Into the future with our eyes open

The final entry in our blog series is from Victoria Hume, the new Director of the Culture, Health and Wellbeing Alliance.

This blog series is meant to provoke and challenge. Advocating for arts in health by itself has ceased to feel like a provocative concept. But it was, only a few years ago. It’s only thanks to the many people persisting with an apparently eccentric idea over many years that the idea of arts and culture as central to health and wellbeing is becoming mainstream. It has taken active advocacy to get us to this point. But now that I write it down I remember again how absurd it is to think that they might ever be separate.

Until this summer, I had been based in South Africa for the last four years. On returning to the UK, I have found the connection between culture and health so much more accepted than before I left. A few months ago I found myself watching the apex of a certain kind of mainstream, the Chelsea Flower Show on the BBC. It was gratifying to see, via the medium of Monty Don, just how normal these ideas have become, in this case in the guise of a new collaboration between the Royal Horticultural Society and Camden and Islington Mental Health Trust. I remember years ago, going with Damian Hebron of London Arts in Health Forum to meet the chair of one of the Royal Colleges relating to health, to persuade him that we should collaborate on a grand scale to bring the arts into mainstream health practice. He kept talking about gardening. At the time it drove me mad that we couldn’t get him to focus on art. Now I wonder why I was pointlessly separating one cultural, imaginative, productive activity from another.

There is a small challenge in this, though: How do we talk about the special value of the arts and culture, and yet make a broader argument for something more evanescent – an idea of feeding ourselves with creativity, of valuing the community generated by certain productive activities that have little in common except their unlikelihood to produce money? How does this not just become a mush of alternative-ness?

The business of not producing money is perhaps more pertinent than we think. In fact the non-money-ness of what we do may be a defining characteristic, more than any particular form of artistic or cultural endeavour.  The reintegration of culture and health recognises that consumption cannot compensate for creation. It is perhaps a post-growth concept. It is attempting to upset hidebound ideas about what constitutes good health. Must it always be a clinical trial that determines the economics of medicine? Can it be sometimes a novel? A painting? A pop song? If it can then what does that say about the mechanisation of care, and the knowledge economies that dominate treatment. Alan Howarth’s 2013 speech for the international conference for Culture, Health and Wellbeing sums up the radicalism of this movement; I am delighted to be one of the ‘heretics’ he says stand opposed to the “pathology of the west”. We could be more strident about this.

For years, we have been trying to prove that (for example) music saves money in dementia care. Of course it does. Of course it gives people the kind of experience that lessens demand on staff and drugs. What worries me about the case for efficiency is that it implicitly accepts the need to cut funding to the NHS. We are being told again and again that longer lifespans mean more cost and over-stretched services… it’s a disingenuous position. We must remember that funding or starving health services is an ideological decision – it is, at root, not to do with ageing populations but a view on the state and its level of responsibility for its citizens. See Harry Smith’s intensely moving speech for the 2014 Labour party conference if you’re not sure. As an arts in health advocate, I refuse to be drawn into making the chronic underfunding of our health service OK. We must be careful how we argue, and what we argue for. This is not a negative proposition, a removal of stress, or a distraction – it is about building public health, about creating a thriving, multi-faceted health and social care sector.

Perhaps we need to think more clearly about sustainability. This is a movement with minimal infrastructure, yet it is constantly engaged with sustainability. No-one wants to helicopter in for a nice workshop and then disappear. How do we set something up that will last, how do we create momentum on the minimum of resources? This is a natural cousin not to austerity but to ecology. We are all about imaginatively reconsidering existing resources. We have been thinking about health in terms of culture for a long time in this arts-and-health movement. But now we have to make sure this view is broad enough to take in the whole of what ‘culture’ means: language, history, work… what makes us different, where we can connect.

The coming together of the museums and health movement with arts in health under the banner of the Culture, Health and Wellbeing Alliance is one significant part of this. Another is working with the expanding world of medical humanities: our case for another kind of health will be better made in tandem with the philosophers, historians and anthropologists grappling with just this question, rather than in parallel. And as last year’s international conference for Culture, Health & Wellbeing demonstrated, we have to keep thinking internationally. It’s clear that if we want to consider health, we can no longer think of this as a discrete issue, separate from the environment, from raging inequality, from the movement of peoples and the shifting of culture. Arts in health is no longer a parochial nice-to-have backwater. It is part of a bigger, long-overdue shift in the way we think – against silos and for conversation. We must articulate what is radical in our work in the context of these huge questions. For anyone sensitive to the world around us, it is hard not to question the importance of creativity and culture in such politically fractious and divisive times.[1] Yet if we want change, we have to develop our imaginations. We have to think creatively, boldly. This, after all, is where change will come from – this is the healthiest form of art.

[1] For more on this see the brilliant Brainpickings blog on Toni Morrison: “There is no time for despair, no place for self-pity, no need for silence, no room for fear. We speak, we write, we do language. That is how civilizations heal.”

Victoria Hume photo by Yeshiel Panchia
Victoria Hume photo by Yeshiel Panchia

Blog Image Credit: The Bucketloads of Health project, Sustainable Livelihoods Foundation (


One thought on “Into the future with our eyes open

  1. Dear Vicki, A good read. Thanks for writing on the subject. What concerns me is that, as the argument/case for arts activities by individuals can, does and is contributing to their health being accepted by both them and health professionals – GPs, Doctors , Nurse specialists, Public health Officers etc etc, we seem to be getting further away from allocating any resources – particularly financial to pay for artists to work in healthcare as either part of the NHS, public health or allied sectors. It is almost as if it is being said ‘case made and accepted’ now go out and do it and pay for the activities yourselves. We seem to be no nearer integrating artists as part of healthcare programmes. Indeed the news stories and investment is still 99% directed to cures for physical illnesses via new ‘sciences’. There is very little/insufficient attention or investment about the contribution of what and how our mental approach to living makes to present and future health, how creativity, imagination and activity in these fields prevent ill health or how this maintains health when living with a health condition. Society and the NHS still seem to want to pass by on this aspect and not engage and this is really where artists are best at operating and contributing most effectively. It is also what can limit the onset and causes of physical ill health. The case for the arts needs to be made deeper and wider. Artists and the arts are still being regarded as something good if you have the spare time, finances and luxury of spare mental capacity. At the moment with the financial austerity of post 2008 and looming Brexit the arts and artists are almost being squeezed out of the NHS and the gains from the years 1970/80/90/00 sidelined. We still have to get the NHS as a whole to take the arts and artists seriously and understand what the arts actually are and do.

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