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Dramatic increases in life expectancy are one of the defining achievements of the modern era. From 56 years for men and 60 for women in the UK a century ago, this vital measure of the quantity of life rose to 79 and 83 respectively in 2022. The trend towards increased longevity is global, although not all countries have seen gains on the same scale, and the pandemic sent it into temporary reverse.
We probably don’t talk about this enough. It is remarkable that most of us can expect to live for so long and that deaths from diseases such as tuberculosis, and of women in childbirth, have been so drastically reduced.
Quality of life is a different matter. Estimates of healthy life expectancy – the number of years during which people are in good health – are less reliable and more subjective than data based on deaths. But chronic and long-term illnesses have become more prevalent in the UK (and other western countries) as overall life expectancy has risen. Recent years have also seen highly troubling rises in health inequalities, including infant mortality and obesity. Last week, two thinktanks warned of worsening mortality rates across all four UK nations compared with other high‑income countries.
For the UK government, which shares responsibility for health with the devolved administrations, the challenge is to reduce the toll of illness and disability so that more people live well for longer. If they are to succeed, finding ways to prevent as well as cure diseases is crucial. This shift is one of three big themes of Labour’s health policy. So it is alarming that, just two months after the launch of his 10-year plan, Wes Streeting is facing criticism from experts.
In particular, the heads of the King’s Fund and Health Foundation are concerned that lobbying by the food, alcohol and tobacco industries have led to restrictions on junk food and alcohol advertising being watered down – as happened under the Conservatives. They warn that if rising levels of alcohol- and diet-related diseases are to be tackled, and pressure on the NHS eased, there is no alternative to regulatory measures such as a minimum unit price for alcohol, and a renewed focus on child poverty.
Mr Streeting, when Labour was in opposition, pledged to use a “steamroller” to force food firms to cut fat, salt and sugar from their products. The danger now is that the government’s fixation on economic growth, combined with anxiety about the populist right, has made it too timid to risk annoying businesses – or to give ammunition to libertarian critics who would attack it for restricting people’s choices.
On high-caffeine energy drinks, ministers are doing the right thing by banning their sale to under‑16s. New rules about junk food advertising will be an improvement. But these are limited measures when what is needed is an ambitious overview of the social determinants of worsening public health, including the rise of deep poverty, and the myriad ways in which people of all ages are nudged towards unhealthy behaviours.
This is a task for the whole government, not just the health secretary. Councils, businesses and regulators all have roles to play in what Labour ought to regard as a national improvement project. Health policy is not just about treatment. It’s about power, profit and having the political will to act.
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