RSPH welcomes the publication of the highly anticipated Green Paper on the prevention of ill-health. The document sets out the Government’s plans on a range of prevention priorities, including obesity, smoking, and mental health, as well as its vision of health as ‘an asset to invest in throughout our lives, and not just a problem to fix when it goes wrong.’ RSPH welcomes this commitment to health promotion throughout the life course, and is looking forward to working with the Government to achieve its ambitious goals. 

Among these are plans to develop and launch a new Composite Health Index, as recommended by the Chief Medical Officer for England in last year’s annual report. This will provide a tracker for the nation’s wellbeing, to be taken into consideration alongside national GDP and used to evaluate the impact of wider government policies. 

Other headline announcements include an ambition to end smoking by 2030 – with a mandatory levy on industry as one option for funding this goal – and a commitment to end the sale of energy drinks to children under 16s. Other plans related to diet and obesity include: 

• An option to extend the sugar levy to sugary milk drinks, if industry does not make enough progress on reducing sugar content; 
• A plan to deliver Chapter 3 of the Childhood obesity plan, as well as pushing ahead with consultations from Chapter 2 of the plan on price promotions and the 9pm junk food advertising watershed; 
• A consultation on how to improve our nutritional labelling scheme once we have left the EU;
• Reducing salt intake to 7g per day.     

RSPH commends the Government’s bold targets for obesity and smoking, which remain two of the largest sources of health inequalities in the UK. Wider plans set out within the Green Paper include:

• Publication of clear national guidance on the daily recommended hours of sleep;
• The launch of a mental health prevention package, including the national launch of Every Mind Matters;
• Improving child oral health, with a new school tooth-brushing scheme, and support for water fluoridation;
• Embedding genomics in routine healthcare and making the UK the home of the genomic revolution;
• Working with industry to deliver increased availability of alcohol-free and low-alcohol products by 2025;
• A new contractual framework for Community Pharmacy, aiming at providing a wider range of health advice and support roles for community pharmacists. 

RSPH will be submitting evidence to the consultation on the Green Paper, which runs until 14th October 2019, congratulating the Government on their approach while also urging them to consider further measures where necessary. These will include: 

• The roll-out of minimum unit pricing for alcohol to the rest of the UK;
• The extension of the sugar levy on soft drinks manufacturers to other products high in sugar;
• The use of effective drugs harm reduction interventions and a public health approach to drugs policy more generally;
• A mandatory targets-based framework for salt targets, to support the 7g per day target;
• The reversal of public health funding cuts. 

Shirley Cramer CBE, Chief Executive of RSPH, said: “When the Secretary of State Matt Hancock took office last year he made prevention one of his key priorities, and we commend the Government on sticking to this principle in publishing this forward-thinking and much needed Green Paper. 

“For many years we have been arguing that a prevention approach to ill-health will only be successful with backing from all government departments, not just Health; so we’re pleased that the new proposals have now been published as part of a ‘government-wide’ document, and hope that this is reflective of an approach to prevention that is now truly cross-sector. We urge the new government to take forward the spirit and content of this vital agenda as a matter of urgency. 

 “We are especially pleased to see plans to enforce an ultimatum for the tobacco industry to deliver a smoke-free nation by 2030. This is an ambition of admirable scale, and will require strong leadership from Government in demanding a ‘polluter pays’ levy from industry – as alluded to in the Green Paper. This funding should be used to ensure the vital but dwindling stop smoking services are available for all who need.

“At the same time we are wary that public health teams in councils nationwide have had their budgets slashed year on year by central government. Local authority workers have proven time and again that they can deliver excellent frontline prevention services, but the persistent cuts to their budget need reversing urgently if they are to continue to do so. We urge the Government to address this at the forthcoming Spending Review.”