COMMUNITY CARE HEALTH AND WELLBEING


PASSING THE BLAME Lee’s argument is borne out of an idea that some individuals are perhaps more ‘deserving’ of the privilege of free healthcare, because they make a conscious effort to eat well, stay active and therefore reduce the amount they have to rely on the NHS – whereas others don’t. And this is where we get into complicated territory. How can anybody say what lifestyle choice is right or wrong – and more importantly, whether it is in fact a choice and not a result of circumstances or upbringing? He says that ‘clearly’ not all chronic conditions are self-inflicted – but that in itself makes the situation very unclear. “People who speak about this are not usually those who are aware of which patients are ‘expensive’,” says David Thorne, chief executive of Newcastle Bridges CCG. “In any case expensive is a relative term and a pejorative. If Great Ormond Street spend £100,000 saving a child’s life and providing a lifetime


ahead, then that may be high-cost, but it isn’t expensive. Any discussion like this should be objective and based upon health economic fact.”


MAKING ASSUMPTIONS Does this all boil down to class-related prejudice? Thorne believes that the whole idea is underpinned by “snobbery and [a] one- dimensional perspective, that – usually – poorer people are making lifestyle choices that are costly to the NHS. If a rich guy crashes a glider or a wealthy woman breaks her leg skiing, then what is that?” An HSJ reader posted at the bottom of an article reporting on Lee’s proposals, saying that they had sustained a self-inflicted condition, caused by a ‘lifestyle choice’, that has required numerous costly surgeries: a degenerative ankle injury sustained from years


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