The year that’s been

2024 has been a busy and exciting year for public health, with lots of announcements and promised change. Before the General Election, we saw the introduction of an historic Tobacco and Vapes Bill which went far further than we had dared hope. In the months since, we have seen an even bolder Tobacco and Vapes Bill, along with a raft of legislation from the new Government that aims to meet its manifesto pledge to halve the gap in healthy life expectancy between the richest and poorest.

Whether or not the ambition will be realised remains to be seen, but the Government’s commitment to re-thinking the country’s approach to health is very welcome. They have rightly recognised that preventing people from becoming ill and needing health and social care is the only way to improve both individual people’s health, and that of the economy.

The introduction of legislation to phase out the sale of tobacco products, extend smoking bans to specific outdoor spaces, and introduce tight restrictions on the sale and marketing of vapes and other nicotine products is this year’s big game-changer. It has overwhelming support from MPs across all parties and the public and, if passed, will save thousands of lives. The extra money for Directors of Public Health and their teams to provide stop smoking services is also hugely welcome and will support so many more people to quit.

This groundbreaking legislation also recognises the power of industry tactics in shaping our environment and the need to restrict that power to give people freedom to live healthier lives. This is something Directors of Public Health are increasingly tackling at a local level and the lessons being learnt are slowly but surely being transferred to national legislation around other harmful products. For example, in October next year, we will finally see the ad ban on unhealthy food and drink online – and before the watershed on tv – come into force.

Thanks to the revised National Planning Policy Framework, local authorities will also be able to stop new junk food outlets being opened near schools – another important step to creating an environment that promotes the creation of a healthier environment for all. The framework also says that planning policies should aim to achieve healthy, inclusive and safe places through the provision of, for example, accessible green spaces and sports facilities.

Meanwhile, one of the first things the new Government did was introduce the Child Poverty Taskforce and then this week, the new Children’s Wellbeing and School’s Bill was introduced, a bill that prioritises early intervention to address risks before they escalate. The focus of this legislation is on safeguarding children and places the emphasis on taking a holistic approach by strengthening families and improving services to give all children the opportunity to thrive.

It is this holistic approach which will make the difference. For too long we have seen stand-alone policies that haven’t addressed the root causes of the issues they have been tackling. Labour’s health mission seems to really acknowledge the need for a health in all policies approach and builds on work being done in Scotland and Wales. The fact that the implications for health are being considered in discussions around poverty, abuse, education, diet, planning, transport – and more – across all four nations is really encouraging.

There is however a but in all this and one which mustn’t be overlooked. All this forward-thinking, bold, cross-governmental working must be backed up with the right resources, structures and funding to make it work. This isn’t just a case of more money, but a case of making the best use of the resources already available too.

The new ten-year health plan has great potential but there is a concern amongst the public health profession that it is too focussed on the NHS. We know that less than 20% of our health and wellbeing is determined by access to traditional health services and so while it is absolutely right to invest – and ‘fix’ – the NHS, it is vital that the wider determinants of health, the remaining 80%, aren’t overlooked.

Much of that 80% is determined by local decision making and so we must make sure that local areas are given the powers they need to implement changes that create healthier places for everyone to live, learn, work and play in. In July, we heard from the Covid-19 Public Inquiry’s Module 1 report how important it is not to overlook existing local expertise, and the message remains the same for all areas of public health: Directors of Public Health are local leaders for the health and wellbeing of the residents in their area. They understand the needs of their local communities and are best placed to commission services and introduce initiatives and programmes in partnership with local organisations that will promote and protect their health.

The devolution white paper published earlier this week is definitely a sign that the tide is turning and that this type of vital local knowledge should be harnessed and used to its full potential. However, while the ambition to give local leaders more control, and align public authority boundaries with those of strategic authorities, is to be applauded, we must make sure that existing, effective roles within those boundaries are not compromised, or duplicated.

2025 then is set to be another ground-breaking year where some of this legislation is passed and change can really begin. We will of course continue to call for an increase to public health funding across the UK following so many years of effective cuts – an increased, multi-year settlement that helps us plan consistent, effective support is our number one Christmas wish, but we know it may take time.

In the meantime, we are pleased to be working closely with colleagues in all four nations and feeding into discussions at all levels about the funding, workforce and structure reforms required, as well as about what evidence-based interventions and policies are needed, to help the Government achieve their ambitious target of turning the UK’s health around.

Happy Christmas and here’s to a healthy New Year!