NHS spending should focus on mental rather than physical health to promote wellbeing.

Health budgets should be reallocated to focus on mental rather than physical health if the United Kingdom is serious about enhancing wellbeing, the former head of the Civil Service has said. Lord O’Donnell, now retired as cabinet secretary and currently chair of a new government initiative to promote the measurement and use of wellbeing measurements, said that the work done by the Office for National Statistics (ONS) and similar bodies abroad “clearly shows” that a greater emphasis on mental health is justified. Lord Layard, an economist from the London School of Economics who has pioneered the economic studies of happiness, agreed. Emotional health correlated more strongly with an individual’s perception of wellbeing at the age of 34 than any other factor except being in work. Income was far less important, his studies had shown. “Depression reduces life expectancy as much as smoking,” Lord Layard said. “So the NHS should spend much more on mental health.” Both men were speaking at the launch of the ONS’s first annual report on wellbeing, which shows that life satisfaction has remained broadly stable as the economic crisis has developed. People had shown resilience in the face of economic difficulties, said Glenn Everett, who leads the ONS programme. Healthy life expectancy had increased, as had people’s overall satisfaction with their health. But one in five respondents to the ONS programme’s survey had shown some kind of psychological distress. Lord O’Donnell said that wellbeing measures would in future play an increasing part in policy making. He chairs a commission set up by the Legatum Institute, a London based public policy institute that aims to promote that objective.Would a focus onwellbeing have helped avoid the economicmeltdown, Lord O’Donnell was asked. He replied cautiously, suggesting that smoothing out the economic cycles and avoiding “bubbles” or sudden rapid expansion of economic activity might have helped. David Halpern, a Cabinet Office civil servant, gave some concrete examples of how wellbeing might influence policy. People were muchmore inclined to bemoan a loss than celebrate a gain, he said, so any policy that “clawed back” benefits once given would prove unpopular. It might be better simply to leave the recipients with the overpayment in their pockets. “That wouldn’t be current policy,” he admitted. Closing post offices was another example. It might appear to make economic sense, but the impact on the wellbeing of individuals and communities deprived of their post office might be disproportionate to any economic benefit gained. “If that’s not factored in, we’re making an uneven decision that doesn’t balance economic and wellbeing measures,” he said. Another example was provided by the “hundreds” of websites run by government. They offered information, but no opportunity for users to interact with one another. Yet studies had shown that social interaction was a strong positive influence on wellbeing. Another strong influence was a sense of autonomy, which argued in favour of people being given their own budgets for services such as social care. He added that policy makers needed to understand why some areas of the UK had higher levels of wellbeing than others. Was it housing, the length of the commute to work, or whether you knew your neighbours well? More research was needed, but he questioned whether the relief of inequality, the aim of so many governments over the years, was necessarily the best route to better wellbeing. That might be true in Scandinavia, but not everywhere: many Latin American countries scored high on wellbeing measures while remaining very unequal.