John Bird: We’re living in a low-health economy

The NHS is finally catching up with the Big Issue's founder's idea that they focus on prevention as a way to ease the burden on services. Here he explains the thinking behind his much-debated suggestion

I wish you the very best of New Years. New years themselves, and the promises of them, are often more hollow and empty because we take with us the practices, patterns, and behaviours of former years. But we all like the idea of a break with the past, if that past has been loaded down with a lack of opportunity or joy, fun, sex, prosperity, or whatever else we would like in abundance.

‘Wishful thinking’ is how you might put much of our ambitions for things; whether that is personal stuff-money, health etc – or social justice, a Brexit or non-Brexit future, the ending of our dreadful toll on the planet. Wishful thinking is imagining, daydreaming, hoping for something, without putting the work in to bring about the desired change.

Last year at New Year I listened to some doctors, including my own GP, about how you could help them in their work; how could you help the NHS to do their job better. My GP said if I had 10 people in the surgery rather the 20 that would be a start.

Talking to nurses they would say the same. Less patients mean more time for people seriously ill. I suggested that we all made a health pledge to stay as healthy as we could so that people who were ill could be concentrated on.

Being in control of your own health, something that we all battle with, is not open to us all

It caused a Twitter storm, my first, because it could also be interpreted as the deserving ill and the undeserving ill. Which a Guardian writer, among others, saw it as.

We have raw nerves over the NHS because it means so much to us. Therefore if someone comes along and says ‘take the pressure off the NHS by staying healthy’ there are some who are going to say ‘how dare you divide the worthy and the unworthy, the deserving and undeserving ill’.

Being in control of your own health, something that we all battle with, is not open to us all. So the ones who can’t make a choice through accident or congenital illnesses from birth etc need our fullest attention and support.

But if as many of us who are able can put our bodies first then the weight on the NHS would be greatly reduced. And those in dire need could be supported in a fuller, deeper, more caring way.

It’s not a ‘them and us’ but if you really wanted to you could see it as that. In the same way that you could say helping homeless people was letting the government off the hook. That was the big argument in the early days of The Big Issue.

Virtually every bit of thinking, like reducing the waiting list by helping more people to stay healthy, can be seen malevolently, if you so choose.


Since 1991 The Big Issue has sold more than 200,000,000 copies – helping the most vulnerable in society earn more than £115 million.

My call for a ‘health pledge’ last year did not start a big debate, which I hoped it would, on how tangentially you could help the NHS. That is, by doing things around health how could you help the health service to be a more efficient health service. More money is certainly one aspect that needs addressing. But a healthier UK?

What I was hoping to raise also in the last new year was PREVENTION. I will be trying that in the new New Year also. I don’t know how we can ever get anywhere in life about wrongdoing, ill health, mental illness, if we don’t put an enormous effort into preventing stuff from happening.

We are all moving into a different world after March 29

But what the rather derogatory interpretation of my ‘health pledge’ article did was raise the question of how poverty is the killer that it is. How poor food that comes from poor pay or poor social security support is such an important part of the game. That you have this system that provides for poorly paid work or poorly paid social security, and that this is the biggest driving force behind ill health among people in need.

I relished that awareness that it created; that all of the talk about keeping ourselves healthy should not mask us from understanding that we have an ill-health-making form of economy.

It’s as plain as a pikestaff, but it sometimes needs to be expressed differently, and graphically. In short those that I believed misinterpreted me enriched my understanding.

Of course all of our New Year wishes for each other and for ourselves may well be just wishful thinking in more ways than one. For we have to climb the Brexit mountain. We are all moving into a different world after March 29. A world where people in the British Isles, it’s still called that I hope, are more divided and angry. Where whatever is done to weather the storm will piss off almost a half of all who voted for or against Brexit.

In human history there is no precedent.

But we know all this. Perhaps only the Second World War when people entered it without knowing its outcome, and it looked decidedly sticky, can bear comparison with it.

Holding one’s nerve, not panicking, stay calm; I shall be trying all of this. Certainly wild speculation will not aid us in these trying times. But I did say ‘Happy New Year’ did I not?