The Chief Medical Officer for England has produced her first annual report, Professor Dame Sally Davies says:
Fair Society, Healthy Lives notes that only 4% of NHS funding is currently spent on prevention. Given the health burden attributable to risk factors, there is a clear case for arguing for this proportion to be increased. This is not new: the final report of the review led by Sir Derek Wanless looking at the resources required to provide high quality health services in the future, projected that a substantial reduction in costs could be achieved by an increased emphasis on prevention, coupled with higher levels of public engagement in relation to their health.
However, while she does talk about preventative services quite a lot in Chapter 6 of the report when it comes to tobacco, drug and alcohol services the focus is treatment and recovery rather than upstream interventions. Interestingly she does call for much more focus on alcohol which she says has been a poor relation to drug services.
This is also reflected in Chapter 3 where she highlights risk factors for poor health including the abuse of drug, alcohol and tobacco, but again the focus is on over 16s rather than on younger adolescents.
That said Dame Sally does set out her reading of a life course model which describes the influences on health. As you’ll see from the graphic representation (above) there is a strong recognition that we need to build skills and knowledge during childhood and adolescence which she describes as including:
all life skills (from social skills and resilience, to vocational skills), and knowledge gained through all forms of direct and indirect education.
From my perspective the way that Dame Sally has set out her thinking suggests that for those of us focusing on preventing drug and alcohol misuse still need to find a way of describing how we can make a contribution to better health in ways that will encourage those in public health to invest in the sorts of interventions we’re trying to develop. At the moment there is some sympathy for increasing the role of prevention, but what is meant by that seems quite different to the way that we might think of it.