Reports have indicated that NHS leaders intend to extend the rationing of treatment for smokers and obese patients.
A leaked letter has been acquired by the press, with NHS bodies across England seemingly forced to implement restrictions on access to treatment.
The plan is outlined in a letter sent on 15th March by Dr David Black, NHS England’s medical director for Yorkshire and the Humber, to Rotherham Clinical Commissioning Group.
Within the letter, Black praises the GP-led group that controls the NHS budget for introducing what has been described by critics as ‘lifestyle rationing’.
“We are very supportive of your work to best manage resources for the benefit of all patients and understand that this may mean that difficult decisions need to be made,” Black writes.
The letter goes on to suggest that the scheme could be extended to other aspects of the NHS system in the coming months.
“We expect that many CCGs will be in the process of developing similar schemes and initiatives to deliver plans for 2017-19. This is something we would encourage, where plans are well developed and clinically validated.”
There has been huge opposition to curtailing NHS treatment on the basis of lifestyle issues.
And ex-health minister Norman Lamb has been one of the critics of this notion, suggesting that it is inimical to the ethos of the NHS.
“This is yet more evidence of the creeping advance of rationing. Guidance based purely on medical judgment on weight loss is fine, but what is happening around the country goes well beyond that in practice. It will inevitably result in those people with money paying for speedy treatment, while everyone else is left waiting,” Lamb commented.
Lamb went as far to suggest that the Conservatives are presiding over the destruction of the NHS.
“We are seeing, bit by bit, the destruction of the solidarity that this country has been so proud of with the NHS – the idea that whatever your income or wealth, you get access to the care you need, in your hour of need.”
Jonathan Ashworth, the shadow health secretary, suggested that the Tories have failed to fund the NHS adequately, and now healthcare bodies are consequently forced to make tough decisions.
“This secret memo from NHS chiefs reveals the truth of what’s happening to the NHS under the Tories – more and more rationing of treatments. People will be waiting longer and longer in pain and discomfort for surgery such as hip and knee replacements. There is now a very clear choice in this election. Cuts, longer waiting times and restrictions on treatment under the Tories, or Labour, who will return our NHS to its founding principle of universal provision, free at the point of need, with best quality of care for all.”
A former government obesity tsar has attacked the policy of the government over Britain’s obesity crisis.
With the Department of Health placing a particular emphasis on addressing overweight children, Dr Susan Jebb suggested that this approach is completely misguided.
Jebb pointed out that two-thirds of British adults are currently overweight, and that this should be considered as significant a problem as childhood obesity.
It is believed based on many previous studies that the attitudes of parents play a major role in whether or not children end up being obese.
If parents are essentially comfortable in being overweight, it is far more likely that they will pass this on to their children, if only subconsciously.
Jebb believes that parents who eat unhealthy diets and fail to engage in satisfactory exercise will often influence children to do the same, resulting in a younger generation that is equally unhealthy.
Yet the government is mostly focusing on schoolchildren through its “Children’s Obesity Strategy”, which is expected to be published later this month.
Dr Jebb, was the Coalition Government’s lead adviser on obesity until May’s general election, yet is now openly critical of government policy.
“If the focus of this strategy is entirely on children then that would be a mistake. The Government needs to have a comprehensive strategy and that needs to include adults and children. Children live in families and families are incredibly influential to that way that they [children] eat and so we need to engage adults as well.”
In addition, the health adviser suggests that the strategy is too heavily focused on prevention, rather than also diverting resources toward treating people who are already overweight or obese.
While prevention is unquestionably valuable, the fact remains that the existing situation already represents an epidemic, and it is thus too late for the majority of overweight adults to take the preventative pathway.
“We also need to include both prevention and treatment. You cannot ignore the facts that a third of children leave primary school overweight and two-thirds of adults are overweight,” Jebb argued.
Jane Ellison, the Health Minister, had suggested in a Commons debate that the government will focus on children with the aim of creating a healthier generation of young people.
“Young children in particular have limited influence over their choices and governments have a history of intervening to protect them: we do not question the requirement that younger children use car seats on the grounds of safety, for example. Children deserve protecting from the effects of obesity, for their current and future health and wellbeing and to ensure they have the same life chances as other children, especially those in better-off parts of our society,” Ellison commented.
Results for 2014 showed that 61.7% of adults were overweight or obese (65.3% of men and 58.1% of women). The prevalence of obesity is similar among men and women, but men are more likely to be overweight.
A substantial proportion of obese adults have a body mass index (BMI) of well over 30. Women are more likely than men to have extremely high BMI values.
As the debate on sugar, diet and obesity rages on, the World Health Organisation (WHO) has thrown its has into the ring.
The authoritative health organisation has stated its support for the introduction of a sugar tax in soft drinks.
This opinion forms part of a major report on the childhood obesity, with sugary drinks fingered as a major contributor to this phenomenon.
The move increases pressure on the UK government, as it prepares to issue its own strategy for tackling obesity in the UK.
Although there have been critics of the idea of a sugar tax, and the idea has previously bombed in Germany, the World Health Organisation outlines the arguments in favour of the idea in its recent report.
The WHO’s Commission on Ending Childhood Obesity indicates that there is significant evidence suggesting that a sugar tax can have a strong influence on childhood obesity, when combined with other measures.
In addition to the sugar tax, the organisation also suggests that tackling portion sizes and improving food labelling would be beneficial for consumers.
The WHO believes that if countries fail to act sufficiently in order to address the existing situation that the medical, social and economic consequences will be of major magnitude.
Junk food is also targeted by the report, with the WHO suggesting that the marketing of fast food to children should be clamped down on in particular.
The suggestion is also mooted for schools to completely ban the sale of unhealthy food in their cafeterias.
Recent figures have indicated that the level of obesity in Britain is reaching an extremely unhealthy proportion.
Indeed, the UK is now the second lardiest nation in Europe, with only Hungary having a higher percentage of obesity according to the latest research.
The report states: “Childhood obesity is at crisis level in many countries and poses an urgent and serious challenge. The increasing rates of childhood obesity cannot be ignored and governments need to accept the responsibility to address this issue, on behalf of the children they are ethically bound to protect.”
Current estimates indicate that sugar is responsible for nearly 15% of all calorie intake in UK school-aged children.
And research by the University of Liverpool, which reviewed 22 separate studies, found that food advertising exposure has a massive influence on food consumption.
Dr Emma Boyland, from the University of Liverpool’s Institute of Psychology, Health & Society, commented that advertising has a particularly pernicious influence.
“Through our analysis of these published studies I have shown that food advertising doesn’t just affect brand preference – it drives consumption. Given that almost all children in Westernised societies are exposed to large amounts of unhealthy food advertising on a daily basis this is a real concern.”
Although Prime Minister David Cameron has yet to commit to a sugar tax, it does seem that the possibility is looming.
This will undoubtedly anger libertarians and those who believe it is both nannying and an ineffective way of addressing the issue of obesity.
A new British report suggests that rising levels of obesity and the unhealthy weight of the general population could lead to a vast increase in the number of cancer cases.
The Cancer Research UK and UK Health Forum Predicts that there could be an increase of 670,000 cases by 2035.
A report produced by the organisation suggests that advertising regulation related to food should be made considerably more strict.
In particular, the Cancer Research UK and UK Health Forum suggest that commercials for certain foods should be banned before the 9 o’clock watershed.
Recent studies suggest obesity is linked to several cancers – including oesophageal (gullet), womb, and bowel tumours.
In addition, being overweight is also associated with a wide range of debilitating health conditions, such as diabetes and coronary heart disease.
Yet population data suggest that Britain has never been in worse physical shape.
For some male age groups, as much as 80 per cent of the population can be considered overweight, and this pattern is reflected across all other demographics as well.
The work of researchers in this report also suggests that a rise in the number of people who are overweight or obese would contribute to 4.6 million additional cases of type-2 diabetes and 1.6 million extra cases of heart disease by 2035.
Not only will this have dire consequences for the population, but the financial cost to the NHS is also considerable.
Experts believe that the NHS may be forced to shell out an extra £2.5 billion for 2035 alone.
This latest report will renew political calls for a sugar tax on unhealthy food and drink.
This is indeed contained within the text of the document, with a 20p per litre tax on sugary drinks suggested in particular.
Yet it is debatable whether this could be expected to have a serious impact on the health of the population.
Critics of the policy and libertarians alike will both suggest that it is little more than a revenue generating mechanism.
Although the rate at which obesity is increasing in Britain has noticeably declined, the fact is that from an already serious situation, the number of overweight people continues to climb.
Professor Susan Jebb, at the University of Oxford, commented on the outcome of the report, and stated that addressing this issue is critical.
“Most people know that smoking causes cancer, but fortunately, most people in the UK now don’t smoke. And for them, managing their weight is the single most important thing they can do to reduce their risk of cancer.”
According to the English chief medical officer, Dame Sally Davies, obesity is a huge threat to women’s health, not to mention the stability of future generations.
Davies has recently submitted her annual support, which represents part of her role of chief medical officer.
And this year’s report particularly focuses on women, with Davies suggesting that tackling obesity should be considered a national priority.
Indeed, the officer went as far as suggesting that the situation related to obesity in the UK can be described as a “growing health catastrophe”.
In particular, Davies focused on the food industry and the recent suggestion of the government that some form of the sugar taxation should be introduced.
England’s top doctor said obesity was so serious it should be a priority for the whole population, but particularly for women because too often it shortened their lives.
Around 60 per cent of women in the United Kingdom are classified as overweight or obese.
This is an extremely serious health situation, as obesity greatly increases the chances that any individual may experience numerous extremely serious conditions.
Obesity increases the risk of many diseases including breast cancer, type 2 diabetes and heart disease.
The report makes 17 recommendations across a range of women’s health issues.
Many factors are suggested to have contributed to the obesity epidemic.
On the one hand, while diet is frequently blamed for the situation, the increasingly sedentary lifestyles of the population also play a serious role.
However, Davies particularly emphasises that responsibility of food manufacturers.
“I think we’re at a tipping point. If industry won’t deliver then we’ll have to look at a sugar tax,” Davies suggested.
Davies also recommends that everyone with an eating disorder should have access to a new and enhanced form of psychological therapy, called CBT-E, which is specifically designed to treat eating disorders.
Speaking to the BBC, Davies outlined some of the important measures that she believes will be central to changing the culture of the United Kingdom.
“I think it is inevitable that manufacturing has to reformulate and resize, that supermarkets and others need to stop cheap promotions on unhealthy food and putting unhealthy food at the check-out, and limit advertising dramatically.”
Dame Sally also stated that she wanted to “bust the myth” that women should eat for two when pregnant, adding a healthy diet with fruit and vegetables and avoiding alcohol was important.
While obesity is just one of the many health problems facing women in the UK, it is also one of the most common.
Many health professionals have compared the obesity situation in Britain to a ticking timebomb.
Data acquired by the Health and Social Care Information Centre suggests that the obesity epidemic in young people shows no signs of abating.
The report conducted by the organisation suggests that around 10 per cent of children were obese when they began primary school.
Yet this figure had doubled by the time that children leave these schools at the age of around 11.
Figures for obesity in Year 6 continue to rise, despite efforts to educate parents and people in general across the country about the dangers of obesity.
The study also suggested that there are clear demographic issues facing the country as well.
Children living in the most deprived areas were twice as likely to be obese as children in affluent areas.
Figures were acquired as a part of the British government’s National Child Measurement Programme for England which covers all state primary schools.
In Year 6, 19.1 per cent of children were obese; an increase on figures from eight years ago.
In some of the least successful regions, over one-quarter of children in Year 6 were found to be obese.
For example, 28 per cent of Year 6 pupils in Southwark were classed as obese and 44 per cent were either obese or overweight.
Commenting on these disturbing figures, Councillor Barrie Hargrove, Southwark’s cabinet member for public health, indicated that numerous people and groups must take responsibility for directly tackling the issue.
“Childhood obesity is an on-going and long term health issue in the borough with no single solution, and we are already implementing a range of initiatives to combat it, such as our free healthy school meals programme, and free fruit programme, to encourage healthy eating habits. We recognise that we need to do more to support children and their families.”
Wolverhampton had the largest number of obese 10 and 11-year-olds outside London, and Ros Jervis, the City of Wolverhampton Council’s director of public health, is similarly concerned about the problem.
“Obesity is associated with a number of serious medical conditions – so doing nothing is simply not an option.”
Going forward, numerous regions have indicated that action plans will be put in place in order to address the issue.
Information will be provided outlining what both organisations and individuals can do in order to tackle the obesity epidemic.
Additionally, programmes are being put in place with the aim of encouraging families to value nutrition more highly and encourage exercise.
Simon Gillespie, chief executive of the British Heart Foundation, said: “Falling rates of obesity in Reception age children is promising, but the fact remains that we now have more children leaving primary school overweight or obese and this is simply unacceptable.”
Although there have been numerous prominent programmes and initiatives undertaken in recent years in an attempt to tackle the obesity crisis, it seems that this is ultimately having little tangible effect.
As the debate over sugar and the proposed tax related to it continues, one famous figure has lent his support to the campaign.
The television chef Jamie Oliver has urged government ministers to introduce such a sugar tax on fizzy drinks.
Speaking to members of parliament at the House of Commons’ Health Committee, Oliver suggested that a tax would be the “single most important” change that could be made.
It is suggested that added sugar in food and drinks is one of the major contributors to the obesity epidemic worldwide.
This has seen the number of overweight people in the Western world in particular skyrocket in the last few decades.
According to official figures, over 60 per cent of adults in the United Kingdom are currently overweight, with approximately one-third being clinically obese.
Naturally this contributes to a wide variety of health problems, and is probably the single greatest factor in premature deaths in the United Kingdom.
It has been estimated by government sources that a 20 per cent sugar tax could raise as much as £1 billion per year.
Oliver suggested while speaking to MPs that the money raised could be shared between the NHS and primary school funding.
Commenting on the suggestion of the television chef, the Department of Health took a predictably neutral tone.
“The causes of obesity are complex, caused by a number of dietary, lifestyle, environmental and genetic factors, and tackling it will require a comprehensive and broad approach. As such, the government is considering a range of options for tackling childhood obesity,” a Department of Health spokesman stated.
While many experts support the idea of a sugar tax, there are certainly arguments against such a scheme.
Rather in common with the recent decision to charge 5p per plastic bag in large retail outlets, the scheme could simply be viewed as a money-spinning idea, with little or no practical benefits to the amount of sugar being consumed.
Ultimately, with a can of soda costing around 70p, even a 20 per cent tax would only necessitate a price rise of around 15p.
It is extremely doubtful that this would have a significant impact on the amount of sugary drinks that are actually consumed, just as charging 5p a carrier bag may have little or no impact on the amount of plastic bags utilised.
Regardless of the legitimacy or otherwise of taxing sugary drinks, there will certainly be a strong lobby against the idea.
The food industry is naturally an incredibly powerful entity, and lobbyists representing some of the more powerful corporations on the planet will doubtlessly argue strongly against the idea of taxing sugar.
Whether or not this will ultimately prove to be successful remains to be seen, but it certainly appears possible that we will see an increase in price of unhealthy beverages in the foreseeable future.
A study commissioned by Public Health England will examine the obesity epidemic in Britain with the intention of finding lasting solutions.
In particular, researchers at Leeds Beckett University will investigate the best way for local authorities to tackle this growing problem.
Public Health England has worked in collaboration with the Local Government Association, the Association of Directors of Public Health Germany, and with colleagues in local government organisations in commissioning this program.
All of the groups involved will attempt to identify methods that local authorities can use in order to create a holistic approach to tackle obesity.
The program has been funded by Public Health England, and will run over a three-year period.
It is hoped that a cohesive and co-ordinated approach will be developed by experts at the Leeds-based university.
Previous research has indicated that a whole systems approach is essential in addressing the obesity epidemic.
Central to this will be linking a whole range of sectors and influences including planning, housing, transport, children’s and adult’s services, business and health.
By attempting to implement this scheme at the local level, it is hoped that local authorities across the country will be able to make significant inroads into the obesity battle.
Although there are obvious health benefits to winning this particular struggle, it is also suggested that tackling obesity effectively can improve quality of life, save money for local authorities, and even contribute to sustained prosperity for regions across the country.
The Leeds Beckett’s team will work closely alongside a number of pilot local authorities to understand their perspectives and the realities for local government.
Capturing best practice, the importance of collaborative working, and the co-ordination of new and innovative approaches to obesity will all be floated as part of the overarching scheme.
Researchers at the university will be carrying out a systematic review of research evidence on the subject of obesity, while also gathering experience of dealing with the problem from across the world, thus gathering a raft of good practice case studies.
The Leeds Beckett team and the pilot local authorities will then create a process and develop a roadmap and practical strategies for local authorities to apply in practice, in order to address the current high levels of obesity.
Speaking about the programme, Pinki Sahota, Professor of Nutrition & Childhood Obesity at Leeds Beckett, outlined its importance.
“Obesity is a major global health crisis and tackling obesity is a complex and multifaceted problem. Local Authorities are investing great efforts into tackling these issues but clearly they are enthusiastic to do more and gain the benefits that come from a healthier population.
“All the evidence shows that if we can link together many of the influencing factors on obesity by coordinating action and integration across multiple sectors, including health, social care, planning, housing, transport and business, then we can bring about major change to combatting obesity, making better use of resources and improving wellbeing and prosperity,” Sahota asserted.
The Health Survey for England indicated recently that 62.1 percent of UK adults are overweight or obese (67.1 percent of men and 57.2 percent of women).