Lord Mawson: I congratulate the noble Lord, Lord Howarth of Newport, on securing this debate. It is a subject very close to my heart and an area of work I have actively promoted for many years through my work at the Bromley by Bow Centre in the East End of London. I declare an interest as the founder of a centre that has spent 25 years exploring the relationship between the arts and healthcare in the midst of a challenging group of East End housing estates where traditional approaches to health, which have followed the biomedical model, have been far from satisfactory and very costly.
The key question is: what does it mean to be a healthy and fully rounded human being and what kind of services do we need that will help, rather than hinder, such human development? More precisely, do we want to develop a National Health Service or, as I fear we have at present, a national illness service? Yes, it is a fairly good national illness service, but it is expensive and wasteful to focus on illness rather than health.
The problem with an illness service with an ageing population is that the demands upon it are potentially infinite, particularly given the tendency endlessly to pathologise; for example, on happiness, food or weight. The NHS treats these matters as illnesses rather than giving enough thought to how to promote health. Through working with artists and creative people, social entrepreneurs like myself have learnt how to turn these problems into opportunities for health.
One of the reasons we involved artists from a very early stage in people’s healthcare in Bromley-
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that everyone is creative and has potential. One of the key roles of an artist is to engender change and transformation. What does this mean in practice in our health centre in Bromley-
The Bromley by Bow Health Centre has GPs who work alongside artists and a multi-
The workshops were designed and run in three phases: monitoring asthma, trigger factors and controlling asthma. Each week the art produced from the session was hung in the reception area, thus creating an instant involvement with all the participating children and, of course, with other patients. All the children were given a peak-
Each of the workshops had an educational component integrated into the art-
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outcomes with equally clear economic benefits to the health service. However, there remains an important need for research into the costs and benefits of that type of intervention. I am told that it would be straightforward to set up clinical trials to gather evidence as to whether or not they are effective.
A number of important unintended consequences also occurred. Parents began to understand the science of their children’s illness, and were thus less fearful and could respond accordingly. Parents, trainee doctors and members of staff came to know each other on first-
Was the whole exercise about health, the arts, science, education, social care or relationships? Actually, it was about all of them, but none of them in a box. Does it have implications for the noble Lord, Lord Darzi, and his thinking about polyclinics? I hope so, because the Bromley by Bow Centre is probably the first polyclinic. But who knows? Was it cost effective? Yes, and no prescriptions were given out. The final twist was that, as social entrepreneurs, we realised that we could package the course, turn it into a business opportunity, sell it to every school and health centre in the UK and use the money to fund other health projects at the centre.
A key to our success in Bromley-
To maximise the opportunities presented by the reforms of the noble Lord, Lord Darzi, we will need to ensure that we provide a health service rather than just an illness service—a service that is about more than just the biomedical model of health, which is very expensive. Twenty-
The £300 million healthy living centre programme was full of opportunities to expand this thinking when it was boldly launched by Ministers in 1997, but it is in danger of withering on the vine because local clinicians were not actually prepared to give up fiefdoms and engage. Institutionally in all its forms the NHS and
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the Department of Health singularly failed to engage with this important opportunity. One suggests that all that they saw was yet another demand on their resources, rather than an opportunity such as that described in our asthma project, to reduce the drugs bill and the number of hours that expensive clinicians have to spend with patients.
In my experience, connecting the arts and health is good for patients, builds a healthy and dynamic staff team and is very cost-