On taking the prevention of ill health seriously.

One of the most persistent themes of recent health care discussions has been the importance of prevention. Most health care policy recognises that unless society plays a bigger part in helping us stay healthy for many more years, the NHS cannot, on its own, provide sufficient health care to develop and maintain a healthy nation.

NHS health care can achieve a lot, but not if the way in which society is organised creates more and more ill health.

Today, a cross party group publishes, with the help of the King’s Fund, a report entitled, “A Covenant for Health” which,  rather than expressing some wistful thoughts about creating better health, goes into some detail about how this might be achieved.

We (for I am one of the authors) recommend an Emergency Better Health Programme, supported by a committed Government, and delivered by business, the NHS, localities, and individuals, to create a healthier society. This would help millions quit smoking, see fewer people living with obesity, more breathing cleaner air, enable better detection of cardiovascular diseases (CVD), and critically, more of our children growing up in good health.

Up until now far too little has been done to prevent ill health by government, society, the NHS, and some business sectors. By focussing on the role of the NHS we have prioritised treating illness over making it easier for people to live healthy lives. To correct this there will need to be a new broad political alliance across all main parties.

Because if we don’t the current bad health – suffered by so many – will only get worse.

So, over the next five years,

  • Let’s take smoking much more seriously.
    Since the ban on smoking in public places began in July 2007 little more has been done to reduce smoking.100,000 people still die from smoking and air pollution every year.
  • Let’s tackle obesity.
    The epidemic of obesity continues to grow. By 2028, on present trends, 16 million of us will be obese, including 25% of all 10-year-old children.
  • Let’s reduce the risk of strokes and heart attacks.
    Without action, in five years from now another 5 million people will have high blood pressure, or high blood sugar levels and so be at greater risk of stroke and heart attacks.These figures are not just overwhelming for the NHS, but very bad for the British economy. If, as a country, we are interested in economic growth we must overcome the structural weaknesses caused by ill health.

    • Workforce productivity. Almost 2.5 million people in the UK labour force cannot work due to ill health; more, aged 50+, drop out of work now than in the 1970s with ill health being the main reason. These shortages will worsen over the next decade as the population ages.
    • Fiscal benefits. More healthy people will mean lower welfare costs, increased tax revenues, and less expenditure on treating ill health. We must help people to stay healthy and contribute to society, economically and fiscally.
      90% of people who died with Covid-19 were in poor health; a healthier nation would have had fewer deaths, fewer days of lockdown and less economic damage.

If we don’t act increases in ill health will not only swamp the NHS but diminish the ability of our economy to pay for it.

The report outlines the practical changes a government can take to begin reversing the decline in health.

  • Help 3 million people quit smoking.
    Most people who smoke would like to give up. With care and drive we could, halve our smoking rate.
  • Prevent 4 million people from becoming obese.
    We need to help people make healthier food choices.
  • Help at least 4 million be more active.
    This doesn’t mean joining a gym – but it does mean walking a bit more when you can.
  • Help more children become more physically and mentally healthy, and fewer at risk of developing.obesity.
  • Reduce the 30,000 deaths a year from poor air quality.
  • Help 5 million people reduce their risk of CVD, still 24% of all deaths.
  • Help the people and places with the poorest health.

Of course, all of this will cost money, but it is vastly less expensive than simply paying for more treatments. Acting on these issues would help millions of people live longer, in good health and with economic and social benefits for the nation and localities.

The argument against action is usually built along the lines of an attack on the ‘nanny state’. But I believe most people would welcome a little help from a broad range of institutions to do the right thing for themselves and their family.

Let’s get on with providing that help as quickly as possible.


This will my last post for the moment. The blog will restart on October 9th. For those of you that can get away – have a great break!