Tentatively I had resolved to make no new year's resolutions. From a distance they seem incongruously joyless, the annual celebratory declarations of gruesome intent. Now that the moment is almost here I feel the urge, as always, to rise to the occasion. My resolve is weakening. Here is a chance to give some structure to the shapelessness of life and body: no coffee, no wine, Kate Winslet's fat-free diet, more cycling and running. Yes, I am starting to enjoy this, the act of making some resolutions for a healthy new year.
Most of us will succumb by midnight tomorrow. We will all be on Kate Winslet's fat- free diet for an hour or two. The difference this year – or next year – is that the stakes will be incomparably higher than normal, not so much for us as for the future political landscape of Britain. It goes without saying that if we all stuck to our resolutions Britain would be a much healthier country. As ministers have placed our health at the centre of their agenda for their second term they will keep their fingers crossed that these resolutions are met, that we eat no more fried Mars bars until Easter. If we get healthy the politics of health will become a little less strident – and the politics of health will dominate 2002, more even than the politics of the euro.
If there is a flu epidemic next month the Conservatives will seize their chance. Iain Duncan Smith, who sounds as if he is the victim of a unique all-year-round flu epidemic, will cry throatily that the NHS is failing under Labour. The Government will cry back that this shows why it needs to raise more money through "general taxation". Even if there is no epidemic the emblematic battle lines are already defined.
The new year outbreak of concern about our diets is a reminder that there are two sides to the debate about the future of the NHS. There is the heated debate about how to raise the level of investment and how the NHS should be structured. Then there is the understated other side: the way we choose to live. There is only a limited connection between our healthiness and the level of spending on health. As our resolutions tomorrow night imply, the state of our health depends largely on us. There is no getting away from it, or our own flabbiness.
Cuba is healthier than the US in spite of spending far less on its health service. The Cubans tend not to go for big breakfasts at Pancakes Are Us. Similarly, Mediterranean countries are healthier than Britain. In the current search for solutions to Britain's run-down health service no politician or economist has headed to Portugal or Greece for inspiration. Yet the Portuguese and the Greeks are in good shape compared with the British. Within Britain, Scotland outspends England on its NHS, but the Scots are less healthy.
We are agonising over the relatively high death rate from breast cancer. What should be at least as great a priority is a reduction in the incidence of the disease in the first place. According to medical specialists it would be substantially lower if the rate of obesity were as low – and the rate of breast-feeding as high – as in Scandinavia.
None of this suggests that the Government is wrong to invest more in the health service. There is not a single political leader in Britain who is arguing against further investment. Britain does not spend enough on its health service, just as it does not spend enough on its education and transport systems. The level of spending is part of the problem. But the British diet and lifestyle point to a third factor. We will not become healthy even if investment increases, and the NHS becomes more efficient if we continue to eat fried Mars bars and drive a few hundred yards in our cars.
Some in the Government suggest that making us healthier in the first place is an ideal role for the private sector. They point to the booming industry in private gyms and the expanding pages of newspapers devoted to personal lifestyle. But neither counters the raw statistics that show Britain to be an increasingly obese place. Most of those who attend gyms are pretty fit in the first place. The flabby ones join with an excess of zeal but, unlike their appetite for food, their enthusiasm is soon sated. As for those health pages in the newspapers, we all read them as a form of escapism rather than as a manual for a new lifestyle. As we read them we briefly become waif-like figures, like the subjects themselves. Then we reflect on it all over a large glass of wine.
What we need is a bit of joined-up government, to revive a phrase. Classy, sophisticated information about diet and lifestyle can start to make a difference. In Finland, for example, the population once suffered a similar death rate from heart disease to Britain. It was brought down over 20 years by a campaign that relentlessly focused on diet and lifestyle. In Britain we tend to have bland campaigns that provoke defensive rows, such as when the then health minister, Edwina Currie, blamed the north of England for eating badly. The north of England continued to eat badly almost as a protest.
This is where the private sector could play a part by bringing in the best advertisers in the business to make it fashionable to eat better. I suggest Arsène Wenger, the French manager of Arsenal, to front such a campaign. He transformed the diets of his players and helped them to play longer and better. Wenger could do almost as much for us as a GP who is occasionally willing to see patients on the day they request an appointment.
Other government departments should also get involved. Children should be encouraged to cycle and walk to school. This was the only idea to emerge from John Prescott's "historic" White Paper on transport published during the Government's first term. Even this policy, hardly ambitious in its scope, has not been implemented. School runs still clog up the roads. For such a policy to work Stephen Byers, the Secretary of State for Transport, should seek some of the additional money being made available to the NHS to improve cycle lanes and public transport, which might also encourage more adults to get on their bikes. The Department of Education could also have a word with the Treasury about extending free school meals with an insistence that the food is stylishly healthy. Surely there is a way to make Brussels sprouts the "in" food for teenagers.
The Government will be in big trouble by the end of next year if it relies partly on individual self-discipline, the resolutions of an unhealthy nation. My resolve not to make a resolution may be weak. It is nowhere near as weak as my inability to keep the resolution I will make tomorrow night. Let's drink to 2002. Cheers!Reuse content