Newsletter Monday
Hello Reader,
One of the health stories doing the rounds this week is the NHS exploring a scheme that could reward people for walking regularly with shopping discounts or vouchers.
Predictably, social media did what social media does.
Within minutes there were claims that this was really about spying on people, mining for data, linking your walking data to your GP records, or even using it to decide whether you deserve benefits.
As someone who works inside the NHS, I had to smile.
If only our health IT systems were that sophisticated.
At the moment, if you end up in hospital with a heart attack, there’s a good chance the team treating you can’t see most (or any) of your GP record.
Different IT systems still struggle to talk to one another. If you’re admitted outside your local area, you probably as much of an outsider as someone who arrived from Germany that morning.
So the idea that the NHS is quietly building some all-seeing national database of everyone’s daily step count doesn’t really fit with the reality I see every week.
That doesn’t mean we shouldn’t ask sensible questions about privacy. We absolutely should. Any app collecting health data should be transparent about what it records and why.
But once I’d got past the early paranoia, I actually found myself thinking…
I quite like this idea.
Society changes behaviour in two ways.
Carrots and sticks.
We’ve become very familiar with sticks.
Congestion charges.
Parking restrictions.
Luxury car taxes.
Whether you agree with them or not (and I’m certainly often in the “not” camp), they do influence the choices people make. That’s exactly why governments use them.
The problem is you can’t really stick people into becoming more active.
You can’t fine somebody into enjoying a daily walk.
Meanwhile, almost every nudge in modern life points in the opposite direction.
Food arrives at our door.
Shopping arrives at our door.
We have escalators, lifts, streaming services, robot vacuum cleaners and voice assistants.
Human beings are comfort-seeking creatures by design, and we’ve become incredibly good at designing comfort into every corner of life.
Perhaps what we need are a few more carrots.
Let’s imagine the vouchers end up being £5 off at Amazon, Asda or Next.
Would I use one?
Absolutely.
Not because I need bribing to go for a walk, but because if someone offers me £5 off something I was probably going to buy anyway, why wouldn’t I?
Plenty of people would hardly have to change their behaviour. Dog walkers would qualify with their eyes closed.
Some people already walk to work.
Others have physically active jobs.
That’s absolutely fine.
They aren’t really the target.
The target is the person who currently does very little.
The person who keeps saying they’ll start on Monday. The person who thinks, “Actually… if I walk round the block every evening this month, I could earn a voucher.”
And here’s the important bit.
The voucher isn’t really the intervention.
It’s the hook.
The hope (and it is only a hope) is that somewhere along the way they discover something much more valuable.
They sleep a little better.
Their mood improves.
Their knees hurt a little less.
They enjoy listening to a podcast while they walk. ( I hear the prescription strength podcast is fantastic)
The daily walk stops being something they have to remember to do and simply becomes part of who they are.
If that happens, the voucher has done its job.
The companies involved won’t be acting out of pure generosity either, and that’s fine too. They’ll know plenty of people will spend more than the value of the voucher.
Next might sell an extra pair of trainers they wouldn’t otherwise have sold. Asda gains another customer. Amazon gets (yet) another order.
That’s how partnerships work.
If retailers benefit, individuals become more active, and the NHS ends up looking after a population that’s just a little healthier than before…
…I’m struggling to see the downside.
Will it transform the nation’s health?
Of course not.
Walking won’t solve obesity, muscle loss or every chronic disease we face.
But if a modest incentive persuades even a small proportion of people to build a habit that lasts long after the vouchers have stopped, that’s a remarkably cheap public health intervention.
Sometimes all a new habit needs is a little nudge.
Or perhaps…
…a small carrot. 🥕
