Jeremy Miles MS, Cabinet Secretary for Health and Social Care
The importance of preventing ill health is universally recognised and is a core value in our long-term strategy for health and care in Wales: A Healthier Wales. Unfortunately, too many people die too early from conditions and diseases, which could be prevented. And too many years of healthy life expectancy are being lost to disease and disability.
Prevention is more important than ever as we face the prospect of demographic change and, with it, increasing numbers of people living with life-long and life-limiting health problems, which will put greater pressures on our health and care services.
It is a key priority in the NHS planning framework for 2025-28 and will be reinforced in the priority actions I will be issuing to NHS chairs and chief executives to improve access to services, provide better care and to help prepare the health service for the challenges to come.
To support our efforts to become a nation which promotes good health and wellbeing, we will work with Sir Michael Marmot’s Institute of Health Equity to become a Marmot Nation. In practice this will mean working with a number of communities across Wales to reduce health inequalities using the Marmot principles, in the same way Torfaen has so successfully done since Gwent became a Marmot region.
I will lay regulations in the autumn to mandate the use of health impact assessments in certain circumstances by public bodies, strengthening our health-in-all policies approach. Preventing ill health is not just the job of the NHS. It must be at the heart of all our services. The building blocks for good health include having enough money in our pockets, fair work, a good education, and a safe and warm home.
Good health is as much about the environment and social relationships we grow up and live in, as it is about reducing some of the big risk factors associated with long-term health conditions and disease – smoking, alcohol, a diet high in fat, sugar and salt and a lack of exercise.
Smoking and obesity are the two main causes of premature death and preventable illness in Wales.
Levels of obesity in Wales have been rising steadily over many years, and we know from international evidence that turning the obesity curve at a population level is a mammoth task.
We know targeting action and resources at the start of life, towards children and young people, through a whole system approach at national and community levels, can produce real results that last a lifetime. I will be publishing the new Healthy Weight Healthy Wales delivery plan before summer recess, which will have a targeted focus on the early years.
But there will also be action throughout the life course – I have agreed more than £200,000 to support the Football Association of Wales FIT FANS 12-week healthy living and weight loss programme for men and women aged 35 to 65 this year, for example.
This week we mark Diabetes Awareness Week. Public Health Wales will today publish an evaluation report which shows how preventive support can reduce the risk of people with pre-diabetes symptoms developing type 2 diabetes.
Trained healthcare support workers, supervised by dietitians, work with people who are at risk of developing type 2 diabetes to make changes to their diet and to be more physically active. I have agreed funding to continue this programme this year so the approach can be mainstreamed, and more people will benefit.
We have made a lot of progress in reducing smoking rates, from 23% in 2010 to 13% today. But with one in 10 of all deaths linked to smoking, we must be more ambitious in reducing smoking levels because this will help to save lives and reduce the number of people who are diagnosed with cancer and other smoking-related illnesses every year.
The UK Tobacco and Vapes Bill has the potential to radically transform our relationship with smoking by creating the first truly smoke-free generation as it bans the sale of tobacco to people born on or after 1 January 2009 as well as regulating the sale of vapes to under-18s. We have worked closely with the UK Government on this Bill, and we strongly support its aims. There will be an opportunity for Members to debate an LCM soon.
Lung cancer is the third most common type of cancer in Wales, but it is by far the leading cause of cancer death. It is also the form of cancer with some of the widest inequalities in incidence by sex, by age and by deprivation. Two years ago, we started testing lung cancer screening in the north Rhondda area. Six hundred screening scans were undertaken, which led to the diagnosis of 12 lung cancers – two-thirds of these were detected at an early stage. I am reviewing advice based on the report from Public Health Wales on the proposed model for a national lung screening programme and will make a decision about the way forward before the summer recess.
We will be introducing some changes to the childhood immunisation programme this year, which are designed to increase protection. This includes giving the second dose of the meningococcal B vaccine at 12 weeks instead of 16 weeks to protect against bacterial infections that can lead to serious illnesses like meningitis and blood poisoning. With the other UK nations, we will also be the first countries in the world to introduce a targeted adult vaccination programme for gonorrhoea, from next month.
Increasing vaccine uptake and equity is a key focus of the work for this year, including a focus on the HPV vaccine, which is successfully reducing cervical cancer rates. We are also working to increase uptake of the RSV vaccine to avoid serious illness and reduce the need for hospital admissions.
The new Chief Medical Officer for Wales Professor Isabel Oliver will play a key role in advising the Cabinet in our work to prevent ill health. She has set up an advisory group to drive forward the work on prevention and reducing health inequalities.