By Tom Forrest | 12 March 2013
A think-tank has been criticised for suggesting that people who live a healthy lifestyle should be able to jump to the front of the queue for non-emergency NHS treatments and operations.
In a report published today, Demos proposed the government adopts a ‘nudge-plus’ approach that explicitly rewards people and communities for acting responsibly. This builds on the ‘Nudge’ philosophy that the public can be encouraged to act appropriately without the need for sanctions or legislation.
Under nudge-plus, individuals would be rewarded by their GPs for eating healthily and going to the gym, while communities could receive a ‘community cash back’ from the government for establishing a Neighbourhood Watch scheme.
But Claire Fox, director of the Institute of Ideas, described nudge-plus as the ‘ugly sister of nudge’. Speaking at a Demos panel discussion chaired by Public Finance editor Mike Thatcher, she said that public health initiatives were creating ‘cotton-wool adults’.
Fox said: ‘We are not trusted to learn from our own mistakes and not trusted to set our own parameters on our lives. We are not even trusted to go shopping on our own.’
She claimed that a preoccupation with public health had led to ‘institutionalised hypochondria’. An ‘over-anxious worried well’ were consequently clogging up doctors’ waiting rooms.
‘It scuppers the idea about queue jumping if you have a healthy lifestyle. Actually these people shouldn’t be in the doctor’s room in the first place because there’s nothing wrong with them.’
But Max Wind-Cowie, head of the Progressive Conservatism Project at Demos and author of the report, rejected Fox’s assertions. ‘People who are prepared to engage in improving their lifestyles and reducing risks to themselves and to the NHS should be explicitly rewarded,’ he told the panel audience.
Nick Hurd, the minister for civil society, was also supportive. He highlighted the work of the Behavioural Insights Team, generally known as the Nudge Unit, in the Cabinet Office.
‘We have seen some quite startling results [from the Nudge Unit]. Some of it is quite simple, but it goes with the grain of human nature.’
The Control shift report, produced by Demos in association with Zurich, also proposed the establishment of a risk commission. This would collect, analyse and communicate information about risk and carry out ‘responsibility audits’ to examine any unintended consequences from legislation.
