Will parties really prioritise the prevention agenda?

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All three main parties see public health and prevention as a significant issue for the future of health policy. The three parties' commitments are so similar on this issue that it's hard to distinguish any differences.

Take the following three commitments, for example, each taken from a different manifesto:

It's a hard task to identify the first as Conservative, the second as Liberal Democrats, and the third as Labour.

The Liberal Democrats provide the least detail on how they will improve public health, stating only that they will 'link payments to health boards and GPs more directly to prevention measures'. Labour refer to current initiatives such as health checks and the Change4Life programme but otherwise lack detail of new initiatives. The Conservatives are the most specific as they seek to turn the Department of Health into a Department of Public Health. The assumption is that separating public health from the rest of the DH will lead to it becoming a more fundamental issue for the NHS. But Labour prioritised public health in their three terms and appointed a Minister of State for Public Health – so is there anything we can learn from the past 13 years?

Public health practitioners and academics were excited about the appointment of the first Minister of Public Health in 1997– finally, we had a government that put prevention at the heart of the NHS. And prevention did figure significantly in some Labour policies (for example, Saving Lives, Choosing Health). However, at the Cabinet table, public health and prevention were all too often put at the bottom of the agenda. Take the Olympics as an example of public health battling against – and losing to – other departments. Public health ministers saw the games as an opportunity to improve exercise, but the Olympics also required sponsors to alleviate pressure on the public purse. The result? Olympic sponsors such as McDonalds, Coca Cola and Cadburys advertise their burgers, soft drinks and chocolate alongside messages to eat more healthily and increase exercise. So one message cancels out the other and which one has the larger budget and is more likely to succeed?

Similarly, policy discussions about alcohol include the views of the Minister of Public Health but also of the Department for Culture, Media and Sport and the Department for Business, Innovation and Skills, who represent pubs and the drinks industry – jobs – in the UK. Even with a Minister of Public Health sitting at the table, it is difficult to keep prevention at the top of the government agenda.

The next generation of Ministers of Public Health, under whichever government is elected, will need to be ever more forceful in trying to make themselves heard. The past 13 years have shown that even when governments make decisions, it is difficult to prioritise the prevention agenda. Fortunately, all three parties now agree prevention is important, so perhaps now is the time for a Secretary of State or Minister for Public Health to become a robust player in the Cabinet.


Peder Clark

Comment date
21 April 2010
Hm, agree that all parties are light on detail about prevention agenda while all paying lip service to it... not sure the Lib Dems have the least though - check my blogpiece for FPH: betterhealthforall.org/2010/04/14/public-health-and-the-public-vote

Michael Shepherd

Comment date
23 April 2010
I agree there is really a lukewarm feel about the three main parties public health agendas, neither detail, nor innovation very evident. Its only Plaid Cymru that really take on the challenge of thinking about public health in a 'new' (for politicians) way. Their maifesto focuses more on wellness than the tired old proposals of the other parties. Shame that as an English voter I will have no chance to vote for them.

Mary E Hoult

Comment date
23 April 2010
I'm on my hobby horse again,Public Health etc,facts, we are an ageing population who will need good eye care at some point in our life,there was/has been a great opportunity over the last few years with the extra funding for more community eyecare services having already established increased volumes in deman.We are still experiencing access problems effecting school age children and the elderly the very people who we should be looking after if we are to reduce the inequalities gap.I am looking forward with interest to the inequalities report due out soon in my area when I am sure it will highlight my key areas of concern them perhaps the Public health team will listen to the patients concerns

Mark McCarthy

Comment date
23 April 2010
Or have we failed? Some encouraged the Labour government to see public health as a limited form of health promotion, rather than the broader WHO approach including disease control, health services organisation and resource allocation that was the earlier vision. This led even to such oddities as 'public health and health inequalities' - as though the latter was not part of the former.

Perhaps a national Department of Public Health is worth considering. Many current DH activities properly replicated at local level would give major health benefits, and could release local energy for innovation, if combined with local accountability and good outcome monitoring.

Mary E hoult

Comment date
23 April 2010
Most if not all th epublic health team in my area were there prior to 1997 so I don't think this is a political issues more a performance one.

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