A Covenant for Health

Policies and partnerships to improve our national health in 5 to 10 years

A report led by Geoffrey, Lord Filkin CBE with Professor Kate Ardern; James, Lord Bethell; David Buck, The King’s Fund; Dr Paul Corrigan CBE, former Health Adviser, No 10; Professor Sian Griffiths CBE; and Professor David Halpern CBE, Behavioural Insights Team, with project support from The King’s Fund.

Download the Covenant for Health report and appendices in full from Dropbox.

You can also download the related report Health is Wealth: A Fast Start for A Covenant for Health in full from Dropbox. This report sets out the first steps Government could take to make important and needed progress in improving the health of the nation.

Summary

There is an opportunity to make significant improvements to the health of our nation in just 5 to 10 years, benefiting millions of people, society, our economy and our health systems. This paper explains where and how to do so.

It is urgent to act, the UK has among the worst population health in Europe, the highest levels of obesity, the worst excess drinking levels, very large health inequalities, and very many people become ill much earlier than they should. Our high level of premature, often avoidable ill health, damages lives, our society, localities and our economy. Without resolute action it will get worse. We must act so that lives are not degraded, and to sustain our health services and labour supply.

Because of the urgency, this project explored what could be achieved in 5 to 10 years, looking at key risk factors and population groups. The remarkable conclusion is that a great deal can be achieved by an active government working with all parts of society, with people and communities themselves. In 5 to10 years, we should be able to:

• help 3 million people quit smoking, halving our smoking rate
• help 4 million people avoid becoming obese
• help at least 4 million be more active
• help more children be physically and mentally healthy, fewer at risk of obesity
• reduce the 30,000 deaths a year from poor air quality
• help 5 million people to reduce their risk of CVD, still 24% of all deaths
• help the people and places where health is worst.

This report sets out how to achieve these goals and why they are possible.
Creating a healthier nation with better healthy life expectancy needs a collaboration between people, places, the NHS, and businesses, as well as government. The things that only government can do, it must do, but, above all, it needs to make the case for better health, and empower all parts of society to work to make it happen.

So, we suggest a Covenant for Health, a resilient cross-party commitment to build a healthier nation, and to develop partnerships for health with business, local authorities, and key charity groups. Suitably framed, this could be an attractive offer for the public (see Annex, page 26).

Surprisingly, this agenda of change should also be affordable; the costs are small compared to the growth of the NHS’s budget and they would be born across society as well as by government. The benefits would be great. A new government should move fast, define early what it wants to achieve, prepare for it, legislate, if needed, and make difficult changes early.

There is a fantastic opportunity for any new government to define and promote such a mission.

Introduction

This paper seeks to contribute to manifesto thinking in all political parties and for discussion with organisations concerned about population health.1 It is good to see ideas beginning to emerge from political parties and others. This paper proposes not just a programme for government action, but a new Covenant for Health that brings together business, the NHS, communities and individuals.

There is a great opportunity for any new government to co-create a healthier nation, with healthier air, water, food, workplaces and transport, creating healthier lives for us and our children, and better health in the places where it is worst. The good news is that this is possible; a small number of policies resolutely pursued could significantly and rapidly improve our nation’s health and they should be affordable. Too often in the past political leaders have focused on immediate pressures and been timid.

We propose a Covenant for Health, a resilient cross-party commitment to build a healthier nation over a generation, robust enough to sustain across government.

Download the Covenant for Health report and appendices in full from Dropbox.

You can also download the related report Health is Wealth: A Fast Start for A Covenant for Health in full from Dropbox. This report sets out the first steps Government could take to make important and needed progress in improving the health of the nation.

Testimonials

Daisy Cooper, Liberal Democrats Deputy Leader and Health & Social Care Spokesperson

“The national health service has become a national treatment service, so if we’re to save our NHS and get our economy back on track we need to enable people to lead healthier lives. This is a timely report that will contribute to the debate on how we can do just that.”

Dame Carol Black DBE, Chair, Centre for Ageing Better

“This is a welcome report, seeking over a five- to ten-year period to sustainably improve the poor health of the UK population. For the first time since the industrial revolution, poor health is now detracting from both growth and wellbeing. The report makes it clear that we know what would bring about change. It describes the barriers and has identified policies and practices that would, if adopted, lead to healthier and longer lives.”

Professor Dame Theresa Marteau DBE, University of Cambridge

“Essential reading for all those drafting credible plans for social justice, economic growth and NHS sustainability, this succinct report identifies evidence-based policies and partnerships that could achieve important and affordable change within 5 to10 years to improve our nation’s health.”

Professor Roger Kirby MA MD FRCS, President Royal Society of Medicine

“This is an important report which I commend. Sadly a considerable proportion of our population is now losing a significant number of years of healthy living as a result of obesity, diabetes and other avoidable disorders — and things are getting worse. This well written report sets out practical and achievable means by which preventive measures can be deployed to improve the health of the nation. This preventative approach is surely preferable to allowing the situation deteriorate further and then vainly trying to deal with the inevitable consequences”.

Dr Sarah Clarke, President, Royal College of Physicians

“We are seeing first-hand the additional pressures on the health service due to avoidable illness caused by poor housing, unemployment, food quality, air pollution and smoking. The RCP agrees with Lord Filkin that the health of the nation must be prioritised by all political parties. We strongly welcome the recommendation that action be led by the Prime minister and Chancellor, with a cross-government strategy to reduce health inequality.”