Years ago, when I had a TV show called Where There’s Life, we decided to do a programme on QUALYs, a new measurement that was decisive in apportioning money for treatments between equally deserving patients in order to share out scarce NHS funds.
A QUALY was the combination of how the quality of life of a patient would improve as the result of a treatment versus its cost and was graded in Quality-Adjusted Life Years.
For the show I had two patients in the studio, one needed a hip replacement costing, at the time, about £2,500, and one, a single mother, with two small children needed a kidney transplant. Much more expensive, in fact 10 times as much as a hip (10 hips for one kidney).
Who should get the scarce resources? I asked the audience to vote and to my astonishment they allocated the funds to a new hip meaning the mother with kidney disease, theoretically anyway, would die.
Well, we’re on the horns of a similar dilemma now, trying to weigh up which Government choices will have good outcomes (fewer deaths, save the NHS) and which bad (unemployment, business closures economic harm).
How can we judge these disparate outcomes?
The answer is with WELLBYs – a policy’s impact on the nation’s wellbeing – proposed by Oxford University’s Jan-Emanuel de Neve and Andrew E Clark, from the London School of Economics. By wellbeing, they mean how people feel about their lives, their life satisfaction.
People are asked: “Overall, how satisfied are you with your life these days?” on a scale of 0-10, 0 being not at all satisfied and 10 being extremely satisfied. The researchers have shown it predicts life-expectancy and it’s reliable, when retested people give consistent answers.
We can now measure the change in wellbeing as a result of losing your job or becoming depressed or anxious. So we can anticipate the effect of government policies on the nation’s wellbeing and measure it in WELLBYs, representing the change in wellbeing over time, in years.
The average life-satisfaction of a Brit is approximately 7.5.
So the Government could demonstrate the effect of each of its policies by the positive and negative impact it has on that 7.5 and use it in deciding its course of action. WELLBYs could be a decision-making tool for politicians, providing a framework for how we spend money in order to maximise the wellbeing of the nation.
The researchers propose that policies should be evaluated by their WELLBYs per pound of expenditure and hopefully move, like New Zealand has, to a more holistic framework to policy making.