Prioritising health to save lives

What do we want the world to be? A vision of something better can be hard to define, but perhaps it shouldn’t be. Is it so hard to imagine a world that prioritises the health and wellbeing of people and the planet? The simplest of concepts often requires the most radical and deep rooted change, and this change goes beyond “health.” It’s a complex and difficult journey but one that we will commit to arguing for.

The NHS, indeed healthcare, is complex, and it might be better if each health professional settled for making a contribution that is achievable, even if small (doi:10.1136/bmj.n3128; doi:10.1136/bmj.n3140).12 But health professionals tend not to settle for doing just enough, as the effort of staff to cope with overstretched health systems makes plain. That effort might result in burnout, a decision to leave healthcare, or self-isolation because of covid-19. Whatever the reasons, the effect is the same: workforce pressures that threaten patient safety (doi:10.1136/bmj.n3139; doi:10.1136/bmj.o3).34

Running staff into the ground isn’t a vision of something better (doi:10.1136/bmj.o2).5 Neither is the absence of a viable workforce plan, nor the ongoing failure to provide staff with adequate protection against airborne SARS-CoV-2 transmission. These are important features of a “vaccines plus” strategy that over a hundred health professionals from around the world argue should be followed by every nation (doi:10.1136/bmj.o1).6

Their central premise is that vaccination alone, particularly vaccinating only your own nation’s population, is a dangerously inadequate strategy and that much else can be done without resorting to the toxic endgame of lockdowns. Arguing for or against lockdowns is a dangerous distraction. The debate should be about which public health measures—such as duration of self-isolation (doi:10.1136/bmj.n3164)7—and what type of economic support will ensure health and wellbeing while keeping society “open.”

A health lens would see asylum seekers as people with lives to improve rather than a negative statistic underlying an immigration policy. Health professionals in London did just that by setting up a new service that aims to ensure access to healthcare for this underserved population at a time when inequalities are widening (doi:10.1136/bmj.n3069).8 Indeed, a health lens would also help us focus on the inequalities that women still experience, and a new government strategy document is merely a first step (doi:10.1136/bmj.n3142).9

A focus on health and wellbeing outcomes also means listening more to the experiences and insights of health professionals, as well as building the scientific basis for a society worldwide with new priorities. The work of collating that evidence has already begun (https://www.bmj.com/health-wealth-profits; doi:10.1136/bmj.n2425).10 More immediately, Christine Outram’s shocking review of how the whistleblower Patricia Mills was treated by her employers underlines the damaging outcome of failing to prioritise wellbeing of patients and staff (doi:10.1136/bmj.n3147).11

It all goes back to being clear about what we want the world to be, and fighting each day to make this a reality.