Lack of public health policies designed to prevent ilness, MSP finds

There are not enough public health policies designed to prevent illness, a Holyrood committee has found.

MSPs on the Health and Sport Committee found that the health service was over-reliant on tackling existing problems rather than preventing them from happening.

Most activity focuses on treating illness at an early stage or preventing the problem becoming worse, according to a report published on Monday.

The report looked at eight specific areas of preventative action, including for Type 2 diabetes, substance misuse, sexual health, detecting cancer early, neurological conditions, optometry services, sport and leisure trusts, and clean air.

On Type 2 diabetes, the evidence the committee received suggested a clinical focus on preventing complications and early detection, described as secondary and tertiary prevention, to the exclusion of primary prevention.

Lewis Macdonald, convener of the committee, said: “We’ve all heard the old adage that prevention is better than cure.

“The preventative agenda - spending money now with the intention of reducing public spend on negative outcomes in the future - is nothing new.

“However, what this inquiry has found is that there simply is not enough activity within Scotland to support this.

“It is imperative that across all policy areas focus is prioritised on preventing people becoming ill with diseases we know are avoidable.

“By doing this we can also start reducing health inequality and whilst the health service can’t fix everything, it must play its role in tackling this fundamental issue.”

The report noted that an estimated 40% of cancers are attributable to preventable risk factors which could be addressed through behavioural change.

On detecting cancer early, the study found that there is a lack of urgency or incentive within health boards to meet the targets in relation to cancer treatment.

The committee is asking the Government when they expect each health board to meet the 62-day target which covers the period from referral through diagnostics to treatment, and the separate 31-day target covering the period from diagnosis to treatment.

The committee did highlight some positive examples which demonstrate how well preventative policies can work.

In 2012 NHS Highland reported that around 80 hospital beds a day were used by older NHS Highland residents who had experienced a fall, at a cost of around £400 per day per patient and £11.6 million per year.

By delivering training in care homes, town halls and leisure centres on falls prevention there was a “significant drop” in the number of admissions.

A Scottish Government spokesman said: “We published our public health priorities in June and will consider the committee’s report to see what, if anything, from its findings might be added to our delivery plans.

“The Scottish Government has a long history of taking action to improve public health.

“Many of the bold steps we have taken in recent years have been followed by countries around the world, including banning smoking in public places, introducing a minimum unit price for alcohol and the Daily Mile for children now in two thirds of primary schools.

“Tackling obesity is a key priority and the Diet and Healthy Weight Delivery Plan focuses on children and those with Type 2 diabetes in particular.

“We are also investing more than £100 million in our cancer strategy to help improve the prevention, detection, diagnosis, treatment and aftercare of those affected by cancer.

“We are supporting GPs to diagnose cancers as early as possible and the investment includes £5 million to improve cancer waiting times across Scotland.

“We will also establish a new national public health body for Scotland by 2019 to collect data, undertake research and inform policy making and the public.”