Comment Blog 25 May, 2023

A prescription to save the NHS

Sebastian Rees
Senior Researcher

This article was first published in Men's Health Magazine on the 16th May 2023. 

The NHS crisis is, yet again, in full swing. Ambulances queued outside hospitals, year-long waits for treatment and endless hold tones on GP phone lines.

But the usual toolkit to solve these problems isn’t working. More money into the system? We’ve tried that – more than 40% of day-to-day government spending goes on the NHS. More doctors for our overcrowded hospitals? The number of hospital doctors is up by 33% since 2010.

Add yet care gets worse and health declines – 64% of us are overweight or obese, one in six young people live with a mental health condition and our likelihood of surviving bowel cancer is lower than most comparable countries.

Seventy-five years after the founding of the NHS, our sickness service is no longer up to the job. It’s time to radically rethink the system itself.

Doing things differently starts with acknowledging a simple fact: prevention is better than cure. Success shouldn’t be measured by how many patients we treat, but how many we stop from needing healthcare in the first place.

Many of our modern health ‘giants’ are avoidable. From type 2 diabetes to heart disease, addressing the circumstances that lead to unhealthy choices can help shift the dial. For our system, that means a massive movement of resources away from treatment and towards prevention. It means dismantling our hospital-centric model.

In Singapore, the government uses data from wearable devices to drive healthier choices. Citizens log their exercise patterns and diet, and if they meet their health goals, are rewarded with vouchers. Those who don’t meet their targets are nudged by their device to do better. A real-time, prevention revolution, driven by people power.

In Brazil, the frontline of the health system is not the GP surgery, but patients’ homes. Local residents are recruited to become community health workers, trained to deal with a range of common health issues, and spend their working days visiting local households to carry out health checks and dispense medical advice. This proactive, community-driven care has delivered extraordinary results, including big reductions in deaths from stroke and heart disease. It costs no more than £40 a year per citizen and the model is currently being trialled in London.

Obsessing about healthcare is not the same thing as obsessing about health. Failing to recognise that feeds our seemingly insatiable – and ultimately unaffordable – demand for more clinical care. If best estimates suggest healthcare accounts for just 20% of health outcomes, then we need to get serious about what drives the other 80%. That means ensuring that our lifestyle choices, and the places we live, work and socialise, are health boosting. That, in fact, is the only way to save our NHS