UCL Health of the Public


Episode 4 Transcript: How is law good for your health?


health, people, inequality, law, public health, ucl, pandemic, problem, laws, camden, housing, services, crime, life, issue, parliament


Sir Keir Starmer, Professor Dame Hazel Genn, Xand Van Tulleken, Rochelle Burgess


Xand Van Tulleken  00:00

Hello and welcome to episode 4 of Public Health Disrupted – the brand new podcast from UCL Health of the Public.  I’m Xand Van Tulleken – a Doctor, writer and TV Presenter and I’m prepared to do pretty much anything to start a conversation on public health. And I do mean anything, whether it’s editing journals on humanitarian healthcare or experimenting on my body for children’s television.


Rochelle Burgess  00:20

And  I’m Rochelle Burgess - a community health psychologist, specialising in community-based approaches to health. I’m a Lecturer at the UCL Institute for Global Health and a self-confessed hippy here to talk about the importance of community, solidarity and social change to pretty much anyone who will listen.


Xand Van Tulleken  00:40

We're calling this podcast public health disrupted because that's exactly what we want to do. We're going to be breaking down disciplinary, sectoral and geographic boundaries to really understand the diverse complex issues impacting our health. In today's episode, we're going to be exploring the intersection of law and public health and how law and legal services can help to mitigate these health inequalities.


Rochelle Burgess  01:01

Our first guest is Sir Keir Starmer, who has been Leader of the Labour Party and Opposition since 2020. Sir Keir is a former lawyer and has been Member of Parliament for Holborn and St Pancras since 2015, so is UCL’s local MP. After qualifying for the Bar, Keir acted exclusively as a defence lawyer, specialising in human rights issues, before being appointed as a Queen's Counsel in 2002. In 2008, he became Director of Public Prosecutions and Head of the Crown Prosecution Service, holding these roles until 2013. For his role as Director of Public Prosecutions, he was appointed Knight Commander of the Order of the Bath in the 2014 New Year Honours


Xand Van Tulleken  01:42

Our second guest is Professor Dame Hazel Genn, Professor of Socio-Legal Studies in the UCL Faculty of Laws and Currently UCL Vice Provost Advancement & International. Dame Hazel is a leading authority on access to civil and administrative justice. Her prize-winning scholarship focuses on the experiences of ordinary people caught up in legal problems and the responsiveness of the justice system to the needs of citizens. In 2013 she established the UCL Faculty of Laws Centre for Access to Justice and in 2016 developed its activities into an innovative partnership with a GP practice in East London to deliver free legal advice to vulnerable patients within the practice. She regularly lectures about integrating health and community legal services and recently published an influential article When Law is Good for Your Health. It's lovely to have both of you with us I sort of can't think of two better people to be having this incredibly important conversation at the moment with Hazel the last time you and I spoke, you said that you're more interested in what the law does than what the law says, which I thought was a lovely way of capturing the kind of range and the impact of your work. First of all, can you just talk to us briefly about the ways in which law affects our health?


Hazel Genn  02:58

It's a great question. I think it's something it's often missing from discussion. When we talk about public health, I think if we think about the things that affect health and well being not illness, but what affects health and well being things like having enough money to feed your children having a roof over your head, safe conditions, to live in safe working conditions, appropriate education, decent air to breathe security at home and elsewhere, if you think of all of those things that actually affect our health, the law is involved in every single major determinant of health. And it operates, I would say, at three different levels. And I think one of the problems is in public health, we only ever talk about it at the broadest level. So at the broadest level, if we're thinking about legislation, so laws passed by Parliament, we pass laws that actually are designed to protect vulnerable and needy things to do with benefits, things to do with housing. So we have plenty of law on the books. But once you've got the law on the books, that isn't the end of the story. And sadly, in public health, people forget that once you've got the law, it doesn't mean that everything automatically happens, because we'll always have to be implemented. So the middle range, what's the law has been passed, you've got lots of institutions that have to decide how that's going to be implemented. So you may have a law that says no one should be homeless, but how does a local authority decide on their housing policies? And then at the individual level, you can say, well, individuals or families on low incomes should have enough money they should be housed. They shouldn't be thrown out of their jobs. But can people get the benefits and services to which they are legally, legally entitled? So as I say, just having law on the books doesn't mean the vulnerable families and individuals get the protection that they need. So I'm not when I'm talking about the relationship between law and health. I'm not necessarily talking about public health law, like things like sugar tax and smoking laws. I'm talking about laws that create the conditions to support health in more indirectly. And I think that's the bit that gets left out, and how do we make sure that those protective laws are in practice, implemented properly and can be enforced? At the level of an individual into all families,


Xand Van Tulleken  05:03

I think you've really captured there the barriers for so many people to access what they're entitled to. So Keir, bearing in mind the vast impact that law does have on our health. How much is that taken into consideration when you're creating new laws? And I guess you're one of the few people in the country who is in the business of actually making laws? And if it's not taken into account very much, should it be


Keir Starmer  05:31

absolutely fascinating question this because it goes to the heart of what we actually do in Parliament, where there are very few rules and constraints on what laws we can pass, if you've got a working majority in parliament, we don't have a written constitution, which in other countries would have at least put a framework around what laws you can pass. We don't have that. And so the answer the question is health is sometimes taken into account, but not always. It depends. But there's no checklist. You don't if you're about to pass a law, there's no law that says, Well, before you vote for this, we better have a discussion about health, the health implications, because the law making doesn't work like that. Obviously, in some areas, it's absolutely a consideration. If you're passing laws on health and safety. If you're creating the NHS or restructuring the NHS, as we're apparently about to do, then health is right in the middle of the consideration, just as it is. I mean, you know, how timely is this? We've got very, very strong laws in place at the moment on COVID-19 that are restricting things which otherwise we would be perfectly entitled to do. And at the heart of that is health. And so it's been at the heart of the debate. But is it always at the heart of the debate? No, it isn't. Although we don't have a constitution, there's an emerging, I suppose view that health does have to be at least severe health impacts have to be taken into account when we look at things like the Human Rights Act. And this idea of where there are severe impacts on health, whether the human rights legislation actually constrains what we can do. But that's in pretty strong and extreme cases. It's not a routine requirement to look at the health implications.  I'm very interested just to spin on from this. A number of countries have introduced a sort of well being test for pretty well, everything that they do. So they have to assess government action, local government action against well being and the impact there on health and mental health. Actually, I'm fascinated by that. I think it's a step in the right direction. The best two examples in this, Hazel will know better than me, I think New Zealand has got a well being act. And Wales has got a well being Act. And so arguably, there's a move towards in the United Kingdom, where well being becomes more of a factor. The only other thing I'd say, just to echo what Hazel says, which is making law is one thing, actually accessing it and making it work is another so let's take health and safety. Obviously, health is right in the heart of that it's a health and safety set of provisions. But how many people you have on the ground actually enforcing it makes a material difference to whether it works very well in practice. But the simple answer is yes, sometimes health taken into account, but absent any overriding obligation, Parliament could pass legislation without regard to the health implications.


Hazel Genn  08:09

Can I just add to that, that, of course, what the welsh have done is to have a health in all policies measure so that in the way that we do with equality is that when we're passing legislation, and we say does it meet, you know, you do an equality impact assessment. So they have to do a health assessment impact on all policies. And I don't think that we do anything like that. And it is something worth thinking about, because as we but we both agree on all kinds of legislation have both direct and indirect impacts on health and well being.


Rochelle Burgess  08:42

Yeah, I think that's so so fascinating, all this discussion about the bidirectional relationship and this idea of, you know, we still need to do a lot to make it work. And it sort of brings me back to one of the first research projects I've worked on many, many moons ago, back in Canada, I did a study where we sort of did medical chart extraction, trying to look at the backgrounds of homeless men in the city that I was from, and sort of looking at their experiences of cycling between homelessness and prison experiences. And one of the things that we found in that study was that the majority of these men had histories of head injuries, actually that sort of like pre dated their homelessness and then their experiences with with criminal justice. And because both of you have so much rich examples of this in the world of practice, I wondered if maybe Hazel and then Keir could give examples of this type of phenomenon.


Hazel Genn  09:35

I can give you an example. That was a case that we dealt with in the health justice partnership that we set up in Nuem. And the partnership was basically free legal advice provided by students and qualified staff to patients in the practice, and we train the doctors to kind of recognise cases that might benefit from having some legal advice. And one of the cases which we I call Alicia and her baby was a mother with a baby with breathing problems and skin infections. And she was repeatedly going back one day over and over again to the doctor, she had a sense that her living conditions might be making her child ill or worse, because she was living in social housing that had terrible damp, insects and rodents. And she'd been to the doctor several times. But when we were there, on one occasion, he just thought, hang on. And he said to her, do you know what, you know, I can give you more medications for the baby. But I really think you should go and see these people downstairs. And of course, we were downstairs, and she came down and saw us. And we talked to her. And then we got in touch with her local authority. And we asked for a review, and they reviewed her housing. And they said, Yes, she was living in inappropriate housing. And she was, and she was rehoused. And I have numerous examples like that. And that is a case where it shows where you may have a law that says you should be living in decent housing, but the question is, is is the implementation and does the individual know what they have to do. And even if they have a sense of what they might need to do all that they might need to move? Do they have the ability to make things change, and I think sometimes you need what I call legal heft. And that doesn't necessarily mean very expensive, qualified lawyers just sometimes social welfare advisors can do that if they are available, but you need those those links, the critical things there were the doctor recognising that this was a medical issue underlying which was a problem for which there was a legal solution. And we could help with that.


Keir Starmer  11:21

Let me go into the world of criminal law and give a couple of examples. One is a very real example that we're working on at the moment. And that is, in Camden for a number of years. Happily, we didn't have any fatal stabbings of young people. And then in the last three or four years, about 18 months, two years ago, we had a number of them, which were very, very traumatic, obviously, for the immediate families, but also for the communities involved. And it was young boys, and I mean, young, you know, usually teenagers, and, you know, we would hear of a stabbing the young boy on the pavement dead, and Georgia Gold, the council leader, and I would go and see the family and the community is very, very hard. And we decided to start a piece of work, which would look more beyond the immediate policing response to the incident and more of the sort of the wider impact and how we could try to in Camden, put our arms around this and reduce the likelihood of it happening. And that took us into a lot of work of law and public health. And the more we went into it, the more we discovered the links, which I've always believed to be there. I think health and education and crime are all mixed up. It's one of the reasons that silos don't work. If you have criminal justice here, education, there health, there mental health there, you're probably not going to get very far with crime reduction, you've got to do it on a cross cutting. The more we went into this issue, there was this issue of trauma. And what we worked out was that both victims and perpetrators of knife crime in Camden boys, not always boys, but predominantly boys, there was usually a trauma incidents that preceded the behaviour that they got involved in. And sometimes it was perpetrator. Sometimes it was victim, but there was trauma. And that led us to then work with our schools in Camden. Then the next question was to our staff at our schools understand trauma and the health side of crime, are they talking to children do they notice when a child appears to be traumatised because of something that has happened previously in his or her life, so that brought public health like right into not only crime  but into our schools been an amazing piece of work. But then this is linked, obviously to your college that uclh have got now a ward, they did have a ward whether it's still there in COVID, I don't know, dealing with children and young people and what they then began to pick up but through red thread and other things which was an incredible initiative was that they realised that they could see some of those that were victims of more serious crime coming in with lesser injuries to start with, and it was this health pathway into crime. And so we started working on that. So there are lots of links there.  And then I think the final thing I'd like to here because I think it is relevant, I don't think pay enough attention to it is that because there are health and mental health issues, mental health runs right through the criminal justice system, both perpetrators and victims, the huge impact that being a victim of crime has. And so actually, I mean, certainly for the criminal law and the civil law as well, trying to suggest that law and health are mutually exclusive is wrong, they are absolutely tied up. And and I don't believe that we will ever properly reduce crime if we don't tackle the health and mental health issues.


Xand Van Tulleken  14:28

What you're describing is almost a diagnostic pathway for criminality or that are the determinants of criminality and also the determinants of being a victim of crime. And so, in the same way in healthcare now, we'd say that you need a multidisciplinary team. If you're trying to address the underlying causes or trying to address a particular case of criminality or being the victim of a crime that you need multiple disciplines involved is such a nice description, you've talked about the perhaps slightly arbitrary way in which public health may or may not be incorporated into making legislation in Parliament. What about the local level? When we think about things like housing planning environmental decisions, I suppose the bits of law that I maybe see materially around me in my neighbourhood affecting specific individual people, how is public health incorporated into those kind of decisions? Keir an I can I ask you that


Keir Starmer  15:24

it is, and obviously, I'm not involved in the decision making of Camden Council on planning, environmental, but they are making decisions and that can be in planning it can be in the way of building is going to be put up. And these days environmental and health impacts are taken into account and quite right to think if you look at what for example Camden council is doing, there's a wider piece of work, which you see on areas like air pollution, which is an obvious public health issue in and around Camden, Euston road we've got a real air pollution problem. And that has to be addressed and taken into account by the Council when they're designing not only new builds, planning concern, but also how we use our roads. And one of the things that Camden have been trying to do is to get as many cars off our roads as possible. That's why you see the various changes to the traffic systems, etc. So it is, I think, now much more central to the council's decisions, because if deaths from air pollution were recognised for what they are, they ought to be front page news in terms of the numbers of people that die from things like air pollution, but it isn't in the same way. So I think it is becoming increasingly important and central to what good local authorities like Camden do.


Xand Van Tulleken  16:36

It's interesting, isn't it? This idea that increasingly, the state's job is to ensure our health and our survival and kind of optimise our our health. Hazel, we know that the health of lots of people is very dependent on access to particular services, particular protections like welfare benefits, community support, the legal system has obviously created those benefits and made them available in some way. But what role does it play in enforcing the services that they actually do benefit the most vulnerable? Is that is that a legal issue?


Hazel Genn  17:10

It's an issue for individuals in terms of accessing services, benefits, entitlements, which the law provides them with. And the problem for the kind I'm not talking about the the the whole of the population, but particularly focusing on those groups who have possibly the most complex health, social needs a range of needs. Often, they may not be aware of what their rights and entitlements are, things don't always happen automatically. You need to know you need to apply for things. So people don't know necessarily what they're entitled to, or what they have a legal right to. And even if they do, they're not always sometimes it's quite difficult to access those services or to get the thing that you actually need. So the question is, where do you go for help, and this is, we're gonna keep coming back to this question kind of integrated services. Because I do it's the point that came before and I'm absolutely This is kind of my mission at the moment is to get things better integrated having much more of a holistic approach to the needs of people, getting help to the people who have the most complex needs. And if we care about things like health inequalities, if we care about life chances of children, you know, the life course of improving things, we need to make sure that people have those protections, access to those services at the earliest possible stage, so that we avoid bad things from happening, or bad things from getting worse. And what the role is of certainly free social welfare, legal services, which is what I've been talking about at the moment is to provide that kind of advice, information and support, if necessary, to people who don't necessarily know what their rights are. And even if I have some sense of what they are, they don't know how to go about accessing the services that they need. Particularly, they get kind of pushed back in need initially. So they need those kinds of services. And those services need not to be hidden away somewhere where you have to go and find them or queue up in the street. And this is exactly the kind of image that Keir was setting out before. What you need to multi-disciplinery centres in the places that people go. And the reason that I have focused on getting free legal advice into primary care, but also into hospitals as well is because those are the places that people go when they don't necessarily know what what it is that they need. But the problem that we've got, we might talk about this later, is that going to those places doesn't necessarily get you to the right kind of advice.


Rochelle Burgess  19:44

It sort of seems to me that when you enter into these spaces that we would like to see to become multidisciplinary, and you're talking about GP clinics and environments that a lot of non medical issues are increasingly sort of accounting for a large proportion of GP consultations and sort of engagements in those spaces. And and I guess this question possibly is better and better for for Keir really, it's a thinking about how we can get the law, I suppose better integrated within the NHS or to better support more most vulnerable populations at that sort of Nexus and that interface and sort of what you would see there.


Keir Starmer  20:19

I think this is a fundamental question, Rochelle, you lead us into this through the through the inequalities and poverty and inequality of every sort here, and on Tuesday, I was with Michael Marmot who, again, is University College, in my view, fantastic professor. And he's done, you know, three groundbreaking reports. Now, the 2010, report into health inequality, the 2020 version of the same report, which was compelling in its evidence of greater inequality and the impact of what governments do on inequality. I mean, without making a political argument, he's making a profound political argument about what happens if you do x rather than y. He's now done a third report, as you know, which is the impact of COVID on the inequalities that he had been following in that decade. And where we go next, I mean, answer your question, Rochelle is, for me is informed largely and hugely by that, because as we come out of COVID, now, you know, the vaccine, I hope will be the light at the end of the tunnel. And therefore we can begin to say, Well, what do we want the future to look like post pandemic is our aspiration to build back to where we started to go back to as we were a year or 18 months ago, which is to take us back to the scenario that is painted so vividly by Michael Marmot, or do we say no, after this, we need to go forward to something different and better and to actually to conjure up something of the spirit of the post Second World War Labour government to say out of this, we have to go forward.  We often challenge the Prime Minister on the basis that we've got one of the worst COVID death rates in Europe, and the worst recessions because of his indecision, his slowness, etc. And the way he's made decisions. And I do believe that but I think equally, if not more of a cause is written there in the Marmot reports in the health inequalities, the public health inequalities, and the structural inequalities that we've had going into this, we had a very, very unequal framework, we had underfunding across our public services, we had a fragile health service, and that has impacted so for me, Rochelle, the answer, your question is, I think there's actually a fork in the road politically. Now coming up in the next few months, we have to take the path, which is to say you don't build back to business as usual, your aspiration is not to get back to where you started as quickly as possible, your aspiration now, because all of these inequalities have been brutally exposed by this pandemic, almost every existing inequality, health, disproportionality across ethnic groups, housing, jobs, all of them brutally exposed. And so we have to take the path through government, I hope to a better a different future that actually reflects some of the broader conversation we've had this morning, because this is going to I think there's going to be the issue of our time now, which is, which path do we take coming out of this pandemic, it'll be a defining moment, and a really, really important political argument. And health and inequality are right in the in the heart of it, because if you don't deal with health and inequality, it's not just a moral wrong, it actually it means that, you know, the economy won't work properly. And it goes back to the thing about well being the idea that people's well being and fulfilment in life isn't measured only in pounds and pence, it is measured in the quality, the broader quality of their lives. And health and mental health are a fundamental part of that. And I hope this becomes a central political question. In the coming months.


Hazel Genn  23:36

Can I say something on that as well, I completely agree with everything that you've said Keir. But what I what I will say is that one of my criticisms of kind of discourse in public health has been a absolutely correct focus on documenting describing health inequalities. We knew about this before COVID, we absolutely knew about it before. And I get frustrated coming in as a lawyer looking at something from the outside and coming in, I tend to get frustrated with kind of endless descriptions of the problem. And what I say partly because of the kind of person I am, is, we need to get much more solutions focused, what do we do and not just talking about passing another law that says we need or saying we need less inequality? What do we do in practical terms that will have an impact what will work to have an impact? And I think the point you made before about this requires cross departmental collaboration. This is not a problem of the of the health service or one particular department. This requires collaboration across departmental foot portfolios, and government is not good at working in that cross way. It's so it's a multifaceted problem. And it needs multifaceted solutions


Keir Starmer  24:47

of the cross cutting stuff. I completely agree when I saw it when I was working in criminal justice see as a constituency MP, obviously not the moment but we do walk in surgeries every Friday in Camden, where anybody who lives in Camden County See me with any problem that they want help with 50% of the cases that come with housing, overcrowded housing, where you've got mom, dad and two or three children in a one or two bedroom flat, and the children are growing up. And that is a health issue in terms of the living conditions very quickly accelerates into an education issue, because by the time the child is at secondary school, you can almost guarantee that mom or dad is going to come with a letter from the school saying that their son or daughter is now failing at school, because they've got nowhere at home to do meaningful work or homework or anything like that. It then accelerates into a criminal justice issue, because particularly for teenage boys, if you've got three teenage boys, and one bedroom, it's intolerable, and they go outside, and they will then go and accumulate in groups outside on the streets and squares in parks, because they can't bear to be cooped up inside a tiny flat. And the next thing you know, the code that binds them is not anymore, what the rules are at home, but what the rules are on the street, for want of a better word or in the park, or whatever it may be. And suddenly, then there's an operation, and then you get into the health and mental health issues that I was describing earlier. And so the cross cutting is absolutely crucial to this. And it's very hard to see I can deliver meaningful change without cracking that it's not the only thing, of course, but it is a huge issue in terms of seeing that link up.


Rochelle Burgess  26:21

I think you're both alluding to sort of this vision of a future that makes me feel really excited. And I guess I sort of as a question, as we sort of come to the end would be a bit more detail on what that vision is, what does the future really look like? But we're going to be dealing with these interacting factors and and trying to do this cross disciplinary approach between law and health and education. And we're bringing it all together. What does that look like tangibly? Is it more surgeries? Is it what does it look like?


Keir Starmer  26:50

Firstly, it has to be a sort of steely determination. That's what we want to achieve. And to be absolutely clear about that, and be realistic about how long that will take and some of the bold steps are going to be needed along the way, you do need cross cutting, we've already discussed that you need an economy that works for people. I mean, I think there are three pillars to this, these are this is very broad term. So just bear with me, the first pillar is not to 18, if you haven't taken action at ages, naught to 18, to deal with inequality, then the chances 18 onwards of doing it are pretty minimal. And that is about brilliant education, of course, but also the other stuff that goes around it, sure start, youth centres etc, etc. So that's pillar one. pillar two is then what happens at work and poor pay and conditions, low expectations, short term economy, with low standards builds in inequalities and health and mental health issues. And that is wrong. In fundamental terms. It's also counterproductive. There's not a good functioning economy. So that needs to be fixed. And then you've got your third pillar, which is what happens in older age, a security and dignity for older people. And then you tie that up with issues like social care, all of that has to come together, I actually think the biggest change in our country, and I'm looking through the lens of the Labour Party now, so you have to forgive me and take it as coming from the leader of the labour party. I think the Labour Party is at its best when it sees the future and says things can be different. We don't do that, that often. We did it in 45, where we were saying if you vote labour, things are really going to change. And this is what it's gonna look like Wilson did it in the 60s with the white heat of technology, he was saying things are changing. And Blair did it in 1997. With different tools, I think our challenge now is to present that future that mission rather than a vision, I think, and that actually does involve bringing it back to public health, having a proper appreciation of what the future economy what the future really looks like. Because you know, the Turing centre is just over the road, not the way at Kings Cross course from where you are now, which is the centre where they're developing big data, I was fascinated when I went with what they told me you could do with big data for health prevention, in terms of to take the strain off your NHS, one way to do it is to grasp the future and understand how big data tech can play a real part in that. So there's a lot of moving parts in this. But I think that with the appropriate changes, we could really make significant change. But we're not going to do it by tinkering around the edges.


Hazel Genn  29:17

I'm thinking of this in more narrow and narrower terms. So what I want to reinforce is the fact that we need to look at people as a whole, particularly about kind of target groups, the people that we're trying to help thinking about Keirs point about the life course think about people as a whole life course the journey that they might be on and say, you know, how do we deal with this at the earliest possible stage, to get people on a better course to get people out of these cycles of deprivation that we see. And I think this is just repeating what we said we need cross departmental willingness determination. To do this. We need integrated service delivery. I'm talking about integration of health and social welfare legal services, but we need integrated service delivery in general in the better integration of our public services that look at people and families rather than this is the, you know, this is the job. This is the policy of this department for the next five years, you know, which actually isn't doing that you've got lots of departments doing things in their silos. So in an integration of service delivery, and in the health field that needs to be across primary care, midwifery, a&e, all of those acute care. I also think in in health, we need social welfare, Legal Services actually integrated into care pathways. So you know, Macmillan, in cancer care, has advice about kind of employment rights and things in care pathways, we're doing something with dementia, rare dementia cases, it's that you that you're thinking when people are ill, you know, aside from the medicines they need, what are the other things that they need, they need these other bits of support, that are part of that care pathway, which I think again, is just reflecting the idea of integration.


Xand Van Tulleken  30:54

I couldn't agree more between the two of you, you've captured the kind of the big picture and the real nuts and bolts of what needs to change. We ask everyone who comes on the podcast, because we want to disrupt thinking in public health, there are multiple ways into that is there what we've called an artefact a piece of art or music or poetry or a particular event in your life a particular object maybe is that something that you rely on to keep your perspective disrupted to shake you up or to inspire you when you're thinking about these hefty issues Keir?


Keir Starmer  31:25

This is not a long term thing. It's not something I've had in the back. But there was something yesterday that really struck me because I went to Heathrow to look at the operation at Heathrow Airport. One thing again, really, really interesting that I've been struck by this pandemic, by the way is the emotional reaction of going to places you haven't been for a long time, which you associate with something you're not at the moment allowed to do. And so going to an airport and I had to take my passport in my pocket in order to get airside arriving at Heathrow, which normally connotes going away travelling, the emotion of seeing the place, but of course not being allowed to travel. But what I saw there just to come back to the question was the sculpture by Richard Wilson, which is called slipstream. Yes. And so I'm arriving at an airport, there's a piece of sculpture there, which it was said was going to be the most viewed sculpture in the world because of the 20 million people going through Heathrow every year, and nobody's going through. So they've got this to talk about disrupting your thinking, you know, this is there so its seen by millions of people, but nobody can go past it. because not many people can go past it. You know, it's in the middle of a pandemic, when a slipstream through an aeroplane where most aeroplanes are not causing a slipstream because of the pandemic. They're grounded. And if anything disrupts us, it's the position where enough because when I saw this question, I thought, well, you know, the easiest thing is to just identify something I've always liked. But actually, that really did disrupt I thought, well let there's something that on its own terms is being challenged. It's a slipstream of an aeroplane, which is grounded first to be seen by millions of people at an airport where nobody's currently going. And it was just the emotion of being there that that did actually disrupt my thinking.


Xand Van Tulleken  32:59

I love that. It totally changes the meaning of that piece of art. Yeah. Hazel what about you?


Hazel Genn  33:05

Actually, I really struggled with this. But then I came up with something which actually has been very valuable during COVID. A few years ago, I was quite ill. And I was reading some books about sort of coping with that I can't I'm not a very Zen person, believe me and I came across and kind of Zen ideas that the most what they say is that most human suffering comes from endlessly wishing that things were other than they are other than they were. Well, I think we didn't always wish that things what other than they were, we wouldn't have progress, you know, we'd probably still be living in caves or something. But actually, it is quite helpful in different situations to stop wishing that things that were other than they are when you can't do anything about it and focus on the now and be grateful for what you have. And I did at that time. And it actually did change. It flipped the way I was thinking and I found that extremely helpful at that point, and actually through COVID You know, when you wake up and you think, Oh, my God another day and I can't and you think we're actually what can I do? What can I do? What can I take pleasure in and I think actually this is something that lots of people have found that we have refound, now I'm going to sound really folksy, but you know, we have refound some simple pleasures.


Rochelle Burgess  34:08

 I think that's beautiful. I think that was perfect.


Xand Van Tulleken  34:12

Thank you so much both for giving that particular question. So much thought.


Rochelle Burgess  34:16

You've been listening to Public Health Disrupted. This episode was presented by me, Rochelle Burgess and Xand Van Tulleken, produced by UCL Health of the Public, and edited by Cerys Bradley.


Xand Van Tulleken  34:16

If you would like to hear more of these podcasts from UCL Health of the Public, subscribe wherever you download your podcasts or visit https://www.ucl.ac.uk/health-of-public/. This podcast is brought to you by UCL Minds - bringing together UCL knowledge, insights, and expertise through events, digital content, and activities that are open to everyone.