Our public health system is modelled on the UK’s NHS, conceived as a “cradle to grave” health service, free at the point of use and funded through general taxation.
In the middle of the last century, there was little recognition of the impact of slow-burning health challenges affecting every population sector. It is time to ask ourselves whether our public health services adequately meet the community’s needs. To answer this question, we must understand health policymakers’ top challenges.
Like most other European public health services, this sector is suffering from insufficient funding. Economically, public health services have always been a battleground competing with other public spending priorities.
Medicine today has become more capital intensive with the need to buy expensive high-tech equipment for diagnosis and treatment. People have high expectations as they know more about the latest medical technologies that can address their medical challenges.
But lack of funding is also one of the causes of other obstacles to achieving excellence in public health. Chronic staff shortages contribute to hospital waiting lists at a time when the population has increased substantially in the last few years.
Nursing staff, in particular, suffer from high stress levels in their work while they feel that they are not adequately compensated for the important and challenging work they do.
Industrial disputes in the medical professionals’ sector are often resolved with short-term tactics that do little to attract more young people to the medical professions. For young people to be motivated to become health workers, work conditions must reflect the importance of their contribution to the community’s well-being. Many applauded and appreciated healthcare workers’ crucial role in saving people’s lives during the pandemic. However, it appears that these same healthcare professionals are again taken for granted.
Many applauded and appreciated healthcare workers’ crucial role in saving people’s lives during the pandemic. However, it appears that these same healthcare professionals are again taken for granted
The ageing population is another top challenge for our public health service. People are living longer, but age-related illnesses are also increasing substantially. Dementia, diabetes and cancer afflict older adults who often lose their independence and need to be supported in care homes. While efforts are being made to give more older adults access to the care they need while still living in their own homes, the demand for care home places is increasing at a fast rate.
Another often ignored threat to the well-being of society is the lack of sufficient focus on children’s mental health. Young people are much more literate than ever about mental health. It is estimated that in Western countries, 18 per cent of children aged seven to 16 and 22 per cent of young adults aged 17 to 24 have a probable mental disorder. While various voluntary and school-based services offer counselling and other interventions, demand for help vastly outstrips supply.
We need systemic change to support children and young adults to address their mental health issues. This means starting with prevention – offering early help for young families, ending child poverty, and tackling racism, domestic abuse and bullying. It means building comprehensive systems of support adapted to every child’s needs.
Other challenges that threaten the success of our public health services are related to lifestyle risks. Childhood and adult obesity have long been a long-term threat to people’s health, often leading to diabetes, asthma and high blood pressure in the population.
Diabetes, for instance, is a rapidly escalating crisis, with type 2 diabetes becoming more prevalent among younger people.
The causes of obesity are often complex and layered. Still, we know children living in the most distressed households are more affected. It is no coincidence that such households have the highest rates of food insecurity.
It is time to start thinking long term about current health challenges. More must be done to decrease pressure on an already stretched public health system. Policymakers must ask themselves whether the current funding model of public health services is still the best to support the investment needed to give the public the best service the country can afford. Rationing of medical services to compensate for insufficient investment in people, facilities and technology must never be an option.
Our public health system has undergone significant changes and challenges recently. The onset of the COVID-19 pandemic, the ongoing concerns about workforce shortages and pay, and increasing pressure for services due to fast population growth are seriously stretching the system.
The public health system is the only viable option for most people to address their health challenges. Societal leaders must act now to treat these people fairly by addressing their health priorities effectively.