It’s widely accepted among independent public health experts, including the former chief medical officer Dame Sally Davies, that Britain’s health is going backwards relative to many other countries. This is true on so many indicators – obesity rates, cancer survival rates, healthy life expectancy and child malnutrition. While the modern history of public health is one of progress, the past 14 years in the UK, in which the Conservatives have been in power, have seen population health stagnate and even decline. Here are three priorities that would improve life for all.
1 Reduce childhood obesity
In 2023, NHS England released data showing that 36.6% of children aged 10-11 were overweight, including 22.7% who were obese. Children living in the most deprived areas of the country were more than twice as likely to be obese than those living in rich areas. For this reason, child obesity has been seen as a health marker of poverty. While recognised as a problem by the government, ministers have postponed concrete action to improve the situation until at least October 2025. So this is what must be done: expand and improve free school meals to include less ultra-processed food and more fruits and vegetables; provide subsidies for healthier options such as fruit, vegetables and grains; and regulate the sale of ultra-processed foods including misleading health claims on packages, advertising to children and multibuy promotions.
2 Invest in physical activity
The UK is facing a rising burden of mental and physical health issues such as depression, type 2 diabetes, heart disease and dementia. Clear evidence exists on how regular exercise and movement reduce the risk of all of these conditions, across the lifespan from children to older people. The government can help facilitate physical activity through investing in places such as swimming pools, gyms, football and basketball pitches, playgrounds, indoor soft plays and green spaces, which also become social and community spaces. Recent years have seen these types of facilities privatised or shuttered, with the consequence that exercise becomes a luxury good instead of a basic right as a citizen. A new government could reverse this trend by making a commitment to improving community activity centres with local authorities.
3 Improve NHS morale
The NHS is at breaking point – or already broken, depending on your definition of a functional health service. The core issues are spoken about as if the staff are the enemy and the cause of those problems, instead of the lifeblood of the system. For example, Rishi Sunak blames striking staff for the long waiting lists, instead of recognising their concerns about patient safety. Others have used the same blame language to talk about immigrants taking up places. In truth, it’s immigrants, and their children, who do huge amounts of care work within the NHS. The consequence of not having access to care is a growing economically inactive population. An unhealthy workforce means an unhealthy economy. A new government can take a fresh look at this challenge by engaging senior medical leaders, junior doctors, nurses and support staff as equal partners, finding solutions rather than demonising them.
All of this will require a much better stewardship of public health finances than the British public have become used to. For example, the New York Times analysed 1,200 contracts worth nearly $22bn during the Covid-19 pandemic and found that about half went to companies run by friends and associates of Conservative party politicians, or with no experience in that area. Rachel Reeves, the shadow chancellor, has announced that Labour would appoint a new Covid corruption commissioner to track the billions of pounds lost and return as much of it as possible to government. It’s fair that when this money is recouped, it’s put transparently and directly into the nation’s health to make up for Tory mismanagement.
Prof Devi Sridhar is chair of global public health at the University of Edinburgh
• The alternative manifesto: Securing the future of the NHS
On Tuesday 27 February, 8pm-9.15pm GMT, join Denis Campbell, Narda Ahmed, Siva Anandaciva, Greg Fell and Dr Trudi Seneviratne as they discuss what an alternative manifesto for health and social care could look like. Book tickets here or at theguardian.live
