In the UK, the investment in preventive healthcare is relatively small compared to the amount spent on treatment. Currently, about 5% of the NHS budget is allocated to preventive activities, while the majority of the budget is spent on treating illnesses. This disparity highlights the significant potential for cost savings and health improvements if more resources were directed towards prevention.

For example, it is estimated that 70% of the NHS budget is spent on managing long-term conditions, many of which could be mitigated through preventive measures. Shifting more focus and funding towards prevention could help reduce the burden of these conditions and improve overall public health. I shall look at one of these preventative measures here; namely, increased physical activity and exercise levels.

As health and fitness professionals, we are acutely aware of the vital role that physical activity plays in preventing chronic diseases and promoting overall well-being. Despite widespread awareness of these benefits, a considerable number of individuals still fail to meet the physical activity guidelines set forth by the UK Chief Medical Officers. This reality presents a formidable challenge for Keir Starmer and the Labour government’s new emphasis on a preventive health agenda, which seeks to shift the focus from treatment to prevention.

The prevention paradox

Preventive healthcare, although not a new concept, presents numerous challenges when implemented on a national scale, particularly in terms of encouraging increased physical activity among the population. The paradox lies in the fact that while preventive measures have the potential to significantly reduce healthcare costs and enhance quality of life over the long term, they necessitate upfront investments and societal changes that may not yield immediate, tangible results. For the Labour government, the success of their preventive health agenda is contingent upon their ability to overcome the numerous barriers to physical activity. Failure to address these barriers could result in the initiative falling short, thereby maintaining the existing strain on the NHS and public health systems.

Economic and social implications

In the absence of increased physical activity levels, the economic and social implications could be profound. The NHS is currently under considerable pressure due to the treatment of lifestyle-related diseases, which constitute a substantial portion of healthcare expenditure. Without a successful transition to preventive measures, these costs are likely to escalate, exacerbating existing funding challenges and potentially impacting the quality and accessibility of healthcare services. On a societal level, the inability to foster a more active population could exacerbate health disparities. Physical inactivity is often more prevalent in disadvantaged communities where access to resources and safe environments for exercise is limited. Should preventive measures fail to effectively engage these communities, existing health inequalities could become even more deeply entrenched.

Policy and strategic implications

For Keir Starmer and the Labour government, these challenges underscore the necessity for comprehensive strategies that extend beyond mere awareness campaigns. Policies must be crafted to create environments that inherently encourage active lifestyles. This could involve investing in infrastructure that promotes walking and cycling, ensuring equitable access to recreational facilities, and integrating physical activity into educational curriculums and workplace settings. Collaboration across sectors is vital. Forming partnerships with local governments, community organisations, and the private sector can help foster innovative solutions that are tailored to the specific needs of different communities. Furthermore, healthcare professionals should be engaged to advocate for and guide patients towards more active lifestyles, playing an essential role in the preventive agenda.

Why are so many people inactive?

• Complexity of modern life: The intricacies of modern life, characterised by the juggling of professional responsibilities, family duties, and social commitments, leave little time for exercise. The rapid pace of urban living, coupled with technology-driven conveniences, often results in sedentary lifestyles. For instance, remote work and online meetings, while beneficial, have drastically reduced incidental physical activity, such as walking to meetings or commuting on foot. Furthermore, the convenience of technology has permeated daily life, offering shortcuts that reduce physical exertion. From food deliveries to automated home systems, these conveniences, while time-saving, inadvertently displace opportunities for physical activity. The challenge lies in reimagining these daily routines to incorporate more movement, without necessarily overhauling your lifestyle completely.
• Psychological and social barriers: Many individuals experience anxiety or fear of judgment when embarking on an exercise regimen, particularly if they have been inactive for prolonged periods. Social support is vital, yet not everyone has access to a network that encourages an active lifestyle. Isolation, whether physical or emotional, can stifle motivation. Societal norms and cultural attitudes towards exercise also play a significant role in shaping how individuals perceive and prioritise physical activity.
• Educational and environmental factors: There exists a significant gap in the public’s understanding of how to seamlessly incorporate physical activity into daily life. Many people equate fitness solely with structured, high-intensity workouts, overlooking the benefits of day-to-day activities. Public education about the importance of activities such as walking the dog. cycling to work, or even household chores is essential. Environmental factors, such as urban planning that favours vehicular traffic over pedestrian pathways, can deter walking and cycling. The availability of green spaces, safe walking paths, and community fitness programmes can either encourage or hinder active lifestyles. Addressing these barriers through thoughtful urban design and community initiatives can create supportive environments that facilitate and encourage regular physical activity.

Please note that the barriers mentioned above are just a small fraction of the many obstacles to physical activity. Any shift towards prevention must undoubtedly strive to tackle this multitude of challenges. Furthermore, I have only touched upon one health behaviour here—physical activity and exercise. There are numerous other health behaviours, such as diet, sleep, smoking, alcohol consumption, and stress management, that all play a role in prevention. Implementing the preventative agenda may be more complex than it initially seems.

Conclusion

The Labour government’s commitment to a preventive health agenda offers a promising pathway to a healthier and more sustainable future. However, realising this vision requires a comprehensive understanding of the complex barriers to physical activity (and other health behaviours) and a dedication to addressing them through thoughtful, inclusive policies. By prioritising these efforts, Keir Starmer and his team have the potential to make substantial strides towards reducing the burden of lifestyle-related diseases and enhancing the health and well-being of the nation.

Links:

https://www.bbc.co.uk/news/articles/c3w6g0gzw40o – No extra NHS funding without reform, says PM

https://www.bbc.co.uk/news/articles/crlrljjz884o – Why Starmer’s NHS reforms may give you a sense of deja-vu

https://www.ft.com/content/81f70218-742a-49a2-b4e0-076d89be5de8 – NHS to receive ‘no more money without reform’, says Starmer

https://bmjopen.bmj.com/content/10/10/e036411 – Martin, S., Lomas, J., & Claxton, K. (2020). Is an ounce of prevention worth a pound of cure? A cross-sectional study of the impact of English public health grant on mortality and morbidity. BMJ Open, 10, e036411.

https://www.nuffieldtrust.org.uk/news-item/prevention-is-better-than-a-cure – Prevention is better than a cure

https://institute.global/insights/public-services/moving-from-cure-to-prevention-could-save-the-nhs-billions-a-plan-to-protect-britain – Moving from cure to prevention could save the NHS billions: A plan to protect Britain.

https://ukhsa.blog.gov.uk/2016/02/22/investing-in-prevention-the-need-to-make-the-case-now/ – Investing in prevention: the need to make the case now

https://ukhsa.blog.gov.uk/2016/02/29/investing-in-prevention-is-it-cost-effective/ – Investing in prevention: is it cost-effective?