‘Towards a health biosphere’

The National Health Service is one of this country’s proudest achievements. I have seen its strengths and its strains every day, not only as a Member of Parliament but as a practising NHS physiotherapist on the frontline of patient care. Today, it sits at a crossroads: a ballooning budget on one side, and a social care system in visible crisis on the other. The question we must now confront is not whether we value the NHS, we unequivocally do, but whether we have the courage to renew it for a very different age.

How do we reduce deep-rooted health inequalities, improve genuinely patient-centred care, and still ensure long-term financial sustainability? Can we preserve this national treasure without passing an ever-growing burden to future generations?

When Clement Attlee’s post-war government founded the NHS, under the stewardship of Aneurin Bevan, its mission was clear: to treat acute illness and to provide universal access to healthcare, free at the point of need. It was visionary, and it was right for its time.

But Britain in 2026 is not Britain in 1948.

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Seventy-seven years of medical and scientific progress have transformed both the nature of illness and the expectations we place on healthcare. In my clinical work, I increasingly treated patients managing multiple long-term conditions – many that before would have ended lives or cut active life short. That is a triumph. Yet it also increases the pressures on our NHS. Costs for staff, for medicines, for ever-more sophisticated treatments continue to rise, placing unprecedented strain on finances and supply chains.

We must be honest: the model we inherited is no longer sufficient for the realities we now face.

At its core, the NHS was built on equality. But the reality I see in clinics – and as evidence consistently shows – is that health outcomes remain profoundly unequal. Where you are born, and the socio-economic conditions you grow up in, still shape how long and how well you live. These factors shape behaviours, diet, exercise, smoking, alcohol use, not as abstract “choices”, but as consequences of circumstance.

Health does not begin in hospitals. It begins in homes, schools, and communities.

That is why the solution cannot rest solely with the Department of Health and Social Care. A whole-systems problem demands a whole-government response. Housing, education, employment, transport and more must all play their part.

There are encouraging signs. The shift towards community and primary care is both welcome and overdue. As a physiotherapist, I know that early intervention, whether recovery from injury or prevention of deteriorating mobility, can transform lives and reduce long-term costs. These services are the NHS’s front door: our best opportunity to prevent illness, intervene early, and reduce pressure on hospitals.

Yet they have been chronically underfunded. Between 2016 and 2024, we lost 1,800 fully qualified GPs, leaving a shortfall of over 4,000. 

This approach to prevention must change. 

In 2026, we should embrace the technological revolution reshaping every aspect of our economy. Artificial intelligence and data analytics can enhance diagnostics, streamline care, and free up clinicians to focus on what matters most: patients.

But the opportunity goes beyond efficiency. It is about redesigning how we deliver care and building health infrastructure around the communities it is intended to serve.

I want to see a system reflecting a what I call a ‘health biosphere’.

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Imagine a system that uses data not only to treat individuals, but to understand entire communities. A system that maps our society by bringing together insight on demographics, age, gender, ethnicity, deprivation, housing conditions, employment patterns, regional job opportunities, educational attainment, and access to green space, alongside the wider built environment shaping health and activity levels.

When designing a healthcare system, you should see not only a patient’s symptoms, but the broader social and economic realities influencing their health outcomes. Treating a patient with mobility issues or obesity would not stop at referral; it would trigger a co-ordinated local response shaped by real-time insight into that community’s needs and opportunities.

This is what a true systems-thinking approach looks like.

It would bring together NHS providers, local councils, employers, charities, schools, and community organisations. It would embed healthcare alongside housing, welfare, education, and employment support, delivering services in partnership rather than in silos.

We need a ground-up rethinking of how we approach healthcare and society. The needs of local people and their situation are not understood enough. By tailoring how we view regions by understanding the whole picture of health, we will be better equipped to tackle the root cause of our failing system.

The NHS, then, does not simply need reform. It needs reimagining.

Attlee once said: “We had not been elected to try to patch up an old system but to make something new.” That same spirit should guide us today.

We should be bold enough to move towards this ‘health biosphere’. A locally tailored, integrated ecosystem of care in every community. One that is proactive, data-driven, and grounded in the realities of people’s lives. 

This is not about abandoning the founding principles of the NHS. It is about fulfilling them.

Because equality in 1948 meant access. In 2026, equality must mean outcomes.

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