politics of health

Politics of Health
Name
Institution

Politics of Health
Defining policy in relation to health care
A health care policy refers to an approach targeted at controlling or influencing outcomes in a specified medical facility or health care environment (Collins, 2005, p. 193). In fact, it can be construed as an approach that links the analytical and theoretical tools of law, psychology, philosophy, medicine, engineering, political science, and economics with real world health care needs. In essence, it is a governance instrument that offers an awareness of the barriers and advantages of ensuring effective cooperation between health care stakeholders to meet medical needs (Carney, 2015, p. 249). In this respect, health care policy can be interpreted as a context for framing and assessing suitable normative goals, defined in terms of the well-being of humans that includes fairness and justice as concerns economics, political philosophy, morality, and ethics within the context of health care.
For instance, an obesity management policy can be used to ensure that medical personnel, patients and the community lead healthy lives through lifestyle, exercising and diets. As such, a policy can be construed as a health management tool that directs results in a medical environment. Either an individual or office typically manages health care policies. These persons have been nominated to formulate the policies and ensure that they are aligned with medical procedures, and are routinely implemented.

Although a particular person may be charged with managing the control policies, all the medical personnel and stakeholders are actively involved in applying them (Rowitz, 2014, p. 232). As a result, health care policies are tools that are applied to influence medical stakeholders into guaranteeing favourable outcomes.
Within the context of the United Kingdom (UK), health policies as used to bring the tools and principles of administration into practical application to guide decision making, from the perspective of both the public, health practitioners, politicians and government (UK Government, 2016). As such, a health care policy is a governance and management tool that offers a compromise between social and political needs.
The UK fares better than most other nations in regards to the key measures of childhood health and well-being. This is because they take on an individualistic approach that looks to meet self-needs first before the collective. Even as the government struggles with the current public health problems, it refers to past core lessons, with particular focus on disease prevention rather than treatment, and the need to tackle problems that affect the largest population proportion. This is especially true when it is considered that children have health problems that require broad-based responses (HM Government, 2010, p. 23).
As governance historians would note, understanding the history of public policy is crucial to the advance of informed policy debates today and in the coming years. The UK has taken this statement to note such that public health advances have suffused creating an ever-burgeoning child welfare movement. Conquering the medical conditions plaguing children, allocation of more public resources to solving their problems, building of research centres, medical schools, clinics and hospitals, as well as the creation of a national public health infrastructure all signal that the government is committed to protecting and preserving the health of children, and ensuring their well-being in the future. Obviously, the exponential increase in personal income, and creation of new health programs have increased provision and public access to high quality health services (Ham, 2009, pp. 160-162). As a result, UK fares better in key measures of childhood health and well-being owing to favourable policies.
Political ideology underpinning ‘Healthy Lives, Healthy People’ as a health care policy
In the month of November 2010, the coalition government of Conservatives and Liberal Democrats published what it envisioned for the public health sector under its rule in a document titled ‘Healthy Lives, Healthy People’. The document was in response to Marmot Review’s recommendations for addressing social inequalities in health. That was published in 2010. The review recommended focus on prevention, creation of sustainably health communities, improving health living standards, enabling all demographics to maximise their capabilities and control, and giving every child the best start in life (University College of London, 2014). In line with these recommendations, ‘Healthy Lives, Healthy People’ presents a novel approach to public health management that seeks to introduce new methods supported by tangible evidence, enable professional freedom and empower local communities to take control of their health needs while ensuring that the nation remained resilient to alleviate against threats to current and future health. In justifying the document’s content, the government noted that a radical shift was necessary to tackle the health care challenges in the country since most of them were lifestyle driven and had already reached worrying levels. For one, it illustrated that the country was the most obese when compared to the rest of Europe. In addition, it was noted that lifestyle-driven health issues placed a large burden on medical resources with the situation exacerbated (HM Government, 2010, p. 2). As such, the coalition government thought it necessary to present a policy document that outlined strategies for addressing lifestyle-driven health concerns since this strategy would be cheaper in the long run.
In its justification for the policy document development, the coalition government clarified that the difference in resource access for wealthy and poor communities affects development of lifestyle-drive health problems. In fact, poverty was noted to have a negative influence on health outcomes while affluence improved outcomes through enhancing access (Nuffield Trust). By definition, poverty is the inability of an individual to meet their basic needs that include shelter, food, education, healthcare, and water. As such, poor individuals focus most of their attention in obtaining the basic needs for their immediate use, thereby forcing them to divert the resources meant for health care towards their immediate survival. In addition, many of them are forced to degrade or deplete natural resources in a non-sustainable manner. The result is that they are more concerned with meeting the immediate basic needs at the expense of future needs, thus having a negative impact on health outcomes. In contrast, affluence is believed to have a positive impact on health outcomes since it allows an individual to meet his or her basic needs in a sustainable manner. Still, affluence is also thought to have a negative impact on health outcomes. This is because affluence is associated with risky behaviour (Nuffield Trust). Overall, the necessity for government intervention in addressing lifestyle-driven medical issues is driven by the acknowledgement that health inequalities exist between the poor and rich with the situation worsening over time (HM Government, 2010, p. 2).
The dilemma faced by the government was that it was not possible to have a single solution to address all lifestyle-driven medical issues since demographic factors influenced outcomes. On the other hand, it was not possible to let the situation resolve itself since it only worsened and increased social differences noted in the population. As such, a new approach was necessary to offer communities tools to address their health needs and empower the population into making healthy choices. With ‘Healthy Lives, Healthy People’ as a health care policy, the central government sought to decentralise control and offer government structures the funding, responsibility, freedom and capacity to hand their particular health needs through innovative approaches. The new approach was anticipated to apply a reward based system to include financial incentives for programs that reduced health inequalities and applied greater transparency measures (HM Government, 2010, p. 2).
In addition to easing health management at the local government level, the policy has simplified the way in which health is managed at the national level. This has occurred through the creation of Public Health England as a public health service that replaced the existing complex structure with the intention of disseminating health information, offering leadership in disease control, and supporting local innovations (HM Government, 2010, p. 2). The efforts to improve health outcomes at both the national and local government levels would then be supported by collaborations from other health stakeholders who seek to promote healthy living. This is based on the awareness that novel technologies and practices are already being applied to revolutionise disease prevention and health improvement efforts, and harnessing these technologies can enable real progressing in improving health outcomes. The collaborations would entail forming partnerships with the community to incentivise its members to be more physically active and avoid risk behaviours even as they incorporated the use of new technologies such as healthy weight loss cell phone applications (King’s Fund, 2011, pp. 2-3).
Overall, ‘Healthy Lives, Healthy People’ was a policy documented presented by the coalition government of Conservatives and Liberal Democrats to improve public health outcomes. With the mandate of the people, the government was duty bound to act in the best interest of its people by addressing the noted trends of increasing incidence of a lifestyle-driven medical issue, gap between the rich and poor, and technological innovations. Recognising that change was necessary, the government opted to decentralise control of health resources, and allow local populations to direct change towards their most important needs thereby ensuring that all interventions would guarantee a positive outcome (King’s Fund, 2011, pp. 2-3). Therefore, the political ideology underpinning ‘Healthy Lives, Healthy People’ as a policy document was a need to improve public health outcomes while reducing overall costs as a government mandate.
It is evident that the ideology underpinning the development of ‘Healthy Lives, Healthy People’ is neoliberalism. That is because the policy transfers control of public health factors away from the control of the central government and into the control of the local governments. With this approach, public health management eliminates regulations and barriers that restrict the inclusion of local opinions in identifying the best approaches, adopting a laissez-faire approach (Allmendinger, 2016, p. 93).
Impact of ‘Healthy Lives, Healthy People’ on childhood obesity
In 2009, Forbes reported that the UK was ranked 28th in a survey of the world’s most obese countries. This survey highlighted obesity as a major national public health concern within the country. This was supported by health statistics indicating that 61% of adults and 30% of children, between two and fifteen years of age, across the country were obese (GOV.UK, 2013). University of Birmingham adds to this knowledge by reporting that the UK had the highest obesity rate at 20 per cent of the population with excesses of £ 3 billion spent annually to tackle obesity related issues. 10 per cent of primary school entry children are obese, a worrying trend as this generation is likely to die before their parents as a result of obesity induced cardiovascular ailments (University of Birmingham, 2013). Public Health England reports that obesity accounts for at least 1 out of 13 deaths in the UK, and an excess of £16 billion annually in health care costs, to includes £5 billion spent by the National Health Service (GOV.UK, 2013).
The UK government recognises that obesity within the country is lifestyle-driven and caused by changes in dietary and physical activity patterns resultant from variations in the environment and society that act in concert with lack of supportive policies in health, agriculture, urban planning, transport, food processing, environment, marketing, distribution and education sectors (Bates, 2013). The result is that obesity, as a social problem, is largely ignored as insignificant when analysing issues of public health concern (Kass et al., 2014, pp. 788-789).
In 2011, the coalition government of Conservatives and Liberal Democrats proposed a call to action to combat obesity in the UK to be in line with the ‘Healthy Lives, Healthy People’ policy. The call to action included (GOV.UK, 2013):
Setting out plans to involve the whole community in combating obesity.
Considering obesity as a societal problem with individuals assigned the responsibility of changing their lifestyles and behaviour to have healthy weights.
Developing partnerships between the local and nations government, and other bodies to encourage people to have healthy weights.
Considering obesity in children as important and unique since each segment had its own etiology.
Reducing the number of calories the nation eats every day by 5 billion over the next ten years.
In addition, the health ministry undertook programs to educate the public on the importance of limiting energy intake, increasing uptake of vegetables, fruits, grains, legumes and nuts, and engaging in a regular physical activity. This included campaigns being implemented to encourage people to eat and drink more healthily, and have more active lifestyles. Also, the front of pack labelling of processed food compositions has now become compulsory to inform consumers about their foods composition thereby allowing them to make informed diet choices (GOV.UK, 2013). Besides that, the food industry has promoted healthy diets by, reducing the fat, salt and sugar content of processed foodstuffs, availing healthy and nutritious food choices at affordable prices to consumers, and practicing responsible marketing that includes all information about the foods without regard for impact on marketing or profitability. These measures have been carried out under the mandate of the health ministry’s public health responsibility deal that encourages responsible business practices (GOV.UK, 2013).
Local governments have also been encouraged to create public health budgets that allow for meeting local health needs. This has allowed them to have health wellbeing boards that bring together local organisations in creating a healthy choices environment even as interventions are tailored for the local population to ensure a favourable outcome (Bates). Additionally, the education ministry has encouraged schools to change unhealthy school diets with health cost efficient diets. As a result, schools are only allowed to serve fried foods a maximum of twice a week, removed soft drinks from diets and can receive dietary advice from the school food trust. In fact, there is a £60 million initiative to support and advice schools on how to provide healthy diets in schools (Bates, 2013).
Currently, the local government is developing a soda tax on all unhealthy drinks. The tax targets drinks with a sugar content exceeding 5g per 100ml with the levy rates increased in direct proportion to sugar content exceeding 5g per 100ml. The government is justifying the tax as a way of reducing the unhealthy drink choices available to children in the UK since sugared drinks represent the largest source of dietary sugar for children. The measure is intended to aid in cutting down on the worrying childhood obesity figures, which report that 20% of children are obese when they graduate from primary school. The tax would then be contributed to hospitals and other facilities that address obesity on the UK. The 20% soda tax is anticipated to reduce the number of obese individuals by as much as 1.3% across the whole population (Cheng, 2013; Kottasova, 2016).
Other than the anticipated benefits of ‘Healthy Lives, Healthy People’ as relates to childhood obesity, it has had some immediate effects. This is seen in the reports that both McDonalds and Burger King have closed down 25 and 21 fast food outlets respectively within the country thereby reducing children’s access to fast food that would increase incidences of obesity. In fact, these companies decision to close down the mentioned outlets is as a result of slumping revenues occasioned by an increasingly health conscious population that can correlate diets to obesity outcomes. This is an indication that the general population is eating healthy foods and keeping away from unhealthy choices that would increase the incidence of obesity (Obesity Learning Centre, 2013). The policy has also used tangible evidence to show that although exercise and healthy diets have been pursued as the most effective strategies of combating childhood obesity in the UK, additional research into exercise forms and diet types most effective at reducing obesity is necessary. This means that the policy has made it possible to identify an existing research gap. It must be noted that even with the policy being in place, most UK inhabitants ignore the lifestyle changes needed to address obesity and as such present an urgent need for viable interventions that can successfully influence the adoption and maintenance healthy diets and active lifestyles (University of Birmingham, 2013). This means that the policy has only been partially successful in addressing childhood obesity concerns and population needs.
Independent views on ‘Healthy Lives, Healthy People’
There is a general consensus among independent health organisations operating in the UK to indicate that ‘Healthy Lives, Healthy People’ policy has made some commendable progress in improving public health outcomes to include actively reducing childhood obesity incidence. In fact, Nuffield Trust indicates that the policy must be commended for improving public health management by decentralising responsibility to allow for personalised care approaches that guarantee more favourable outcomes and judicious use of resources. In addition, the trust lauds the new focus on lifestyle and other wider determinants of health along with demographic inequalities. Still, the trust notes that despite its noble intentions, the policy is incomplete and likely to face some delivery problems. In this case, the accounting rules are criticised for not specifying how the funds should be used. For that matter, there are loopholes that health officials can exploit to divert funds towards core health services and away from public health initiatives as the policy initially intended. In addition, there is a need to clarify the accountabilities, responsibilities and roles of public health involvement within larger health management functions (Nuffield Trust, 2016).
The Chartered Institute of Environmental Health (2011, p. 3) expresses similar sentiments, and adds that the policy is a noble attempt at improving the UK public health by undertaking a prevention approach that addresses both the narrower and wider social determinants of health in the same way. In addition, it points out that the policy offers the fastest strategy for improving the health of poorer persons. It also criticises the paper for being overambitious and broad. This is seen in its approach to decentralisation that would shift public health management from the central government to local government. In this case, the problem is the lack of clarity on the coordination of action and responsibility. For that matter, it is recommended that formal links be created to clearly outline responsibilities (Chartered Institute of Environmental Health, 2011, pp. 3-7).
The King’s Fund (2011, p. 2) also indicates that it welcomes the policy and its intentions to improve public health outcomes in the UK. It extols the political commitment to public health, intention to decentralise health care management, and inclusion of the local community. Still, it has reservations concerning budgetary limitations for implementation, resource allocation formulas, accountability issues, and technical challenge in coordinating care (King’s Fund, 2011, p. 2). The same sentiments are expressed by the Royal College of Nursing (2011, p. 3), which notes that the policy paper is an indication that the UK government is committed to protecting its citizens from public health threats. On the other hand, it notes that the commitment and policy approach may be ill advised since it does not address the root cause of the public health concerns. It takes particular issue with the act that the policy does not address the correlation between public health and poverty incomes. In essence, it notes that the reforms presented in the policy are counterproductive for the public health of vulnerable populations. In addition, it notes that the lifestyle change approaches have very limited success potential, relying on weak evidence. Finally, it indicates that the morale of medical personnel is not taken into account (Royal College of Nursing, 2011, pp. 3-7).
The current analysis makes it clear that although the ‘Healthy Lives, Healthy People’ policy was developed with noble intentions it faces some difficulties that would derail its capacity to meet set goals. On the one hand, the policy is commended for improving public health outcomes by allocating resources and decentralising health management and governance. On the other hand, the policy is criticised for lacking financial oversight, and failing to outline responsibilities and accountabilities. As such, there is a general consensus that the policy needs to be revised to improve its outcomes with the focus being on addressing the identified shortfalls.
Conclusion
One must accept that policies form an important part of public administration and health care management. In this case, a policy refers to an approach targeted at influencing outcomes in a specified health care environment. For that matter, it acts as a context for framing and assessing suitable normative goals, defined in terms of the well-being of humans that includes fairness and justice as concerns economics, political philosophy, morality, and ethics within the context of health care. This is true for the UK where policies are the tools that the government uses to protect and preserve the health of children, and ensure their well-being in the future. The ‘Healthy Lives, Healthy People’ represents a policy in which presents a novel approach to health care delivery that seeks to introduce new methods. The new methods are supported by tangible evidence, enable professional freedom and empower local communities to take control of their health needs while ensuring that the nation remained resilient to alleviate against threats to current and future health. In fact, the policy has been instrumental in improving childhood obesity outcomes in the country by making it possible for sugar and fat intake to be reduced. Still, concerns have been raised about the policy shortcomings that could derail its capacity to include lack of financial oversight, and failure to outline responsibilities and accountabilities. The recommendation is made that the shortcomings should be addressed to improve the policy’s outcomes.

References
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