One in four people still die due to preventable disease. These entirely avoidable illnesses, such as heart or respiratory disease, put an enormous and unnecessary strain on our already struggling health service. What we often fail to acknowledge is that it is the very model of our health service that has led us to this situation.
Since its inception in 1948 the NHS has been focused on treatment rather than prevention. Decades of decision makers have been resolutely committed to funding a service which is focused on quick fixes, medication and surgery, and as a result we have seen the system begin to fail.
Thanks to a lack of foresight and poor strategic thinking we have reached crisis point and our overstretched ‘healthcare service’ has been brought to its knees. We are left funding a financially crippled organisation which is too big to change and is all too often used as a political football.
I don’t need to restate the crushing funding deficit, or concerning levels of understaffing to make a well worn point that something needs to change. Perhaps most worrying is the impact the healthcare system is having on the people within it – over 1,000 GPs have sought help from the NHS GP Health Service since it was set up a year ago with one in four quitting medicine for good.
The British Medical Association has previously warned that we need a new model for the NHS, and they, along with many others believe it has to be one that is focused on prevention rather than cure.
According to the ONS, in England, public health expenditure – which is largely how we categorise our current investment in preventative health measures – accounts for approximately 5 per cent of total health spending, and in 2013/14, the average spend on such initiatives was £49 per head compared to the average £1,742 spent on treatment by the NHS.
This imbalance is unlikely to be addressed anytime soon. For most politicians, preventative health initiatives are not an attractive area for investment. As Liz Kendall said recently at the Spectator Health Summit, the positive outcomes are just too long-term – politicians are looking for payback within years, not decades.
As ever with politics, the urgent crowds out the important – and which Chancellor will be willing to stand at the box in Parliament and prioritise investment in preventative measures whilst people are queuing for beds and being put on waitlists for cancer treatment.
The second challenge is that the bodies investing in these initiatives are not the ones to receive the financial returns further down the line. Public health campaigns paid for by local government often benefit the NHS, or national government which can restrict the level of investment at source.
The painful irony is that the devastating issues our communities and health service are facing are the direct result of poor future-planning and investment in prevention in the first place and they impact our communities most greatly.
The large proportion of spending in ‘preventative healthcare’ is on ‘healthy condition monitoring’ programmes such as health checkups, public information campaigns for alcohol and substance misuse, smoking cessation, sexual health and obesity, with some left over for immunisation programmes and early disease detection.
It has been claimed, in a University of Liverpool study, that every £1 spent on public health returns an average of £14.30 in savings. There are problems with this calculation, and it largely ignores the fact that the delivery of preventative healthcare has largely been ineffective.
The problem is that these campaigns haven’t been delivered to a behavioural change level of quality, so they remain underfunded and putting more cash into the same system isn’t going to change the outcome.
Only 1 in 4 adults now eat ‘5 a day’ – 16 years after ‘the campaign launched. Simply put, posters and leaflets and ads on the sides of buses are not going to fix our problem of growing obesity and Type 2 diabetes.
But instead of wringing our hands and endlessly debating why we can’t find more funding for prevention, could we acknowledge that the current model for prevention hasn’t worked and look for better solutions.
Wearable tech, health-tracking and solutions that help people better understand their bodies and wellbeing, are empowering people to manage their own health. Apple’s watch app can detect a common form of heart irregularity with 97 per cent accuracy and billions are being invested in the health-tech space in order to help people stay healthy and reduce the numbers of deaths by preventable disease.
These tech innovations are enabling a new level of granularity when it comes to understanding what can make and keep us healthy and in the most part, as consumers, we’re becoming more educated and empowered.
These innovations are nascent and targeted largely at the well-informed and relatively affluent but this is the beginning of what we see as a more accessible path for all. This is the springboard from which we can test the market for a new preventative approach and it will be the private sector that needs to lead the way.
Today, there are more valid opportunities for us to invest in preventative healthcare solutions that can help us prove the case. We no longer need to rely on flyers and adverts which largely, cannot be tracked or analysed.
Instead we can empower people to make changes to their health which they can manage themselves, which can offer insights and data into behaviour that we’ve never before had access to.
And let me be plain. The reason I’m so passionate about preventative care is because I so firmly believe in its ability to help the NHS get back on track and deliver the sick care it’s so good at. With a parent on one of those cancer wait lists, I’ve never been more aware of the desperate need for change and I have never been more sure we have the answers within our grasp.
Hamish Grierson is CEO and Co-Founder of Thriva, the preventative health-service offering finger-prick blood tests you can do at home.