The government’s new prevention green paper Advancing our health: Prevention in the 2020s rightly recognises the importance of good health as a personal and social asset and endorses the NHS Long Term Plan’s focus on reducing health inequalities.
With complex issues such as substance use, which are driven by an array of factors including adverse childhood experiences (ACEs) and trauma, a correspondingly complex understanding of the wider determinants of health and wellbeing is essential. In the document’s discussion of mental ill health these are touched on, but they are lacking from its consideration of substance use. The role of poverty and social exclusion in entrenching these issues is also not explored.
Collective Voice welcome the unambiguous endorsement of the importance of an adequately funded treatment system to address drug use and promote recovery — “investing in drug treatment reduces mortality risk, improves quality of life and saves money”. Treatment can have a transformative effect, and as well preventing further harms from drug use prevents some of the related harms associated with homelessness, mental ill health and offending.
We are unsure though, as to why this recognition of the power of treatment has not been extended to problematic alcohol use.
We welcome the commitment to “develop a shared understanding of the current challenges facing the substance misuse treatment and recovery workforce” and hope that this will fully tackle alcohol treatment as more and more services are co-commissioned.
We also welcome the ambitions around effective partnership between local government, the NHS and the voluntary sector, although note that the lack of clarity over the future of the public health grant may undermine the long-term planning needed for these partnerships to truly flourish.
We are pleased to the see the paper recognise the necessity of a cross-departmental approach to public health and look forward to supporting its work where appropriate.
Without sufficient resource, though, the green paper’s ambitions will remain just that — ambitions. Funding is needed to turn them into reality.
The Chancellor announced last autumn that austerity was over. We are now at a crossroads where political decision making over the future of the public health grant and spending review will help to determine the future health and happiness of many of the children right now affected by the ACEs which play such a major role in determining outcomes in later life.
We urge the new government to ensure that sufficient public spending is made available to sustain both a person-centred and ambitious treatment system for citizens currently struggling with drug or alcohol problems, and appropriate upstream interventions to prevent future generations developing such issues.