Chief Executive's Foreword
Tom Mullarkey MBE
Chief Executive
"The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not"
Mark Twain
A government's public health agenda may not inspire universal popularity, since it must, as Mark Twain noted, implore people to moderation. But there are some messages which are more welcome than others and one of these is accident prevention. Restrictions on diet and alcohol or exhortations to vigorous exercise seem more likely to be rejected than advice or information which can lead people to keep themselves and their families safe from violent death or injury. Whether it is the immediacy of the reward or the belief that it is the least of "evils" inflicted by the "nanny state", there seems to be more accord between our message and the population's genuine interests than in other parts of the public health agenda.
So it is as well that the long-term epidemic in home and leisure accidents is to be addressed in the Government's new public health plans. While road safety is achieving all-time-lows in death and injury, these gains are being more than offset by the uncontrolled rise in home and leisure accidents. What is critical about this is that the systematic, evidence-driven, road safety improvement programme which has been in train for decades, over several Governments, has been mirrored by piecemeal and unfocused anarchy in these other areas. It is simply extraordinary that home and leisure accidents in the UK cost society £95bn per annum1.
In the new public health plans, which are for England, accident prevention has been given its place. But the real task is to make sure that it achieves its rightful place, which is at the top of the list. It should be there because although it is not by any means on the same scale as other public health issues (heart disease, cancer, smoking, obesity etc. kill many more people than do accidents), it offers many advantages over them. Accident prevention, primarily directed at the young, puts more Quality Adjusted Life Years (QALYs) back into society than trying to prevent disease, which generally affects people in their later years. Accident prevention is cheap and easy to deliver and, because advice and information given to a more generally receptive audience produces better results, it is a more cost-effective use of public health funds. Accident prevention also offers the practical and political advantage, unlike disease prevention which is very long term, in that it saves money straight away, a truth that can be measured at the door of A&E. For an NHS that has to save £20bn over the next five years, this is surely welcome news.
Mark Twain may have been right about the unwelcome message which seeks to accompany virtuous living. At RoSPA, our approach, that "life should be as safe as necessary, not as safe as possible", strikes a chord - perhaps because people do not object at all to being given the knowledge and information to make their own decisions on safety. And they certainly do not object to following another well-worn but little-enacted piece of homespun advice - that "prevention is better than cure". It is time to adopt this common-sense approach and converge the need to save money in the NHS with the need to save the lives of our people. Accident prevention is the "low hanging fruit" of public health and should now become its first priority.
Tom Mullarkey MBE
Chief Executive
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