Creating ’breathing space‘: A salutogenic moment in British politics?
Photo: Stonehenge, © English Heritage
Posted by: Jake Sallaway-Costello, Amanda Avery, Angela Hewett, Fraser Hewett, Jemma Orr, Emma Parsons, Paula Smith, Bhawna Solanki, Marie Swettenham, William Tyne and Judith Wayte
The people of the United Kingdom are tired: life in the world’s 5th largest economy is not a coherent experience. Neoliberal politics of the 2010’s shifted economic conditions to favour those who have, leaving behind a growing segment of the population who have nothing. For many, British life is bleak. 18% of children experience chronic food insecurity, while 20% have no access to greenspace. The number of unemployed young adults is the highest in recorded history, and 1.9 million retired people live in poverty. An overstretched National Health Service offers a ‘postcode lottery’, making healthcare access unpredictable. Infrastructure, built with 1950’s post-war aspirations and public investment, is crumbling. For most people, the UK is a confusing mess: a dichotomised society where life is characterised by excessive access to resources, or no access at all.
With massive social inequity comes massive health disparities, leading to a state of national overwhelm: the challenges are incomprehensible, and the resources to solve them perceived inaccessible. The result is a divisive fragmentation of UK society, in which the only thing the British people can agree upon is that change is urgently needed. How we achieve this is unclear. Rapid political polarisation has seen unprecedented growth of far-right groups, typically attributing the UK’s problems to immigration, solvable by mass deportations. The fractured political left presents unpalatable policies of massive government intervention, at a time when trust in the state is at an all-time low. The centrist British politics of the 20th Century have evaporated. The UK desperately needs a new kind of politics for health, and our latest gamble is that Andy Burnham can deliver it.
Burnham, then the Mayor of Manchester, went from local municipal leader, to national parliamentarian, to Head of Government, in under a month. Credited with transforming the economic fortunes of the UK’s 3rd largest city, Burnham has promised to expand his vision of “Manchesterism” to the whole country. Upon his appointment as Prime Minister in July 2026, Burnham undertook a ritual of British politics, standing outside 10 Downing Street to outline his immediate policy agenda. With bated breath, the nation waited anxiously, watching on live national television for Burnham to describe his legislative priorities. But policies, there were none. Seeming as overwhelmed as the electorate, Burnham described an overarching vision of creating ‘breathing space’ for people in all parts of British society, before promising specific policy proposals would be revealed in September when Parliament reconvenes after the summer recess. This is where the nation stands today: thinking about the ‘breathing space’ we need, and what that might mean for the policy agenda ahead.
This question sparked our imagination. As public health teachers, health promoters and social critics, we wondered what policies might bring about this ‘breathing space’. From a salutogenic perspective, ‘breathing space’ could mean many things. It might be the Generalised Resistance Resources that enable us to buffer stressors and thrive in the presence of challenges. In current UK society, it could also be the Specific Resistance Resources such as community groups and third sector organisations, that shoulder the burden of decreasing public investment in health and social care services. Or perhaps ‘breathing space’ is something more individual, like a strong Sense of Coherence that enables us to navigate life and make realistic assessments of the challenges ahead. Whatever form it takes, it is clear ‘breathing space’ must mean the provision of some health promoting resource. In a divided nation, what policies might Burnham consider, that allow the UK to breathe?
Starting health in communities, not clinics
A bold concept to frame our ideas and orient the nation towards a healthier policy landscape: creating ‘breathing space’ means reducing, relieving, or removing the pressures that make people unwell. The UK must move beyond a sickness-treating model, towards health promoting systems that integrate public health, clinical healthcare, municipalities, and community action. Joined-up services and investment in the social determinants of health should be at the centre of any policy agenda. By improving housing, employment, local environments and social connectedness, we strengthen the resources that help people manage life’s challenges. The application of salutogenic theory is not about treating illness but creating the conditions for flourishing. Whether in the health promoting food system or harnessing community spirit and mutuality, a return to post-war focus on the social determinants of health would launch the salutogenic policy agenda.
Marie Swettenham (marie.swettenham@canterbury.ac.uk)
Resourcing people to thrive in the technological age
In a fast-paced digital world, ‘breathing space’ is needed for people to cope with advances in technology. Does fear-of-missing-out or lack of digital skills move us towards dis-ease? Use (and overuse) of everyday technological necessities such as mobile phones revolve around competency, capability and affordability, leaving many people behind. Current policy interests prioritise the digitally literate, but necessity often drives digitally unconfident people to tap into their resources to develop their Sense of Coherence. People often rely on family and friends, or work-based IT support, to cope in the digital world, while technology companies charge for their guidance. Reducing digital health inequalities could mean providing free technology advice outlets, presenting people with an opportunity to buffer their technological frustrations (dis-ease) and navigate digital environments, providing much needed virtual ‘breathing space’ for the technologically excluded.
Bhawna Solanki (bhawna.solanki@bcu.ac.uk)
Learning from the healthy settings of other countries
On a recent visit to Sweden, I saw a street where health could happen in lots of spaces: a trampoline, followed by a swing, then a children’s play area. In just a short walk, there were three public resources where people can enjoy physical activity and social connection. Bus shelters communicated positive health messages, not commercial adverts or warnings about disease. Open water swimming was possible in so many places, without the litigious culture of risk avoidance that hinders blue health in the UK. In Sweden, outdoor swimming in lakes and rivers isn’t just an activity, but a destination: I saw families spending time at the lake, dancing, picnicking, playing games and laughing: ‘breathing’ together. In the UK, those facilities would be vandalised, and in most communities non-existent. If it can be done there, it can be done here.
Judith Wayte (judith.wayte@nottingham.ac.uk)
Investing in community infrastructure to share foodwork
Foodwork – meal planning, budgeting, shopping and preparation – is essential, yet remains largely invisible and falls disproportionately on women. In the UK, women undertake vastly more unpaid care work per day than men, including twice as much time cooking. Public health nutrition policies often rely on families to translate dietary guidance into everyday practice, individualising responsibility for eating well whilst overlooking the gendered labour required, ignoring the social determinants of nutrition that prevent access to cooking facilities. A salutogenic approach would recognise foodwork not as a private responsibility, but as a health opportunity. Investing in community food infrastructure, such as neighbourhood dining spaces, community kitchens, universal free school meals, and workplace meal provision, would redistribute the work of feeding families, support wellbeing and create the ‘breathing space’ people need to enjoy eating.
Jemma Orr (jemma.orr@nottingham.ac.uk)
Changing the conversation about migration
We need to value the benefits of migration; borrowing the language of the Hope not Hate movement and building connections rather than division. This would resource migrants, minoritised communities, and the wider population. I’ve spent 30 years addressing health inequalities, including time in Bosnia, supporting people from all communities affected by the war, where I saw the long-term consequences of hate. In the UK, negative conversations about migration hurt everyone. The last year was dominated by the hijacking of national flags to send a message of hatred. Politicians who should know better use inflammatory language without consequence. The media stokes fear and assigns blame. An ICE-style immigration service is being touted for the UK. Immigrants are literally holding their breath, for fear of being verbally abused, physically assaulted and violently torn apart from their families and friends. To create ‘breathing space’, changing the conversation around immigration is essential, and needs to come from the top. The language used by parliamentarians should be respectful and carefully chosen to build connection between isolated communities, not stoke division. We are not an “island of strangers”.
Paula Smith (paula.smith@bcu.ac.uk)
Preventing undernutrition through neighbourhood health plans
Undernutrition is common and under-recognised among older people living in the community, yet it is a modifiable risk factor for frailty, functional decline and loss of independence. Neighbourhood health plans provide an opportunity to move from reactive care to prevention, by making nutritional wellbeing a shared responsibility across primary care, community services, pharmacies, municipalities, and the voluntary sector. Early identification and timely support for undernutrition can help older people maintain strength, resilience and social participation, enabling living well for longer, and supporting the salutogenic ambition of “adding life to years”. Prioritising nutritional wellbeing in neighbourhood teams would strengthen community resources whilst deescalating care needs. This approach creates ‘breathing space’ by building and sustaining the personal, social and community resources that enable older people to remain independent, connected and in control of their health as they age.
Emma Parsons (emma.parsons@nottingham.ac.uk)
Protecting paid working time for movement
Lack of time remains one of the most frequently reported barriers to regular physical activity, despite the well-established physical and psychological health benefits. We spend more than 75,000 hours in the workplace across our lifetime: much of it inactive, particularly in prevalent desk-based occupations. Work therefore contributes to prolonged inactivity and reduces the discretionary time available for movement. But in the UK, with a long history as a leader in employment rights, policy can be a powerful driver for healthy workplaces. Ring-fencing paid work time for physical activity could create genuine ‘breathing space’, by limiting demands on peoples’ personal time, and reducing reliance on motivation and effortful self-regulation to be active outside work. Implementing such a policy could also shift workplace norms by demonstrating that maintaining health and wellbeing is a legitimate, valued part of working life.
William Tyne (will.tyne@nottingham.ac.uk)
Trusting people to identify the resources they need
The new Crisis and Resilience Fund is an experimental pilot programme: all UK municipalities can make one-off payments to vulnerable people experiencing an unexpected challenge. Although seemingly pathogenic at first – waiting for and addressing crises – I argue this new funding is actually a series of small but highly meaningful SRRs, that can act as ‘breathing space’. People can apply for funding to fix their broken washing machine, or pay for house moving costs, for example. Critics argue this is the “nanny state” wasting taxpayer money. But what if the broken washing machine prevents a single parent from washing their work uniform, and earning a wage? What if the house move is for a survivor of domestic violence, relocating to safety? The CRF enables vulnerable people to participate in decisions about how they buffer unexpected stressors, and resources them to move towards health. If the UK is going to be brave and engage in this experimental project, fund it properly, and trust that vulnerable people can be the experts in their own lives.
Jake Sallaway-Costello (jake.sallaway-costello@nottingham.ac.uk)
Questioning the commercial determinants of health
Impactful public health work requires a multisector approach, involving the state, private companies, and the voluntary and community sector: partnerships between diverse actors benefit from diverse expertise and resources. There are many examples of successful multisectoral partnerships for health improvement in the UK, such as Tier 2 weight management services and Local Authority holiday food programmes. But a new government should be cautious of the role of industry in health, particularly where massive imbalances in power mean the state and non-profit groups cannot meaningfully contribute to the partnership. For example, whilst hailed as a groundbreaking innovation in obesity reduction, the commercialisation of GLP-1 agonist medications have further deepened an already complex health inequality in weight management, increasingly perceived as making weight loss a hyper-exclusive privilege. In this sense, a new administration focused on ‘breathing space’ might more robustly scrutinise the role of industry in health innovations, to prevent commercial interests from widening the inequalities we seek to narrow.
Amanda Avery (amanda.avery@nottingham.ac.uk)
Abolishing fines for family holidays in term time
Family holidays can be salutogenic. For children, they act as happiness anchors, storing positive emotional reserves that serve as coping resources during future challenges. For parents, vacations relieve chronic stress and prevent burnout. Holidays strengthen Sense of Coherence by supporting mental wellness, emotional regulation, and social bonding, with uninterrupted family time creating dedicated space for dynamic play and meaningful shared experiences. From an educational perspective, rest restores cognitive and emotional bandwidth, equipping children with the mental resources needed to handle academic and personal stressors. The emotional reserves built by family holidays create opportunities for children to reflect during uncertain or stressful periods, providing internal emotional stability and making life more predictable. ‘Breathing space’ is experienced during and beyond the holiday, buffering other stressors later.
The policy of fining parents for taking children out of school fails to recognise the healthful benefits of family holidays and exacerbates inequalities. Wealthier parents are less likely to be affected, and have resources to pay any fines incurred. Poorer families are pushed into further socioeconomic stress. Holiday fines are inherently pathogenic, imposing stressors which are experienced inequitably across income levels. Many countries with the strongest educational performance do not use fines as a disincentive (Finland, Scotland, South Korea), suggesting there is no benefit to this system.
The Department for Education should replace punitive fines with an “Experiential Learning Leave” framework, giving pressured families ‘breathing space’ to take a holiday. Under this policy, families would receive up to ten days of authorised annual leave for cultural or family travel, allowing them to book affordable, off-peak holidays without threat of legal action or financial hardship during ongoing cost-of-living pressures. Parents would submit a brief pre-travel plan, and children would complete a reflective learning journal upon return. To safeguard academic progress, leave could require a 90% baseline attendance rate (excluding medical leave and illness absence) and be restricted during assessment windows. Excess days would be marked as unauthorised on transcripts without monetary penalties. Replacing fines with accountability would promote educational equity, build trust between families and schools, and support holistic student and family wellbeing.
Angela Hewett (a.hewett@bham.ac.uk) & Fraser Hewett (fraser.hewett@nhs.net)
Breathing space: new resources, better resources, or fair resources?
It has been argued the UK’s greatest challenge lies in tensions around the size and scope of the state: a chronic post-war mismatch between a low-rate taxation system and a high-spend government service provision. What is notable about this diverse offering of policy ideas for the creation of ‘breathing space’ is that none of them demand increased government spending or the requisite additional taxation: indeed, many of these ideas advocate greater participation of people and communities, and a reduced role of the state, in making decisions about health. This speaks to Antonovsky’s vision that health can be created not by providing new resources, but by reimagining assets around us as resources for wellbeing. Perhaps, for Burnham’s new policy agenda, ‘breathing space’ does not need to be newly created resources, but a more effective, fair, meaningful use of, and equitable access to, the resources we already have.
The ideas we share here are just that – our initial thoughts, about the direction of our nation as it strives towards a healthy and equitable future. In the first Hitchhiker’s Guide to Salutogenesis, Lindstrom and Eriksson anticipated the day a national government became the first to adopt a salutogenic approach to policymaking. Could this be the UK’s salutogenic moment?
