Welsh Future Generations Commissioner Derek Walker has demanded fundamental changes in the approach to health inequality, asserting that the National Health Service lacks the capacity to resolve the issue independently.
His remarks follow the release of the Welsh Government’s Wellbeing of Wales: 2026 report, which documents that residents of Wales’ most disadvantaged regions experience fewer years of good health compared with those living in wealthier areas.
Data from the commissioner’s office indicates a widening disparity, with women experiencing an approximate 19-year gap and men an 18.1-year gap in healthy life expectancy, representing the largest recorded difference for Welsh men.
The document additionally reveals that healthy life expectancy in Wales has declined for the fourth successive reporting period.
Women anticipate spending 58.5 years in good health, while men expect 59.2 years.
The report identifies declining mental well-being among younger demographics and notes that merely 18.3 percent of individuals participate in at least one hour of physical activity daily.
However, long-term achievements are acknowledged, including substantial enhancements to air quality since the 1970s.
Walker contends that determinations regarding housing, income, employment, transportation, nutrition, air purity, and green space availability all shape population health well before medical intervention becomes necessary.
His proposals include positioning Wales as the inaugural Marmot nation.
Walker emphasised that geographical location should not dictate an individual’s prospects for healthy living, and reversing current trends necessitates sustained financial commitment and coordinated efforts across governmental bodies, extending beyond the NHS.
He stated that prioritising prevention involves not only supporting individuals in maintaining and enhancing their health but also investing in energy-efficient housing, unpolluted air, thriving natural environments, nutritious and accessible food, equitable employment, and integrated public services designed to eliminate obstacles preventing people from achieving better health outcomes.
Walker warned against continuing to fund the repercussions of poor health without intensifying efforts to address underlying causes, particularly given that the report demonstrates ongoing deterioration in national health with widening disparities, much of which remains preventable.
He noted that decisions made presently will determine the health trajectory of Wales for decades ahead.
Research conducted under Walker’s direction indicates that preventative investment may fall short of required levels, with health boards allocating less than 5 percent in certain cases.
Public Health Wales calculations suggest that preventative measures can yield returns reaching £14 for each pound invested.
His office has created a prevention budgeting instrument, scheduled for introduction on 22 October, intended to assist public organisations in assessing expenditure directed toward averting problems prior to their emergence.
During January 2025, Walker called upon the Welsh Government to establish protected funding for prevention initiatives and progressively increase such allocations.
Following negotiations surrounding the autumn supplementary budget, he has reiterated this appeal to the Plaid Cymru-led administration, urging ministers to demonstrate how their expenditure priorities will tackle root causes of ill health.
According to the release, Wales now possesses its inaugural Deputy Minister for Prevention, who has appealed to the Welsh Government to safeguard prevention funding within the upcoming budget.