Is it time for the government to follow the lead of many of its citizens – and adopt some new year’s resolutions of its own when it comes to health?

There’s clearly a need for some new thinking by government as it faces yet another NHS winter crisis.

At the risk of stating the obvious, we need:

  • To address the root causes of ill-health, like our current obesogenic environment and high levels of social inequality.
  • A true National HEALTH Service – which gives higher priority to stopping people falling ill in the first place, rather than simply waiting until they fall ill and then trying to treat them.
  • To recruit and importantly RETAIN health professionals – and ensure they have the training and the skills to encourage health, not simply treat illness.
  • To provide practical carrot and stick incentives for businesses to produce goods and services which are good for our health and for employers to ensure healthy working environments.
  • Central and local government to lead by example – including considering the health implications of ALL their policies and ensuring they too provide healthy work places.

So, taking each in turn, we recommend these New Year’s Resolutions for government.

1. To address the root causes of ill-health

1.1 Consider what action is needed in relation to fast food, takeaways and home delivery (on which UK consumers currently spend £30 billion p.a.) – to complement existing action on sugary drinks.

1.2. Consider how to make physical activity at school a varied, fun and enjoyable experience, as an integral part of the learning environment – to build a commitment to physical activity that can be sustained into and rekindled in adult life.  

1.3. A simpler, fairer tax system, where the amount of tax you pay doesn’t depend on whether or not you can afford expensive tax avoidance advice – to reduce the social inequality that fuels health inequality.

1.4. Many more affordable homes to buy and rent, by enabling Local Authorities and Housing Associations to contribute more, encouraging more factory-built homes (to avoid weather delays during construction) and reducing commuting costs to better connect affordable housing and employment.

1.5. Actively encouraging and supporting volunteering, both to increase support for those in need and for the mental and physical health benefits experienced by those volunteering.

1.6. Objectively review changes and initiatives which have taken place within the health, benefits, education and care systems, to see which have reduced health and social inequalities and which haven’t.

2. To create a true National HEALTH Service

2.1. Ensure Clinical Commissioning Groups (CCGs) commission health improvement, not just the treatment of accident and illness – with a particular focus on the importance of the early years for long term physical and mental health.

2.2. Ensure NHS Trusts report on the action they have taken to improve health, over and above the treatment of accident and illness, in their Annual Reports.

2.3. Find ways to fast track career progression for health professionals who are actively engaged in health improvement – to encourage a move away from paying lip service to the importance of prevention to making this a reality.

3. To recruit and importantly RETAIN health professionals with the right skills

3.1. Write off student loan debts for doctors and nurses who complete five years continuous full-time employment with the NHS, to help reverse:

- the one third fall in applications for nursing courses since bursaries were replaced by student loans in 2017.

- the 13% fall in applications to medical school since tuition fees rose to £9,000 p.a. in 2012.

3.2. Set up a task force, led by someone like Dr Sarah Wollaston MP (Chair of the Health and Social Care Committee) to consider how to make the NHS an employer that qualified health professionals actively wish to continue working in – to avoid the record number of health professionals currently leaving the NHS (resulting in 41,000 nursing and midwifery vacancies currently; and only half of doctors completing their first two years of on the job training now going on to NHS training to become a specialist or GP, down from 71% in 2011).

3.3. Modernise the medical school and nursing curriculum, and Continuing Professional Development (CPD) post qualification, to include a significant focus on preventative health – including providing health professionals with the knowledge, skills and expertise to help their patients adopt healthier lifestyles and the potential of initiatives such as GP-based social prescribing and the hospital-based Ottawa Model of Smoking Cessation.

4. To provide practical carrot and stick incentives for businesses to produce goods and services which are good for our health and for employers to ensure healthy working environments - recognising that voluntary approaches have failed to achieve the progress needed and that financial incentives or regulatory action are now needed:

4.1 Start with clear regulation to limit the mass production of food high in sugar, salt and saturated fat, as recommended by the British Retail Consortium – and make R & D corporation tax relief only available to food and drink companies undertaking R & D to develop healthier products.

4.2. Ban added sugar in baby and infant formula, to avoid ‘hooking’ children on sweet tasting products, as recommended by the UK’s Chief Medical Officer.

4.3. Provide tax or other financial incentives to organisations which secure Health at Work accreditation and/or financially incentivize Investors in People to add a new indicator to IIP accreditation i.e. supporting the physical and mental health of employees (to reach the thousands of employers nationally with IIP accreditation – employing around a third of the UK’s workforce.)

5. Central and local government to lead by example:

5.1. Reverse the cuts in public health funding, the front line when it comes to preventing illness, and then increase funding for public health annually, in line with RPI inflation.

5.2. Agree a mechanism to ensure that the health implications of all government policies are seriously considered, including those for transport, housing, education, the environment, agriculture, business, energy, work and industrial strategy.

5.3. Seek appropriate Health at Work accreditation for all central and local government organisations and their component parts (including hospitals and schools).

 Michael Baber