The NHS – still a market leader

It is 50 years since Aneurin Bevan oversaw the creation of the National Health Service. A bright new universal scheme to provide a safety net for the whole population that in recent years has become more closely associated with waiting lists, shortages and low pay.

In that 50 years, and especially in the past 15, the language of health has changed. It is no longer about medicine and illness. Now its about ‘making lifestyle decisions’, at least for those who can afford to make them.

Health now dictates what we eat, how much we drink and how much we exercise. It surrounds us on television from dramas such as ER and Casualty to documentaries on children’s hospitals. There is enough material in magazines and newspapers to feed the fantasies of the biggest hypochondriac.

The advertising and marketing worlds have not been slow to exploit our growing obsession. Whole new markets have been created in food, insurance and magazines – others, such as condoms, have had a dramatic renaissance – and the images have moved away from stethoscopes, hospital beds and illness to security, comfort, prevention and long life.

It has catapulted the combined annual sales value of the low-fat and slimming food sector from zero to almost 1bn. And yet levels of obesity in the UK are at a record high, which either suggests that there is even more room to grow that particular market or nobody is listening.

The emerging functional, and genetically modified, food markets throw up their own debates on food safety. But they also provide dilemmas for marketers and those who regulate food claims in advertising. Complaints on food and drink ads to the Advertising Standards Authority halved last year to 175. But already in 1998 large mainstream advertisers including Kellogg and Van den Bergh Foods (Olivio) have found themselves being investigated for their health claims.

Our obsession with health has been fuelled by scares ranging from listeria and BSE to Aids and heart disease. Some critics claim that health marketing, especially that for the private health insurance companies, is based on exploiting people’s fear of illness – indeed their fear that the NHS may not be there for them when they need it.

That partly explains attempts to encourage pharmacies to act as local health advisers and the creation of walk-in GP surgeries to take the pressure off established GPs and hospitals. In effect, the Government is asking people to take more control of their own health needs.

There can be no doubt that people are better informed about their health. We are living longer, but we do appear to be more neurotic about it.

The NHS may be looking its age but most people continue to rely on it for all but a small part of their health care. It is still the universal service Bevan created.

Cover Story, page 26

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