Glyn Davies has some interesting reflections on last night’s IWA event in Wrexham on the ‘Future Health of the People of Wales’. And once again the issue of powers rears its head.
The argument the IWA made in the recent Putting Wales in the Driving Seat research was that the current system – with LCOs and all the rest of it – is by nature restrictive when it comes to tackling issues in a rounded, strategic way. We cited public health as an example that could benefit if the Assembly were to receive further powers that would come after a yes vote in a referendum.
A legislative approach might be beneficial to public health because of the breadth of its determinants (the Swedes cite eleven); and because of the weight of legislation, as opposed to ministerial responsibilities (which can be changed more easily). A relevant precedent for public health interventions occurred in Victorian Britain, when town planners were public health officers who ensured adequate sanitation and ‘healthy’ city design. They aimed to tackle those things that affected the whole of the population’s health but which the population could do little about themselves. As the report noted, modern examples might include the salt, fats and sugar content in food and in the design of urban developments.
It was slightly disappointing that the Western Mail’s coverage of the report did not seem to pick up on the argument about making our laws strategic and rounded. It focused more on the couple of ideas the report had mentioned for some of the possible contents of a public health law. The law would not be about telling people what to do or trying to exercise control over their lives, but to write into law the responsibilities for tackling public health determinants and to make it as easy as possible for people to lead healthy lives. People are not being able to make free choices when urban settlements are built a long walk away from public transport links – and with barely any thought to cyclists – and energy-rich foods are cheaper per unit of energy than more nutritious foods people. The unhealthier options seem to be a whole lot easier or cheaper. The latter in particular will favour those with more disposable income.
In any event, the point is that achieving a holistic (legislative) approach to any issue, like public health, is difficult with the current arrangement. You might well disagree with the public health example — but there are many other fields that could benefit from a more strategic, rounded legislative approach.