Pledges, prevention and public health

With just over a week to go until the General Election, I wanted to reflect on all the promises and analysis the last six weeks has given us and share my thoughts – for what they’re worth – about what the next Government should prioritise.

Regardless of who wins next Thursday, it has been positive to hear so much discussion about the need to create a healthier society. The manifestos brought a whole plethora of pledges about public health – all of course welcome, some not going far enough but clearly steps in the right direction. There are of course different motivations, but that our politicians recognise that the numbers of people who are unhealthy are too high, and that healthy people make for a healthier economy and nation has to be a good thing.

Before the election was called, the Tobacco and Vapes Bill was making its way through Parliament. The debate around it brought into focus how supportive the public are of improving the environment around us. The next Government mustn’t shy away from that – we need policies in place that promote good health and protect us from harm.

The Public Health Act, which was passed over 175 years ago, was the UK’s first step on that road. Since then, the world has undergone a huge amount of change brought on by conflict, industrial and technological progress, pandemics, social change and more. In response, we have seen multiple pieces of legislation that have had an impact on our health and increasingly, I see evidence that we are at another ‘moment in time’ for Public Health where a new Public Health Act – one fit for the 21^st Century – could reduce fragmentation and support a coherent approach to improving health and wellbeing across all four countries and dependant territories.

Meanwhile, I think all the parties would agree that the current gap in healthy life expectancy is unacceptable. There are multiple factors as to why and so it will require a multi-faceted solution, but committing to a strategy with clearly defined targets for those factors is a must. We have to level the playing field so that everyone has the opportunity to live in decent housing, access green spaces with good air quality, be educated and employed fairly, and have access to healthy, affordable food regardless of which area of the country they live in, or how much money they have.

That so many households are living in poverty is of course one of the contributing factors. The issue of child poverty is especially concerning as so much of our long-term health outcomes are determined by our childhoods. We therefore want to see a new Child Poverty Act that commits to ending poverty for all children in the UK by 2030. Again, it won’t be easy, but it is achievable using existing, well-evidenced interventions like free school meals and the Healthy Start Scheme, and existing legislation like the Wellbeing of Future Generations Act in Wales and Tackling Child Poverty Delivery Plan in Scotland could provide a solid base to build on.

For any – and all – of these things to happen, we also need to see an increase in funding for public health. In England for example, the public health budget has been cut by over a quarter over the last decade and will need real investment to restore it to the levels of 2015/16. This funding pays for a multitude of services including smoking cessation, weight management and sexual health. It also funds a network of community organisations and partnerships that are working to create healthier environments for people to live and work in, and, ultimately of course, pays for a whole wealth of public health expertise. It is this expertise that led us through Covid-19 and, with the right investment, will lead to the creation of a healthier society and better health for all.

The relationship between central and local needs to be nurtured by the next Government – yes with funding, but also with a commitment to cross-party and cross-sector working to make our communities healthier. So, when the ballot papers have been counted and we have our winner, we will be here waiting to work with them and help them translate those manifesto pledges into long-term solutions that will support everyone to live healthier lives for longer.