A budget for belonging - why social infrastructure deserves investment

Loneliness is a deep and costly social challenge.

David Barclay

David is a partner with the Good Faith Partnership, collaborating on solutions to social problems.

Warm Welcome Campaign

There has been much discussion in the run-up to the Budget about how changing the ‘fiscal rules’ could enable Rachel Reeves to invest more in physical infrastructure like green energy, schools and transport projects. But what usually gets less focus in these discussions is the vital role of ‘social infrastructure’, and how public funding can help build a more connected society.

We are facing many challenges as a country, but few are as deep and costly as loneliness. Nearly half of UK adults report feelings of loneliness, with seven per cent experiencing chronic loneliness (defined as feeling lonely always or often). More than 1 million people over 75 report going over a month without speaking to a friend, neighbour or family member. Loneliness is strongly linked to mental health issues such as depression, anxiety, and stress. It can lead to lower self-esteem and exacerbate existing mental health conditions. Chronic loneliness is associated with various physical health problems, including cardiovascular disease, weakened immune function, and increased mortality risk. Studies have shown that loneliness can increase the risk of premature death by up to 26 per cent.

Loneliness is a global issue, and it’s not a surprise that countries around the world are starting to develop strategies to respond to this highly significant public health challenge. Seoul in South Korea is putting $326 million toward combating the scourge of loneliness and preventing the growing number of “lonely deaths.” The new initiative in the South Korean capital plans to set up a 24-hour hotline for people feeling isolated, expand one-on-one mental health counseling services, and open four locations next year where people can have meals and talk to others.

Closer to home, the Welsh Government has just announced a £1.5m funding package to support Warm Spaces this winter as a way to tackle both fuel poverty and social isolation. I’ve had the privilege over the last three years to lead the Warm Welcome Campaign, a network of over 4000 community spaces across the UK who initially came together in the height of the energy crisis to keep people warm through the winter. What we have learned is that people might come for the warmth but they stay for the welcome, with rates of chronic loneliness plummeting through engagement with a local community space.

Given the slow but steady erosion over the last decades of physical spaces in communities where people can connect, the new Government would be wise to consider how we can turn the tide on this and develop a flourishing national network of spaces of connection and belonging.

Government funding for this kind of social infrastructure might seem outside of the norm for a Budget, but it would represent an investment of public funding which could reap huge long-term dividends.

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Assisted dying

Care

Comment

Ethics

27 November 2024

2 min read

Who holds the keys of death? The logic of assisted dying

The ethical principle of double effect.

Tom Dove

Tom is a physician and completing a theology doctorate.

white pills form an angle on a blue background

Hal Gatewood on Unsplash.

Healthcare hinges on the principle of double effect. This ethical principle makes the vital distinction between intent and effect. That is, one’s intent does not always result in a single intended effect, whether foreseen or not. In taking a patient’s blood, for example, my intent is to acquire information to aid treatment. An additional effect of this process is that—almost inevitably—this patient will experience pain, albeit minor. This principle of single intent and multiple effects applies throughout the practice of caring for human bodies, in all those instances where caring for those bodies involves physical interference, from prescribing medications to surgical procedures. And, in some instances, identifying and treating symptoms (such as terminal breathlessness) involves the use of medications that, as an unintended effect, result in death.

In the case of assisted dying, the distinction is important. The intent of assisted dying is to end pain and suffering by ending life. The ending of life is the treatment used to relieve pain and suffering. The intent is not to isolate and treat particular symptoms associated with a condition. The intent is to bring the condition itself to an end—which requires bringing the patient’s life to an end. This is not to make any judgment whatsoever about whether such a course is “right” or “wrong”, but rather to draw out the simple observation that this course involves an unprecedented change in medical practice. Assisted dying involves the categorical adoption of ending life as a possible treatment for a condition.

This is not quite the same as the slippery slope argument; it is about the logic of assisted dying. The point I am making is this: once ending life is introduced as a treatment, the key ethical step has already been taken. Applying that treatment in other instances of “suffering” (be they mental illness or ageing, for example) does not involve any new ethical steps. It simply involves the further application of a principle that has already been adopted. Despite the considered safeguards of the bill, therefore, the moral-ethical arguments against applying this treatment more widely will, at best, stand on shaky ground. For who could be so bold as to insist on what constitutes “suffering” for an individual?

Should the bill hold out the keys of death in this way? I can only think of One who is strong enough to wield those…