Lose A Hundred Pounds With This One Weird Trick: public health as class war

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Above: The Victorian era’s prison treadmill, “a very useful piece of machinery for the purpose of correcting the tarnished morals” of the undeserving poor.

[First published in The Morning Star, 04/01/13]

You’d be forgiven this week for thinking every paper in the country had merged with the Daily Mail. It was shaping up to be a desperately slow news week. And then, like manna from a bitter, paranoid, ethnically homogenous heaven, a quintessentially Daily Mail headline landed too good for any editor to resist: HIT THE GYM OR JOG ON, FATTIES ON BENEFITS TOLD. Except unusually for the Mail, it’s actually true.

Thank the sombre-sounding Local Government Information Unit, a thinktank who drummed up this brilliant idea in “A Dose of Localism: The Role of Councils in Public Health”, co-authored by the Tory-controlled Westminster council. You may recall them as the friendly folk who sought last year to ban soup kitchens around Westminster Cathedral.

Weighing in at just ten pages, with not a single footnote or reference to the vast body of public health research, the offending report includes such daring recommendations as “create and develop healthy sustainable places” and “ensure a healthy standard of living for all”.

It’s not entirely buzzwords, mind you. There’s talk of doctors offering prescriptions for exercise at local pools, gyms and the like: not a bad idea, even if a 33 percent discount on a gym membership is still out of many people’s reach.

Then amidst the pabulum there’s a paragraph simply titled “Welfare”.

“Relocalisation of council tax benefit and housing benefit combined with new technologies provide an opportunity for councils to embed financial incentives for behaviours that promote public health.

“The increasing use of smart cards for access to leisure facilities, for instance, provides councils with a significant amount of data on usage patterns.

“Where an exercise package is prescribed to a resident, housing and council tax benefit payments could be varied to reward or incentivise residents.”

That’s the pitch in its entirety. Not “is there evidence to suggest this is an effective approach?”, not “has the medical community demonstrated any support for this?”, not even “what are the ethical and practical implications of making people with existing health conditions homeless?”.

It’s little surprise then that the report’s author Laurie Thraves moonlights for the Tory-founded think-tank Reform, the same incisive mind who would scrap tuition fee caps entirely and who was among the first to tout for police and crime commissioners [PDF].

Nor is it a surprise that Westminster council leader Philippa Roe has already endorsed the report as “exactly the sort of bright, forward-thinking and radical ideas that need to be looked at.”

Presumably she will also look at reversing her council’s decision last year to close Queen Park’s Jubilee Sports Centreone of the most deprived wards in the entire country [PDF] – with the nearest centre now half a mile away on the decidedly more posh Regent Street. Meanwhile literally hundreds more centres across Britain face a similar fate under the Con-Dems’ cuts to local authority budgets.

As it happens there’s no clear relationship between obesity, class and income: the Health Survey for England, administered by the Department of Health, has consistently shown in recent years that the lowest obesity rates are among the poorest fifth of working-age men and the very richest fifth of working-age women.

Us proles still have generally worse health: official figures show below-average earners are three times more likely to develop a long-term illness or disability in middle-age than high earners. But obesity isn’t necessarily one of them.

So to be clear, Westminster’s pitch for the Biggest Benefit Loser is less about targeting those most in need than simply manipulating those most vulnerable.

At least in this instance claimants will have the medical community fighting on their side for the sake of the patient-doctor relationship: if anything the scheme seems likely to leave people afraid of visiting their GP for fear of losing their benefits. And in that regard, Atos’ tick-box testing of disabled claimants has given us all the case studies we need.

A cynical spectator might even think it simply another pretext for stripping away benefits, in much the same way that ‘localism’ has become a pretext for defunding public services. But Tories, cynical? Never. They’re just fact-free.

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