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For Too Long We Have Had a System That Fails to Pre-empt Illness

03/08/2016 11:14 | Updated 03 August 2016

In order to live up to the bold rhetoric of her first speech as Prime Minister, Mrs May will need to address the alarming health inequalities in the UK. As she pointed out, a child born into a poor background will die on average nine years earlier than a child born into a wealthier family. Poverty and its impacts are widely acknowledged root causes of the health inequality gap. The hallmarks of poverty, including unemployment, insecure employment, poor quality and poorly heated housing, affordability of good food and more limited access to high quality childhood services all contribute to poor health outcomes.

Given that a large proportion of the causes of poor health lie beyond the healthcare system, it is necessary that Mrs May address the wider causes of health in order to mitigate this problem. A multitude of public services - education, employment, transport, planning, community groups and charities - all impact on the health of our citizens, and so it makes sense to provide an incentive to plan health outcomes into these public services.

The government readily invests in Infrastructure Development Funds. A Community Health Kickstarter Fund, in similar vein, would give councils the chance to identify projects that have an impact in community healthcare improvements. Such a fund would provide the seed capital needed to introduce a host of interventions outside the traditional health field at scale and at pace to achieve improvements in health, wellbeing and reductions in demand.

Mirroring this programme, Mrs May's government should also set up a Whole Families Help for Health programme that would take a compassionate, whole-family approach to resolving issues around excess weight and providing incentives for participation. In recent years, there have been a number of innovative programmes with multidisciplinary approaches to troubled families, for example the Troubled Families initiative that takes a holistic approach to helping families resolve their issues around unemployment, absenteeism and anti-social behaviour. The number of obese children doubles from between the start and end of primary school and 82% of obese 11 year olds will go on to be obese adults. Therefore, there is urgency in working with early primary children and their families to help tackle problems of overweight and health issues before later years.

One area of particular importance is housing and its determinants for health outcomes. Supported housing provides a vital, stable foundation for some of the most vulnerable in our society, meaning they can access support while they establish their lives. Without this supported housing, many are likely to end up homeless with their pre-existing conditions exacerbated - all of which would lead to much greater pressures on health care system, especially on A&E and other community services. As an 'invest to save' intervention, combined authorities should be invited to submit a business case for a ten-year exemption of supported accommodation from current plans to reduce the Local Housing Allowance to the equivalent of market rates to ensure supported housing remains financially viable and an effective method of preventing uncontrolled demand on other public services.

For too long we have had a system that reacts to, but fails to pre-empt illness and ill-health; a system that responds, but does not prevent. In order to build a truly 'one nation' legacy Theresa May will need to develop policy that recognises that many of the wider causes of ill health lie upstream of the health and social care systems, not only addressing those with acute need, but preventing people needing that help in the first place.

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