How a ‘wellbeing’ budget could care for the most vulnerable in society

With Budget 2020 set for October 8, and with ‘fiscal space’ of some €700m, is there room for a focus on long-term wellbeing or just short-term tax cuts? Joyce Fegan reports

How a ‘wellbeing’ budget could care for the most vulnerable in society

This summer, the trailblazing prime minister of New Zealand, Jacinda Ardern introduced a “world-first” wellbeing budget.

Normal budgets, where tax bands might change and cuts are introduced or where welfare payments are increased or decreased, leaving you maybe €100 better or worse off annually, appear to focus only on economic growth. But Ms Ardern’s budget focused on something else entirely.

Its focus was wellbeing, in fact the title of the New Zealand Labour government’s document was the ‘Wellbeing Budget’.

They set out six key policy areas that would improve the overall wellbeing of their nation, if funds were consciously and strategically allocated in specific directions.

The six areas are:

  • Taking mental health seriously;
  • Improving child wellbeing which included addressing family and sexual violence;
  • Supporting Mãori and Pasifika aspirations;
  • Building a productive nation;
  • Transforming the economy;
  • Investing in New Zealand.

“While economic growth is important — and something we will continue to pursue — it alone does not guarantee improvements to our living standards. Nor does it measure the quality of economic activity or take into account who benefits and who is left out or left behind,” said Ms Ardern when introducing her government’s budget.

She explained that in the years that New Zealand experienced steady economic growth, there were also high rates of poverty and suicide. “We know for example that New Zealand has had strong growth for a number of years, all the while experiencing some of the highest rates of suicide, unacceptable homelessness and shameful rates of family violence and child poverty.

“Growth alone does not lead to a great country. So it’s time to focus on those things that do,” she said.

While the budget was hailed as radical and reported widely around the world, Barra Roantree from the Economic and Social Research Institute (ESRI) told the Irish Examiner that no government focuses solely on economic growth.

“People are overstating what has been done in New Zealand, in that they created a budget looking beyond economic growth. What New Zealand is doing isn’t as radical as some of the commentary suggests.

“Most governments have competing needs. The Irish Government itself doesn’t exclusively focus on economic growth.

“I don’t think that’s true of any government, the Government will have multiple priorities and it tries to allocate resources between them,” Mr Roantree said

told the Irish Examiner.

However, New Zealand is different, he said, in that they set out six broad priorities, and are sending funds and resources to these areas. They are also committed to evaluating the results of their efforts.

“That is something we could learn from here, process wise, so where the Government sets out very clearly what its policies are, how budgetary decisions contribute, and then do a performance analysis,” said Mr Roantree.

“In an Irish context, there is some impact evaluation, but there is room for more, in a lot of areas we don’t know how affective our spending is. Where do we spend our money, what is the most effective use of funds — we don’t do enough impact evaluation, but are we not alone in that,” he added.

The need to look at the impact spending has is something that the Parliamentary Budget Office (PBO) recently pointed out.

In 2018, the PBO passed comment on Budget 2019, which had an expenditure of €66.6bn. The office said that performance analysis of “key high level metrics” requires better development and better links to outcome indicators.

The PBO describes outcomes as “the direct short-term result on the groups or individuals the programme was targeted at and the longer term impact on them”.

With Budget 2020 set for October 8, and with “fiscal space” of some €700m, is there room for a focus on long-term wellbeing or just short-term tax cuts?

Several social organisations from Mental Health Ireland (MHI) to the National Women’s Council of Ireland (NWCI) and from Barnardos to Friends of the Earth are calling for exactly that — a renewed focus on wellbeing.

Mental health

How a ‘wellbeing’ budget could care for the most vulnerable in society

Martin Rogan has spent the last 36 years working in mental health. He is chief executive of Mental Health Ireland (MHI) and when it comes to Irish people’s wellbeing, he believes in the fundamental difference that community and connection can make, as opposed to the roll out of endless treatment centres. “You always hear about the need for more treatment and better access to services, but with the scale of mental health need, you’re not going to treat your way out of it.

“It’s like giving out inhalers to everyone living in a city with polluted air, without addressing the pollution,” Mr Rogan said.

“Increasingly across the world, people are seeking or trying to achieve wellbeing, a sense of safety and connectedness. The question is in order to do that — do we give people an extra €10, or do we bring people together through community?”

Mr Rogan cites the smoking and loneliness analogy, to demonstrate his point. “Vivek Murthy, a former surgeon general of the United States, figured that loneliness is as dangerous as smoking,” said Mr Rogan.

Returning to America again, he cites research from a huge public healthy study that has consistently broken down the level of mental wellbeing across societies.

“An American psychologist and sociologist, Corey Keyes [from Emory University in Georgia], has done some really interesting research in mental health and its prevalence in society.

“He found that across the world, about 16% of population enjoy good mental health, 54% have adequate mental health to get by on and in developed countries, 20% of people are in some kind of treatment or have a diagnosis. The other 10% are languishing, they’re not really enjoying life, they’re unhappy, it’s complex,” explained Mr Rogan.

“These are huge public health studies he has carried out and when he repeated the exercises, he found the same proportionality, but the people in the groups had changed, showing that people do move on and recover, and showing that no one is immune to difficulties,” he added.

The focus on recovery is another aspect Mr Rogan is another element of mental health is keen to point out.

“An unhelpful aspect to mental health recovery here is a tendency for people not to mention ‘that really difficult period of time I went through two years ago’. This means that successful outcomes aren’t visible, and unsuccessful, even fatal ones, are very visible. But people do recover, they recover all the time.

“There is a very successful psychologist in Washington, and they say: ‘You would know my clients as highly- successful business people, but I don’t identify them and they certainly won’t identify themselves’,” he added.

In Ireland, approximately 35% of all GP visits are related to mental health. This translates to 6m visits annually

to our GPs to talk about our mental health.

Another Irish statistic is that 10% of our population is on anti-depressants.

Above all else, when it comes to funds and possible state investments to improve mental health, Mr Rogan advocates for one action.

“If a stingy leprechaun only gave me one wish — I would wish for a society where human connection is fostered. We’ve gone from being interdependent to independence, but we are designed to live in community, anything that avoids that is unhealthy,” he said.

“We are the only creature that can’t self birth, each of us is incomplete without each other. It’s not companionship, it’s simply connection. We can’t remove people out of world.”

he added.

Loneliness aside, Mr Rogan cites the importance of people being able to meet their basic fundamental needs of shelter, safety, and sustenance.

“If you have a place to live, where you know you’re not going to starve, where you’re not hiding from an ESB bill, you can live a noble life with dignity, where you can make choices and be responsible for those choices. Not clinging to the edge is an important aspect of mental health,” he said.

While the MHI chief is positive about the breaking down of the taboo around mental health in Ireland, he urges people to take action, and develop a “tool box” where possible.

“In Ireland we are in a better place when it comes to mental health.

“It’s like what Oscar Wilde said, ‘there is something worse than being talked about it and that’s not being talked about’. We have moved away from mental health being a taboo. There is a swing from one end of the pole to the other, there is lots of chatter about mental health, but what are you going to do about it?

“The pragmatic step naturally resides in the community, we’ve come through years of evolution showing that community works, we are still here, we’ve been sleep walking away from community.”

Mental Health Week takes place from October 6 to 12, and people can look out for conversation cafes around the country as a way to connect.

Parenting and childcare

Barnardos believes that the experiences we have as children lay the foundations for healthy development and positive outcomes throughout life.
Barnardos believes that the experiences we have as children lay the foundations for healthy development and positive outcomes throughout life.

Ireland has the highest rate of women homeless in Europe, a fact that stands alongside our extremely high childcare costs — costs that keep lone parents out of the workforce.

These two facts also stand beside the statistic of 20% of Ireland’s children living in poverty.

Is there a way to address any of these issues in Budget 2020, one that does not involve a few extra euro in benefit payments, in order to bring about greater wellbeing for children and families in the long term?

Orla O’Connor, director of the National Women’s Council of Ireland (NWCI), told the Irish Examiner that an equality-focused budget could bring about lasting change.

“Gender and equality budgeting provides the framework for a budget that allows us to harness the economy for the general wellbeing for all in society. Alongside finally tackling the affordability of childcare, it is crucial that Budget 2020 builds the necessary public housing and provides the appropriate number of refuge places for women fleeing violence,” Ms O’Connor said.

Separate to the issues of public housing, the cost of childcare and refuge places, the NWCI is also calling for the issue of free contraception to be addressed in the upcoming budget.

Access to free contraception would have a plethora of knock-on effects, from the reduction in the number of sexually transmitted diseases (STIs) to a decrease in unplanned pregnancies.

“We’re calling on Budget 2020 to provide free contraception for all women who need it,” Ms O’Connor said. “Free contraception would best ensure women have access to all forms of evidence-based contraception and importantly, that they can use the method that is most suitable for them.

“Contraception is typically still largely a woman’s concern, which means that it is women who are paying for it. Universal access would ensure women have access to the healthcare required to enjoy fulfilling and healthy sexual relations; support prevention of unplanned pregnancies, reducing the need for abortion; and reduce incidence of STIs.”

Meanwhile, Barnardos’ focus for improving wellbeing lies in early investment in childhoods — which research has shown to have several positive long-term effects for the individual and society.

“Investment in early childhood and poverty reduction are recognised as key mechanisms through which inequalities can be tackled but Ireland has been historically underfunded, and to a large degree,” a spokeswoman for Barnardos said. “The experiences we have as children lay the foundations for healthy development and positive outcomes throughout life.”

One major step, which would cost very little when the €700m of fiscal space is taken into account, is that of concretely investing in this early intervention.

Barnardos estimates an investment of just €3.2m in early childhood support.

“A key means of tacking inequalities is through the provision of early childhood and family support services in tandem with early childhood education,” said the Barnardos spokeswoman.

She said that such services were cut in the recession and were never restored.

“The majority of service providers were cut at the beginning of the recession a decade ago and these services have not been restored.

As a first step to addressing this situation, an investment of €3.2m is required in Budget 2020 to stop any further retrenchment of services,” she said.

Although Barnardos serves as a children’s charity, the organisation advocated for a “housing first approach”, so that every child and family has a comfortable safe place to call home, something which is a fundamental to their wellbeing.

In order to do this, they ask that the Government increases its output of built and acquired local authority and approved housing bodies’ social housing in 2020, to ensure that the target of 50,000 social housing homes are delivered by 2021 as committed in Rebuilding Ireland.

Housing and poverty

The Peter McVerry Trust advocates for a government approach that tackles the root of homelessness, as opposed to just calling for more accommodation.
The Peter McVerry Trust advocates for a government approach that tackles the root of homelessness, as opposed to just calling for more accommodation.

Housing is the big issue of the day, from renters unable to buy their own homes to young adults living with their parents, and from homelessness to those still in arrears as a result of the crash.

The number of people officially homeless in the State is over 10,000, a figure that has been rising for several years now despite multiple efforts to address it.

The Irish Examiner asked two housing charities, the Peter McVerry Trust (PMVT) and Focus Ireland, as well as St Vincent de Paul (SVP), how they might bring about a sense of wellbeing in the budget, if economic growth was not the sole focus.

PMVT advocated for an approach that tackles the root of homelessness, as opposed to just calling for more accommodation.

“Our view on a wellbeing budget is that it would invest in the systemic issues that give rise to increased risk and likelihood of experiencing homelessness in later life. “By increasing the number of social workers we would increase the availability of staff to support young people, allow individuals to be supported more intensively, and avoid people slipping through the system,” said Francis Doherty from PMVT.

Another issue that is linked to homelessness is lack of education.

Again, aside from calling for more homes to be built, the homeless charity said a wellbeing budget would look at education as a tool to prevent homelessness in the first place. “Education can play a key role in preventing and reducing the risk of homelessness. A wellbeing budget would surely have to look at dramatically-reduced class sizes and much-improved wraparound supports for children. Without extra intensive supports, students will see reduced engagement and progression in school, and ultimately disengage with the education system at an early age,” Mr Doherty said.

Meanwhile, Focus Ireland plainly called for more housing, because without a place to call home, any person’s wellbeing suffers.

“Focus Ireland believes that having a place to call home is central to every single person’s wellbeing so we would like to see providing enough social homes and affordable rental homes a real priority in the next budget to help the 10,275 people homeless and the hundreds of thousands struggling in the private rented sector,” said Roughan McNamara.

from Focus Ireland.

However, it is not just about building homes wherever a piece of land is available, Mr McNamara said. Community and one’s environment were also central to wellbeing.

“It is also vital to ensure that people have access to things like sports facilities as this really helps wellbeing and that this type of planning is taken into account when planning any housing developments.

“The environment in which people live has a massive impact on people so it is important that all budget decisions are taken with a view to ensuring they are helping to deliver a society where people who are homeless or at risk and living in poverty are supported and not marginalised,” he said.

SVP, whch directly assists those experiencing poverty has seen first hand the impact that the housing crisis is having on people.

Patricia Keilthy, head of social justice for the society, said wellbeing is “very difficult” to achieve when a person is experiencing financial insecurity.

“It is very difficult to have good health and wellbeing if you do not have financial security.

“Every week, SVP see the consequences of living in financial insecurity, the cumulative impact it has on family wellbeing, and the risk to children’s development and quality of life when households have an inadequate income,” Ms Keilthy said.

“Housing costs and insecurity are one of the main reasons people get locked into poverty. State investment in public housing will always pay dividend by supporting people to work or study and bring up their children in a secure environment,” she added.

Aside from housing, SVP said “sustainable employment” and education are fundamental to tackling poverty, something that can absolutely be done through the right policies.

“Poverty is not inevitable, and its eradication is possible, but it requires well-designed policies, resources and political will,” said Ms Keilthy.

Ethnic groups

How a ‘wellbeing’ budget could care for the most vulnerable in society

New Zealand made the health of their Mãori population one of their six areas in the wellbeing budget.

Pavee Point, which represents Travellers and Roma people, said a number of measures are needed if wellbeing is to be brought about in their communities.

“A variety of factors need to be in place to bring about wellbeing.

“Every Traveller and Roma person needs a home where you can be safe and secure — where there is access to toilet facilities, electricity and running water,” a spokeswoman said.

She also cited the importance of access to education — one that respects different cultural identities.

Access to healthcare is another way that their wellbeing could be improved, because at the moment they often encounter discrimination.

“Travellers and Roma need access to health services that meet the community’s needs — a health service where you don’t have to be afraid of discrimination — of dirty looks, whispered comments, put-downs or made feel ashamed if you can’t read or write,” the spokeswoman from Pavee Point told the Irish Examiner.

Lastly, access to jobs is the main way in which ethnic groups can “participate fully in society”.

Pavee Point advocates that every government office could employ Traveller and Roma, allowing the State to lead the way by offering opportunities for Travellers and Roma.

The elderly

One key area Age Action sees as essential to the wellbeing of our elderly is the ability for people to remain in their own homes when being cared for.
One key area Age Action sees as essential to the wellbeing of our elderly is the ability for people to remain in their own homes when being cared for.

A wellbeing budget would measure the long-term impact of policies on the quality of people’s lives. By its nature, a wellbeing budget is also an evidence-based and collaborative process to managing a country’s finances. The primary starting points is asking people what they need and then responding to those needs.

Age Action looks at the needs of all elderly people in Ireland, discovering what their challenges are and trying to address them from there.

One key area they see as essential to the wellbeing of our elderly is the ability for people to remain in the home when being cared for.

“A wellbeing budget would prioritise investing in ‘ageing in place’, which is ‘the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level,” a spokeswoman for Age Action told the Irish Examiner.

If the Government took this approach when it comes to our elderly people, Age Action said it would lead to “significant long-term benefits to people’s lives”.

The provision of homecare and of adequate local healthcare would enable people to remain in their homes and their communities for longer.

One thing Ireland is unusual for, says Age Action, is the Government’s changing of the pension rate without the use of a formula.

“Ireland is unusual in setting the pension rate in the budget every year without using any particular formula.

“People who rely on the State pension learn how much they will get in an annual budget,” said the spokeswoman.

Age Action believes that income security is essential to people’s wellbeing and therefore, the Government should organise pension rates according to proper planning.

This would “provide peace of mind for older people, and all of us as we age, and crucially it depoliticises the budget process”.

Overall, the organisation calls on the Government to commission research on the cost of ageing to ensure that there are sufficient resources available to meet the needs of an ageing population.

Domestic abuse and sexual assault

How a ‘wellbeing’ budget could care for the most vulnerable in society

Domestic abuse and sexual assault were two areas that New Zealand’s government addressed in their wellbeing budget. But how do we address that here?

The Dublin Rape Crisis Centre (DRCC) said “timely access to support services” is essential if we are to minimise the impact of harm an assault has had on a person and to facilitate their recovery.

But before any harm has been done to a person, the DRCC said much more needs to be done to prevent assaults happening in first place. “An understanding of consent and how consent in sexual activity is a key factor in the prevention of sexual violence, requires a wide-ranging, structured debate in our society which has public health as a core issue,” a spokeswoman for DRCC said.

As well as a debate, the charity said school-based sex education should provide our young people with the “understanding and skills to develop positive attitudes towards sexuality”, and “to take care of their sexual health”.

Women’s Aid also called for an investment in education as a way to reduce rates of domestic and family abuse.

“We need investment in prevention work to ensure a compassionate whole- community response to those at risk of or experiencing domestic violence at all ages,” said CEO Sarah Benson.

Disability and carers

People with disabilities are among the most vulnerable in our society today, they are at risk of experiencing greater levels of poverty, and consistently under-represented in the workforce.
People with disabilities are among the most vulnerable in our society today, they are at risk of experiencing greater levels of poverty, and consistently under-represented in the workforce.

People with intellectual disabilities experience higher rates of poverty due to being locked out of the workforce.

Inclusion Ireland, in their ideas for a wellbeing approach to a national budget, said the provision of meaningful work would go a long way to improving the health and happiness of people living with intellectual disabilities.

“A health and wellbeing budget would address the much higher rates of poverty experienced by people with disabilities, would support people to access meaningful work, and crucially, would uphold the right of all people with disabilities to live independently and be included in the community with whatever supports are needed,” said a spokeswoman for Inclusion Ireland.

Meanwhile, Enable Ireland, which works with people with physical disabilities, also said poverty is a major issue. “People with disabilities are among the most vulnerable in our society today, they are at risk of experiencing greater levels of poverty and consistently under- represented in the workforce,” a spokeswoman for Enable Ireland said.

Like many Irish organisations that have contributed to the conversation around the idea of a wellbeing budget, Enable Ireland did not just call for services and funds as a way to increase health and happiness, but much like when it comes to mental health or our elderly, the organisation said community engagement matters.

“Being able to get out of your home and being included in your community, whether that is in school, in the work place, in a sports club, is critical to wellbeing.

“Supporting measures that will ensure greater accessibility and inclusion in communities would go a long way towards improving wellbeing for people with disabilities,” the spokeswoman said.

The environment

How a ‘wellbeing’ budget could care for the most vulnerable in society

Thanks to recent damning UN reports on climate change and the activism of Swedish teenager Greta Thunberg, the importance of protecting our environment through whatever means and policies possible, is now at the forefront of the agenda.

Friends of the Earth said three simple steps are needed for improved wellbeing. These are:

  • Making every school a “solar school by 2025” where solar panels generate electricity on the roof;
  • Make public transport free for under 12s, for life, so everybody born on or after the September 29, 2008, the night of the bank guarantee, has the benefit forever;has free public transport for life
  • Stop “using GDP as the main or only measure of progress”.

“We need to use an index that captures what actually matters: health, education, poverty and nature,” a spokesman said.

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