Introduction

It is easy to understand why a national sickness service, as the NHS has been described,1 might choose largely to ignore young people. The common perception is that young people are rarely ill. However, in setting out its plans for the NHS, the government is now calling for a shift to a service focusing on the whole of health and wellbeing.2 3 The national service framework for children, young people and maternity provides a lever for local change, but securing the short and longer term gains in population health and reducing health inequality will call for a much keener focus on the health of young people.

Background

Before the government's 2002 spending review, Derek Wanless was asked to consider what would be required to provide high quality health services in 20 years' time. Wanless showed that the least expensive future scenario, and the one that also gave the best health outcomes, was the “fully engaged” scenario: the level of public engagement in relation to health is high and people are confident in the health system and demand high quality health care. The health service is responsive, with high rates of technology uptake, particularly in relation to disease prevention, and resources are used efficiently.1

The potentially “fully engaged” citizens of 20 years' time are today's seven million young people. However, the health of young people seems to have little priority in the United Kingdom. Aside from the teenage pregnancy strategy, few public health initiatives focus on adolescent health. So what might a fully engaged scenario look like for today's young people?

Where are we now?

For adolescents (defined by the World Health Organisation as 10-20 years of age), key public …