‘RIP Public Health’ was the tweet of Tory MP and GP Sarah Wollaston at the government’s gutless retreat in July from its pledge to introduce plain packaging of cigarettes and a minimum unit price for alcohol.
Across the piece we see a strong fightback from industry, a failure to win cabinet support and a prevailing orthodoxy that we have a cultural scepticism towards what’s now regularly portrayed as a nanny state.
This all stands in the way of helping people to have healthier and longer lives, while at the same time soaking up precious health resources.
What are the lessons for Labour to ensure we can produce a public health policy that we can deliver and which improves lives and wellbeing?
Sadly we still find people in the UK enjoy fewer years of good health before they die than others in comparable EU countries.
We’re told we face an obesity epidemic which could overwhelm our health service and cost us £10bn a year by 2050. But the food industry applauds its own snail pace reductions in fat and sugar in its products. And the breakfast cereal manufacturers shriek when Labour consults on a 30 per cent cap on sugar in breakfast cereals.
Action to get us moving is also stalled. The deputy chairman of London 2012, Keith Mills, calls for an integrated national sports strategy that brings together health, education, sports clubs and local authorities – driven by the prime minister! And former Olympic champion, Jonathan Edwards laments the impact of local authority cuts on sports facilities as a major threat to the games legacy (a local swimming pool and sports centre in my constituency could close by the end of this year).
Alcohol abuse, and not just its most public manifestation of youthful binge-drinking, is also costing the tax payer £21bn a year. It blights lives and fuels violence. But the prime minister’s short-lived commitment to a 45p minimum price for alcohol crumbles in the face of cabinet, Treasury and industry opposition (though many pub chains and nightclubs support the measure.)
The smoking ban has certainly made the air in our pubs and restaurants healthier and more pleasant places to relax. But young people (more than 200,000 under 16 start smoking every year) are still being recruited to the habit and the government ditches plain packaging of cigarettes.
So the cumulative outlay from the taxpayer to cope with the consequences of our taste for too much alcohol, cigarettes and the sweet things in life is vast.
The voluntary sector and medical experts regularly tell us this is a big ticket issue where delay is costly and cowardly.
So why aren’t the public and politicians more engaged?
How in the 21st century do we get the momentum for tougher action that in the last century delivered the improvements in water and sanitation and air quality that have made us and our environment so much healthier?
The priorities set out for 2013-14 by Public Health England are broad-brush and easy to support. In Wales the government has consulted on placing a statutory duty on bodies to consider public health issues.
But we’re not achieving the pace of change and improvement we need.
First, I think we should draw together in an annual publication statistics from across the UK that tell us how much our bad habits and health inequalities cost the taxpayer, so that we see clearly where progress has been made or stalled. This should give us a firm basis to engage with the public about what works and what action from government is needed.
As we know public health is much more than tackling obesity, alcohol misuse and smoking, important though they are. It covers vaccination, early intervention, sexual health, drug misuse, health and safety and the non-medical causes of ill-health such as worklessness, fuel poverty or isolation.
As Danny Dorling, Sheffield University professor of human geography, has succinctly stated, ‘It is now well known that the strongest correlation to poor health is poverty, and the longer people live in poverty the shorter lives they can expect to live.’
So part of Labour’s narrative for our policies, whether it be tougher measures to tackle fuel poverty, investment in housing or the extension of high-quality domiciliary care to keep our elderly living independently in their own home for as long as possible, should stress that investment in such measures will improve our health and wellbeing.
Given this mega portfolio, shouldn’t there be a strong leader, a cabinet minister for public health driving this vast agenda forward? David Cameron glibly told MPs that he and the health secretary had discussed, then dumped, plain packaging.
The public health minister, Anna Soubry, has had the carpet pulled from under her. Indeed she’s now the public face of the climbdowns, defending policies she’s previously scorned.
Our shadow minister for public health, Diane Abbott, is rightly relishing the job – but deserves more support from us in parliament. After all we represent the people with relatively poorer health and life expectancy.
We must defeat the mantra that those who want to up the pace of reform are advocates of the nanny state and greater regulation. We need to show that reforms we suggest will save lives and money and are clearly the right thing to do.
The food, drink and tobacco industries know the importance of availability, affordability and advertising in delivering sales. That’s why they fight any proposed restrictions.
If we’re serious about improving the wellbeing of our constituents and saving public money then a wide ranging but cohesive public health strategy across government departments should be a political priority for Labour.
A cabinet minister for public health in the next Labour government would be a good start.
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Nick Smith is MP for Blaenau Gwent and a member of the Progress strategy board. He tweets @BlaenauGwentMP
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