Charities have duty to speak out on social policy
Charities have been in the political firing line again after George Osborne urged business leaders to speak out in favour of the free market to counter “an anti-free market movement led by trade unions and charities”. The Chancellor’s comments come hot on the heels of a suggestion by one of his ministerial colleagues that charities should “stick to their knitting”.
One can’t help wondering what happened to the Westminster government’s commitment to the “big society”. It would seem that we are “all in this together” when it comes to charities setting up food banks to deal with the fall-out from the global financial crisis, but they are not to be permitted to take a position on policies that are seen to contribute to the problem in the first place. Charities provide information, support and services to people in need every day. But charities do not exist only to deal with the detrimental effects of issues such as poverty, health inequality, and environmental degradation. Charities also have an important preventative role and exist to press for action to address the root causes of social problems.
A Commission on the Social Determinants of Health, established by the World Health Organisation and chaired by Professor Sir Michael Marmot, noted that the “toxic” combination of bad policies, economics and politics was, in large measure, responsible for the fact that a majority of people in the world “do not enjoy the good health that is biologically possible”. The commission noted that the unequal distribution of income, goods and services caused health inequity and that this inequity was not in any sense a natural phenomenon but was the result of policies that prize the interests of some over others “all too often a powerful minority over the interests of the disempowered majority”.
As a charity working to reduce the health and social harm that alcohol causes, we take to heart the commission’s assertion that the health sector is “a defender of health, advocate of health equity, and negotiator for broader societal objectives”. What that means for us is that, as well as providing information and training for people working in communities, schools, workplaces and in licensing, we will speak out in favour of policies that are going to improve health and wellbeing and reduce inequality. We have clear evidence that, to reduce alcohol harm, society must reduce overall alcohol consumption and the best way to do that is to reduce the affordability and availability of alcohol. So we support policies like minimum unit pricing and restrictions on granting new licences because we believe that such policies will ultimately reduce the number of people in Scotland who suffer ill health or die because of alcohol. As our core charitable purpose is to reduce the harm that alcohol causes, it would be a severe dereliction of duty not to speak out in support of such policies.
This inevitably brings us into conflict with powerful corporate interests who lobby against policies which seek to regulate their activities in order to reduce the harm that their product causes.
Our colleagues in tobacco control spent many decades fending off tobacco industry efforts to undermine public health policies. Environmental charities have to navigate similar territory. If the circumstances that have led to the current “austerity measures” have taught us anything, surely they have taught us that unregulated and unchecked markets can be destructive to the public good.
Regulation serves an important function in ensuring that economic growth is sustainable and balanced with wider societal objectives. History shows us that the most substantial advances in improving population health have come about as a result of regulation.
Clean air legislation and improved housing and sanitation significantly reduced morbidity and mortality in the 19th and 20th centuries. More recently, policies such as health and safety at work, seat belt legislation and banning smoking in public places have greatly improved our health and wellbeing.
Some of these advances have been achieved in the face of considerable opposition by vested interests, and charities have often been at the forefront of championing these causes. Promoting health, challenging poverty and protecting the environment requires charities to care about regulation, to challenge business interests and to advocate for the wider public interest.
With social and health inequalities stubbornly persisting and increasing global concern about the degradation of our planet, the campaigning role of charities is more important than ever.
• Dr Evelyn Gillan is chief executive of Alcohol Focus Scotland www.alcohol-focus-scotland.org.uk