The NHS has seemingly decided that Britain’s “inactivity crisis” can be solved in much the same way as coffee chains persuade a customer to buy another coffee. If you walk twenty minutes a day, you collect your points, and those points could earn you a freebie.
Under the new Movement 26.2 campaign, those who complete the equivalent of a marathon each month through everyday walking might eventually be rewarded with discounts and vouchers through an NHS-backed loyalty scheme.
Movement 26.2 is yet another example of the state believing that the public are there to be nudged
Each year, the NHS is spending £1 billion as a result of physical inactivity. Britain has become increasingly sedentary, and many are suffering the harmful effects of this, through heart disease and diabetes. People should probably be walking more, that’s a given. But is a state-backed reward scheme the best means to achieve this?
There’s something quite modern about the idea that the route to a healthier nation lies somewhere between the Tesco Clubcard and Duolingo. Instead of focusing on the reasons why people become less active, government’s instinct is to ask how behaviour might be nudged via points, badges and gamified incentives.
This reflects a much broader shift in government. Politicians have become convinced that human behaviour is simply awaiting the right incentive structure, that individuals are not capable of individual agency.
One difficulty this scheme, due to launch early next year, presents is the fact that those easiest to reward are quite often the people least in need of rewarding. The retiree who already walks to the shops to pick up the paper in the morning. The dog walker or the commuter who puts in 10,000 steps before midday. All will download the app and enjoy the benefits of what they continually do on a daily basis anyway. Deadweight costs end up leaving taxpayers on the hook.
The scheme should be focused on how much additional walking the scheme actually creates. One could imagine the then Health Secretary, whomever that might be in January next year, celebrating a million participants, but the vast majority of these will be Britons collecting rewards for habits they already possessed. The nation’s health, however, will have improved considerably less.
Conversely, the individuals the NHS is particularly worrying about are unlikely to be transformed by the offer of a discounted latte. People are rarely sedentary because nobody has explained that walking is healthy. They are often not active as a result of struggling with obesity or poor mental health, living in neighbourhoods where walking is unpleasant or simply trapped in routine that have developed over decades. Against such realities, offering a voucher for a supermarket begins to look far less like clever behavioural economics and much more like wishful thinking.
Perhaps the most revealing aspect of the proposal is the machinery required to administer any vouchers that are dished out. On the surface, encouraging people to walk is an extraordinarily simple objective. But delivering it will inevitably involve an app, activity verification, retailer partnerships, some level of fraud prevention and likely procurement exercises. The simple act of putting one foot in front of the other has acquired an entire administrative ecosystem.
This is symptomatic of a broader problem where the state mistakes the measurement of activity for the achievement of outcomes. Goodhart’s Law – “When a measure becomes a target, it ceases to be a good measure” – is incredibly apt.
Once app downloads or the quantity of vouchers distributed inevitably becomes the key metric – due to those likely being high figures – the natural temptation is to maximise those numbers rather than question whether the country’s health is actually improving. Such data tell us remarkably little about whether obesity falls or the burden on the NHS has been meaningfully eased.
Naturally, there is also the issue of opportunity cost. Every pound spent developing digital platforms and funding vouchers is a pound unavailable elsewhere. Instead, it could be used to repair crumbling pavements, ensure neighbourhoods are safe places to walk around in or simply put the money towards weight-management treatments such as the weight loss jabs Wegovy and Mounjaro.
Movement 26.2 is yet another example of the state believing that the public are there to be nudged. Britain’s inactivity crisis did not arise due to a lack of vouchers. By offering incentives, the scheme risks rewarding people who already behave in a healthy manner, while doing relatively little to change the habits of those driving the costs in the first place. If so, Britain will have built in another apparatus around a problem, it has barely begun to resolve.
Comments