We Need a Cultural Shift in Attitudes Towards Health says Future Generations Commissioner
Wales needs a cultural shift in attitudes towards health, says the Future Generations Commissioner.
The calls come in The Future Generations Wales Podcast, hosted by Derek Walker, Future Generations Commissioner for Wales, which continues its exploration into how the Well-being of Future Generations Act is shaping a better future.
Wales is the only country in the world with a Well-being of Future Generations Act, and the commissioner's role is to challenge public bodies to take action today that protects people tomorrow.
In this episode, A Healthier Wales, Derek is joined by Tanni, Baroness Grey-Thompson, one of the most accomplished Paralympians in history and a passionate advocate for health, well-being and inclusivity.
A multi-Paralympic medallist, Tanni, Baroness Grey-Thompson secured 11 gold medals while competing as a wheelchair athlete in five Paralympic Games from 1988 to 2004. Her dominance extended beyond the track, winning the London Wheelchair Marathon six times and setting more than 30 world records.
Beyond sport, she has served as an independent cross-bench member of the House of Lords since 2010 and with a lifetime dedicated to advocacy, is a powerful voice in the discussion on long-term health strategies. As chair of Sport Wales, she is accountable to the Deputy Minister for Arts and Sport for Sport Wales' performance and for the delivery of strategic priorities.
At the heart of their conversation is the principle of prevention, a cornerstone of the Future Generations Act. Tanni and Derek discuss the necessity of embedding long-term health strategies rather than relying on short-term fixes. They use the metaphor of a fence at the top of a cliff rather than an ambulance at the bottom to emphasise the importance of proactive well-being measures.
By 2025, we can expect to spend, on average, the last 20 years of our lives in ill-health, according to the Well-being of Wales report, 2024.
Tanni advocates for a cultural shift in attitudes towards health, with a greater focus on collaboration between sectors to foster lifelong habits that support physical and mental well-being.
The Economic Value of Sport report found sport in Wales is helping to directly deliver £1.9 billion in GVA for the Welsh economy, securing 38,345 full time equivalent jobs.
As a fierce advocate for accessibility and inclusion, Tanni also highlights the need for physical literacy from an early age. She stresses that sports and physical activity should be available to all, regardless of socioeconomic status or disability. Ensuring that every child has the opportunity to engage in sports, she argues, is essential for building confidence, resilience, and lifelong healthy habits.
Despite the well-documented benefits of physical activity, barriers to participation persist. Tanni shares her personal experiences as a wheelchair user navigating an often inaccessible world, shedding light on the daily challenges faced by disabled individuals. She also discusses the additional difficulties women and children encounter in accessing sports and exercise opportunities. These issues, she argues, must be addressed through targeted policies, investment, and a commitment to inclusive programme design.
Derek highlights the Future Generations Report, which assesses public bodies' progress and offer recommendations for the next decade.
The report, published at the end of April 2025 to mark 10 years of the legislation, serves as a roadmap for embedding well-being into policy, ensuring future generations benefit from healthier, more inclusive communities.
In it, the commissioner makes several challenges around health, including calling for annual ringfenced prevention budgets and a move towards long-term funding arrangements to safeguard people's long-term needs.
It was launched with a Future Generations Action Summit at National Museum Cardiff, where public bodies made commitments to key recommendations in the report.
Since Wales committed to future generations thinking, we have seen a progressive school curriculum, a move to greener transport and a new way to define prosperity away from GDP. When Derek took on the role as commissioner in 2023, he said the law needed to work harder and faster so that people in Wales felt the everyday benefits.
Both Derek and Tanni stress in the podcast the importance of maintaining momentum in the face of short-term funding pressures, advocating for sustained investment in long-term health initiatives.
The full episode is available now as part of the Future Generations Wales Podcast series produced by Business News Wales.
For more information and to read the Future Generations Report 2025, see https://futuregenerations.wales/discover/about-future-generations-commissioner/future-generations-report-2025/
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Kim Leadbeater is the MP behind the Bill (Jordan Pettitt/PA) The implementation period has been doubled to a maximum of four years from royal assent, the point it is rubber stamped into law, rather than the initially suggested two years. If the Bill was to pass later this year that would mean it might not be until 2029, potentially coinciding with the end of this Government's parliament, that assisted dying was being offered. Labour MP Kim Leadbeater, who is the parliamentarian behind the Bill and put forward the extended timeframe, has insisted it is 'a backstop' rather than a target, as she pledged to 'hold the Government's feet to the fire' on implementing legislation should the Bill pass. The extended implementation period was one of a number of changes made since the Bill was first introduced to the Commons back in October. – What other changes have there been? 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Ms Leadbeater has previously said there is nothing in the Bill to say they have to, nor is there anything to say they do not have to, adding on the Parliament Matters podcast that this is 'the best position to be in' and that nobody should be 'dictating to hospices what they do and don't do around assisted dying'. – What will happen next? MPs debated the Bill in the House of Commons (Malcolm Croft/PA) Friday's vote in the Commons makes it more likely for the assisted dying Bill to become law, now that it has the backing of a majority of MPs. But this is not guaranteed, and first it must continue on a journey through Parliament. The Bill now heads to the House of Lords, as both Houses of Parliament must agree its final text before it can be signed into law. During the next stages, peers are expected to put forward amendments to the Bill. 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Speaking about the end of the session to reporters, Ms Leadbeater said: 'I am not imagining that is going to be imminently, but it could be before the end of the year.' One member of the House of Lords, Bishop of London Dame Sarah Mullally, has already indicated she is against it. The Church of England bishop said peers 'must oppose' the assisted dying Bill when it reaches them because of the 'mounting evidence that it is unworkable and unsafe'. – What about assisted dying in the rest of the UK and Crown Dependencies? The Isle of Man's parliament took its final vote in favour of assisted dying in March (Alamy/PA) The Isle of Man looks likely to become the first part of the British Isles to legalise assisted dying, after its proposed legislation passed through a final vote of the parliament's upper chamber in March. 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The implementation period has been doubled to a maximum of four years from royal assent, the point it is rubber stamped into law, rather than the initially suggested two years. If the Bill was to pass later this year that would mean it might not be until 2029, potentially coinciding with the end of this Government's parliament, that assisted dying was being offered. Labour MP Kim Leadbeater, who is the parliamentarian behind the Bill and put forward the extended timeframe, has insisted it is 'a backstop' rather than a target, as she pledged to 'hold the Government's feet to the fire' on implementing legislation should the Bill pass. The extended implementation period was one of a number of changes made since the Bill was first introduced to the Commons back in October. – What other changes have there been? On Friday, MPs bolstered the Bill so people with eating disorders are ruled out of falling into its scope. Another amendment, requiring ministers to report within a year of the Bill passing on how assisted dying could affect palliative care, was also approved by MPs. Previously, a High Court safeguard was dropped, with the oversight of judges in the assisted dying process replaced with expert panels. The change was much criticised by opponents, who said it weakened the Bill, but Ms Leadbeater has argued it strengthens it. At the end of a weeks-long committee process earlier this year to amend the Bill, Ms Leadbeater said rather than removing judges from the process, 'we are adding the expertise and experience of psychiatrists and social workers to provide extra protections in the areas of assessing mental capacity and detecting coercion while retaining judicial oversight'. Changes were also made to ensure the establishment of independent advocates to support people with learning disabilities, autism or mental health conditions and to set up a disability advisory board to advise on legal implementation and impact on disabled people. Amendments added earlier this month during report stage in the Commons will also see assisted dying adverts banned if the Bill becomes law, and a prohibition on medics being able to speak to under-18s about assisted dying. – Do we know much more about the potential impact of such a service coming in? A Government impact assessment, published earlier this month, estimated that between 164 and 647 assisted deaths could potentially take place in the first year of the service, rising to between 1,042 and 4,559 in year 10. The establishment of a Voluntary Assisted Dying Commissioner and three-member expert panels would cost an estimated average of between £10.9 million and £13.6 million per year, the document said. It had 'not been possible' to estimate the overall implementation costs at this stage of the process, it added. While noting that cutting end-of-life care costs 'is not stated as an objective of the policy', the assessment estimated that such costs could be reduced by as much as an estimated £10 million in the first year and almost £60 million after 10 years. – Do healthcare staff have to take part in assisted dying? It was already the case that doctors would not have to take part, but MPs have since voted to insert a new clause into the Bill extending that to anyone. The wording means 'no person', including social care workers and pharmacists, is obliged to take part in assisted dying and can now opt out. Amendments to the Bill were debated on care homes and hospices also being able to opt out but these were not voted on. Ms Leadbeater has previously said there is nothing in the Bill to say they have to, nor is there anything to say they do not have to, adding on the Parliament Matters podcast that this is 'the best position to be in' and that nobody should be 'dictating to hospices what they do and don't do around assisted dying'. – What will happen next? Friday's vote in the Commons makes it more likely for the assisted dying Bill to become law, now that it has the backing of a majority of MPs. But this is not guaranteed, and first it must continue on a journey through Parliament. The Bill now heads to the House of Lords, as both Houses of Parliament must agree its final text before it can be signed into law. During the next stages, peers are expected to put forward amendments to the Bill. If the Commons disagrees with these amendments, this will spark a process known as 'ping pong' which will continue until both Houses agree over its text. – Will the Bill definitely become law? There is a risk that the Bill could be stuck in a deadlock between the House of Commons and House of Lords, as it goes back and forth in disagreement. If this continues until the current session of Parliament ends, then the Bill would fall. Ms Leadbeater told journalists on Friday she hoped there were no attempts to purposefully wreck it by peers. 'I really hope there are no funny games, because the process has been extremely fair,' she said. The Spen Valley MP said she did not know when the current parliamentary session would end, but suggested it could stretch into late 2025, giving her Bill the best part of six months to complete the full parliamentary process. Speaking about the end of the session to reporters, Ms Leadbeater said: 'I am not imagining that is going to be imminently, but it could be before the end of the year.' One member of the House of Lords, Bishop of London Dame Sarah Mullally, has already indicated she is against it. The Church of England bishop said peers 'must oppose' the assisted dying Bill when it reaches them because of the 'mounting evidence that it is unworkable and unsafe'. – What about assisted dying in the rest of the UK and Crown Dependencies? The Isle of Man looks likely to become the first part of the British Isles to legalise assisted dying, after its proposed legislation passed through a final vote of the parliament's upper chamber in March. In what was hailed a 'landmark moment', members of the Scottish Parliament (MSPs) in May voted in favour of the Assisted Dying for Terminally Ill Adults (Scotland) Bill, backing its general principles. It will now go forward for further scrutiny and amendments but will become law only if MSPs approve it in a final vote, which should take place later this year. Any move to legalise assisted dying in Northern Ireland would have to be passed by politicians in the devolved Assembly at Stormont. Jersey's parliament is expected to debate a draft law for an assisted dying service on the island for terminally ill people later this year. With a likely 18-month implementation period if a law is approved, the earliest it could come into effect would be summer 2027.
