The healthmatters blog; commentary, observation and review
Recent analysis by ACA of data held by the World Health Organization (WHO), the Organisation for Economic Co-Operation and Development and the Commonwealth Fund about the healthcare systems of G20 members reveals which countries are driving healthcare innovation and which are underperforming in certain areas. The study examines factors such as the percentage of publicly funded healthcare, the percentage of GDP spent on healthcare and the number of beds and nurses available in each country.Japan has the highest percentage of publicly funded healthcare (84%), which is significantly higher than the OECD average of 72 percent. The role of the state in providing healthcare services outstrips many other developed countries. Japan is closely followed by the UK (83%), Italy (78%), Germany (77%), and Turkey (77%).
The USA (48%) and Brazil (46%) were the two countries with the lowest figures for public finance. Brazil’s low funding could in part be down to its public health system run by Rio’s state government reaching breaking point at the end of last year after authorities admitted to a budget shortfall, which was blamed on the drop in oil revenue.
The USA is the number one country when it comes to healthcare as a percentage of GDP (17.1%) and health care spending far exceeds that of other high-income countries. Available cross-national pricing data suggests prices for healthcare are notably higher in the U.S., potentially explaining a large part of the higher health spending.
France has the second highest healthcare spend as a percentage of GDP (11.5%) and Germany the third (11.3%). Turkey and Mexico were the G20 countries with the lowest percentages (5.4%) and (6.3%). The UK was in eighth position (9.1%).
Whilst the UK has ranked well for public funding and its GDP percentage, it was less successful when it came to other areas. The UK was in the bottom five for the number of available hospital beds (261 beds per 100,000 people). The countries that ranked lower were Canada (258), South Africa (231), Brazil (229) and Mexico (152).
The UK was also in the bottom five for the number of nurses having only 300 nurses per 100,000 people. The only two countries with lower results were Turkey (248) and Mexico (244). The shortfall could be attributed to the cuts in the numbers of training places in each year under the coalition government. A recent report revealed the NHS is facing such a chronic shortage of British nurses that one in four had to be recruited from abroad in 2015.
In contrast, Japan fared particularly well in these sectors coming first place for the most hospital beds (1317 per 100,000) and third place for the number of nurses (1081 per 100,000). Other countries that performed well included Germany (fourth position for hospital beds and first position for number of nurses) and France (fifth and fourth positions).
ACA’s Director of Operations James Ware commented on its latest findings by saying:
“Our analysis reveals the UK stands out as a top performer in most categories except for healthcare outcomes, where it ranks near the bottom of results. We hope the latest G20 summit will help to accelerate addressing some of the UK’s key healthcare issues. It’s also interesting to see how well countries such as Japan and Germany fare in several categories.”
The above healthcare data was taken from the following data sets; theOrganisation for Economic Co-Operation and Development, the World Health Organisation and the Commonwealth Fund and all GDP and population figures are taken from the World Bank. The data sets are relative of 2015 which at the time of publishing is the most recent data consistently available for all countries.
The country’s chosen were representative of those selected to participate in theG20 summit, as these represent the largest global economies. However, not allcountries have been included, due to data sets not being publicly available or from a credible source.
To fairly compare certain statistics such as the number of nurses and number of hospital beds, these figures were standardised relative to the population of the given country, to show figures comparative to every 100,000 members of the given economy.
The first memoir by Henry Marsh , neurosurgeon, ( Do no Harm 2014) was received to high acclaim. His second book is a mixture of personal memoir, detailed description of the craft of neurosurgery with wider reflections on the practice of his speciality and thoughts on the NHS , to which he is passionately committed. He is also facing retirement, and his own ageing and mortality.
“I am starting all over again, but am running out of time “he writes.
He describes the internal cemetery surgeons have in their imagination, where they can revisit the patients who died, either because of surgical error or the wrong decision to proceed to operate at all.
The descriptions of micro brain surgery are fascinating –a tiny spatial misjudgement can result in catastrophe for the patient –but his reflections on the difficulty of making the decision to operate or not are just as powerful. The patient will die without an operation –but may be left with profound disability if operated on. He has difficult conversations with patients and their families and feels the burden of those decisions.
After retirement from the NHS he spends time operating in Nepal-language barriers means those conversations cannot be had, and because the patients are paying for the surgery, they insist on operations even when the outcomes will be disastrous. He describes the way a fee for service private system distorts clinical decision making. He is obviously devoted to his work, hardworking and sees his patients as people with their own lives.
However he is also arrogant, nostalgic for the days when junior doctors in training worked 80 hour weeks, resents moving from a smaller hospital( where he was left to get on as he liked,) into the large teaching hospital ,albeit with state of the art facilities. He is anti-management and scathing about systems of clinical governance. This has made him a heroic figure to some –to others, they can see that working relationships must have been very difficult. He describes a serious altercation with a nurse who refuses to go against protocol despite his instructions (luckily for him this happens just before his retirement -otherwise he almost certainly would have been disciplined.) It’s interesting that he is able to be honest about this, as the incident certainly does not show him in a good light.
He retires from the NHS angry that he is no longer completely” in charge “as the consultant. Retirement means continuing to operate in Nepal and the Ukraine, where he eventually (inevitably ?) falls out with his long standing colleague .He takes on a” retirement project”, renovating an old cottage –still being practical with his hands.
This is a mixture of a man –with a capacity for great arrogance and great humility. He has a refreshing ability for reflection –on his work, on his own impending mortality and the wider issues of euthanasia. As he describes himself with all his flaws, he does not come over as likeable. However, this is a fascinating account, well written and well worth reading.
Dr Linda Patterson Retired NHS consultant physician
Henry Marsh Admissions A life in Brain Surgery is published by Weidenfeld and Nicolson: 2017
Alzheimer’s Research UK, the UK’s leading dementia research charity, has backed a call from the Brexit Health Alliance for the government to protect patients’ interests in Brexit negotiations.
In dementia research, the UK is currently leading the way with recent statistics showing the country’s research productivity has almost doubled over six years, compared to much smaller increases in other countries. At the same time, the number of UK dementia publications that are internationally collaborative have increased. But Alzheimer’s Research UK has already outlined concerns that if this collaborative effort is threatened, momentum could be lost, leading to unnecessary delays in the search for much-needed treatments.
Dr Alison Evans, Head of Policy at Alzheimer’s Research UK, the UK’s leading dementia research charity, said:
“It’s vital that people with dementia do not lose out as we negotiate our exit from the European Union. Research offers our best hope for transforming the treatments we can offer to people with dementia, and if medical research is to continue to thrive we must protect cross-border collaborations that are helping to speed up our efforts. New breakthroughs in research must reach the people who need them quickly, and co-operation on issues such as regulation of new treatments is crucial to ensure people with dementia in the UK can benefit from advances in medicine. Alzheimer’s Research UK backs today’s call and would urge the government to ensure that these issues are firmly on the table during Brexit negotiations.”
Bulk buying has a slow start
A programme of rationalised procurement of commonplace products needed by the NHS is running behind schedule (Nick Carding HSJ 28 July 2017). The aim of the Nationally Contracted Products (NCP) programme is to reduce product and price variation by agreeing deals for a shopping list of products on behalf of all NHS Trusts with a minimal number of suppliers. Products for the NCP are identified by NHS Business Services Authority and NHS Supply Chain based on advice from a Department of Health-funded clinical evaluation team. Contracts are then awarded to suppliers after NHS-led E-auctions.
NHS Improvement forecast that 12 centrally-purchased product lines – including examination gloves, patient dry wipes, syringes, and needles – would be available by this summer. NHS Improvement (NHSI) claimed that these products account for around £100m of NHS annual expenditure, and that the NCP team anticipated savings of up to 25 per cent, subject to market circumstances. So far only two of the 12 categories have been made available – couch rolls and blunt needle products – saving the NHS about £2 million so far.
The whole process is turning out to be slower than expected, with “supplier engagement”, currency fluctuations and contract complexity getting in the way of more rapid procurement. Reading between the lines, it looks as if commercial suppliers are being cautious about NHS attempts to shape and control the market. NHSI says it will introduce another 120 products to be made available by the end of December this year, with an estimated gain of £4million.These products include toilet rolls, bedpans, double adjustable crutches, scissor clamps, surgical face masks, and trays. The NHSI spokesman said more categories of products will be rolled out as the programme continues next year, unlocking more of the targeted savings. Ominously NHSI will “contact” NHS Trusts that carry on shopping individually rather than use the NCP product catalogue.
Enter the strong
There is leadership and then there is leadership. Northern Lincolnshire and Goole Foundation Trust, which was placed in both quality and financial special measures earlier this year, is about to get a new leader( Allison Coggan, HSJ, 28 July 2017). Dr Peter Reading, who has a history of turning around struggling Trusts, is moving from Price Waterhouse Cooper to be its new chief executive. His long career as a senior manager in teaching hospitals led to a turnaround role in Doncaster and Bassetlaw Hospitals FT from 2010 to 2011 and then Peterborough and Stamford Hospitals FT from 2012 to 2014. He is said not to shirk from difficult conversations.
Meanwhile a team of leading consultants has been assembled to lead 14 national reviews aimed at improving efficiency and reducing unwarranted variation in the outcomes of NHS services (Allison Coggan, HSJ, 20 July 2017). The team will visit every Trust running services in their specialty as part of the Getting It Right First Time (GIRFYT) programme and use Trusts’ data to highlight variation and outcomes. The team will produce national reviews of each specialty with work beginning before the end of the year, at a cost of £60m. The reviews will cover: Breast surgery, Acute and general medicine, Cardiology, Respiratory medicine, Geriatric medicine, Dermatology, Neurology, Gastroenterology, Diabetes and endocrinology, Renal medicine, Anaesthetic and perioperative medicine, Hospital dentistry, Intensive and critical care, and Imaging and radiology.
Flexibility for Whom?
A report from the Institute for Public Policy Research argues that younger workers face a future employment landscape that could damage their mental health and wellbeing unless action is taken now.
As a result of the evolution of the UK labour market over the past 25 years, today’s generation of younger workers – millennials and centennials (those born during or after 1982) – risk losing out on access to permanent, secure and fulfilling work. Compared to previous generations, they are more likely to be in work characterised by contractual flexibility (including part-time work, temporary work and self-employment).
Relatedly, they are also more likely to be underemployed (and so be working fewer hours than they would like) and/or overqualified (being a graduate in a non-professional or managerial job). For some young people in part-time or temporary work (particularly where this involves being underemployed and/or overqualified), their experiences of work may be putting their mental health and wellbeing at greater risk.
New analysis reveals younger workers in part-time and temporary work are more likely to experience poorer mental health and wellbeing, while there is more of a mixed picture among those who are self-employed. Similarly, younger workers who are underemployed or overqualified also experience worse mental health. This is likely to be explained – in part, but not entirely – by part-time and temporary work being linked to low pay and insecurity.
The full report – “Flexibility for who? Millennials and mental health in the modern labour market” – can be downloaded from https://www.ippr.org/
Austere times for private medicine?
It is not just the NHS that is worried about its budget; the private medical sector is too. Increases in insurance premium tax (IPT) are causing distress in the private health insurance market. IPT is a tax levied on general insurance premiums. In the 2015 Budget IPT was increased from 6% to 9.5%. Then, in October 2016 there was a further increase, taking the rate to 10%. In June 2017 IPT was increased again, to 12%. Elliott Silk, speaking for Wealth and Investment managing company Sanlam UK said: “The escalating cost of the tax is reaching a tipping point, and will likely affect employers’ ability to offer private healthcare as a benefit in the workplace. The Government should consider ring-fencing private healthcare from the increase to IPT”.
Over the last decade the cost of private medical insurance doubled, mainly because of the costs of new treatments (especially cancer therapies) in an ageing population. Part of the reason for the jump is that more people were buying private insurance and using it. Around 5 million people in the UK have private medical insurance, of which four-fifths are covered by corporate (employer purchased) policies. The average cost is just over £700 a year, but there are wide variations between policies, and prices for older customers can be much higher. (Source: Oliver Ralph, Insurance Correspondent, Financial Times, May 6th, 2016)
Bits of the NHS quarrel with each other over lots of things, size being one. For example the North Staffordshire GP Federation does not support the Staffordshire and Stoke-on-Trent STP or capped expenditure proposals aimed at the creation of a single community and mental health provider covering Staffordshire and Shropshire (Shaun Lintern HSJ 27 July 2017). The GPs want a multispecialty community provider based on the local North Staffordshire and Stoke-on-Trent footprint, arguing that the needs of these local communities are different from needs elsewhere in Staffordshire. The economies of scale that the STP desperately needs to save money point to the need for a big organisation, whilst the GPs doubt that proposed mergers will yield savings. Little wonder that progress with STPs is slow.
Stuffing their mouths with gold (or bronze, silver or platinum)?
Data obtained by the Health Services Journal shows the amount paid to senior doctors on top of their NHS salaries was £157m in 2015-16 and £147m in 2016-17 – tidy sums given the public sector pay freeze. The awards were paid to 2,948 consultants in England and Wales during 2015-16. The number receiving the awards dropped to 2,779 consultants receiving an award up to March 2017. The 2016 annual report from the Advisory Committee on Clinical Excellence Awards said more than 25,300 consultants in England and Wales (54 per cent of the consultant workforce) received an award (Shaun Lintern HSJ 28 July 2017). Clinical excellence awards are added to consultant pay and are pensionable.
The Clinical Excellence Awards (CEA) scheme is intended to recognise and reward those consultants and senior academic GPs who contribute most towards the delivery of safe and high quality care to patients and to the continuous improvement of NHS services. In particular, awards are made to doctors who:
Demonstrate sustained commitment to patient care and wellbeing or improving public health
Sustain high standards of both technical and clinical aspects of service while providing patient-focused care
In their day-to-day practice demonstrate a sustained commitment to the values and goals of the NHS by participating actively in annual job planning, observing the private practice code of conduct and showing a commitment to achieving agreed service objectives
Through active participation in clinical governance contribute to continuous improvement in service organisation and delivery
Embrace the principles of evidence-based practice
Contribute to knowledge base through research and participate actively in research governance
Are recognised as excellent teachers and or trainers and or managers
Contribute to policy-making and planning in health and healthcare
Make an outstanding contribution to professional leadership.
The function of CEAs varies across the nations of the UK. In England they are awarded to consultants and academic GPs who perform ‘over and above’ the standard expected of their role. In Scotland the CEAs are intended to reward consultants who show commitment to the NHS by not doing private practice.
The administration of the scheme is in the hands of the Advisory Committee on Clinical Excellence Awards. There are 12 levels of award. Levels 1-8 are awarded locally by employing NHS Trusts, with 8 being the highest, and levels 10-12 (silver, gold and platinum hereafter) are awarded nationally. Level 9 awards can be awarded locally or nationally, and are usually referred to as ‘bronze’.
The value of individual national awards in England and Wales for 2016-17 was £35,832 for “bronze”, £47,110 for “silver”, £58,888 for “gold” and £76,554 for “platinum”. Local awards, run by individual NHS employers, varied from £2,986 to £35,832.
CEAs, once called ‘distinction awards’ or ‘merit awards’, were introduced at the foundation of the NHS in 1948 to win support for it – Aneurin Bevan is said to have described these awards as “stuffing their mouths with gold”. By 1979 about half of all consultants received an award during their careers and at any one time just over a third were award holders. Negotiations about a new consultant contract were rumoured to include removal of clinical excellence awards, including those currently held (Shaun Lintern HSJ16 February 2017). If that happens it will be interesting.
Dr Mariya Moosajee, Clinician-Scientist and Consultant Ophthalmologist, will lead visitors on a sensory exploration into the science of the eye in her new exhibition ‘Science of Sight’ at the Science Museum, London. A keen advocate that art can be for everyone, she will include tactile, scent and sound pieces from the BlindArt Collection at Moorfields Eye Hospital
A new exhibition will be launched on 8th August 2017 at the Science Museum, London. The exhibition ‘Science of Sight’, part of the BBC Tomorrow’s World Live series, will be visited by thousands of people each day1. Dr Mariya Moosajee will be joined by a team of scientists, researchers, artists and patients.
The exhibition, supported by The National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, will include demonstrations and examples of pioneering science such as growing an eye in a petri dish, a model eye and brain, scent and sound boxes and tactile blood cells. Dr Moosajee will educate and entertain children and adults with demonstrations, talks and science exhibits during the three-day exhibition while discussing her own research and discoveries in sight and genetic conditions of the eye.
Art will be a key feature of the exhibition with sensory pieces on display from the BlindArt collection from Moorfields Eye Hospital. Visitors to the exhibit will be welcomed and encouraged to touch, smell and listen to art, thereby demonstrating that art can be created and enjoyed by people with visual impairments.
Dr Moosajee said of the exhibition, “We are thrilled to be invited to display our work at the Science Museum. It’s exciting that we are able to access so many people of all ages and showcase some of our innovation and research. We want to highlight that learning about the science of the eye and some of the conditions that affect it is accessible to everyone whether you have full sight or not. That extends into art as well, and I have an especially keen interest in ensuring that it can be enjoyed by everyone. We will be showing the science behind that too.”
A wealth of artists and experts, including those with blindness and partial sight, will be discussing the science and art. These include: Marcus Inniss who has Usher Syndrome and is partially deaf and blind, Annie Fennimore a blind artist, Suki Chan a film maker and Alexandra Contil-Lacoste a senses artist.
The Tomorrow’s World gallery can be found towards the rear of the main floor, between the restaurant and the IMAX theatre. Thousands of people are expected to visit the exhibit each day.
Journalists are welcome to visit the exhibition, please contact for details and media information.
Dr Mariya Moosajee is available for interview prior to and at the Science Museum, please contact to schedule an appointment.
Interactive demonstrations and talks will run each day from 8 to 10 August from 11am to 1pm and 2pm to 4pm. The Science Museum is located on Exhibition Road, South Kensington, London, SW7 2DD.
Smokers who undergo a CT scan of their lungs are more likely to quit than those who don’t, concludes a trial led by Cardiff University.
The findings of the study, looking at the effect of CT screening on smokers at high-risk of developing lung cancer, dispute the belief that a negative screening result offers a ‘licence to smoke’ and reveal that engaging with lung screening can give smokers an opportunity to access smoking cessation support, at a time when they are likely to be receptive to offers of help.
Dr Kate Brain, Reader at Cardiff University’s Division of Population Medicine, said: “Our trial shows that CT lung cancer screening offers a teachable moment for smoking cessation among high-risk groups in the UK. We now need evidence about the best ways of integrating lung cancer screening with stop-smoking support, so that services are designed to deliver the maximum health benefits for current and future generations.”
The trial, led by researchers at Cardiff University working with the University of Liverpool, King’s College London and Queen Mary University, involved 4,055 participants aged 50-75 years who were randomised either to a group who underwent low-dose CT screening for early detection of lung cancer, or to a control group who did not undergo screening.
Of the smokers who took part in the screening, 10% had successfully quit after two weeks, and 15% had quit at two years – both higher than rates in the control group.
The UK Lung Cancer Screening (UKLS) pilot trial is the first to assess the feasibility, cost-effectiveness and behavioural impact of lung cancer screening, using a single low-dose CT screen on a high-risk population in the UK.
Lung cancer is one of the most common and serious types of cancer and has the highest mortality of all cancers in the UK. Around 44,500 people are diagnosed with the condition every year in the UK.
The UKLS pilot trial was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme.
The full scientific publication ‘Impact of low-dose CT screening on smoking cessation among high-risk participants in the UK Lung Cancer Screening Trial’ is published in PR News Wire.
Nutrition research in the UK needs an urgent boost if it is to provide real benefit to the UK and global populations.
The Medical Research Council (MRC) and the National Institute for Health Research (NIHR) have responded to a wide-reaching review of nutrition research in the UK with new proposals aimed at revolutionising the field.
The Review of Nutrition and Human Health Research, commissioned by the Office of Strategic Coordination for Health Research (OSCHR), was overseen by an expert Review Group and its aims included:
To ascertain the strengths and weaknesses of nutrition research relevant to human health in the UK; to assess whether the research base was well placed to meet the needs of policy makers; to identify opportunities for further interaction with the food/nutrition science industry both in the UK and globally; to consider whether there is sufficient capacity to provide a sustainable future for nutrition research in the UK.
The Review praised the excellent nutrition research in the UK, but warned that the field was facing a potential crisis as fewer younger scientists entered the field and experienced researchers approached retirement. It noted that while the behavioural/social science aspect of nutrition research remained strong, the basic mechanistic understanding of nutrition research and its translation to healthier food was beginning to fall behind.
The report’s recommendations may be found here.
In response to the review and after broad discussion, the MRC and NIHR have identified three courses of action to take place immediately which will be followed with longer term activities. The three key pillars will be:
A UK nutrition and human health research partnership
The MRC and NIHR will establish a UK Human Nutrition Research Partnership comprised of experts from academia, health research and industry to develop and realise an implementation plan for the review recommendations. The focus will be on some of the tougher scientific challenges such as: linking cohorts to interventional nutritional research; linking nutritional epidemiology to mechanistic understanding; and looking at longer-term solutions to fundamental problems such as standardising measures. The partnership’s outputs will feed into decision-making bodies, devolved health administrations and policy units, and inform industry and public guidance.
Developing plans for global nutrition research
Global nutrition research has the potential to transform health and wellbeing across the world. Nutrition, and its influence at all life stages, plays a pivotal role in non-communicable diseases in lower and middle income countries and also has an impact on response and resilience to infectious diseases. Working across the Research Councils, the Department for International Development (DFID) and the Department of Health (DH), through the Global Challenges Research Fund (GCRF), the MRC will launch new funding opportunities to tackle some of these global challenges. Full details will be available via www.rcuk.ac.uk/funding/gcrf/ This approach will link groups that have expertise in working in these countries with nutrition researchers here and in LMICs, while allowing groups not traditionally involved in LMIC research – or even nutrition – to form new partnerships and seed small projects.
Working with the food industry
The OSCHR review highlighted that to truly understand the nutrition ecosystem we must work with all stakeholders, including the food industry – agricultural, retail, food production, packaging etc. Industry must be seen as part of the solution and partnership with the food/nutrition science industry is vital so that research can lead to healthier products and improved nutritional support. This partnership must be governed by clear principles for engagement. The MRC is working with key stakeholders to build on its existing guidance in this area by developing a framework for engagement between researchers and industry.
Professor Chris Day, Vice-Chancellor and President of Newcastle University, who chaired the Review, said: “The UK has a well-earned reputation for its nutrition research but we are in danger of falling behind if we don’t consolidate our strengths and build up capacity in key areas.
“A new nutrition research partnership will identify challenges in the area and then direct resources to meet those challenges. Most importantly, it will inform policy.
“Working more closely with industry partners will provide opportunities to build capacity in the field, enhance the sharing of expertise and resources, and ensure that excellent nutrition science is available to all.”
Dr Louise Wood, Director of Science, Research & Evidence at the Department of Health, welcomed the report:
“The UK has a strong history in undertaking high quality and impactful nutrition research and the report highlights the huge potential of building on this for the benefit of the health and wellbeing of the public – both nationally and globally.
“To realise the potential highlighted in this report, we shall be working with a range of stakeholders and, via NIHR, with other research funders including industry to take forward the recommendations.”
The Royal Society for Public Health (RSPH) has warmly welcomed the publication of a new report, ‘Creative Health: The Arts for Health and Wellbeing’, launched today (19 July 2017) by the All Party Parliamentary Group on Arts, Health and Wellbeing (APPGAHW), which illustrates and champions the hugely valuable role the arts can play in supporting health and wellbeing.
RSPH provided input and consultation in the delivery of the report, which comes after two years of evidence gathering from service users, health and social care professionals, artists and arts organisations, academics, policy makers and parliamentarians from all parties and both Houses. The evidence shows overwhelmingly the beneficial impact that arts can make to health and wellbeing:
- The arts can help keep us well, aid our recovery and support longer lives better lived.
- The arts can help meet major challenges facing health and social care: ageing, long-term conditions, loneliness and mental health.
- The arts can help save money in the health service and in social care.
The report also explores a number of projects across the UK, such as Artlift, a charity delivering an arts-on-prescription scheme;The Alchemy Project, which uses dance as a form of early intervention in psychosis; and The Homeless Library, a collaborative project between arts organisation Arthur + Martha and Manchester’s homeless population, offering a space for potential healing and shared experience.
To more fully exploit the role the arts can play for health and wellbeing, the report makes 10 recommendations, including:
- Leaders in the arts, health and social care sectors to establish a national strategic centre for arts, health and wellbeing.
- A cross-governmental strategy to support the delivery of health and wellbeing through the arts and culture.
- Designated individuals to be responsible for arts, health and wellbeing within NHS England, Public Health England and each clinical commissioning group, NHS trust, local authority and health and wellbeing board.
Read the full report, Creative Health: The Arts for Health and Wellbeing, here.
Shirley Cramer, Chief Executive, RSPH, said: “At RSPH we have long championed greater awareness of the significant health and wellbeing benefits of the creative arts, both in preventing ill-health or poor wellbeing, and in aiding recovery. We are delighted that this comprehensive report illustrates and champions these benefits, and we hope that it will transform the conversation in the health sector around arts and stimulate the widespread implementation of new and innovative approaches. We fully support the APPGAHW’s calls to action to help support the integration of the arts into health and social care, and we truly believe that this can make a real impact on the public’s health and wellbeing.”
The Royal Society for Public Health (RSPH) has expressed its disappointment and frustration that the Joint Committee on Vaccination and Immunisation (JCVI) has today (19 July 2017) announced its decision not to extend human papillomavirus (HPV) vaccinations to all adolescent boys. This interim decision precedes a six week consultation period, after which time the decision will be made final unless the JCVI can be persuaded to change its mind.
HPV is responsible for 5% of all cancers, and while the existing vaccination scheme for adolescent girls provides a level of ‘herd protection’ to boys, the decision not to extend the vaccination means some 400,000 boys remain at risk of contracting the virus. A decision to extend the programme today would have brought the UK in-line with 11 other countries who currently offer universal HPV vaccinations.
Shirley Cramer CBE, Chief Executive RSPH, said: “We are deeply disappointed by the JCVI’s decision today, which suggests that fundamental priorities are focused more on saving money than on saving lives. Such a simple vaccination programme has the potential to make such a big impact on the public’s health on a national scale. We hope that the Government’s advisory committee reconsider this decision as soon as possible and put the public’s health and wellbeing before cost-saving. This process has already dragged on for a considerable period, and every moment we delay lives continue to be unnecessarily put at risk.”
Peter Baker, HPV Action Campaign Director, said: “It is astonishing that the Government’s vaccination advisory committee has ignored advice from patient organisations, doctors treating men with HPV-related cancers, public health experts and those whose lives have been devastated by HPV. The decision not to vaccinate boys is about saving money not public health. HPV Action will continue to make the case for a national vaccination programme that protects men and women equally. There may also be grounds for a legal challenge on the grounds that the decision breaches equality law.”
Matt Crossman, engagement manager at Rathbone Greenbank Investments, comments:
“Ethical investors have long avoided the tobacco sector because of its clear links to premature death and disease. Tobacco companies have consistently demonstrated poor levels of corporate responsibility, often undermining public health bodies through their advertising and messaging. Although tobacco use is a matter of personal choice, and its usage still legal, the arena in which we exercise our choice is not neutral: the messaging and promotional activity of the industry has created a situation where smoking has fallen in countries like the UK, America and Australia, but risen in the developing world and in Eastern Europe. This trend is confirmed by WHO reports that cite ‘aggressive’ marketing in these regions.
“It’s no exaggeration to say that the industry has only ever moved in more responsible directions when it has been forced to do so by regulation; at the same time, the industry has become more and more adept at shifting its growth efforts to areas where regulation is weaker. It has also actively fought the restriction of advertising. Having broadly lost those battles on advertising, it has now considerably upped its investment into the ‘vaping’ trend. Although public health bodies are still split on the long-term health benefits of e-cigarettes – with some seeing the technology as a useful tool in giving up smoking – commentators have been quick to point out that the tobacco industry’s increasingly large-scale investment in the technology might be an attempt to ‘normalise’ smoking and retain their market position, rather than a genuine effort to mitigate the harmful effects of tobacco.
“Put simply, smoking remains a leading cause of preventable harm in the world. Treating its effects on populations is a huge drain on healthcare systems. As more countries take up the WHO recommendations and begin to implement stricter control, we expect growth opportunities to stall for the industry. Responsible investment is about investing in companies making useful goods and services which benefit society, pursued in a responsible manner. Tobacco does not pass this test.”