Advancing our health: prevention in the 2020s – consultation response

In October 2019, we responded to the Department of Health and Social Care’s consultation on their prevention green paper, which looks at how our health is shaped by the environment in which we live, the choices we make and the services we receive.

In July 2019, the Department of Health and Social Care (DHSC) published its prevention green paper, Advancing our health: prevention in the 2020s, building on the Secretary of State’s prevention vision that was announced in November 2018. The paper contains a number of proposals to tackle the causes of preventable ill health in the England. The full paper and consultation can be found online, or you can read our summary

You can download our full response to the consultation below. For more information on the evidence we’ve cited, read our full Prevention Vision, released in June 2019. 

Our response

  • We are supportive of many of the Government’s ambitious plans, including commitments to challenge the food industry and commission an infant feeding survey. It is important that these plans are not diluted, and sufficient funding is provided to ensure their success.  
  • Good prevention has to start from before birth. In our response we explain why the early years of life are critical to shaping our long-term health and quality of life. Despite having a globally-renowned health system, infant mortality is particularly high in the UK - around 60% of deaths during childhood occur before the age of one. RCPCH’s Child Health in England in 2030 report found that, if this trend in child mortality continues, the UK’s infant mortality rate will be 140% higher than comparable wealthy countries in 2030.
  • Poverty lies at the root of many risk factors for poor child health and we will not be able to prevent these risk factors and poor outcomes from occurring until we can prevent the wider social problems that underly them. There has been little change in the proportion of children living in poverty in recent years. A total of 1 in 5 (4.1 million) children now live in poverty in the UK, a rise of over 500,000 since 2011/12.
  • We have used our response to restate many of the recommendations made in our prevention vision, covering healthy weight, stopping smoking, breastfeeding and feeding in the early years, mental health, sleep, oral health, creating healthy spaces, sexual health, and prevention in wider policies and in the NHS. 
  • In order to achieve a deliver a truly preventative approach to health, there must be a cross-government focus on improving the social conditions in which people are born, grow, live, work and age. In order to maximise effectiveness there should be a greater focus on population health and synergy with the work on this in NHS Long Term Plan. 

Our recommendations

  • We want to see a ‘health in all policies’ approach to decision-making and policy development at national and local levels, with the Treasury disclosing information about the impact of the Chancellor's annual budget statement on child poverty and inequality. We believe that such an approach would facilitate the natural adoption of policies that are inherently preventative of negative outcomes and experiences for children and young people.
  • We urge Government to restore public health funding budgets urgently in order to reverse current trends in child poverty. At the very least, Government should reverse public health funding cuts until a clear impact assessment of the effects of the most recent cuts is undertaken. 
  • Universal early years services, including health visiting and school nursing, must be protected, prioritised and supported financially, with additional targeted help offered for children and families experiencing poverty. 
  • Prevention should be at the centre of workforce planning. Children's health workforce mapping and modelling should be joined-up across the NHS and public health workforce to put the child's journey and care at the centre. Prevention should be identified as a priority in NHS local area implementation plans and the refresh of the Healthy Child Programme, with appropriate funding allocated to these areas.
  • In order to maximise the benefits to children and families, departments need to ensure that services don’t work in silos and join up data between services to better understand and address needs. An oversight review is needed to establish what data is collected on children in different places and identify what the gaps are. The health index should prioritise the health of children, given they are the future. 

We respond to a wide range of consultations to ensure that the College’s position, and ultimately children’s health, is represented. Members can get involved in current consultations by contacting the Health Policy team: health.policy@rcpch.ac.uk.