Ian Findlay: Our Health Service is in desperate need of system change

On Green Health Week, our Chief Officer blogs on why our NHS should switch from illness service to wellbeing service

Ian Findlay at Paths for All's Volunteer Awards

I’ve found it alarming and distressing the number of times I have heard in the news that the National Health Service (NHS) is in crisis.

I’ve had reasons to be in contact with the NHS recently through losing close family members, an on-going health issue of my own and becoming a grandad!  From these experiences (and the experiences of others I know), I’m certain that the crisis is not due to the highly dedicated and professional people who work in our health service.  They are truly amazing!

Instead, I think it’s the wider health system which is in crisis and no longer fit for purpose.  I appreciate that I’m going to generalise here, but our NHS is overwhelmingly an ‘illness fixing service’.  It fixes us when we are broken, does an excellent job of doing this and there will always be a need for a high quality, free illness fixing service.

However, the system needs to change from being predominantly an ‘illness fixing service’ to a ‘wellbeing promoting service’ and the balance of resources needs to move with this system change. 

We need a system that focusses on keeping us as well as possible for as long as possible.

Such a system would be a very different to one we have currently and would move health care beyond the hospital and health centre gates into the community.  Everything from the way we plan our communities, transport ourselves about and live our lives would be part of this wellbeing system.

Such a system would also focus on our complete health or wellbeing and not simply our physical health.  The World Health Organisation definition of health has 3 dimensions, physical, mental and social health.  A wellbeing system would promote all 3 dimensions.

Thinking of the WHO dimensions of health, the wellbeing system would also devote more resources to community interventions which promote physical, mental and social health.  A good example of this is Paths for All’s Health Walks programme, but there are many, many others.

So, going back the constant media coverage of our NHS being in crisis, I, unfortunately, cannot see this changing with the current system even if significantly more money is allocated to the NHS.  Society and our current systems are creating more and more ill, unhealthy, unhappy people which inevitably are going to put more and more pressure on the NHS.  It’s a vicious, no-win cycle. 

Conversely, a well-being focussed health service would keep more people healthy and happy for longer and hence reduce the pressure on the NHS. A virtuous, win-win cycle.

I appreciate that system change is hard, very hard!  It requires strong leadership, culture change and sometimes unpopular decisions.  However, as well as being good for our wellbeing and for the public finances, I think we owe it to our amazing health professionals to create a system which is not constantly in an inevitable crisis, but is focussed instead on wellbeing.

Dundee's Green Health Partnership Prescription

As I write this in ‘Green Health Week’, it is becoming increasingly clear to me that the idea of a wellbeing service is catching on. This week across Scotland, a unique group of new partnerships, set up as part of Scottish Natural Heritage’s ‘Our Natural Health Service’ initiative, are promoting our natural environment and greenspaces as valuable health-promoting tools.

These ‘Green Health Partnerships’ are working across health, environment and transport to provide ‘wellbeing’ solutions to the current health challenges and inequalities facing our communities.

From Health Walk groups to gardening clubs to led cycles, Green Health Partnerships are using simple but effective nature-based activities to not only treat ill-health, but to prevent it and promote better health. I wish the GHPs and their vital work all the very best. 

They are helping to lead the way to a happier and healthier Scotland, which incidentally is Paths for All’s Vision.  

Written by Ian Findlay, Paths for All Chief Officer. Follow Ian on Twitter @i_findlay


Read This Next