Jenny Jackson is a health consultant. She was previously a Special Adviser at the Department of Health, and Director of Women and Child Health at University College London Partners.
I remember working on the Conservative health manifesto in 2007 for an election that never happened. Osborne pulled inheritance tax breaks out of the hat, and Brown bottled calling a poll.
Today, as Brexit speculation grips Westminster, I can’t help thinking that Labour is bottling it once again because they lack imagination. They’ve zero to offer people beyond their duplicitous EU policy. Right now, there’s probably some poor spud-faced nipper in Labour HQ piecing together the health sections of their manifesto from Socialist Worker back copies.
Meanwhile, the Conservatives have already laid the cornerstone for their manifesto: more NHS funding. The public backs raising taxes for this purpose, including a majority of Conservative Party supporters. The other abiding issues remain access to primary care and waiting times.
But beware the latter. One top pollster disclosed to me his unpublished findings, which show repeatedly that, if you talk about waiting times, the public is always left with a negative impression. Even if the waits are going down, there’s still a wait.
Beyond these key building blocks, what should be our focus? I think we should begin at the beginning.
Every new administration has a plan for the first hundred days of office. During this time, the tone is set for the duration of that term. A strong start sticks. And so it is with each one of us.
The first thousand days, from conception to two years old, frames the rest of our life in terms of health and prosperity. Clinical academics have also shown the benefits of maternal preconception health as a determinant in the lifelong health of children. Public policy needs to catch up with this new body of evidence. But how do we translate it without creating the mother of all nanny states?
The key is to empower people with information that doesn’t suggest blame, but is matched by a range of solutions, tailored to their preference. The current mistrust about MMR is a classic case in point. Despite campaigns to counter misinformation on MMR, many are still sceptical about its benefits. So we should conduct a cost benefit analysis to give parents a choice between single doses or the all-in-one vaccination. If it means sustaining herd immunity, it’s worth a shot.
Choice should extend to the range of services required post-birth. The NHS is good at offering expectant mothers a choice of birth location, and so it should be after birth. If mothers were empowered to exercise choice over their health visitor for example, it’s likely they’d be more responsive to advice and to more visits. This is especially important when it comes to supporting mothers with post-natal depression because of the social stigma attached to it.
The NHS offers free prescriptions, including for health supplements, to expectant mothers and in the year post-birth. This option should be extended to parents planning a pregnancy, given the evidence between maternal health pre-conception and a child’s long-term prospects.
Suggestions like these, designed to make the NHS more responsive to an individual’s choice at the most important juncture in our life cycle, would sit best in our Conservative manifesto. Corbyn’s Labour doesn’t understand about choice in public services. And no-one knows what the Liberal Democrats stand for beyond the repeal of Article 50.
A focus on the first thousand days is compatible with the progress we’ve already made with early years initiatives. In particular, the work of Tim Loughton strikes at the core of our compassionate Conservative values in terms of supporting the most vulnerable families. And Andrea Leadsom’s leadership on innovative cross-departmental partnerships, in order to provide a more holistic and seamless service to parents and children, is key.
Our approach could also draw judiciously on the recommendations set out in the recent reports from the Health Select Committee and the Science and Technology Committee, which have both looked at the evidence base for interventions in the first thousand days of life.
The upcoming election will centre on Brexit. The health manifesto will rightly front up NHS spending. But beyond that, I hope the Conservative health ministers and their advisers, with their wealth of expertise, will prioritise policies that support the first thousand days of life. That is how we will make the biggest gains in national prosperity for the long term and start to regain the debate beyond Brexit.
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