Health is made at home, hospitals are for repairs

Is the wonderful title of an article, concerning his own book, in the ‘New Local’ by Nigel Crisp former CEO of the NHS, and now a crossbench peer.

He says:

I argue in the book that we need to think about health differently and recognise that health creation plays an important role alongside health services and the prevention of disease. It is time to bring it into focus, celebrate and support the health creators and recognise that health is made at home and in the school, the workplace and the community …

I think that’s a good concept and would be one we could adopt to replace the classic (and disastrous) ‘cost benefit’ analysis. We could and should instead just be asking: will this change make people more healthy?

Marcus Rashford in his willingness to use his own money for change has shown us how money works for change – we now have to realise that government creates it, in order also to realise that that change is within any elected government’s general grasp.

If we thought that government should promote health the surely most people would realise that poverty, which is so all consuming, is disastrous for the nation’s health. For, even when people have the means they often make crazy decisions because all their mental bandwidth is focused on feeding their children.

Thus eliminating food poverty is likely to incur less government expenditure and not more. Meanwhile the rest of us have that tax of charitable giving…

It is not a question of not being able to afford equality because you need to resource health, but if you have greater equality you spend considerably less on sickness – so yet another win-win.

It is certainly true the Tories have purloined the NHS as an icon.

Yet in effect it is a sickness service.

We need actually to promote ‘Health’ itself both mental and physical as an even better icon.

I suggest that all government legislation should have included in its title details of how exactly it will promote the electorate’s health.


  1. Andrew -

    More broadly, health is just one aspect of happiness, which as Thomas Jefferson famously said (in various formulations) is the only legitimate objects of government. (At various times he added in care of human life, prosperity, or freedom as a second “only object”.)

    We know prevention is better than cure – better for the people concerned, and cheaper to boot – yet there seems an innate hostility to health interventions based on lifestyle (diet, exercise, smoking, etc.) compared to drugs and operations to fix the problems they cause.

    One difficulty is measurement. It is relatively easy to measure what is spent, but more difficult to measure outcomes, particularly for a nebulous concept such as happiness, compared to the number of hospital beds or number of operations performed.

    1. Peter May -

      Agree entirely about happiness.

      Health, I suggest, is a bit easier to measure. We could measure days off through sickness, GP visits and hospital admissions. (A reduction in these things would also ‘cost’ less money.)

      ‘Lifestyle interventions’ seem to be fine when Coca-Cola advertises its junk to me but not when the government tries to persuade me not to drink it!

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