Achi news desk-
In a blog published today by independent think tank Reform Scotland as part of its NHS 2048 series – which looks at how to sustain the health service to its 100th birthday – Mr Johnston stressed that the NHS “cannot take all the responsibility” for health and well-being.
He added: “Tackling poverty affects health, as does the availability of good work, high-quality education and childcare, affordable housing, tackling climate change, and tackling racism.”
Life expectancy has started to fall in Scotland for the first time since the creation of the NHS, falling to 76.5 for men and 80.7 for women.
However, women living in the most deprived parts of Scotland tend to remain in good health until the age of 47 only and just under 45 for men, compared to 72 and 71 respectively for those in the wealthiest areas.
Mr Johnston, a lawyer and former director-general of the Scottish Government who was appointed chief executive of PHS in March 2023, said a “joint focus and solution” was needed.
He said: “People in Scotland are now dying younger than in any other country in western Europe. People are spending more of their lives in ill health.
“The gap in life expectancy between the poorest and the richest is growing. We have seen great progress in the past but, at the moment, Scotland’s health is getting worse.
“Further challenges also face us. The Scottish Burden of Disease Study predicts a 21% increase in disease by 2043, as our population continues to age.
“Two-thirds of this will be due to increased incidence of cancer, cardiovascular disease, and neurological conditions.
“All of these are a significant challenge to the long-term sustainability of the health and social care system.”
Mr Johnson called for a “joint focus on prevention” to “prevent problems from happening in the first place and help reduce demand on public services”.
He noted that a report in May 2023 by the Institute for Public Policy Research (IPPR) found that £2.3bn of health board budgets in Scotland “is directed towards responding to the effects of poverty”.
He added: “Obesity and overweight are estimated to cost the UK around £98 billion, with costs to the NHS of £19 billion.
“A joint focus on these two areas alone has the potential to contribute significantly to reducing the demand on our health system as well as having a positive social and economic impact.
“An increasing focus on prevention raises fundamental questions about how and where we invest already strained resources and capacity where they will have the greatest impact.
“There are new ideas emerging that, if adopted, could fundamentally change the way we deliver healthcare.”
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Mr Johnston’s contribution is the latest article from clinicians, service users and politicians for Reform Scotland’s NHS2048 programme, which explores how public sector reform can help restore the NHS to better health.
Chris Deerin, director of Reform Scotland, said: “This is a thoughtful and significant intervention by the Chief Executive of Public Health Scotland, who does not try to hide from the crisis we face in our national health and in our health service.
“His focus on the preventive agenda makes good sense in terms of population health and public spending, and his obvious admission that people in Scotland die younger than people in other countries in Western Europe, and that the gap in life expectancy between the poorest and the richest. is growing, a call to action for our political leaders.”
A Scottish Government spokesman said: “Economic austerity, the Covid pandemic and the cost crisis have all contributed to slowing progress in health outcomes over the past decade.
“However, we are using all the powers and resources available to us to tackle poverty, reduce inequality, increase healthy life expectancy – thereby creating a fairer Scotland.
“Our public health initiatives, such as the universal healthcare visitor pathway, the minimum unit price for alcohol, which has been shown by research to contribute to reducing alcohol-related health inequalities, and actions to create a smoke-free generation by raising the selling age tobacco is. which is supported by broad actions to reduce poverty and mitigate the impact of the increase in the cost of living.
“By increasing fair access to employment, education and training, and improving our physical and social environments we make people’s lives better.
“Research endorsed by internationally renowned public health experts estimates that our world-leading Minimum Unit Pricing (MUP) policy has saved hundreds of lives, likely avoiding hundreds of alcohol-attributable hospital admissions and has contributed to reducing health inequalities.”
