We can’t tech or jab our way out of a public health crisis
Plant-Based Health Professionals UK’s response to the 10 Year Health Plan
By Dr. Shireen Kassam, Consultant Haematologist and Director, Plant-Based Health Professionals UK
The newly published 10 Year Health Plan for England sets out an ambitious vision to shift from a sickness service to one rooted in prevention, and for that, it deserves genuine praise. A renewed focus on keeping people well, rather than simply treating illness when it arises, is exactly the direction we need. As a doctor and advocate for public and planetary health, I welcome many of the plan’s proposed interventions.
The good bits
Measures like restricting junk food advertising to children, expanding free school meals to those on Universal Credit, improving school food standards, and restoring the value of the Healthy Start programme are long overdue. These actions go beyond rhetoric and begin to acknowledge the role that our food environment plays in shaping health outcomes, especially for children and the most vulnerable. The plan also breaks important new ground by introducing mandatory reporting of healthy food sales for large companies, a bold step toward holding the food industry to account for the health impacts of what it promotes.
The Plan’s approach to alcohol consumption is also encouraging. New standards for labelling and support for the growing no- and low-alcohol market reflect a mature, evidence-based strategy for tackling one of the UK’s most under-addressed public health challenges.
Misplaced emphasis on tech and pharma
But these strong foundations are undermined by an overreliance on high-tech interventions and pharmaceutical fixes. Technology, AI, wearables and genomic sequencing are positioned as transformative solutions to our healthcare crisis. While these tools have potential in specific contexts, they cannot replace the hard work of rebuilding a just and equitable health system. We do not suffer from a lack of tech, we suffer from a lack of joined-up records, adequate staffing, and access to the basics of care. It is difficult to imagine a seamless AI-powered NHS app delivering personalised care when many parts of the country still lack integrated electronic health records.
The emphasis on genomics as a tool for prevention is also misplaced in my view. While understanding genetic predispositions can inform care in certain cases, the vast majority of chronic diseases, such as type 2 diabetes, heart disease, dementia and many cancers, are overwhelmingly driven by lifestyle and environmental factors. Even individuals with high-risk genetic variants can significantly reduce their risk through healthy behaviours, including a nutritious, predominantly whole food plant-based diet, regular physical activity, and avoidance of smoking and alcohol. Genomic information might tell us ‘who is at risk,’ but it doesn’t tell us ‘what to do’ and the solutions remain the same. Pouring resources into genomic screening risks diverting attention and funding away from proven, population-level public health strategies. Whilst the NHS is proud of pioneering whole genomic sequencing into routine care for people with cancer, I am yet to see high quality data (i.e. randomised controlled trials) that demonstrates this high resource endeavour has significantly impacted patient outcomes. Conversely, cancer outcomes would be improved if we got the basics right i.e. addressing delays in referral, diagnostics and treatment, whilst ensuring equity of access. The cynical view here would be that this emphasis on tech and genomics is in part driven by private enterprise rather than public good.
The same applies to the plan’s embrace of weight-loss injections. While GLP-1 drugs may play a role for some individuals, they should not become a cornerstone of our national strategy. The causes of obesity are complex, rooted in socioeconomic disadvantage and driven by a food system that promotes ultra-processed products at the expense of affordable, nutritious whole foods. The Plan wants to widen access to weight loss drugs to afford everyone the same access as those with greater means (including, it would seem, many parliamentarians). But medicalising this issue will further burden the NHS without addressing the structural drivers of poor diet and chronic disease. We should be using our public health resources to fix food deserts, support UK growers and ensure every child grows up with access to healthy food, not subsidising expensive drugs. Even if drugs are required for some people, there still needs to be a wraparound service that supports a diet and lifestyle approach to ensure improved long-term outcomes.
Is this truly about prevention?
Much of what is described as ‘prevention’ in the Plan centres on early detection and diagnosis. This is not the same as preventing disease in the first place. True prevention involves creating the conditions for good health through clean environments, healthy food systems, and addressing the root causes of ill health long before screening tests can detect disease. Atherosclerotic heart disease, for example, begins in childhood, if not earlier in a mothers womb. Screening tests, especially for cancer, have become more and more resource intense only to find that they don’t deliver on predicted outcomes and are serving private interests over public good. Instead, identifying those who are not exercising, drinking too much, and eating a poor diet, will provide clinicians with a good indicator of who is on their way to developing cardiovascular disease and at higher risk of cancer and dementia.
The Plan’s commitment to neighbourhood health services is an encouraging step toward making care more accessible, continuous, and rooted in the community. Bringing services closer to where people live and integrating teams around patient needs reflects a long-overdue rebalancing of our healthcare model. However, the suggestion that these services should be personalised based on genomics has little evidence to support it. Most chronic conditions have modifiable risk factors that respond powerfully to diet and lifestyle interventions that are well-studied, low-cost, and scalable. Personalising care should mean enabling healthy choices for all.
Illusion of choice
The emphasis on “patient choice” throughout the Plan reveals a fundamental misunderstanding. Most people don’t want more choice; they want fair access. They want to know they can see a GP when they need one, access mental health support without endless delays, and trust that the care they receive will be consistent in quality regardless of postcode or income. Choice without access is a hollow promise and a distraction from the deeper reforms needed to make the NHS truly universal and equitable.
True prevention must start with social justice. That means confronting inequality, supporting healthy environments, and making nutritious, largely plant-based diets accessible and affordable for everyone. It means prioritising the basics: good food, clean air, secure housing, and a health system that delivers compassionate care without delay. Only then can we bend the curve of chronic disease, significantly reduce the burden on NHS services, and build a system that serves both people and planet. Where the plan acknowledges staff are demoralised and demotivated, reducing demand through these basic measures would go a long way to making the day job seem more manageable.
To conclude
The 10 Year Health Plan contains sparks of hope. But prevention cannot be achieved through apps and algorithms alone. Nor can it be outsourced to pharmaceutical companies. If we are serious about creating the healthiest generation in history, we must put people, food, and fairness first.
Our focus at PBHP UK will be to continue to advocate for a plant-based lifestyle approach to protecting our health and the health of the planet. We want the medical profession to evolve into one that focuses on promoting chronic health rather than tracking and mopping up chronic disease.