The NHS Long Term Plan, prevention, and a century of promises

George Gosling - 11 January 2019

Bringing together prevention and cure, health and social care, is hardly a new – or strange – idea. So why hasn’t it happened?

The fanfare that surrounded the publication of the NHS Long-Term Plan made sure to highlight its promise that a shift away from hospital treatment will not only save the NHS “over £1 billion a year in new expenditure averted” but also save half-a-million lives. Which rather raises the question: if the locus of care is to be relocated away from the expensive hospital, then to where? There is one popular alternative that has had a difficult history, not least with the Conservative Party, over the past century.

In the aftermath of the First World War, Lloyd George was turning the attention of his government to post-war reconstruction and social reform. This included the creation in 1919 of a new government department – the Ministry of Health – under the direction of Christopher Addison, a GP turned Liberal MP and one of the Prime Minister’s closest allies. One of his first acts as Health Minister was to establish a committee under the chairmanship of Lord Dawson, formerly the King’s physician, to investigate the “schemes requisite for the systematised provision of such forms of medical and allied services as should… be available for the inhabitants of a given area”.... See more

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