Prioritise Public Health

My suggestion is that Public Health (i.e. our country's efforts to keep people well) should receive a much higher priority than is currently the case.

Our national spend on public health is around £1.3m out of a total "health" (sick!) budget of nearly £250m. In my view this is a wrong prioritisation.

I say that because I believe that a large part of our ever increasing spend on "heath" can be attributed to this seemingly under-resourced approach to public health.

Specifically, our health services appear largely reactive to public sickness whilst we as a population deal with the ever more costly implications of our diets, lifestyles and arguable inability to take informed decisions about our own health.

Our Doctors should not simply be handing out pills and treatments for symptoms, rather we need to address the root causes or else we will risk running out of money for a health system that is clearly struggling under the weight of demand with even more concerning demographics for the years ahead.

To achieve this, I would suggest moving the department of public health OUT of the DHSC due to the apparent conflict of interest i.e.  Public Health needs to be able to critically hold the DHSC to account for health outcomes not be part of the organisation itself. 

I would suggest establishing public health as a seperate body with wider representation than just health professionals. With a wider mix of professionally experienced people, receiving commensurate remneration, but with accountability and a more results based / commercial focus this new body would be the overseer of the health of our people.  Its powers and structure would be more like a regulator.

That body would need to analyse what our population is sick with in considerable detail, down to the person level where necessary, and to develop strategies to deal with causes as well as treating symptoms. It would champion all the people - both those who are sick and those who are well - and be proactive in ensuring that our people had the best information possible to live healthy lives.

It would critically examine the outcomes (and value for money) that we are getting from the existing system and have the power to make changes to the existing approach in the interest of public health.

It would be open to commercial opportunity - possibly including a research arm and could benefit from a power to compel DHSC personnel to trial things in the interest of public health with appropriate consents from patients. Savings on "sick" spend could/should be captured for the public health.  

It would have links to the department for enterprise to maximise opportunity.

It would need to access data about our people's health and lifestyles and be able to do so securely with necessary consents.

It would also have powers over things like food labling to help people make better choices and an input into taxation strategy to influence people's food/beverage consumption behaviors. 

It would also have input into things like vaccination strategies.



Why the contribution is important

This idea is, I think, important because it not only seeks to address an inherent conflict of interest in the existing structure (public health should not be in the sdepartment of health) but also it gives more focus to outcomes, value and the causes of ill-health of people rather than simply reacting to sickness as happens too much now. 

Free "sick" care is essential if we are to protect the most vulnerable but we have to reduce demand if we are to continue to be able to afford to offer it.

We can only reduce demand if we help our people to live healthier lives.



by GJW on July 10, 2018 at 11:17AM

Current Rating

Average score : 4.0
Based on : 3 votes


  • Posted by Nab July 10, 2018 at 20:37

    I agree that we should prioritise public health and that the DHSC should be subject to scrutiny by a regulator but I don't see that these 2 roles would fit within the same body.
  • Posted by Nab July 10, 2018 at 20:41

    I also agree that Drs should be thinking wider and more long term than simply dishing out pills and treatments for symptoms; however, I have previously been advised by a Dr to try yoga as my symptoms/illnesses all appeared to be stress related. It was very useful advice which I followed but yoga is not as cheap/easy as taking a pill. People also need educating to take responsibility for their own health.
  • Posted by Nicola2IOMGov July 18, 2018 at 12:15

    Social prescribing schemes where Doctors refer patients to non-medical treatments (such as gym, creative activities and volunteering schemes) recognised that some long term conditions, such as diabetes, can improve with lifestyle changes.
    A similar policy on the IOM would encourage lifestyle changes that would enhance healthy well-being thereby saving long term costs for the health service.

    Feedback received through offline engagement and a 4* rating attributed - Site moderator
  • Posted by manxklookie August 07, 2018 at 10:42

    I totally agree that more effort needs putting into encouraging people to be more healthy and to take more responsibility for looking after their bodies but there has to be some incentive for this to work. Maybe there could be some tax breaks for those spending more money on living health lifestyles such as subscriptions for chiropractic treatment, yoga classes, physiotherapy, private dental care plans etc. There is already a section on the tax return for professional subscriptions and work garments so why not for personal healthcare expenditure?
  • Posted by Nicola2IOMGov September 11, 2018 at 19:39

    Fitter people make for less use of the health system. Drive should be to help and reward those who take care of themselves and have healthy lifestyles thus reducing the financial burden.

    (Feedback received through offline engagement - Site moderator).
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