The government’s green paper on preventing ill health ‘lacks ambition’ and falls short in key areas, the BMA has said in its full response to the proposals.
Although it welcomed the Department for Health and Social Care’s ‘long overdue’ aims to prioritise prevention, the BMA said the green paper’s vision was not supported by enough action, funding or regulation.
Among its proposals, the Advancing our health: prevention in the 2020s green paper called for tailored screenings for high-risk populations, a vaccination strategy by spring 2020, plans to tackle childhood obesity and a review of NHS Health Checks for adults aged 40 to 74.
But the BMA highlighted that public health budgets have been cut by £850m in real terms since 2015/16 despite hospital admissions for alcohol, smoking and obesity rising in recent years. It called for the government to commit to the £1bn per year investment that the sector has said it needs to deliver preventative services.
The response said: ‘We largely agree with the priority areas identified in the green paper but are concerned by the lack of political ambition and action that follows.
‘For the green paper to succeed, it is necessary that the workforce and services needed to deliver the vision actually exist and that requires funding.
‘From recognising the increase in multi-morbidity and designing services to meet this challenge, to maintaining and improving vaccine coverage rates, to removing prescription charges for those with long-term conditions or ensuring that the health service role models best practice, we agree that the NHS has an important role to play in prioritising prevention.’
The BMA argued that the green paper had an ‘alarming lack of detail’ on how the government plans to reduce health inequalities and improve health among those who are homeless or in poorer communities.
While much of the responsibility for tackling inequality lies outside the NHS, the BMA called for more investment into general practice to ensure GPs have enough consultation time to support the health needs of poorer communities.
But it welcomed a review of NHS Health Checks, stating that the programme should be targeted at high-risk groups, rather than using a ‘blanket approach’ that might not be effective for healthy people.
It also welcomed the green paper’s focus on mental health — which included the launch of the Every Mind Matters tool and a further £2.3bn per year for mental health services by 2023/24. But it added that CCGs need to double their mental health spending over the course of the NHS Long Term Plan to meet the ambitions of the plan.