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kurzer deutscher Kommentar
Improving the Public Health of England
A new white paper from the government calls for a nationwide smoking ban in pubs and restaurants, heavier restrictions on junk food advertising to children, and a personalized health guide for every resident.
A cigar smolders in an ashtray in a London pub. Britain unveiled tough plans Tuesday to ban smoking in all workplaces and restaurants, as well as most pubs and bars, as part of a major push to improve the health of the
nation.
Excerpted from the Executive Summary of Choosing Health: Making Health Choices Easier
Department of Health, National Health Service
England has a proud history of improving the health of its people. Over the past three centuries, the combined impact of individuals, families, communities, national and local government, education, business and industry, and voluntary, faith and charitable bodies has seen unthought of progress in the health of the people of England.
Some of that progress has been driven by wider social, economic, environmental and cultural trends as England benefited from economic growth, improving education, better housing and better sanitation. In the twentieth century health services also began to make a significant impact, gathering pace after 1948 as the establishment of the NHS enabled free universal provision of immunisation, screening and treatment to make inroads into ill health and premature death.
The role of Government in the prevention of ill health during this time was often a top-down approach, reflecting the cultural and political relationships of the times. In the post-war era of deference in a homogenous society, 'Public Health' was often seen as something that was done to the population, for their own good, by impersonal and distant forces in Whitehall and the public bodies and professionals that it directed, with varying degrees of success.
As rapid progress was made on the big killer infectious diseases of the past, more intractable issues and conditions such as cancer and coronary heart disease came to the fore. The absence of obvious simple, quick solutions to these diseases and the increasing preoccupation of the NHS in coping with rising demand for treatment, meant that too often public health was diverted into better analyses of the problems they were witnessing rather than practical solutions. With widening health inequalities, a sharp rise in obesity, a slowing in the decline of smoking rates, growing problems with alcohol, teenage pregnancy and sexually transmitted diseases, old ways of thinking about and responding to public health problems were increasingly being shown to be inadequate.
While there were many notable successful public efforts, such as the response to HIV and AIDS, too often work to tackle longstanding, intractable or emerging problems was increasingly caught up in a sterile national debate, disconnected from the real lives of the public, that created a false dichotomy between those proposing a heavy handed nanny state on one hand, and those supporting inactivity bordering on neglect in the name of individual freedom on the other.
At the same time, new opportunities have been opening up rapidly. The public is now used to consuming a range of goods and services and enjoy the choices available to them. However, they look to Government to assist them with information about healthy and unhealthy choices. Not to make the decisions for them, but to provide them with clear information. Information technology and the Internet have transformed the way in which we can communicate information. At the same time, the NHS is freeing itself from a decades-old crisis focused on waiting for treatment, which is creating the time, space and resources needed for effective action on prevention. Now action to improve health and to provide the practical support to achieve this is needed urgently...
Overarching Priorities
• Reducing the numbers of people who smoke, because it leads to heart disease, strokes, cancer and many other fatal diseases; because many people felt this was an area in which they needed more support in addressing the problem; because many people were concerned about the effects of secondhand smoke; and because many parents were concerned about their children taking up smoking.
• Reducing obesity and improving diet and nutrition, because the rapid increase in child and adult obesity over the past decade is storing up very serious health problems for the future if it is not addressed effectively now. Effective action on diet and exercise now will help to tackle heart disease, cancer, diabetes, stroke, high blood pressure, high cholesterol and a range of factors critical to our health.
• Increasing exercise, because it reduces the risk of major chronic diseases and premature death. Over a third of people are not active enough to benefit their health, and rates of walking and cycling have fallen over the last 25 years.
Encouraging and supporting sensible drinking, because alcohol misuse is associated with deaths from stroke, cancer, liver disease, injury and suicide; because it places a burden on the NHS, particularly on Accident and Emergency departments; and because it is related to absenteeism, domestic violence and violent crime.
• Improving sexual health, because risktaking sexual behaviour is increasing across the population; because diagnoses of HIV, Chlamydia, genital warts and Syphilis have increased in recent years; because sexually transmitted infections can lead to cancer, infertility and death; and because delay in diagnoses and treatment can lead to more people being
infected.
• Improving mental health, because mental wellbeing is crucial to good physical health and making healthy choices; because stress is the commonest reported cause of sickness absence and a major cause of incapacity; and because mental ill health can lead to suicide...
Just as sustained investment and reform is transforming England's NHS, the new approach to public health set out in Choosing Health will, through sustained investment and fresh thinking, backed by the public, deliver sustained improvement to the health of the people of England. It will do so by responding to people's concerns about their health with practical support on their own terms and by providing the context and environment needed to make real progress. This white paper sets out some very significant changes -- on smoking in public places, on advertising to children and on Health Trainers. But it also sets out a large number of other measures which together will have a significant combined effect. The opportunities are now opening up rapidly for everyone to make their own individual informed healthy choices which together will sustain and drive further the improvement in the health of the people of England.
Full text
White Paper
BBC
News: re alcohol /White Paper,
BBC News: 2 reactions / White Paper
The Guardian: Britain's big issue
Comment:
It is very clear that alcohol has not a high priority in this plan. The Portman Group is the only stakeholder mentioned for cooperation. Highest priority has the selfdetermination, everybody has the choice and responsibility if and how to become healthier. Regarding to alcohol this is not a promissing way. There is again the call for sensible drinking. Much importance is given to increasing exercise, walking and cycling. Perhaps at least this will result in less alcohol problems.
Das Weissbuch der britischen Regierung zur öffentlichen Gesundheit
Kommentar htm
Das Schwergewicht liegt bei der persönlichen Wahl und Verantwortung, wie jedermann seine Gesundheit verbessern will. Die Bedürfnisse der Menschen seien berücksichtigt worden. In Bezug auf Alkohol entsteht allerdings der Eindruck, dass mehr die Interessen der Alkoholindustrie, vertreten durch die Portman Group beachtet wurden. Die Zusammenarbeit mit dieser Interessengruppe wird ausdrücklich erwähnt. Dazu soll die Ärzteschaft die Früherkennung von Alkoholschäden verbessern, das Rauschtrinken bekämpft und die Werbung, die auf Jugendliche und Kinder zielt, beschränkt werden. Grosses Gewicht wird auf die Förderung der körperlichen Bewegung, des Sports (Wandern und Radfahren) gelegt. Vielleicht bringt das ja auch eine Verbesserung im Alkoholsektor.
