Our Future of Britain initiative sets out a policy agenda for governing in the age of AI. This series focuses on how to deliver radical-yet-practical solutions for this new era of invention and innovation – concrete plans to reimagine the state for the 21st century, with technology as the driving force.
Contributors: Isabel Atkinson, Adam Bradshaw, Roshni Joshi
Chapter 1
Preventative health care has significant potential to not only improve the nation’s health but also the health of the economy by increasing the number of people in work.
In this paper, we explore the economic case for preventative health care, delivered through the Protect Britain programme first proposed by Tony Blair Institute for Global Change (TBI) in December. We focus the bulk of our analysis on a foundational version of the Protect Britain delivery model that aims to use upgraded digital infrastructure, better health checks and a wider uptake of existing treatments to reduce incidences of cardiovascular disease (CVD) by 20 per cent. But we also explore a more future-focused scenario where advances in medical treatments enable similar reductions in disease incidence across a wider range of conditions.
Our analysis shows the following:
Protect Britain could significantly reduce CVD incidence by making it easier for the public to access preventative health-care services. By increasing uptake of regular health checks and use of existing CVD treatments, particularly statins, Protect Britain could lead to an extra 60,000 to 70,000 people in work per year once fully rolled out.
Protect Britain would involve a range of costs to operationalise, including £1.6 billion upfront (and £70 million a year in ongoing costs) to upgrade the UK’s existing digital-health infrastructure. This would ensure every citizen had a digital health record and access to a significantly upgraded National Health Service (NHS) App.
We estimate Protect Britain would result in around £0.4 billion in annual net savings to the NHS and social-care system by the end of this parliamentary term in 2029 and £1.3 billion by the end of the next term in 2034. This reflects the net impact of higher health-check and treatment costs (£0.7 billion a year in 2029, £0.9 billion a year in 2034), which are more than offset by lower health-care costs from preventing people from suffering heart attacks, strokes and other CVD events (£1.1 billion a year in 2029, £2.2 billion a year in 2034).
Using a new model developed by economists Professor Andrew Scott and Yannick Schindler of the London Business School (Schindler and Scott (2024),[_] we estimate that the potential gains to the wider economy are substantial. (Schindler and Scott’s modelling also forms the basis of TBI’s concurrent report Prosperity Through Health: The Macroeconomic Case for Investing in Preventative Health Care in the UK.) By boosting the number of people in work, Protect Britain could generate an extra £1.2 billion a year for the Exchequer by 2029 (and £2.1 billion by 2034) through higher tax revenues and lower benefits spending.
People living healthier and longer lives also means they will draw on their state pensions for longer. Given the high and rising value of the state pension, preventative health care creates a significant indirect cost to the Exchequer in higher pension payments, which we estimate will be about £1 billion a year by 2029 and £2.1 billion by 2034.
Summing up across these costs and benefits, we find that the foundational version of Protect Britain would create around £0.6 billion per year in net fiscal savings by the end of this parliamentary term and £1.2 billion per year by the end of the next. The latter figure would rise to £1.4 billion if the savings from the programme were used to pay down the national debt and reduce debt-interest payments.
Preventative health care can thus provide a triple benefit of a healthier population, a stronger economy with more people in work and an improved fiscal position.
All of the above figures are based on a narrow assessment of the potential for preventative health care to reduce CVD using existing treatments. But there is a wide range of upcoming medical breakthroughs that Protect Britain could seek to incorporate in the near future. These include advances in early detection of Parkinson’s and melanoma, the widespread rollout of novel drug treatments such as GLP-1 RAs to reduce the prevalence of a wide range of conditions and the advent of personalised disease treatments through the use of CRISPR gene-editing technology.
In this paper, a companion to The Economic Case for Reimagining the State, we therefore also explore a forward-looking scenario whereby novel treatments would enable a 20 per cent reduction in disease incidence across a wide range of other conditions (including musculoskeletal disease, cancer, mental health, diabetes and respiratory illness) within a decade. Given that the foundational costs of setting up the Protect Britain programme would already have been met, this expanded version of the programme would build on the existing fiscal savings – creating net fiscal savings of £4.3 billion a year within the decade (or £4.9 billion if the net savings from the programme were also used to pay down the national debt). These figures include the cost of higher pension payments, which are substantial (worth £3.3 billion by 2034). However, given the scale of improvement in healthy life expectancy enabled by this preventative health-care model, this could spark a broader debate about pension reform, including whether the pension age should rise more quickly as people live longer, healthier lives. In a scenario where the pension age rose to offset the improvement in healthy life expectancy, Protect Britain could generate net benefits to the Exchequer worth around 1 per cent of GDP by the middle of the century.
Read the full paper here. This is one of four companion papers to The Economic Case for Reimagining the State.