Paul Burstow writes… Healthy lives, healthy people

Britain is now the most obese nation in Europe. We have among the worst rates of sexually transmitted infections on record. Rising levels of harm from alcohol, and over 80,000 lives lost every year because of smoking. These are the public health challenges the Coalition Government faces.

And what of Labour’s public health legacy? Under Labour inequalities in health and life expectancy between rich and poor got worse. As a result people in the poorest areas can expect to live up to 7 years less than people in richer areas.

Under Labour huge amounts of money was spent on public health. But it was spent on tackling the effects, instead of identifying the causes. Where Britain spent big, other countries spent better.

Promoting healthier lifestyles through top-down government diktats does not work. That does not mean we sit back and do nothing.

Leadership and action is needed. That is why we are launching a radical plan to go further and faster in tackling today’s causes of premature death and illness and reduce health inequalities, with a public health service to make it happen.

Today we have set out our plans for a new public health service in a White Paper entitled Healthy Lives, Healthy People. We set out a new approach that builds from the grassroots, promotes accountability, local freedom, and protects funding for public health to tackle the preventable causes of ill-health.

An end to central control and a new opportunity for local government to lead with the freedom, responsibility and ring-fenced funding to innovate and develop local solutions to the local public health challenges they face. For the first time in a generation, central Government will not be pulling the strings.

Directors of Public Health will be employed by local government and be the ambassadors and agents for action on health issues for the local population. In practice, this means that they will lead discussion about how the ring-fenced money is spent to improve health. By putting local government in the driving seat, we will empower local communities to come together to tackle the challenges they face.

Local government already supports people’s health and wellbeing through their work on transport, decent housing, public space and leisure facilities, social care, children’s services and environmental health.
Putting public health in local government opens up new opportunities for a much more joined up approach.

As the White Paper sets out, new health and wellbeing boards will begin to join up the way we design and deliver health, social care and public health. These new roles for local government come as a direct result of Liberal Democrats shaping policy in the Department of Health. Welcomed in the recent Health White Paper consultation our reforms create huge opportunities for healthier, happier communities.

Big changes will be taking place nationally too, with health agencies being brought together to create a dedicated new public health service – Public Health England – to support local innovation. With a ringfenced budget of at least £4billion, it will provide strong disease control protection and advice, and spread information and best practice on the latest innovations and advances in behavioural science from around the world.

There will be new financial incentives rewarding local government for their progress on improving health and reducing health inequalities, and greater transparency so people can see the results and hold Councils to account.
Our new health premium will take into account health inequalities and reward progress on specific public health outcomes. The premium will be simple and developed with key partners. Disadvantaged areas will see a greater premium if they make progress, recognising that they face the greatest challenges.

This White Paper marks the most fundamental shift in how we tackle our public health challenges since the inception of the NHS itself. We have to be bold because so many of the lifestyle driven health problems we see today are already at alarming levels. Too many people are dying too young, spending too long suffering from preventable ill-health, and the gap between rich and poor isn’t improving.

Our reforms will foster a more innovative, integrated and dynamic approach to improving public health, with local innovation replacing central control, and people and communities directly driving the change we need to build a stronger, healthier society for everybody.

Paul Burstow is Minister of State for the Department of Health

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This entry was posted in Op-eds.


  • Here we go again. Previously sensible Lib Dem sounds like gung ho Tory as he slates past public funding. This is an area where there is considerable public consensus across the parties. A LD Minister should be building on this not playing to the gallery and point scoring. Odd how this drastic change of approach is based significantly on the Marmot review set up a few years ago by Alan Johnson when he was in charge of Health and also supported by Burnham more recently.

    Come on Paul, think longer term. Differentiate yourself. In areas like this we can set out a consensual but radical way forward if only you could leave the old politics behind.

  • “There will be new financial incentives rewarding local government for their progress on improving health and reducing health inequalities, and greater transparency so people can see the results and hold Councils to account.”

    Oh really? What happened to the Performance Reward Grant, then?

  • “As a result people in the poorest areas can expect to live up to 7 years less than people in richer areas.”

    True, but still considerably longer than they could expect to live before Labour came to power. And presumably the widening gap has nothing to do with the very rapid recent improvement in the life expectancy of women in the highest social class.

  • Ok let’s be a bit real about Labours record.

    All social groupings seem to be doing better. As new and hugely expensive health screening, treatments and drugs become available the rich will always benefit the most. I presume that this Goverment will be happy to be judged on whether the gap has closed and will accept it as failure if it hasn’t ?

    Historically the biggest worry was the gap between male and female. This is partly due to different attitudes towards seeking treatment, and the absence of formalised screening programmes (as per the hugely succesful cervical and breast screening prgrammes) for the big problems to affect males. This gap has actually been closing.

    As for top down projects. I have two children, one 18 and at University and one 6. The difference in their knowledge of healthy living through exercise and diet is huge. The eldest would need virtual force feeding to accept anything healthy, the youngest has been telling us about fruit, veg and exercise since pre-school. School meals were to be avoided if you wanted to control their diet when the eldest was at Primary School, with the youngest the food is excellent, well balanced and enjoyable for the kids.

    Lets not through out the baby with the bath water and lets not move away from what has, to date, been a fairly apolitical approach to a point scoring game.

    Please see below from with illustrate my points regarding gender imbalance.

    Life expectancy at birth in the UK has reached its highest level on record for both males and females. A newborn baby boy could expect to live 77.7 years and a newborn baby girl 81.9 years if mortality rates remain the same as they were in 2007–09.

    Females continue to live longer than males, but the gap has been closing. Although both sexes have shown annual improvements in life expectancy at birth, over the past 27 years the gap has narrowed from 6.0 years to 4.2 years. Based on mortality rates in 1980–82, 26 per cent of newborn males would die before age 65, but this had reduced to 15 per cent based on 2007–09 rates. The equivalent figures for newborn females were 16 per cent in 1980–82 and 10 per cent in 2007–09.

    Life expectancy at age 65 – the number of further years someone reaching 65 in 2007–09 could expect to live – is also higher for women than for men. Based on 2007–09 mortality rates, a man aged 65 could expect to live another 17.6 years, and a woman aged 65 another 20.2 years.

    Within the UK, life expectancy varies by country. England has the highest life expectancy at birth, 78.0 years for males and 82.1 years for females, while Scotland has the lowest, 75.3 years for males and 80.1 years for females. Life expectancy at age 65 is also higher for England than for the other countries of the UK.

  • Oh dear. This morning when I heard about the Andrew Lansley it was the first time I didnt want to shout abuse at the radio. I understood and agreed with what he said. I have heard Michael Marmot speak and he puts an impressive case which I didnt expect the Tories to adopt. But they have accepted five out of his six recommendations. Brilliant.

    And then, instead of building on what is an imaginative bit of social policy, Paul Burstow uses it to make cheap political points at the expense of the last Labour government. When are the Lib Dems going to start acting like a party in governemnt rather than just sniping at Labour. Absolutely pitiful!

  • Quote from the Marmot website..

    “In February 2010, the Marmot Review Team published Fair Society, Healthy Lives. This was the culmination of a year long independent review into health inequalities in England which Professor Sir Michael Marmot was asked to chair by the Secretary of State for Health.”

    The review setup by those bad bad Labour people who also brought you the smoking ban (tackling those 80,000 lives) and speedier cancer treatment. It doesn’t have to be partisan, build on success don’t ignore it, I thought the new politics was about building consensus on the big issues.

    Part of Marmot’s response to the government’s white paper can be found through this link:

    •While the White Paper picked up five of the six domains of recommendations from the Marmot Review it was silent on ensuring a healthy standard of living for all.

  • So they’re going to replace inane nannying from central government with inane nannying from local government? Whoopee. What on earth possesses the government to think that we’re going to want health advice from a bunch of people most of us wouldn’t ask for directions to the corner shop?

    Stop trying to micromanage life. It’s not what the state is for.

  • Emsworthian 1st Dec '10 - 8:57am

    When do we stop getting off on slagging Labour and look nearer home?
    The Tories have just put the processed food and drinks industry in charge of
    making the nation fitter. Bit like asking the tobacco barons to
    back a no smoking campaign. Lansley is more concerned about the
    health of the Tory Party than anything else.

  • David Rogers 1st Dec '10 - 9:29am

    I am one of the two Liberal Democrats chairing a Programme Board of the Local Government Group: the Community Wellbeing Board, which covers adult social care, public health, and much more. In that capacity I warmly welcome yesterday’s announcements by Paul and by the Secretary of State. It marks a homecoming for public health, 36 years after it left local government…………..back indeed to the origins of local government in the nineteenth century, when issues of clean water, sewage, and mass outbreaks of disease were faced by our predecessors as local leaders.
    That is the key message to be drawn from the White Paper: a recognition that almost everything councils do – whether it’s social care, education, transport, culture, or any one of a number of other activities – has an effect on the health and wellbeing of individuals and communities. It therefore follows that formally joining all this together in our villages, towns, and cities – and recognising that the detail of the issues to be faced with the greatest priority will be different in each of these – is fundamental to further progress.
    There will be some practical issues to discuss between local and central government, such as the precise nature of the transfer of employment (including terms and conditions) of current Directors of Public Health. We shall do this in a spirit of optimism, and in the knowledge that the principles set out yesterday are most welcome.

  • david thorpe 1st Dec '10 - 2:08pm

    stds are not an issue thats any business of the government, in thatt, accoridsng to the harm princiapl they dont affect anyone else, so if a person wants to be promsiscous thats there business.
    More people die in britain from car crashes than std’s, cars are a bigger threat to public heaklth and a bigger cost on the NHS, so why worry about Stds

  • John Harris 1st Dec '10 - 6:35pm

    There is some evidence to suggest that infection with an adenovirus [Ad 36] could be a cause of significant weight gain leading to obesity. One internet published article: Science Daily Sept 10 2010, claimed that children in a study sample, with antibodies to Ad 36 were on average almost 50 pounds heavier than those without!. Research is needed- a vaccination against that virus could make significant contribution to preventing obesity.

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