Prevention saves lives - politicians must do more
Urgent action is needed to prevent harm to the UK population, says independent public health consultant, Dr Michael Craig Watson
I recently wrote to the leading medical journal, The BMJ, in support of an article arguing that bold action from politicians is needed to strengthen primary prevention in public health.
The article, by Professor Petra Meier and Professor Srinivasa Vittal Katikireddi (both of the University of Glasgow) and Professor Katherine Smith (Strathclyde University), argued that primary prevention, in other words tackling the underlying causes of poor health in order to prevent (or substantially delay) avoidable deaths, is currently facing a severe lack of political will and action.
The authors cite the recent scrapping of a white paper on health inequalities, a delay in action on junk food and the splitting of the Public Health England, as well as large departmental budget cuts, as examples of this neglect of preventative action on protecting the country’s health.
I would add accident prevention as a major area that has suffered particular neglect over the past decade. Preventable accidents result in huge costs to health services, social care, economies and people’s lives. Every year in the UK alone, 16,000 people die from accidental causes, with hundreds of thousands affected by life-changing injuries.
Yet effective and adequately supported primary prevention is vital in helping individuals and families to be healthier and live longer by tackling the root causes of issues such as accidents, obesity, poor mental health, smoking and so on. It is also hugely cost-effective, lessening the demand on our overloaded NHS and social care systems, reducing inequalities and keeping people in work for longer.
A crucial area in which to improve primary prevention in relation to accidents is the use of data from emergency departments and other key sources. There has been little in the way of national accident data coming from emergency departments for some years. Good quality data is vital for finding out new priorities, raising awareness (among both the public and professionals), promoting action and evaluation. Data should be made easily accessible to local and national practitioners.
Government action is key to the success of primary prevention. Areas where funded and implemented primary prevention programmes could make a life-saving difference include reducing child home accidents; falls prevention (especially among children and older people); courses for young drivers; cycle training; courses and awards for couriers (in driving and safer handling); and safer driving campaigns.
When political force has been applied to preventing accidents, whether through funding or enforcement, there have been many considerable achievements. In the home for example, measures on smoke detectors, child-resistant packaging, the flammability of children’s sleepwear, safer foam furniture and fitted plugs have prevented many injuries and saved many lives.
We know that the mandatory wearing of seatbelts immediately reduced passenger and driver deaths by 29 per cent when introduced and save on average 7,000 lives a year in Europe. In addition, child car seats reduce the chances of death in a collision by close to half. And in the workplace, legislation has transformed the UK into one of the safest places to work in the world – reducing injuries by a staggering 90 per cent over the last 50 years.
The Government’s apparent disregard for primary prevention is writ large in its proposed Retained EU Law (Revocation and Reform) Bill, currently making its way through Parliament. Under the Bill, thousands of pieces of legislation, including more than 200 that directly protect the safety of individuals, will be abolished wholesale on December 31, 2023, unless otherwise preserved. These include regulations covering seatbelts, car seats, safety at work and many, many more.
However, it is not too late. RoSPA’s Protect Our People campaign is leading the way - calling for a careful consideration and evaluation of every law before it is removed, in consultation with key stakeholders.
Indeed, Professor Chris Whitty, England’s Chief Medical Officer and the UK Government’s Chief Medical Adviser, recently told the Health and Social Care Committee’s inquiry into prevention that “primary prevention issues are largely ones of political choice”, and that legislation is a vital tool to achieve success, stating: “I have been quite struck by how many of the political leaders are expecting industry to say, ‘please give us no more regulations’ or ‘no regulations’. It is quite the reverse.”
I do hope more individuals and organisations will recognise and support RoSPA’s Protect Our People campaign. If successful, I believe many injuries will be prevented and lives saved.
Find out more about RoSPA’s Protect Our People campaign at: Protect Our People
Michael Craig Watson, BSc (Hons), PGCE, MA(Ed), MPH, PhD, MIHPE, is an independent public health consultant. In the NHS he worked mainly as a Director of Health Promotion for different health authorities. Director posts involved: managing a department, initiating and leading multi-agency groups (including accident prevention), and initiating and advising on research and evaluation.
At the University of Nottingham he was involved in injury research for 20 years. He was a temporary adviser for the World Health Organisation (WHO) and has provided advice at national and local levels on accident prevention. He has been involved in research in different countries including: England; Iran; Malawi; Palestine; and Uganda.