Views And Reviews Acute Perspective

David Oliver: Getting serious about prevention

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k583 (Published 21 February 2018) Cite this as: BMJ 2018;360:k583

Re: David Oliver: Getting serious about prevention

The Institute of Health Promotion and Education fully agrees with David Oliver that it is now time to become “serious about prevention”.(1) In recent years we have consistently argued for an increase in public health funding.(2-8) We strongly believe this is needed to cope with our current and future public health priorities. The case for funding is further reinforced by evidence of how effective interventions have resulted in major successes in tackling pressing public health issues.(9-14)

Oliver highlights some of the recent authoritative reports; however, there is a growing number of eminent individuals, groups and organisations that are calling for increased action.(15-21)

Specifically we urge the Government to act in five key areas:

i) Produce a long term UK public health strategy.
ii) Address capacity issues in the NHS and schools, especially in areas with high levels of deprivation.(22,23)
iii) Promote the health of NHS staff.(24,25)
iv) Make PSHE compulsory in all schools.
v) Give power and resources to Directors of Public Health so that they can become the true “Masters of Public Health”.(2,26)

If these actions were to be instigated, we believe that vital issues such as obesity; smoking; alcohol abuse; mental health; and inequalities would be tackled effectively. In addition, we believe that having a healthy population would have economic benefits and relieve much of the pressure on our overloaded NHS.

References
1) Oliver D. Getting serious about prevention. BMJ 2018;360:k583

2) Watson MC and Lloyd J. Re: BMJ briefing: meet the new masters of public health. British Medical Journal Rapid Response 8th July 2013 http://www.bmj.com/content/346/bmj.f4242/rr/652995.

3) Watson M C and Lloyd J. Raiding the public health budget. Action is needed to tackle current public health threats BMJ 2014;348:g2721

4) Watson M C and Lloyd J, 2016. Need for increased investment in public health BMJ 2016;352:i761.

5) Watson M C and Thompson S. Re: Government must not shy away from bold action on public health, says MP. British Medical Journal Rapid Response, 25th November 2016. http://www.bmj.com/content/355/bmj.i6319/rr

6) Watson M and Tilford S. Re: Government’s response to inquiry on public health raises fears of more cuts. There should be investment – not cuts. British Medical Journal Rapid Response 10th January 2017. http://www.bmj.com/content/355/bmj.i6853/rr-1

7) Watson M and Tilford S. RE: Next government must tackle public health “ticking time bomb,” says BMA. 15 May 2017 http://www.bmj.com/content/357/bmj.j2325/rr-0

8) Watson M C and Lloyd J. RE: Spending on public health cut as councils look to save money. British Medical Journal Rapid Response, 14 July 2017. http://www.bmj.com/content/358/bmj.j3401/rr-0

9) CDC. Ten Public Health Achievements of the Twentieth Century - United States, 1900-1999. MMWR Weekly 1999;48(12):241–3

10) Tones K, Tilford S. Health promotion: effectiveness, efficiency and equity. Nelson Thornes, 2001.

11) Gray S, Pilkington P, Pencheon D, Jewell T. Public health in the UK: success or failure? J R Soc Med 2006;99: 107-11.

12) Hemenway D. While We Were Sleeping. Success Stories in Injury and Violence, Berkeley: University of California Press, 2009.

13) Watson M C and Errington G. Preventing unintentional injuries in children: successful approaches. Paediatrics and Child Health. 2016; 26(5), 194-199

14) Thompson S. The Essential Guide to Public Health and Health Promotion. Abingdon: Routledge, 2014.

15) Wanless D. Securing our future health: taking a long-term view. Final report. 2002. http: //si.easp.es/derechosciudadania/wp-content/uploads/2009/10/4.Informe-Wanless.pdf.

16) Marmot M. Fair society, healthy lives: strategic review of health inequalities in England post-2010. 2010. www.instituteofhealthequity.org/projects/fair-society-healthy-lives-them....

17) NHS England, Public Health England, Monitor, Care Quality Commission, Health Education England. Five year forward view. October 2014. www.england.nhs.uk/wp-content/uploads/2014/10/5yfv-web.pdf.

18) House of Commons Health Committee. Public health post-2013: second report of session 2016-17. House of Commons Paper No 140, 2016-17.

19) Richmond Group of Charities. What is preventing progress? Time to move from talk to action on reducing preventable illness. 6 Nov 2014. www.richmondgroupofcharities.org.uk

20) BMA. Public health and healthcare delivery task and finish group: final report. Jan 2015. http://bit.ly/2cpiHIp.

21) BMA. Funding for ill-health prevention and public health in the UK. May 2017. http://bit.ly/2quLN3K.

22) Watson M C and Forshaw M, 2016. Tackling the crisis in general practice. Prioritising prevention and health promotion BMJ 2016;352:i1333.

23) Watson M and Tilford S. Re: UK children have “alarming gap” in health between rich and poor, report finds. British Medical Journal Rapid Response 30th January 2017 http://www.bmj.com/content/356/bmj.j377/rr

24) Poland B, Green L and Rootman I (eds). Settings for Health Promotion. London: Sage Publications, 2000.

25) Watson, M. Going for gold: the health promoting general practice. Quality in Primary Care. 2008; 16:177-185.

26) Watson M and Tilford S, 2016. Directors of public health are pivotal in tackling health inequalities. BMJ 2016;354:i5013.

Competing interests: No competing interests

23 February 2018
Michael Craig Watson
Associate Professor of Public Health.
Sue Thompson, Secretary Institute of Health Promotion and Education, Welwyn AL6 0UD, UK. http://ihpe.org.uk/
University of Nottingham, Faculty of Medicine and Health Sciences, Queen's Medical Centre, Nottingham. NG7 2HA