Tax as Early Action?

The new Health & Social Secretary Matt Hancock tweeted this month that prevention would be one of his top priorities in his new role. One of the areas where he could seek to expand prevention policy is obesity, particularly because an official report by Public Health England (PHE) says the NHS could save £15bn and almost 80,000 lives in a generation by weaning the public off its sweet tooth. Today’s children and teenagers are consuming three times the recommended level of sugar. An international study carried out in 13 countries has found that sugar taxes have major health benefits, and are a promising way to improve these figures and tackle the obesity epidemic, particularly among the poor. Advocates point out the success rate of similar taxes in other countries, including Mexico, where the number of sugary drinks sold reduced by 12% in the first year alone.

Although the sugar tax can be seen to be Early Action practice, the model is controversial as it places an economic burden on consumers and raises concerns about potentially widening the gap between the rich and poor. It may be worth considering alternative methods proposed by the PHE report before enforcing anything. Other options include introducing a national programme to reduce sugar content in foods and drinks, banning high-sugar foods from supermarket till areas and the end of aisles, and working to stop advertisement of unhealthy foods.

Acting early to reduce fire risk

The South Wales Fire and Rescue service have been working to satisfy the long-term goals highlighted by the Welsh Well-being for Future Generations Act to make South Wales safer by reducing risk. They have recently launched a strategic plan outlining their intentions, priorities and financial commitments for the next five years.

Statistics suggest Early Action programmes by the South Wales Fire and Rescue service have been successful in mitigating emergencies. Despite having the fourth highest number of deliberate fires per 10,000 population, their recent Early Action work has reduced this by an impressive 15.8%.

The Scottish Government have also been doing some work around fire prevention and have released Fire Safety Guidance for existing premises with sleeping accommodation following the Grenfell fire. The guidance advises on acting early to implement fire safety procedures that can reduce risk.

In other news, the National Fire Protection Association in the United States has recently announced the theme for its Fire Prevention Week: Look. Listen. Learn. Be aware. Fire can happen anywhere. This is observed in October in the United States and Canada and aims to educate communities about essential Early Action steps that can be taken to reduce the risk of fire.

Early Action is counterproductive?

You may have seen a recent story about new research led by Dr Nora Pashayan (UCL Department of Epidemiology and Health), which argued that women at lower risk of breast cancer would be better off not being invited for NHS screening for the disease. The researchers say risk-based breast screening could have benefits as it would reduce over-diagnosis, women being put through unnecessary tests and the demands on expensive NHS cancer treatments.

This story caught our eye because, at first glance, the research seems to suggest that Early Action is expensive and counterproductive. However, numerous other case studies and the work of Community Links on cancer screening has shown that acting early is vital for saving lives when it comes to cancer – with survival rates at almost 100% for those whose cancer is detected through the breast screening service. Furthermore, a systematic study by BMC Public Health has argued that Early Action is needed to increase awareness and knowledge of genetic testing for cancer risk and to reduce the perceived stigma and taboo surrounding cancer.

This demonstrates that the benefits of Early Action are still not widely understood, particularly in some media reports. One of the important contributions of the research, however, is that it highlights the issues of over-diagnosis and over-treatment. Whereas usually Early Action is a great means of reducing demand on more targeted, more acute interventions, this case appears to highlight a continued over-reliance on some interventions. As we clarify in our report, Early Action is a good starting point but cannot always guarantee successful outcomes – just like any other intervention, it can have unintended consequences.

Further Reading

The Social Change Project have launched a new report exploring how civil society can truly bring about transformational change. This report makes the case for a new conception of civil society potential called ‘Social Power’ and sets out Early Action recommendations for sector leaders, funders, regulators and governments to unlock this latent capacity.

Warm wishes,

The Early Action Task Force