Letters

Spending (slightly) less on health and more on the arts

Robust research is needed

Public should decide

Healthcare budgets can include money for arts

Robust research is needed

EDITORSmith raises some important issues about the role of arts in our society and on the relative value we attach to arts and health, as reflected in their budgets.¹ Perhaps a move to divert some modest funding from the health budget into the arts might prove more popular if some positive health benefit can be shown. But, despite the experiences of Simon Rattle (and any artist who has engaged with poverty and exclusion), the health benefits of the arts are not immediately obvious.

Although we might agree with Brown on bmj.com that the arts have positive effects in a hospital environment, there is a lack of robust evidence of the arts providing such benefits in other areas. ^{2 3}

The potential health benefits of participating in the arts to individual people and to the community have received widespread attention in recent years. The arts have been used as a medium for health promotion and as therapeutic interventions; in the case of the United Kingdom, health action zones and social inclusion partnerships arts projects have been used specifically to tackle social exclusion. As with other healthcare and social interventions, the arts might have an impact on health, but such impacts need to be shown, whether the outcomes are improvements in specific health outcomes or increases in rates of social participation.

Perhaps now that the BMJ has put the issue on the agenda, the door will open to supporting research in this area.

Christine M Hamilton, director. 
Centre for Cultural Policy Research, University of Glasgow, Glasgow G12 8QQ C.Hamilton{at}arts.gla.ac.uk

Mark Petticrew, associate director. 
MRC Social and Public Health Sciences Unit, University of Glasgow

Competing interests: None declared.

Public should decide

EDITORIn his editorial Smith advocates spending less on health and more on the arts.¹ The problem with art is that it is profoundly elitist. Switching money from health to art benefits the upper classes (who probably have medical insurance anyway).

What percentage of the population reads poetry, goes to the opera, enjoys or is touched by contemporary art, or cares who wins the Booker prize? Cultural things that most people identify with tend to be self fundingfor example, football, pop music, trashy television soaps, etc.

Perhaps diverting public health money to things that are relevant to most people (such as ailing football clubs, youth sport projects, community centres) would be easier to justifybut it really should be up to the public to decide this.

Philip V Kaye, histopathologist. 
Queen's Medical Centre, Nottingham NG7 2UH philipkaye{at}mail.qmcuh-r.trent.nhs.uk

Competing interests: None declared.

Healthcare budgets can include money for arts

EDITORTo replace rheumatoid tablets with Rattle, state funded bathchairs with free access to Bachis there anything new in Smith's editorial?¹

These are Utopian concepts to an artist, hellish to a fiscal utilitarian. Academics have been quibbling for years about the relative worth of funding the written word at the expense of the high tech laboratory. Families and teachers have been split for generations over whether taking the "arts" or "science" track at A level is likely to lead to a more socially useful career. The debate has raged uselessly for at least 40 years. Whether it is "good" for society to give fiscal encouragement to the arts, the Philistine nature of contemporary political culture means that such a proposal is unlikely to produce any more than a scornful or indifferent media or public response.

Fortunately an alternative exists. Healthcare budgets canand in many countries doinclude money for the arts. This can range from money for arts-inspired healthcare education (through theatre in education or arts information projects) to formal strategies of occupational and artistic therapy, university teaching modules that strive to educate doctors and nurses into more empathetic human beings through the use of art and literature, artistic attempts to brighten hospital environments and reduce the clinical atmosphere, and the longstanding culture of "hospital radio."

All these activities are potentially classifiable as arts, and all are an integral and generally accepted part of NHS life and national health care. We don't need to change anything to divert the arts into the nation's health: they're there already. What we can do is learn more from other countries. Countries such as the United States can teach us about medical humanities. Countries such as Cuba and South Africa can teach us about how health care and the community arts can work together and how low budget health education programmes, relayed through the medium of the arts, can greatly improve the general picture of a country's "health."

Kerry S Kidd, postdoctoral Wellcome research fellow. 
Institute for Genetics and Biorisks in Society, University of Nottingham, Nottingham NG7 2RD kerry.kidd{at}nottingham.ac.uk

Competing interests: KSK is currently working on a grant project for humanities in medicine.