Saving Lives: Our Healthier Nation



3.25 it is the role of the Government to provide information about risk. But in most cases it is for the individual to decide whether to take the risk. And there is also a balance between risk and personal freedom. Some people enjoy pursuing outdoor sports which others would consider too dangerous to undertake. As long as people are aware of the risk which they are taking, it is their decision whether to put themselves at risk.

Guiding principles and key steps

3.26 The guiding principles and key steps in our approach to risk are:


Guiding principles
  • high quality assessment of science
  • full risk/benefit evaluation
  • consistency of approach across risk areas
  • clear framework of interventions
  • approach should have integrity if judged in retrospect
  • protect the vulnerable
  • realistic sharing of uncertainty
  • information should provide insight
  • greater public participation in risk deliberations
Key steps
  • ensuring that there is access to high quality scientific and medical advice
  • communicating to the public an assessment of risk at an early stage making clear the areas of uncertainty
  • giving advice where there is public anxiety because people do not know what sort of a risk they might be facing
  • identifying the options for intervening to eliminate, reduce or control the risk
  • selecting the appropriate option(s) in a way which involves the public and evaluates its appropriateness against specific criteria
  • ensuring that the intervention is successful in controlling the risk for which it was intended


1.26 People are responsible for their own actions in health as in other areas. But the decisions people take over their health are more likely to result in better health and a healthier life if they have the opportunity to make informed decisions.
1.29 For people to make such decisions against the background of such powerful determinants, they need to make informed decisions. Such decisions must be based on information about the risks involved in a range of activities, practices and products. People cannot and should not be pressured into responsibility. We do not believe in the old nanny-state approach. But there is a powerful role for Government in making clear the nature and scale of risk, and in some cases, taking protective action in the light of it.
1.33 Individuals are central to our new vision for better health. People need to take responsibility for their own health - and many are doing so. There is a new and clear realisation that individuals can improve their health, by what they do and the actions they take.
1.37 Government will play its part by creating the right conditions for individuals to make healthy decisions.
1.41 ... tackling smoking depends on relieving the conditions - social stress, unemployment, poor education, crime, vandalism - which lead far more people in disadvantaged communities to smoke than in other sections of the community.

Communicating risk

3.15 Every day people are faced with decisions in their daily lives, including decisions which affect their health. Sometimes they recognise that certain decisions put their health at greater risk than others. But it is not always clear how great or small a risk they are taking.

3.16 We can help people to understand better about risk. Driving a car is a daily necessity for many, playing sport an occasional pleasure, and eating a plate of shellfish from a roadside caravan a personal preference. All, however, can carry risks of death, injury or acute illness. Armed with knowledge and information about risk, and being aware of the conditions under which risks can be greater, people can make informed decisions in managing their everyday life.

3.17 There are other potential risks to health where individuals expect Government or other responsible bodies to ensure that measures are in place to protect their health. For example, people expect to have a safe supply of pure drinking water; they do not expect a fast food restaurant to serve them partially cooked frozen chicken; and they do not consider it their responsibility to check that a train in which they are about to travel will be operated by a properly trained and competent driver.

3.18 There are still other risks to health where the public accepts that there is a need for more than passive release of information to allow them to make a decision. For example, in areas where lifestyle can affect health - HIV and AIDS, cigarette smoking, use of medicines in pregnancy - most people will expect the Government to have an active programme of education to explain the risks and advise the individual on the action to be taken to avoid them. They will also expect special efforts to be made in relation to children, young people, and those who are vulnerable or at particularly high risk.

3.22 Initiatives deployed to reduce risks to health .... include: information and labelling, health education, counselling and support, skills training, regulation, legislation to manage the performance of health services and good surveillance.

3.23 Perhaps because of the very diversity of factors which can pose a risk to health, perhaps because of their complexity, or perhaps because of the apparently unique circumstances of each, no clear ground rules have been established in the past on the interventions to be used when a hazard poses a risk to human health.

3.24 In some fields of health, being exposed to a risk carries with it no benefits and therefore the aim has to be to eliminate or substantially reduce the risk. In most other situations a potential risk must be weighed against a potential benefit. Vaccines carry great benefits. They prevent diseases which can sometimes be deadly. Against these benefits must be balanced the rare risk of an adverse reaction to the vaccine. Similarly, medicines can relieve pain, restore lost function and, sometimes, save life. They carry risks in the form of side-effects, some minor, some major.