Remember A Healthier Nation – the Conservative party document that promised a focus on improving public health? Policy, it claimed, would be evidence-based, and health inequalities reduced. The department of health was even to be renamed the department of public health.
A genuine focus on preventative public health strategies would of course be a highly welcome step to reduce health inequalities. But it’s already clear from their announcements that the Tory-Lib Dem government is interested in nothing of the sort. While much of the debate to date has been focused on the government’s reorganisation plans for the NHS in this week’s white paper, and about the decision to remove targets for treatment times, other pronouncements tell us more about the government’s attitudes, priorities and intentions, and could have far greater and highly damaging implications for the nation’s health.
Ministers’ plans to engage consumer businesses in the Change4Life campaign which promotes healthy lifestyles, fitness and diet, have begun to provoke alarm. And that sits alongside a range of measures – axing the health in pregnancy grant, cancelling the extension of the free school meals pilots, freezing or restricting benefits which leave the poorest without the means to eat a healthy diet or heat their homes adequately, cutting free swimming for under-16s and the elderly – which fly in the face of improving public health. Instead Andrew Lansley and his ministerial team have made clear their view that it’s up to individuals to take responsibility for their and their families’ health.
This is old-fashioned Thatcherism, based on the traditional Conservative agendas of minimal public spending, minimal regulation on the business community, and antipathy to anything that smacks of the ‘nanny state’. If ministers were truly interested in the evidence, they would avoid knee-jerk cuts and pay more attention to the experts. Only last month, the BMJ carried a report of a new study that showed the importance of wider social spending (as opposed to specific healthcare spending), in relation to addressing health conditions associated with social circumstances, such as TB, cardiovascular disease and alcohol related deaths. And Professor Sir Michael Marmot, in his report on health inequalities earlier this year, suggested that increasing the national minimum wage would be the most significant step government could take to improve the nation’s health.
Of course, ministers will argue that reduction of the deficit means cuts have to be made. But as ever with the coalition government, the sum of individual policy decisions shows the real extent of their assault on the welfare state. Measures which help the poorest, reduce inequality and offer long-term benefits to society all face the axe.
Labour must find a way to build up the pressure on the government’s strategy, and perhaps it’s the broad-based, popular and everyday nature of the practice and policies that are needed that offer a chance to do that – whether it’s banning fast food outlets near school gates, securing the funding for the local football club, or making sure young pregnant women can afford a healthy diet. Parents, teachers, women’s organisations, family support groups, youth workers, sports clubs, the police, nursery and childcare staff, housing associations, employers, the local farmers’ market, as well of course as healthcare professionals – all could be allies in such a campaign. If we’re serious about improving health outcomes, but more broadly in protecting and making the case for our welfare state, let’s start that campaign now.
I absolutely agree with all of this. However, However, the proposal to fragment PCTs, with GP practices taking on the role of commmissioning services could have other really negative consequences. Many voluntary organisations rely on the support of PCT funding, such as carers’ centres. Others deliver support on chronic poor health and succeed because people fund their ethos more comfortable than visiting their GP. Are we seriously contemplating the wiping out of such organisations?
I absolutely agree with all of this. However, However, the proposal to fragment PCTs, with GP practices taking on the role of commmissioning services could have other really negative consequences. Many voluntary organisations rely on the support of PCT funding, such as carers’ centres. Others deliver support on chronic poor health and succeed because people fund their ethos more comfortable than visiting their GP. Are we seriously contemplating the wiping out of such organisations?
Most of it makes sense but do we have to maintain the middle class predjudice agains fast food outlets. The number of people who state the fact that they have never been to a McDonalds as some kind of campaign badge – whilst reveling in the new red wine they have discovered is starting to get a bit boring – it also demonstrates how out of touch so many on the left are.