Re the article by Wes Streeting (I love the NHS: it saved my life, but the operation to rescue it must be led by the people and its staff, 21 October), the government’s health plan must devote serious attention to the public’s health. Focusing on individual lifestyle behaviour change because it’s the easier option will not result in sufficient progress in tackling preventable illnesses such as obesity. Nor is prescribing more weight-loss drugs the answer. Medicalising problems chiefly caused by health inequalities is not a long-term solution. Only by tackling the causes of much avoidable ill-health at source will sufficient and lasting progress be made. This means getting a grip on the commercial determinants of health, thus reducing the demand for addictive, ultra-processed foods.
As part of this crusade, attention needs to be given to the public health function, nationally and locally. It has been eviscerated by the previous government, as noted by the recent Darzi review. Restoring the funding cuts to local government and to public health is an urgent first step. The organisation of the public health function nationally also needs attention having been seriously weakened by the sudden abolition of Public Health England in 2021. The Office for Health Improvement and Disparities should be replaced with a more visible and independent body. The government could look to Wales and Scotland for models. Without a strong public health function, independent of government and able to speak truth to power, progress risks being desultory.
