Is it right that the government is going to let more people use weight-loss jabs on the NHS? Anti-obesity jabs, such as Ozempic, are one of the hottest talking points right now. How fat we are has long been one of those problems that people think can be solved by ‘one quick trick’.

But these solutions are often a complete and improbable overhaul of our entire society. People can’t eat the highly palatable, highly calorific, highly processed foods that are so easy and cheap to access. This week’s announcement is a trendy one: around £40 million to expand access to the ‘game-changer’ injections such as Semaglutide (or Ozempic). There’s also some new weight management services that are going to help patients trim in the long-term.

Health Secretary Steve Barclay has been emphasising that the main reason for the pilot is to improve the health of people struggling to control their weight. But he also said it could have a knock-on effect on the government’s efforts to get people back into the workplace and off sickness benefits. What is most interesting about this new scheme is that it represents a move towards preventive medicine: something the NHS was founded to deliver but which has always struggled to realise.

The history of the NHS’s approach to preventive healthcare has not been particularly stellar

Preventive medicine is in vogue at the moment: Labour has made a lot of noise recently about shifting resources from acute, hospital settings and into the community so that illnesses are treated or even prevented earlier. Obesity wasn’t an issue when the NHS was founded, but it has become a serious concern now, both in terms of the cost to the health service and because of people taking time off work with musculoskeletal problems and mental health issues.

The history of the NHS’s approach to preventive healthcare has not been particularly stellar: it took ages for ministers and officials to take seriously the warnings and then definitive evidence about smoking causing cancer, and still longer to set up a proper stop smoking programme. The health service is also not structured in a way that prioritises patients being seen at an early stage in what health management boffins might call their ‘journey’, hence the calls from Wes Streeting and others to change the balance.

The mentality of the Treasury never helps with this: bean-counters have always been suspicious of campaigners or other ministers coming to them with wizard plans to save the exchequer billions of pounds – but just in a decade’s time and after significant upfront investment. Often they are right to be suspicious because it is easy to overpromise, but as often that reluctance stems from the very short-term nature of the political cycle, which does not reward these kinds of long-term policies anyway.

This is one of the reasons, by the way, that the government has cut funding for ‘active travel’ schemes. These are infrastructure projects to encourage people to travel under their own steam rather than in a car: so cycle lanes, better pedestrian and wheelchair access, and so on. This is something that isn’t the responsibility of the NHS but which does have a knock-on impact on the obesity crisis because these schemes should help people move more.

The National Audit Office this week published a highly critical report of the money the Department for Transport has spent on active travel, saying this funding was being used by local councils for ‘some poor value investments’. That money, around £2.3 billion between 2016 and 2021, included interventions which ‘were largely cosmetic and did not provide a safe space for cycling’. This kind of thing is the sort of ‘overhaul of society’ policy that is actually within the power of ministers to influence, unlike a radical change to diets, but it also involves long-term planning and spending that isn’t going to deliver dramatic results like an injection will.