The future of the left since 1884

Untapped potential

Prevention is better than cure – and the wider public health workforce can help us get there, writes William Roberts



It is a critical time for health in the UK.  The health and social care system is creaking at the seams. More than one million people in England died prematurely in the decade after 2011. The latest figures from the Office for National Statistics suggest there are now 2.8 million people not looking for work because of health issues. Waiting lists are at an all-time high. Measles cases are on the rise due to lower uptake of the MMR vaccine. Regional inequalities are lowering life expectancies. Behind each of these deeply troubling figures – and we could list many more – is a failure in prevention.

‘Prevention’ is the word that has defined much of Labour’s output on health in the run up to the next general election. A ‘prevention first’ approach underscores the Labour party’s NHS mission, and with good reason. Investment in preventative public health policy costs far less than doing nothing. For instance, analysis commissioned by Impact on Urban Health found that expanding eligibility for free school meals to every state school child would generate a return of £1.71 for every £1 invested. It is a similar case with better regulation. The Tobacco and Vapes Bill which is making its way into legislation will save thousands of lives and billions for the NHS. Every year, road safety regulations prevent countless fatalities.

We will not be able treat our way out of our crisis of ill health.  Long-term investment in preventative policies that address the social determinants of health is the only way we are going to build a healthier and more productive future. People need decent homes, good jobs, access to healthcare and great places to live in.

This change is not going to happen overnight. If Labour does form the next government,  as looks increasingly likely, it will need to act quickly and back up its talk about prevention with concerted action and strong political leadership. In a difficult economic climate, thinking about how it makes the most of the resources that it has at its disposal is going to be key. The best resources we have when it comes to tackling the UK’s ill health are people, and many of them are hiding in plain sight.

The Wider Public Health Workforce

Millions of people across the UK workforce are positively contributing to health of the public through their jobs – sometimes without knowing it. Allied health professionals, sports and fitness trainers, town and country planners, community health champions, emergency services, pest control workers, housing support, cleaning and hygiene operatives and many more all do their bit to protect and promote better public health.

It is occupations like these that make up the UK’s ‘wider public health workforce’, as opposed to the core public health workforce of around 40,000 people. Its value is not always recognised, but the wider workforce is uniquely placed to have a positive impact on the nation’s health. It encompasses a vast range of settings, including workplaces and communities. With the right training, support and recognition, members of the wider workforce could go even further.

Our new report, The Unusual Suspects: Unlocking the Potential of the Wider Public Health Workforce, sets out four key recommendations to help it do more:

  • The UK and devolved nation governments should develop a cross-sector national strategy for the public health workforce as a whole. This would be a joined-up approach tying together industry, public health and the workforce.
  • The public health sector and relevant government departments should think collectively about how to resource, upskill and empower the wider public health workforce to maximise its impact. In practice this would mean resourcing and funding training for the wider workforce.
  • The wider public health workforce’s contribution to public health and prevention should be better recognised.
  • Members of the wider public health workforce need clearer routes into public health and ways to develop and be recognised for their expertise in public health. These routes would create better career development opportunities and enable progression into public health.

The recommendations are clear, actionable and realistic. And, to put it simply, they don’t come with a large price tag. Yet the payoff of supporting the wider workforce would be huge. We have identified that there are up to 1.5 million people in the wider workforce who could further contribute to improving public health if they had more support. To put this figure in context, the NHS employs 1.4 million people in England.

It would also be popular with the public. Polling commissioned by RSPH found significant support for the public health workforce as a whole, with 82 per cent of the public saying that it is crucial to safeguarding the nation’s health.

We cannot accept a situation where declining health is the norm – it is both unfair to those affected and damaging to the economy. To reverse these alarming trends, we will need an army of people doing public health. Supporting the wider public health workforce offers the potential to help produce better health outcomes, reduce pressure on the NHS and grow the economy. If Labour comes to power, we urge them to make the most of it.


Photo credit: Adrià Crehuet Cano via Unsplash

William Roberts

William Roberts FRSPH is the chief executive of the Royal Society for Public Health. He has previously worked as a senior leader in the NHS across roles in public health, commissioning, strategy, transformation and planning. He is a registered nurse who has worked in both hospital and community services, and as a nurse specialist in tuberculosis and HIV.


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