Executive summary

Saving lives: Our Healthier Nation is an action plan to tackle poor health.We want to:

• improve the health of everyone
• and the health of the worst off in particular.

Good health is fundamental to all our lives. But too many people

• are ill for much of their lives
• die too young from preventable illness.

'the first comprehensive Government plan'

We are putting forward the first comprehensive Government plan focused on the main killers: cancer, coronary heart disease and stroke, accidents, mental illness.

We reject the previous Government's scattergun targets. Instead we are setting tougher but attainable targets in priority areas. By the year 2010:

• CANCER: to reduce the death rate in people under 75 by at least a fifth
• CORONARY HEART DISEASE and STROKE: to reduce the death rate in people under 75 by at least two fifths
• ACCIDENTS: to reduce the death rate by at least a fifth and serious injury by at least a tenth
• MENTAL ILLNESS: to reduce the death rate from suicide and undetermined injury by at least a fifth.

'tougher but attainable targets'

If we achieve these targets, we have the opportunity to save lives by preventing up to 300,000 untimely and unnecessary deaths. To achieve better health for everyone and especially for the worst off we are:

• putting in more money: £21 billion for the NHS alone to help secure a healthier population
• tackling smoking as the single biggest preventable cause of poor health
• integrating Government, and local government, work to improve health
• stressing health improvement as a key role for the NHS
• pressing for high health standards for all, not just the privileged few.

'social, economic and environmental factors
tending towards poor health are potent'

In securing better health, we reject the old arguments of the past.
We believe that:

• the social, economic and environmental factors tending towards poor health are potent
• people can make individual decisions about their and their families' health which can make a difference.

We want to see a new balance in which people, communities and Government work together in partnership to improve health. Our drive for better health is in line with a background of real improvement in health:

• people live longer and healthier lives
• life expectancy is now 80 for women and 75 for men
• many infectious diseases of the past - such as cholera, diphtheria and polio - have been brought under control
• death in childbirth is now rare.

But new problems arise, including AIDS and variant Creutzfeldt-Jakob disease.

'people can make individual decisions about their and their families' health'

People can improve their own health, through physical activity, better diet and quitting smoking. Individuals and their families need to be properly informed about risk to make decisions. We are introducing new Healthy Citizens programmes to help make decisions:

• NHS Direct - a nurse-led telephone helpline and Internet service providing information and advice on health
• Health Skills programmes for people to help themselves and others
• Expert Patients programmes to help people manage their own illnesses

Communities can tackle poor health, which springs too from a range of wider, community factors - including poverty, low wages, unemployment, poor education, sub-standard housing, crime and disorder and a polluted environment.

'tackling sexual health, drugs, alcohol, food safety, water
fluoridation and communicable diseases'

Health inequality is widespread: the most disadvantaged have suffered most from poor health. The Government is addressing inequality with a range of initiatives on education, welfare-to-work, housing, neighbourhoods, transport and the environment which will help improve health.

As well as taking action on our key targets, we are also tackling other important health issues like sexual health, drugs, alcohol, food safety, water fluoridation and communicable diseases - to put our new approach into practice.

We will reorient the NHS to ensure that for the first time ever, health improvement will be integrated into the local delivery of health care:

• health authorities have a new role in improving the health of local people
• primary care groups and primary care trusts have new responsibilities for public health.

Local authorities will work in partnership with the NHS to plan for health improvement:

• health action zones will break down barriers in providing services
• healthy living centres will provide help for better health.

'Local authorities will work in partnership with the NHS'

For partnership to work, public health will need high standards, and for public health to be improved, it will need success measures. On standards, we will:

• establish a new Health Development Agency, a statutory body charged with raising the standards and quality of public health provision
• increase education and training for health, with a new skills audit and workforce development plan, and specific measures for nurses, midwives, health visitors, school nurses and others
• review public health information, establish public health observatories in each NHS region, set up disease registers, and promote research
• establish a new Public Health Development Fund.

'take the opportunity of better health'

On success measures, we will:

• chart progress through interim milestones in the four priority areas to demonstrate how far we have got towards our targets by 2005
• require local targets for improving health
• manage performance through the new NHS performance assessment framework.

We want to see healthier people in a healthier country. People improving their own health supported by communities working through local organisations against a backdrop of action by the Government.

We want to see everyone take the opportunity of better health - now, and for the future.

We welcome your comments on this site. Prepared 5 July 1999