Cameron: Did he pay lip service to well-being or make a commitment?

David Cameron made a commitment to the ‘well-being’ of the nation should he become Prime Minister despite it being a notoriously slippery concept that tends not to mean a great deal even within professional practice at best and possibly at worst means the least when it is used by politicians. There may have been great honour in intent when this statement was made and I think this could have been given, amongst other statements, to try and divide the Cameron era from that of his predecessors – there seemed very little in the way of genuine concern for the quality of life of the population especially the working class during the Conservative parties domination of national politics in the eighties and the first part of the nineties and an overwhelming interest in the success of the wealthy. This probably caused some resentment towards Conservative party from anyone who had a degree of either professional or personal moral responsibility for reducing health inequalities and Cameron may be interested in trying to capitalise on the dissatisfaction with the Brown-Blair governments who work in public health related professions over relatively meaty issues such as this.
The under-spend on Public Health nationwide which appears to have taken place as a result of the lack of ring-fencing of funds aimed at public health initiatives is not likely to be a target for the Conservative party as a whole – they are less than likely to maintain their track record of reducing inequalities in health, inadvertently as they did under Major, than the Blair-Brown government and unlikely to pursue this as a policy. Perhaps the Blair and Brown governments are using measures to lead to the general improvement in some lifestyle factors and not in others? It does seem unusual that there has been some concern that there was not the reduction in inequalities that one may have anticipated since Blair & Brown have tackled the great many root causes of mortality and morbidity in the UK. While this goes on and maybe hasn’t been explained in terms of the causal models that will dictate funding maybe those in public health and health promotion are restricting themselves until a coherent explanation has been put forward through the national bodies for the professions related to public health.
The concern that the concept of well-being will be devalued by a politician may be present in some corners and to a degree this may be a valid concern. However, it is likely that like any concept worth discussing it will be the site of ideological struggle, as Norman Fairclough would state. As a result issue areas like ‘crime’ and ‘the family’ are hotly debated within politics in terms of the level of involvement from the state and this tends to be how political action occurs. It does strike me as interesting that Mr. Cameron has not stamped his own personal mark on what well-being would mean within the context of his environmentally concerned conservatives. There is some potential that this use of the term may lead to the progress that is necessary in order to move the conceptualisation of well -being on from the definitions of health offered by the World Health Organisation as a complete state of social, mental and physical well-being and that described in the Ottawa Charter. Maybe there could be developments made in the next few years shaped by the current British political scene.
The extent to which well being is taken seriously as a goal within the health service may be still under question. There has been a greater emphasis than before of examining the nature of the power relations within professional consultation and improvements made in Doctor-patient communication and offering choice in patient consultations where this is feasible – to a degree the changes in operation of the NHS should results in advances in theory including changes in the way that well-being is thought of. To a degree these changes may have already have taken place. A few things spring to mind from time to time that I think could be taken forward within the political agenda at present and the current political bottle neck in British party politics may provide what could be a substantial opportunity to
It is difficult to predict what forms of finance would be necessary to make a real commitment to well-being - no doubt this is something that was also considered under Blair. Cameron has criticised initiatives which may have been likely to lead to substantial changes in well-being perhaps necessary many years before someone can alter the course of their lives, for instance the drug misuse interventions that have not substantially increased success rates of termination of drug misuse. Has the technocratic nature of the Blair Brown agenda and the ‘what works’ approach replaced ideological approaches to party politics and will this commitment to well being be a similar approach by Cameron to a branded conservatism which will act as a benchmark for his political arrival? If anything I assume it is highly likely that well-being will be dropped down the agenda further rather than be taken forward conceptually. This appears to be pure lip service to the term.
While overspends in other NHS delivery areas are soaking up funding that may have initially have been set aside for public health interventions there does seem to be a potential political scalp to be claimed: it does seem that controlling the spending within public health would be necessary in order to achieve a substantial change in well-being. Taking the agenda forwards requires a style of leadership and willingness to listen to the workforce that Mr Cameron hasn’t demonstrated frequently. If this is to be managed ‘on existing resources’ perhaps some form of challenge laid down by the UK national health promotion and public health bodies to Mr Cameron to say what he means and mean what he says may be timely. Would the UK health promotion network offer anything in the way of the necessary political melting pot of conflicting issues between groups that would provide a means of making a significant amount of progress in this area and greatly improve the impacts of policies that are developed in this area?