The headlines usually focus on deficiencies of NHS funding but Jeremy Hunt’s focus must equally be on the way we live, writes Emily Crawford
After three weeks of unprecedented political turmoil, the UK boasts a new government and a new “one nation” agenda.
Indeed, almost the only thing that is not new is the health secretary. Given the difficult relations that have developed between the medical profession and Jeremy Hunt during his time in post, it is time for a more positive and preventative approach to health policy.
With Theresa May clearly stating she wants to prioritise the needs of the have-nots, now is the moment for preventative population health to get the kind of political backing it sorely deserves to close the health inequality gap. The Marmot review six years ago gave us the startling statistic that only 20 per cent of health is attributable to clinical care within the formal health system.
The remaining 80 per cent lay outside in the “wider determinants” of health such as physical environment, lifestyle choices and social networks.
Time off sick costs the UK economy £100bn a year
The need for preventative population health has long moved out of the niche world of policy wonks and health economists. Indeed, the Five Year Forward View, which is guiding the transformation of the UK health and care landscape over the next five years, explicitly places prevention at the heart of the strategy.
“The future health of millions of children, the sustainability of the NHS, and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.”
A healthy population is central to contributing to the productivity of the nation – too much potential is lost due to early exit from working life, time off sick costs the UK economy £100bn a year, and for those people who are signed off as long term sick, they are more likely to die than return to work. At the same time, it is crucial to tackle the onset of avoidable ill health in order to reduce demand on a stretched health and care system.
Obesity and its related negative health impacts is estimated by Public Health England to cost the NHS £6.1bn and the wider economy £27bn.
Not just absence of illness
Good health is more than the absence of illness. Social isolation is a huge cause of mental distress – cost £70-100bn according to the Mental Health Foundation – and supporting voluntary and community groups who provide crucial community links is part of ensuring wellbeing.
Population health has not been given the same resources, attention, status or political clout as more visible parts of the health system
Yet it is fair to say population health has not been given the same resources, attention, status or political clout as more visible parts of the health system. Threaten a local hospital at your peril minister, but cut the public health budget by £200m and there is barely awareness, let alone objection.
In Res Publica’s recently published Manifesto for the North, we argue for the creation of a Community Health Kickstarter Fund. Governments readily invest in Infrastructure Development Funds.
A kickstarter fund that takes a similar investment based approach to people would provide the seed capital to introduce a host of evidence based community health interventions at scale and at pace to achieve improvements in health, wellbeing and reductions in demand. This fund could be accessed by those areas with the largest health inequality gap and be matched by local authorities.
We argue that one of the programmes that could be part of the Kickstarter Fund is our Whole Family Help for Health initiative, mooted in our Manifesto. Taking a multi-disciplinary approach, Whole Family Help for Health would identify children in the early years of primary school and work with their families through a multidisciplinary team to tackle the whole family’s weight and overall health profile.
The number of obese children doubles between the start and end of primary school. Working with early primary children and their families will intervene early to tackle weight and health issues before it becomes more difficult to do so in later years.
Much is made of our stretched NHS and the funding it needs to serve a growing and ageing population. Much more should be made of the urgent need to improve the health of the population, for both individual wellbeing and to reduce demand on public services.
Jeremy Hunt should seize this agenda with a new flagship initiative that will mark a step change in community based health and a positive approach to health policy.
Emily Crawfor is principal research consultant, Res Publica