Perils and pluses of a pledge to look after our own health

Rebecca Earle and
Big Issue founder
John Bird on the idea of prescribing a dose of ‘self-health’

Fruit in a fridge

‘Removing the healthy from the health equation via “self-health” should in no way be seen as an attack on the poorest among us,’ writes John Bird. Photograph: Aluxum/Getty

So the Big Issue’s John Bird wants us to sign a pledge to eat better, drink less and exercise more. We mustn’t be “an unnecessary drain” on the NHS, after all. Dawn Foster is absolutely right to question the merits of this approach (Bossy diet advice won’t fix the NHS, 23 January).

Not a day goes by when I am not reminded of the tense atmosphere in Britain in the revolutionary years of the 1790s. As people up and down the country protested against the rising price of food and falling standard of living, members of the great and good signed pledges promising the 18th-century version of Dry January: they would ensure that their households ate wholemeal bread for the next two months.

Did the hungry poor appreciate this gesture? The same files in the National Archives also contain anxious reports from Oxford that “a sett of villains” was threatening to burn property on college lands if food prices did not come down, that someone in Hartlebury had been arrested for wishing “All kings’ hides were tanned to make umbrellas for Jacobins to walk under”, that poor people in Ormskirk were being “misled by a false notion that rioting will reduce the price of corn”. And a group in Portsmouth were denounced for singing “Now is the time to assert the rights of men”. I don’t think a pledge is going to get us out of our current mess. The group in 1796 Portsmouth had it right.
Prof Rebecca Earle
Department of history, University of Warwick

While I admire Dawn Foster’s spirited defence of the poorest among us, I was not pleased to be yoked together with the enemies and denigrators of the poor. In my health pledge, I advocate a dose of self-health, suggesting that we might find additional resources for the NHS if more people took more control of their own health.

Preventing ill-health is one of three themes in the NHS Forward View, though this approach has been advocated since the beginning of the service; I well remember as a slum child being given milk, cod liver oil capsules and countless hours of exercise.

But removing the healthy from the health equation via “self-health” should in no way be seen as an attack on the poorest among us. Just because the poor aren’t in the luxurious position of eating, presumably, what you, your staff and I can now afford, it doesn’t mean that we should not stand by our own health.

Give a Rolls-Royce service to the poorest, and let not the healthy be a drain on the NHS’s always-limited resources.
John Bird
House of Lords

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