Abstract

The author examines the National Health Service through a criminological aspect, investigating how state stewardship of health transforms welfare tools (taxation, surveillance, conditionality, prioritisation) into instruments that can discipline, exclude or criminalise. Drawing on historical reforms, comparative systems, COVID‑19 responses and empirical examples (taxes, waiting lists, remote monitoring, conditionality in transplantation), the research highlights tensions between prevention and cure, professional autonomy and managerial control, and individual responsibility and social determinants. The paper argues for reforms that prioritise upstream determinants, transparent priority‑setting and distributive impact assessments; it calls for restrictions on surveillance uses of health data and for strengthened clinical judgement to avoid punitive outcomes and safeguard equitable access.