Intended for healthcare professionals


Hancock pledges to invest in prevention to tackle “root causes” of ill health

BMJ 2018; 363 doi: (Published 05 November 2018) Cite this as: BMJ 2018;363:k4684
  1. Gareth Iacobucci
  1. The BMJ

England’s health secretary, Matt Hancock, has pledged to invest more in primary and community care services and in tackling the social determinants of health as part of a major policy focus on prevention.

Hancock has made prevention one of his early priorities for the NHS.1 In a speech2 to the International Association of National Public Health Institutes on 5 November, he announced a forthcoming government green paper to take forward plans to place greater emphasis on early intervention and self management to improve the nation’s health.

As well as diverting more investment to primary and community care, the government will aim to tackle the “root causes” of poor health, including housing, employment, transport, and the environment, he said.

It will also encourage people to take more responsibility for their own health, and explore how technology could offer targeted prevention to different sections of the population.

Hancock said: “Our focus must shift from treating single acute illnesses to promoting the health of the whole person. And from prevention across the population as a whole to targeted, predictive prevention.”

The government has set itself a target to increase the number of healthy years of life by five years by 2035, to halve childhood obesity by 2030, and to increase the early detection rate for cancer to 75% by 2028.3

In last week’s budget,4 the chancellor Philip Hammond committed an extra £20.5bn (€23.4bn; $26.7bn) for the NHS over the next five years. Hancock did not say what proportion of this would go to prevention, but said, “We must see the proportion of funding on primary and community care in the NHS rise.”

Healthcare leaders and experts backed the policy direction, but said the government needed to match words with actions, given cuts to public health budgets that have occurred in recent years.

Niall Dickson, chairman of the NHS Confederation, said, “We have been here before and the recent record of cutting public health spending must now be reversed. We need an end to misleading statistics and mixed messages, and we hope this announcement signals just that.”

Peter English, BMA Public Health Committee chair, said, “There is a need to reverse the cuts to public health budgets, as in many areas, public health services do not adequately meet the health needs of the local population. Reductions to services such as smoking cessation and sexual health in some areas are directly contributing to unacceptable variations in the quality and quantity of care available to the population.”

John Middleton, president of the UK Faculty of Public Health, welcomed the announcement, adding: “A new cross government focus on prevention is the key to the long term sustainability of not only our health and social system but all of our public services.”


  • Correction: This news story originally described Matt Hancock as “UK health secretary,” not England’s.


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