A Healthy Nation?

A number of reports published last week raise questions about whether improvements in the nation’s health are starting to stall and pose some interesting questions about how far the changes observed are linked to public policy changes and levels of funding.

A report from the Nuffield Trust presents data on health and wellbeing for early childhood in the UK and 14 comparable countries, recognising the particular influence that a child’s development in this period can have on his or her future health and quality of life.

It concludes that whilst the UK is doing well on many of the indicators, in other respects progress has stalled or worsened over the past 2 – 3 years. This is true of childhood mortality, immunisation rates and low birth weight. And on life expectancy a girl born in the UK can expect to live to almost 83 years; three years less than a girl born in Spain, and the lowest of all European comparators. For both boys and girls, improvement in life expectancy has plateaued since 2011.

The author notes that these are the very indicators that are most susceptible to public health interventions and ‘therefore most at risk in the face of increasing threats to children’s (and particularly early years) services’.

Other research discussed on the ‘conversation’ website suggests that 12.4% more people died in the first seven weeks of 2018 than is usual for this time of year. Moreover, the first available data finds that flu only accounted for a very small part of the overall rise in mortality in early 2018, though it would be good to see more information about the data behind this claim.

The summary report also notes that on March 1, 2018, ONS announced that there had been noticeable falls in female life expectancy at birth in the 20% most deprived populations in England”. Also ‘it’s not just the poor who are affected. The rise in life expectancy for better-off groups of men and women had abruptly slowed compared with the 1890- 2010 norm’.

Indeed, the slowdown in life expectancy for the average person in Britain is worse than anything seen since the early 1890s, and no other country in Europe has witnessed a similar fall


Finally, the ‘UK in a Changing Europe’ research group published a report on the challenges that Brexit poses for the NHS and public health more generally. This was not picked up by the UK media preoccupied with other issues, but it paints a worrying picture.

Apart from funding pressures which are likely to be exacerbated, Brexit is also likely to worsen existing staff shortages. There has already been a fall in the number of EU-origin nurses, attributed at least in part to uncertainty about their future status. Longer term, the NHS and the social care sector are dependent on immigration but as yet unclear what this policy will be. ‘The risks, however, are evident’.

It is too early to say what degree of alignment will exist between the UK and the EU but there are numerous health systems and databases, such as the Clinical Trials Database and the Rapid Alert System for Blood and Blood Components (RAB) that will require specific agreements in order that the UK retain access.


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