Can the political parties’ auction of promises make the difference that’s needed for our health and wellbeing?  (That’s the UK 2015 general election, by the way, in case you’re reading this some time later and/or from elsewhere in the world.  And it’s the May election – in case we end up having another).

It does seem a bit Pythonesque at times:

“If I were Prime Minister, I’d have a same day GP appointment for over 75s”

“Well, we’d fund 20,000 more nurses, 8,000 more GPs and 3,000 more midwives”

“Pah, we’d do all that and give the NHS £8bn a year.”

“Well we’d ensure parity of esteem for mental and physical health, integrate health and social care, devolve health to the regions and promise no big new top down reorganisation.”

So is any of that going to fix our health?  Bits might help.  But there are serious reasons why overall it might not.

It’s not just picking random targets of staff or services that’s a problem.  Although it’s not clear how they’ll be paid for when the £8bn in the Five Year Forward View was just to continue the service not add bells and whistles, and even that required heroic assumptions on efficiency savings.  But, hey, this is an election and parties make promises to win votes.  That doesn’t necessarily mean there’s no coherent plan underlying it.  Not necessarily.

And it’s not just that the main parties don’t seem prepared to tackle head on how to make an impact on the social determinants of health and how deprivation and inequality affect health and wellbeing.  Too much fear of frightening the horses – or maybe a fear of getting a metaphorical horse’s head in the bed from the media moguls.

No, I think a big part of the reason why the parties can’t fix our health is because it’s outside the realm of their control.  It’s not just the job of central government.  There’s a big role for local organisations – councils, CCGs, health and care providers and the rest of the public, private and voluntary sectors.  Health and Wellbeing Boards have a vital role in bringing that together but devising coherent, practical and effective health and wellbeing strategies is proving cunningly complex (perhaps we need to get together, maybe on social media, to devise a good model which we can then tailor to our local areas).

But beyond all that there’s the general public.  And that’s where most of the management of health happens, whether that’s ‘prevention’ or ‘treatment’.  Even people with long term conditions spend a very small proportion of their time in the formal health system.  We help ourselves and we help each other, whether our children, parents or others.

So, is it a question of “ask not what your government can do for you, but what you can do for your government?”  Or is there a way all the parties – central government, local government, health, other agencies, the private and voluntary sectors and the public – can somehow work together, in partnership to stop us falling ill, to ensure more efficient and effective treatment if we do and to promote health and wellbeing amongst us all, more equitably?

P.S. After writing this, I saw similar issues covered (much better) in this Community Links blog about the Big Society.  And on the same site, this blog about early action is also worth a look.