The UK Conservative Government has just released a new strategy document, Prevention is better than cure: our vision to help you live well for longer. I’ve now got a case of policy envy.
The UK Government last month announced “austerity is over”, but is still managing the effects of almost a decade of cuts to public services, welfare payment freezes (the latter ongoing) and the looming Brexit. It’s a tough environment for politics and for publicly funded programs like the National Health Service. Yet in the midst of all this, the new prevention strategy is very solid by Australian standards.
First, there is a clear, measurable target. The Secretary of State for Health and Social Care, Matt Hancock, states in the foreword, “The mission is to ensure people can enjoy at least five extra healthy, independent years of life by 2035, while narrowing the gap between the experience of the richest and the poorest.”
Targets are important. The Australian Health Policy Collaboration has set targets and indicators for a range of chronic disease risk factors, measured in Australia’s Health Tracker. Yet we continue to struggle in asking any Australian government to commit to any measurable target.
The second point which deserves praise are the linkages between health, social care and economic policy. Health is not a vacuum; where you live matters, and how you live matters. Secretary Hancock notes that the UK will not meet their mission with business as usual, that more funding for prevention is needed, and that there is a need for “services which target the root causes of poor health and promote the health of the whole individual.”
The strategy talks about jobs, education, housing, schooling, crime, justice, welfare, pollution, and the wider environment in which people live.
There’s a clear link made between mental health and physical health, which we have recently highlighted in Australia’s Mental and Physical Health Tracker. I particularly like the UK’s Five Ways to Wellbeing project, a very sophisticated, yet simple, approach to mental wellness.
The UK strategy document highlights the need for a more nuanced approach to prevention rather than a one size fits all approach, using predictive technology and data to look at prevention in the context of individuals’ lives, their own circumstances and their own behaviour. We’ve done work at the Australian Health Policy Collaboration to highlight the geographical differences in Australia’s Health Tracker by Area, and put the spotlight on disadvantage through Australia’s Health Tracker by Socioeconomic Status, but would be among the first to say that more data-driven and place-based prevention strategies are sorely needed in this country.
The kicker is a simple phrase that in the UK, “we only spend 5% on prevention.” There’s an explicit recognition from this government document, and in the Secretary of State’s foreword, that this isn’t enough.
In Australia, we spend 1.34% of our health budgets on prevention. It’s not even close to enough to deal with the challenges in our health system.
While the UK has nice new exciting strategy document, implementation is crucial. The UK is planning a Green Paper, and has put on some downpayments on prevention strategies. It remains to be seen if the reality matches the rhetoric in that country.
In the meantime, Australia has much to learn from the UK’s approach to preventive health. Australia’s health system, community and economy will continue failing to meet our potential without a strong strategic approach to preventing chronic disease.
Ben Harris is Manager, National Policy Strategy, at the Australian Health Policy Collaboration at Victoria University.