NHS ‘should give councils more grief’ on health

The 10-Year Plan’s focus on the NHS risks sidelining the need for more effective action by national and local government on prevention, public health directors are warning.

Association of Directors of Public Health president Greg Fell also told HSJ integrated care boards should “give us [councils] more grief” to take more action on prevention, rather than prioritising NHS upstream interventions that are not as effective as primary prevention.

Mr Fell, director of public health at Sheffield City Council, said policy makers, NHS leaders and media too often looked to growing “preventive” treatments – such as weight management treatment, and weight-loss drugs – as the solution to problems like growing obesity and falling healthy life expectancy.

He said the routine “framing” of prevention as something the NHS can solve with upstream treatments risked diverting from national and local government actions that could make a much bigger difference.

Mr Fell said such interventions – and the high-profile GLP-1 drugs for obesity – may be worthwhile, but for overcoming the big health threats were “like emptying an ocean with a teaspoon or, being kind, a soup ladle”.

He said: “The answer is way upstream of better treatment. [It] is effective regulation of junk food industries, and that isn’t primarily a Department of Health and Social Care thing, and certainly not an NHS problem. It’s a problem across the government.”

Mr Fell said he expected the 10-Year Plan “would be pretty good” but means “the bandwidth has been taken by the NHS”.

He called for government to outline its plan for preventive cross-government action as part of its health mission, beginning a “debate about the right mix of policies” across multiple government departments, local government, and others. 

“We haven’t yet seen much on the health mission,” the director of public health said, adding that it would need to cover tobacco control, alcohol, air quality, obesity, and “how does all that hang together across the totality of government?”

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Source: HSJ, 31 March 2025