The UK should commit to spending 10p out of every £1 of the NHS budget on preventive measures to improve the nation’s health within 5-10 years.
This is the suggestion in a new report led by public services expert Lord Filkin – flanked by other experts and the King’s Fund think tank – arguing that the poor health of the nation costs almost £16bn annually.
As such, they argued, committing to spending on preventive measures should ‘surprisingly’ be affordable, and should become a cross-party ‘covenant for health’.
The experts narrowed down the key priorities to nine priority areas with specific intervention suggestions for each area: smoking; obesity; alcohol; children’s health; physical activity; air quality; mental health; early detection; and health inequalities.
This could achieve 3 million fewer smokers; 4 million avoiding becoming obese; 4 million people increasing physical activity; more children in general staying physically and mentally healthy; reducing 30,000 deaths a year from poor air quality; and 5 million people reducing their CVD risk, they claimed.
The report’s key suggestions for improving health
- much more support to help smokers quit, particularly in areas of deprivation
- pay for this by a tobacco industry levy, which must win the support of HMT
- prescribe vaping to help smokers quit, accompanied by a fierce clamp down on its general marketing and sale
- help smokers to quit at every interaction
- progressive phasing out of smoking including, but not limited to, promoting vaping to smokers
- rapid implementation of a sugar and salt reformulation tax
- mandatory calorie reduction targets for the food industry
- make healthy foods affordable and available to poor families
- public health campaigns
- school-based interventions
- regulations on food marketing to children
- increasing duty by 2% above inflation every year
- introduce minimum unit pricing in England, as in Scotland, Wales and Ireland
- restrict alcohol marketing which leads people to drink more and at an earlier age
- better access to treatment
- planning and local traffic management actions to make walking and cycling easier
- work energetically with local authorities and advocacy groups to create environments that support and encourage active travel
- reduce air pollution by purchasing cleaner vehicles for public services and public transport
- set up clean air zones focused on places with high pollution and high population density
- investing in health promotion, prevention and early intervention
- a cross-government mental health and wellbeing plan
- commission a report to identify practicable interventions to reduce the risks of mental illness with a
particular focus on children and young people
- focus on four topics: obesity, mental health, physical activity and early years
- re-introduce an upper limit on the amount of sugar served to children in school meals and regulate excess sugar in baby and
- launch a new ‘Eat and Learn’ initiative for schools; extend eligibility for free school meals; fund the holiday activities and
food programme and expand the Healthy Start scheme
- open access mental health hubs for young people and specialist mental health support in every school
- ramp up the training and recruitment of mental health support for children
- schools and colleges too need to support the mental health and wellbeing of pupils and to build youth resilience
Earlier detection and treatment of ill health
- further development of regular health checks, focusing hardest on people and places with high risk of premature ill health
- to be effective these checks must be matched with effective treatment and help with changing behaviour
- regular offers of support for healthier lifestyles may be essential for people aged 20 and 30 before problems
- ICBs setting clear strategies
- identify the 20% of upper-tier authorities with worst risks and worst healthy life expectancy and mandate all national and local policies and programmes to bend their policy goals to help such people and places
- fund £10m to every local authority with worst health
- cross-government investment in the early years
The report said: ‘A public commitment to match increases in healthcare spending to a proportionate increase in prevention would make sense to the public. For example, from every £1 allocated to the NHS, 10p could be designated to promote good health, tightly defined and ringfenced.’
And it summarised: ‘There is an opportunity to make significant improvements to the health of our nation in just 5 to 10 years, benefiting millions of people, society, our economy and our health systems. This paper explains where and how to do so.
‘It is urgent to act, the UK has among the worst population health in Europe, the highest levels of obesity, the worst excess drinking levels, very large health inequalities, and very many people become ill much earlier than they should.
‘Our high level of premature, often avoidable ill health, damages lives, our society, localities and our economy. Without resolute action it will get worse. We must act so that lives are not degraded, and to sustain our health services and labour supply.’