Save the Health Survey for England!

I have taken a break from blogging to write a report for the Resolution Foundation on employer-focused disability policy (co-authored with Louise Murphy), which is coming out this Thursday. My normal blogging can now start again, starting with this call for action by this Friday:

With all of the headlines about declining health in the UK, you might think that it’s very easy to see if population health is getting better or worse - but you would be wrong.

It is relatively straightforward to look at deaths/life expectancy, but this doesn’t show what’s been happening to the health1 of still-living people, as people might be living longer in worse health. For example, people are now much more likely to survive after traumatic brain injuries (e.g. car accidents), but they often have impairments that continue to affect them for the rest of their lives - so increasing survival has also increased working-age disability.

We can use administrative data to have a look at trends in health treatment for particular conditions - how many people are diagnosed, or prescribed medications, or have GP or hospital consultations. But again, this doesn’t tell us about whether people’s symptoms or impairments have changed. For example, in a 2020 paper that looked at health trends 1994-2014, I showed there were rises in people reporting a diagnosis of asthma (by almost 5 percentage points for lifetime diagnoses) and a slight rise in people reporting any longstanding respiratory condition, but there were sizeable falls in symptoms of breathlessness or symptoms of COPD.

The only way of finding out if people’s health has got better or worse is to ask them - and this is done best by the Health Survey of England (HSE), which has tracked the nation’s health nearly every year since 1991. This is the survey that underpins the figures I just told you about respiratory health, and underpins a huge range of wider academic and policy research too.

But NHS England is planning to scrap the HSE - according to the UK Data Service, NHS England has recently said it:

“will not be prioritising population health surveys in its long-term strategic work plan, and that the Health Survey for England 2025 will be the last HSE it will resource”

This would be an unmitigated disaster, making it impossible to know if rises in medical treatment reflect genuine increases in ill-health vs. increased medicalisation - and thereby making it much harder to build a policy agenda to tackle either of them.

When this was revealed at a recent event for health survey users, there was such an outcry that this led the consultation on scrapping the HSE to be reopened. So if you are an HSE user (either as an analyst or a user more broadly) and want to help stop the HSE being scrapped, please do complete this questionnaire on the HSE by midday this Friday (25th July).

And either way, I’ll be returning to issues of medicalisation regularly in the coming months and years - the issues aren’t going away, even if the data does.