The problem with NHS “Prevention”
Words matter, especially when the public and policymakers use them differently
When the NHS talks about “prevention,” what do you picture? Stopping disease before it starts? That’s what most people think.
But in NHS and government speak, prevention doesn’t just mean prevention. It’s been stretched to include catching problems early and even managing the damage after they’ve happened - things that aren’t prevention in the everyday sense.
Detecting lung cancer after years of smoking? Prevention.
Prescribing medication for high blood pressure caused by unhealthy food? Prevention.
Helping people live with type 2 diabetes caused by excess weight? Prevention.
See the problem? Words matter, especially when the public and policymakers use them differently.
If prevention includes treatment, we risk losing sight of the kind that actually stops problems before they start.
Call It What It Is
If officials resisted the temptation to overburden the word “prevention”, we might more accurately say:
Prevention – Stops problems before they start.
Early detection – Finds problems before they worsen.
Damage control – Manages disease, reduces harm.
This way, when policymakers talk about "investing in prevention" the public is more clued up on what they mean.
What’s Really Being Funded?
A new 10-Year NHS Plan is coming, promising a major shift toward prevention. When it does, be ready to ask:
Are we seriously asking the NHS to help improve our surroundings and culture so that more of us are willing, able and free to make the healthier choices most want? Through better food, homes, finances, cleaner air, vaccines and the many, many things we know actually build good health?
Or are we simply expanding screening programs and disease management?
Both matter. But only the first prevents. The rest? That’s the NHS doing what it already does - diagnosing, treating, and managing illness. Not a shift in focus at all, more a re-brand.
Where Prevention Actually Happens
The real scope for prevention lies outside the NHS, in the 90% of life that happens before people become patients:
The Individual – Lifestyle, habits, decisions - including knowledge, mental bandwidth, stress levels and all the constraints that shape those choices.
The Family – Early education, role modelling - including family stability, economic security, and the capacity to create a health-supporting home.
The Neighbourhood – What’s available, what’s affordable, and what’s encouraged—including access to healthy food, safe spaces, reliable transport, and whether the default environment makes health really easy or really hard to choose.
The Society & Culture – The behavioural norms, expectations, incentives, and blind spots that shape our unthinking default choices. Social mobility, opportunity, job security, advertising, business interests, regulations - all determine whether healthy choices are accessible, affordable, or even culturally expected.
We know Hospitals treat the aftermath. And that prevention happens elsewhere.
Confusing the two is how we end up funding consequences sold as solutions.
Bottom line
“Prevention” sounds like progress, a smart investment in the future. But too often, it’s a bait-and-switch - just another way to fund treatment under a different name.
Lose sight of the everyday meaning of prevention and we might wake up to find we live in a society that never prevented anything at all.
Where attention goes, we go @melodie_tld.
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Classic
“You can shirk it [thinking] by simply throwing your mind open and letting the ready-made phrases come crowding in. They will construct your sentences for you—even think your thoughts for you, to a certain extent—and at need they will perform the important service of partially concealing your meaning even from yourself.”
Politics and the English Language (1946)
Modern
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