The value of wellbeing

Speech by The Rt. Hon, Lord O’Donnell, Chairman, Pro Bono Economics

Event: UKActive Annual Summit 2019

Delivered: 31 October 2019

Note: This is the speech as drafted and may differ from the delivered version

Key takeaways

• As a country, Britain is struggling with poor levels of physical activity and health.
• Good data is the catalyst for behavioural change.
• An emphasis on cost alone is risky; wellbeing should be the objective.
• A preventative NHS, based around what works, would be a game changer.

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Speech

Good morning everybody.

It’s such a pleasure to see so many of you here today.

To explore the different ways in which physical activity can touch upon and improve our lives…

…and those of the communities we live and work in.

My name is Gus O’Donnell.

In a previous life, I was Head of the Civil Service to three Prime Ministers: Tony Blair, Gordon Brown, and David Cameron.

Now I wear many different hats.

• I’m a Trustee of Wimbledon (the tennis club, rather than AFC), and I am Chair of the Board at the consultancy Frontier Economics, and the charity Pro Bono Economics.
• I also serve as President of the Institute for Fiscal Studies, and as Patron of the What Works Centre for Wellbeing.

So there’s a fair amount on to keep me busy, and through these organisations I can keep in touch with the latest thinking in three areas:

Economics, physical activity, and wellbeing.

So today, I am delighted to share some thoughts on the links between these three and how they can help build a happier and healthier nation for the future.

Because sport has always been a huge part of my life.

At University, I was lucky to be part of a decent Warwick football team.

As a civil servant, I was also a member of the Mandarins Cricket Club for many years.

I always loved being part of a team, valuing the benefits it gave me not just in terms of fitness, but also social skills, a sense of camaraderie…

But my role at Wimbledon stemmed from my love of individual sports, tennis, and golf.

They bring something different

In the same way, swimming or gym workouts, using the facilities run by many of you here today, contribute to a healthier, happier, and ultimately more productive society.

But even I will admit to the odd setback in my fitness programme.

While I was still in the civil service, I decided, well in advance of my next annual physical, to kick my fitness levels up a notch.

So I got myself down to the House of Commons gym…

…But come the physical I was told I was essentially in the same shape as last year.

It was a bit of a blow and the doctor picked up on this, saying: “Don’t worry Mr O’Donnell, at your age it’s all about managing decline”.

A hard truth, but it was good for my resilience, another benefit of regular physical activity of course.

But a whole other challenge is actually finding the time to exercise in the first place.

Now, here is David Cameron arriving in Downing Street back in 2010.

It was a great moment for him I’m sure, but he was about to get a lot more on his already crowded plate.

After all, Samantha is pregnant here.

They’re moving house.

Both, fairly stressful scenarios in their own right.

And I’m about to tell him about all the risks, all the confidential problems that up until that point he was unaware of.

The reality is that being Prime Minister is a tough job.

And to make matters worse, it’s extremely difficult to find any time to relax and recuperate through exercise.

Where’s the commute? You live above the shop, so hardly good for the step count.

Also, when you do have external meetings you’re driven everywhere from door to door.

We worked hard to give the Prime Minister every opportunity to stay fit and healthy, but I’m sure you can appreciate this wasn’t easy.

And we all have busy lives.

So it’s very encouraging to see such an emphasis placed on the healthy workplace at this conference, as I know first-hand just how important that is.

But despite widespread awareness of the benefits of physical activity, we are still doing really badly in the UK.

For example, 15-year old students in the UK are considerably less active than those of other countries.

The UK ranked 40th out of 54 countries in the most recent OECD PISA  survey here.

The number of British students who exercise vigorously is 40 percent, yes 40 percent lower than in Iceland, the most vigorously active country.

And as you can see here, obesity levels have been getting worse for adults for going on 30 years now.

Why is this?

Part of the problem is data and its measurement, or more precisely the lack of it.

Now, you might be underwhelmed to hear that measurement is part of the  solution here.

But let’s look at it a different way, taking behaviour into account….

We know trying to reach your daily step goal may be good for you.

But it’s hard to get motivated unless you can track the progress you are making on any given day.

No one is forcing you to take more steps of course, or banning you from public transport. You are simply being nudged gently, to improve your physical health.

This is the premise of behavioural economics, and I’m delighted to see that one of the breakout sessions today is with the Behavioural Insights Team, another organisation with whom I work

They know how powerful data can be as a catalyst for changing behaviour.

But I would stress this data needs to account for the differences between men and women.

We as a society are falling short here.

Caroline Criado Perez’ wonderful book – “Invisible Women – Exposing Data Bias in a World Designed for Men” – shines a light on how male-centric the world is.

And the world of fitness and leisure is unfortunately no exception.

As Caroline notes: Treadmill calorie counts are based on male weight and male calorie burn (about 8 per cent more than women of the same weight).

Users of activity trackers like this may not record while the user is pushing a pram because the arm is stationary.

I’m thrilled that Caroline will be speaking more about this topic in depth at next year’s Pro Bono Economics Annual Lecture, scheduled for May 26^th…

…and would urge you to join us then for what promises to be a fascinating discussion.

As this is a huge problem all of us need to recognise and address.

And while we’re on Pro Bono Economics, we are proud to do our bit to help charities demonstrate their impact and to scale up with confidence, ultimately changing more people’s behaviour for the better.

For example, past work has shown that pupils’ academic success and life chances can be improved through intensive sports coaching and mentoring.

This was the conclusion of a study performed in conjunction with Loughborough University on behalf of Greenhouse Sports.

Now, Greenhouse is a charity that uses sport to help young people  in cities realise their full potential.

The impact of their  sporting programmes was an improvement in participating children’s attainment levels.

But I would say there is one word that must be front of mind when we speak of impact, genuine impact, and that’s causation.

When thinking about sport and the good it can bring, we must acknowledge it is largely done by the more well-off.

With that in mind, is it really physical activity and sport that delivers the goods, or is the bigger factor here relative affluence and access to opportunity?

We need to hold ourselves to a sometimes painfully high burden of proof.

And that means identifying and avoiding confirmation bias.

It also means using the best analytical tools at our disposal.

Most economics studies speak in terms of what certain actions mean in pounds and pence.

We often hear talk of what having say, five good GCSEs means for your earnings potential later in life.

But I would argue that an exclusive focus on financial returns risks missing the point.

To give one example, in his recent book “Happy Ever After”, LSE Professor Paul Dolan argues forcefully that we cannot just make decisions on the basis of cost, as policymakers but also in day-to-day life.

If we did, we might be encouraging people to start smoking…

As Paul says, long-term smokers die ten years earlier than non-smokers on average and therefore reduce the burden on healthcare services at an expensive time of life.

But we all know smoking is bad for you…

Yet such intuitive knowledge is not always well captured in existing analytical frameworks.

So what to do?

I have argued for many years that we should be measuring and targeting wellbeing as a society.

Wellbeing includes everything that is important to people and their lives.

And physical health plays a crucial role in building and maintaining an individual’s wellbeing levels.

So for me, improving wellbeing should be a central goal for our society and the overriding aim of government policy, rather than say narrow targets for academic attainment.

Greater wellbeing has many benefits; it raises productivity; reduces benefit dependence; cuts absenteeism; and reduces physical illness.

So even if this Government does not accept wellbeing as its overall objective, we in civil society, in the business community, in the leisure community, should favour it over the more traditional indicators of success.

Policymakers abroad are already using this approach…

New Zealand recently published a  ‘Wellbeing Budget’ and closer to home, Wales and Scotland are looking at this - targeting improvements to what matters most in people’s lives.

So where does this leave us and what still needs to be done?

Two years ago, Simon Stephens, Chief Executive of NHS England spoke at this conference and said that if physical activity were a pill, every doctor would prescribe it.

I see some of that thinking has filtered through to service design and we have breakouts today to look at the NHS Long-Term Plan, and the Prevention Green Paper.

Again, this is great to see.

In my view, any long term thinking about healthcare must embrace the mantra: “prevention is better than cure”.

We need a preventative NHS, built around what works.

And we can only learn what works with the help of data.

Look at the work of Pro Bono Economics, look at the work of the behavioural economists working out of Frontier Economics, and the Behavioural Insights team…

…delivering unique insights around the impact of social action.

We need to embrace this approach on a national level…

…with the design, testing and implementation of a consistent measurement framework, one that UKActive Members here today could use…

…and that can deliver genuine insights into the wellbeing of our population drawn from different sources, from different people, in different locations, at different times of their lives…

With this, we can begin to understand the value of physical activity from a wellbeing perspective…

Many of us accept this intuitively…

But would agree that we need more, more data, more information, to get to the heart of what’s needed to build a nation that is happier, healthier and more productive.

That’s my call to action to any policymakers, help devise a new wellbeing measurement framework to underpin a preventative NHS.

I find that vision compelling. I hope you agree and I look forward to hearing more from all delegates on this topic throughout the day.

Thank you very much for your time and enjoy the conference.

6th November 2019