Poor investment in public health leading cause of preventable long-term conditions

Too many people are dying prematurely or suffering preventable diseases because of poor investment in public health, a new paper from BMA suggests

The British Medical Association (BMA) has said that there is an urgent need to prioritise healthcare prevention and tackle the leading causes of preventable long-term conditions in a new report that calls for greater investment in public health.

Making the case for prevention investigates the causes of long-term conditions associated with premature deaths – such as cancer, heart disease, stroke, lung and liver disease – and identifies the leading causes – ultimately, calling for action to be taken to tackle them.

With adequate investment in services to reduce smoking, drinking alcohol, and improve physical inactivity and diet, it is estimated that uptake of health services in England could be cut by as much as 40%.

This would diminish the strain on health services and support the long-term sustainability of the NHS.

Now, the BMA is calling for public health prevention to be a central focus of future NHS planning and says that this must be supported by investment in services such as smoking prevention and the key lifestyle factors driving ill-health and poor diet, with a commitment to reducing health inequalities.

Among the key data highlighted in the report are:

• Preventable ill-health accounts for an estimated 50% of all GP appointments, 64% of outpatient appointments and 70% of all inpatient bed days;
• The demand on health services could be cut by as much as an estimated 40% with the right investment in services to reduce smoking, alcohol consumption, physical inactivity and diet;
• Preventable long-term conditions are associated with premature death, in the UK the top five causes of which are: cancer, heart disease, stroke, lung and liver disease. As well as this Type 2 diabetes affects around 3.7 million people and dementia which is the leading cause of death since 2015;
• Smoking and poor diet account for the highest number of deaths due to preventable disease in the UK (19% of deaths were attributable to smoking, and 17% to poor diet);
• There is a need to address the factors that influence people’s health behaviours. Unemployment and poverty, for example, can impact a variety of health behaviours such as smoking, increased alcohol consumption and decreased physical exercise as well as the association with mental health problems and suicide.

To prioritise prevention and secure the long-term sustainability of the NHS, the BMA is calling for:

• Improvements to the population’s health and reduction in health inequalities to be a central goal of future NHS planning at a local and national level.
• Adequate funding for ill-health prevention across the UK, following £550m of cuts to public health funding since 2015/16;
• Comprehensive regulatory, legislative and educational measures to be introduced at a national level to tackle key lifestyle factors driving ill-health;
• Specific targeted action including:

– Introducing a minimum unit price for alcohol across all UK nations as part of a comprehensive new alcohol strategy;

– Delivering an increase in taxation on all tobacco products above the rate of inflation;

– A comprehensive approach to tackling diet-related ill health;

– Greater restrictions on the marketing and promotion of unhealthy food and drink;

-Adopting a health in all policies approach to explicitly consider health in all government policymaking.

Commenting on the findings in the report, BMA board of science chair, Prof. Dame Parveen Kumar, said:

“It is unacceptable that each year, so many people are dying needlessly from preventable illnesses and long-term conditions such as heart and respiratory diseases, stroke, and some cancers. Tragically, the failure to prioritise public health prevention continues to cost people their lives.

“The BMA is calling on the government to make the population’s health a priority by putting prevention at the forefront of their future planning, with the necessary investment in services to tackle smoking, alcohol consumption, physical inactivity and diet.

“People living in the most deprived areas are often unfairly subject to the health inequalities that lead to a higher prevalence of preventable illnesses; from greater incidences of obesity in young people to increased risk of mental health problems and suicide. We must reverse the cuts to public health services in these areas if we are to see any noticeable change.

“Investing in preventative health measures will be beneficial in the long-run; both in the impact on our health and wellbeing and in ensuring the greater sustainability of the NHS. This requires a departure from the short-term thinking that has inhibited progression and a move towards a long-term plan that recognises the importance of prioritising prevention.”

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