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Investing in the future of public health

Lynn Young
Primary Healthcare Adviser for the RCN

2011 is here and it is difficult to be optimistic about the state of the nation's health, the economy, the current value of one's house and the rising level of unemployment. But what does the future hold for the NHS?

Long-term unemployment is bad for your health and that of your family. Let's leave it to Florence Nightingale to offer some common sense on the subject: “Every family needs a secure breadwinner to keep it in good health”. How much changes and how little things change. This was as true in the Victorian era as it is today.

Health is all about the economy, how we share the wealth of the nation and education. Education needs to be freely available to all and we must give far more to the children and young people who are born to a life of disadvantage, but have huge potential, should we have the determination to invest in it.

The state of the economy counts and so, too, does the political will. Does the government of the day wish to leave well alone and allow its people to sink or swim? Or do we take action, intervene and direct precious public funds to the less wealthy in our communities?

These are the dilemmas of the day and the line taken currently by our coalition government is to:

  • Manage the economy better and reduce public debt.
  • Sack the managers, reduce the power of the state and facilitate the development of the Big Society.
  • Take money away from the public sector and make noises about the regeneration of volunteering and resilient communities.

It is quite extraordinary to remember that there was a time when, overnight, the NHS budget was increased from £40bn to £60bn. Life does not stand still and we are now, after 10 years of NHS development, looking at ways of saving a mere £20bn, and sacking a huge number of staff from all parts of the NHS - but mainly primary care trusts and strategic health authorities - as well as moving towards wholescale reorganisation (or, as some would call it, carnage).

This year is not destined to be an easy one for many people, so perhaps there is a double duty upon those of us who are fortunate to be employed to take the time to look after ourselves and stay well.

We should also be doubly determined to join the better health movement and be utterly obsessed with the prevention of disease. Here are some shocking statistics: more then one in five children living in London are obese; 18.7% of pupils in Year 6 are obese; and the children living in London are the fattest in the nation.

This is bad enough as we know that being obese does not enhance health and wellbeing; but at a recent meeting I heard a most shocking fact. A consultant in diabetes informed the audience that when he began his illustrious career 30 years ago he did not know one young person with type 2 diabetes. Apparently, with 25% of our young people now overweight we are facing a type 2 diabetes tsunami. However wonderful our NHS is, and regardless of the billions we throw at it, the UK is incapable of managing the side-effects of diabetes in 25% of the population.

The future has to be more about prevention, more about public health, and more about healthy lifestyle then ever before. This is the area in which the governments of the UK must focus political will and effective action right now, without a moment's delay. The consequences of failing to take such action could be completely dire.

So, take a quick look at your lifestyle, live well without being purist and have fun - life is here to be enjoyed too.