A Critical Policy Document 'Prevention Is Better Than Cure' Analysis

Introduction

The policy document, Prevention Is Better Than Cure, by the Department of Health and Social Care, puts prevention at the core of national health in the UK. Its vision is to increase life expectancy by an additional five years by 2035 while reducing the gap between the health experiences of the richest and the poorest. The policy objects to helping people stay healthy, reducing the chances of experiencing health problems, and then supporting those already experiencing the problems to manage them as much as possible. The King's Fund (2014) supports this approach, claiming that the government and NHS should prioritise prevention and help people tackle wide determinants of health and wellbeing (WHO, 2014). With the help of the policy development process, practices and theories, this essay critiques the DHSC's policy document, outlining the impact of the political perspectives, the influence of the stakeholders, and recognising factors that may hinder the effective execution of its recommendations.

Policy Development Process

Policy development refers to an iterative process that focuses on continuous improvements in the health sector, outlining the policymakers' commitment to bettering the wellbeing of the citizens. It has four stages: problem identification, policy formulation, implementation and evaluation (Hallsworth, 2011; CDC, 2014). The problem identification state helps policymakers identify the root cause of the health problems the policy would seek to address and their effect on a population's health. For instance, some identified problems during this stage include obesity, mental illness, dementia and diabetes (DHSC, 2018). It is only after realising the problems that the policymakers can manage to set goals and policy agendas, knowing what they want to achieve exactly (Cappucio et al., 2017). The stage helps one understand whether the prevention approach has been implemented in the past, how it has been carried out, the challenges faced, why it failed or its outcome, and more details that help set realisable goals and policy recommendations. The health policy would yield no desirable results without addressing a specific problem(s).

During the policy formulation stage, policymakers lay out different policy options that could help solve the identified problem(s). These options are then narrowed down, and the most feasible ones are selected (De Leeuw et al., 2014). Before DHSC decided to settle on a prevention policy, they may have considered alternatives like public awareness, improving the customer service and supporting the local management problems. Thus, this stage helps the policymakers formulate a strategy that can better help solve the identified problems, gauging its advantages and disadvantages against other policy alternatives (Cappucio et al., 2017). Policy formulation and setting agenda and preferred outcome involve consultations with various stakeholders, like NSH, national and local government, the public and health employees. This stage is fundamental in achieving the desired health outcomes.

The policy implementation stage involves taking action and spending money. DHSC should hire staff to push the policy and ensure it has enough funds to run the program. The implementation process should always reference the policy agenda and problem statement, and the policymakers make necessary decisions to avoid mistakes (Cappucio et al., 2017). Finally, the evaluation stage would help the policymakers track the policy's efficiency and relevance in addressing the identified health problems (CDC, 2015). And during this stage, DHSC (2018) should examine what worked, what failed to work, and why. If further improvement is needed, the policymakers should make such suggestions and correct the mistakes. And if the policy yielded undesirable results, they should consider another alternative and repeat the procedure.

Impact of the Political Perspectives

The former Secretary of State for Health and Social Care, Matt Hancock, published the policy document. And during the entire process, the Department of Health and Social Care considered all the communities. For instance, some consulted stakeholders included the national and local governments, National Health Service (NHS), employers, charities, social care and the public (DHSC, 2018; Kennedy, 2020; DH, 2013). After reviewing case studies and previous government initiatives and consulting with these stakeholders, the DHSC understood the health problems faced by the citizens. According to Hancock, through government interventions, vaccination and cutting smoking were two of the most successful prevention mechanisms in the country. The government then worked with other stakeholders to publish a Green Paper in 2019 that details the policy's plans (Mahase, 2019). The Green Paper was then presented to the government for further consideration, and further consultations were made, including public participation, meaning that the policy needs assessment was undertaken (Gov.uk, 2019). The government is keen on consultation, making sure the public is acquainted with the health policy in question, and recommendations for improvements are taken seriously by the legislators. The UK government published the Green Paper, which contained the policy document, without political interference.

Influence and Involvement of Stakeholders

Various stakeholders, as earlier mentioned, were involved throughout the policy implementation process. For instance, DHSC (2018, p.8) insisted that "local and national governments should collaborate in creating an environment that makes healthy choices as easy as possible and addresses the conditions that lead to poor health." These powerful stakeholders can implement this role by creating and implementing laws, regulations and incentives (DHSC, 2018). The policy document also asserts that in collaboration with the local government, the National Health Service is accountable for conducting a joint assessment of the local need. They should deliver the assessment through the Health and Wellbeing Board that brings together leaders from the social care system and local health to advance the locals' health status while minimising health inequalities, especially among the vulnerable groups in the society (DHSC, 2018; DH, 2013). More so, the national and local governments have the power to enforce regulations and incentives that could help the citizens make better health choices, creating a condition for them to live well. However, the DHSC recognised that the government alone could not monitor the implementation of the policy recommendations. For this reason, DHSC (2018) calls upon all stakeholders, including social services and youths, to participate in the policy implementation process. The Directors of Public Health, another powerful stakeholder, also have a critical leadership role. They should be engaged during the planning stage and, together with other local experts, tailor the public health services to local needs (DHSC, 2018). These stakeholders would assist the local government and authorities deliver social services, information and advice.

Employers also have a key role to play throughout the policy formulation and implementation. According to DHSC (2018), more than half of people with long-term health conditions have cited health as a significant barrier to the type and amount of work they can handle. Also, those living with a disability are twice likely to quit their job as those without a disability. Therefore, employers can adjust the workplace to accommodate all employees, such as altering the working hours or allowing others to work remotely. In collaboration with the government, they can give their employees access to occupational health. They have a role in helping the government achieve its target of seeing at least one million people living with disability get access to work by 2027 (DHSC, 2018).

Lastly, the citizens living with or without any health conditions are the people the policy targets and whose needs must be met. Therefore, all other stakeholders must jointly identify their needs and propose measures to address their health problems (DHSC, 2018). They should be engaged throughout the policy process's four stages and encouraged to change their habits for a better life. According to Public Health England, the government and other stakeholders should work on eradicating health inequalities, ensuring all citizens have access to quality and affordable health care.

Health Implications of Strategies Suggested in the Policy

According to the Public Health England (2016, p.4), "the Health in All Policies (HiAP) is a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across sectors, policy and service areas and addressing the wider determinants of health" (Lawless et al., 2018; WHO, 2014). Based on this definition, DHSC's (2018) policy adheres to HiAP, and the measures proposed are meant to boost the prevention of health problems at a national level while minimising the gap between the health experience of the rich and the poor. For instance, DHSC recognises local authorities and appreciates their efforts in boosting the local health since they engage more frequently with the communities and understand what the government should do to improve health.

The HiAP is also applied while proposing that the country attain zero-rate tobacco intake, aiming to create a tobacco-free generation. The DHSC focus on collaborating with the national and local government, and other parties like NHS and social service, to ensure the local people prevent exposure to health problems and support those already living with health conditions (DHSC, 2018). On the same note, Public Health England (2016) confirms that Health in all Policies is built on the collaboration of key stakeholders and targets the residents. The DHSC policy focuses on shifting the health emphasis from the national to the local level, implying that HiAP is considered.

Therefore, the HiAP approach supports the decision process during the formulation and implementation of the DHSC's (2018) policy, especially while empowering the local authorities and experts to participate in the process. The active consultation with all partners would ensure all the health factors affecting the locals are addressed, ensuring the policy recommendations are relevant in meeting the local people's health needs (Baggott, 2013). According to Public Health England (2016), the HiAP approach helps the DHSC boost the nation's economic growth since a healthy population is a great economic resource, ensuring productivity remains high. The approach would also help the government eliminate duplication and coordinate efforts, thus boosting its efficacity and accountability.

Barriers to Implementing the Policy Recommendations

One of the barriers to effective implementation of the health policy is the lack of clear roles, especially because all parties have a role to play for a better outcome (Brownson et al., 2009). To eliminate this barrier, the DHSC should clearly define the roles and ensure no duplication of efforts between the local and national-level officers. Safety and perception of safety, as outlined by DHSC (2018), is another challenge that can hinder people from cycling or walking. Although the government have invested £7 million to help local authorities improve cycling safety, more efforts are needed to educate the locals on the health benefits of cycling and walking. Additionally, inadequate resources are a major barrier to implementing health policy recommendations or financial unsustainability (Smith et al., 2019; Brownson et al., 2009). For instance, small businesses might not afford to adjust the work environment to suit workers with disabilities, thus challenging the government's initiative of ensuring that over one million people living with disabilities are employed by 2027 (DHSC, 2018). Hence, the government should collaborate with all employers and devise a mechanism to ensure their initiative bears fruit.

Another major barrier facing the implementation of the DHSC's (2018) recommendations is insufficient information regarding people's mental health and wellbeing. And to eliminate this barrier, DHSC should involve as many local authorities as possible to ensure they gather all relevant information regarding the health status of the citizens. The local authorities should consult with the communities and collect all relevant information to help DHSC devise effective policy recommendations addressing all the local health problems. Finally, poor policy supervision and law enforcement can challenge the implementation of the recommended strategies (Smith et al., 2019). Therefore, DHSC should delegate duties to the local authorities and make sure they report to the officers at the national level regularly.

Conclusion

If the DHSC's policy is fully implemented, the wellbeing and health status of UK citizens can be improved. The essay explains how the policy implementation stages can help identify factors related to the policy, outlines the major stakeholders, including national and local government, and explains how the UK Parliament adopted the policy without political interference. It also explains how the policy followed the HiAP approach and presents the main barriers that can hinder the implications of the suggested recommendations and how to avoid them.

References

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