As a country we are used to having a conversation about healthcare. A&E, access to GPs, the future of local hospitals are core to the daily news and to political debate. Indeed there are aspects of the current debate, as we all grapple with the challenges of consistently delivering high quality care, that are of the utmost importance.
Yet what we all really care about is our health, and the health of those around us, our families and our friends. Protecting and improving our health is not something the NHS can do on its own. Indeed a recently published study suggests healthcare only accounts for 10% of avoided early deaths. Lifestyle, social circumstances and our genes play much greater roles.
We need a much richer conversation about health. One that recognises the immediate risks (while no one will be surprised by the impact of tobacco on early death, that high blood pressure is the next biggest risk may be a surprise to many), and that considers the wider determinants of health – jobs, homes, friends, the start we get in life – that Michael Marmot set out so powerfully. But most of all, we need a conversation that is about people, and how together we can make a difference to health and wellbeing.
This is not a new conversation for the public health community. We need to take our knowledge and experience and reach out to a much wider audience: to councillors and local authority chief executives, to NHS professionals and leaders, employers and indeed a conversation with the public. This is already happening as local authorities up and down the country push forward with their new responsibilities for improving the public’s health.
Our other challenge is to be relevant to the agendas of all those we seek to influence. In these times of austerity we must recognise the financial challenges faced by local authorities, the NHS and, not least, hard pressed families. Public Health England and the public health community need to make the case for prevention and early intervention in terms of return on investment and pounds saved as well as in the improved outcomes.
At Public Health England we have started this conversation and work with all those who share our commitment to improving health and wellbeing. With local authorities and the public health community we will pull together the evidence for what works and describe the healthier future that could be achieved if we acted on what we know. We will speak straight from the evidence. And we will seek to capture the emerging evidence of practice, and the wisdom of communities who know how to tackle their own issues.
Changing the conversation is only the start, a platform, for the action that will be needed – from Government, local authorities, the NHS and yes each and every one of us – if we are to improve health across all our communities and tackle the health inequalities that persist between them.