Put the family before the state for a real Conservative healthcare policy

Put the family before the state for a real Conservative healthcare policy

by Dr Sutherland MacNeill
article from Thursday 12, January, 2017

I WAS interested to read the latest press release on improving health from the Scottish Conservatives who have, it seems, not one but three spokesmen on health.


On the train from Perth this afternoon I was relieved to see a call for a return to free swimming lessons. I think this seems pretty reasonable, not overly generous, and the English have focussed on this recently so it makes sense we should, or we'll be left behind in that too. There was also the idea that childcare should include some physical exercise as part of it. This seems at first very sensible, though of course childminders and carers would need education and safety training to delivering this if it's anything more than a walk in the park. Personally I can't see why parents don't do this themselves.

It all becomes a bit sticky after that though. Encouraging voluntary sectors to do this and that isn't really policy at all but, by its nature, a polite request. There is a definite naivity regarding how healthcare delivers health, which of course it doesn't and never has. 

GPs simply do not have the time to socially prescribe. Nor do they have the money. Social prescriptions are subjective and outside the training of GPs and nurses and that inverse care law will always apply; giving most to those most able to seek it which is never the people that need it. As an example Mental Health is in vogue and GP surgeries should all provide it. I always thought they did anyway.

Community hubs, innovative solutions, segregrated "funds" for this and that – rather than deciding what first is needed. This is very Liberal Democrat isn't it? To talk about breaking down barriers and using loose definitions of where responsibility will lie.

The analysis of public procurement is a very odd one. I'm sure locally grown vegetables are good for own economy but why are they any better for us? I haven't heard any recent reviews of orange juice sourced from Ayrshire but I doubt it's any good. In any case it breaks EU procurement law, and that will need repealed if any procurement based on anything but cash value of service can be mooted. I doubt it somehow.

Home economics was a mainstay of education for many years and the obsession with having a qualification for everything means it is wrongly downgraded on the basis it isn't an employable skill for many, which is absurd. We could even combine it with food procurement and have every child prepare their own school meal the night before at home. That seems like innovative homework to me.

Much of the report is a horlicks of wishlists which is all to the good but none of that ever needs delivering or measuring years from now. Time again the Scottish Tories seem to want to put the state at the heart of everything rather than the family. That's not Conservative. Who on Earth in the real world thinks we need public funding and an action plan to go... jogging? Or playing football in the local park? PE lessons are an essential, wouldn't it be nice if someone thought of retraining former servicemen to teach sport and exercise and discipline at school?  I doubt the arty lefty types would approve, then again all the better.

The biggest observation for me is the one for which no action has been recommended. That those in the bottom fifth of the income distribution do far worse health-wise than those at the top. What is to be done? Perhaps improving the incomes, job stability, life chances and reforming the tax code to suit two parent families with children who are in that lowest fifth. 

If we used that bit of income tax we control to give to the breadwinner of every family with children, or at least those under 5-years-of-age, a tax free allowance then it would pay for families to work things out a bit more and develop a more stable family life with at least one breadwinner per household. All the lefty academic data shows that once one parent is in work child poverty essentially evaporates. 

With both parents at home, childcare can be juggled more easily and that breadwinners allowance would mean families could buy all the Ayrshire oranges they want. They might find the time to jog to the shops to buy them.

A health family breeds healthy children. 

When poor people can reliably and steadily earn salaries a respectable fraction of those of richer families, maybe they will start living as healthily. Then they can rationally discount tough choices today against better health tomorrow. We could start from worse.

Your's in Philosophical pain.

Dr Sutherland MacNeill

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