COMMUNITY CARE HEALTH AND WELLBEING
of running. Does this constitute a lifestyle choice which is undesirable to the NHS? Thorne raises a similar point: “Patients with eating disorders are mainly drawn from higher social classes,” he says. “The same applies to skin cancer. You could argue both are lifestyle choices. I wouldn’t. What this MP implies is working class people eating pizza – healthcare is more complex than that.”
TREATING THE CAUSE
So if charging for healthcare in relation to how much an individual uses it isn’t the answer, what is? The UK was recently dubbed as the ‘fat man of Europe’ by the Academy of Medical Royal Colleges (AMRC) in its report ‘Measuring Up: The Medical Profession’s Prescription for the Nation’s Obesity Crisis’. According to the paper, one-quarter of men and women are obese and two-thirds of adults are obese or overweight. The National Child Measurement Programme 2011-12 shows that for children aged 10-11, one in five are obese and one in three are overweight or obese and the number of morbidly obese adults has more than doubled in the past 20 years. Not to mention the impact smoking has on the NHS as the primary cause of preventable illness and premature death – accounting for 81,400 deaths in England in 2009 according to
ash.org.uk (Action on Smoking and Health). Thorne believes that the problems are rooted far too deep to be solved by putting a price on treatment and laying the blame on patients – effectively treating the symptoms rather than the cause. “Rather than blame people whose lives are horrible, maybe MPs should look at legislating to support improved alcohol policies,” he says. “Locally you can buy three litres of super-strength cider for less than £4. I await the Conservative Party’s actions to stop that nonsense.”
Dr Charles Alessi, chair of the NHS confederation agrees that although this is a real issue that isn’t going to go away, it is not for the NHS to play god – deciding who deserves treatment and who does not. “The new world is one where health is personalised and where the patient has responsibilities as well as the service,” he says. “There is difficulty if we start to go down the road of restriction of treatment, as these ethical issues should be left in the consulting rooms between the health carer and the patient, not legislated upon, as one size does not necessarily fit all our populations.”
He believes that the means to achieve a healthier lifestyle need to be more accessible to the masses and that the new association between commissioners and the local authorities should help to leverage better access. “In a world of capitated health care within a fiscal envelope, it is in the interest of the commissioners to incentivise these initiatives. We look forward to seeing many more innovative schemes here,” he says. Putting a premium on healthcare would do very little to address
the true cause of the problems we have in our relationships with food, cigarettes and alcohol. The cost of implementing such a scheme and its propensity for unfairness would surely outweigh any possible gain to the NHS anyway. As the report from the AMRC states: ‘Across all four nations in the UK, doctors want to do what they can to help… And they can help – by setting an example, by giving advice on losing weight, by treating the complications such as diabetes and, in extreme cases, by offering life-saving surgery.’ And it’s also about getting the right advice to patients at the right time, before it’s too late and they become another lost cause, says Thorne: “One example is designing services to immediately respond to people who wish to give up or reduce alcohol consumption with support on the day of their decision.”
“Rather than blame people whose lives are horrible,
maybe MPs should look at legislating to support improved alcohol policies”
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