CHAPTER 1: INTRODUCTION
1.1 The protection of public health is a key component in the Executive's drive to improve the health of the people of Scotland. Despite the significant advances we have made over the past 100 years, we still face the challenge of responding appropriately to a range of infectious diseases, environmental nuisances and hazards. This consultation describes why action to deal with these problems remains a priority and seeks views on a range of proposals for updating our legislation to respond to the challenges of the 21st century.
1.2 Public health is:
"The science and art of preventing disease, prolonging life and promoting health through organised efforts of society."
1.3 Government, NHSScotland and local authorities have specific responsibilities in respect of public health. The services dedicated to the public health function were defined in the CMO's Review of the Public Health Function in Scotland in 2001 as having a duty to:
"Secure and sustain the public health, addressing health policy issues at a population level and leading a co-ordinated effort to tackle underlying causes of poor health and disease."
1.4 This involves making progress in three overlapping areas:
- Health improvement: reducing inequalities in health and promoting healthy lifestyles; educating for good health; developing public and private sector policies and practices, which facilitate the attainment of health and wellbeing; and supporting the family and community in this goal;
- Health protection: ensuring the safety and quality of food, water, air and the general environment; preventing the transmission of communicable diseases; managing outbreaks and other incidents which threaten the public health; and promoting safety at home, in the community and at work;
- Health service design and planning: improving the clinical effectiveness and quality of health and related services; facilitating their efficient delivery; and supporting the development of an ethical framework for the governance of services.
1.5 This consultation is mainly concerned with health protection. As our physical and social environment presents us with new challenges, we need to develop new ways to defend ourselves against those hazards which can damage our health. These hazards may be:
- Biological - bacteria, viruses, parasites, prions, allergens;
- Chemical - lead, asbestos, ammonia;
- Radiation: ionising (alpha and beta particles), non-ionising (electromagnetic fields).
1.6 The challenge before us remains a hugely important one. Up to 4,000 Scots die every year from infectious diseases, a figure which represents between 5 and 6% of all deaths. Infections account for three of the most common five reasons for a GP visit in under 5s and 5-14 year olds whilst they also serve to exacerbate other diseases, such as stomach ulcers, asthma and chronic bronchitis, cervical and liver cancers.
1.7 New intensive methods of food production, expanding leisure opportunities, the globalisation of trade and travel, and increasing pressure on the environment have contributed to the re-emergence of old, infections such as Tuberculosis and the emergence of new threats such as SARS. The threat of pandemic influenza has been headline news recently. Another item that often features in the news is terrorism, particularly relevant from the point of view of this consultation is the deliberate release of chemical, biological, radiological or nuclear agents into our environment.