A Bill of Health An Expert Panel on how to make a whole government approach to health a reality

To create a society where everybody can thrive and live a healthy life requires sustained action across the whole of government. We've brought together an Expert Panel to make recommendations for a 'Bill of Health' to enable a long-term shift in how government approaches improving health and reduce health inequalities.

The challenges

We know that our health is shaped by the world around us – from good-quality homes, to stable jobs, social connections, and neighbourhoods with green space and clean air. These factors are what we call the building blocks of health and wellbeing.  

Yet progress on life expectancy has stalled and good health remains out of reach for too many people in the UK. Health is increasingly unequal and stratified by factors like income, geography and ethnicity. Women and men in the most deprived areas of England die, on average, 7.6 years and 9.4 years earlier respectively than their counterparts in the least deprived areas. A woman born in Wokingham can expect to live 15 more years in good health than a woman born in Blackpool.

It is not sustainable to continue meeting growing demand in the NHS, while doing little to keep people healthy for longer. Taking action requires a stronger and more coherent approach to the ways in which public policy shapes our health. For example, the social security system, transport and housing are outside of the control of the Department for Health and Social Care but shape the nation’s health.

Although it is widely accepted in principle that action across government shapes our health, in reality efforts to take a cross-government approach to health have faced many barriers. Lofty government ambitions – such as the intention to improve Healthy Life Expectancy by 5 years by 2035 – have lacked sufficient focus and there has been inadequate investment, follow-through and accountability to make scale of change required.

Making health a cross-government, long-term priority

With an election expected this year, whoever forms the next government will face the challenge of how to coordinate work across the wide range of policy areas that affect health, at a time of limited financial resources and many competing priorities.  Even if we assume that those at the top of government have the right intentions and understand the importance of health in all policies, they will need a clear understanding of which levers they can pull to make the greatest difference. 

In 2021 the Health Foundation published a paper calling for a whole government approach to improving health that emphasises the critical role that mechanisms within government can plan in driving joined up action on health. There is now a lively policy debate and growing consensus that action to improve our health should be seen as a national imperative, for the sake of individual well-being, the economy and the future of public services. 

One focus for this debate is what lessons can be learned from the Climate Change Act 2008, which uses binding statutory targets (“net zero”) and an independent body (the Climate Change Committee) to review progress and policies, and to hold government to account. The Institute for Public Policy Research, the Tony Blair Institute and the Times Health Commission have all recommended applying a similar approach to health, as has the Health Equals coalition of which the Health Foundation is a founding member. 

The Expert Panel

Despite this increasing interest in putting greater emphasis on preventing ill health, crucial questions remain around how such an approach could be delivered most effectively. Helping to answer these questions could give any future government more confidence to change systems of policymaking, coordination, oversight and delivery, with a full understanding of the advantages and potential risks of different approaches. 

It is for this reason that the Health Foundation has convened a group of 12 people with a wide range of experience across national and local policy development, analysis and delivery. The aim of the Expert Panel is to develop and publish credible, implementable proposals for how mechanisms within government, including targets, can best deliver cross-government action and, crucially, sustain it. 

The Expert Panel has started work and aims to publish an interim report in the early summer and a final report in autumn 2024, to give the next government a clear set of recommendations to consider taking forward.

In parallel, the Health Equals campaign – of which the Health Foundation is a member – will be campaigning for a Bill of Health.