P 36
Ymchwiliad i’r Adolygiad Blaenoriaethau ar gyfer y Pwyllgor Iechyd, Gofal Cymdeithasol a Chwaraeon
Inquiry into the Priorities for the Health, Social Care and Sport Committee
Ymateb gan: Sefydliad Bevan
Response from: Bevan Foundation
Priorities
for the Health, Social Care and Sport Committee:
response from the Bevan Foundation
1. The Bevan Foundation develops new ideas based on sound evidence to make Wales fair, prosperous and sustainable. It is an independent, non-aligned charity. In the last three years it has made a significant contribution to public policy in Wales on:
· the outlook for the Welsh society, including health and social care, by 2020; [1]
· improving care at the end of life (for Marie Curie);[2]
· reducing smoking prevalence especially amongst disadvantaged groups.[3]
We welcome the opportunity to submit our views on the Committee’s priorities for the coming term.
2.
Wales faces
major challenges in health and social care in the next
five. They include
rising demand (as a result of changing demographics and
expectations), increased incidence of certain diseases and
conditions (mental as well as physical), new therapies and
treatments, and unforeseen risks e.g. new diseases, antibiotic
resistance. A focus by the Committee on preparedness for the future
as well as on the present is vital.
Public
Health
3.
People from low
income groups experience higher levels of ill-health and die at a
younger age than those from higher income groups. Some of this
inequality is driven by so-called lifestyle factors (e.g. diet,
exercise and smoking) and by much less widely recognised
environmental factors (e.g. damp housing, poor air quality). The
persistence of inequalities raises questions about the
effectiveness of public health interventions to date. Our recent
work on new devolved taxes highlighted that the Welsh Government
could shape behaviour by imposing a levy on added sugar in food and
drinks and on the use of sunbeds.
4. We welcome the proposals to consider sport, loneliness and gambling as aspects of public health. We also suggest that the Committee investigates the effectiveness of current interventions, particularly on low income groups, in respect of the big health risks, namely:
· physical inactivity (i.e. wider than participation in sport)
· poor diet (including malnutrition as well as obesity)
· smoking
·
environmental
factors (especially housing and air quality).
NHS
Services
5.
We
welcome the proposals to consider neonatal services, primary care
and ambulance services. We would urge the Committee to add to
this list of services to be scruitinsed those available for people
with mild to moderate mental ill-health, e.g. depression and
anxiety. Mild to moderate mental illness affects around
one in five of the population, has a serious effect on
people’s quality of life and accounts for a significant
‘burden’ on health services. Parental mental illness is
strongly associated with poor outcomes for children, and we
recommend the Committee looks specifically at parental (and
especially maternal) mental illness.
6. We understand the concern with waiting times but do not consider that these should be the sole measure of performance. We also recommend that the Committee scrutinises:
· equity of access including to end of life care;
· patient safety (including management of hospital acquired infections, compliance with best practice e.g. safety alerts, and adverse incidents);
· preparedness for risks e.g. new diseases.
7.
We
anticipate that leaving the EU will have an impact on the NHS
including the workforce, regulation of medicines, and environmental
regulation. We suggest that the Committee scrutinise the
preparedness of the Welsh NHS for these changes.
Social
Care
8.
Demand for
social care – both in formal settings and unpaid care –
is forecast to rise but social care budgets are under considerable
pressure. There are significant concerns about access to and the
quality of formal care and about the human rights of those
receiving formal care (e.g. deprivation of liberty).[4]
The support for unpaid carers is uneven.
9. We welcome the proposal to investigate the integration of health and social care services and the use of anti-psychotic drugs in care settings. In addition we suggest that the Committee scrutinises:
· deprivation of liberty in formal care settings;
· the impact of financial pressures on community-based social care services;
· support for unpaid carers.
10. We would welcome the opportunity to submit evidence on these matters in future.