Public Health Review: Analysis of responses to the engagement paper

9 Topic specific responses

9.1 As has been set out earlier, the public health function is a very broad endeavour, encompassing activities and efforts across the domains of health improvement, improving health services and health protection, and in the area of public health intelligence. The responses to the engagement paper reflected this: with some responses directed at the totality of the public health function while others gave more topic focused responses.

9.2 The topic specific responses were themselves highly diverse, for example, covering issues such as alcohol, smoking, asthma, cancer, cerebral palsy, optometry, dentistry, environmental health and occupational health, among others. Respondents often used their responses to describe the work that their organisation does, and to show how that work contributes to public health.

9.3 Relative to other topic focused responses, the topic discussed most frequently was in relation to early years / children and young people. Key issues raised in these responses are presented below.

Early years priorities

9.4 Many respondents from across all sectors discussed the importance of focusing on the early years in relation to improving public health; it was widely accepted that investment in these early years – and in particular a focus on primary prevention in the early years – was vital to address health inequalities.

9.5 In addition to these general comments, however, six respondents provided more detailed submissions on this topic / life course stage, with five identifying specific priorities for action. There was some overlap between the focus of the comments from these six respondents, and also a wide diversity of specific points made in relation to the early years agenda. A range of contextual factors were also highlighted. The focus on the first 1000 days of a child’s life (from conception to age 2) was seen to be particularly important.

9.6 Specific priorities for action identified (often by a single respondent) covered:

• Reducing child mortality. It was noted that the UK has one of the highest child mortality rates in Europe. Specific elements which would contribute to this included: maximising health and wellbeing during pregnancy, reducing injury and poisonings, promoting health and wellbeing and reducing risk taking behaviours and reducing healthcare amenable deaths
• Improving routine surveillance systems for child health. It was noted that investment in child health surveillance was weak in comparison to adult / older people surveillance systems. This would include improvements to newborn screening ( it was noted that there are no national standards for this at present), routine surveillance of disabled children, a more consistent approach across the country to the provision of paediatric ENT and opthalmology services, and a consistent approach to the provision of children’s services in the context of health and social care integration
• Improving maternal nutrition and health and infant feeding and nutrition. This includes increasing preconceptual nutrition, increasing uptake of Healthy Start vouchers, increasing breastfeeding rates, reducing smoking in pregnancy
• Reducing unnecessary (medical) intervention in childbirth
• Focussing on wider factors relating to poverty, social isolation, and mental health and wellbeing. These factors are important in general but are especially important during pregnancy and the early years
• Improving relationships and trust between parents and health care professionals as well as between children and parents / guardians.