The Week

The Week 19 April 2024

Florence Conway
Researcher

It’s been a busy week in Westminster as Parliament returned after the Easter recess. And while most eyes were on the release of Liz Truss’s long awaited 10 Years to Save the West, over at Reform, we’ve been getting into the weeds of the health policy debate.

First up, we’ve been reading a report by our friends at the Health Foundation: Health Inequalities in 2040.

Worryingly, their analysis revealed health inequalities will continue to persist and grow in the next 15 years, with 700,000 more working age people likely to have a major illness by 2040. What’s worse, 80 per cent of this increase is likely to be in more deprived areas. Luckily, Reform’s recently released Close Enough to Care report sets out new ideas for how the NHS should be structured to help deal with the geographic variation in health outcomes and health inequalities.

The Health Foundation’s report also shows how it is a small number of conditions which contribute most to health inequalities: chronic pain, type 2 diabetes, anxiety and depression. The report points out that these conditions are largely managed in primary care, and so stresses the importance of investing in general practice, community services, prevention and early intervention. This is something we at Reform have also emphasised, and we are hard at work on our own vision for primary care reform.

Elsewhere, the Tobacco and Vapes Bill passed through the House of Commons, meaning that ‘Generation Alpha’ — that is, those born in the early 2010s — will be the UK’s first smoke-free generation. While many have cried horror at this ‘nanny state’ intervention, health campaigners have praised it as a “huge milestone” on the road to a smoke free UK. We at Reform know that smoking is one of the biggest drivers of poor health, and so think it is right for government to think about the ways we can reduce its impact. Nonetheless, we recognise that it is an imperfect policy.

This policy risks an unequal effect with different demographics, could potentially lead to the emergence of a black market, and creates the conditions for the absurd-seeming scenario of one day going to the shops with your 41-year-old friend and finding that you can buy a pack of Marlboro Reds while they cannot!

Even so, given the addictive nature of nicotine, it is hard to think of policy to produce a ‘smoke free’ generation in any other way.

There will always be pressure to prioritise policies to address the immediate demand pressures facing the NHS. But the real prize lies not in health related political soundbites, but in charting a long-term course to tackling the underlying causes of poor health — for example, by focusing on health behaviours and the places we live.

What we’ve been reading…

Aside from launching our report on missions; we have enjoyed reading the FT’s interview with Gordon Brown. The articles takes us through both Brown’s personality and his policy agenda, past and present. Brown’s musings are shown to be vast: he laments the loss of policies around social mobility and improving outcomes for the young: SureStart, educational maintenance allowance, child trust funds; and also comments on the lack of modern British philanthropists. The article praises the introduction of Brown’s multibanks, foodbanks for non-food items which provide a range of household goods to those who can’t afford them, but the tone is constantly permeated with a bleakness of how bad things have got. However, it is not all doom and gloom. The former PM does have hope for a better future for Britain. We agree!