Alison Barrett writes:
In the run up to today’s United Kingdom election, health experts have sounded the alarm on a raft of critical public health challenges that need addressing, regardless of who forms government.
Health inequalities, poverty, climate change and women’s health are just some of the concerns that have been raised in a selection of articles – reported on in more detail below – in the BMJ and The Conversation in the lead up to the election.
It is predicted that, following 14 years in power, the British Conservative Party currently led by Rishi Sunak will lose the leadership to the Labour Party headed by Keir Starmer.
Significant leadership changes are also expected in France with the far-right National Rally party leading the polls in the first round of the legislative elections last weekend. The second round of the elections will take place on 7 July.
Concerns have been raised that, aside from its overtly xenophobic politics, efforts to improve social welfare in France will be “significantly diluted” if the far-right National Rally obtains power.
Fraying health status
As with many other countries across the globe, the cost-of-living crisis is a major concern in the UK, and pre-election surveys have signalled that health and the economy are at the top of voters’ minds (here and here).
Dr Lesley Russell wrote in the latest edition of The Health Wrap that, with the UK’s “national health status fraying”, it is critical that the new government must “spend more on health and social welfare”.
Austerity policies under the Conservative-led government has led to declining quality of care in the National Health Service, according to a new study.
Russell also points to a study led by Sir Michael Marmot that found that in the decade from 2011, “more than one million people in England died prematurely due to a combination of poverty, austerity and COVID-19”.
A Health Foundation think tank has found that the next government needs to increase healthcare funding by 4.5 percent per year over the next five years to meet rising healthcare needs and improve services.
Below is an overview of some of the key health priorities for the new government, as raised in the BMJ and The Conversation.
Social determinants of health
According to Lucinda Hiam, PhD candidate at the University of Oxford and a GP, worsening health in the UK and the social determinants of health including housing, education and poverty, have not been prominent in the headlines.
Nor have the major parties acknowledged the need to tackle hardships or the role of austerity “in the dire state of health” in the UK now, Hiam writes in the BMJ.
While ample evidence exists of the urgent need for action on the social determinants and recommendations to address have been available for some time, the “situation is considerably worse” now than it was 14 years ago – when the Conservative/Liberal Democrat coalition government came to power, she writes.
Hiam calls on the new government to acknowledge the problems of poverty, poor housing and nutrition, listen to the evidence – “and, crucially, to act”.
Climate change
With climate change largely invisible during the election campaign, Greenpeace has been running a campaign asking people to push candidates on climate action.
Climate debate in the campaign has predominantly focused on commitments – or lack thereof – to net zero and not so much on adaptation, according to Professor Chris Brierley at London’s Global University and PhD candidate Hannah Woodward at University of London.
They write in The Conversation that the “UK is failing to adapt to the changing climate”.
Brierley and Woodward created a series of maps where people can look up how the climate has changed, and how it will continue to change, in their local constituency, with the suggestion that if people are aware of their local climate changes, they can ask candidates necessary questions in future elections.
Pandemic preparedness
COVID-19 has been on the election agenda, but predominantly in the context of blame for the current state of the economy or in reference to trust in politicians, according to Professor Kent Buse at The George Institute for Global Health and Professor Martin McKee at the London School of Hygiene and Tropical Medicine in the BMJ.
Little has been said about preventing future ones pandemics, which is significant given the “enormous damage” from COVID-19.
“In these circumstances, the virtual absence of any ideas from the various manifestos seems surprising, especially given other issues that the parties have chosen to emphasise, such as the number of potholes they hope to fill,” Buse and McKee write.
“The first duty of a government is to protect the lives of its citizens”.
Buse and McKee recommend a health in all policies approach and co-ordinated actions across and between governments as effective responses for pandemic preparedness and antimicrobial resistance.
Obesity epidemic
The political parties running for government “seem sanguine about the costs – human and financial – of the growing obesity crisis” in the UK. Health-related pledges remain “almost exclusively” focused on fixing the NHS, according to Buse and McKee in another article in the BMJ.
“While the NHS certainly needs fixing, it will always struggle if the population becomes steadily less healthy,” they write.
They note that some of the parties’ manifestos include commitments to banning the advertising of junk food to children, improving food labelling or providing free school meals for children experiencing poverty.
However, Buse and McKee say that while they indicate an intended direction, “manifestos are an unreliable prediction of what political parties will, or even can do once in power”.
Women’s health
The parties’ manifestos covered two women’s health issues well – childcare and supporting women return to work after pregnancy and tackling violence against women and girls – according to Dr Kate Womersley, Professor Jane E. Hirst and Dr Edward Mullins at the George Institute of Global Health, Imperial College London.
However, other issues of concern did not feature as well, “showing that there is a real risk that women’s health in the UK could fall off the political radar”, they write in the BMJ.
Given the “dearth of women’s voices in economic and policy arenas”, this is perhaps not surprising – only 30 percent of 2024 parliamentary candidates are women.
Womersley, Hirst and Mullins say that there is a risk that important work under the Women’s Health Strategy may be “diluted or undone” by a new Labour government.
“In women’s healthcare, things can’t only get better, there is a risk that they might get even worse.”
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See Croakey’s archive of articles on global health.
