Taking the pulse

Wary that I might be breaking some sort of journalistic rule, I’m not going to start this article by writing about the recession. The reason for this is that, like other areas of the arts, arts in hospital settings are subject to micro-climates and local pressures just as much as the wider, more macro implications of the current political and economic situation. While these are testing times for all of us, those of us working to develop the role of the arts in healthcare currently have reason for a degree of cautious optimism.
At the end of 2008, the Department of Health established a new working group to look at the role the arts can play in health. This stemmed from the (then) Secretary of State for Health, Alan Johnson, who, in a speech last September, declared that “hospitals and other care settings that pay close attention to the overall physical environment for patients achieve real improvements in the health of patients… Access and participation in the arts are an essential part of our everyday wellbeing and quality of life”. This was significant, as it was the first time that a Secretary of State had been so positive, encouraging healthcare providers to get on and commission artists. His speech followed a debate in the House of Lords earlier last year, which again reiterated the value of the arts in health. This new working group is currently “considering how arts and health can be included more regularly in [the Department of Health’s] policies, and whether systems and incentives should be adapted to reflect the contribution of arts and health”. Which all sounds pretty positive.
Further to this, London Arts in Health Forum (LAHF) was recently awarded a grant to try to bring together a more nationally co-ordinated approach to arts and well-being. As well as working to develop the profile of arts in health work, LAHF is working with regional partners to try to support local networks of arts in health practitioners and to encourage clinicians to recognise the value the arts can bring to hospitals and other healthcare settings. This work has the potential to provide a focus to this burgeoning area of practice and the means to stand up and shout about it. One element will be to look closely at exactly what is being done in hospitals and other healthcare settings around the country. By establishing a clear and current sense of what is going on, it will be possible to measure how things develop and to identify what is needed to support the sector.
 

New hospitals
One aspect of this is to look beyond the traditional sense of art in hospitals – and even of hospitals themselves. Art in hospitals is more than simply making hospitals prettier: it must be at the forefront of a cultural shift, the creation of bespoke environments created with patients in mind. Serving as it does a more eloquent, demanding and diverse population, the modern NHS needs what artists can bring. Artists overturn orthodoxies and question preconceptions; the challenge and beauty art can offer can serve to personalise huge institutions. But to work effectively, art in hospitals requires generous input and consideration from hospital staff and patients – almost the creation of a curating community, not work imposed from outside.
At the same time, new healthcare developments in community settings are challenging the traditional vision of the county hospital. Polyclinics are an increasing reality, and many community-based healthcare providers (especially in urban areas) are developing new services for changing local communities. These new developments are being funded by complicated procurement processes which involve a lot of different partners. In this context the challenge is to ensure that you don’t get a situation where a focus on the bottom line makes art seem like a luxury – or, at the very least, someone else’s responsibility. Arts in health consultants Willis Newson are currently drawing up guidance for the commissioning of art in new healthcare developments. Commissioned by ixia, the public art think-tank, this work is designed to set out a clear scheme for healthcare providers and their partners to think about art at the earliest opportunity in the design process, and to think about what can be done to integrate art into healthcare developments. The aim of the guidance (due out this autumn) is to plot out a route map to give hospitals and other healthcare providers more confidence when it comes to commissioning artists.
Climate change
This positive activity is all going on against the backdrop of the economic storm which is swirling on the horizon. Earlier this month, the NHS Confederation warned that the NHS will need to make cuts of around £10bn over the three years from 2011. In due course, this will inevitably limit the spending on capital projects and consequently the arts activity associated with new buildings. The squeeze is already being felt across the health service as NHS executives pull in their horns anticipating no jam tomorrow. The arts – which no one would claim to be the NHS’s top priority – have to line up behind the demands placed on the health service. Swine flu won’t help, nor will the growth in unemployment with its attendant increase in mental ill-health and substance abuse. Demographic changes and the increase in demand for expensive treatments will all contribute to the debate around how the NHS spends its money.
Coupled with this is the fact that the vast majority of arts activity in healthcare – and perhaps particularly in hospitals – is funded by charitable trusts. These trusts have been hit (along with many other trusts and foundations) by the slump in the stock market, and many are reviewing the funds available to support arts activity. All this means that in the current climate, the case for arts in hospitals and across the NHS needs to be made all the more clearly. The increasing focus from health providers on the quality of the patient experience (rather than numbers, waiting lists, etc.) presents a real opportunity for the arts. By demonstrating that the arts can have a real and positive effect on patients, we will continue to see demand for good art in our best hospitals.