In Jeremy Miles recent article for the Welsh Fabians titled “Wales in a changing world” the following sentence caught my eye: “Bevan was an architect of the Welfare State. Tomorrow’s task will be a Wellbeing State”*.
This passing suggestion set me thinking and pondering what exactly a “Welsh Wellbeing state” would look like? If, in this ever changing world, we set this as our future destination then, as we travel through legislation, policy making and budget decisions, how should governance be re-shaped in providing people with a “Wellbeing state”?.
At one level Jeremy’s suggestion struck me as a very natural evolution of recent legislation in Wales — not least the prominence given to Wellbeing in the Future Generations and the Social Services Acts. But it was Jeremy’s reference to our cherished Bevanite inheritance that, for me, took this challenge to core Labour territory. Not least the suggestion that our traditional ‘welfare state’ safety net could usefully be evolved in to a more holistic ‘wellbeing state’.
It struck me as an idea that echoes and reflects some recent debates that I have followed around our NHS — how can we shift the focus of the NHS from an ill-health service to a wellbeing service? It would also build upon some ideas piloted in our 2016 Assembly manifesto including social prescribing.
Yet at another level it is not an easy debate. Work in South Australia around a “State of Wellbeing” states that “defining wellbeing is not a simple task ………. There is a greater need for a common language, to be clear about what is being measured….”.
Well there is no point in me posing these questions without at least suggesting some solutions to encourage further debate and thinking.
The debate will inevitably be constrained by the realities of our structure of Governance. Welfare and benefits are (predominantly) not devolved and the policies we might pursue will have to be pragmatic. But that need not restrain our thinking. Indeed within our existing competencies there are building blocks available.
At the core of such an approach must be a “Wellbeing in all policies” approach.
We know that how we as politicians choose to measure performance can be hotly contested. Over the decades we might all recall debates involving variations around the importance of inputs, outputs and outcomes. Wellbeing takes us to the heart of an effective measure — will the activity enhance wellbeing, and if not why should we invest public money in it?
So we should not be shy to develop and put a Welsh Wellbeing Index at the core of our work and break the narrow, obsession with limited measures like GDP. The Index would report on a range of matters that give us all a more detailed understanding of Wellbeing in Wales. There might be an integrated suite of measures with responsibilities on Welsh Government (strategic measures) local councils (local wellbeing indicators), Government agencies and Third sector (sectoral wellbeing) etc.
Measures would need to be developed, in some cases evolved and integrated, on a range of issues (this is indicative, not exhaustive):
· Disparities of wealth and capital,
· Physical and creative activity, building upon the ‘exercise by referral’ by providing free use of leisure centres etc. for Wellbeing activities (art, adult education etc).
· Inter-generational activity,
· Access to services,
· Health and care measures,
· Housing, homelessness and condition of living,
Not least expanding our work on mental health as a state of well-being. Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Underpinning a “Wellbeing State” should be a move from a ‘welfare recipient’ to a ‘Wellbeing participant’. This would acknowledge an obligation to be an active citizen in the community in which we share a common responsibility to enhance wellbeing.
How might a Wellbeing state therefore be delivered in more practical terms?
Well before birth existing work on life guidance and skills would be strengthened. There can be no firmer foundation than support and guidance in the first 1,000 days.
In the pre-school years we would invest even more in preventing adverse childhood experiences.
In the school years it could be compulsory for all schools to host at least one “inter-generational” event per week. That might be as simple as a shared lunch, walking football or a short concert but would build bonds that can serve the emotional needs of the whole community.
Young adults should be required to contribute to the wellbeing of their local community. Work, skills or helping in a Community Wellbeing Service could be compulsory from 16–25 and shaped according to ability and personal need.
In our middle years we might offset any periods of economic inactivity by an Adult Community Wellbeing service funded from proceeds of crime.
Finally in a new Third age we could reinvigorate lifelong learning, building a new Adult Education and Wellbeing activity. For example any request for early retirement to carry an adult wellbeing and education obligation so skills are shared and developed between generations.
I have little doubt some finance would be required. It would be great if legislation like the Minimum Unit Price for Alcohol could include a levy that was invested in Wellbeing Activity Funds administered by local authorities to support activities which enhance wellbeing.
Finally Labour at a UK and devolved level should together consider those levers which are not devolved to Wales:
· A Minimum Income Guarantee for a Welsh citizen equivalent to a real living wage, an uplift in circumstance for many with an associated cost efficiency saving,
· Top up of welfare state payments — a Personal Wellbeing Payment to be paid in short periods to offset stress and debilitating conditions (e.g. mental breakdown)
So I have now had a first attempt at answering my own question.
Jeremy Miles prompted this article by his reference to Bevan. The question I must ask is — would Bevan see 21st century wellbeing as a natural evolution of 20th century welfare?
It leads me to conclude with a further question hanging in the air: does a “Wellbeing state” require a reordering of priorities?
A reordering that might be uncomfortable for some and require a challenge to some cherished traditions. Yet without that challenge we might miss the opportunity to enhance our wellbeing, miss the chance to give Wales the Wellbeing state, and thereby restrict the chance of the generations who follow us.
Dawn Bowden AM