Department of Health's
'Saving lives: Our Healthier Nation' report:
"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".
www.archive.official-documents.co.uk/document/cm43/4386/4386-sm.htm
"1.26 People are responsible for their own
actions in health as in other areas. But the
decisions people take over their health are more
likely to result in better health and a healthier
life if they have the opportunity to make informed
decisions".
"1.29 For people to make such decisions
against the background of such powerful determinants,
they need to make informed decisions. Such decisions
must be based on information about the risks involved
in a range of activities, practices and products.
People cannot and should not be pressured into
responsibility. We do not believe in the old nanny-state
approach. But there is a powerful role for Government
in making clear the nature and scale of risk, and in
some cases, taking protective action in the light of
it".
"1.33 Individuals are central to our new
vision for better health. People need to take
responsibility for their own health - and many are
doing so. There is a new and clear realisation that
individuals can improve their health, by what they do
and the actions they take".
"1.37 Government will play its part by creating
the right conditions for individuals to make healthy
decisions".
"1.41 ... tackling smoking depends on relieving
the conditions - social stress, unemployment, poor
education, crime, vandalism - which lead far more
people in disadvantaged communities to smoke than in
other sections of the community".
www.archive.official-documents.co.uk/document/cm43/4386/4386-01.htm
"Communicating
risk
3.15 Every day people are faced with
decisions in their daily lives, including decisions
which affect their health. Sometimes they recognise
that certain decisions put their health at greater
risk than others. But it is not always clear how
great or small a risk they are taking.
3.16 We can help people to understand
better about risk. Driving a car is a daily necessity
for many, playing sport an occasional pleasure, and
eating a plate of shellfish from a roadside caravan a
personal preference. All, however, can carry risks of
death, injury or acute illness. Armed with knowledge
and information about risk, and being aware of the
conditions under which risks can be greater, people
can make informed decisions in managing their
everyday life.
3.17 There are other potential risks to
health where individuals expect Government or other
responsible bodies to ensure that measures are in
place to protect their health. For example, people
expect to have a safe supply of pure drinking water;
they do not expect a fast food restaurant to serve
them partially cooked frozen chicken; and they do not
consider it their responsibility to check that a
train in which they are about to travel will be
operated by a properly trained and competent driver.
3.18 There are still other risks to health
where the public accepts that there is a need for
more than passive release of information to allow
them to make a decision. For example, in areas where
lifestyle can affect health - HIV and AIDS, cigarette
smoking, use of medicines in pregnancy - most people
will expect the Government to have an active
programme of education to explain the risks and
advise the individual on the action to be taken to
avoid them. They will also expect special efforts to
be made in relation to children, young people, and
those who are vulnerable or at particularly high risk.
3.22 Initiatives deployed to reduce risks
to health .... include: information and labelling,
health education, counselling and support, skills
training, regulation, legislation to manage the
performance of health services and good surveillance.
3.23 Perhaps because of the very diversity
of factors which can pose a risk to health, perhaps
because of their complexity, or perhaps because of
the apparently unique circumstances of each, no clear
ground rules have been established in the past on the
interventions to be used when a hazard poses a risk
to human health.
3.24 In some fields of health, being
exposed to a risk carries with it no benefits and
therefore the aim has to be to eliminate or
substantially reduce the risk. In most other
situations a potential risk must be weighed against a
potential benefit. Vaccines carry great benefits.
They prevent diseases which can sometimes be deadly.
Against these benefits must be balanced the rare risk
of an adverse reaction to the vaccine. Similarly,
medicines can relieve pain, restore lost function
and, sometimes, save life. They carry risks in the
form of side-effects, some minor, some major.
3.25 In short, it is the role of the
Government to provide information about risk. But in
most cases it is for the individual to decide whether
to take the risk. And there is also a balance between
risk and personal freedom. Some people enjoy pursuing
outdoor sports which others would consider too
dangerous to undertake. As long as people are aware
of the risk which they are taking, it is their
decision whether to put themselves at risk.
Guiding principles and
key steps
3.26 The guiding principles and key steps
in our approach to risk are:
Guiding principles
- high quality assessment of science
- full risk/benefit evaluation
- consistency of approach across risk
areas
- clear framework of interventions
- approach should have integrity if
judged in retrospect
- protect the vulnerable
- realistic sharing of uncertainty
- information should provide insight
- greater public participation in risk
deliberations
|
Key steps
- ensuring that there is access to high
quality scientific and medical advice
- communicating to the public an
assessment of risk at an early stage
making clear the areas of uncertainty
- giving advice where there is public
anxiety because people do not know
what sort of a risk they might be
facing
- identifying the options for
intervening to eliminate, reduce or
control the risk
- selecting the appropriate option(s)
in a way which involves the public
and evaluates its appropriateness
against specific criteria
- ensuring that the intervention is
successful in controlling the risk
for which it was intended
|
Healthy
citizens
3.27 People can, do and should make their
own decisions about their own and their families'
health. But the Government can help, acting through
local organisations in the community, to make sure
that people have the best information available on
which to base their decisions - on risk, for example,
or on assessing health or health problems.
'Healthy
Citizens programme ensuring people have the knowledge
and expertise they need'
www.archive.official-documents.co.uk/document/cm43/4386/4386-03.htm
Health Impact Assessment
4.45 We need to ensure that in all areas of
Government policy-making the actions that flow from
our policies will contribute to our goals of
improving the health of the population and reducing
inequality. So we have decided that major new
Government policies should be assessed for their
impact on health.
www.archive.official-documents.co.uk/document/cm43/4386/4386-04.htm
