Preventive model of health care needed, says King's Fund
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《英国医生杂志》
UK government health policy will have little impact unless it includes practical measures to build a health system that promotes health rather than just caring for people when they become ill.
That is the warning from the independent charity the King's Fund, in a discussion paper by Anna Coote marking the launch of the fund's new Putting Health First programme.
Rather than ignore the NHS, the government should design and build a health system that promotes health and reduces health inequalities, it says.
The paper highlights rises in the prevalence of obesity, which it says has trebled in the past nine years. It also noted large increases in other preventable diseases, such as diabetes, alcohol misuse, and sexually transmitted diseases, as well as the extra costs they will bring to the NHS.
A report for the Treasury for future health spending (6 March, p 542) produced last month showed that the huge sums invested in NHS modernisation will be wasted if high levels of preventable illness hit over the next two decades.
The paper set out several ideas for change, such as the formation of new membership based health centres, rather than conventional doctors' surgeries. These new organisations could work as clubs, which would provide members with both health information and advice and but would also offer treatment when a person was ill.
The paper also suggests that each city could have a high profile executive health commissioner or "health mayor"—a concept that already exists in some cities in the rest of European.
A dialogue is needed between the government and the electorate, which recognises that people are more than simply patients or consumers of services, but are actively engaged in safeguarding their own health, says the report.
Ms Coote said: "The NHS has become a national icon. It is tempting for politicians to try to 憇ave' it, without looking very hard at ways of preventing illness."
Policy makers fear being accused of creating a "nanny" state if they intervene and encourage healthy lifestyles. This is a disincentive for governments to focus on health, as distinct from health services, says the paper. However, it argues that most public health measures are not about directly controlling individual behaviour but about providing the means for all people to choose to live healthier lives.
The King's Fund's chief executive, Niall Dickson, said: "Individuals have a clear responsibility to take control of their own health and make the choices that will help them to live healthier lives. But they need support from a variety of sources, and there is a strong role for government, not only in providing information but also in creating the conditions that allow people to choose healthy lifestyles regardless of their social and economic circumstances."(London Debashis Singh)
That is the warning from the independent charity the King's Fund, in a discussion paper by Anna Coote marking the launch of the fund's new Putting Health First programme.
Rather than ignore the NHS, the government should design and build a health system that promotes health and reduces health inequalities, it says.
The paper highlights rises in the prevalence of obesity, which it says has trebled in the past nine years. It also noted large increases in other preventable diseases, such as diabetes, alcohol misuse, and sexually transmitted diseases, as well as the extra costs they will bring to the NHS.
A report for the Treasury for future health spending (6 March, p 542) produced last month showed that the huge sums invested in NHS modernisation will be wasted if high levels of preventable illness hit over the next two decades.
The paper set out several ideas for change, such as the formation of new membership based health centres, rather than conventional doctors' surgeries. These new organisations could work as clubs, which would provide members with both health information and advice and but would also offer treatment when a person was ill.
The paper also suggests that each city could have a high profile executive health commissioner or "health mayor"—a concept that already exists in some cities in the rest of European.
A dialogue is needed between the government and the electorate, which recognises that people are more than simply patients or consumers of services, but are actively engaged in safeguarding their own health, says the report.
Ms Coote said: "The NHS has become a national icon. It is tempting for politicians to try to 憇ave' it, without looking very hard at ways of preventing illness."
Policy makers fear being accused of creating a "nanny" state if they intervene and encourage healthy lifestyles. This is a disincentive for governments to focus on health, as distinct from health services, says the paper. However, it argues that most public health measures are not about directly controlling individual behaviour but about providing the means for all people to choose to live healthier lives.
The King's Fund's chief executive, Niall Dickson, said: "Individuals have a clear responsibility to take control of their own health and make the choices that will help them to live healthier lives. But they need support from a variety of sources, and there is a strong role for government, not only in providing information but also in creating the conditions that allow people to choose healthy lifestyles regardless of their social and economic circumstances."(London Debashis Singh)