Guest blog post: What about health?

What about health? This is the question that the BMA wants public bodies to have to consider when developing policies and making decisions on key development plans.

In many circumstances, the impact major decisions may have on human health does not have to be considered, let alone acted upon. But we’re already used to assessing policies and decisions for how they might impact on the environment or on equalities, so why not extend this approach to health as well?

By watching this 2 minute video you can see for yourself the positive impact Health Impact Assessments (HIAs) will have if they are put on a statutory footing.

What has happened so far?

We believe that requiring HIAs for specific polices and developments would be a major step forward. It would provide a reliable way to avoid or minimise negative impacts on health and well-being, as well as identifying ways to better promote positive health outcomes.

The Welsh Government previously consulted on requiring HIAs in certain circumstances, a proposal which gained much support from organisations across Wales. It is hugely disappointing that the idea has not been taken forward in the Public Health (Wales) Bill.

Legislating for mandatory HIA would provide an important contribution to improving the future health and well-being of the nation. At the same time, it could cement Wales as a World leader in the application of public health policy. In our view, it is essential that this opportunity is taken to ensure that everyone’s health is a priority.

We believe that the Public Health (Wales) Bill is the appropriate vehicle for making HIA mandatory in specific circumstances. These could include: Strategic and Local Development Plans, certain larger scale planning applications, the development of new transport infrastructure, Welsh Government legislation, certain statutory plans such as Local Well-being Plans, new NHS developments (e.g. new hospitals) and health service reconfiguration proposals.

The Bill is currently coming towards the end of its Stage 1 consideration in the Assembly, and the Health and Social Care Committee is in the process of producing its report. BMA Cymru Wales has called for that report to recommend the Bill be amended to include a requirement for HIA within its scope.

What are the possible excuses?

HIAs are too bureaucratic

We would disagree as HIAs need not be overly burdensome. The first stage should be a screening exercise which can determine whether an HIA would both be valuable and feasible within a particular decision-making context.

HIA is not just a tick box exercise. A methodology could easily be developed which would ensure those policies, plans and programmes which should be subject to an HIA could then go on to be subject to a suitably more rigorous assessment – but for those for which this would not be necessary, this can also be straightforwardly identified. HIAs also don’t need to be undertaken as a stand-alone process. They could for instance be integrated into a wider impact assessment.

The Future Generations Act already covers this

We don’t believe that the Well-being of Future Generations (Wales) Act 2015 goes far enough. Whilst the Act’s draft Statutory Guidance does talk about adopting a health in all policies approach, there is no clear definition of what is meant by this or how it should be applied in practice. We feel this is much too vague and HIA would still therefore be left as something that would be optional.

In our view, it remains important that a statutory requirement for HIA is included in the Public Health (Wales) Bill. This would complement and strengthen the approach of the Well- being of Future Generations (Wales) Act 2015 by making sure that the numerous benefits of undertaking HIA can be realised in the most important circumstances.

Why is BMA Cymru Wales campaigning for HIA?

We believe that a mandatory requirement for HIA, in certain defined circumstances, would be entirely in line with the wider Welsh Government policy direction, and the approach taken in other recent Bills.

Putting HIA on a statutory footing would make sure that decision makers give far greater consideration to ways in which negative impacts on health can be mitigated, and positive health benefits maximised. Issues that were previously unforeseen could be identified and addressed. Communities would also be reassured that the decisions being made are based on a full and proper assessment of how their health might be affected.

Legislating for mandatory HIA would provide a significant contribution to improving the future health and well-being of the people of Wales, at the same time as helping Wales to become a World leader in the application of public health policy.

Join our campaign

Join our campaign by completing our e-action. Simply fill out your details and click ‘submit’ to bring up a list of your Assembly Members and an email template, containing a link to the video. Complete the e-action, here.

Carla Mahoney is Acting Head of Public Affairs at BMA Cymru Wales.