Scotland's poor health record holds the nation back as surely as a pair of concrete trainers.
We lag behind the other nations of the UK for life expectancy, and the burden of ill-health puts strain on the NHS every day. So it is far from reassuring to discover that over-40 health check-ups, a key SNP manifesto policy and part of the party's commitment to prevent ill-health, have been quietly dropped by the Scottish Government, a move that was only uncovered when The Herald asked questions about it.
Back in 2011, the-then public health minister Shona Robison seemed to have no qualms at all about the Life Begins at 40 health checks. Announcing that 74,000 people would be invited to undertake a health self-assessment in a bid to encourage more healthy lifestyles, she said: "Prevention is better than cure and we are dedicated to doing all that we can to identify those at risk from as early as possible."
A perfectly laudable sentiment, but just two years later, the scheme was shelved without public acknowledgment. To use the scheme to trumpet ministers' commitment to preventing ill-health and then to fail to follow through, is unimpressive. What happened? This was a long-standing policy on which the Scottish Government had plenty of opportunity to gather professional opinion before it was launched. Indeed, GPs made clear they believed it would be a waste of money, have a small take-up (a trial in Grampian found only 10% of 40-year-olds responded) and resources would be far better targeted at high-risk groups. Ministers went on with it anyway. The Scottish Government says a subsequent evaluation found the programme "would provide greater value in conjunction with other sources of information on health and well being", but this leaves key questions unanswered. Ministers need to explain what has occurred. A key electoral promise on health promotion has been broken and they must own up and explain why.
Scotland desperately needs sound, effective, well-funded schemes to prevent ill-health, not eye-catching policies that are launched and then abandoned.
The Herald's campaign NHS: Time for Action has highlighted the growing pressures on the NHS caused by the ageing population. Reducing the burden of chronic illness is clearly crucial to meeting that challenge.
The outgoing Chief Medical Officer, Sir Harry Burns, believes Scotland's poor health is rooted in the social collapse caused by the breakdown of communities and families following the decline of heavy industry in many parts of Scotland. There is no quick fix. Rebuilding community and family bonds, supporting good parenting and improving early years education will all help boost health in the long term. Yet healthy-living campaigns and efforts to encourage people to engage more with their health also have their place.
The critical point is that ill-health prevention drives should be well thought-through, properly executed and part of a sensible, coherent programme of work, not launched in a flurry of publicity and then quietly dumped.
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