I've never really understood the concept of 'free votes' in parliament. The idea is that on issues of conscience, such as assisted dying or abortion time limits, MPs do not have to follow the party whip. Instead, they can vote as they wish, sometimes guided by their religious faith.
Yet how different really is, say, a vote to raise employer national insurance contributions or scrap the two-child limit for Universal Credit? Sure, these are fiscal choices, but they can equally be guided by questions of ideology and morality. More often than not, I suspect free votes are granted because party leaders are worried they will not be able to force their MPs into the 'right' lobby.
I was thinking about this on reading Keir Starmer's pronouncement that weight-loss drugs will be “very important” for cutting obesity rates and helping to reduce the burden on the NHS. Because there is something about this kind of medical intervention that raises hackles. It's curious, because this new class of weight-loss drug appears to be working.
The obesity rate in the United States fell by 2 per cent between 2020 and 2023, according to a report by the Centers for Disease Control and Prevention. And while no direct link has been established between the drugs and this reduction, the latest KFF Health Tracking Poll finds that about one in eight American adults (12%) say they have ever taken a GLP-1 agonist – such as Wegovy or Ozempic. There is a real possibility that America may have passed peak obesity.
This would ordinarily be seen as a major public health success story, or at least the start of one. Governments around the world have poured billions into campaigns to reduce rates of smoking, drinking and illegal substances. Lower levels of smoking for instance mean fewer cancer deaths leading to longer, healthier and happier lives. The same will happen with lower levels of obesity.
There is a major economic benefit too, particularly for a nation such as the UK. Data from the Health Survey for England finds that in 2022, 29 per cent of adults in England were obese and 64 per cent were considered to be overweight or living with obesity.
Writing in The Telegraph, health secretary Wes Streeting pointed to the growing impact on the NHS, where obesity costs £11 billion a year, more even than smoking. And this has a knock-on effect on the economy. "Illness caused by obesity causes people to take an extra four sick days a year on average, while many others are forced out of work altogether."
Some of the instant media reaction has been inevitably crude, conjuring up images of the overweight unemployed being repeatedly jabbed with needles, forced off the couch and back to work. In other quarters, taking this medication is considered, if not out-right cheating, then not in the spirit of the game.
But if economics is not a morality tale, then neither is weight-loss. And if these drugs can improve people's quality of life while saving the state money, it seems an odd hill to die on.
