Health warning for Wales

A stark health warning for Wales has been issued. Our director, Victoria Winckler, looks behind the headlines.

It’s long been known that the number of people living with a major illness is likely to increase over the next couple of decades, mainly because of our ageing society.  Older people tend to have poorer health, and so the more old people there are the more ill-health there is. 

This is worrying enough, but new findings from the Health Foundation should cause alarm bells to ring.  According to their research, people in deprived areas will be especially hard hit by the rise in ill-health, and growing numbers of people of working age will be affected.  Put these together, and the Health Foundation estimates that 700,000 more people of working age will have a major illness by 2040, and that 8 out of 10 of them will live in deprived communities.

The findings relate to England, but we can expect at least the same or worse in Wales. This is because the  population in Wales population is, on average, already sicker than England and because there are already huge differences in health between the most and least deprived areas. 

The consequences are huge.

If the forecasts are correct, there is likely to be rocketing demand for health care.  That demand is likely to be across the board, from management of many conditions by GP practices to emergency admissions for complications of diabetes, mental health crises, and so on.  This demand will be greatest in deprived areas – precisely the places that are already under-provided with health care services.

The increase in major illnesses amongst people of working age will also hit hard.  Some people with a major illness do manage to work, but many cut their hours or have to give up altogether.  Employers may struggle to recruit, the government misses out on taxes, and people will have to rely on not very generous social security benefits to get by.  It is a pretty grim prospect. 

What should be done?

Stark warnings often result in decision makers behaving like frightened rabbits, staring at the headlights of an oncoming car.  But there is in fact a clear route to avoid impending disaster. 

As recommended by the Health Foundation, there needs to be investment in community-based health care to manage common health conditions such as diabetes, chronic pain, anxiety and depression.  It is hard enough to get a GP appointment now let alone if numbers rise further. 

Crucially, that investment must be directed towards the most deprived areas.  Many disadvantaged communities are already ‘under-doctored’ – with many large housing estates in Wales having not a single GP.  A call to invest in primary care is nothing new, but it just hasn’t happened on a significant scale in Wales let alone in the most deprived areas.  

In the longer term there needs to be urgent action to prevent illness in the first place,  The major illnesses identified in the Health Foundation report are all closely associated with low incomes.  To reduce the number of people living with them, reduce poverty. 

The persistence of poverty makes it look like it is near-impossible to solve, but that is not the case. By taking bold steps the Welsh (and UK) governments could make a real difference.  Here’s how:

• More, decent housing so people have somewhere warm and safe to live, avoiding the chest infections associated with cold, damp homes or the anxiety of being evicted. 
• Better jobs, so that workers have enough to live on with secure hours, avoiding the stress of making ends meet, and fair conditions that do not expose them to hazards. 
• And alongside that, a social security system with benefits above destitution levels, so people can afford to eat and heat their homes, and without fear of sanctions or deductions. 

The UK government has responded to the Health Foundation report that it is ‘helping’ people back to work through the stick of cutting sickness benefits and the carrot of employability programmes. This might work for some people, but it won’t for people who are genuinely too ill to work especially if their job was a physically demanding one. 

There’s just sixteen years to go before the reality outlined by the Health Foundation hits. 

One of the mantra’s of the Wellbeing of Future Generations Act is prevention – so let’s see the prevention of devastating illness put into action by the new First Minister and cabinet.   And by the way, the answer is not only people eating more veg and exercising. 

Victoria Winckler discussed the Health Foundation findings on BBC Wales Breakfast on 18th April 2024.