Helen Salisbury: Sick notes and a national illness service

A common complaint about the NHS is that it’s not so much a health service as an illness service and that we’d be a healthier, happier, and richer society if we focused on prevention rather than leaping into action only when people fall ill. There are many analogies, such as not just fishing bodies out of the river but going upstream to find out who’s pushing people in, or building a fence at the top of the cliff rather than parking your ambulance at the bottom.Of course, the NHS has some effective prevention programmes, including immunisations and the screening programmes for bowel and cervical cancer. The NHS Health Check is an attempt to find people who would benefit from specific interventions to prevent strokes and heart attacks.However, only 10-20% of health is attributable to healthcare.12 With the honourable exception of our colleagues in public health, most doctors are downstream or…
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