Policy makers and legislators should pay heed to Dame Sally Davies’ 2018 annual report that gives practical solutions to the challenges facing the health of the nation, exhorts Peter Carter
Dame Sally Davies is one of the most successful chief medical officers we have had. She became the first woman to hold the post in June 2010 and has made a huge contribution to our health and social care services.
At the end of September she will leave her post to become master of Trinity College Cambridge, again the first woman to hold this post.
Over the past nine years of her tenure she has been prepared to speak truth to power and has been consistent in airing her concerns over the health of the nation.
I believe, however, she has not been adequately supported by the successive governments that have been in power during her term of office.
Of particular concern to me has been the lack of focus on her 2018 annual report Health 2040 - Better Health within reach.
This is easily one of the most interesting, sensible and valuable reports on health-related issues that I have ever read.
As the title suggests, better health is within reach by 2040 providing we act on the recommendations in this report.
It has four main sections:
Health as the nation’s primary asset;
The health environment we live in and build together;
Using emerging technologies to improve health for everyone; and
Effective planning for the future.
The report is a treasure trove of information relevant to both health professionals and the general public. It reminds us that 50 per cent of the health burden across the country is lifestyle induced.
Page after page is rich with data and facts. Each chapter gives conclusions and recommendations.
Despite the quality and relevance of the report, I can find very little evidence that it has been discussed by NHS trust boards. My conversations suggest many in the NHS have either never heard of it, or if they have, it is lodged somewhere in their peripheral memory.
What is so frustrating is that the report gives practical solutions to the challenges facing the health of the nation.
Dame Sally’s legacy should be this report. My concern is that contribution has been undermined by politicians who are reluctant to take difficult decisions that might be unpopular but are ultimately in the interests of the health of a significant proportion of the population
Life expectancy in the UK has begun to plateau. Inequalities in life expectancy and healthy life expectancy are discussed, as are obesity, alcohol smoking and sedentary lifestyle.
Dame Sally’s legacy should be this report. My concern is that contribution has been undermined by politicians who are reluctant to take difficult decisions that might be unpopular but are ultimately in the interests of the health of a significant proportion of the population.
The Department of Health and Social Care published the report on 21 December, a few days before the nation embarked on its annual festival of gluttony.
Why could they not have waited until the week after New Year when the nation is still recovering from its excesses, the new year resolutions have not worn off and the bank balance is feeling the pinch of the over-indulgence?
Furthermore, they should have been more proactive in producing a synopsis of the report that would have appealed to the public, clinicians, NHS managers and policy makers, and most importantly the government and MPs.
Behavioural change needed
In the mid 1960s, the then minister of transport Barbara Castle was vilified for introducing the breathalyser test. She was infamously challenged by a BBC journalist who described her policy as a “rotten idea” and asked her: “You’re only a woman, you don’t drive, what do you know about it?”
Before we get too smug in believing that that kind of public belittling would not happen now, we should remember how the CMO was treated when she appeared on Radio Four’s Today programme.
The distinguished BBC journalist Nick Robinson trivialised Dame Sally’s work by referring to her as “The Nation’s Nanny”. She replied that Mr Robinson would not have said that to a male CMO.
We all wish behavioural change could be brought about purely through logic and persuasion. Sadly this is not the case.
We need more politicians of Barbara Castle’s tenacity who are prepared to make the difficult decisions and suffer the short-term unpopularity and criticism for the long-term good
Yes, you need those qualities, but you also need enforcement. All of the major changes in the health of the nation (seat belts, crash helmets, no smoking in public places, as well as the breathalyser test) within the last 50 years have been achieved through legislation.
We need more politicians of Barbara Castle’s tenacity who are prepared to make the difficult decisions and suffer the short-term unpopularity and criticism for the long-term good.
The highly respected physician epidemiologist and medical historian Thomas McKeon said: “Public health boils down to the extent to which government is prepared to interfere in the lives of ordinary people.”
I urge policy makers and today’s politicians to have the courage to legislate. The sugar tax, availability of fizzy drinks in and around schools, vaccinations for children are just a few examples of areas where they could act to underpin the work of Dame Sally.
A failure to do so will be a matter of huge shame for those putting short-term popularity above the long-term needs of future generations.