Dr Tony Jewell issued the warning as he published his third annual report on the state of health in Wales.
Dr Jewell writes about ‘preventing the preventable’ in his 2008 report. The report looks at different methods of prevention to ensure the long-term health of the nation, including immunisation, screening and education.
He said that more emphasis needed to be placed on preventing ill-health in the first place.
Dr Jewell said:
“With the increase of chronic conditions in an ageing society in Wales, money would be better spent on trying to promote health and prevent people getting chronically ill in the first place rather than being forced to spend increasing amounts on treatment.
“A broad estimate suggests that around £94 per Welsh citizen is spent per year on prevention activities – that’s only around five per cent of the Welsh health budget – while the cost of smoking alone to the NHS is £127 per citizen a year.
“We need to educate and empower people to make healthy lifestyle choices. It is as much the responsibility of society as a whole to help improve people’s health as it is that of the NHS. We need to make healthy choices the easy choices.
“There needs, however, to be more of a focus in primary care to determine risk factors in patients. We need to move to a model of ‘anticipatory care’, and be as interested in those patients who may not be attending check-ups as we are in those that do.
“Spending more now on health prevention, including health promotion marketing campaigns, will pay both health and financial dividends for future generations. We often say that prevention is better than cure and that is why we need to invest sufficiently in preventing the preventable.”
Dr Jewell says that overall health in Wales is continuing to improve but continued action is still needed to address issues like obesity, binge-drinking and smoking.
“I remain concerned about the longer term impact of our unhealthy lifestyles in respect of the food we eat, what we drink and the relatively low rates of physical activity in all age groups.”
Other recommendations in the report include:
- Addressing health inequalities – the financial crisis that developed in 2008 is an ongoing threat to the health of the people of Wales. The combined pressures of historical and long-lasting deprivation together with the contemporary onset of financial uncertainty present significant challenges for health, not just now, but in the years to come.
- Using familiar clinical points of contact for advice and treatment. Health advice offered during a visit to a GP – for example on safe alcohol consumption – is more likely to be adopted than advice provided outside of a clinical setting.
- Thinking globally, acting locally – across the world there are many challenges such as climate change and poverty and many solutions being offered on how to improve and protect people’s health. Wales needs to learn from these and also work in partnership with other countries to offer solutions.
Dr Jewell also points out some successes of the past year, including:
- The effect of the smoking ban. Research commissioned by the Welsh Assembly Government shows clear evidence of a reduced exposure to environmental tobacco smoke, particularly in pubs, clubs, bars and at work, meaning the legislation has achieved its main objective to reduce environmental tobacco smoke. Also encouraging is that the studies found no evidence of any shift of smoking to the home, or of increased exposure to children. Hospital admissions for heart attacks were reduced in 2008* and although this decline cannot be wholly attributed to the smoking ban, some studies suggest that at least some of the reduction is due to the legislation.
- Reducing the number of children under 14 years old who are knocked down and injured in car accidents. Our continued progress means the target for 2012 of 392, a 35 per cent reduction from 2002, has already been achieved.
- Reducing the number of deaths from stroke in 65 to 74 year olds. Wales continues to surpass the target set for 2012 of 135 per 100,000 with a current rate of 122 deaths per 100,000.
- Reducing the death rate from suicides at all ages. Current progress has seen Wales pass the target to reduce the rate by at least 10 per cent by 2012.
Health Minister Edwina Hart said:
“I welcome the Chief Medical Officer’s report.
“The restructuring of the NHS in Wales was designed to shift the balance of care from hospitals to primary and community based settings, and I welcome the recommendation that more focus should be placed on preventative measures.
“The new integrated health boards have a stronger grounding in primary care and public health, which is designed to change the way healthcare is delivered over time.”
*In 2006/07, the number of hospital admissions for heart attacks was 4,324. In 2007/08, the number of hospital admissions for heart attacks was 4,164, a drop of 3.7 per cent. Source: Hospital Admissions Data On-line, Health Solutions Wales website.
9 December 2009