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Learning from the past makes better policy
Learning from the past makes better policy

New Statesman​

time10 hours ago

  • Health
  • New Statesman​

Learning from the past makes better policy

Photo by Douglas Miller/Keystone/Getty Images Harold Wilson famously quipped that a successful prime minister needs 'sleep and a sense of history'. Gordon Brown, armed with a PhD in the history of the Scottish Labour Party, actively championed integrating historical insights into governmental practice. Today's politicians however, trapped in 24-hour news cycles, soundbites and crisis management, probably don't have time to consult the history books. Despite the pressures and tempo of governance in the 21st century, there is a growing imperative to look to history in order to sharpen decision-making. In an era marked by swift, radical changes in short-term political cycles, history can offer strategies for future-proofing policy – especially when the future appears unpredictable. Historical approaches to policy encourage us to consider context, continuity, and long-term consequences. These tools can provide comprehensive frameworks to counter the corrosive effects of policy churn and the erosion of institutional memory. Just as we strive to avoid treating policy areas in isolation, we must also resist separating present-day policy priorities and decisions from their historical contexts. Lasting positive outcomes typically emerge gradually from multiple, interconnected efforts rather than single interventions. This idea can be seen across a range of policy areas, as shown by the British Academy's Policy Histories series, which has so far examined the histories of regional development, environmental, science, trade, and health policy. The series demonstrates the value of historical insights and makes clear that policy history is not purely the realm of historians. Policy histories are a multidisciplinary affair that can involve economists, geographers, and many other researchers. British health policy history since the mid-1800s shows that population health improvements have been driven by far more than advancements in healthcare services alone. These improvements were achieved not only by explicit 'health policy' initiatives, but significantly by measures addressing broader determinants of health: sanitation, economic development, education, and environmental factors. Consider the 'plural formation' that historian Tom Crook identifies in nineteenth-century health policy: instead of a single, centralised programme, a patchwork of initiatives unfolded at various levels of government. Four key priorities laid the groundwork for Britain's population boom – from approximately 10.5 million in 1801 to nearly 21m by 1851 – including improved sanitation and civic cleanliness, protection of factory workers' health (especially children), state-driven medical responses to infectious diseases, and increased accessibility to doctors, medicines, and hospital care. This multi-layered approach created conditions for the sustained improvements in public health we rarely see today. Recent reports on the failure of plans to boost access to NHS dentistry are just one example of the need for multiple, complementary interventions that address wider societal issues to tackle health policy challenges in the long term. Successive governments have made narrowing Britain's regional inequalities — or 'levelling up', as the previous government jargonised it — a flagship ambition. History shows why it matters: London's per-capita GDP now sits about 77 per cent above the national average, compared with 37 per cent in 1921. This trajectory teaches two crucial lessons. First, the UK economy is not a single engine orbiting London but a mosaic of interdependent local and regional systems. Second, policies that focus only on jobs and headline growth miss the point; de-industrialisation and the 2008 financial crisis have loosened the traditional link between employment and prosperity. Today, the magnetism of a place depends as much on affordable housing, reliable transport, and robust public services as on raw growth figures. Any credible regional-development strategy must start there. Subscribe to The New Statesman today from only £8.99 per month Subscribe Trade policy has unexpectedly become a sitting duck for Keir Starmer's government. Yet the strategic dilemmas are hardly new. After 1945 Britain faced a stark choice: cling to a sterling-centred trading bloc – the 'two-world' option – or accept a dollar-dominated multilateral system. Either path raised a second, equally consequential question: how tightly should Britain bind itself to the continent and in the post-war period, the fledgling European project? Trade architecture was grand strategy then, and it is now. Naturally, the landscape has changed. Britain has exited the European Union; sterling is no longer a reserve rival to the dollar; China is the world's second largest economy by GDP; and Washington – under Donald Trump – is re-writing the rules. A credible twenty-first-century trade strategy must walk the line between commerce, geopolitics and domestic welfare. The goal should not be to reprise post-war solutions, but to confront the same enduring question: how do we balance the needs of international trade while also safeguarding domestic industries and interests, and ensuring a sustainable policy ecosystem for future generations? While each policy history has a different story to tell, there are many cross-cutting themes that remain constant. This suggests that there are key elements of policymaking that endure no matter what area you are working on. Questions relating to governance such as public trust in political leaders and the need for transparency, openness and inclusivity across the policymaking process are recurring themes. Culture and society also emerge as an important but often overlooked element in shaping public opinion, building and eroding trust, and influencing policy decisions. Fostering a culture of critical reflection and continuity within policymaking processes can transform seemingly isolated or arcane historical lessons into cohesive strategies for resilient governance. Perhaps most importantly for the current age of polycrisis, a critical lens on history not only offers clarity on how we arrived at our current circumstances but also provides sharper insights into future possibilities. When uncertainty and rapid change are the norm, the real advantage lies in imagining multiple plausible futures – and in crafting the strategies that let us shape, rather than merely survive them. Related

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