The time has come to “supercharge” preventative measures with the aim of creating a healthier and more resilient population, Dr Nicola Brink has argued in her latest Medical Officer of Health Report.
Within that she has backed six goals to stop Guernsey’s health service being overwhelmed.
Modelling predicts that by 2024 there could be a 61% increase in the number of dementia cases, a 50% rise in heart failure while chronic kidney failure could be up 46%.
“We cannot continue to focus on acute care at the expense of prevention,” she said.
“We need to shift the focus where prevention of disease and ill-health is given equal consideration to the management of acute conditions.
“If we don’t our health and care services will become overwhelmed in the next 20 years. Impossibly difficult choices will need to be made – for example healthcare services may need to be rationed.
“We also have to change the narrative from ill-health being a burden to good health being an economic enabler. Quite simply, a healthy population is a productive population. We need to have a longer-term vision and not just focus on short-term ‘fixes’. If we don’t, we will face a crisis within the next 20 years. The hospital that we are building now will not cope.”
Data from the UK has estimated that investing in prevention can be three to four times more cost-effective than investing in treatment, with an extra year of good health costing an estimated £3,800 via means of prevention, compared to £13,500 via treatment.
Dr Brink’s six goals to help improve health outcomes are:
- Halve the smoking rates from a baseline of 9.1% in 2025 to achieve a smoke-free Bailiwick (defined as a smoking prevalence of 5% or less);
- Reduce alcohol consumption to less than 20% of people living in the Bailiwick consuming more than 14 units a week on a regular basis;
- Reduce the number of those aged 16 years and above living with obesity by one third;
- Help at least 4,000 islanders be more active;
- Help more children be physically and mentally healthy with a reduction in obesity;
- Help 5,000 people to reduce their risk of cardiovascular disease.
These goals, supported by the right policies, could supercharge change locally in the next five to 10 years, her report says.
“The case for prevention has never been stronger – we need to look further than the next year or two and take bold steps to shape the health and wellbeing of islanders in decades to come. Failing to do so will mean that we leave a larger burden of ill-health for future generations – this is neither fair, nor ethical.”
She backs implementing a Health in All Policies programme.
Compressing the rising number of people living with two or more long-term health conditions as they get older and maintaining the health of patients needs to be central to all government policies, her report argues.
This would reduce the portion of people’s lives they spend in ill-health, demands for public services and free up resources for other uses.
But it was unlikely to lead to a saving in the health and care budget. There will still be an increase, but this would be far lower than what would be needed if prevention was not prioritised.
“Decision makers need to be brave in investing in preventative measures that will not always produce an immediate return,” the report says.
“The benefits of prevention extend way beyond the utilisation of health and care services.
“These can include higher quality of life scores, a reduction in levels of depression or anxiety and a reduction in stress levels. Improving health and wellbeing will improve the health of our economy and our prosperity as a Bailiwick.
“This can reduce the indirect costs stemming from productivity loss and disability which further exacerbate the economic impact of poor health.”
The MoH report was released in tandem with the Guernsey and Alderney Wellbeing Survey.
This provides comparative data on self-rated health and caregiving; weight status; fruit and vegetable consumption; physical activity; alcohol consumption; smoking and vaping; cannabis use; and sun safety.