With ever-increasing health budgets merely papering over the cracks we consider a sustainable solution to the nations ill health.
‘The NHS is broken and our health system is in crisis!’ It’s hard to disagree with such views when hardly a day goes by without mention of lengthy hospital waiting times, poor access to GPs and in some parts of the country almost non-existent dental care.
Furthermore, our current model of ‘free health provision at the point of use’ has become financially unsustainable. Expenditure reached a staggering £292 billion in 2023 or 10.9% of GDP, posing a huge strain on the public purse1.
Sources of pressure on the NHS
Our health system is facing challenges from multiple sources including an ever increasing population, the widening scope of healthcare, high cost of modern treatments, systemic wastage and its politicisation.
At the same time there has been a marked decline in peoples health with a staggering 64.0% of adults aged 18 years and over in England estimated to be overweight or living with obesity. This is an increase from 61.2% in 2015/162.
Mental health issues such as anxiety and depression have also seen a dramatic increase, particularly since the COVID lock downs. Worryingly, nearly one million children and young people in 2022/23 were referred to Child and Adolescent Mental Health Services3.
Government action on health
Building ‘an NHS fit for the future’ is one of the Labour governments stated missions. They have now recognised that there must be greater focus on the underlying causes of its failure, rather than simply spending more money.
As part of this wider agenda the government is pursuing several pieces of new and amended legislation. These will aim to reduce smoking, safeguard young people online as well as putting tighter controls on junk food advertising4. It has also said it wants to provide more NHS investment for the early detection of diseases including cancer.
Time will tell whether such steps will be implemented meaningfully and whether they can help to reduce the burden on the NHS.
The need for a sustainable solution
While the central role of diet and exercise is recognised by practitioners across the health sphere little is done in practical terms to embed this in our system of healthcare.
If you visit your GP today they are more likely to prescribe diabetic and heart medications (e.g. metformin and statins) than provide meaningful structured advice on the lifestyle changes you should make.
Putting aside the somewhat perverse system of financial incentives that GPs receive for prescribing certain drugs5, the ever-increasing incidence of both heart disease and diabetes indicate that the current approach isn’t working.
Health education is the key
Increasing the nations awareness of health matters and disease prevention is the single most important step we can take to improve health.
The starting point should be the education of new parents, helping to ensure that good early habits become lifelong habits for their children. This has to continue right through the school years with far greater investment and focus than at present.
Furthermore, health care practitioners need to receive additional training in the critical role of diet, targeted nutrition (including food supplements) and exercise in health. This should form the cornerstone of a more preventative and holistic approach.
Finally, all individuals will have to accept a larger measure of personal responsibility for their health rather than defer that responsibility to the state. Only then can we hope to achieve a sustainable solution to the nations ill health.
References
1. Office of National Statistics – Healthcare Expenditure, UK health accounts, 2022/23.
2. Office of National Statistics – Obesity profile: short statistical commentary, May 2024.
3. Children’s Commissioner – Children’s mental health services.
4. Labour’s Manitesto – Build an NHS fit for the future.
5. Role of Incentive Schemes in General Practice – Department of Health and Social care, 5th March 2024