A new report by the Health Foundation says that, in the wake of the pandemic, there is a window of opportunity to build an improved public health system to take on the major health challenges facing the country. The independent charity says that this will be vital for improving the nation’s health in future.
Following the decision to abolish Public Health England (PHE), the Health Foundation says it is essential that the government prioritises the wider services that keep people in good health. With huge resources being poured into the pandemic response, there is a risk that other vital aspects of public health will be neglected, leaving the public health system weaker in future.
The Health Foundation says that the government’s decision to maintain current levels of funding for public health, in last week’s Spending Review, will not be enough. A significant increase is needed to reverse major cuts in previous years – £1.2bn is needed just to restore funding to its 2015 levels** while a further £2.6bn would be needed to level up public health across the country. In addition to increased funding, the new public health system will need the right strategy and structures in place – including an independent body that reports to parliament on the nation’s health*.
The report also says that the reorganisation – which will see PHE’s existing functions split up – needs to be carefully managed to ensure it doesn’t disrupt the pandemic response or wider public health services. It points to lessons learned from the reorganisation of cancer services in 2012, which was highly costly, led to an exodus of experienced staff, and caused confusion about accountabilities and responsibilities.
Highlighting the need for major action, new analysis by the Health Foundation reveals that people living in the more affluent half of the population are much less likely to die prematurely (before the age of 75) than those living in more deprived areas. The analysis shows that 77,000 premature deaths would have been averted in 2018, if everyone in the country enjoyed the same health as those living in the more affluent areas ***.
Tim Elwell-Sutton, Assistant Director of Strategic Partnerships at the Health Foundation, said:
‘There is huge scope to improve people’s health and give more people the opportunity to live a healthy life. Decisions made now will shape the nation’s health for many years to come and it is vital that government takes this opportunity to create a stronger public health system for the future. The pandemic makes it all more urgent that we prioritise keeping people healthy. A strong public health system isn’t a luxury – beyond the obvious benefit to the individual, good health brings with it huge economic and social benefits that are vital to the country’s prosperity.
‘The government has pledged to increase healthy life expectancy and narrow the gap between the richest and poorest. To achieve that they need a to make a serious cross-government commitment to improving health. They also need to put in place the right public health infrastructure and provide it with adequate funding – a tiny cost in comparison to what is being spent on responding to the pandemic. All of these are essential if we are to level up health.’
* The Health Foundation says that it will be vital that the system that replaces PHE has the right structures in place, including an independent body that regularly reports on the nation’s health to parliament, a national function supporting the public health system, and strengthened local and regional infrastructure to provide services on the ground.
** The Health Foundation says an extra £1.2bn is needed for restore public health funding to its 2015 levels taking into account inflation and population growth. This is £1.2bn for the public health grant to local authorities and £56m to fund the non-health protection functions currently carried out by Public Health England. A further £2.6bn is needed for the public hlth grant to local authorities to level up public health across the country. The Health Foundation also recommends that government should commit to ensuring that national and regional public health funding keeps pace with NHS funding increases in future.
*** ONS data from 2018 shows that the most common causes of avoidable death were: cancers, cardiovascular disease, respiratory diseases, and alcohol and drug related deaths
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