My Lords, I am delighted to open this debate on the case for the Government to use well-being as a key indicator of national performance when setting budgets, deciding policy priorities and reviewing the effectiveness of policy goals. It is a debate of growing salience both overseas and in this country and one that cuts across a wide range of interests for many noble Lords speaking today, including health, the environment, the world of work, education, transport, housing, community, culture and the arts, sport and leisure—the list goes on. I am very much looking forward to hearing the contributions from all noble Lords.
I should say at the outset that I feel it is right that, while Parliament and the whole nation are having to face up to the immense and immediate challenges of the coronavirus pandemic, we pause, however briefly, to consider the long-term well-being of the nation. While it is a timely debate, it is in fact not a new one. In 1968, Bobby Kennedy famously said that measuring a country’s GDP accounts for
“everything … except that which makes life worthwhile”, highlighting that the orthodox approach included
“air pollution and cigarette advertising” and “napalm and nuclear warheads”, but failed to account for
“the health of our children, the quality of their education or the joy of their play” or
“the beauty of our poetry or the strength of our marriages”.
Since then, a growing number of economists and academics have argued that there is something fundamentally wrong with the way we measure economic and social progress. Indeed, leading academics such as Nobel laureate Joseph Stiglitz suggest that measuring people’s well-being is important for determining priorities in public policy, rather than focusing solely on gross domestic product. It is a stance gaining some prominence as Governments and businesspeople alike have joined the chorus suggesting that we reconsider how we evaluate our success as a society and how decisions are made about how public money is spent between competing priorities.
So what do we mean when we discuss well-being? Typically, well-being relates to a set of different ways of measuring quality of life and human flourishing which takes account of the broad spectrum of human needs rather than looking only at economic measures. It is about how individuals evaluate their lives and what really matters to them.
The picture that emerges in the UK is one in which well-being, for too many, is perilously low. Indeed, based on the well-being index set up by the former Prime Minister David Cameron back in 2010, the Office for National Statistics recently reported a fall in both life satisfaction and the feeling that things done in life are worth while. That was according to its most recent February bulletin. Furthermore, the same bulletin reported elevated anxiety at the end of 2019, with around 10.6 million people reporting high levels of anxiety. This of course chimes with current concerns over rising levels of poor mental health.
In 2018, the Intergenerational Foundation used well-being to measure the overall quality of life of young adults in the UK to evaluate improvements from one generation to the next. It found that, rather than improving over the last 20 years, overall well-being had declined by 10%. Satisfaction with well-being had fallen in terms of economics, relationships, health, personal environment and the sense of belonging.
Like other countries, we have historically focused on gross domestic product. However, while accounting for many things that are bad for us in health and other terms, GDP also fails to account for many things which are good for both people’s well-being and the economy. Very recently, journalist Jeremy Hazlehurst wrote about the importance of good metrics in the Work Magazine, identifying four main shortcomings of GDP. His framework provides a useful way of thinking how we can come up with improved and more rounded measures. First, he said that GDP is better at measuring goods and services, having originated to capture value derived from the manufacturing industry; I am sure I do not have to remind any noble Lord of the role that services play in our economy—approximately 80%. Secondly, it quantifies without having anything to say on quality. Thirdly, it is a so-called offline measure, which fails to account for time and money saved by online services, such as booking a rail ticket online. Finally, it deals in averages. This final point is crucial. In an era of increased inequality, GDP fails to capture wealth distribution and gaps in well-being. As we know, societies with the largest discrepancies between the rich and the poor tend to have higher levels of crime and exhibit much less trust and social cohesion. Unfortunately, we are failing to combat this trend of rising inequality. Only last week, a rise in income inequality was reported by the Financial Times, with the average
“disposable income for the poorest fifth of people” having fallen by 4.3%. It is also worth pointing out that survey evidence shows that a lack of money is a strong predictor of low well-being, but the relationship between money and well-being drops dramatically as incomes rise. I do not suggest we dismiss GDP entirely; it has and will continue to be an important measurement for average growth across the country. Rather, my argument today is that additional and more qualitative measures are needed to help generate a richer debate. While growth can be a useful metric for economic success, we must ask ourselves other questions. What is the purpose of our economic policy? What is the overall goal of government policy? Are there limits to sustainable growth? What do we do with growth? Surely our goal should be to maximise the well-being of our citizens.
The case for measuring well-being is, in part, an economic one. Understanding well-being can help policymakers make public spending more effective at improving the lives of our fellow citizens. If we understand measurements of well-being, we can better understand where to direct public spending. In this sense, we can think of well-being measurement as a means for improved return on investment. The noble Lord, Lord Layard, is highly distinguished and a global authority on this issue, and it has been my absolute pleasure to work with him for a number of years on the All-Party Parliamentary Group on Wellbeing Economics. He has suggested that the Government should evaluate improvement in well-being for every pound they spend, so I very much look forward to hearing his contribution today, which I do not have to wait long for.
Far from being an unaffordable luxury, well-being data has the potential to improve the effectiveness of public spending and, in some cases, save public money. As the noble Lord, Lord O’Donnell—another collaborator on the all-party group and leading expert in this area, who is unable to be in his place today—said, in May 2019,
“we need to understand that some of the big issues, such as improving air quality, are things that may not show up in pounds, shillings and pence. But it will show up by making our children healthier. You get long-term gains that give you a long-term fiscal gain as well”.
I would be remiss not to mention the importance of measuring children’s well-being specifically. A recent report from the Children’s Society found that an estimated 219,000 children across the UK are unhappy with their lives. Children’s happiness with their school and friends is declining, and the UK ranks 40th of 44 countries in the OECD’s PISA rankings for children’s well-being. We know so much more about adult life satisfaction than that of children. My case today is that well-being measurement will not only allow us to inform decisions on where to direct money more efficiently but serve as a tool to understand the outcomes of specific policies. Without a reliable and comprehensive mechanism to collect this data, we will simply not make progress on this issue.
Research has told us that participation in the labour market is a path to life satisfaction. Indeed, good-quality work can build a sense of fulfilment and generate involvement in community that gives people a real sense of purpose. The reverse is also true for poor-quality work and insecure work: it produces low well-being. In this sense, economic progress and well-being are inextricably linked. It may sound trite, but a happy, healthier and satisfied society is also an economically productive one.
As I have just mentioned, well-being is also about fairness between generations, social groups and regions. A successful well-being economy would, for example, ensure sustainable growth. To bring this bang up to date, consider the trade-offs suggested in the Financial Times editorial on
Well-being seems highly relevant to the Government’s levelling-up agenda and surely could be used as one means of shifting the dial. I also stress a point made by the OECD’s How’s Life? 2020 report, which came out recently. It says that we must not only measure well-being today but identify the resources needed to sustain it. This is vital when we think about the case for capital investment. It should not just be about physical infrastructure, but should include human and social capital.
It is not just economists and academics who are making the case for well-being; I was really fascinated to read recently in the pages of the Financial Times that an American hedge fund manager, no less—not the kind of person I often quote—made the case for companies, both private and public, to measure well-being. He cited the example of PayPal, a company that chose to gauge the financial stress levels of hourly and call-centre employees. Upon finding that 60% had difficulties and struggled to make ends meet, wages were raised, healthcare costs were reduced, employees were designated as shareholders and financial education was promoted—metrics led to action. The simple question I ask today is: why would the Government not do the same?
Other Governments have been taking steps forward in well-being economics. Here in the UK, Scotland and Wales have become examples of the practical implementation of well-being through things like the Scotland Performs framework and the Well-being of Future Generations Act in Wales. Tomorrow, of course, we have the Second Reading of the Wellbeing of Future Generations Bill of the noble Lord, Lord Bird, to which I am very much looking forward to contributing. Further afield, New Zealand Prime Minister Jacinda Ardern has set aside 4% of the national budget as a well-being budget for a sustainable and low-emissions economy, a reduction in child poverty and improvement in mental health. More recently, Prime Minister Justin Trudeau of Canada charged one of his Ministers with leading work within the Department of Finance to better incorporate quality-of-life measurements into government decision-making and budgeting in preparation for their budget. Surely we now have an opportunity to join close partners in the Commonwealth and beyond to be leaders in well-being.
We have just had a Budget that, for obvious reasons—and quite rightly—was dominated by measures to combat the impact of coronavirus. Another particularly noteworthy aspect was the Chancellor’s whacking great £640 billion capital investment in physical infrastructure over the next five years for things like building roads, bridges, housing, broadband and so on. But the Budget had little to say on building human and social capital and was sadly silent on social care, one of the greatest challenges of our time. We have another opportunity though coming up soon to focus on well-being and on human and social capital infrastructure in the forthcoming spending review, which looks at longer-term spending. What would a spending review focused more on well-being look like? Happily, the APPG on Wellbeing Economics, which I have been involved in since joining your Lordships’ House, last year produced a paper with recommendations on that in a wide range of areas, including mental illness, children and schools, entry into skilled employment, social care, community services and improved well-being at work.
The current approach encourages a damaging short-term approach. In practical terms, there is much that the Treasury—and indeed the whole of Whitehall—could do in the way it operates to shift the dial on well-being, including by publishing data on well-being, reviewing the Green Book rules on how spending is categorised, providing guidance and technical support to departments on how to categorise the impact of policy on well-being, and asking departments to justify their spending review bids in terms of impact on well-being relative to their cost. We could introduce well-being impact analyses into legislation and departmental business plans and we could have a national strategy for reducing well-being inequalities.
There is much that we could do, and I conclude by saying that well-being has the potential to reconnect people with politics and to create a shared vision for what society and the economy are for. It is not an add-on to be considered once economic policy objectives have been achieved; it offers a new approach to policy across the board and has the potential to make government more effective in improving people’s lives. I very much hope that, 50 years on, the spirit of Bobby Kennedy’s visionary insight can start to bear fruit in this country.
My Lords, I really welcome this debate and congratulate the noble Baroness on securing it. As she said, this is a timely moment to consider the fundamental question of what the objective of government is, because that should be reflected in the spending review. In my view, the well-being of the people is the only really sensible objective. As Thomas Jefferson said:
“The care of human life and happiness … is the first and only legitimate objective of good government.”
I cannot think of any other equally defensible objective—provided that we also include the fairness with which the happiness and well-being is distributed.
What reason do we have to hope that the Government will follow this? The reason is that it is in the self-interest of the Government to follow it. There is now a massive volume of research on what determines the outcome of elections, and study after study shows that if you want to explain the share of the popular vote, it is better explained through the well-being of the people than through all the economic variables that we use and assume are the main influences upon it. Whereas Bill Clinton said, “It’s the economy, stupid” that determines elections, actually “It’s well-being, stupid.”
Let me press this point. One does not easily change the direction of the Government without appealing to their self-interest. The reason people vote the way they do is not surprising, because it reflects what matters to people. When we study the factors explaining the variation of happiness and well-being across the population, we find that economic factors play quite a small role. Unemployment is, of course, very serious, but it affects a relatively small number of people. Income explains only about 1% of the variation in happiness of the British population, and the same is true in most European countries. We can explain another 20% by measuring mental and physical health; those come top. Then, there are all the various human relationships we are involved in—family relationships, work relationships—and the quality of those relationships, at work and in the community. So it is in the Government’s interest to fundamentally rethink their priorities. First, they must change the methodology, as the noble Baroness said, and then change the policies in consequence. I shall say just a word about the methodology.
As we know, the Treasury is rethinking the Green Book, which is very helpful. We are told that it will now stress that when you have monetary measures of benefit, you should weight these according to the income of the beneficiary, because the extra money is more valuable to a poor person than to a rich person. That reweighting is going to benefit the north, which is why the Government are doing it. The more important point, looking to the longer term, is that it is not possible to measure in monetary terms the benefits of most public expenditure. You cannot put a monetary value on health, social care, child well-being, law and order, community services or redistribution of income; these are really important for people’s well-being. However, you can put a well-being value on the associated outcomes, because a science of well-being now makes this possible. We have to change the way the Treasury Green Book works, so that it combines the kind of thing it always did, weighted by income, with direct measures of well-being. That was to some extent foreshadowed in the way the Green Book was revised in 2018.
Well-being as a measure of output is not new to our system of government, because it has been used in the NHS for 20 years. The NHS authorises treatments only if they produce at least one quality-adjusted life year—QALY—for every £30,000 of expenditure. We want to apply this same general approach to all other fields of government expenditure. I tried applying that criterion to HS2, converting the monetary value into the equivalent well-being value through the well-being effects of money, and I found that HS2 produces only 1/40th of the benefits that would be required by the NHS from the same amount of spending.
We can get an integrated way of analysing these problems. Let us apply this lens of well-being fearlessly to all expenditure, and then we will see what priorities follow; much more for mental health, more for physical health, more for our social infrastructure. I beg the Chancellor to move from the obsession with physical infrastructure to the social infrastructure which has been so seriously cut, and which is crucial to our well-being.
As the noble Baroness said, this is a movement which will succeed; in the end, we will be doing this. The OECD and the European Union have already asked member Governments to analyse policy in this way, but only three countries have done it: New Zealand, Scotland and Iceland. They are all led by women, and they are all small. Surely it is the time for a large country, led by a large man, to do the same.
My Lords, the noble Baroness, Lady Tyler, has given us the opportunity to question assumptions and to think through an important question. The noble Lord, Lord Layard, set it out very well when he said that a prime object of government should be the well-being and happiness of people. Although Thomas Jefferson wrote very well about these things, he did not practise them to quite the same extent.
The problem comes in trying to devise metrics to place alongside GDP. GDP may be an inadequate measure of the well-being of the country, but to find metrics to place alongside it is really quite difficult. Whatever the deficiencies of measuring GDP, it is an important indicator of the size and distribution of the cake. It is reinforced by other statistics we have on unemployment and employment, longevity rates, crime rates, divorce rates and all the rest of it. We are not without means of testing the temperature of the country and the well-being of its people.
We need some other value-based, non-statistical criterion against which to test policy proposals and their likely or possible consequences, as well as providing an additional means to assess the state of society. I believe that had those existed in 2010, the Government might not have pursued their austerity programme with quite the disregard for some of the consequences as they did. That austerity programme was a classic example of making balancing the books the primary object of policy, rather than seeing it as one of a number of means to achieve the goal of national well-being. To that extent, it was therefore based on a fundamental error.
This brings me to the question of what the other criteria should be, and I see three particular problems. First, any list of those criteria is likely to reflect the political bias of those who draw it up, so that it is unlikely to be universally shared. Even when one looks at a particular item, such as inequality, to which the noble Baroness, Lady Tyler, drew attention, one has only to read the numerous reviews of Thomas Piketty’s latest book to see how very differently people interpret the question of inequality and the extent to which it matters. There are big definitional problems.
Secondly, priorities can change sharply in quite a short time. One has only to think how much more concerned people are now about the implications of climate change than they were just a very short time ago. It would loom much larger in any list now than it would have done even three or four years ago.
Thirdly, for many the biggest single threat to their sense of well-being is change itself—technical change and social change. The Government certainly have a duty to mitigate the effects of change where they are damaging and cause difficulties, but we cannot stop change. We cannot stop the world and get off. The extent to which change is itself a cause of unhappiness and detrimental to well-being is, like the rising and going down of the sun, one of those things.
I have come up with a very modest proposal for this stage of the debate. We in the UK could learn from the conclusions of the French Stiglitz-Sen-Fitoussi commission that was described in the excellent Library briefing for this debate. Such a multidimensional definition of well-being could provide a reference point against which policy proposals might be tested by both those putting them forward and those judging them. However, at this stage perhaps the most useful result of this debate and the efforts of the proponents of taking well-being into account in policy formation is that it promotes a wider national debate over the issues involved and on how to put GDP into a wider context.
My Lords, I join others in congratulating the noble Baroness, Lady Tyler of Enfield, on introducing this important debate. I will comment briefly on three aspects: the developing international consensus that well-being should become a key indicator of national performance; ways in which obstacles to further progress can be overcome; and current opportunities for the Government to promote this application both here and abroad.
Even in theory, let alone as a desirable political deployment, well-being has always been slightly suspect, such as the reference of Epicurus to happiness as the only good. Picking up the reins later on with utilitarianism, Jeremy Bentham may have been a bit more convincing, but there was still the challenge of demonstrating how something as private as well-being could ever be much assisted within the necessary nuts-and-bolts machinery of a working economy. In view of this apparent inconsistency, although he and Mill remained staunch advocates of collective human well-being, there came to be the joke rhyme pretending that the latter might have become tempted to change horses all the same:
By a mighty effort of will,
Overcame his natural bonhomie
And wrote Principles of Political Economy.”
Nevertheless, within OECD countries in recent years there has been a growing consensus for well-being to take a central role. One explanation for this shift of opinion is the recognition that, however subjective, its effects can still be fairly easily measured over a number of different fields, including health, education, relationships, personal activities and so on. Another explanation is the understanding that GDP and well-being indicators do not have to conflict with one another. Instead, they can be complementary.
Influencing this new thinking has been the work of the French Government’s Stiglitz-Sen-Fitoussi commission, to which my noble friend Lord Tugendhat just referred. It published its first report in 2009. Shortly afterwards came the OECD’s Better Life Index. I used both sets of helpful criteria as evidence in writing a recent report on this subject for the Council of Europe.
I know that your Lordships will support me in paying tribute to the noble Lord, Lord Layard, for his enormous contribution and vision in the wide field of well-being and its deployment.
In this country, we have benefited considerably from the What Works Centre for Wellbeing, set up by the coalition Government in 2014, whose report of last month illustrates significant achievements over the past six years covering mental health, community income and work.
For mental health, service and research investment are both undoubtedly improving. On community, there is now a cross-government strategy for loneliness and a Minister for the subject. Well-being at work has become a priority in a variety of sectors, with many large and medium-sized organisations currently adopting staff well-being projects.
Be that as it may, to continue sufficient momentum, a number of actions so far relatively neglected should be taken, such as those supported by, among others, the All-Party Parliamentary Group on Wellbeing Economics. They are those for the treatment of mental illness, well-being of children in schools, young people’s entry into skilled employment; and, concerning prisoners, rehabilitation, craft and skills acquisition, as well as improved mental health.
Does my noble friend the Minister agree that the Government should pay greater attention to those matters? Does she also concur that the Treasury might ask other government departments to justify their bids in terms of impact on well-being and that, as the noble Lord, Lord Layard, implied, spending plans for different government departments ought to include a much clearer national focus on well-being?
My noble friend the Minister will recall that the main strategy of the United Kingdom’s chairmanship of the Council of Europe a few years ago was to strengthen local democracy in Europe. At local level, that was to encourage valuable grass-roots protection against forms of extremism or imbalance if arising within the politics of different nation states. It was also to help safeguard the political rights and well-being of those within the regions and communities of the 47 states themselves.
The United Kingdom remains a much-respected member of the Council of Europe. Both here and within that institution abroad, it should now help to promote improved well-being standards, to the advantage of all.
My Lords, I begin by humbly making two recommendations of ways in which your Lordships might profitably spend their time.
The first is to visit Portsmouth’s historic dockyard, where the nations historic naval hardware is on display. It is the stuff of national myth: from the “Mary Rose” to HMS “Victory” to HMS “Warrior”. Beyond them, visitors can see one or sometimes both of the Royal Navy’s latest, hugely powerful expressions of British sea power: the great aircraft carriers HMS “Queen Elizabeth” and “Prince of Wales”. These great ships, old and new, represent projections of hard power, but what often speaks more powerfully to those visiting the dockyard is the soft side to life on board: the story, how people lived their lives, their feelings, aspirations, hopes and fears—their well-being.
It seems to me that this exemplifies the challenge faced by policymakers and any assessment of how well, and if, a policy has worked: whether it has produced the desired outcome. Crunching the numbers is one way, but what policy looks and feels like in Whitehall and Westminster can be very different from the feelings and experience of those it directly affects. I am not arguing for the warm and fluffy against objective measures; as an economist in an earlier life, I cannot. I am arguing for voices and experience to be used in how we measure well-being—for soft and hard data.
I congratulate the noble Baroness, Lady Tyler, on securing this debate and on her involvement in the excellent work of the APPG that informs our debate. I read the chapters of the group’s reports on young people with particular interest. This leads me to my second recommendation, which is to direct your Lordships to the letters page of the current Church Times. In it, there is a letter from my right reverend friend the Bishop of Derby to which I am a co-signatory. This makes a compelling case for the Government to measure children’s well-being on a national level, a case informed by the Children’s Society’s excellent Good Childhood Report for 2019, the latest in these annual publications. They should be required reading for policymakers.
The report makes salutary and sobering reading. Girls and now boys are increasingly unhappy with their appearance. Many struggle with their friendships and are unhappy at school. These long-term trends are often the result of societal pressures, which cause worry, tension and stress. It is also clear that, for these young people, well-being is not just about being “happy”. It is about how they can be satisfied with their lives, feel listened to, be optimistic about the future and develop resilience to cope with life’s ups and downs. It is about stronger relationships between parents or carers, and children; it is about better local neighbourhoods; it is about good physical and mental health.
We have made strides in understanding and responding to the well-being of adults. A national well-being measure is now collected and studied, and it informs policy-making. However, we do not collect an equivalent measure for children and young people. At present, their well-being is measured in an ad hoc manner, using unstandardised approaches, resulting in data that is of little use locally or nationally. That is despite our children bearing the brunt of increasing imbalances in society, of the ever-growing pressure of the obsession with school attainment results, and of rising mental ill-health and poverty.
The most powerful, compelling parts of the Children’s Society’s report are the voices of young people themselves; they are resourceful, resilient and reflective. They are often sanguine about the challenges they face. Such voices deserve to be heard and must be heard: more than heard, they must be front and centre of policy-making, locally and nationally. Introducing a national measurement of children’s well-being would mean policy informed by listening and responding to young people and showing that they and their voices really count. It could—it should—lead to action to arrest a deeply worrying trend. I therefore urge the Government to listen to such voices, introduce a measure of well-being and act accordingly.
My Lords, I congratulate the noble Baroness, Lady Tyler, on securing this debate today. I would like to plug what I am doing tomorrow, which is introducing the Second Reading of my Wellbeing of Future Generations Bill. It was very peculiar for me when we started to talk about future generations. I could understand entirely the idea that we should not create laws and do things now that, in 10, 20 or 30 years, will cause all sorts of problems—the laws of unintended consequences—bearing in mind that this House, and the other place, are full of attempts to reverse the mistakes made in former times.
When we looked at the idea of a future generations Bill, lo and behold, around the corner came my staff and they added on the “Wellbeing”. Unfortunately, I did not understand it, because I had never really thought about well-being. The reason that I had never really thought about it was that I thought it was a bourgeois trap—one of the kind of things that you do when you want to avoid talking about the real world of work, the real world of class and the real fact that in the world you have people with too much GDP and others with not enough. You could put it another way: you could say that well-being is out there, but there are some people who have too much of it and some people who do not have enough of it.
One of the problems for me is that, when I look at the world, because I am a very old git—I am 74 now —I have passed through this tremendous 70-year change and have seen people from the working classes and middle classes getting more and more complex in their needs. It is not enough simply to be alive, be healthy and have loads of fun: you have to have well-being and happiness. I find that a very difficult thing: I am struggling with it and I am willing to go to evening classes to learn about how I can stop looking at well-being as a kind of chimera of not facing up to the real issues.
When I was 18 years of age, I was blessed by Her Majesty’s prisons allowing me to leave custody and go to Chelsea School of Art. When I went there, my well-being went through the roof: it was absolutely enormous. At the same time, my parents moved into another council flat, where their well-being also went through the roof. I am trying to make the same point that was made by the noble Lord, Lord Tugendhat: well-being is assessed in the context of where you are looking at it from and what position you hold in society. It is not something you can just leave to chance. I would love to kick the concept around, look at it very carefully and ask if it is a ruse or something that we can actually measure. Is it something that we can bring to our children and say, “Actually, simple financial advantage is really only a basis on which you can build change”?
I believe that well-being is very far away if you are in poverty. The first thing you need in order to build the basis of well-being is to be as far away from poverty as possible. If you go to India, you will find that many people have been lifted out of feral poverty: feral poverty is when you get up every day of the year and you do not know how you are going to feed your children. If you move into exploitative poverty, meaning that you get three or four dollars a day, it means that your children can go to school and that you have a regular life. Anybody looking at that kind of well-being—that sense of “my children have a future”—from the West, or a particular class aspect, would say, “That’s not well-being”, but it is. My father and mother lived practically the whole of the last stages of their lives in a glorious council flat, fully worked, fully fed; they had more well-being than virtually anyone else I know.
My Lords, it is an absolute pleasure to follow the noble Lord, Lord Bird. I wish his Bill—the Wellbeing of Future Generations Bill—every success. I will talk about something that has transformed my own well-being and that of thousands of others; it has a great contribution to make in practically every field of government.
My life changed about seven or eight years ago, when an email arrived from my colleague Jo Swinson inviting us to come along on a short course on something called “mindfulness”. Jo talked about how it had helped her to cope with the challenges of being an MP and enabled her to feel much happier in herself. In those days, your Lordships would have seen a very different woman before you from the one that you see today. I was depressed and I did not realise it; only when I came out of that depression did I realise what a bad place, emotionally and mentally, I had been in. I was very underconfident and saw life as a difficult challenge every single day, but I was keen to find potential tools to help. The effect that the mindfulness course had on me was transformational, and this is why.
So many of us live in our heads. We tell ourselves stories about how the world is, and that shapes our perceptions, our mood and our abilities. It is a series of messages that play again and again in our minds. They repeat themselves over and over until they become embedded, and they shape our perceptions of the world. For me, the light-bulb moment was on the parliamentary mindfulness course—available to any noble Lord on Tuesdays in the early evening—when we were talking about how we see the world and the negative perceptions which we allow to rule us. “But these are only thoughts—they are not reality”, said the tutor. What? I had been giving myself a hard time for years and years. Mindfulness gives us the tools to remove ourselves from this perceived reality that we have built for ourselves and to watch thoughts processing before us without them taking us over.
The human mind is like a monkey: it is restless, into everything, and it gets drawn in by every small distraction. From mindfulness we learn how to calm our monkey mind. We can watch thoughts from a distance and see them for what they are—just thoughts, which you can watch go by and decide not to engage with. Guess what happened. I found that being able to calm my mind and see things more objectively from a distance had an incredible, transformational effect on me. For the first time in years, I started to experience inexplicable moments of happiness. I became more open, aware and effective in my work life, my social life and my family life—in fact, practically perfect in every sense.
Your Lordships may be sitting there, thinking, “That’s a very nice story, but what does it have to do with well-being economics?” Its applications extend into many areas of social policy. Mindfulness works in the field of mental health without the need for drugs, and it has proved to be as effective for depression as current NHS first-line therapies. In clinical healthcare, there is also good evidence that mindfulness training improves well-being among those living with long-term health issues, particularly pain, multiple sclerosis, cancer and IBS. It also works in the workplace, particularly where individuals operate in stressful situations—and who does not from time to time? When online training was offered to police officers, they showed a marked improvement in their ability to do their jobs. Health service professionals have also benefited hugely. Just imagine what better decisions politicians would make if they had more insight and compassion for those whose lives they were making laws for.
Mindfulness works in schools, particularly helping children to improve their concentration, so it is particularly effective with children who suffer from ADHD and those perceived as disruptive. But imagine if we offered it to all children. What a generation of well-adjusted, compassionate and resilient individuals we would raise. Of course it also works in prisons. I have heard moving testimony on how mindfulness techniques help prisoners to calm themselves in stressful situations and avoid kicking off. It works for older people, who often suffer from isolation and depression, helping them to develop positive approaches to ageing well.
We had the Budget yesterday. As the noble Lord, Lord Layard, said, with billions of pounds invested in physical infrastructure, if a fraction of that was devoted to developing our social infrastructure, through mindfulness and some of the other suggestions made by my noble friends and others made today, it would have a far-reaching effect on the well-being of our nation.
My Lords, I thank the noble Baroness, Lady Tyler, for introducing this topic. However, for various reasons I am among the sceptics. I will make this short speech more technical than may be strictly welcome to other noble Lords—it may not add to your Lordships’ well-being, but I had better get it over with.
First, this is not new. As the noble Earl, Lord Dundee, said, this is where Bentham started, saying that the purpose of government was to secure the greatest good of the greatest number. We are now in this same logic, except that we are defining “good” in a different way. In those days—to make this story rather rapid— there was something called the welfare function. The Government had to maximise the social welfare function, which was the sum total of the utilities of individual citizens that they derived from various things like consumption. That was logical, and it also turned out that utility was such a peculiar thing that the higher the income, the lower the margin of utility of the extra dollar you got. It was no good to give money to the rich, so inequality turned out to be a bad thing for social welfare.
That led to a counter-reaction, especially from Lord Robbins, whom the noble Lord, Lord Layard, remembers, because he first put forward his brilliant analysis of happiness in the Lord Robbins memorial lecture. The thing is, you may be able to make a connection between say, income and well-being, but your well-being and my well-being may conflict. Well-being is not what we call aggregable—you cannot add up different people’s well-being. There might be the reaction: I may not like your happiness or your riches—I may feel unhappy that you are rich. What will you do about that? The idea was, “Let’s forget about those things and go to objective, measurable variables.”
The real question then arises. Suppose you had a measure of welfare, well-being, or whatever it is. Can government do anything to achieve it? What is the transmission mechanism between government policy and the outcome regarding well-being? Do only the Government cause well-being, or are they only one of the many actors that could promote well-being? Of course, they may not succeed—not every government policy succeeds, regardless of the Government’s intentions. Therefore this situation is not as simple as it looks. We can talk about well-being and it makes us feel good, and if we say that the Government ought to encourage well-being, who could object to that? The problem is whether this is a measurable variable and an achievable policy goal.
I am aware that GDP is not a very good measure, therefore we ought to try a better one. I was involved in something called the human development index. Basically, it adds up life expectancy, educational enrolment and income, which are weighted in a particular way. All those things are characteristics of aggregates. You can say that life expectancy can be measured for a whole population—it has to be. School enrolment is obviously a collective variable for a society, and income was basically calculated on a per capita basis. Therefore, one may be able to get a measure of a group of people without worrying about individual welfare. If I go from a country with a low life expectancy to one with a high life expectancy, my human development index does not go up; my life expectancy is mine, because it may be to do with my health. But you can say that, collectively, this society is better off than that society, because we are measuring collective variables, which do not conflict among individuals.
Any Government at any time can claim, “Of course we encourage well-being. We will give you a measure of well-being that will show that we encourage it.” Well-being is such a soft thing; get some clever people and you will be able to say every time, “That is our business. How could we not measure well-being? We have been doing that for ever and ever. Even austerity was good for people because we learned to live within our means and that is a good thing to do, because spendthriftness is a bad thing.”
One must be aware that things that are subject to manipulative measurement should not be used or urged on Governments as policy variables, because Governments are not to be trusted and they are not very competent.
My Lords, when I was a student in the early 1980s here in the UK, I visited my father who was commanding a mountain division. He was the major-general at the Chinese border, and his role was to protect Bhutan. We went to visit Bhutan, one of the most fascinating countries I have ever visited —Shangri-La on earth.
Five years ago, I was in India. Prime Minister Narendra Modi was hosting a conference, “Vibrant Gujarat”; I heard one of the most memorable speeches of my life, given by the Prime Minister of Bhutan, Mr Tshering Tobgay. He said:
“Bhutan is a small country, tucked away in the Himalayas, sandwiched between the world’s two largest countries, India and China. Our economy is” less than $2 billion. He said that there were many people in the audience worth much more than his country’s GDP, and that he knew that Bhutan’s economy is small,
“but we have used our limited resources wisely.”
He went on to say how they have achieved economic growth, social progress and democracy, and then said:
“Our … King has famously said, that for Bhutan, ‘Gross National Happiness is more important than Gross National Product.’ Gross National Happiness has attracted considerable attention and interest, both within our country and from abroad. And so scholars and philosophers, politicians and economists, have offered to define GNH in countless ways, but His Majesty the King has repeatedly reminded us that Gross National Happiness simply means development with values.”
I thank the noble Baroness, Lady Tyler, for initiating this debate. I wish my noble friend Lord Bird all the best with his Bill about well-being for future generations; it is terrific.
In 2011, Prime Minister Cameron said that the UK would
“start measuring our progress as a country, not just by how our economy is growing, but by how our lives are improving; not just by our standard of living, but by our quality of life.”
The ONS has developed measurement frameworks consisting of 10 domains and 38 measures of well-being following national consultation. We have these well-being indicators: personal well-being, relationships, health, what we do, where we live, personal finance, economy, education, skills, governance and environment. In February 2020, the What Works Centre for Wellbeing published a report about the lessons, as did the Commission on Wellbeing and Policy in 2014. We have seen shifts in policy and public opinion towards mental health, community, promoting volunteering, addressing loneliness, income, work, economic growth, unemployment through active welfare, well-being at work, governance, and treating citizens with respect and empowering them more—so we are making progress.
“I will try to create more happiness and less unhappiness in the world around me.”
“Recent research into brain functioning has confirmed that we are hard-wired for love and compassion … When we’re kind to people we know it strengthens our connections with them and provides a source of support … Doing kind things for strangers helps build co-operation, trust and a sense of safety in our communities … Mindfulness has been shown to help us be healthier, less affected by stress, more relaxed, more creative, more open to learning, sleep better, improve our relationships with others and feel happier and more satisfied with our lives.”
We heard that very clearly from the noble Baroness, Lady Burt, who attended the mindfulness course in Parliament, which the head of my team, Monica Sharma, also attended and was glowing about. Hundreds of parliamentarians and members of staff have attended this course, run by the Oxford Mindfulness Centre, free of charge.
As Chancellor of the University of Birmingham, I consulted one of our academic staff members, Daniel Wheatley, at the Birmingham Business School, who is an expert in this field. He said that well-being
“is closely linked with definitions of ‘happiness’ and ‘quality of life’, and incorporates both physical … and psychological well-being which is concerned with our mental health and happiness … Mental health costs to the Department of Health and Social Care equate to around £12bn per year … which reflects around 10% of overall spending … poor mental health and well-being include those associated with crime, lower educational outcomes, reduced access to work ... Work is central to the health of individuals, organisations and society … work could be designed and organised in a way that would allow it to be undertaken without having a negative impact on employee well-being and could potentially promote or enhance employee well-being.”
He said that work is good for you and that recent evidence from the 2019 UK Working Lives survey shows a “positive impact” on well-being and health, but also that work can act as a “significant stressor” and cause “negative health impacts”.
He went on to say:
“Poor quality staff health and well-being has” huge cost implications in the UK. For example,
“absence caused by sickness and injury in 2018 equated to … 141.4 million working days”, with a
“significant proportion of absences related to minor illnesses”.
We are talking about coronavirus at the moment but, as Daniel Wheatley said, minor illnesses such as colds and flu constitute 27% of the total absences, musculo- skeletal problems such as back pain constitute 20%, and 12% of working days—17.5 million working days—are lost as a result of “stress, anxiety or depression”. He said that the Working Lives survey
“shows that two in five workers experienced some form of work-related health condition” at the time, and states that low quality of work and mental health are estimated to cost £34.9 billion. We have to do something about all these negative aspects. He went on:
“The costs for organisations … associated with low quality health and well-being highlight the potential value … in improved health and well-being”.
We have the well-being measures that we have spoken about: life satisfaction, our relationships and health, and where we live.
In the 2019 World Happiness Report, which the noble Lord, Lord Layard, was involved with, the UK came 15th in the rankings; Finland came first. The report produced by the Commission on the Measurement of Economic Performance and Social Progress by Joseph Stiglitz and my friend Professor Amartya Sen of Harvard, says that the
“key message, and unifying theme of the report, is that the time is ripe for our measurement system to shift emphasis from measuring economic production to measuring people’s well-being. And measures of well-being should be put in a context of sustainability.”
It says that well-being is “multidimensional”, and:
“All these dimensions shape people’s well-being, and yet many of them are missed by conventional income measures.”
When my father retired as commander-in-chief of the Central Command of the Indian Army, with 350,000 troops under his command, I visited him and saw that everyone was happy. Everyone was smiling. I said, “Dad, what’s your secret?” He said, “Son, the secret is not just having an efficient team, but having a happy and an efficient team.”
My Lords, I congratulate the noble Baroness, Lady Tyler, on securing this debate. It is an important subject and we have heard so many interesting speeches already.
“The welfare of a nation can scarcely be inferred from a measurement of national income”.
That has to be right. Last year, New Zealand acknowledged this with a ground-breaking well-being budget. Everything that was spent had to be measured by one of five criteria, all of which would add up to a healthier, happier country. New Zealand’s Finance Minister, Grant Robertson, said:
“For me, wellbeing means people living lives of purpose, balance and meaning to them, and having the capabilities to do so.”
The definition of a life of “purpose, balance and meaning” is inevitably somewhat subjective, but the noble Lord, Lord Layard, with all his expertise in this area, made clear the types of metrics which could be brought into play to start broadening our measurements beyond GDP. According to the London School of Economics, the noble Lord, Lord Layard, is an expert on happiness—an admirable accolade for anyone to have, and too rare.
As the noble Baroness, Lady Tyler, mentioned, last August the Children’s Society found that childhood happiness in the UK was at its lowest level in a decade. On a scale of one to 10, the 10 to 15 year-olds who were asked rated their happiness at an average of 7.89 and almost 5% reported scores of below 5. We may still have one of the largest economies in the world, but if around 219,000 children are unhappy, our economy is failing.
We have to ask whether we have got our priorities right. Clinging to GDP as the major key to national budgeting and policy-making is clearly not delivering. Now is an opportune time for a rethink since, after all, the Office for Budget Responsibility is now forecasting that Brexit alone will cost the country a 5.2% loss of GDP over 15 years. If GDP is all-important, our country is going to be in a sorry state, so it would be wise for the Government to broaden their way of measuring their success.
Growth is not necessarily good. We have seen what the unfettered pursuit of growth delivers: drastic climate change, huge discrepancies between the people at the top of business and the rest, and too many people now who are the working poor. Our policy-making needs to focus more broadly. The noble Lord, Lord Bilimoria, referred to Bhutan, which is famous for measuring gross national happiness. While the aim may be worthy, I am afraid that it has not proved an unmitigated success. Some 200,000 people in Bhutan are surviving on less than $1.25 a day—they are probably not too happy. A rise in violent crime there is not destined to bolster the gross national happiness index either.
Nevertheless, government should be interested in fostering the public’s well-being. We know what makes people flourish. The welfare state was intended to provide people with the confidence that if things went wrong for them, they would not be allowed to fall below a certain standard of living. Universal credit may be a good idea in principle, but there is far too much evidence that it is causing misery in this country.
What produces a sense of well-being? Clearly, mindfulness can do that, and we have heard from the noble Baroness, Lady Burt, what a difference mindfulness has made to her life. Exercise, too, is not just a benefit physically but mentally; equally, access to the arts and cultural activities is truly life-enhancing. Lord Lloyd-Webber has pioneered a fantastic scheme for handing out musical instruments to children in troubled schools. The instruments are theirs to keep, and they are having a dramatic effect on the way those children behave. Instead of joining gangs, they join orchestras and have a totally different attitude to life. In Manchester, an enlightened approach to health has led to doctors prescribing museum visits and drawing lessons instead of pills. It works and it is cost-effective. One surgery there is trying a new scheme: sending people home with a pot plant. They find that having something to care for and nurture is a real tonic for those suffering from depression.
Perhaps the clue lies there: the greatest threat to our well-being is loneliness. A study by the Co-op and the Red Cross has found that more than 9 million people in the UK often or always feel lonely. Age UK has found that half a million older people go for at least five or six days a week without seeing or speaking to anyone at all. That is a terrible condemnation of our society. Investing in the rebuilding of our social infrastructure should be a priority for this Government and every successive one.
My Lords, I am grateful to my noble friend Lady Tyler of Enfield for enabling us to have this debate. Most people tend to think of well-being in terms of having a secure home, a rewarding job with some prospects, a good-quality education, access to a health service when needed, and enough money to enjoy life. They see those as being about their quality of life, and that quality of life suffers if they have poor housing, a low income or poor connectivity to get to, say, further education. As we have heard, the Government want to deliver people’s ambitions, but they prefer to assess their performance in terms of gross domestic product because growth drives tax income and the Government’s public spending. The consequence of this approach is a loss of environmental and social priorities as part of the measurement of success.
In a recent lecture at Northumbria University, Paul Polman, for 10 years the chief executive of Unilever and now the co-founder and chair of IMAGINE, a benefit corporation and foundation accelerating business leadership to achieve global goals, issued a welcome call to businesses to reinvent capitalism for the good of society generally. He showed that the companies demonstrating growth in most economic markets are those with clear social and environmental objectives. He has also shown that responsible business models can create more successful businesses and more successful places. Successful businesses, he has concluded, need more equal societies to be successful.
In my view, there is far too much short-term thinking in the private sector, which surely has a social responsibility to support places that are poorer and which feel left behind. I was pleased to be briefed earlier this week by Local Trust, which was founded by an endowment from the National Lottery Community Fund and which is the delivery agent for Big Local. It has as its key objective trusting local people in left-behind areas to decide what help they need the most. Research by Oxford Consultants for Social Inclusion published in August last year by Local Trust under the title Left Behind? Understanding Communities on the Edge showed that areas that suffer multiple deprivation and have few places to meet, be they private, voluntary or public, which lack an engaged community and which have poor connectivity
“fare much worse than other deprived areas.”
This is important research because it recognises that deprived areas can be very different, with some suffering deep structural deprivation that is hard to reverse but which can be if local people lead the process. For me, this is an example of encouraging place-based well- being where local people are empowered to identify their own priorities, define their own solutions and help put them into practice. The solutions may be about places to meet or perhaps the provision of transport to improve connectivity. Often, these are places which have not been able to access lottery or statutory funding.
In recent weeks, we have learned from the Marmot review that health inequalities have widened over the past decade, with a slowdown in life expectancy. We have learned that south-east England has had half the gain in new jobs over the past 10 years, while we have learned from an OECD report that Britain has the widest regional inequality of any advanced nation. We have learned from the Office for National Statistics that the median income for the poorest 20% of people fell by 4.3% per year over the two years to March 2019. Moreover, we have learned from the UK2070 Commission of the coming opportunity to retrain the 4 million workers in the Midlands and the north currently in carbon-intensive jobs into work in new green industries.
The delivery of well-being for all needs clear leadership from the Government and adopting a strategy that addresses the inequalities between places. It needs all Whitehall departments to adopt well-being standards in their planning and establishing agreed reporting mechanisms. As the noble Lord, Lord Layard, said earlier, pursuing well-being should be the main objective of any Government: it is in their interests to adopt it.
My Lords, I congratulate the noble Baroness, Lady Tyler, on securing this debate, which has been universally excellent. I particularly commend the noble Baroness, Lady Wheatcroft, for her contribution and I enjoyed her reflection on the importance of culture to our lives. That is even though she has pre-empted me with a quote from Simon Kuznets which bears repeating. We should remember that he was a Nobel laureate who helped to create the measure of GDP. He said that
“the welfare of a nation can scarcely be inferred from a measure of national income.”
It is interesting that we have heard from all sides of the House and people from many different political perspectives an acceptance that GDP is a very poor measure of well-being, yet this morning I opened a newsletter from a left-wing publication, which—as you might expect—was attacking the Government over the Budget. Its top line of attack was: “Growth is anaemic and down substantially on previous forecasts.” You might have expected this publication to be attacking on universal credit, regional disparities or child poverty—many of the things we have heard reflections on from noble Lords—but its top line was GDP.
The idea that what matters is the economy is deeply embedded into our national politics. Should an alien land on earth and look at our newspapers and television screens, it might well think that we all existed to be servants of the economy. We have this turned around the wrong way. The economy is and should be there to deliver a decent life for our societies and to deliver us a secure future.
The noble Lord, Lord Tugendhat, suggested that we have difficulty agreeing on what measures would be included in well-being. I respectfully disagree with him, because the whole world has agreed on measures of well-being: the sustainable development goals signed up to by the world’s nations. When we talk about them in your Lordships’ House and elsewhere in the UK, we tend to talk about this as something for DfID and the international development community to think about. But I refer your Lordships to a report from the UKSSD network, which considered whether the UK would meet any of those goals by the target date of 2030. The answer is no.
Many noble Lords have referred to potential difficulties and questions about how to measure well-being. It is worth taking a little time to consider this, something the APPG on Limits to Growth has done considerable work on. One option is multiple indicator sets, which the SDGs are. That is my preferred option, because it accepts that there are trade-offs here. You cannot have everything, so you have to look at how things affect each other. Alternatively, you can have aggregated non-monetary indices—essentially a single number that is a measure of well-being—but you will very quickly get bogged down into questions of the weighting in that figure. You can also have aggregated monetary indices such as the genuine progress indicator, but that involves putting a financial value on everything. That is a very dangerous path.
We can also look at subjective measures of well-being. I am sorry that the right reverend Prelate is not in his place, because on graphs of salaries versus people’s judgment of personal well-being, the clergy is very high up—so are fitness instructors and play workers. Economists and financial managers do very poorly.
I point noble Lords to the European Economic and Social Committee’s own-initiative report The Sustainable Economy We Need. It calls for a “Green and Social Deal” to achieve
“a just transition to a wellbeing economy.”
This is being discussed around the world.
But these are very abstract terms. We need to be concrete when talking to people about the well-being economy. The noble Lord, Lord Bird, was very powerful when he said that you cannot put poverty and well-being together. People in poverty do not have a basic level of well-being. That is why I believe that security—freedom from the fear of not being able to put food on the table and keep a roof over your head—has to be a basic element of a well-being society. That is why I believe in a universal basic income. I also believe strongly in equality as an essential. The Spirit Level was an excellent book that explored how everybody does better in a more equal society.
We had a powerful lesson in our rather detailed discussion earlier today about cleaning and coronavirus. We are all now utterly dependent on the well-being of cleaners—people who in our society are on average very low paid and often on insecure employments.
We also need a healthy environment. That is not just a cuddly thing about it being nice to have trees and flowers. We have increasing evidence that a biodiverse, green environment makes us physically much healthier.
I conclude with a final thought: there are enough resources on this planet for everyone to have a decent life, for the well-being of all, if we share them out fairly.
My Lords, I declare my interest in the register as chairing a large learning disability care provider. Some of my remarks will follow the theme of the right reverend Prelate the Bishop of Portsmouth, who is now back in his seat, so that was admirable timing.
It has been a fascinating debate to prepare for. I confess that, like many in the sector, I have used the term to talk about some warm, woolly added value, as used in health, care and other areas of social policy. The UK Office for National Statistics defines well-being as having 10 broad dimensions that have been shown to matter to most people in the UK. The noble Lord, Lord Bilimoria, outlined these. A particularly important dimension is personal well-being, which we define as how satisfied we are with our lives, our day-to-day emotional experiences and our wider mental well-being.
In this debate I will talk about adults with a learning disability, particularly those whose care is funded by the state. In saying that, I record my huge disappointment that after the Budget yesterday there is still no clarity on social care funding. It is worth noting that when government talks about people with learning disabilities, there is a pattern of adding “and well-being” on to discussions about health, where well-being is not defined and only health outcomes are then measured. So I congratulate my noble friend on securing this debate; this is a worthwhile topic.
For too long, economic measures have been used to guide policy-making. This does not reflect what matters to the public. I would like to stretch my noble friend’s debate title to include the use of well-being in commissioning services. Yes, economic growth is important, but people want secure housing, stable work and the ability to pursue meaningful interests outside that.
About 50% of people with a learning disability have at least one significant health problem. People in this group are more likely to die prematurely than those in the general population. A holistic well-being approach as the guiding principle of policy and commissioning services would help reduce these inequalities. I would welcome the Minister’s view on this. Two issues are at play here: the well-being of those with learning disabilities and, often forgotten, that of those who care for them. For adults with learning disabilities it is important to define what well-being means. Too often in policy documents, “and well-being” is tacked on to health outcomes without a clear definition or a strategy.
There is great diversity within this learning disability population, and therefore we need a range of tools. Some people’s lives can be vastly improved by offering them paid employment, properly supporting them to gain life skills that could be translated into more meaningful work. Here I draw noble Lords’ attention to Project SEARCH, which works to find employment for those with a learning disability. This is used by our teams in Bradford and Flintshire, placing young men and women in meaningful employment and instantly ticking off seven of the 10 components of well-being.
I would like to tell noble Lords the story of a young woman whose job it is to ensure the Perspex cots that newborn babies are put into are properly sterilised after use. I commend Bradford Royal Infirmary on all its work in encouraging people with a learning disability to work. This young woman told me in great detail and with enormous pride about her job. The lead obstetrician commented that she brought a level of humanity to the department. Again, well-being wins all round.
Another young man got a job and his parents were increasingly anxious because he insisted on going by public transport from home to where his new job was. They spent a week teaching him which buses he could catch and where the bus stop was. They practised it several times. The morning arrived, Mum waved him off and closed the door, ran to the back of the house, got in the car and followed him all the way there. I agree wholeheartedly with the noble Baroness, Lady Tyler, that well-being should be the driving force of such initiatives.
Sometimes volunteering can offer a sense of purpose. However, it is important that individuals who are doing what should be paid work are not exploited simply because they have a learning disability. Improving the workplace well-being of the carers who look after the everyday needs and well-being of adults with learning disabilities undoubtedly improves the lives of those with learning disabilities. A workforce who feel that they are valued and in stable employment will have a lower turnover rate, improved quality of care, better attendance and less need for agency staff.
As we have heard quite recently, there is a context in which care workers are undervalued, with little room for career progression. This demonstrates just how low a priority the well-being of workers in this sector is. I remind noble Lords that although care work is poorly paid, it is not unskilled. If you watch people who care for adults with learning disabilities, you will see that they are using family caring skills. I hope that the Home Secretary now has this message. Well-being is as important to someone with a learning disability as it is to everyone in this House.
My Lords, when I put my name down for this debate, I was thinking, “This is a good topic, there are lots of interesting things here”, but what exactly is the topic? We are talking about well-being. The noble Lord, Lord Tugendhat, pointed out that whoever compiles a list about well-being will bring with them their own prejudices. I may be putting words in his mouth. Ah, he is nodding; thank God for that. But we bring our own perceptions to this. I asked myself, “Do I talk about the barriers?” My interests have been aired far too often—learning disabilities, special educational needs and the barriers to entering employment—and I have had a couple of goes at them in the last week, so I will look at something else, which adds to what we are doing.
The noble Baroness, Lady Wheatcroft, did not pull the rabbit out of the hat but she did wave its ears over the brim, when she talked about exercise. A very important part of my life has been the organisation and playing of sport. It gives purpose, providing all the benefits of exercise—a wonderful way of countering many of the things that lead to mental illness—and social interaction. You have a group that you can go back to, even when you are not involved in the activity. I could talk about the virtues of rugby union and how, if you carry on playing, you keep physiotherapists in a good income for a long time.
These benefits are probably true of any sport, and any amateur activity—music, arts or any hobby. We should encourage them. Where do the Government come in? In this country, the Government get off lightly when it comes to sport, because we build and maintain our own clubhouses and pitches. In France, you play at the stade municipal. Germany’s equivalent of the FA, when asked how much it spends on pitches, said, “We don’t. The Government do it for us.” Most places in Europe have huge activity by Governments to ensure that these social interactions happen. In our country, local government, the backbone of all this, is squeezed, and the huge facilities in parts of our education system are not open enough for people to use them.
We then have the problem of the arts people not talking to the sports people. There was a point of revelation in our DCMS cluster, when someone was complaining about a lack of rehearsal space for an acting project. I said, “Have you spoken to your local sports club?” “Why?” “Because they have a clubhouse. They will lend it to you, or you can rent it from them. If you have a drink in the bar afterwards, which usually funds their activities, they will be keen to have you there.” The Government are not taking a lead in ensuring that these people talk to each other. These people are part-timers, so have the problem of fitting in their work and this activity. They do not have the time or energy for this. Political parties like to talk to themselves about themselves. We have all been in that room. Amateur groups for sports or the arts are the same; they talk to themselves about themselves, say somebody else should help but do not know how to communicate with them. The Government must take a lead here.
Another thing that mitigates this is the gig economy. It is great; you can dictate your own times if you are, for example, a well-paid computer nerd. I use the derogatory term, but I mean someone well paid who commands their job. If you are driving a taxi and being paid only when people want that taxi, your livelihood is controlled by when other people want you. If you are an on-demand, no-contract waiter or barman, you must wait around to be needed and cannot fence off time for your hobby. We must give better rights to these groups to ensure that these activities take place. Put bluntly, a cricket team with nine men does not win very often if it has lost two people to work in the local pub. The same is true of losing your leading man in a theatrical production. We must ensure that there is a better way of focusing and allowing people to do these things, because it enables them to have a slightly more pleasant life. As the noble Lord, Lord Bilimoria, said, productive workers tend to be happy workers. Most people will not get all their satisfaction from their job, but from something outside. We must look outside the workplace to ensure that our workers are at their best. That will generate a bit more income and ensure that everybody is a little happier.
My Lords, your Lordships will be aware that I have been an advocate of mindfulness and yoga for many years, in the knowledge that mind and body are one and that you should care for each for the sake of the other, as spoken about beautifully by the noble Baroness, Lady Burt. Every year about 850 scientific articles on mindfulness are published. These studies have consistently shown that from just eight weeks of mindfulness practice there can be significant increases in well-being. Mindfulness has proven a radically popular approach to treating poor mental health at one end of the well-being spectrum and supporting flourishing at the other. It is now routinely used by corporations to help reduce stress and improve well-being, as well as boosting performance among their people. Organisations such as HSBC, GSK and SAP all have established mindfulness programmes, with SAP citing a 200% return on investment in its mindfulness programme.
However, there is a societal divide that needs healing here, as addressed by the noble Lord, Lord Bird. Yes, there are those receiving mindfulness training through the NHS to treat recurrent depression but, by and large, the people accessing mindfulness training are generally in the affluent middle classes, who have heard about it and can afford it. The lack of public funds or co-ordinating policy to widen access to those who cannot afford it, but arguably need it most, is creating greater inequalities in society. Well-being inequalities are interrelated with social and economic inequalities, so are every bit as serious. We need a wider and deeper concept of what it means to be a fair and equal society—one that includes well-being, emotional intelligence and self-regulation capacities, which underpin citizens’ ability to thrive.
Similarly, national surveys investigating the health characteristics of yoga consistently reveal that practitioners’ experience improved mental and physical health, which ultimately reduces their healthcare utilisation. It saves money in the long run for the state and local authorities. Yoga requires practitioners to stay present with a host of sensations and emotions and provokes neuroplastic changes. Practitioners are thereby more empathetic towards others and report a greater sense of connectedness to the world in general. These findings indicate positive social, health and financial outcomes, which equal well-being. To increase well-being, then, yoga and mindfulness should be rolled out nationally in schools and the NHS.
That brings me to a wider point. Unfortunately, current conceptions of well-being tend to combine hedonistic, subjective measures with good functioning; thence meditation and yoga are often used as a drug to deal with stress and enable one to get on with the painful job of living. That is not holistic enough. Yoga and mindfulness were developed within ancient wisdoms that saw the benefits of developing the spiritual and relational dimension of being human. Well-being is more than pleasure and good functioning. It should be constituted by deeper spiritual features of our lives, such as the quality of our consciousness; our sense of ourselves as persons; our lived emotions, especially joy, hope and love as opposed to fear, sadness and despair; and, importantly, our relationships with each other—the sense of belonging to our communities and an experience of oneness with all that is.
Economic growth for its own sake does not make sense humanly or environmentally. A holistic understanding of human well-being must be the basis for developing indicators. These should include a human’s spiritual well-being and our oneness with the natural universe. Government policies to improve people’s lives should be designed around such experiences and purpose. In particular, education in schools, rather than just testing performances that turn students into exam machines—the pressure of which has partly been at the root of their ill-being—must stress the spiritual and relational aspects mostly missing from pupils’ current educational experience. That should include nurturing human consciousness, interconnection and oneness, as well as cultivating relational appreciation across difference. An excellent programme to help enable teachers to introduce such concepts into the classroom is already being rolled out in many of our schools by an independent organisation called Loving Classroom. To widen its adoption in schools, perhaps the Minister might accept a meeting with this flourishing organisation utilised by many schools in the UK and other countries.
If, after good schooling, one finds in life what one enjoys doing, what one is good at, what the world needs and how one can earn money from doing it, it will provide well-being for oneself and others. It comes from a system called Ikigai, from Okinawa, where people live longer and for many more happy years than any other place in the world. Perhaps we should look into that more closely.
Finally, we are what we eat. Trillions of bacteria live in our guts. We know that these can be altered by diet to promote well-being. Again, there are thousands of published research studies showing how prebiotic and probiotic interventions can have positive effects on our well-being. They address coughs and colds, eczema, inflammatory bowel disease, bowel cancer, obesity and even mental illness. The International Scientific Association for Probiotics and Prebiotics brings together leading scientists in gut microbial research to enhance understanding in this area. As such, there are many useful resources available on its website. That would be another route to national well-being that the Minister might have the department examine, thereby increasing well-being and saving money and resources in the long term.
My Lords, I thank the noble Baroness, Lady Tyler, for introducing this important discussion. In 2013, I co-authored a book with my son called How Much is Enough?, so I have a continuing interest in the limits of GDP as a measure of a good life. Before we embark on a programme to improve people’s well-being, we should be aware of the considerable pitfalls in this endeavour, starting with the definition of the term itself, to which other noble Lords have alluded.
The only sensible definition that I can think of is “a state of contentment or happiness with one’s circumstances or in the way that one’s life is turning out”. I emphasise that because it is an entirely subjective state of mind. It is therefore wrong to think of well-being as having both a subjective and objective component. That is simply a mistake in thought. There are measurable, objective conditions for good states of mind and those are within the scope of policy, such as better health, less insecurity and less frantic pressure for change; a point mentioned by the noble Lord, Lord Tugendhat. But the connection always needs to be argued and based on evidence, not just assumed.
For example, it is implicitly assumed that economic growth is a necessary and sufficient condition of well-being. But suppose it is neither necessary nor sufficient? Suppose that we had a better quality of life if we had de-growth with a lower quantity of goods and services available. That point is never acknowledged by the advocates of well-being. My second point was made by the noble Lords, Lord Tugendhat and Lord Desai, about welfare as a measure of well-being. It was realised in the 19th century that an aggregate quantity of goods and services is not a good measure of welfare because welfare depends on how they are distributed. That gave rise to welfare economics. Over the last 30 years, the growth in average real income per head has been accompanied by a marked increase in inequality. Is that a good or a bad thing? Most of us would argue that the rise in inequality represents a fall in aggregate welfare, but how much of a fall? Welfare economics cannot say anything scientific about that and it is a matter of political judgment. So there is another point of difficulty, and the connection between welfare and well-being is another black box.
So, what can and should Governments do? Happiness researchers ask people what things make them happier, less happy, not very happy, not at all happy and so forth, and then rank their replies. Those replies serve as indicators of policy. The noble Lord, Lord Layard, has done so much, importantly, to open up this subject. He found that the seven big factors affecting happiness, in order of importance, were: family relationships, financial situation, work, community and friends, health, personal freedom and beliefs. An interesting finding was that people who believed in God were happier than people who did not, although I know of no policy being advocated to encourage that particular source of well-being.
Three of the noble Lord’s seven factors—financial situation, work and health—are directly related to economic conditions. The remaining four—family relationships, community and friends, personal freedom and belief—are weakly connected to economic conditions and, in some cases, not at all. So, policy should focus on creating those undisputed material conditions of a good life for all. They are the conditions of financial security, work security and health security. None of them, incidentally, involves adding new items to GDP: they increase GDP and well-being simultaneously.
The noble Lord, Lord Layard, says in his book that
“Unemployment … reduces income but it also reduces happiness directly by destroying self-respect and social relationships created by work.”
Even when in work, people fear unemployment and when unemployment goes up it has a major impact on the happiness of everyone, including those in work.
So, low and stable unemployment must be a major objective for any society. In the past 40 years it has not been a major objective of our kind of society, even though in 1997 all the Prime Ministers in the European Union agreed that Governments should guarantee their populations work or training. That pledge has not been followed up. Only Denmark, Holland—and Hungary, interestingly—have made any steps in that direction. It is about time we started.
My Lords, I shall speak briefly in the gap. I thank the noble Baroness, Lady Tyler, for tabling this interesting debate. As growth is considered not only essential but positive, there is a need to think about how it is achieved and at what cost; recognition of that measurement itself should not be the end goal.
With 10 UK national well-being indicators across all departments, the goal is to drive a more robust agenda, so we can make the UK an even better country. Putting people’s well-being at the heart of policy requires better data and adapting the methods through which policies are formulated, appraised and evaluated. The caveat is that investment will be made only if leaders are convinced it will result in better policy decisions and thus better outcomes for people. It is about bringing well-being monitoring efforts closer in line with policy by producing shorter and more communicative dashboards of indicators that are timed to coincide with strategic decisions, and shifting priorities towards employment, which has a long-lasting impact on our well-being. I am pleased that at last, mental health is recognised as one of the top drivers of well-being, from childhood through to adulthood. There has been a seismic change in how we treat mental illness—as professionally as we do physical health. On loneliness, having someone to rely on in times of need can make the difference between high and low well-being levels.
Another part of this valuing concept is that wherever you are and whoever you are with, and whatever your cultural background, we all value happiness and well-being. We all need the confidence to thrive and to forge a sense of self-direction, self-achievement, esteem, relatedness and purpose. All these emotions are embedded in our culture. While many things are important to us, some life events, such as losing a job, can have a far more dramatic impact than others on our life satisfaction. Businesses and employers appreciate that a healthy and happy workforce is good for productivity as well as for employees. There is a growing evidence base of what works well in improving the well-being of people in the public, private and voluntary sectors. Good government is about improving the lives of our fellow citizens, and the well-being that makes their lives worth while.
My Lords, I too congratulate my noble friend Lady Tyler on securing this important and interesting debate. I thank her for her introduction to the enormously wide-ranging debate we have had over the past two and a half hours. Noble Lords who are not Liberal Democrats might want to know that she practises what she preaches. She led a policy working group inside the party a few years ago to make sure that all our party policies looked at well-being and social inequality. That is why as a party we stand full square behind her.
My noble friend made a number of points. For me, the most important was what she said at the start that this debate: that this debate is timely and not new. Over the years, many people have tried to grapple with the difficulties that the right reverend Prelate the Bishop of Portsmouth described: hard and soft data, the outcomes and how we manage that. I am grateful to the noble Lord, Lord Skidelsky, for challenging us on some of our thinking. Professional economists can see things much more clearly than the rest of us who are struggling to make things add up and work out. Today’s debate has demonstrated that across all parties and none in this House we see that well-being is critical to the success and future of our people and our country.
It was a pleasure to hear the noble Lord, Lord Layard. Like many colleagues, I am in awe of his expertise on this. I will come back to QALYs later on, because I have a particular issue about them. He is right that it is all about the quality of relationships, whether in your community, at work or between Governments and other people. The moment we start to think about well-being in them and all the issues that make it up, it becomes extremely important.
My noble friend Lord Addington talked about sport and the reduction in children’s happiness, and he spoke a little about education. It is interesting that the reduction in children’s happiness shown in the Children’s Society’s regular survey coincided with Governments’ focus on STEM and the reduction and removal of arts, music and dance from the curriculum. They were the spaces in our school system where children learned about well-being with each other and about how to practise it outside and as they grew up. Speaking for colleagues who are passionate about the creative and sports worlds, I regret that those subjects are sadly lacking in our schools at the moment.
The noble Lord, Lord Stone, talked about yoga, which was interesting. Before I was wheelchair-bound, I used to take part in T’ai Chi for people with disabilities. It combines physical and mental abilities. I always felt better mentally after a session of T’ai Chi. I look forward to the day when I can do it again.
My noble friend Lady Burt outlined her introduction to mindfulness in Parliament seven years ago, which was encouraged by Jo Swinson, who was then an MP. Many people have talked about mindfulness today. It is understood and followed by many people across the country. The noble Lord, Lord Bilimoria, talked about Bhutan and its gross national happiness. Then, in his typical style, he immediately linked it to styles of working and employers. It is extremely useful to have businessmen who see so clearly the benefits of mindfulness and happiness in the economy.
The noble Lord, Lord Bird, spoke about how poverty and well-being are distant bedfellows. I wish him well with his Private Member's Bill, which starts its progress tomorrow. There may be ways in which we can start to mark this through legislation, and it is very useful to look at that.
The right reverend Prelate the Bishop of Portsmouth highlighted the importance of good physical and mental health. For people living with long-term conditions, as I do, depression can be all too common and until fairly recently it was ignored by clinicians, but changes are happening. CBT and other things are now not quite routinely but often offered to people facing difficulties over a very long period. I started on a new drug about five or six years ago. I had to inject myself in the stomach, and I had never injected myself before. I was pretty unhappy about it, along with the three-page list of horrors—I am now used to them—that might befall you when a consultant starts you on a new drug, including immunosuppression, cancer and various other things. Of course people with long-term conditions faced with such a list have difficulties. The pharmaceutical company that provided the injections also provided a mental health workbook, and for the first six months on the drug there was a helpline where someone called me and I could call them. When I asked the company why it did that, it said that it was to keep me on the drug. If it could support patients in the early days of trying something new, they would feel better about it, which is better for the NHS, because patients were not chopping and changing and needing help, and it is better for the pharmaceutical company because it has long-term customers. So there are some very specific things where starting to think about people’s well-being becomes important.
An excellent report from the Mental Health Foundation sets out how essential mental health is as a component of well-being. Tackling Social Inequalities to Reduce Mental Health Problems states:
“Public mental health is the art and science of improving mental health and wellbeing and preventing mental health problems through the organised efforts and informed choices of society, public and private organisations, communities and individuals.”
It goes on to say that despite the fact that “The evidence is clear” that
“Inequalities can influence and sometimes directly cause mental health problems ... The good news is that it is possible to act, collectively and individually, to reduce inequalities in mental health effects thereby improving the mental health of the population.”
My noble friend Lady Jolly commented on an incredibly important part of the community that is so often ignored in relation to well-being: those with learning disabilities. I want to highlight the work of learning disabled champion Ciara Lawrence, who is an outstanding young woman. She talked a few months ago about the experience of having a cervical smear. We know that the health outcomes for people with learning difficulties are frequently poorer because, very often, they are at the back of the queue for the routine, public health things that everyone else has. Ciara did not influence just her own peers; she influenced the medical profession by publicly talking about it. She has started to change the attitude of those working in these fields with adults with learning disabilities—good on her.
I like the idea of QALYs. For years, I have been arguing that they ought also to be used by the DWP and BEIS when we look at the wider benefit of medicines in communities. The problem with a QALY is that it does not look at the economic benefit of getting somebody well. How might that manifest itself? When I was first advised to use a wheelchair, I was not allowed an electric wheelchair on the NHS because I could walk from my sitting room to my kitchen with a stick—but I could not get to work. That seems a short-sighted thing about QALYs; NICE says that you can mark things in this way, but that decision could have prevented me from being economically active had I not been able to get a chair myself. That would have had adverse effects on my contribution to society, my personal well-being and a whole string of other things. We need to tackle QALYs much more across the board rather than purely in health terms.
I mention briefly the four golden rules for surviving coronavirus suggested by the right reverend Prelate the Bishop of St Albans. As he says, they are not the official advice, but I think they absolutely summarise a key approach to well-being: protect and support our neighbours; think of those who are worse off than us and try to help them; do not panic—he says do not hoard food either—and live today and each day to the full because none of us knows about the future, and never give in to fear. These are also good well-being messages for life. They are not just something that his parishioners in St Albans should be thinking about. This is much more about wider society and how, as the noble Baroness, Lady Bennett, said, we think about how we are going to manage during the coronavirus outbreak.
I end with a sentence on the Marmot review, 10 years on. It is absolutely vital that we listen carefully to the recommendations from the Marmot review group following the things that we did not achieve the first time around. Every single one of those recommendations has been addressed in the debate today. We do not have time to go through them, but it is absolutely vital that we use Marmot as the road map to secure well-being for our country.
My Lords, I join others in thanking the noble Baroness, Lady Tyler of Enfield, for securing this debate, which has enabled us to discuss this important issue today; I congratulate her. My noble friend Lord Layard talked about the point of Government—which is of course the well-being and happiness of the people. I agree with that very much. I agreed also with his point that all Governments are attracted to things that are in their own self-interest. All Governments do that. They need to fundamentally rethink their priorities and the methodology used to decide those priorities, to ensure that direct measures of well-being are included in what they do. As we have heard, such thinking has been used in the NHS for many years; the more the Government do the same, the better.
As we have heard, our gross domestic product—GDP—has been the usual performance indicator used in recent decades, although there have been recent moves to widen how we measure national performance. There are limitations to just using GDP, as many noble Lords have said, with its measurements based on the three different approaches of income, expenditure and production. While this measurement is a key performance indicator of the overall strength of the economy, it is not enough on its own. That has been generally accepted by everyone who has spoken today. As we have heard in this debate, it is recognised by many that this fails to capture other things that are of value to society, and captures some things which may not be of such value. The right reverend Prelate the Bishop of Portsmouth is correct that while policy is decided in Westminster and Whitehall, it can feel very different on the ground where the policy is in place. The pressures on young people, which he talked about, are huge and very worrying. The fact that in recent years we have spoken about mental health much more freely is a good thing. More needs to be done.
I had not read the report from the Children’s Society, to which the noble Baroness, Lady Wheatcroft, referred. She shared some really alarming figures showing that so many young people are so unhappy; that cannot be something we want. I left school a very long time ago. When I meet young people now, they have such different experiences of life. It is not healthy that they often spend hours in their bedrooms playing on their computers, iPhones and iPads. I am guilty of those things—I play on my iPhone as well—but equally, when I was a young person, I did lots of other things. I got out of the house and went to football and cricket. These are the kinds of things all young people should be doing.
The gang culture also affects so many parts of our communities—including communities close to this House. On the Wyndham estate in Southwark, which is on one side of the Camberwell New Road, you will meet young people who have never crossed that road and walked into Lambeth—because another gang runs Lambeth and they are terrified of them. That is a ridiculous situation, just two or three miles from where we sit today. It is very worrying.
Let us consider the amount of voluntary work that is done, where people support relatives and others in the community. There is no payment, no money changes hands, but this is vital to our well-being and we would be considerably poorer if that work was not done. The work that the noble Baroness, Lady Jolly, mentioned with people with learning disabilities is also very much in that vein.
I was interested to read in the excellent Library briefing for this debate about the work in many other nations over many years, including that of the French Government in 2008, setting up the Stiglitz-Sen-Fitoussi commission, which found that the time was ripe for new measurements of the system—for shifting the emphasis from measuring economic production to measuring people’s well-being. There has been a general move since then on the international scene for additional indictors or measures of performance to supplement GDP and other more established measures. Progress has also been made in the United Kingdom.
Some welcome initiatives were undertaken by the coalition Government to measure national progress not just by economic performance but by our quality of life. The noble Lord, Lord Tugendhat, talked about how we achieve national well-being. He made a very honest, welcome and good point about the austerity agenda pursued by the Government from 2010. I know the case that the Government made for doing that but, looking back, that approach could have been tempered. It is important to recognise that sometimes we have to go beyond the argument of balancing the books.
In November 2012 the Office for National Statistics published a first report looking at life in the UK, and it published another in 2016. It was interesting to see the changes that had been observed over that period. I will name four indicators: there were improvements on measurements such as the employment rate, as well as deterioration with measurements such as satisfaction with the National Health Service, and there had been a decrease in disposable income but a welcome fall in greenhouse gas emissions.
Using well-being as a measure for informing policy priorities and goals has considerable merit in validating decisions and enabling better choices to be made when used alongside more traditional measures, as well as making good economic sense, as many noble Lords have said. Economic and non-economic indicators are used to enable better policy-making outcomes and a more accurate picture of how our policy decisions affect people’s lives on the ground—the very point made by the right reverend Prelate.
The OECD suggests potential benefits of considering well-being indicators in a policy context: this provides a more complete and coherent picture, highlighting such things as inequalities and diverse experiences. All these things are very important, if we are to make better policy.
When the noble Lord, Lord Bird, spoke he reminded me of when I was very young, seven years old, and we moved out of private rented accommodation and into a council property, in 1969. That move was transformative: my siblings and I had lived in quite cramped conditions, and for the first time—all of a sudden—we each had our own bedroom. The property was clean, safe, warm, dry and had a rent my parents could afford. My parents worked every day of their working lives to enable their family to survive and thrive. Now my siblings and I are all home owners, and all much better off than our parents; living in that council property really helped us. My parents now live, retired, happily back in Ireland where they came from to the UK in the 1950s.
I often ask questions here about council housing, and the need to build more homes on social rent. I know I disagree with the Government on this, but I think the affordable rent model does not work. We need to move much further, and look at this more.
The point made by the noble Baroness, Lady Wheatcroft, about loneliness is very well made. Loneliness destroys people’s lives, and tackling it should be a priority for all Governments, as she said. I agree with her on the importance of art to stimulate young people and get them engaged in more positive activities. When I was first elected to Southwark Council in 1986, my first vote was to end the ridiculous dispute with Sam Wanamaker and build the Globe theatre. I am very proud of that, as it is a wonderful theatre on Bankside. The Globe’s wonderful education department engages with young people from schools in London and beyond. That means young people can see the works of Shakespeare, go to the theatre and see a live performance for the first time. Arts education like this is really important. The Fabian Society has published a report, Primary Colours, which looks at the question of arts and young people. It states how important arts are for stimulating young people and giving them other things to do. I very much welcome that.
The noble Lord, Lord Bilimoria, is right that work is good for people. It is much better to work, if you are able to, than to sit around not working. I used to have a Saturday job when I young—they have all gone now. I used to work in a clothes shop where I learned to talk to people and handle money. These things are all good, and there needs to be more of it.
In the few seconds I have remaining, I thank the noble Baroness, Lady Tyler of Enfield, for her Motion today. This has been a fantastic debate. I look forward to the response from the noble Baroness, Lady Scott of Bybrook, who I congratulate on her appointment to the Government.
I thank everybody in the Chamber who has taken part in this debate. I note how insightful, wide ranging and extremely interesting it has been. I particularly thank the noble Baroness, Lady Tyler, for proposing the debate, but also for the work she has done in this area over many years—thank you. In the interests of the well-being of noble Lords, I will try to keep my closing remarks as succinct as I can.
The first duty of government is to keep people safe, and to protect and promote the health, well-being and prosperity of the citizens it serves. This was particularly reflected in the contributions by the noble Baroness, Lady Tyler, and the noble Lord, Lord Layard, and in those of many other noble Lords.
Clearly, at times like this, duty comes into sharp focus. Yesterday, we saw how the well-being of the population and the nation was first and foremost in the Chancellor’s mind in guiding his decision-making. We will ensure that the NHS has all the support it needs for the challenges that may lie ahead, and we will make sure we do everything we can to keep supermarkets stocked and the economy working.
The debate today has reflected on a range of approaches to defining well-being, as well as on its role as an indicator for measuring performance in guiding policy priorities and in the appraisal of policy outcomes.
As part of the Budget yesterday, we announced a reform to the public value framework, a practical tool for understanding how well public money is turned into policy outcomes. We are currently developing real-world priority outcomes for public services, and we will publish these outcomes as part of the comprehensive spending review later this year. This will include areas where closer working between departments could help achieve better results. It is crucial that increased government funding leads to real-world improvements that make a meaningful difference to everybody’s everyday lives.
We also announced that our assessment of the impact of our spending on these priority outcomes will be central to decisions made in the spending review. For the first time, departments are required to demonstrate how the outcomes of their proposals will drive improvements to public services. I am pleased to say that these reforms will make the delivery of public services a greater consideration for spending decisions than ever before, and put the UK at the forefront of international approaches to driving public value. This will help the Government provide world-class public services, with the best value for taxpayers’ money.
The noble Baroness, Lady Tyler, brought up a number of points about the way we look at well-being. One of the ONS’s largest surveys, the Annual Population Survey, which it did recently, talked about this issue to 150,000 adults in the UK over 16 years old. That measures national well-being, and it was about looking at GDP, but going beyond GDP, to measure what really matters to people. The aim is to produce accepted and trusted measures of well-being.
Noble Lords mentioned the complexities involved. The noble Baroness, Lady Brinton, rightly raised long-term health issues, as well as the Marmot review, which I will look at. The noble Baroness, Lady Jolly, raised the well-being of people with learning disabilities and of course their carers.
The noble Lord, Lord Addington, rightly talked about the importance of arts and sports and about how we can better use community space. I have to say that I would be challenging local authorities to shape the places they work in—now that they are being better funded, they can do a little more joining up in this space. These are all things which are important in some people’s lives but not in others’. The noble Lord, Lord Kennedy, talked about how important housing is, but for some people it is not important.
The noble Lord, Lord Desai, reflected on the difficult question of how we define well-being across our nation. But, difficult though it is to define, we have to do it—we have to find the right questions and try and find answers to those questions.
The noble Lord, Lord Bilimoria, talked about mental health and worthlessness. It is important to look at the differences between what well-being means to different members of our community.
While GDP has been, and will continue to be, an important measure of national economic performance, noble Lords may be aware that in 2010 the Office for National Statistics started the measuring national well-being programme across the UK, as several noble Lords mentioned. The programme measures personal well-being through a number of factors, including relationships, health, where we live, what we do, our personal finances, the economy, education and skills. This gives an insight into well-being that goes well beyond GDP to measure wider factors that have a bearing on people. Monitoring personal well-being across the nation year on year helps to show how people feel their quality of life changes in relation to changes in circumstances, policies and wider events in society.
A number of noble Lords talked about young people. I will take this on board, because they are absolutely right that much of the work that has been done so far has focused on adults and, as we know, young people have a different view on life. That is a very interesting thing that has come out of this conversation, and I will take it forward with those who will listen.
In 2018, the Government published the Civil Society Strategy, intended to help us strengthen the organisations, large and small, which together do so much to support society and our country. The Government are committed to making policies that make not only financial but social sense. The strategy sets out how the Government will work with and support civil society in the years to come, so that together we can level up opportunities across the country.
We are determined to ensure that public spending generates social value in addition to purchasing goods and services. By “social value”, we mean enriched lives for individuals and a fairer society for all. Social value flows from thriving communities with strong financial, physical and natural resources, and strong connections between people. This includes public funding, private investment, buildings and other spaces for communities to use. The noble Baroness, Lady Bennett of Manor Castle, talked about the importance of the sustainable development goals and I hope she can see that that is also what we are looking at in this piece of work.
The strategy also includes trust and good will, and the organisations and partnerships that bring people together. To help communities thrive, the strategy focuses on improving five foundations of social value: people, places, the social sector, the private sector and the public sector. As a result of the strategy, the Government have funded a wide range of organisations, including the police cadets, faith-based organisations and many British charities, to reach vulnerable young people, particularly in deprived areas. Although we have achieved much, we remain committed to implementing the strategy, to deliver on the people’s priorities.
In addition to the Civil Society Strategy, in 2015 the Government committed to supporting the delivery of the UN sustainable development goals, which a number of noble Lords mentioned. The goals are an urgent call to action to improve global health and education, reduce inequalities and spur economic growth. Goal 3 relates to health and well-being and is a pledge to ensure healthy lives and promote well-being for all, at all ages.
This Government believe that the most effective way to deliver this goal is to allow departments to deliver, in particular through their single departmental plans. All departments must report their contributions to delivering the global goals, including goal 3, as appropriate in their departmental annual report and accounts. A number of noble Lords talked about how we are not just talking about this work but delivering it. Departments involved in achieving goal 3 include: the Department of Health and Social Care, which is working with our NHS on programmes for physical and mental health; the Department for Education, which is supporting schools and colleges to promote well-being in children and young people; and the Ministry of Justice, which is working with the NHS to ensure offenders can get the addiction treatment they need.
A detailed record of the progress the UK has made with respect to sustainable development goal 3 is recorded in last year’s voluntary national review. The UK was at the forefront of negotiating the global sustainable development goals and will be at the forefront of delivering outcomes.
A number of other things came up which do not seem to fit into the things on which I have been briefed, but I will have a go at addressing them. Before I do, I want to mention the Green Book; there was quite a lot of talk early in the debate on this. The Green Book is issued by the Treasury and is a world-leading resource used by not only this Government but the New Zealand Treasury and NGOs such as the World Bank. It offers guidance on how to ensure a new policy or project achieves the best outcomes and the best use of public resources.
As part of this, the Green Book incorporates well-being as an important factor in policy-making. It defines a policy’s value beyond narrow financial terms to consider the direct impact of policy on public welfare and well-being. It challenges decision-makers to think carefully about the full range of a policy’s impacts. The relevant costs and benefits are those for UK society overall, not just those for the public sector or originating institution. Decision-makers consider the impact on businesses, households, individuals and the not-for-profit sector. Appraisal is based on the principles of welfare economics—how the Government can improve well-being for all.
As the noble Baroness, Lady Tyler, said, in addition to thinking about new policies we must also evaluate the effectiveness of old ones. Robust evaluation plays a crucial role in maximising the value of public spending and improving outcomes for the public, as my noble friend Lady Redfern mentioned. The Magenta Book sets out guidance and best practice for evaluating policy. It covers various techniques to assess the effectiveness and efficiency of government policies. Like the Green Book, the Magenta Book identifies public welfare as an important factor in evaluating how effective a policy has been and encourages policy- makers to think about outcomes holistically.
As I said, there are a number of other things I would like to address. My noble friend Lady Wheatcroft talked about good infrastructure. She is absolutely right, and I am really pleased to say that £100 billion for UK infrastructure was announced in the Budget yesterday, with £30 billion of that for upgrading roads. As a Government, we realise how important infrastructure and access to all sorts of services, not just health services, are to this country.
My noble friend Lord Dundee asked whether Her Majesty’s Government should include stronger well-being guidance in the Green Book. I think I have made it very clear that that is what we are doing. The noble Lord, Lord Layard, also talked about reviewing the Green Book. It has been reviewed and will be reviewed continually as we move forward. This is an important part of this Government’s levelling-up agenda, which will be a focus of our work in the future.
The noble Baroness, Lady Tyler, talked about well-being being a measure of direct public spending. I hope that what I have said about the Green Book shows that we recognise that. We have changed the Green Book to recognise that even more and will keep this under continual consideration.
I thank the noble Lord, Lord Bird, for his contribution; I always enjoy listening to him speak. Absolute poverty rates have fallen in every region in this country since 2010, and there are now over 1 million fewer workless families than there were then. We cannot be complacent; we have to continue with that. As we all know, it is about not just reducing worklessness but providing good work. The Government are working on that all the time.
The noble Baroness, Lady Tyler, mentioned New Zealand, which I thought might come up. New Zealand had a well-being budget in 2019 and is in fact using our Green Book. Different countries are very different —we are not New Zealand—but we will always keep a close eye on what other countries are doing. We will look at and learn from them, if their activities are relevant to the UK.
My noble friend Lord Tugendhat talked about the French commission. This would create a very rigid and singular part of legislation, so I think it is up to individual departments to create policies and frameworks, using the Green Book if necessary, to make sure all that they do includes well-being of our nation.
I thank my noble friend Lady Redfern. The only other thing that I probably need to say is that I wish I had gone to a mindfulness session before I stood here this morning, so I thank all those noble Lords—the noble Baroness, Lady Burt, and the noble Lords, Lord Bilimoria and Lord Stone—who have sold it to me. It is not just mindfulness that I have to look at but also yoga and T’ai Chi as well.
This Government put the well-being of their citizens high on the agenda. As well as committing to specific action plans, such as the Civil Society Strategy and sustainable development goal 3, the Government provide guidance, such as in the form of the Green Book, on how to proactively embed well-being into policy-making. As we have heard, there is an interesting debate about on how well-being can guide and inform the development, outcomes and evaluation of this policy, and exactly what well-being is to many people and groups of people in this country.
This debate will help us inform the ongoing thinking as to how well-being can be further reflected in the policy-making process. It will, I am sure, be of keen interest to the Civil Service Policy Profession, which promotes policy-making techniques across all our departments.
I ask any noble Lords or Baronesses to please forgive me if I have not responded to their questions, but I will look at Hansard and make sure your Lordships get an answer. I am very happy to meet any noble Lord; I think the noble Lord, Lord Stone, would like to talk to me about one or two projects.
All the Government’s approaches to well-being will continue to evolve. We must keep abreast of all the developments if we are to keep the UK as one of the best places in the world to live. That is what the British people, quite recently, elected us to do, and we will continue to repay their trust.
My Lords, I thank all noble Lords for participating in this debate. It has been hugely thoughtful, stimulating and wide-ranging, and I hope other noble Lords have enjoyed it as much as I have. I thank, in particular, the Minister for her very thoughtful response.
We have heard a very wide range of perspectives—you would expect that. I particularly welcome the noble Lords who contributed perspectives that challenged the notion of well-being. They were sceptical around it, but it is an important part of this emerging debate. There are, without a doubt, tricky definitional issues around well-being and how it is used as a measure. I hope the point has struck home about the need for better children’s well-being indicators.
There has been a lot of refreshing agreement across Benches and parties in today’s debate. I very much hope this will translate into a wider, national debate, as one noble Lord referred to, which was part of my purpose today.
Finally, I am very pleased that various noble Lords agree with me that well-being is not a bourgeois trap or something pink, fluffy and cuddly but something fundamental to the purpose of Government and economic policy. If I ever need to find a way of ramming that point home in the future, it will be the words of the noble Lord, Lord Tugendhat, that will ring in my ears for some time. He said that if the Government had had a greater focus on well-being, rather than balancing the books, then the austerity programme of recent years may not have been pursued with quite some vigour. Frankly, there is nothing pink or fluffy about that.