The Labour Government wants to shift the NHS from “analogue to digital” and from “treatment to prevention”.
The PM, Keir Starmer, in a speech on the NHS at the King’s Fund, said: “The NHS is uniquely placed for the opportunities of big data and predictive and preventative medicine”, and ”we’ve got to be much bolder in moving from sickness to prevention”,
The rapid-fire Darzi report said it had diagnosed the NHS woes, and Darzi wrote in the Guardian that he had now found the cure: a “pivot to prevention”.
All of this has impressed the Rt Hon Wes Streeting. The new Secretary of State for Health and Social Care at the Institute for Public Policy Research said: “We will publish a 10-year plan early next year that will set out how we deliver three big shifts in the focus of the NHS: from analogue to digital, hospital to community, and sickness to prevention.”
Speaking at the Labour Party conference this week, Streeting said, “Without action on prevention, the NHS will be overwhelmed.” He’ll be “going hell for leather” to enact the changes.
Yet the prevention mantra is a familiar line for a Health Secretary to trot out.
Here at the Trust the Evidence office we thought we would ask how common the prevention mantra is amongst the 13 Health Secretaries we’ve had since 2000.
As it turns out, prevention is a go-to line for all Health Secretaries (See the PDF for the table of statements).
It was a favourite strategy for the Labour Government until 2010. Alan Milburn said: “The NHS will be able to make further progress still by focusing not just on further advances in treatment — through faster waiting times and new drugs —but also on prevention.” John Reid said there would be an emphasis on prevention rather than just cure if Labour retained power.
The party did retain power. In 2007, Patricia Hewitt published ‘Our Health, Our Care, Our Say: A New Direction for Community Services’. Guess what? “Better prevention now will avoid costly illnesses later.” Alan Johnson replaced her in the Health Secretary merry-go-round, and guess what? “The health service would put greater emphasis on prevention of illness,” he said.
Andy Burnham took up the reins as the Labour term of office ended. He must have had the same advisors as he told the news: “For the NHS, that is the direction it’s got to go – a prevention service to keep people healthy in the first place.” The case for investment in preventive care was “cast-iron”.
When the Conservatives came to power, they were also quick to the mark regarding prevention. Andrew Lansley said: “But as well as re-focusing the treatment side of healthcare, we need to do far more on prevention.”
In 2013, the DHSC published ‘Living Well for Longer: A Call to Action’ to reduce avoidable premature mortality. And guess what? “If we are to tackle the challenge we face, we need to make improvements across the three domains of prevention, early diagnosis and treatment.” When I’m a celebrity, Matt Hancock came into the job he was also a prevention disciple as he made prevention one of his earliest priorities for the NHS and social care, publishing the ‘Prevention is better than cure: our vision to help you live well for longer’ plan.
As the Tories went into meltdown, they had a raft of Health Secretaries. However, all of them were able to get in on the prevention act. Javid delivered a white paper that championed health and well-being as a real priority and greatly emphasised prevention. Barclay (who did the job twice) showed his direction of travel — you guessed it — prevention.
Therese Coffey – who was only on the job for about 30 days, still managed to say that “prevention is, of course, at the heart of what we do so that people do not need to turn to the health service at all for treatment”. Finally, Streeting’s predecessor, Victoria Atkins, was gung-ho for more – guess what – prevention. “There is, of course, one topic fundamental to my plan to reform the NHS to make it faster, simpler and fairer – and that is prevention,” she said.
So when Streeting gets up and emphasises more prevention, you may want to ask how this differs from all those who have gone before him and whether they all have the same advisors and speech writers to hand.
Streeting said he “won’t let us down” at this week’s conference. There’ll be more “preventive, personalised and precision medicine for the many”. And when the next Health Secretary replaces Streeting, can you guess his or her priorities?
This post was written by two old geezers who have seen 20 Health Secretaries come and go while in the NHS. Next up?
Dr. Carl Heneghan is the Oxford Professor of Evidence Based Medicine and Dr. Tom Jefferson is an epidemiologist based in Rome who works with Professor Heneghan on the Cochrane Collaboration. This article was first published on their Substack, Trust The Evidence, which you can subscribe to here.
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