A key issue in health is being ignored this election.
It’s good to see Labour and Conservatives bidding to outspend the other on the NHS. But in an era where increased spending struggles to keep pace with increased demand have any mainstream politicians talked about prevention being better than cure?
Historically, the innovations with the biggest impact on our average lifespans have been in public health, like the sewers, or the Clean Air Act.
So why aren’t we discussing a new Clean Air Act, or safer roads, detoxing our food, or even the elimination of poverty, as part of the discussion about health?
Travel along the circle line in London and you move from the affluent streets of Chelsea where (on average), a boy will outlive one born in one of the poorest areas by 8.4 years. This gap in life expectancy has been growing since 2001 and there are a variety of reasons why, but income is the key.
That is why a Universal Basic Income is one of the biggest budget items in the Green Party manifesto. It is a daring idea, backed up by small scale trials, that everyone gets a minimum payment with no strings, tests, or stigma attached. By itself, Basic Income won’t eliminate poverty. You still need a Living Wage, more social housing and stronger tenant’s rights, but it would help stop an early death being the unfair outcome of being poor.
There is a well-established link between poverty, air pollution and ill health. If you’re poor then you will often live in the cheaper accommodation that is to be found along busy main roads. Air pollution is linked to dementia, heart attacks, asthma and a variety of other problems. It accounts for around 64,000 premature deaths in the UK.
Think of the cost to the NHS. For example, there were an estimated 4,000 admissions for asthma aggravated by air pollution in London 2014-16. A bad air day in Bristol accounts for 9 extra stroke patients. In one bad air pollution episode in 2013, a government sponsored analysis found that in a ten day period there were 300 extra deaths and several thousand hospital admissions across the UK.
Imagine if we reduce all emissions to zero by 2030? You improve public health; help deal with climate change and enable NHS resources to be used on other things. That makes a separate Clean Air Act – as advocated by the Greens, Labour and Lib Dems – a big priority for the next government.
The same argument holds for road collisions, which account for 170,993 casualties of all severities in reported in 2017. The big issue for the NHS are the severely injured as these can take years of recovery and multiple interventions to deal with. Sadly, many are so badly injured their lives change forever and the care budget picks up the bill.
I know that many of the costs are recovered from the insurers, but we are still talking about several hundred million pounds for the NHS and several billion lost to the wider economy. Most of these collisions and injuries are preventable if the mix of engineering and enforcement is stepped up.
I know from my experience as the London Mayor’s Road Safety Ambassador that bringing the casualty numbers right down is more than possible, but it requires a lot of political will.
We need to go through every aspect of the health service and identify what are the causes we could deal with that require action by other departments of government.
Whether it is reform of the drug laws, or reducing the use of pesticides, there are a lot of changes we could make that are both desirable in their own right and good choices for an overstretched health service. Will the big parties try and out-bid each other on these issues?
Baroness Jenny Jones is a Green Party peer.
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