Why creating a healthy society is more than prevention

In last month’s blog we discussed public health successes and how we could learn from them, particularly in terms of harnessing the power of partnership. In the second part of my look at the future of public health, I want to focus on where and how ‘health’ is created and what to do to improve it.

We are very fortunate to have the NHS. However, the NHS is not the full picture. Health is actually far more than the NHS. Our health system is embedded in our communities, through the voluntary and community sector, through local business, and through local government. All of these organisations already play a huge role in enabling us to live healthy lives. However, with consistent funding and support, they have the power and potential to improve health and wellbeing even more.

Of course, the NHS is an important part of all of these systems, as deliverers of long-term support, treatment and care, as well as being the first port of call for emergency medicine. However, although the largest, the NHS aren’t the only delivering agency. For example, our schools deliver a Personal Social Health and Economic curriculum; businesses have a responsibility to promote the health of their employees; a vast array of charities support people facing a huge range of physical and mental health challenges to live independently; and our prison service help people to stop drug and substance use.

I could go on, but in short, appreciating this cross-sector, cross-department element of our health system is crucial to improving both the system, and our actual health.

Policy – and resourcing the implementation of policy – needs to be considered in the long term, as something that will endure across the decades. All Government departments need to be held to account for the consequences their decisions and trade-offs (which we know must happen) have on people’s health. By rethinking health as a long-term social investment that is rooted in all policies, we will all benefit.

The other factor that we need, as a society, to rethink is that of responsibility. Historically, a huge emphasis has been placed on educating the individual to make “healthy choices”. However, the playing field is far from level and some choices are easier to make for some, than for others.

Instead, we need to be looking to our health system (and remember that that means far more than the NHS in isolation) to embed decisions that support our health into the very heart of all their policy making so that health becomes a societal responsibility, not an individual one.

We also need industry and big business to play its part in promoting and facilitating those “healthy choices”. A lot of the products that are harmful to us (tobacco, alcohol, gambling, junk food, fizzy drinks…) are marketed in a range of clever ways, directly at children and young people. Unless these commercial determinants of our health are tackled, today’s children and young people will become the next generation of people who need treatment for mental and physical health conditions that could have been prevented.

It is within the wider health system’s collective power to tackle all these issues and there is much to learn from elsewhere on how to do it.

For example, in Scotland, the minimum unit price of alcohol has resulted in a demonstrable decrease in alcohol harm. Elsewhere, the Wellbeing and Future Generations Act in Wales was introduced to ensure that a whole-system approach is taken to prevent persistent problems that are affecting people’s health and wellbeing.

We are at a crossroads and indeed, there is increasing talk about prevention from Government and industry alike.

However, although there is plenty of work taking place at a local level, national policy is not yet following the rhetoric through to nationally required practice. If we are ever to prevent people from getting ill from preventable diseases, we need to take real action.

Let’s now take one step further, and instead of talking about preventing ill-health, start talking about the creation of good health. Although arguably the same thing, the emphasis is a world apart and sets the scene for a much brighter, healthier future.

There is no doubt it will take bold decision making and a break from the norm. But what is the alternative? We need to be honest and open about the compromises and trade-offs involved in different policies, and the knock-on consequences for health – both long and short term – have to be a consideration in every single decision.

In the coming days, we will be publishing our own manifesto ahead of the myriad of manifestos set to come our way in the run up to the next General Election. In it, we will set out very clearly what our future leaders must do to make this vision of a society where good health is an expectation – one which is entirely within our grasp – a reality.