David Oliver: Getting serious about prevention

It’s hard to attend any conference or read any report on health service reform without prevention of ill health featuring prominently. What might once have seemed a radical proposition is now an orthodoxy—but people commenting on health system redesign still advocate a greater focus on prevention and early intervention as if it’s a revelation, even for those in government.

The arguments advanced for prevention contain two broad elements. Firstly, our health services are still too centred on responding to ill health, especially acute illness in excessively hospital based models. We therefore need a shift of resources and approaches to ensure that more people remain well for longer (primary prevention) or are supported to self manage any long term …