At the recent comprehensive spending review, Rishi Sunak reiterated the Government’s commitment to levelling up. He was right to do so. Spreading opportunity more fairly beyond London and the South East was at the heart of our manifesto, and is now rightly at the heart of our economic policy.
Important research published recently by the Institute for Public Policy (IPPR) demonstrates that health is a key ingredient in delivering on that vision through this parliament.
Rather than think of Covid as a distraction from delivering this promise, we should take it as a catalyst for redoubling our commitment to regeneration and making sure “building back better” means boosting our health as well as our economic resilience.
The pandemic has shone a stark light on how inextricably linked our health and prosperity are. 2020 has not just shown the cost of disease, and the value of health to our economy. It has shown how poor public health exacerbates disease risk. Our complacent neglect of public health in recent decades – with soaring rates of obesity and associated cardiovascular disease, type 2 diabetes and respiratory illness – have made the Covid death toll and economic destruction so much worse than it could have been.
Covid has also shown why our life science sector is so valuable to ‘UK plc’. Not just as a major source of investment in new businesses and jobs, but also in providing the mass diagnostics and now vaccine that is the only real way out of this pandemic.
After coming to Parliament in 2010 from a career in the life science sector and as the first British Minister for Life Science and the UK Life Science strategy, I oversaw the Accelerated Access reform of MHRA and NICE processes, the launch of Genomics UK and NHS digital, and investment in UK vaccines and pharmaceutical manufacturing. These have paid dividends this year, and it is great to see the life science sector getting the public recognition it deserves.
Because the link between health and wealth is about more than just physical infrastructure. As it stands, someone in the North of England can expect to die two years younger than someone living in the rest of England – just on the basis of their postcode. IPPR’s research shows that closing this gap could put £20 billion into the economy alone.
This shouldn’t come as a surprise. Good health is vital in enabling people to reach their potential: to do productive jobs, for longer. Those with poor health are more likely to be unemployed, to take time off work, or suffer from presenteeism.
For me, this is exactly the kind of thing the Prime Minister had in mind when in our manifesto he said: “Talent… (is) uniformly distributed across our country. Opportunity is not. Now is the time to close that gap – not just because it makes economic sense, but for the sake of simple social justice”. Health is the vehicle through which opportunity can be spread.
The question is, how do we put health at the heart of our national mission to drive national economic regeneration and levelling-up in the years to come? I think there are three key steps.
First, we need to get preventative community health and care funding to the places that need it. Health need is higher in some places than other’s in the UK – and public health and NHS and social Care services should have the resources they need to proactively meet that need. This principle is established in schooling through the ‘pupil premium’ – which targets resource towards lower income students – we now need a ‘patient premium’ for health.
Second, we need to invest in a life science and health innovation economy, that plays to our strengths: generating both the prosperity and health treatments we need. Many regions have amazing potential in health research – Liverpool on infectious disease, Manchester on data, my own county of Norfolk on nutraceuticals. Let’s capitalise that by channelling investment into these sectors, in those places across the countries that need skilled jobs and vibrant economies the most.
Thirdly and perhaps most crucially, we need to stop treating health as an “add-on” to our economy and embed health in our national economic modelling and public accounts. The Treasury should put a value on British health and a cost on disease and our lack of health resilience. As a good company invests in its employees’ health, so UK plc should make the health of our children, workforce, and population a fundamental policy objective across the whole of Whitehall.
For too long we have mistaken health for the National Health Service. That means we have relegated public health to PR campaigns and health economics to requiring NICE to focus on absurd questions like “which is more valuable: a plaster or a syringe?”. This zero-sum game means we are missing out of benefits – many of which could be cost effective.
We cannot afford that any longer. Pandemics are not the only health disruptions we’ll face in the future – and without public health we’ll be in a worse position to meet them.
For one, we are an ageing society emerging from Covid, confronting the perfect storm of obesity, diabetes, dementia, and an epidemic of cardio-respiratory disease in our most economically vulnerable communities. We need to make public health a national crusade.
Covid-19 has been a tragedy for many families and communities in this country. But, we can, and must, take strength from this experience. It really is time to ‘build back better’.
If health was the cause of this economic crisis we now face, it can now be at the heart of the solution. Improving health for everyone – but especially in those places where it is needed most – must be at the heart of the government’s levelling up agenda.