In his presentation, Lansley described the prospective legislation as "establishing and making provision about a National Health Commissioning Board and commissioning consortia". The legislation has attracted great controversy, with the chair of the British Medical Association's GP Committee, Laurence Buckman, saying patients will become "internal medical tourists". Here Tony Massey, chief the medical officer of the consultancy, Vielife, discusses his views on the role of employers within the government's proposals.
I agree that the state should engage with employers to tackle public health issues. However, in my opinion the government’s devolution of control over health is a step too far. It suggests greater responsibilities for employers in the provision of public health despite lacking key central guidance, education and cohesive provision of services. The outcome of this could well lead to employers being left to shoulder the cost and burden of a healthy society rather than playing their rightful role.
The state and the private sector have a unique opportunity to work together on health, but without sufficient state direction and commitment the public health purse will remain pressured while the critical issues that drain the human capital of the UK because of reduced productivity and health fail to dissipate. Employers can play a big role in delivery but they need the government to be going beyond lip service and working on coordinated programmes.
Many organisations have already excelled at wellness as a corporate improvement goal and made real financial improvements as a result, but to do so they live and breathe a wholly healthy culture, with no stone unturned. The UK population is no different, only bigger. The government could struggle to nudge people into healthier lives without the provision of a workable joint vision and improved facilities.
Rather than simply devolving responsibilities to its corporate citizens the government must learn from ‘healthy’ organisations. Evidence shows that changing attitudes only works when central drive, direction and campaigning is balanced with empowerment and coaching of individuals to take control.
Health is unique to each individual and must offer different things to different people, but it still must operate in a structural framework. Reducing investment in some sports, for example, will make it harder for individuals to actually find the means to change when they want to. The whole spectrum of the population must have access to facilities whatever their social status.
Many organisations now treat employee wellness as a P&L issue and actively invest in HR and occupational health for success. We seem to have missed the point that a fitter UK can’t be achieved cheaply and must be at the core of our culture in and out of the workplace.
Apparently we are all in this together, which is why in my mind a future health strategy can only succeed if the state learns from the corporate organisations that already improve business performance from wellness. We should let some of them lead us by example, but not dump full responsibility upon them for the UK’s health.
