The NHS was based on the premise that people would be sick for short periods. They would then either recover and be discharged or they would die. The founders of the NHS never expected a situation in which people would live with severe, life limiting conditions decades. They never foresaw things like IVF which are expensive They never foresaw things like organ transplants which are expensive. They never foresaw cures to cancer which are expensive.
So the NHS that we have now is a million miles from the NHS that the founder’s envisioned.
The only way that the NHS can constrain costs is by trying to reduce demand much further down the track of sickness and disability. It has got to get in to the prevention business to a much greater extent.
The fact is that in the early 21c, we live lifestyles that are bad for our health. We don’t exercise enough. We eat too much processed food. We all know it is bad for us and yet still we do it. The bad effects are not immediately apparent. They take 10 or 15 years to emerge, though there is far more childhood obesity than there ever used to be.
The NHS needs to be running gyms and cookery classes in every town and city across the land. You do see the odd cookery course run by the NHS. I did one some years ago. I remember thinking that there was basic knowledge about food that thought I had but did not. I have to admit that it has not changed my behaviour anything like as much as I would like. I admit to feeling guilty but not doing much about it.
I felt then that the NHS needs to do much more of this. They need an army of dieticians to get out and help people to live healthier lives starting with the food they eat. This approach was tried on a small scale in Glasgow – a city notorious for bad food. Even a 6 week course led to people cooking more and eating less sugary foods[i]. This urgently needs to be rolled out on a much larger scale.
[i] Chris Green Cookery class prescription spurs healthy eating, The I, 15 November 2019. The project has been reported in an academic journal.