A new report by the Centre for Progressive Policy (CPP) sets out how the government can improve health and productivity across the population with a focus on health prevention.
Our previous paper, Crumbling foundations, found that 1.5 years of life and 2.6 years of good health per person in England are being lost due to inequalities in five key areas: income and unemployment levels, poor quality housing, exposure to crime and access to education. This equates to 81 million life years and 144 million years of good health lost across England.
We know these issues take a heavy toll on our health, and in turn our productivity. But health policy does not sufficiently target them. In our new report, we set out how a new approach could disrupt some of these powerful social currents that pull people into ill health.
The recent Health and Care Act has seen a major restructure of the English NHS around Integrated Care Systems (ICSs), which include Integrated Care Partnerships (ICPs) of NHS trusts, local authorities and other relevant local organisations. As ICPs, these organisations come together to plan how to meet the health and wellbeing needs of the people who live and work in their area. The introduction of ICSs represents an important opportunity to deliver a more joined-up, local model of preventative healthcare which must not be wasted.
CPP is calling for a concerted strategy to improve health across the population, underpinned by a strong commitment from central government and delivered at a local level by government and health bodies with additional powers and access to long term funding. National targets to tackle food insecurity, child obesity, children’s mental health and inequality in school readiness would provide direction for local health and care systems on these key drivers of poor health for children and young people. Better targeting of existing government spending towards areas with high rates of deprivation would ensure that public money is spent as effectively as possible.
Clear responsibility for health outcomes by ministers would signal intent and accountability. An independent watchdog for health, spun out of and formally associated with the OBR, would focus minds on the strategic direction of health spending and outcomes in the UK.
Regional and local government, together with health bodies have a critical role to play and must be given the freedom and funding to deliver centrally set targets and goals how they see best. Focussing on the role of these organisations as anchor institutions and guaranteeing the real living wage to all those that work there would promote good health through quality jobs and increased incomes. Expanding the combined authority model and enabling local experimentation on how best to align funding, incentives, and accountability would help to realise the full potential of a population health agenda.