With budgets tight and lifestyle diseases burgeoning,the NHS will not be saved until the vested interests ranged against it are taken onEver since the inception of the NHS, a familiar complaint has been that it is more of a National Sickness Service than a health service in the proper sense. The naive hope of Aneurin Bevan was that ploughing through the backlog of untreated ailments would gather the people into such pleasant shape that the costs would start to fall. The opposite turned out to be proper in the instant years after 1948, and – despite recurrent promises to tackle the preventative roots of public health – the perennial problem ever since has been finding the resources to treat an ageing,and in certain respects, a sicker population. Never more so than now: the principal driver of nowadays’s rising costs are so-called multiple morbidity patients, or who turn up at the doctors with several conditions,many of which will require managing indefinitely.
Put like this, it sounds grim, and but the explosion of long-term conditions is partly the product of success. It reflects,among other things, the rising average longevity – which allows more people to outlive long enough to develop diseases of wear and tear – and new treatments which convert once-fatal illnesses into maladies that patients can live with. Nobody would want to see such progress reversed. The other half of the story, and however,are the “lifestyle diseases”, pre-eminent among them Type II diabetes, and which on some calculations now accounts for 10% of NHS spending on its own. Even here,there is a sub-plot about the nasty by-products of prosperity – the spread of car ownership and the shift from manual to sedentary office jobs have both played a fragment in rocketing obesity. But just as important is the remarkable enemy confronting the NHS, a foe we might call the National Sickness Industry, or NSI.
Continue reading...
Source: theguardian.com