The future of improving the nation’s health

Journal of the Royal Society of Medicine, 2006

BMJ, 2021

Medical Research Council No amount of positive spin can detract from the numbers. The UK has not done well in the pandemic, whether measured in terms of mortality, 1 economic performance, 2 or social protection. This should not have happened. In 2019, the UK came in second place in the Global Health Security Index. 3 Yet, when the pandemic arrived, decision making was confused and slow, 4 existing structures were sidelined, and new ones, exemplified by the "eye wateringly expensive" test and trace system, 5 were flawed by design, paying inadequate attention to the needs of those isolating. 6 Weak social safety nets offered little support. 7

The Lancet, 2007

Global health enables the harmonisation of international and domestic-health concerns-its outlook is much wider than a development or foreign-assistance perspective alone. Engaging globally in health requires the creation of relevant and eff ective partnerships to implement solutions for shared or common problems. To build on the UK's achievements and leadership in global health, the central government Department of Health is now leading the development of a UK Government-wide global strategy. This paper describes the rationale and process for developing the new UK Government-wide strategy for global health and highlights some of the issues that must be discussed.

The Lancet, 2011

London: HM Treasury, 2004

The Lancet, 2021

scale is often a disruptive process without any evidence of benefit. 1 We argue instead that the foundations of the NHS can be strengthened through further investment and integration of pre-existing operational institutions. The COVID-19 pandemic has reinforced the economic case to invest in health, which is crucial for fiscal sustainability and enhancing societal wellbeing. 2 However, we acknowledge that committing to increased investment in the NHS, social care, and public health will be challenging in economically and geopolitically uncertain times. To implement the funding recommendations, this Commission estimates that total expenditure would need to increase by around £102 billion in real terms, or 3•1% of gross domestic product (GDP) in 2030-31. Taxation reforms would be required to increase funding and we provide an indicative analysis of the amount of potential change that would be required to personal income tax, national insurance contributions, and valueadded tax. This Commission serves as a call to action. We argue that, similar to the establishment of the NHS after World War 2, after the COVID-19 pandemic and leaving the EU, the UK faces a once-in-a-generation opportunity to invest in the health of all its population and secure the long-term future of the NHS. Failure to relay the foundations of the NHS (ie, strengthen through increased investment and commitment to its founding principles) risks a continued deterio ration in service provision, worsening health outcomes and inequalities, and an NHS that is poorly equipped to respond to future major threats to health.

Medical Journal of Australia, 2005

2022

This report is based on a six-month research project that reviewed the policies and actions behind the establishment and closure of Public Health England (PHE). Its aim is to provide learning for PHE’s successor organisations – the UK Health Security Agency (UKHSA) and Office for Health Improvement and Disparities (OHID) – but its conclusions are much broader, focusing on how public health policy should be enacted in a post-pandemic United Kingdom.

Scandinavian journal of public health. Supplement, 2006

Contemporary Social Science, 2023

The aim of this article is to examine what needs to happen in central, sub-regional and local government to ‘level up’ public health in the United Kingdom (UK). The Government's recent Levelling Up White Paper outlined ambitious targets for reducing regional disparities, including a ‘mission’ to tackle inequalities in healthy life expectancy and reduce inequalities in the social determinants of health outcomes. However, the approach has been criticised for failing to integrate population health policy objectives, programmes and interventions into the implementation of the levelling up agenda and its associated ‘missions’. Drawing on a case study of promoting healthy urban development in the UK, we examine how the wider determinants of health might be incorporated into the Government's levelling up strategy. Based on in-depth interviews with 132 urban development actors, our findings reveal that long-term investment in healthy urban development could play a key role in levelling up public health but is not currently part of the Government's plans. We make a timely contribution to the levelling up debate by placing public health centre stage in social science debates. We conclude by offering a series of recommendations for transformative policy change to level up health.