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Of hairnets and hard hats

Ahead of the General Election Charlotte Augst comments on how our politicians need to get serious not just on healthcare but actually on people's health.

Everyone looks a bit stupid in a hair net – those blue plastic things you need to put on your head when you visit a food factory. It is understandable therefore, that politicians rather reach for the hard hat as they set up campaign photo opportunities on building sites. But nothing seems to tickle our collective imagination as the tucked in tie. Politicians up and down the country roll their sleeves up and head for a hospital ward. A nurse is who you want to talk to in your photograph. With their short sleeves and sensible shoes, the nurse stands in for everything a politician wants to be identified with: kindness, pragmatism, hard work, trust.

So on one level, we could just sit back and enjoy the scene. Of course the health policy talk spilling out of this campaign is increasingly unsophisticated and detached from reality (you cannot avert a winter crisis by throwing money around in November, and you cannot magic up GPs like ginger bread men coming out of the oven by the fragrant tray full). But what’s new?

Leaders from across the whole of the voluntary and community sector in health and care believe that what is new is that we are having this health pantomime against the backdrop of a veritable health emergency: Life expectancy gains have stalled[i], people say their health is worsening[ii] and they’re living more years in ‘bad’[iii] health. Maybe most worryingly, people living in the most deprived areas have seen the biggest decline in improvements.[iv]

This deterioration is not an inevitability after years of gains – we’re doing badly compared to other countries.[v]

So more than 60 charity leaders today call on politicians from all backgrounds to get serious not just on healthcare, but actually on people’s health – physical and mental. Is it naïve to think we might actually find the required parliamentary and public air time to focus on the domestic policies and legislation that is required to tackle the decline in health we are witnessing?

Maybe it is, given we will have more Brexit, more division, and more cynicism about the collective power of politics to focus on health in all policies, a comprehensive health and wellbeing strategy, the need for investment in the community sector, and resources for social care. We think there are green shoots of hope – the NHS’ commitment to making better connections to the community sector through social prescribing, local government rebuilding services in collaboration with communities, and the VCSE itself going back to its roots of working with, rather than just for people. But we have a mountain to climb. What we need now is for our political class to put aside hairnet, hard hat and tucked in tie, and focus on rebuilding the health of this nation.

[i] Life expectancy improvements have been slowing down since 2011, with the UK experiencing one of the largest slowdowns in comparison to similar countries. The future trend of life expectancy is uncertain – in some parts of the UK life expectancy has even decreased. Office for National Statistics (2019). National life tables, UK: 2016 to 2018.

[ii] The UK is one of the few countries where perceived health status has worsened in the last decade, with the proportion of people rating their health as “good” or “very good” falling by nearly five percentage points. OECD (2017). How’s life in the United Kingdom?.

[iii] The number of years lived in “Not Good” health has increased over the last decade. Women can expect to live a greater number of years and greater proportion of their lives in poor health than men – 19.3 years and 23.2% compared with 16.2 years and 20.4%. Office for National Statistics (2018). Health state life expectancies, UK: 2015 to 2017.

[iv] People who live in the most deprived areas of the country experience 19 fewer years in good health than people living in the least deprived areas. Public Health England (2019). Health profile for England 2019.

[v] The number of healthy years a person is expected to live from birth is below the EU average for both men and women [Eurostat (2019). Health life expectancy statistics]. Women in the UK are living shorter lives on average than most of their counterparts in the EU (life expectancy is ranked 17th out of 28). UK male life expectancy has started to fall down the EU rankings – from 6th to 10th.Office for National Statistics (2019). National life tables, UK: 2016 to 2018.