Comment THE CLINICAL SERVICES JOURNAL Editor


Louise Frampton louiseframpton@stepcomms.com


Technical Editor Kate Woodhead


Journal Administration Katy Cockle katycockle@stepcomms.com


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STEP COMMUNICATIONS ISSN No. 1478-5641


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A cold, hard reality… EDITOR’S COMMENTwith LOUISE FRAMPTON


Reform or die… That was the key message of the Prime Minister for the NHS, in the wake of Lord Darzi’s damning report on the state of the health service. As I write this comment, the Government has set about formulating its 10-year plan. The Government assures us that, instead of the top-down approach of the past, this plan will have “the fingerprints of NHS staff and patients all over it”. What we know, so far, is that there will be an emphasis on digital technologies, a shift


towards moving care from hospitals to communities, and an increasing focus on prevention. Lord Darzi said he was shocked by what he found during his investigation - not just in the health service but in the state of the nation’s health. A focus on prevention makes perfect sense – if we keep people well in the first place, we can reduce the burden on the health service. However, tackling widening social inequalities and social deprivation will require a bold vision and significant investment. Furthermore, the Government’s focus on prevention seems to be at odds with its decision


to cut winter fuel payments. Cold homes are linked to thousands of deaths each year (Source: https://tinyurl.com/42fd4m2a). The Institute of Health Equity points out that cold temperatures have been found to impair the functioning of the lungs and may trigger broncho-constriction in asthma and COPD. Moreover, studies have found that visits to GPs for respiratory tract infections increased by up to 19 per cent for every 1°C drop in mean outdoor temperature below 5°C. In addition, the cold affects circulatory health where indoor temperatures fall below 12°C, which results in raised blood pressure, caused by the narrowing of the blood vessels, which can lead to increases in blood thickness as fluid is lost from circulation. Increased blood pressure and increased blood viscosity can increase the risk of strokes and heart attacks. The Institute of Health Equity also highlights evidence that living in homes where the temperature is under 18o


C is associated with higher blood pressure and higher cholesterol (Source: https://


tinyurl.com/mp2zvf3s). According to an analysis by pension consultants LCP, more than 80 per cent of pensioners living below the poverty line are set to lose their winter fuel payments. (Source: https://tinyurl. com/yc2hxc6s) Many pensioners will face a stark choice between heating their homes or eating this winter, as a consequence. Caroline Abrahams, charity director at Age UK points out that a newly released document


shows that, even within the Government, they are projecting that three quarters of a million of older people on the lowest incomes will not put in a Pension Credit claim this year. “The [government’s] partial impact analysis finds that pensioners aged over 80 will lose the most financially through the means-testing of Winter Fuel Payment, and that 7 in 10 disabled pensioners will no longer receive it. These two findings should be considered together, in that the prevalence of disability rises with age. Right from the start, Age UK has said that we are incredibly worried that means-testing Winter Fuel Payment will make poor pensioners poorer this winter, and that many sick and disabled pensioners will also lose the Payment when they can ill afford to do so. Sadly, this Government document comes to exactly the same conclusion,” she commented. Ultimately, health prevention must be a central focus of efforts to reform the NHS going


forward, but we risk taking one step forward and two steps back. Cold homes will increase demand on a health service already finding it difficult to cope. There needs to be better joined up thinking, if we are to reduce winter pressures on the NHS. The government defends its policy by saying there is a need to make ‘difficult choices’. The cold, hard reality is that lives will be lost, inequalities will deepen, and hospital beds will be filled with yet more elderly patients.


louiseframpton@stepcomms.com Get in touch and give us your views, email me:


October 2024 I www.clinicalservicesjournal.com 5


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