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More strategic, long-term investment needed across government for a healthy and prosperous nation

New report shows government is failing to invest in the nation’s health by focusing on short-term spending

New analysis released today by the Health Foundation shows that over the past decade there has been a significant shift in expenditure across government, moving from spending on the services and infrastructure that helps people stay healthy towards addressing problems that could be avoided in the first place. The charity says this short-term approach is storing up significant problems for the future and runs the risk of widening inequalities in people’s health.

The Health Foundation is calling on the government to look beyond short-term spending that just focuses on dealing with the most acute needs – whether in the NHS or other services – and make a more ambitious longer-term commitment to investing in the conditions that keep people healthy in the first place. Good health is essential for people’s wellbeing, their productive capacity and their ability to participate in society. This is why the Health Foundation is calling for a whole-government strategy that re-balances investment towards areas of spending that maintain and improve everyone’s health – areas such as early years and youth services, housing, and social security.

The Foundation recommends five shifts in the government’s overall approach to achieve this aim.

The significant spending reductions that have taken place across social security, housing and children’s services since 2010 are widely accepted. The report highlights that not only have these budgets been cut, but the money spent in those areas is now increasingly spent on problems that, with the right investment, could be avoided in the first place. Within Department of Health and Social Care spend too, the report authors find there has been a shift away from investment in the prevention of poor health. For example, between 2015/16 and 2020/21, spending on NHS England is expected to have grown by 12% on a real term per head basis, compared with a 25% cut in the public health grant since allocations were first set out for 2015/16.

The Health Foundation says the government is unlikely to deliver on its own targets to improve health as a result of this short-term approach. As part of its Industrial Strategy, the government has set out to ensure people can enjoy ‘at least 5 extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and poorest.’ Analysis carried out by the Health Foundation shows that if things continue as they are it would take 75 years – not 16 – to deliver this improvement.

Jo Bibby, Director of Health at the Health Foundation, said:

‘The health of the population is one of any nation’s greatest assets. A healthy population is vital to ensuring a successful economy and a thriving society. At a time when political energy is absorbed by Brexit, and with a one year spending round that will provide only a temporary sticking plaster, the longer-term issues that will shape the future health and prosperity of our nation are being overlooked. Despite the Health Secretary naming prevention of poor health as a top policy priority, our analysis shows that spending on prevention has been de-prioritised in recent years, with a failure to invest in people’s health long-term.

‘Half of the people living in the most deprived circumstances in England are in poor health by the age of 59 – they experience poor health two decades earlier than people living in the least deprived areas. This has consequences for their ability to work and play an active role in their communities and family life.

‘No government should want to see inequalities widen on their watch. But this will be the consequence of continued under-investment in areas such as children’s services, housing and social security all of which are vital in maintaining and improving people’s health and wellbeing. Bold political decisions are now required to create a healthier, more prosperous future for our nation.’

Report recommendations

The Health Foundation is calling for improving health to be embedded as a shared value across the whole of government, with a renewed focus on preventive action that stops people from becoming ill in the first place. This could be achieved by implementing five big shifts:

  1. Change the way success is measured, moving beyond GDP as the main measure of success and evaluating policy on the basis of health and wellbeing as a primary measure of successful government.
  2. Adopt a legislative framework, along the lines of the Wellbeing of Future Generations Act for Wales, designed to encourage long-term joined-up action across the wider determinants of health.
  3. Begin investing in people’s health over the long-term by reviewing the balance of health-promoting versus reactive spending across different areas of government. This should include re-investment in the public health grant as an immediate priority.
  4. Enable the NHS to play a stronger role in preventing ill health as well as treating illness, including by supporting its role as an anchor in communities.
  5. Involve communities and adopt approaches to improving public services that are tailored to local places, paying particular attention to areas experiencing the greatest deprivation.

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