Title: Public health in Wales: a nation comes of age
Abstract: The battle over NHS reform and public health policy in England has been played out in innumerable newspapers, blogs, and television and radio programmes. Less attention has been paid to the quiet revolution across the border in Wales. Since devolution in 1999, Wales has gradually accrued an increased degree of self-government, culminating in the vote this year to give the Welsh Assembly full law-making powers in a wide range of areas: a result First Minister Carwyn Jones hailed as the day “an old nation came of age”. Jones' statement that his government is considering using these powers to ban smoking in cars containing children is a welcome move. The rationale is clear: vehicles are confined spaces in which children can be repeatedly exposed to carcinogens. Society owes these children a duty of care. Other benefits of a ban might include a general reduction in smoking, as well as an improvement in road safety. Similar bans are in place in parts of Australia, Canada, and the USA: Wales could be one of the pioneers of this approach in Europe. “It can be done, and it does make a difference”, Chief Medical Officer Tony Jewell told The Lancet. Yet this is only one of the ways in which Wales is providing a lead in public health. Jewell pointed out that the Welsh Government was the first in western Europe to make sustainability one of its operating principles; similarly, the reduction of child poverty is an integral part of new policies. Naturally, the country of David Lloyd George and Aneurin Bevan, architects of the British health and social care system, has a political inclination towards health equality. Alongside this tradition, strong partnerships between health, government, and the voluntary sector have delivered innovative plans in diverse areas such as child health and suicide prevention. A proposed public health bill promises interesting future developments. If the Welsh Government can deliver, it will be instructive for medical professionals worldwide as an example of a public health approach that other countries can consider introducing—perhaps even England.