Scotland’s worsening health needs ‘concerted focus’ on obesity and poverty – Public Health Scotland chief Paul Johnston

Call for action in Reform Scotland article as life expectancy declines and gap widens between rich and poor

A “concerted focus” on tackling obesity and poverty would significantly cut pressure on Scotland’s NHS in the face of the country’s worsening health, its public health chief has urged.

Paul Johnston, chief executive of Public Health Scotland, also called for a preventative approach for older people, warning that the burden of disease from an ageing population is likely to grow.

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In an article for the Reform Scotland policy institute published on Monday, he highlighted that people in Scotland died younger than in any other Western European country and the life expectancy gap between the richest and poorest was growing.

People in Scotland die younger than in any other Western European countryPeople in Scotland die younger than in any other Western European country
People in Scotland die younger than in any other Western European country

Mr Johnston said: "At a time of resource pressure, encouraging investment in primary prevention is challenging but the case remains compelling."

He said £2.3 billion of Scottish health boards’ budgets in 2023-24 was used to the tackle the impacts of poverty, while obese and overweight people were costing the NHS across the UK £19bn a year.

He said: "A concerted focus on these two areas alone has the potential to contribute significantly to reducing demand on our health system as well as having a positive social and economic impact.”

Improvements in Scottish life expectancy stalled in around 2014 to 2016 and have declined since.

But Mr Johnston stressed: “Excellent health services will support improved health and wellbeing – but cannot bear all the responsibility for this.

“Tackling poverty impacts on health, as does the availability of good work, high-quality education and childcare, affordable housing, addressing climate change, and tackling racism.”

Calling for a “collective focus” on health, Mr Johnston said: “We have seen great progress in the past but, at the moment, Scotland’s health is getting worse.

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“We must be bold and brave in the face of the health challenges we face.”

Scottish Conservatives health spokesperson Dr Sandesh Gulhane said: “The fact that Scots have the lowest life expectancy in Western Europe and suffer disproportionately poor health is a serious cause for concern.

“While the SNP are content to stand back and watch as our NHS plunges into chaos, the Scottish Conservatives have a vision to create and deliver the modern, efficient and local NHS that Scots deserve.”

Scottish Labour health spokesperson Jackie Baillie said: “This intervention is a damning indictment of the failures of two bad governments.

“Scotland’s health inequalities are nothing short of a national scandal, presided over by Tory economic chaos and an SNP Government which has shamefully failed our NHS for years.”

Scottish Liberal Democrat leader and health spokesperson Alex Cole-Hamilton said: "I am yet to meet a doctor or nurse who thinks Humza Yousaf's so-called NHS Recovery Plan is up to scratch.

“The Scottish Government has not delivered the vision or the resources required to tackle the strain our NHS is under.”

A Scottish Government spokesperson said: “Austerity, the pandemic and the cost crisis have all contributed to slowing progress in health outcomes over the past decade.

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"We are using all powers and resources available to tackle poverty, reduce inequality, increase healthy life expectancy and create a fairer Scotland.

“Our public health initiatives are complemented by wide-ranging action to reduce poverty and mitigate the impact of the rise in the cost of living.”



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