Professor Devi Sridhar, chair of global public health at the University of Edinburgh, has called for a fundamental rethink of how the NHS in England allocates its budget, arguing that the health service is too focused on treating serious illness in hospitals rather than preventing disease in the first place. Writing in The Guardian, she said the system increasingly pays for expensive care for heart attacks, strokes and other life-threatening conditions, while funding for primary care such as GPs has fallen.
Sridhar highlighted that people can be walking around symptom-free without knowing they are pre-diabetic, living with hypertension, or at high risk of a heart attack. She welcomed the recent introduction of free cholesterol tests on the NHS but said more needs to be done to identify those at higher risk and intervene earlier to reduce their chances of becoming ill. Her comments come amid an ongoing debate about how to make the health service sustainable in the long term.
The professor invoked Benjamin Franklin's adage that « an ounce of prevention is worth a pound of cure », noting that this simple prescription has been hard to follow in the current NHS. She pointed to a persistent shift within the NHS budget towards acute hospital care, often treating people after they are already quite ill, while investment in upstream prevention has been neglected. This, she argued, is a costly and inefficient way to run a health system.
Sridhar's intervention adds to a growing body of opinion that the NHS must rebalance its spending priorities. The challenge, she said, is not just how much is spent per capita, but where and when it is spent. By investing more in early detection and prevention, the health service could reduce the burden of serious disease and save money in the long run, she argued.
The professor's call for a five-point health MOT is part of a broader push for a more proactive approach to public health. Rather than waiting for patients to become acutely ill, she suggests, the NHS should be identifying those at higher risk and offering support before conditions develop. This would require a significant shift in funding and priorities, moving resources from hospitals back to community and primary care settings.