians, but changes are happening. CBT and other things are now not quite routinely but often offered to people facing difficulties over a very long period. I started on a new drug about five or six years ago. I had to inject myself in the stomach, and I had never injected myself before. I was pretty unhappy about it, along with the three-page list of horrors—I am now used to them—that might befall you when a consultant starts you on a new drug, including immunosuppression, cancer and various other things. Of course people with long-term conditions faced with such a list have difficulties. The pharmaceutical company that provided the injections also provided a mental health workbook, and for the first six months on the drug there was a helpline where someone called me and I could call them. When I asked the company why it did that, it said that it was to keep me on the drug. If it could support patients in the early days of trying something new, they would feel better about it, which is better for the NHS, because patients were not chopping and changing and needing help, and it is better for the pharmaceutical company because it has long-term customers. So there are some very specific things where starting to think about people’s well-being becomes important An excellent report from the Mental Health Foundation sets out how essential mental health is as a component of well-being. Tackling Social Inequalities to Reduce Mental Health Problems states: "Public mental health is the art and science of improving mental health and wellbeing and preventing mental health problems through the organised efforts and informed choices of society, public and private organisations, communities and individuals." It goes on to say that despite the fact that "The evidence is clear" that "Inequalities can influence and sometimes directly cause mental health problems ... The good news is that it is possible to act, collectively and individually, to reduce inequalities in mental health effects thereby improving the mental health of the population." My noble friend Lady Jolly commented on an incredibly important part of the community that is so often ignored in relation to well-being: those with learning disabilities. I want to highlight the work of learning disabled champion Ciara Lawrence, who is an outstanding young woman. She talked a few months ago about the experience of having a cervical smear. We know that the health outcomes for people with learning difficulties are frequently poorer because, very often, they are at the back of the queue for the routine, public health things that everyone else has. Ciara did not influence just her own peers; she influenced the medical profession by publicly talking about it. She has started to change the attitude of those working in these fields with adults with learning disabilities—good on her I like the idea of QALYs. For years, I have been arguing that they ought also to be used by the DWP and BEIS when we look at the wider benefit of medicines in communities. The problem with a QALY is that it does not look at the economic benefit of getting somebody well. How might that manifest itself? When I was first advised to use a wheelchair, I was not allowed an electric wheelchair on the NHS because I could walk from my sitting room to my kitchen with a stick—but I could not get to work. That seems a short-sighted thing about QALYs; NICE says that you can mark things in this way, but that decision could have prevented me from being economically active had I not been able to get a chair myself. That would have had adverse effects on my contribution to society, my personal well-being and a whole string of other things. We need to tackle QALYs much more across the board rather than purely in health terms I mention briefly the four golden rules for surviving coronavirus suggested by the right reverend Prelate the Bishop of St Albans. As he says, they are not the official advice, but I think they absolutely summarise a key approach to well-being: protect and support our neighbours; think of those who are worse off than us and try to help them; do not panic—he says do not hoard food either—and live today and each day to the full because none of us knows about the future, and never give in to fear. These are also good well-being messages for life. They are not just something that his parishioners in St Albans should be thinking about. This is much more about wider society and how, as the noble Baroness, Lady Bennett, said, we think about how we are going to manage during the coronavirus outbreak I end with a sentence on the Marmot review, 10 years on. It is absolutely vital that we listen carefully to the recommendations from the Marmot review group following the things that we did not achieve the first time around. Every single one of those recommendations has been addressed in the debate today. We do not have time to go through them, but it is absolutely vital that we use Marmot as the road map to secure well-being for our country.