Dame Sally Davis is the independent Chief Medical Officer for England, and her recently published annual report on the NHS provides invaluable insights. I agree with her analysis when she says, that while the NHS is often a source of national pride, but despite this, a narrative of health being a cost to society prevails. As the late Hans Rosling said, “When things are getting better we often don’t hear about them. This gives us a systematically too-negative impression of the world around us, which is very stressful.”
Dame Sally says her report “offers cause for optimism and I conclude that it is realistic to aspire to better and more equitable health in the next 20 years. As the NHS has developed its long-term plan for the coming ten years, this report looks at the strategic opportunities over the coming two decades for the health of the nation more broadly.”
Like Dame Sally, I believe we need to reposition health as one of the primary assets of our nation, contributing to both the economy and happiness. We also must measure and track progress in our development of health as a nation and our fairness as a society in delivering improving health outcomes. I support her recommendation that the Government need to develop a composite Health Index that recognises this and is tracked alongside our nation’s GDP and the Measuring National Well-being programme.
Health is generally used to mean the ‘absence of ill-health’. We often focus on the NHS as an ‘illness service’ rather than acknowledging the complex interactions in society that influence our health as individuals. Healthcare is often spoken of as a cost to the state and society rather than an investment that generates returns for the individual, communities and the nation. The NHS and public health services are not a burden on our finances – they help to build our future. Moreover, the good health of our nation is the bedrock of our happiness and prosperity.
Health is an asset that we must protect and promote and is affected by the conditions in which we live and work. These conditions can be health-promoting or health-harming, and often governments, industry, and societies are responsible for those conditions, not the individual. We all have some responsibility for our own health, but we are not individually responsible for the house or neighbourhood we are born into, the school we attended, nor the health environment we live in.
The health system needs to adapt for each individual and ensure both their environment and the care that they receive is helping them achieve ‘good health’. One example is our local social prescribing, which acknowledges our expanded understanding of physical, mental and social health and is an opportunity for the traditional health service to utilise, enhance and amplify existing schemes, including employment. Our local WinterWellness programme is another. One size clearly does not fit all, and this requires different types of care accessed through different places and different ways.