Welsh Journals

10. EVALUATING A HEALTH CAMPAIGN: THE HEARTBEAT WALES NO-SMOKING INITIATIVE1 Ceri J. Phillips and Malcolm J. Prowle INTRODUCTION The issue of how health services should be provided and the extent of resources utilized is clearly one of the most contentious political issues of the day. However, aside from the short-term political controversy, there is a more fundamental issue which is taxing the minds of all governments in the developed world, namely that of longer-term health policies. This is brought about as a consequence of what we have termed the health service dilemma. At the time the NHS was formed, there was a belief that the demand for health services was finite, and that all we had to do was provide sufficient financial resources and all the health demands of the population would be satisfied. With the benefit of hindsight that view seems unbelievably naive, and it is conventional wisdom now to say that the demands for health services are infinite, or at least approaching infinity. There are probably three main contributory factors at work here: (1) The increasing health needs and demands of an ageing population. (2) The continual advances in medical science. (3) The increasing aspirations of the population. Clearly, the resources available for health services (public or private) are finite, and thus we come to the dilemma of health service provision. How do we reconcile infinite demand with finite resources without ending up in a position where 100 per cent of GDP is devoted to the provision of health services, and still fails to meet demand? There are a number of broad policy options, and these are briefly outlined below: ( 1 ) Increase efficiency This option covers a whole variety of themes ranging from reducing the costs of catering or domestic services (through