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27.06.18

UK must conquer ‘nanny state’ fears and create more public health taxes and regulation

National and local government must use “all the means at their disposal” – including by losing fears of developing a ‘nanny state’ by introducing more taxes and greater regulation – in order to improve the public’s health, four influential think tanks have argued.

Analysis for the BBC from the King’s Fund, the Health Foundation, the Institute for Fiscal Studies and the Nuffield Trust looked at the wider determinants of health – in other words, the factors that help keep people healthy stretching beyond just NHS services.

They found that the success of the smoking ban and some early evidence that the soft drinks levy has forced manufacturers to reduce sugar levels in their products has suggested that greater tax and regulation can actually be an effective part of a public health strategy.

Findings from a poll commissioned by the Health Foundation help strengthen this argument. Two-thirds of adults in the UK support the soft drinks levy, more than half agree with a minimum unit price for alcohol, 70% back the limitation of fast food outlets in areas near schools, and 68% would like to restrict advertising of unhealthy food and drink, including by banning junk food ads on TV before 9pm.

While the NHS has a significant role to play in keeping people healthy, much of it comes down to wider determinants – the economic, physical and social environment in which people live.

Helen McKenna, senior policy adviser at the King’s Fund, commented: “It is essential that national and local government use all the means at their disposal to improve the public’s health. This should include being bolder in using tax and regulation where this can be effective.

“Although politicians may balk at the idea of the ‘nanny state,’ our research suggests these types of intervention may enjoy stronger public support than they often assume.”

In an interview with PSE earlier this year, Public Health England boss Duncan Selbie argued much the same thing: he said that devolution, not the NHS, is where the most energy is for health creation. He argued that we must strive to reduce public overreliance on the national health service by shifting the focus to community wellbeing – that is, economic growth, inward investment, and job creation.

Social care premium

In a similar vein, a new report jointly published today by the Housing, Communities & Local Government and the Health & Social Care committees claimed that the government should introduce a ‘social care premium,’ either as an additional element of national insurance or with paid into a dedicated social insurance fund that would be used exclusively to fund social care.

To ensure fairness, MPs argued the premium should only be paid by those aged over 40 and extended to those over the age of 65. Keeping the cash in an independent and audited fund would help gain public trust and acceptance, unlike widespread reaction to previous planned government social care reforms.

“We heard during the inquiry that people would be willing to pay more if there was an absolute guarantee that the extra money would go on social care,” said Clive Betters, chair of the local government committee. “Given the huge funding gulf, the government should now take the opportunity to build both a political and public consensus around the need for a new Social Care Premium to secure a fair and sustainable system in the long-term.”

Top image: BrianAJackson

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