England's Chief Medical Officer (CMO), Professor Sir Chris Whitty called for a more intensive focus on preventing ill health in the most socially deprived areas of the country.
Giving evidence to the Commons Health and Social Care Committee, Sir Chris identified obesity, smoking, and air pollution as key areas for action and that "these preventable things can all be turned around if there is the will to do so".
Areas of the country with "deeply entrenched health deprivation" could be seen as "red flashing areas on the maps" and deserved the "greater amount of effort" to reduce persistent ill health and early mortality, he told MPs.
Prof Whitty told MPs: "My job is to try and see if we can improve it, and I think what is really clear is, we can." He singled out obesity in the population as a factor "going in the wrong direction" and as "a very major cause of multiple diseases", it should be "a very significant one to aim for". Asked about junk food advertising, Sir Chris said that "if advertising didn't make an effect on people's behaviours, then people wouldn't pay the very large sums they do for it", adding that there was "generally consensus about the fact we need to do something about it".
Sir Chris said that while his role was to "make the case that public health is important", it was up to Government ministers to make choices on primary prevention. "If Parliament chooses to enact some of the things it could do, we could improve things like air pollution, reduce things like smoking, and reduce the risks of obesity in the most vulnerable", he said.
An "extraordinary improvement in air pollution over the last 30 to 40 years" was likely to continue, particularly with the growth in electric vehicles, but "what we have not done so effectively, in my view, is tackle indoor air pollution", according to Sir Chris. The CMO, who dedicated his third annual report in December 2022 to air quality, conceded that improving indoor ventilation, which was "good for reducing infection" was frequently at odds with our need "to retain heat", to "reduce our carbon footprint", and "reduce people's bills", although this was a "manageable engineering challenge".
While primary prevention remained largely an issue of political choices, secondary prevention was "mainly around the distribution of resources in the NHS", Sir Chris told the Committee. He emphasised the need for "making the case, politically" that "putting more resource into that secondary prevention in the NHS would be a good investment for the future, because it would help to slow down the speed of the hamster wheel, which otherwise goes ever faster".
Vaping Among Young People
Addressing some specific issues, Sir Chris said more needed to be done to reduce the appeal of vaping among children. "Rates of vaping have doubled in the last couple of years among children", which was "an appalling situation". Whilst vaping had "an important role as a public health tool to help smokers who are addicted", he questioned whether it was "reasonable to have, in any case, flavours and colours that are clearly aimed at essentially encouraging people to vape who may well not be vaping at all". The sale of disposable vapes needed to be examined, since these were "clearly the kinds of products which look as if they're being marketed, in reality, at children".
In response to concerns raised by Committee members about the growing appeal of nitrous oxide, Sir Chris promised a review of evidence on its health implications. Paulette Hamilton (Lab, Birmingham Erdington) cited possible links between inhaling nitrous oxide and early onset multiple sclerosis, and complained of a lack of available health guidance, whilst Committee chair Steve Brine (Con, Winchester and Chandler's Ford) "constantly" found the gas cannisters while out litter picking in his constituency. Sir Chris said he would "guarantee that we will provide a paper on that, and if the data is clear enough, we will say something reasonably clear about it".
Tuesday's session was the first oral evidence to the Commons Health and Social Care Committee in its inquiry into prevention in health and social care in England.