The Treasury needs to stop being a “critical bystander” and own the goal of reducing health risk among the UK population while the prime minister and chancellor must lead on the issue politically, according to a report on improving the UK’s health.
The report written by Lord Filkin and a team of health experts called for an independent review of how the Treasury’s attitudes, policies and taxation could better help to create healthier longer lives.
It accused the Treasury of being “sceptical” that moving towards a nationwide strategy of prevention of illness will reduce NHS and social care costs. This is because “the claims of savings are legion but hard results are rare”.
But the report added NHS costs should not be the only concern adding: “A healthier nation is fundamental for our economic and fiscal sustainability as well as the great wellbeing benefits for each of us from more years of life without serious illness”.
And the report, which was supported by The King’s Fund, further argues that the fiscal reasons for delaying ill health are wider than just NHS costs.
“The Office for National Statistics (ONS) projects the number of people of pensionable age for every 1,000 people of working age, will increase from 280 in 2020 to 341 by 2045, a 22% increase in just 25 years, a staggering demographic shift,” it continued.
“It is critical for fiscal reasons to minimise the number of people who stop work because of ill health, and then pay less tax and make early ongoing demands for welfare, health, and social care support.”
Summing up, the report’s authors argue: “the Treasury itself must own the goal to reduce health risks and not be a critical bystander”.
PM and chancellor must lead
The report added that government must promote better health, post Covid-19, as a goal for all of society and inspire the nation with a sense of mission, as it has on climate change.
“It must do what works and where needed, use taxation, regulation, support, and incentives to drive the changes and to confront vested interests that block reasonable policies,” it added.
The authors emphasised the PM and chancellor would need to lead in this regard and “affirm this goal because the policy levers for population health sit across many departments”.
“Senior ministerial leadership is essential to promote the goal across government and to the NHS, local government, business and wider civic society,” they said.
The report highlighted that the wider social, environmental, economic and commercial determinants of poor health need to be persistently addressed and so health should be included in all policies at central and local level to assess the health impact of policies, and these should be published transparently.
It also criticised the understanding of the impact of public health on the economy.
“Data on the financial implications of public health is woeful, so the Office of National Statistics should build on the Health Index and develop a plan to address this,” it said.
“The Office for Budget Responsibility (OBR) should be required to comment on the impact on population health in every budget, as in New Zealand.”