Is our Health Serice Sustainable?
In yesterday’s edition of the Independent they published two interesting stories about health which could not have been more contradictory.
In the first they quoted a junior doctor as saying, “We won’t let you starve the NHS to death Mr Hunt”. In the second they said that “the latest research suggests that the drug (aspirin) could also have a major role in treating and preventing cancer”.
Of course there is truth in both these statements. More money must be found for the Health Service whilst we change the culture and practices of health. Of course we should look at cheap alternatives for expensive therapies. One of the reasons given for the fact that full studies of all the potentials of aspirin are not fully explored is that no one will make any money out of it. Money is made by the pharmaceutical companies by the development of expensive new drugs not finding better uses for existing drugs.
Somewhere the way forward for the health service is to make such views complementary and not competitive. What few politicians care to admit, and even fewer health professionals, is that unless we change the model for social and health care health will become an unsustainable burden on taxes. One projection is that if we increase spending on the NHS at the current rate we will spend all taxes raised on health by 2050. So nothing for education; defence or anything else for that matter!
The NHS has a simple ambition which should be shared by all interested in the nation’s health – to keep more people living longer and more healthily.
To change this we need to move spending upstream. We need to move it from acute care to general care, from general care to social care and from social care to illness prevention activity.
I am challenging all political parties, those in the Health Service and Social Care bodies and charities to join a big conversation about how we change the culture of health care in the Country. This needs to be all embracing:
How can individuals do more to stay healthy and prepare intelligently for old age?
What is the role of families in stopping inappropriate behaviour such as poor eating habits and caring for their elderly better?
What is the role of communities in caring for the ill and elderly amongst them?
How do councils provide services which keep and plan communities healthier?
How does the Health Service move from high end gadgets and gizmos to more public health and coordinated activity with other services which will prevent illness?
One of the areas of activity which links all these together is the continued support for a caring family and community. I never supported the Tory calls for a ‘Big Society’ because we already have one. Most of us at some time have been carers within our family. In my case it was looking after my Mum with my Sister as she got increasingly frail and then died. I now am a grandpa helping Erica help our children bring up their children. I don’t expect to be thanked or rewarded for either of these services and hope that in turn my children and grandchildren will look after me. BUT if I did not provide such services then the state would have had even more expense or two generations would have a much reduced life experience.
But sometimes volunteering as a family member, as a neighbour, as part of the community helping people in need within our community is both unsupported and unrecognised. Knowing what to do and how to do it needs some support and sometimes, although not in my case, small amounts of cash to help with the expenses of caring. I heard from a father who has a 21 year old son who has just about every medical condition known to man! He said he was fortunate in that he had been in good paid employment which meant that he could retire early and money had not been a significant factor. Even there the pressure on this man’s life and family was almost beyond belief. Of course he used the state but he did not leave the care of his child to the state. Not everyone is that fortunate.
So much of what the Health Service treats is either preventable or by doing the right things the treatments and therefore costs can be reduced. Two examples will suffice:
Obesity is a killer. Much of obesity is caused by eating too much of the wrong types of foods. The likelihood is that if you eat a lot of greasy fried food you will become obese. This will cause problems for your stomach, heart, liver and kidneys. Youth obesity is even worse. Overweight children will have a range of additional problems including bone problems which will not form property and become brittle and fragile earlier. Almost everyone who is obese can be helped to reduce their weight. The state must help with this but the determination must come from the individual who must exercise more and eat better.
Air pollution is a killer. The estimate is that air pollution from cars causes premature deaths for 23,000 people a year in the UK. Much of that is preventable. In this case it is a three way process. Most of us can choose to buy smaller, more efficient cars but as we have seen in the shameful case of Volkswagen it is more complicated than that. We need Governments at an international level to promote and enforce laws that limit harmful emissions. We also need car manufacturers to be honest and not fiddle figures!
Yesterday I challenged the Independent to lead that ‘big conversation’ but it’s a challenge I also make to everyone who will read this blog. How do we change the culture of health so that our services become sustainable in the light of an increasingly elderly and infirm society?
I believe that councils should be at the heart of this conversation. The new Health and Wellbeing Boards and the Clinical Commissioning Groups are able to bridge the gaps between Health providers, social care providers and the other operations such as housing whose role is crucial in creating a healthy self-sustaining community. I hope that all Councils with their local partners will be the leading protagonist of the conversations because if culture is to be changed it will not be by dictat from the centre but from the ground floor upwards.
Will you join this vital conversation?