The People’s Health Movement (Scotland) (PHM Scotland), is a diverse group comprising third sector organisations, academic institutions, campaign groups and individuals in Scotland. We are members of a global movement calling for “Health for All” and campaigning to revise domestic and international policy and other ongoing reforms that impact negatively on people’s health.
Why is PHM Scotland supporting Protect our Future? What has sustainable finance for Scotland got to do with health?
Well, quite a lot. The causes of ill health and indeed, of the conditions for a healthy population are many and varied, and the extent of their impact on health (good or bad) is dependent partly on public investment.1 2
Equitable access to quality health care through a publicly financed and free at point of care NHS and social services, which pick up the pieces when we are ill, and work to help individuals stay healthy is critical, but it is not sufficient. Other factors affecting the health of communities have been found to include: access to good quality secure housing, to good quality education from early childhood, to pollution-free green open spaces, to nutritious food, to social support networks, and many more. Public investment in communities shapes these factors.
Although the causal links are not fully understood, the association of these factors with health is confirmed by research into “social determinants of health”. And, as PHM Scotland has shown, these academic findings chime with the lived realities for many in Scotland.
The People’s Health Manifesto
Through a collaborative process engaging a wide range of people in our network, including third sector organisations, academics, practitioners and individuals, at public meetings, on online forums and through other correspondence, PHM Scotland has developed a People’s Health Manifesto creating an ongoing conversation about what the key priorities for a healthy Scotland are, and what the policy responses should be.3 The People’s Health Manifesto lays out a wide range of policy actions that are required – currently a priority list of 20. The importance of sustainable public finance is recognised with the demand that finance for relevant public services is not profit driven.4
As Protect Our Future is showing, where a commercial return is required on investments into the provision and operation of public services and facilities, the needs of the people using them, and of their communities, can come a poor second to profit.
Health is a fundamental human right, recognized in the Universal Declaration of Human Rights (1948) and PHM Scotland wants to see the people of Scotland recognise and demand that right, and ultimately rid their country of the tag as the ‘sick man of Europe’. This is a big job for Scotland. There are many factors at play, but we need to demand that sustainable public finance is at the heart of the programme. A healthy population is no accident, and we need government to make it their business.
- “Social determinants of health” are defined by the World Health Organisation as: ‘the circumstances in which people are born, grow up, live, work and age, and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics’ http://www.who.int/social_determinants/thecommission/finalreport/key_concepts/en/
- Dahlgren, G. and Whitehead, M. (1991) Policies and Strategies to Promote Social Equity in Health. Stockholm: Institute for Futures Studies
- Kapilashrami et al (2015) “Social movements and public health advocacy in action: the UK people’s health movement” J Public Health (Oxf) (2016) 38 (3): 413-416.
- People’s Health Manifesto demand no. 8: “Scotland must commit to ensuring that the NHS in Scotland will remain publicly funded and free at the point of use. Specifically, ensure that the duty of care remains with the Minister for Health in Scotland; have a ‘no profit motive’ in the commissioning and running of services; and commit to not entering into any Private Finance Agreements to fund publicly funded enterprises.”