Well Being in Wales

Our message on doing more to prevent ill health continues to gather pace. Today, I am pleased to bring to your attention a development that will develop further our approach to improving health and to reducing inequalities in health.

Members should be familiar with Better Health Better Wales, which did much to highlight the importance of addressing the social, economic and environmental factors that affect people’s health. It helped many organisations, particularly local authorities, to develop their role in improving health.

In implementing Better Health Better Wales, we have made good progress on building health into other policies and programmes. For example, health is part of Communities First and Objective 1. Our Network of Healthy Schools Scheme harnesses the potential of schools while health is also reflected in our National Housing Strategy, in our National Economic Development strategy, and in the Children and Young People’s Framework. But we need to do more.

In our plan for the NHS, I made a commitment to produce a follow up to Better Health Better Wales to reinforce our integrated approach. The Townsend report Targeting Poor Health, which has been adopted by the Assembly, endorses this integrated approach. It recommends action to tackle inequalities in access to health care services, which is the particular role of the NHS. It also includes action to tackle the underlying socio-economic determinants of poor health, which is the role of all the Assembly Government’s policy areas working in partnership with local government and other organisations.

The impact of poor health

Over and above the demand on health and social care services, ill health has a huge impact on individuals and their families. It affects people’s ability to work, their income, quality of life and the ability to look after themselves and others. Ill health has substantial economic impacts through lost production and lost skills. Work-related ill health costs employers in Wales around £500 million annually.

Not all ill health can be avoided, but some can be or at least its impact reduced, particularly the damage caused by accidents and injuries, and the outcome of the risks that people take with their health e.g. smoking, alcohol and drug abuse.

Inequalities in health

Inequalities in health are the result of several complex and interrelated factors, including social and economic factors, the services available to people and the opportunities they have. Action is essential, particularly important for children, as health in childhood is a predictor of health in later life.

We are proactive in tackling the health inequalities that exist between communities. For example, our Inequalities in Health Fund has been successful in its aim of stimulating new local action and now has 67 projects operating in deprived communities throughout Wales - far more than the original target of 20-30 projects.

Disadvantage and deprivation affects people’s health and well being, which affects education and economic prospects, which in turn affects health and well being. We have to break the cycle. Ill health is a barrier to economic prosperity, for individuals and for the country as a whole.

Who’s responsible?

Health is not the responsibility of the NHS alone. Responsibility is shared between the Assembly, health services, all arms of local government, community and voluntary organisations, employers, and individuals.

The Assembly and organisations throughout Wales are responsible for providing opportunities and services, and for creating the conditions to help people to look after their health and, where possible, to improve it.

Individuals have responsibility for their own health and their children’s health, and we need to find ways to encourage this. We recognise that it is more difficult for some people to try and improve their health because of their circumstances, which is why our approach also includes action to address the wider determinants of health.

Good health is sometimes taken for granted. The reasons vary but the fact that the effects of some diseases build up during people’s lives leads some people to ignore the risks or to set them aside. Heart disease, for example, leads to a gradual decline in health and quality of life over a long period.

Action

The improvements I am putting in place for the NHS will improve further the quality and the effectiveness of health care, and will ensure fairer and better access to hospital services. For Local Health Boards, action to prevent ill health will sit alongside effective and efficient health services as an equal priority.

Complex problems require integrated solutions that extend beyond the NHS. Many factors that contribute to health inequalities are inherent in problems being addressed by other policy areas. It is not only about what other policy areas can do for people’s health, but also what health can do towards the objectives of other policy areas.

‘Well Being in Wales’ will reinforce our integrated approach. Well being depends on people’s health, safety, and security, the services and opportunities available to them and the care and support they can access. It also encompasses people’s interests and the way they fell about themselves – their confidence and self-esteem, which are prime requirements for learning and employment.  

The idea of well being is a strong test of the extent to which policies and programmes come together to make a difference to people’s lives. Well Being in Wales will make more explicit the connections between health and well being in all policy areas. It will set out proposals for action across all policy areas and in doing so, will contribute to the implementation of the Townsend report.

Underpinning our approach is a commitment to a long-term view and to investment in public services that support people, prevent problems and create opportunities. Also, a commitment to fairness so all people can access the services and opportunities they need for a successful and healthy life.

‘Well Being in Wales’ will be published in September for consultation. Responses will be made available for scrutiny. The Health and Social Services Committee will discuss the document during the consultation period and I urge other Committees to do the same. A plenary debate on our approach is planned for December.

I am sure that the Assembly will welcome this development as another step forward in our integrated approach to policies and programmes.