Dear Colleagues
In April 2003 Derek Wanless an ex banker with the National Westminster bank was asked by the UK Government to provide an update of the challenges in implementing the 'fully engaged scenario' discussed in the first Wanless review on the future of health care with a particular focus on cross-departmental work on preventative health measures and health inequalities. The review will look at how public health spending decisions are taken and how to ensure that they can be taken, by whoever takes them, as cost-effectively and consistently as possible, in order to improve health outcomes for any given level of resources. This will include an assessment of the evidence about what interventions work and at what stage they work and will examine the adequacy of the evidence base on which they are made. The below document helps is intended to help set the context for the review due to be published next year.
Kind Regards
David McDaid
LSE Health and Social Care
Securing good health for the whole population: Population Health Trends
December 2003
H.M. Treasury
Available on-line at
http://www.hm-treasury.gov.uk/media//322B7/wanless_health_trends.pdf
An excerpt from introduction follows below
This paper provides information on the main causes of mortality, morbidity and key risk factors in England, including trends over time. International comparisons have
been made with Australia, Denmark, Canada, Finland, France, Germany, the Netherlands and Sweden - selected for comparison because they have broadly similar
population structures, health care systems and per capita wealth as England.
The main trends examined here show that over the last century there has been a big shift in the burden of disease - from infectious diseases of the nineteenth and early twentieth centuries to chronic diseases in the twentieth century and now. The UK (and England) performs poorly compared to other countries on some key measures of health outcomes and chronic disease such as Coronary Heart Disease (CHD), cancer and particularly on respiratory diseases. Chronic diseases, such as CHD and cancer are also strongly related to lifestyle factors such as smoking, poor diet, physical inactivity and alcohol consumption3. There is a strong social gradient to the prevalence of many of these risk factors, for example, it is estimated that half the difference in survival to 70 years of age between social class I and V is due to higher smoking prevalence in class V4.
Changes over time in the burden of disease have shifted the emphasis of public health from health protection measures to tackle infectious diseases, towards health promotion policy targeting individual behaviour and lifestyle risk factors, as well as the wider determinants of health, such as poverty and education. Although health protection is still an important issue in the context of new, emerging and resurgent infectious diseases (such as HIV, Ebola Virus, vCJD and tuberculosis), and with possible threats to health post-September 11th, this trend seems likely to continue. In addition, there could well be the development of new diagnostic technologies, including those based on genetics, which could also play a role in improving population health. There could also be developments in the use of ICT to predict future health status, and for directing the use of resource to prevent or minimise demand on health services.
This paper aims to set the context for Derek Wanless' final report "Securing Good Health for the Whole Population", due to report in February 2004.
|