Preventing ill-health is an urgent priority – Chief Medical Officer

Wales must urgently shift to a prevention-first approach to tackle stagnating life expectancy rates and growing pressure on the NHS, the Chief Medical Officer (CMO) has warned.

The CMO’s Annual Report, Reflecting on our Health, published today, sets out evidence of worsening  health, particularly in the most deprived communities, and calls for a radical refocus on prevention across government and society.

The report highlights that life expectancy in Wales has stalled and, for many, healthy life expectancy is declining. Women are experiencing the sharpest fall. Preventable disease is now a leading factor in early death and long-term ill-health, with around 75% of deaths in people under 75 considered avoidable through better public health measures.

The CMO, Professor Isabel Oliver, said that six months into the job she had been struck both by the “scale of the challenge” and the “depth of commitment” across Wales, but warned that urgent action was needed.

“If smoking rates had remained unchanged over the past decade, Wales would now have more than 170,000 additional smokers,” she said. “Reducing smoking prevalence from 10% to 8% could prevent nearly 600 deaths and 2,700 hospital admissions every year. The evidence is clear – prevention is incredible value for money.”

Public health programmes deliver an estimated return on investment of 14 to 1, according to the report. Yet progress has stalled in key areas such as healthy eating, physical activity, and reducing harmful alcohol use.

The report warns that without accelerated action, the number of people living with four or more long-term conditions could almost double by 2035, with profound consequences for NHS demand, economic inactivity and social care costs.

Among its recommendations, the report calls for:

a sustained focus on early years support for low-income families

measures to tackle the social and economic determinants of health

stronger action to boost vaccination and screening uptake

policies that make healthier choices easier for adults

Prevention

To drive progress, Professor Oliver has established a new Preventing Ill-Health Advisory Group to strengthen national leadership and ensure prevention becomes a core part of ministerial decision-making.

The Welsh Government is also preparing legislation that will require public bodies – including those in education, housing and transport – to consider the long-term health impact of major decisions.

With the Senedd due to vote next week on new tobacco and vaping restrictions, the CMO said Wales must “replicate the success of tobacco control” across other areas of public health.

“This is a major challenge for our health service leaders,” she said. “But it also demands changes in society and at an individual level. Health must be recognised not only as a right, but as a shared responsibility for everyone in Wales.”