UK Healthy Life Expectancy Decline Threatens NHS and Social Care, Warns Public Health Expert
A leading global public health academic warns that Britons are living longer but not healthier, and argues that Andy Burnham's social care reforms must be matched by prevention policies to protect the NHS and social care system.
Britons are living longer than ever before, but the number of those years spent in good health is shrinking, according to Professor Devi Sridhar, chair of global public health at the University of Edinburgh. Writing in a commentary, Sridhar warns that healthy life expectancy in the UK has been consistently falling even as overall longevity rises, a trend she describes as a major challenge facing governments worldwide.
The warning comes as Andy Burnham, the prime minister, has put forward a bold proposal for a universal, NHS-style social care service. Sridhar acknowledges the importance of that debate but argues that the government should not focus solely on how to care for people in their later years. Instead, she says, real political capital should be spent on policies that help people live longer independently and in good health.
«The data isn’t pretty on this,» Sridhar writes. While the trend over the past half-century in almost all countries has been for people to live longer, healthy life expectancy has been consistently falling. That means more people are spending their final years managing illness, disability or dependence rather than enjoying active, independent lives.
Sridhar, author of How Not to Die (Too Soon), is a prominent voice in global public health. Her intervention places the UK’s demographic challenge in an international context, noting that ageing societies are a near-universal concern. But she suggests that countries which have made healthy ageing a political priority offer lessons for Britain.
The implications for the NHS and social care are significant. A growing population of older people with poor health increases demand on hospitals, GP services and long-term care, even as the workforce available to provide that care remains under pressure. Burnham’s proposed universal social care service is designed to address part of that burden, but Sridhar argues that prevention must be central to any sustainable solution.
She calls for government to reverse the decline in healthy life expectancy, framing it as a necessary step to protect both the NHS and social care. That would mean investing in policies that keep people well for longer, rather than waiting until they need intensive support. The exact measures are not detailed in her commentary, but the direction is clear: a shift from treatment to prevention, and from crisis management to long-term planning.
The debate over social care has been a recurring feature of UK politics, with successive governments promising reform but struggling to deliver a lasting settlement. Burnham’s proposal has renewed attention on the issue, and Sridhar’s contribution adds a public health dimension that often gets lost in funding debates. She argues that the goal should not only be to care for people in old age but to ensure they reach old age in better condition.
For a country with an ageing population and a health service under strain, the stakes are high. If healthy life expectancy continues to fall, the pressure on the NHS and social care will only intensify, regardless of how services are organised or funded. Sridhar’s message is that prevention is not an optional extra but a core part of any credible plan.
Her comments also reflect a wider international conversation about how societies adapt to demographic change. Many countries are grappling with similar questions: how to support older people, how to fund care, and how to keep populations healthy for as long as possible. The UK is not alone, but Sridhar suggests it can learn from those that have made healthy ageing a priority.
As the government considers the future of social care, the warning from Edinburgh is a reminder that longevity alone is not enough. The quality of those extra years matters, both for individuals and for the public services that support them. Whether Burnham’s reforms will rise to that challenge remains to be seen, but the data Sridhar cites makes the case for urgent action.
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