Working Together for a Healthier Scotland

Foreword by the Secretary of State for Scotland

For 50 years, the NHS has helped people who fall sick. This Green Paper is about helping people stay well. It is about respect, self-confidence and the firm belief that Scotland need not remain trapped at the foot of the health league. We produce good food, and can eat well. We live sport, and can be fit. We are known for the quality of our education and ideas, and can turn these towards better health. We are entering a new millennium, regaining powers to legislate and act in our own health and interests.

So this Paper is about a twin health challenge for Scots and for Scottish institutions:

– We can all act to improve our own lives, avoiding illness as we would accidents.

– Public and private bodies - Government, local authorities, agencies, companies - can protect health through their policies, plans and actions.

Both approaches together will have real impact: one alone is not enough.

Poverty, unemployment, poor housing can blight lives and destroy health. Brave attempts to tackle ill-health have often foundered on the rocks of real lives, poor prospects and counter-pressures. This Paper is about planning for health, through personal and community efforts. Our challenge to institutions comes through health impact assessment, health improvement programmes, healthy eating, help in the planning of community development to secure health gains. The challenge to people is to look after the health interests of themselves, friends and family.

Age at death is a crude measure, if a hard test, of our health progress. In reality, good health is the basis for happy childhood, achievement in middle years and independence in old age. It is not just death but pain, depression, fear and disablement that put a limit on lives, and impose social and economic burdens.

I intend this Green Paper to engage ideas and start a broad process of commitment towards improving the quality of Scotland’s health. We all know the mountains to climb in tackling heart disease, cancers and mental illness; and to reduce substance misuse. There is increasing evidence of steps that work and steps that do not, although measurement, like action in this field, is complex.

It is right that the Government leads this process and contributes across its many functions. That is why, along with Sam Galbraith, our Health Minister, all my Scottish Office Ministerial colleagues are signing this Green Paper, as affirmation of our collective commitment to improving health in Scotland. But there are local frameworks and initiatives well down the road, with much to teach. We need to listen at this stage to expert views and local voices before framing the White Paper that will follow. There must be scope within national strategies for breaking new ground locally.

I am confident that contributors will tell us what the Government can and should do. I hope that they will also tell us about the ways they will join in and help us in working together for a healthier Scotland.