Every political party believes that it has the answer to the NHS’s problems. The poor old NHS is never left alone. Policy change after policy change has only ever resulted in higher costs and greater confusion. Isn’t it about time we looked at ways that we could help to reduce the cost burden? Shouldn’t we have a far more responsible attitude towards our beloved NHS? Instead of vainly searching for elusive cost savings and quality improvements, isn’t it time we started to think of ways to make our National Health Service into a true National Health Service rather than what it’s become, a National Illness Service? Don’t we need to start to consider how our behaviour impacts on the cost of the NHS? Shouldn’t the NHS put much more emphasis on prevention rather than cure?
Every year we demand more and more from the NHS. Somehow it manages to absorb everything we throw at it. We’re living longer, so it has to deal with more age-related diseases. We demand the very latest medical treatments, and it delivers. We treat our bodies with scant disregard, and when they succumb to our lack of proper attention, the NHS picks up the pieces. Little wonder that it has little time to pay attention to prevention.
The time has come for prevention to become a major focus for the NHS. Why? Because every year the NHS has to spend more and more of its time and precious resources on diseases that are entirely preventable. Take obesity, for example. Obesity is directly related to an increase in heart disease, stroke, cancer and diabetes. This year, obesity-related diseases will cost the NHS £5 billion. With 60% of men and 40% of women forecast to be obese by 2050, this cost is set to escalate to such a degree that the NHS will be unable to deliver the level of health care we have come to expect without there being a huge, and probably unacceptable, increase in taxation.
So far, any interventions to try and influence people’s eating and lifestyle habits have failed. The obesity crisis is actually getting worse, not better. There is a reason. Obesity has become socially contagious. What does this mean? Research has shown that having a friend, sibling or spouse who is overweight or obese raises a person’s risk of being overweight or obese too. A sense of what constitutes an acceptable body weight passes from one person to the next. You are 60% more likely to be overweight or obese if you have a friend who is overweight or obese. Obese parents are nearly 40% more likely to have obese children. It is now socially acceptable to be overweight or obese. It means that within communities the social norm has changed.
So how could any preventative intervention, either by or for the NHS, reduce the levels of obesity? For some time it has been widely accepted that diets deliver only short-term, temporary weight loss. 95% of people who go on diets never achieve permanent weight loss. What is now understood is that that behaviour change is the best way to lose weight permanently. Learning new eating and lifestyle habits is the simplest and most effective way of changing behaviour.
Behaviour change is not something that can be achieved by going on a 12- week course. Successful behaviour change comes from a combination of two things: learning new eating and lifestyle habits and support: support when making change, and having made change, support to prevent relapse and to allow the process of learning to continue.
There is a new opportunity to make a real and lasting difference to the levels of obesity which could save the NHS £billions. It lies in the fact that obesity, although still an individual problem, now has a new, social dimension. This opens up the possibility for the problem to be addressed in a totally new way.
How? By providing the structure and support within communities for like-minded people who want to lose weight permanently, to organise themselves into mutually supportive groups. By providing these groups with a behaviour change programme and a specially trained team who will give them the support and guidance they need to succeed in losing weight permanently. This makes the community the ‘driver’ for change. If obesity can become socially contagious, being slim can become socially contagious too.
What this programme does is to tap into the power, energy and enthusiasm a community generates when it has a shared goal with a clear benefit. It provides the support and the structure people need to lose weight and then to manage and maintain their weight. It will also provide long-term support to prevent relapse and help individuals and their families enjoy a slim, healthy lifestyle.
The great advantage of a community-led programme is that it is relatively inexpensive. The savings to the NHS could be huge. It also has the potential to make ‘slim’ the new social norm and to set obesity levels on a downward path.
If we don’t want the NHS to be paralysed by escalating costs, unable to deliver the health care we need, it has to invest in prevention. We cannot allow preventable diseases to hijack precious resources. We all have a responsibility to minimise the burden on the NHS. As individuals we may find this difficult, but as a community, we have the power to make a difference, both to ourselves and to the NHS.