As a community based healthcare service, the Well Centre is well placed to fit into ambitions set out in the new NHS plan launched this month. Our current youth intern, Alex Parton, took a look at the plan for us and shared his views on how well it met the needs of young people.
The government’s new 10 Year Health Plan for England is certainly aware of its place in the NHS’s history. The service is at an ‘existential brink’; it must ‘reform or die’ (1). Bleak language with which to preface a plan that aims to dislodge a lumbering institution and make it fit for the 21st Century.
The core of this Plan is to take care out of hospitals and into the community. It calls for citizen-patients to take control of their health through a new NHS app, and be met by local multidisciplinary teams. The focus is prevention, not reaction.
The Plan risks assuming, however, that adults somehow become magically responsible for their own lives at 18. Instead, people learn how to take care of themselves over the course of their lives. By failing to give a more specific focus to young people, the Plan misses a trick: one cannot have responsible, health-conscious adults without responsible, health-conscious young people.
The Plan comes as public satisfaction with the NHS hits the lowest since records began. Just one-fifth of Britons satisfied with the service (compared to 70% in 2010), with satisfaction rising, not decreasing, with age (2). An obvious way to make young people more invested in the health service is to make them more involved in decisions over their health. This is not a new idea: in 2021 the Care Quality Commission found that just 47% of children and young people said they’d been involved in decisions about their care (3). By 2024, after targeted programs, this had risen to 83% (4). Great work has therefore been done in including young people inside the system. Now it must focus on expanding responsibility to those outside it.
The 10 Year Health Plan recognises that healthy children become healthy adults, but risks treating young people as bystanders rather than future citizens. Focussing on the first 1,001 days from birth, though understandable in making the most of stretched resources, risks missing the particular – and different – needs of young people at different ages. For example, the Plan notes that the number one cause of hospitalisation in children is tooth extraction: therefore children will be made an “urgent priority” in dentistry (5). There is no mention of how they will access these additional appointments. The young people most in need of dentistry are the ones least able to get advice from adults on how to do so.
Similarly, banning smoking and junk food advertisements will certainly result in healthier young people, but not better-informed young people. As anyone who’s spent time with teenagers will tell you, paternalism is very easily mistaken for patronisation. Maybe I will smoke a cigarette, Wes, if you’re going to ban me from buying non-alcoholic beer. Young people need to be involved in the decision making processes around improving their health.
Despite children and young people making up 24% of the population, they account for just 11% of NHS expenditure (6). Of course the elderly and chronic illnesses (which become more prevalent with age) will always take up the bulk of health spending. Nevertheless, as the 10 Year Health Plan notes, we cannot have healthier old people without healthier young people. In turn, young people are apathetic over their health because they see it as a problem for when they grow up. If the NHS wants patients ‘fit for the future’, it must prepare them from the beginning to take control over their health.
This is not to condemn the 10 Year Health Plan. Recognising that ‘almost half of mental health conditions develop before the age of 18… yet NHS mental health services have never truly met the needs of the population in a comprehensive way’ (5) is a massive step in the right direction for CAMHS and other youth mental health services. Embedding support for young people where they congregate (with full school coverage promised by 2030), rather than making them seek out help, can only be a good thing.
Still, while the Plan admits that unaddressed mental health problems lead to school absences, it relies on schools and ‘Young Futures Hubs’ (an as-yet undefined Labour manifesto promise) to administer support. This is an obvious chicken-and-egg problem: those furthest from the system are those most in need of it. The failure to mention improving service access (rather than capacity) for children – especially those who do not have parental or school support – shows a crucial blind-spot. It also assumes that young people’s ‘health’ is synonymous with ‘mental health’, but there are many other issues, such as sexual health and long term conditions, which also require targeted services.
Under 18s are constantly told to take responsibility for themselves but have little agency navigating institutions. To make healthy, happy and well-informed citizens, young people must not be allowed to become spectators. If, as Wes Streeting claims, the 10 Year Health Plan will ‘put a megaphone to the mouth of every patient’ (5), it must make sure young people get a turn on the mic too.
Works Cited
- Dept. Health and Social Care, Prime Minister’s Office & 10 Downing St. Fit for the future: 10 Year Health Plan for England – Executive Summary. GOV.UK. [Online] 2025. [Cited: 7 July 2025.] https://assets.publishing.service.gov.uk/media/686639056569be0acf74db89/fit-for-the-future-10-year-health-plan-for-england-executive-summary.pdf.
- Taylor et al. Public satisfaction with the NHS and social care in 2024: Results from the British Social Attitudes Survey. The Nuffield Trust. 2 April 2025.
- NHS England. Youth-led decision making campaign . NHS England. [Online] 2022. [Cited: 8 July 2025.] https://www.england.nhs.uk/london/london-clinical-networks/our-networks/london-babies-children-and-young-peoples-transformation-team/youth-engagement-and-voice/youth-led-decision-making-campaign/.
- Care Quality Commission. Children and young people’s survey 2024 . Care Quality Commission. [Online] 2025. [Cited: 8 July 2025.] https://www.cqc.org.uk/publications/surveys/cyp.
- Dept. Health and Social Care, Prime Minister’s Office & 10 Downing St. Fit for the Future: 10 Year Health Plan for England. [Online] 2025. [Cited: 8 July 2025.] assets.publishing.service.gov.uk/media/6866387fe6557c544c74db7a/fit-for-the-future-10-year-health-plan-for-england.pdf.
- Children’s Commissioner. https://www.childrenscommissioner.gov.uk/blog/putting-childrens-voices-at-the-heart-of-the-nhs-10-year-plan/.
- Arnold et al. Truly fit for the future? The 10 Year Health Plan Explained. The Kings Fund. 5 July 2025.