A Good Society (and how we make it)

What is a good society and how might we build one? This essay, an edited version of the Cochrane lecture delivered at the Society for Social Medicine and Population Health in Bradford 2025, sets out my personal vision of what we should be aspiring to and how we might achieve it. I open with evidence connecting socioeconomic inequalities to well-being and highlight that component parts of a utopian place exist, but not all in the same place. Building upon public health lessons around prevention and upstream intervention, I then introduce what I believe are the two most promising policies we can implement: a universal basic income and a wealth tax, underpinned by citizen's assemblies, participatory budgeting and institutional structures to support evidence-based social policymaking. I make the case that we have the evidence and tools needed to collectively create a good society and that it is possible to change course and bequeath a better world on future generations. A good society is one where everyone's physical and mental health is as good as it could be, because prevention is prioritised, and health inequalities are levelled out by addressing the wider determinants of health. It is one where those who need care-whether children, those with disabilities or the elderly-are looked after without incurring financial stress, in settings where their emotional and social well-being are as important as their physical needs. Our children and young people should flourish in an education system that engages their imaginations, inspires their creativity, equips them with skills for life and leaves no one behind.