A prescription for the future?

By David Pencheon

5th July 2020

Covid-19 has reminded us how quickly we can change if we feel our personal survival depends on it, and if feel we are all in this together.

There has therefore never been a better opportunity to seize the day – to normalise the radical – to put wild visions into practice – to abandon ourselves to the wild ideas of others.

Forty years in the health system have forced me to reflect on things that are relevant to the issues we face today. I hesitate to say multiple challenges, because Covid-19, obesity, the climate emergency, soil and nature depletion, junk food, poverty and hunger, plastic waste, the rights of humans and other animals, are all part of the same failing picture. Covid-19 is not ‘yet another problem or challenge’: it’s part of the same inter-connected mess of our own making.

Yet Covid-19 has reminded us how quickly we can change IF we feel our personal survival depends on it, and IF feel we are all in this together. If not, it’s clear how quickly many people are desperate to return to the ‘good’ old times.

The pandemic has also illustrated how deeply we are in trouble. Greenhouse gas emissions have fallen for the first time in 200 years. But they have only fallen by less than a fifth of pre-pandemic levels – enough to ensure we barely survive to the end of the century. That’s how bad we’ve become. We need global infrastructure changes that lock in temporary changes to create truly sustainable food systems and renewable energy systems. The temporary global behaviour changes necessitated by Covid-19 are historic, but they need to be matched by permanent global infrastructure changes to ensure we don’t go back to business as usual. After VE day 75 years ago, many people were shocked to experience how quickly pre-war behaviours returned. It was a socialist government that seized the moment, and locked in what might have been temporary changes, and gave birth to the welfare state.

One of the consequences of the pandemic is that it has forced us to consider what is both important to wellbeing and prosperity; both individually and globally. Practicing medicine has taught me that most health professionals are taught very little about health, and a lot about disease. This has led to a deficit model of health and an illness obsessed ‘health’ system – if you’re not diseased, you must be healthy. Much as we applaud the NHS (and every member of my immediate family works, or has worked in it); it is essentially an urgent rescue and care system, not a long-term health system. I have worked for decades in the ‘health’ system; and not only are health promotion and illness prevention low priorities for the NHS, so is the ‘future’. We focus on present needs, blue lights, and emergencies. We are crisis junkies and we love it. Individual needs, personal dramas, and heroic rescues are much more exciting and rewarding than long term planning for a system which is really sustainable: environmentally, socially, and economically.

Do I have some suggestions for a prescription for the future? Trust me, I used to be a doctor:

  1. Your wellbeing and that of your children, and your children’s children, depends on the sustainable prosperity of everyone. Help yourself by helping the opportunities of others, born and unborn.
  2. Life is not a rehearsal. Every generation stands at a crossroads. But getting it wrong now is likely to be terminal.
  3. Make your present activities enhance the future, not deplete it. Use your voice and choice without fear or favour.
  4. Question everything, not as a cynic; but as someone who asks: why not? Life unreflected is a life unlived: and a life unrenewed is a life unimproved.
  5. Giving and sharing (of your time, your skills, your company…) is good for your health, especially your mental health.
  6. Engage and collaborate with unlikely partners: first and mostly, by listening, respecting and reflecting.

These behaviours help not only at an individual level, but also at a global level. Thinking and acting at both global and local levels is more important now that it has ever been. At a global level, the Sustainable Development Goals and the UN Climate Change Agreements may not be perfect; but we are seeking survival not perfection; and they are by far the best frameworks we have around which to negotiate, agree and deliver a safe and prosperous for all.

There has therefore never been a better opportunity to seize the day – to normalise the radical – to put wild visions into practice – to abandon ourselves to the wild ideas of others. We should never waste a crisis. We should be even more ready now that others are more ready. We should not only tell future truths, but we should enact them.

Covid-19 reminds us (and we really shouldn’t need reminding) that it is better for us all to be healing the future, not stealing it.

David Pencheon is a Commissioner at the Food, Farming and Countryside Commission and Honorary Professor at University of Exeter. He was formerly Director of the Sustainable Development Unit for NHS England and Public Health England.