Prevention is better than cure
There's nothing new about the concept of prevention being better than cure. Focusing on what matters to individuals to promote better health and well-being and stopping them from becoming ill.
Promotion of healthy lifestyles and the prevention of ill health is a fundamental principle behind public health and improving the public's health. The phrase 'prevention is better than cure' is often attributed to the Dutch philosopher Desiderius Erasmus in around 1500. It is now a fundamental principle of modern health care and inherent within health and social care strategies across the UK (See: England, Northern Ireland, Scotland, Wales).
Prevention is about tackling the upstream causes of ill health, this in itself is not controversial. The challenge is how it is paid for. See: King's Fund - Prevention is better than cure, except when it comes to paying for it. The results are not easily measured, because it is not easy to see where illness has not occurred.
The UK has a rich history of focusing on prevention, from Edward Jenner's smallpox vaccine in 1796 to John Snow using data analytics to determine the cause of the cholera outbreak in 1854.
While there has been huge progress across many public health trends, life expectancy in the UK has stalled and in some parts of the UK, has even decreased. There are worrying trends in health inequalities, with an unprecedented reversal in life expectancy for some groups and stark inequalities between healthy life expectancy between the most and least deprived areas. Increasing rates of alcohol and drugs-related deaths and hospitalisations, STIs, and obesity and a shift in the pattern of ill health towards multiple health conditions are also indicative of the need for action.
Nursing is essentially about providing quality evidence-based care and support to individuals and populations to improve health and well-being throughout life. In the past, public health has been seen as a niche specialty far removed from the typical image of nursing and only practiced by those with very specific qualifications.
Nursing and midwifery staff are now increasingly recognised as instrumental in improving and supporting the public’s health at an individual, community and population level. All nursing and midwifery staff are well placed to do this and need to embrace the contribution they can make to prevention. The ongoing challenge is having enough staff with the skills and time to make this essential contribution.
The RCN have been campaigning for many years for a greater focus on prevention with adequate funding. This is particularly pertinent in England, following the transfer of funding for public health to local authorities in 2013 and thereafter significant year on year cuts to local authority budgets and to the public health grant.
The RCN welcomed the announcement in the recent 2019 spending review of a real terms increase to the public health grant, which we see as a step in the right direction. However, indications are that the increase will likely fall short of the amount needed to offset the years of cuts and is not based on an assessment of population need. Improving public health and preventing ill health is about more than health services; and requires action to address the wider determinants of health, for example, education, transport and employment, which need to be addressed alongside health services in a more systematic way and with cross-government action and investment.
The RCN’s commitment is for a properly funded cross-government prevention strategy with a nursing workforce who are able to deliver this. We are calling for a long term sustainable investment in public health and prevention, which is based on assessment of population need and an understanding of health inequalities. The RCN has key alliances with a number of organisations to support lobbying on public health. For example we are members of the Alcohol Health Alliance who have recently called for £1 billion spent in tax to alcohol industry to be spent on funding 40,000 nurse vacancies. Also the Obesity Health Alliance and as such we have helped strengthen the case for stronger legislation on unhealthy foods.
RCN policy responses and publications
- Response to Scottish Government consultation on a new public health body - Public Health Scotland
- Response to Further Advertising Restrictions for Products High in Fat, Salt and Sugar
- Response to Serious Violence: New Legal Duty to Support Multi-Agency Action
- Response to Restricting Promotions of Food and Drink that is High in Fat, Sugar and Salt
- Response to Public Health Outcomes Framework: Proposed Changes 2019 to 2020
- Response to Funding and Provision of Local Authorities’ Children’s Services
- Response to the First 1000 Days of Life Inquiry
- RCN Briefing on Public Health Funding in England
- RCN: Leaving No-One Behind
Related RCN resources
- The Kings Fund. Directors of public health and the Covid-19 pandemic: ‘A year like no other’
- Health Foundation (2019) Creating healthy lives: A whole-government approach to long-term investment in the nation’s health
- HM Government (2019) Advancing our health: prevention in the 2020s
- Health Foundation (2020) Health Equity in England: The Marmot Review 10 Years On
- BASHH (2019) Consensus Statement on Sustainable Funding for Public Health
- PHE (2019) Supporting professionals to have healthier weight conversations: consensus statement
- Institute of Health Visiting (2020) Health visitors’ fear for children’s wellbeing due to relentless service cuts
See also: Prevention is better than cure
Without safe staffing levels in place, nursing staff are struggling to provide patients with the safe and effective care they would like to, and which patients deserve.
We're calling for safe and effective care to be enshrined in law in each UK country.
Prevention is better than cure podcast
Below you can listen to a short podcast from Helen Donovan, the RCN’s Professional Lead for Public Health, talking about the prevention is better than cure campaign.
Key RCN activity
April 2021RCN responds to DHSC public health reforms survey. Read our response, Securing Our Health.
October 2020RCN submission to the comprehensive spending review (CSR) included public health funding requirements
RCN briefing on changes to the Public Health System in England
2020 Comprehensive Spending Review joint representation on local public health funding
December 2019RCN publishes a member briefing on public health and the impact of financial pressures on the delivery of public health services in England.
December 2019RCN publishes member briefing on public health funding in England.
The Government announces the Advancing our health: prevention in the 2020 Green Paper. The RCN notes that the consultation has been buried in the dying days of the current Government after substantial delays.
Professional Lead Helen Donovan welcomes Secretary of State for Health and Social Care, Matt Hancock’s pledge to focus on prevention, but raises concerns about where the money will come from.
Dame Donna Kinnair writes to Chancellor of the Exchequer, Philip Hammond and the Secretary of State for Housing, Communities and Local Government, James Brokenshire outlining the RCN’s concerns about public health funding and cuts to the public health nursing workforce.
RCN submits a response to the Health and Social Care Select Committee Inquiry into Sexual Health.
RCN Congress calls on council to lobby the UK Government to reverse the cuts in funding for public health nurses.
RCN launches The Best Start: The Future of Children’s Health – One Year on. Valuing school nurses and health visitors in England at Congress 2018.