16 February 2016
Want, Idleness, Ignorance, Squalor and Disease: these were the five "giants" identified by Sir William Beveridge in his wartime report that laid the foundation for the postwar welfare state. He omitted a sixth that is less viable yet as old as civilisation: loneliness.
Isolation inflicts a heavy psychological burden, especially on the elderly. It also has financial costs, in worsening ill health. An innovative scheme in Rotherham suggests how these can be reduced. Health administrators in the town have since 2012 allocated about £500,000 a year to community groups to help vulnerable patients to join them.
It works, for patients and health budgets. GPs direct patients to activities such as yoga, fitness classes or the arts, or counseling for those with financial or welfare problems. This sort of social prescribing reduces the pressure on medical services. Analysis by Sheffield Hallam University suggests that by reducing A & E visits, hospital stays and GP appointments, the programme saves the NHS 43p for each £1 initially spent. If the benefits were continued for five years, the NHS would save twice as much as it spent.
It takes care to interpret and apply these figures. As life expectancy increases and other institutions (such as organised religion) wane in their adherents, however, it makes eminent sense for policymakers to stress social and preventative health measures.
In their recent book Thrive, the economist Lord Layard and psychologist David Clark argue that mental illness causes more widespread suffering in society than physical illness, or than poverty and unemployment. For the NHS to provide effective, evidence-based psychological treatments is money efficiently spent. To prescribe activities for patients before they fall prey to the scourge of mental illness at all is humane and economical.
Article published in the The Times, Monday 15 February 2016, p.29