Maintaining and improving health

Public debate about health tends to focus on the NHS. The government's pledge to boost NHS funding by around £20bn a year by 2022/23 will be important to help maintain current service provision. However, with the ageing of the UK population, rises in the number of people living with multiple conditions, and healthy life expectancy failing to keep pace with overall rises in life expectancy (particularly for the poorest), demand for NHS services is only expected to rise.

Although the funding gap for predicted NHS demand may have been plugged for now, the government has been silent on two important areas of health-related spending. First, as Health Foundation research has highlighted, social care services have seen significant funding reductions in recent years and there is no credible plan for much-needed reform. Second, and the focus of this report, is the need for greater investment in 'upstream', preventive measures that improve the overall health of the population. Although prevention is a stated priority for the Secretary of State for Health, in June 2018 the Prime Minister said only that it would continue to be supported, and spending plans would be set out as part of the 2019 Spending Review. Policy plans have yet to be published and the forms of support the government provides to maintain people’s health continue to be reduced.

People’s health is dependent on more than just the health care system. Health is largely a product of the environment in which people live, their jobs, the education they receive and the places in which children are raised. In other words, the social determinants of health. Ensuring public health requires investment in the things that make us healthy, not just in the services that treat people when they become unwell.

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