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The government has set a vision for putting prevention at the heart of its future health strategy in England.
Matt Hancock, Secretary of State for Health and Social Affairs, said that it was not logical for the country to spend more than ten times more money to treat illnesses and diseases. health problems only to prevent them.
He announced a refocusing on primary and community care services as part of the next long-term plan for the NHS, so that people can be supported to prevent them from getting sick.
It would also be expected to reduce inequalities in health.
Health experts welcomed the government's ambition, but warned that the effects of years of austerity, including major cuts in local government budgets, will need to be addressed before they can be translated in reality.
5 additional years
The improvement in health over the last decades has had the effect of reducing the risk of death from cardiovascular disease by 80% in people compared to 1948, while the cancer survival rate has improved. regularly.
However, recent evidence suggests that in recent years, life expectancy gains have become hard to reach, while about 20% of people's lives are nowadays in poor health, often with comorbidity.
In his document, Prevention is better than cure, the Ministry of Health said it wanted to improve life expectancy so that the English could expect, by 2035, at least five more years of healthy and independent life.
In a speech to the International Association of National Institutes of Public Health, Dr. Hancock said that he "explains how we need a radical change in the way the NHS considers itself," he said. A hospital-based sickness service to a national service meant to keep us healthy. "
He reported a change from the current climate of 115 billion pounds a year spent on acute NHS care, compared with only 11 billion for primary care.
Dr. Hancock put forward a combination of genomics and artificial intelligence that could transform medicine. "In Cambridge, we are about to sequence the 100,000th genome and we are now targeting five million to be able to diagnose rare diseases, faster and with fewer pain tests for patients," he said.
"The world-leading Moorfields Eye Hospital works with Deepmind, the leading AI company, whose AI system has correctly diagnosed more than 50 eye diseases with 94% accuracy." corresponding to at least the best human experts, and this figure will only improve. "
Take personal responsibility for health
Dr. Hancock, however, emphasized the need for a culture shift to ensure that individuals take more responsibility for their own health. This would include staying active, quitting, drinking less alcohol and reducing salt intake.
Dr. Hancock highlighted new digital technologies that would direct people to healthier decisions, coupled with better access to primary care and a "social prescription".
The government has also recognized the need to improve housing and neighborhoods, combat air pollution and encourage employers to take more responsibility for the health of their workers.
The strategies would form the basis of a government green paper in 2019.
The health secretary said that among the main ambitions and plans would be:
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Expand access to specialized mental health services to an additional 30,000 women during pregnancy and in the first year after childbirth, by 2020-2021
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Halve juvenile obesity by 2030
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Reduce loneliness and social isolation and make social prescription available in every region from here 2023
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Diagnose 75% of cancers in stages 1 and 2 by 2028
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Sequencing of 5 million genomes in 5 years and offers whole genome sequencing to all critically ill and cancer-prone children by 2019, as well as to adults with rare diseases or cancers
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Expanding Access to Whole Genome Sequencing to NHS Patients From 2019
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Put forward, by Easter 2019, "realistic but ambitious goals" to reduce salt consumption
A "seminal moment" for health
Duncan Selbie, Executive Director of Public Health England (PHE) described Hancock's strategy as "a defining moment for the health of the public".
He said that it was well known that good health was the foundation of a healthy economy.
"With affluent people enjoying 19 years older in good health than poor, continuing to do as before is not an option and good health in a modern and caring country should not depend on income," he said. he said in a blog on the site of PHE.
Expenditure reductions
The Health Foundation think tank called for clear goals to address the social and economic conditions that affect the health of the population.
Jo Bibby, its director of health, said: "This vision rightly identifies local authorities as playing a vital role in improving local health, but their ability to fulfill this role has been compromised. by substantial cuts in local services and investments the last decade of austerity ".
The Foundation highlighted its own analysis that there would have been £ 700 million in real terms cuts to the public health grant since 2014-2015, while larger local government budgets would have been reduced by the same amount. one third between 2011/12 and 2016/17.
Ms. Bibby warned that "if this ambitious prevention vision were to become a reality, it should be accompanied by a long-term investment."
The British Medical Association (BMA) said that a focus on prevention was a win-win strategy for its impact on the health of the population and the long-term savings achieved by the NHS. However, Dr. Peter English, Chair of the BMA Public Health Committee, commented, "While the plans outlined in this document are a welcome step, the government needs to be realistic about what needs to be done to achieve these results.
"There is a need to reverse cuts in public health budgets, because in many areas public health services do not adequately address the health needs of the local population. Smoking cessation and sexual health in some regions directly contributes unacceptable variations in the quality and quantity of care provided to the population.
"The needed improvements in areas such as mental health will require significant investments in the workforce."
Patients do not deserve blame
The United Kingdom Medical Association (DAUK) said the government's plans were at odds with last week's budget statement, which hinted that there would be more cuts in funding for public health.
Doctors also feared that asking people to take more responsibility for their own health was responsible for diseases such as diabetes, heart disease and cancer, patients who would not choose to develop these diseases.
Dr. Alan Woodall, general practitioner and public health spokesperson at DAUK, said: "Personal responsibility is the main driver of improving health.Without funding and policy change to reduce the risk of poor health. the obesogenic environment, further reduce smoking and drug use, improve social cohesion and recognize the wider impacts of policies on [is] unlikely to succeed. "
The Royal College of Pediatrics and Child Health (RCPCH) stated that the fight against childhood obesity and the promotion of mental well-being were important elements of a large-scale prevention strategy.
Improve children's health and outcomes
Russell Viner, President of RCPCH, said: "Fighting health inequities is also essential to ensure every child gets the best possible start in life.
"We know that children born in the most disadvantaged areas of the country are more likely to have adverse health effects than their richer peers. [the] The government's vision of bridging the gap between the experiences of the richest and the poorest in society is welcome. "
Dentists challenged Mr. Hancock's priorities, which had missed an opportunity by simply referring to the improvement of oral health in children.
Mick Armstrong, president of the British Dental Association (BDA), said: "The health secretary has said he wants to stand up for prevention, but he has a lot more to say about broccoli than preventable mouth disease that costs millions. to our NHS.
"When tooth decay remains the main reason for admissions to a children's hospital, treating dental care after the fact seems more than negligent.
"England's huge inequalities in oral health are fueled by poverty and the lack of a coherent strategy." The starting point of any solution will not be "Big Data" or applications, but a Westminster political will and year-end discounts. "
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