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Wanless demands action

Fast action is needed at all levels to move from a ‘national sickness service’ to a health service focused on preventing disease, according to the final Wanless report.

Securing Good Health for the Whole Population makes 21 recommendations to Government, including a call for a Treasury framework to guide ministers on which economic levers could promote good health.

Some arguments can be made for a regulatory authority for tobacco, a workplace ban might cut smoking by four per cent, and a higher tax on tobacco could produce large gains, says the report by the former NatWest boss Derek Wanless.

It calls for realistic national targets for cutting obesity and more ambitious ones for smoking. It says realistic short and medium term exercise targets should replace the current Cabinet Office aspiration of increasing levels of exercise from 32 per cent to 70 per cent by 2020.

The report wants the consultation period ahead of the public health white paper to seek the public’s view about a workplace smoking ban, the need to take firmer action over smuggling and counterfeiting cigarettes and wider use of nicotine substitutes.

But in the end it is up to individuals across society to decide for themselves whether they want to be ‘fully engaged’ in maximising their health, says the report.

It wants to see consistent national health improvement objectives — including specific targets for children’s health — set for 2007 and 2011. Plans to achieve them should be proposed in the white paper, it says, along with detailed costings and research programmes and a structure for regular reassessment.

National objectives, particularly those for inequalities, should be subdivided where appropriate to cover important groups, with local authorities, PCTs and other relevant agencies devising local targets based on the national objectives but taking local needs into account.

The report says the government’s current review of health quangos needs to assign responsibility for the regulation of nicotine and tobacco and the development of the cost-effectiveness evidence base on public health. It also needs to reallocate both the educational role previously played by the Health Education Authority and the job of reassessing national objectives for all major determinants of health and health inequalities.

Public health spokesman for the NHS Alliance Professor Chris Drinkwater said that while his overall impression of the final Wanless report was positive, ‘the white paper needs to be an operational document and if we don’t get that right I think we’re stuffed’.

The Royal Society for the Promotion of Health said the challenge it was facing along with other NGOs ‘is to argue our cases in the terms Wanless sets out’. It welcomed ‘a sound evaluative framework for consideration of fat, cholesterol and salt taxes’, but said it was disappointed that local government, environmental health, housing policy, integrated transport and other issues were ‘really not considered’.