Prevention work ‘absolutely critical’ to reducing health service demand

Health Improvement Commission chief executive Dr Simon Sebire would like preventative medicine to be seen as no less important.

But he said the island’s current investment in prevention was only a fraction of what it spends on people who already require treatment.

‘Nobody is going to suggest stopping treatment services. Therefore, if we’re going to invest in prevention, we’re going to have to do it at the same time as the treatment.

‘You have to be brave,’ said Dr Sebire.

But he expected that increasing work on prevention would, over time, reduce the demand for acute and chronic health services.

‘You will see that only if you take a medium- and long-term view and invest in treatment and prevention at the same time, and I think that’s possibly the next step for us here.’

The Health Improvement Commission was set up in 2018 as part of the Partnership of Purpose, developed by the previous Health & Social Care Committee and approved by the previous States.

It operates as a charity independently of the States.

It was established to bring together the public, private and third sectors to help limit diseases and conditions, which are more typical later in life, and can be expensive to treat.

Dr Sebire said it had a wide remit.

‘Health improvement is a broad area.

‘Our real mission is to enable, empower and encourage healthier lives, and to do that we focus on the leading causes of preventable ill health.’

Some of the commission’s initiatives are offered directly to people who want to lose weight or take other actions to improve their health, while others are more focused on creating healthier environments.

Its website features details of five key areas of work – eating well, healthier weight, being active, substance misuse, and social prescribing, which revolves around helping people to access support and services in the community which can improve their health and wellbeing.

The commission recently launched a campaign to provide a food map of the island, which it called Nourishing Guernsey. Some of its work is with schools, encouraging children to think about what they eat. It has initiatives for young people and adults.

‘Prevention is absolutely critical,’ said Dr Sebire.

‘This is a bit like an oil tanker. It takes a long time to turn. People use that phrase for lots of things, but it really is going to take time to turn trends around.

‘We have to keep that focus on prevention, even when systems are facing acute challenges.’

Over the past 10 to 15 years, attitudes towards prevention have changed, with more focus on how a person’s surroundings shape them and affect their behaviour, whereas in the past more attention was paid to health promotion and encouraging individual responsibility for making healthier choices.

‘I’d really love to see a common currency of prevention across government, where everybody sees prevention is their business, whether they are the Health & Social Care Committee or a different committee,’ said Dr Sebire.

‘Ultimately, our surroundings are created by all of these different areas, so everyone can do something towards prevention.’

He said he perceived a shift towards looking at the building blocks of health and ‘understanding what housing means for health and what people’s poverty means for health and working conditions, and so forth’.

‘Without those things in place, it’s very difficult to have a healthy society.

‘I’m encouraged by that change, but I think there’s a long way to go.’