PM’s new health adviser says ‘ill-equipped’ NHS does not need ‘more money’

Will Warr also slammed the service’s “feeble” attempts at introducing new technology and claimed NHS “staff have been brainwashed by the financial targets introduced under [Tony] Blair”.

Mr Warr replaced James Kent as the PM’s senior health policy adviser when Boris Johnson entered Downing Street. He had previously worked at the C|T Group – the political strategy business founded by Conservative election mastermind Sir Lynton Crosby.

Writing last month in the Daily Telegraph before taking up the post, Mr Warr said the new PM needed to conduct “a thought experiment” which asked: “If I created the NHS today from scratch, what would it look like?”

The answer, wrote Mr Warr, would be, “nothing like the monolith we have today”.

His article continued: “Our highly centralised healthcare model dates back to a different era of disease:… long before obesity was an issue, before science showed how genes affect disease risk… The NHS legacy system has failed to embrace these shifts and is hopelessly ill-equipped to deal with the chronic diseases threatening the public’s health today.

“But more money is not the solution. The ageing population is often touted as the reason health spending needs to increase faster than economic growth, but this is not the case. The NHS’ own chief economist has confirmed that ageing makes a very small difference to overall costs.”

He continued: “There are of course fundamental issues with the way funds have been deployed, not to mention serious problems with nurse training, junior doctor morale, pension taxation for senior clinicians and a fatal lack of integration with social care. Yet all too often, additional funding has merely been used to treat the symptoms of NHS pressure – waiting times, staff productivity – rather than the causes of pressure: the public health crisis.”

Mr Warr coauthored the government’s life sciences strategy with Sir John Bell and believes using new technologies rather than conventional public health policies is the answer to improving the nation’s wellbeing.

In his Telegraph article, he wrote: “Traditional public health policies treat everyone the same regardless of their lifestyles or risk of disease. Although such interventions have been successful in the past, they also exacerbate inequalities and restrict personal freedoms – ‘sin taxes’ like the levy on sugary drinks are regressive, while public health messaging campaigns resonate predominantly with the middle classes.

“The only way to prevent is to predict. And DNA is the best predictor around. Today, through a genetic test costing £20 we can identify individuals with a 4-5 times greater risk of contracting every major chronic illness. Why would you spend limited government resources screening and treating the whole population the same, when you could focus on those most at risk, and not restrict the personal liberties of individuals whose protective genetic traits leave them at a very low risk?”

Today, health and social care secretary Matt Hancock announced the NHS would abandon “one-size-fits-all” health checks. They will be replaced by an approach which the Department of Health and Social Care says will pay greater “attention to people’s individual risks or needs” and will “focus on offering personalised interventions based on factors such as: age, where people live, [and] DNA”.

The DHSC statement added: “The changes are part of a wider move away from blanket approaches to public health, to an approach that takes personal choices into account.”

In his Telegraph article, Mr Warr wrote: “The average individual spends… three hours a day on their phone. Smartphones can nudge and guide individuals towards healthier habits, shifting autonomy away from doctors and towards the individual. Yet the NHS’s digital efforts have been feeble, relying on clunky, crash-prone apps.”

Commenting on the assertion there were no “financial incentives for [GPs] to treat obesity, he wrote: “This not only demonstrates how staff have been brainwashed by the financial targets introduced under Blair, but also how the architects of those targets are failing to do that all-important thought experiment outlined above.”

Mr Warr’s career has involved time at consultancy McKinsey & Company and the Prime Minister’s Implementation Unit. He has also been a doctoral researcher at The University of Oxford University’s Nuffield Department of Primary Care Health Sciences.

Mr Warr is a world-class rower, being one of only three men ever to have rowed for both Oxford and Cambridge blue boats and winning gold medals for Great Britain at the World Rowing Championships.

Correction: An earlier version of this article said Sir John Bourn coauthored the government’s life sciences strategy. This was corrected to Sir John Bell at 13:43 on 16 August.