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ADPH Manifesto for a Healthier Nation

Position statements | May 16, 2023

Our Ambitions for a Healthier Nation

Read our briefing document which outlines how our Manifesto for a Healthier Nation could be delivered by the next Government.

The state of health in the UK 

The UK’s health is declining and health inequalities are widening – strong leadership is required to change the current situation. Austerity and Covid-19, amongst other factors, have left lasting scars and poor economic performance is both a cause and a consequence of poor health.  

Smoking is the leading cause of premature and preventable death in the country, over a quarter of adults are living with obesity, and one in six adults are experiencing mental health issues. An estimated 149 million days of work were lost due to either injury or illness in 2021.   

Most concerningly, people in the least deprived areas of the country can expect to live 19 more years in good health, compared to those in the most deprived areas. 

Although the adage ‘prevention is better than cure’ is once again in ascendency amongst politicians and policymakers, action and investment consistently fall short of what is needed. For too long, Government spending has focussed on treatment, rather than keeping people healthy and preventing illness from arising in the first place. This short-term strategy does little for the health of our nation. The potential of too many people and places is unfulfilled, hindering our economic success and putting a huge strain on our communities and public services.  

Our health and well-being depend on many different factors. A small proportion – just 10-20% – is determined by access to traditional health services, principally the NHS. The remainder is shaped by our economic, social and environmental conditions such as our income, the education we receive, the housing we live in, the transport we use, and the air we breathe. Well-being and health are two sides of the same coin, and both should be a core function of government.  

We are calling for all political parties across the UK to set out long-term plans to improve public health and reduce health inequalities. Work must start on day one of the next Government. 

The health of the people is the highest good 

Creating a society in which we can all be as healthy as possible, for as long as possible must be the fundamental mission of any Government.  

Below we set out the contribution we will make and the commitments we want the next UK Government to make.  

The change we need nationally

Improving the nation’s health requires a bold vision, strong leadership and political will. We ask the next Government to: 

Develop and pass a new Public Health Act

Current public health legislation in England is fragmented and requires consolidation to be effective and avoid repeating the challenges of Covid-19. This consolidation should involve wellbeing being built into the fabric of all Government decision-making when it comes to both policy-making and funding allocation.  

Recommendation: A new public health act should be developed in England to consolidate existing legislation and ensure health and wellbeing is at the heart of Whitehall.  

Reduce health inequalities

Whilst there has been a disparity in mortality rates between the most and least deprived areas for decades, the gap in healthy life expectancy across the four nations has been steadily increasing in recent years, with issues such as the cost-of-living crisis and the Covid-19 pandemic further exacerbating this problem. 

Recommendation: The Government should introduce a dedicated health inequalities strategy and set clear targets for how this will be achieved.  

End Child Poverty

Poverty is the most significant determinant of children and young people’s health in the UK. The latest data indicates that almost one in three children in the UK are living in poverty.

Recommendation: A new Child Poverty Act which commits to ending child poverty in all parts of the UK by 2030 should be an early priority for the next government.  

Invest in public health

Investment in public health must be increased across the four nations. Public health needs to be funded sustainably and adequately in line with local population health need. In addition, further investment is needed across a wide range of policy areas including housing, transport and welfare to tackle the root causes of ill health.  

Recommendation: The Government should invest an additional £0.9bn in local public health budgets in England. Equivalent investment should be made in public health in the devolved nations.  

The role of Directors of Public Health – the local CMO 

Directors of Public Health (DsPH) are ambitious about protecting and improving public health, both locally and nationally. We believe in the power of a genuine ‘public health partnership’ between the UK Government, the devolved nations, the NHS, local government, charities, professional bodies, businesses, and individuals, to make this happen. 

To achieve this vision, DsPH will: 

  • Provide local place leadership on wellbeing and inequalities. 
  • Promote health and wellbeing in all policies across local public services, from councils to the NHS to the police. 
Deliver efficient and effective services

DsPH have reformed services and achieved good outcomes and will continue to do so, despite what is an increasingly unsustainable balancing act. For example, in England, The Public Health Outcomes Framework (PHOF) tracks 112 health indicators. In the last six years, 80% of those have been level or improving; notable, particularly as they have been achieved in a context of year-on-year cuts to the Public Health Grant.

Work collaboratively on joining up services and promoting population health

DsPH are committed to working with local and regional NHS and local authority colleagues as well as the voluntary and business sectors to ensure integrated pathways between the public health services provided in hospital settings and those offered in the community (like for example smoking cessation and alcohol treatment services); and to ensure that all parts of the health and social care system are focussed on population health outcomes. 

Support efforts for healthy public policy at a national level

As the national voice for DsPH, ADPH, will play our part in developing and promoting effective policies across key agendas like early years, violence prevention, sexual health, alcohol and drug treatment, obesity, smoking cessation, mental health, healthy economic growth and air quality. We will work constructively with Government departments and agencies, professional bodies, commissioners, charities and other partners to implement approaches that improve and protect the health of our communities.  

Get in touch 

We are committed to advising every political party in the UK to understand the role of DsPH and consider policies that will protect and improve public health in the years ahead. 

Please contact us to discuss how we can support you to make our country healthier. 

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