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Prevention green paper no match for scale of public health challenges nation faces

It won’t narrow widening health inequalities and lacks boldness needed to tackle root causes of ill health, say health think tanks

Caroline White

Wednesday, 24 July 2019

The green paper on advancing health prevention published yesterday by the Department of Health and Social Care is no match for the scale of the public health challenges facing the nation, say two leading health think tanks.

It won’t narrow widening health inequalities and it lacks the boldness and ambition needed to tackle the root causes of ill health, say The King’s Fund and the Health Foundation.

David Buck, senior fellow at The King’s Fund, describes the way the consultation paper was quietly released as “shabby,” and urged the new prime minister to “move quickly to restore confidence that the population’s health will be a key priority for the new government.”

While the paper includes some welcome initiatives on child health obesity and mental health in schools, for example, “Overall, it falls short of the scale and ambition needed to address the big health challenges we face as a society, including stalling life expectancy and growing health inequalities,” he suggested.

“The paper is a missed opportunity to build on the success of the sugar tax by taking a bolder approach to using tax and regulation to improve public health,” he added. Polling indicates that public support for these kind of interventions is stronger than politicians often assume, he said.

But government cuts to public health budgets were taking their toll. “It is essential that the new government moves quickly to shore up these vital services by finding the £1 billion needed to restore budgets to where they need to be,” he added.

Jo Bibby, director of health at the Health Foundation also described the paper as a missed opportunity given the widening of health inequalities in England widening and the stalling of life expectancy improvements.

“Perhaps unsurprisingly at a time of political uncertainty, the government has stepped back from the bold action required. But this should concern us all when ambitious whole-government action is urgently needed to tackle the root causes of ill health – including poverty and deprivation, poor housing, poor quality work, social isolation and poor quality environments,” she said.

“By its own admission the government states that this green paper only goes some way to delivering its goal of five extra years of healthy life by 2035 while narrowing the gap between the experience of the richest and poorest.

“But if it is not in the remit of a government prevention strategy to do this then where does the responsibility fall? Our analysis shows that if things continue as they are, it could take as long as 75 years – not 16 – to reach this goal,” she pointed out.  

The creation of a health index for England setting the population’s health on a par with GDP; the recognition of the need for a stronger focus on prevention across all areas of government policy; and the focus on joint working between the NHS and local government were all welcome developments, she said.

“However, with its emphasis on individual-level action and with no mention of the necessary local government funding, the approach risks exacerbating, rather than reducing, health inequalities,” she said.

“Overall, the paper falls a long way short of the comprehensive shift in approach needed to create healthier lives for people in England. A healthy economy needs a healthy population to power it. The incoming prime minister will need to take stronger action if Britain is to have a prosperous future.”

Sarb Bajwa, chief executive of the British Psychological Society was similarly unimpressed.

“It should be a national scandal that people from the most deprived areas of our country are likely to spend two decades more of their lives in poor health,” she said.

“The publication of this green paper is a small step towards tackling that, but truly embracing prevention would allow us to be much more ambitious than just offering people five extra years of good health.”

She added: “It’s also extremely concerning that the green paper was released so quietly, in a way which failed to highlight the difference that prevention can make to standards of care and health outcomes.”

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