As the NHS buckles and public health plunges, our cheap and accessible fitness facilities are being shuttered

In all the noise generated by the collapse of the NHS, you hear one refrain over and over again. The basic point is so obvious as to be almost banal: as the chaos deepens, it is a reminder not only of how much the health service has been underfunded and neglected, but of the UK’s deep problems with the questions of disease prevention, lifestyle and nutrition bundled up in the term public health.

Doctors I have spoken to recently have explained the grim experience of seeing the same patients come in and out of their wards for years. We are all familiar with that litany of conditions that account for so many admissions – diabetes, heart disease, high blood pressure – and the fact that they are often rooted in obesity, sedentary ways of living, bad diets and all the rest. Behind older people’s falls and fractures, moreover, lie many of the same factors. Once again, the necessity of a more preventive approach to health is screamingly clear, but what it might mean in practice is still largely a mystery.

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