David Newell, Gemserv’s Head of Health, looks beyond the pandemic to ask what our response to the coronavirus tells us about wider public health issues.
NEW Year’s Day dawned with a renewed sense of hope – the Pfizer vaccine was being rolled out and the Oxford jab had just been approved. Yet, within days, fresh lockdowns had been imposed; suddenly the weeks ahead felt darker, and not just due to the lack of daylight.
There’s a clear sense this lockdown is proving harder to deal with and many us will be struggling to look forward right now, yet that is exactly what we all must do. We need to learn the lessons from the earlier lockdowns and from tackling the pandemic and pass on that wisdom for the sake of our children and their children.
What lessons can we learn?
There are some obvious lessons that our health services have learned in a short space of time. The rate of adoption of technology to address the pandemic has shown practitioners can move faster than was ever thought possible.
This momentum must be maintained. Online appointments, remote monitoring, and accessing services at a distance must all become part and parcel of the NHS’s powerful toolkit.
But there are deeper lessons we must learn too. I remember an early All-Party Parliamentary Group (APPG) for Longevity session during which the discussion focused on the relative value of investment in prevention rather than treatment.
Little did anyone realise that, within 18 months, that point would be proven beyond any doubt. The pandemic has cost taxpayers tens of billions of pounds – and the final bill will run into hundreds of billions.
Without question, we were not prepared for a pandemic and both the health and economic impact is all too clear.
What about the longer term?
I recently had cause to look at the national longevity strategy and, on page 28 there are two heat maps of England displaying longevity by gender. I instinctively recognised the pattern across England; if you overlay the Covid-19 mortality rate heat map from the first wave of the pandemic then the correlation is stark – they line up exactly.
Earlier this month, I also had the privilege of taking part in a professional development session at which Duncan Selbie, the founding chief executive of Public Health England, was the key speaker. He reminded us that, when looking at the prospects for a healthy life, 50% rests on your economic start – your basic wealth.
The 20-year life expectancy gap between my home in Guildford and parts of North-West England simply cannot be ignored.
Our reaction to the pandemic has been to spend at unprecedented levels on treatment, personal protective equipment, and vaccines – and of course none of this can be avoided. This has also become a downward spiral – the economic impact will have an inevitable health impact for years to come.
But we must now change our thinking about investment and the correlation between the wealth and the health of the nation. You cannot sperate the health of the nation from the wealth of the nation.
Where should we look?
The current narrative is about levelling up and accelerating the “Northern Powerhouse”. I believe this approach is fundamentally flawed.
Why? Because it should be about maximisation the opportunities for economic growth as a nation and using that to drive significant investment in public health. In doing so we can I believe create a virtuous cycle – the opposite of what we have now.
We need a two-pronged approach; we need an economic strategy that grabs the green revolution opportunity at a national level but recognises the need to tailor investment to local needs. Relocating public agencies to Northern England and hoping business will follow is too simplistic to address complex, economic, social, and health issues.
Instead, we need to look at the success of Wigan, which has been held up as an example of good practice by the APPG for its longevity work and build on it. The so-called Wigan Deal has seen citizen-led services delivering improvements in healthy life expectancy which exceed most of its geographical neighbours who faced similar levels of challenge.
During the pandemic, a political choice was made to transform Public Health England, focusing its future on pandemic response. This is absolutely flawed. If we need a pandemic response organisation, then this cannot be done at the cost of long-term public health.
The real value of public health will be achieved when it has the ability to sit outside the Department of Health & Social Care and NHS to drive long-term shifts in policy and funding. Gemserv is supporting the implementation of this model on the Isle of Man, following Sir Jonathan Michael’s review.
While the success of our pandemic response can be measured within weeks, we will measure the long-term success of our economic and public health strategies over generations. Whilst Gemserv are in a unique position to contribute to this journey, I believe we can all influence the direction we take post pandemic – let’s make the world beyond it a better one for all.