Scarlett McNally: Alternative manifestos can help us plan our future

Life comes in waves. We remember the exciting events, but most of our life is routine. It’s similar with health. As a surgeon, I realise that people think of health as operations, scans, decisions, and lifesaving interventions. As a patient, I’m grateful that these amazing treatments exist. But we must think of prevention as an important part of health, since 40% of ill health is preventable and most of it relates to our environments and how we live.1

Political parties publish their manifestos in the run-up to an election, but many other organisations have published their own alternative manifestos, advocating for other areas of focus. We should respect the thought that goes into each one. Every citizen should ponder carefully what they want the future to be like and whether these manifestos align with their vision—not just for themselves but for other people and the economy.

Many political debates and policies are stuck in thinking that there’s a binary division between individual choice and state decision making. But we know that nudges, laws, fiscal levers, disincentives, taxes, and regulations work differently on different people. The concept of individual choice is an illusion when a lack of money, opportunity, education, or respect from society severely limits the choices a person can make. When it comes to deciding how to vote or how to approve funding, we often follow what we think will work best for us in the here and now.

I suggest that we try a different tack: we can each try to picture how political decisions will affect the course of our own life, especially our health. People spend an average of 11.3 years of their life in poor health,1 20% of the population are children, and 18% are over 65—a proportion that’s rapidly increasing.1 We need to aim policies and funding at helping people to live healthier lives.

It’s easy to focus on what’s important to us today rather than on our past or future needs. Unprecedented levels of ill health and disability are affecting both working age and older populations. The UK economy can’t afford for each of us to receive the average 10 years of social care projected to be required.2 Some of this dependence on health and social care is preventable23: we should commit to changing how we live, while building our environments to improve the lives of others to help take pressure off the healthcare system.