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Interview with inaugural Future Generations Commissioner for Wales, Sophie Howe: embedding a wellbeing approach in government July 2023, Volume 33, Issue 2

Sophie Howe, Don Nutbeam

Published 5 July 2023. https://doi.org/10.17061/phrp3322314
Citation: Howe S, Nutbeam D. Interview with inaugural Future Generations Commissioner for Wales Sophie Howe: embedding a wellbeing approach in government. Public Health Res Pract. 2023;33(2):e3322314.

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About the author/s

Sophie Howe | Former Future Generations Commissioner for Wales (2016–2023); Sustainability Futures and Wellbeing Adviser

Don Nutbeam | School of Public Health, University of Sydney, NSW, Australia

Corresponding author

Don Nutbeam | [email protected]

Competing interests

None declared.

Author contributions

DN conducted the interview with SH. Both authors reviewed and approved the final manuscript.

Abstract

In 2016, Wales became the first country in the world to appoint a Future Generations Commissioner – in essence a ‘guardian’ of the interests of future generations – under its Well-being Future Generations (Wales) Act 2015. The Act puts in place seven long-term wellbeing goals: a prosperous Wales; a resilient Wales; a more equal Wales; a healthier Wales; a Wales of cohesive communities; a Wales of vibrant culture & thriving Welsh language; and a globally responsible Wales. The Act also defines five ‘ways of working’ or principles that public bodies must demonstrate in decision making: thinking for the long-term, prevention; integration; collaboration; and involvement. The inaugural Commissioner, Sophie Howe, who held the role for seven years, reflects on the challenges and successes of leading transformational change to achieve a whole-of-government focus on wellbeing across policy and practice. In this interview with PHRP Editor-in-Chief Don Nutbeam, she shares some of the key lessons learned during her time in the role, including the need to embed the future generations approach in law, to set holistic, long-term goals – and to avoid blindly following measures and metrics.

Full text

Key points

  • Delivering wellbeing requires a long-term view with a focus on future generations that goes hand-in-hand with meeting today’s needs
  • A transformational shift is needed to enable policy makers and practitioners to recognise broader connections in wellbeing and to work with partners outside their own area
  • Building capacity and capability within systems is vital to enable public servants can act on the evidence we already have
  • It is important to strike a balance between setting broad goals and objectives and working out how to measure progress without blindly following measures and metrics

Q: How did the Well-being of Future Generations (Wales) Act 20151, and the role of Future Generations Commissioner come about?

A: When power was devolved to Wales in 1999, there was a clause in the Government of Wales Act2 that said sustainable development should be a central organising principle of the government. The Environment Minister at the time, [Jane Davidson], really championed this, resulting in the appointment of a non-statutory Sustainable Development Commissioner. However, in 2010, when the UK Government changed, they abolished the English version of the non-statutory Sustainable Development Commissioner. Amid the push for “clear red water” between Wales and England [a Welsh Labour strategy of distancing itself from the UK Labour Party], it gave the minister a lever to convince the Welsh First Minister that not only should we not abolish the non-statutory commissioner, but we should go a step further and put it on a statutory footing, and legislate for sustainable development. So that’s what happened.

The Future Generations Commissioner3 has powers to advise and support public institutions on how they should reach the Act’s seven long-term wellbeing goals4 and to assess their progress. The overarching duty of the Commissioner is to be the guardian of the interests of the future generations of Wales.

Q: There’s a lot of attention to wellbeing at the moment. Not all of that is linked to the wellbeing of future generations, but that was an explicit position taken by the Welsh Government. Could you tell us what advantages and constraints came with that focus on the future?

A: I feel this is common sense in a way. But we have situations across different governments where you’ve got people doing sustainable development, people developing wellbeing budgets and wellbeing in quality of life indices, and then people looking at existential threats and long-term issues – and the three are kept quite separate.

To me, you can’t deliver wellbeing unless you take a long-term view, and that has to be about future generations. Our Act is about balancing the needs of current and future generations. We should meet today’s needs without compromising the ability of future generations to meet their own needs. So, I think that the three aspects have to go hand-in-hand if you’re going to get a sensible approach to actually delivering this.

Q: Were there ever occasions where the needs of the present generation significantly conflicted with the needs of the next generations?

A: Yes, for example, one of the big changes brought about as a result of the Act is that we’ve pretty much stopped building roads in Wales. It started with a big issue that I intervened in around government plans to spend the entire of their borrowing capacity building a 30 mile stretch of motorway to deal with the problem of congestion.

So this is the rub. If you’re stuck in traffic congestion in Newport, you get pretty irritated… and it’s probably not good for your wellbeing. The problem is that if we keep doing the same thing, nothing ever changes, and we get the same result. So at some point, we do have to stop, pause, and do something differently. You won’t like that if it means you’re not going to get a road built. But fast-forward 10 years when the investment is moved from roads into public transport, and it’s now much easier for you to get the train, we’ve reduced air pollution and carbon emissions as a result, and you’re healthier because there are safe routes to walk and cycle and interact in your community…then, that is actually good for your individual and societal wellbeing in the long term.

We’ve got a similar issue at the moment with big investment in renewable energy in Wales–needed to meet carbon targets, reduce energy costs and the potential to create jobs. But it comes with pylons which are going to be a blight on the landscape. So, there are those tensions.

Q: There’s a sense that a Commissioner is a little bit divorced from the cut and thrust of politics, but I imagine all your decisions would have had a political upside and downside. Can you tell us about that?

A: I’m appointed, not elected, so I don’t have to worry about people-pleasing the existing electorate. My job is to be the voice of future generations who don’t have any voice elsewhere. But yes, everything is set within a political context, and of course, I can’t force anyone to do anything or stop anyone doing anything. But I can hold a mirror up to government and the public bodies and say, “You’ve passed this legislation (in the case of government). You’re covered by this legislation, and you have to show me how you’ve taken into account these considerations around the interests of current and future generations”. Now, that doesn’t mean that we always get everything right and that they always do that, but it is a useful process.

Q: Can you tell us a bit about how your powers and responsibilities manifest themselves in the preventive health domain and what the important issues were in the context of your role in prevention?

A: The starting point in terms of prevention was primarily focusing on those wider determinants of health – we should be looking to do the things in policy that overall make the biggest contribution to each of the seven wellbeing goals. So from that, I chose housing, planning, and transport on the infrastructure side of things, and then jobs and skills for the future, better ways to keep people well and tackling childhood adversities, on the more ‘people’ side of things.

I would say that what we’ve done on transport in Wales – which is stopping spending on roads and investing in public transport and active travel – is a preventive intervention in terms of its benefits to health. Likewise, in terms of the reforms that we’ve driven through on planning policy – how we plan, design, and build our community’s infrastructure.

There have also been some big interventions around a universal basic income (UBI), of which I was a fairly early advocate. We commissioned a big piece of research looking at the benefits of the UBI against delivering the seven wellbeing goals. Of course, the biggest benefit is taking people out of poverty – that was seen as completely impossible just 5 or 6  years ago. But at the beginning of last year, Wales started its first pilot of UBI. It’s targeted initially at care leavers [people leaving care when they turn 18] who’ll be receiving £1600 a month (A$3000) with a big evaluation wrapped around that. What we’re aiming to do here is to really prove, in a UK context, the difference that taking this particular group out of poverty can make and then start to model that out further.

Q: Specialists in public health are quite often driven down a rather narrower pathway focused on primary care, screening, health education etc. What was your experience regarding broadening that view of public health?

A: We tried to get people to recognise the broader connections and the need to work with broader partners. Under the Act, there is infrastructure called Public Service Boards where all the key public services in each local authority area come together. Each of those individual organisations has duties to set objectives that maximise their contribution to all seven goals. But then, as a Board, they have collective duties: first off, to do a wellbeing assessment of their area and then to develop a wellbeing plan encompassing collective actions. In the first set of wellbeing plans, health bodies were focused on health initiatives etc., but the latest iteration of those plans is about making the connections, and there is some really interesting early work.

For example, through the Public Service Board in Cardiff, a public health consultant was seconded into the local authority to lead the development of the transportation strategy and to apply a health lens to a transport problem. If you put highways engineers on that, they would probably find ways of building more roads. However, the consultant, Dr Tom Porter, started looking at the areas with the highest levels of air pollution, the lowest levels of life expectancy, and so on, and started to redirect resources to public transport and active travel there. Because we also have duties around the goal of a resilient Wales, which is about enhancing and maintaining nature and biodiversity, there was an added health benefit to cleaning and greening these communities. So, when putting in cycle lanes, we’re going to build them using green infrastructure, which has the added benefit of providing better drainage. So you’ve got reduced air pollution, the potential for increased physical activity and attractive, vibrant, safe, well-connected communities. So that’s the kind of interesting initiatives that start to come from this.

Q: You called for the introduction of a Minister for Prevention to try to get the kind of joined-up thinking across government that you’ve just described. How is that joined-up Government working in Wales, given the commitment you’ve had in place for quite a time now?

A: My recommendation was not just a minister for prevention, but a minister for prevention with a 10% top slice of every budget across government at their disposal to coordinate action across government and invest in preventive interventions. We don’t have that. But I think you’ve got to put some of those radical things out there because otherwise, you just plod along.

More broadly, this is transformational change. The first three years of the legislation being in force were incredibly turgid and irritating, from my perspective, because we had a traditional public sector response – “It’s a bureaucratic exercise – what we need to do here is just carry on doing what we’re doing and use wellbeing words to describe it”. However, what we now see in the next set of wellbeing plans and assessments is that they are much further forward.

There are areas where some really interesting stuff is happening – on transport, planning and school curriculum reform. I feel it is getting through now. The government has something called an ‘Economic Contract’ – when the government gives money to businesses, they need to sign this economic contract which requires them to sign up for decarbonising, improving the skills of their workforce and focusing on the physical and mental health of their workforce. That’s in line with the Future Generations Act. But no one’s monitoring what they’re actually doing on that economic contract. So that’s really annoying.

The biggest challenge with all of this is capacity and capability in our system. There are many people – for example, public health people – who can see that there’s a better way of doing things, but the system has frustrated them from doing that. The Act gives them permission to challenge the system. But you have to be really tenacious. You have to find the time and space to do that, and it’s still really difficult.

Q: Are there generalisable lessons you can share from your unique experience that might be useful for people who are thinking about the next generation of wellbeing mechanisms, whether that’s by an Act or Commissioner or other means?

Putting such wellbeing mechanisms into law is critically important. It doesn’t mean necessarily you can force anyone to do anything or stop anything from happening, but the ability to wave the law is really important.

The holistic nature is also really important. It needs to be a mission for a whole country so they actually know where they want to go and have a set of long-term goals that the country can aspire to.

We need to focus on how we can act on the evidence we actually have and who is going to roll their sleeves up, get into the system, and provide some of that capacity and support in the day-to-day lives of civil servants. Most of what we do on the outside of the public sector is write reports describing the situation or give a series of recommendations, and that isn’t good enough. Those of us outside the system have a responsibility to reflect on our own ways of working and what is actually going to drive outcomes and change. And I can tell you now, it probably won’t be another report!

The other thing I would say is that you need to strike a balance between having a broad set of goals and aspirations and working out how to measure progress without getting too obsessed with indicators. If you start with looking at how we’re going to measure this, this and this, it sucks away that kind of collective innovation. There’s a real tension there. What I see across a number of different countries looking at wellbeing is that a lot of them are starting with the quality of life index and wellbeing indicators, and so on. And my question there is: ‘So what? How are you using that to actually inform what you do and how you test the indicators that may drive progress here but actually take you backwards in other areas?’

Our five ways of working connected to the objectives are critical. You’ve got to be integrated. You’ve got to be collaborative. You’ve got to be looking at not just short-term wins of your indicators but at what’s the long-term benefits or potential damage from them. So just blindly following measures and metrics is not it.

Acknowledgements

The interview was conducted by DN, Editor-in-Chief of PHRP.

Peer review and provenance

Internally peer reviewed, invited.

Copyright:

Creative Commons License

© 2023 Howe & Nutbeam. This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Licence, which allows others to redistribute, adapt and share this work non-commercially provided they attribute the work and any adapted version of it is distributed under the same Creative Commons licence terms.

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