We need a new Public Health Act and to look beyond our borders – or we won’t be protected from the next pandemic
Birmingham improvements under the 'Artisan's and Labourers' Dwellings Improvement Act 1875', Newspaper engraving of housing in John Street, Steel House Lane and of John Wesley's Chapel, December 1876 (Alamy)
4 min read
Our health is our wealth. It’s not rocket science. If you are ill or in poor health, mentally or physically, everything else either stops in its tracks or becomes exponentially harder to achieve.
Think about the last time you stayed off work or turned down an invitation for a day out to spend more time under the duvet. Were you in peak physical and mental fitness, full of beans and ready to take on the world?
When we think about health in the UK, we think of our beloved National Health Service and all the excellent work that goes on there. But the truth is we don’t use this service when we’re healthy – it is, in fact, a National Sickness Service. Excellent and a reassuring safety net, but not the key to a healthy, long life.
My colleagues in the UK Health Security Agency are now monitoring increases in ‘diseases of poverty’
Ever heard of the 1875 Public Health Act? Among other things, it mandated local authorities to provide clean water, sewage disposal and refuse removal. It prohibited the construction of new homes without proper drainage, water and ventilation. And it supported the establishment of public toilets, street lighting and public parks.
Thank goodness for the Victorians, who understood the key infrastructure and legislation needed for maintaining health. Today, that public-spirited legacy remains, but only just. Tenants of houses constructed with poor or no insulation, or built on a flood plain, will attest to the fact that we have not regulated for the health requirements of our homes. My colleagues in the UK Health Security Agency are now monitoring increases in ‘diseases of poverty’, such as tuberculosis, and vaccine-preventable diseases, such as measles.
That is not to say that my colleagues across the health system and in Parliament do not wholeheartedly wish to address these issues. Within their specialist fields, they work hard to do so. But ultimately a strategic, wider lens is needed. Reducing health inequalities means not just health for all but health in all policies.
The need for this cross-sectional approach is writ large across our food system. Access to affordable, nutritious food is dependent on numerous policy decisions, including agriculture, environment and trade. Which department is fully responsible for this complex system? Well all or, potentially, none of them.
To prioritise this work, the development and delivery of a new public health act must be championed by a secretary of state for public health. This would mark a shift from our current prioritisation, where the Health Secretary spends most of their time and energy fighting rising sickness levels. This realignment would speak directly to our excellent 10-Year Health Plan, with its focus is on moving from hospital to community and treatment to prevention.
This focus is also essential to the future health of His Majesty’s Treasury. It is past time for the wellbeing appraisals currently found in the Treasury green book to be mandated across the economic planning of each government department. Put simply: health equals productivity, equals growth.
Our approach to securing the health of our nation must extend beyond our borders, too. The progress we make on UK health only works if our neighbours, near and far across the globe, are monitoring the emergence of new infectious pathogens and reducing the prevalence of existing infectious diseases. Otherwise, no amount of investment in tanks, guns and border controls is going to protect us from the next pandemic.
Prioritising our public health today is without question the best legacy that we can leave for future generations. For us to live healthy lives, we need green spaces, clean air, clean water, nutritious food, peaceful communities and efficient energy use. In turn, all these help build a healthy planet best able to support the lives of our children, grandchildren and beyond.
Health is our wealth. Let us therefore stand on the shoulders of giants and boldly renew the legacy of 1875.
Dr Beccy Cooper is Labour MP for Worthing West
