Cheap booze and fags: the last gasp of government health policy

Duty Free - Terminal 2 Heathrow Airport, Hounslow, United Kingdom, Architect Hok International, Duty Free - Terminal 2 . (Photo by View Pictures/UIG via Getty Images)

In a government gearing up for an election, where every statement is supposed to be choreographed as part of a finely tuned grid of speeches and events, it takes a particular stupidity for the chancellor, Sajid Javid, to extol the virtues of cheap cigarettes and booze just as the health and social care secretary, Matt Hancock, was heading for Public Health England’s annual conference.

Having alighted upon what he regards as unequivocally good news about leaving the EU without a deal, Javid announced on Tuesday that people travelling to Europe will be able to buy alcohol and cigarettes without paying UK excise duty.

Javid added chirpily that this decision “will help holidaymakers’ cash go that little bit further”, apparently oblivious to the way the pound has tanked against the euro since the referendum.

It left Hancock struggling to defend the government’s commitment to end smoking by 2030 in his speech to the public health conference on Wednesday.

Stocking up on whisky on your way out of the country may be an understandable reaction to the government’s inability to get your usual medication into it. But the chancellor’s promotion of cigarettes and alcohol exposes the government’s failure to take a joined-up approach to tackling stalled life expectancy and the obscene 18-year healthy life expectancy gap between the wealthiest and poorest parts of the country. The announcement shows how different parts of government are so buried in their own silos that they either don’t see or don’t care about the wider harm they are doing.

This policy failure was rammed home the same day by the Health Foundation, with a report spelling out that the only way to deliver substantial improvements in health is concerted government action to tackle the social, economic and environmental conditions in which we live.

The foundation’s plea for good health to become a key measure of successful government would be transformative. New Zealand is showing the way: its first wellbeing budget was published this year, and its five priorities include taking mental health seriously, improving child wellbeing and reshaping the economy to spread the benefits.

Making health a measure of our collective success is a brilliantly simple idea. It would be a goal we could all could benefit from and understand. With air pollution an important factor, it would seamlessly dovetail with action on climate change.

Local government would have a big role to play, particularly in creating environments that support children’s physical and mental health. Reopening hundreds of Sure Start centres would be a good place to begin.

For a government keen on infrastructure projects, affordable and accessible transport systems could be a vote winner. But they do not have to be state of the art rapid transport to make a difference; running decent bus services between deprived coastal towns and major cities could have a massive impact.

But despite endless examples in the UK and across the world of smart things that could improve health and wellbeing, over the past decade our government has been unwavering in its determination to prioritise short-term crisis management, upward wealth redistribution and headline-grabbing proposals over long-term improvements in people’s lives. In-work and child poverty are the result. Health Foundation analysis of government figures indicates child poverty will keep rising for at least five more years on the back of yet more cuts to working age welfare support.

Spending on homelessness perfectly encapsulates the dysfunctional way Conservative governments have approached spending. Analysis by the Guardian and the housing charity Shelter in January found that councils across England spent £997m on temporary accommodation in 2017-18, a 71% increase on the £584m in 2012-13, as more people have been driven on to the streets by benefit cuts, reductions in local authority housing spending and erosion of other services such as addiction treatment. On average, the lives of rough sleepers are 30 years shorter.

Putting health and wellbeing at the heart of government policy would benefit everybody, provide levers on everything from the economy to the environment and encourage joined-up, long-term policies. It might even be a political objective we could all, at least in principle, agree on.


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