LSE analysis of NHS says patient outcomes are very poor, "holy cow" status stops improvement

crunchman

There is no appetite in the country for ID cards.  Criminals would find a way to forge them anyway.

Snap

darthed1981 said:

Snap said:

darthed1981 said:

The reality is, we as a country have an ageing population, and this affects everything, not just the NHS.  It will be a continued economic challenge to look after the elderly without putting a huge extra tax burden on working people.

Actually, that isn't the real challenge it faces. The big problem we have is chronic disease caused by bad lifestyle. Incidence of diabetes up massively for example. The reason? We are a nation of fatties. Over half the population is fat. That means people get ill at a younger age and need health service resources sooner. Drug and treatment advances mean people with chronic disease live longer, thus increasing the amount of cost to the NHS both in the short and long term.

Until the public gets a grip on it's waistline, this will continue. Everything else is minor in comparison, really.

Yes I know I go on and on about fatness, but its the scourge of the NHS. No other single factor plays such a big part in so many burdens on resource.

You can, and I have, traced this link in emerging and growing economies in different parts of the world. As societies adopt more western lifestyle habits, the weight of the nation goes up, disease increases and health service burden rises. Where the average weight is lower, life is longer, heatlhier and less expensive in health service terms.

Thing is, we don't know how to tackle it, and people are sensitive to talking about it.

You want a better NHS? Put the burger/cake/pasty/beer down

Except, it isn't...

You are correct it is an issue, but it's one small aspect of the extra costs, also costing massive amounts are: -

Drinking
Smoking
Sports Injuries (ironically)
Terrible Driving
Idiocy

Oh - and lots of old people who these days we try to care for, not let die.

The western weight problem is caused at least partly by the choices of our economic system, not least laissez-faire regulation of food production which can easily put 1000 calories in the palm of your hand.  1000 calories full of corn starch as natural food production is too expensive

Most food studies point to increased % risks from obesity and excess weight, but with just a few nudges, a bit of education and a bit of regulation, the problem can be made to go away....

Sorry, but nope.

Drinking and smoking, more than covered by taxation. Less than 20% of the population smoke, and its falling. Drinking is on the up, and the morbidities associated are too, but that pales into insignificance when you look at increased lifespan, and increased chronic disease.

If you work with the data (which I do) and you look at trends for cost and burden - it gets quite clear.

Take type II diabetes for example - incidence creeping upto 6.5%, 20 years ago it was round 4%. Type II is for most caused by lifestyle. BUt its not the end of it - its part of a syndrome that often coincides with hypertension, obesity. Obesity will eventually cause both hypertnesion and diabetes. Then it causes musculoskeletal problems, increases the risk of many cancers and increases the risk of depression. Also increase the risk of kidney disease, stroke and heart attack. Every one of these is hugely expensive in terms of system resource and funding

2015/16 stats from NHS England:
The highest prevalence rates are for Hypertension (13.8 per cent), Obesity (9.5 per cent) and Depression (8.3 per cent).

 

Hypertension (7.9 million), Obesity (4.3 million) and Depression (3.8 million) are the conditions reporting the highest register numbers.

Those numbers are pretty staggering really. 8 million people in England alone with high blood pressure! 4 million obese - that's not just fat, that's seriously fat, as in proper biffer fat.

Chronic long term disease (hypertension, diabetes, atrial fibrillation, respiratory disease) is a big big burden on the NHS. Whilst there are parts of this that is inevitable (as we live longer) a lot of it is within the control of the individual.

Boromedic

crunchman said:

There is no appetite in the country for ID cards.  Criminals would find a way to forge them anyway.

Whether there is or isn't doesn't negate the fact they would be a step in the right direction, and not just for the NHS but other things as well.

crunchman

Boromedic said:

crunchman said:

There is no appetite in the country for ID cards.  Criminals would find a way to forge them anyway.

Whether there is or isn't doesn't negate the fact they would be a step in the right direction, and not just for the NHS but other things as well.

Why?

They will cost billions to implement.  They will turn us into even more of a Big Brother state than we are already.  Criminals would find a way to forge them anyway.  Gordon Brown lost that debate years ago.

Boromedic

I give up, I'll find my tin foil hat and join you............... You are on the internet, on a forum, your profile will have been captured numerous times by data companies, governments and flippin Google. Big brother already exists and you're part of it already. Can I reiterate here, I was dead against ID cards, now I've seen them work they are actually great, if we want reforms to the NHS stopping health tourism would be one part of a larger solution, this is just one area they would help.

Also based on the logic in your example, I won't bother locking my car or house up because the burglars will find a way in anyway. FFS

chillidoggy

Personally, I'd be quite happy to have an ID card, and I'm surprised they weren't introduced years ago. They're no different from passports of driving licences when it comes to forgery, the crims can forge all manner of paperwork these days. As for the Big Brother state, well that's already here in the form of the information companies and other organisations hold on you, including the government and its agencies, so to me that argument simply doesn't stack up any more.

I certainly wasn't suggesting that people would be turned away from emergency treatment, though. Even in the States, they cannot legally refuse you treatment whether you're able to pay, or not. The only difference is, they get you to the point where you're patched up and able to leave the hospital.

crunchman

They will be dependent on a huge government IT system that will cost many billions and won't work.  That's money that would be better spent elsewhere.

Then 15 years down the line, they will still be using the same technology that is now way out of date, and there will a massive problem like when the NHS was hit with the thing a couple of months ago.

There will also be a massive campaign of civil disobedience with people refusing to use them.

Even if you think they are a good idea in principle, the practical problems and costs would make them a bad idea in practice.

Boromedic

Yep, like I said I was dead against them, then I saw the benefits and changed my mind on the whole idea.

As for the turning away thing it's a grey area on many hospitals definition of "life threatening" or "emergency", I've seen people turned away with fractures that need treating but aren't immediately life threatening, and also seen treatment delays that could have been detrimental to the outcome of the patient due to insurance issues. These issues would need be ironed out if it was ever implemented in the UK. There was also the long standing issue of patient dumping in the US too, this is why we need to follow a model from other EU countries of a not for profit insurance system also.

chillidoggy

crunchman said:

They will be dependent on a huge government IT system that will cost many billions and won't work.  That's money that would be better spent elsewhere.

Then 15 years down the line, they will still be using the same technology that is now way out of date, and there will a massive problem like when the NHS was hit with the thing a couple of months ago.

There will also be a massive campaign of civil disobedience with people refusing to use them.

Even if you think they are a good idea in principle, the practical problems and costs would make them a bad idea in practice.

The majority of Britons already hold a passport, so the details are already stored, and a good proportion have driving licences. But what's wrong with showing a passport as a means of identity?

Boromedic

crunchman said:

They will be dependent on a huge government IT system that will cost many billions and won't work.  That's money that would be better spent elsewhere.

Then 15 years down the line, they will still be using the same technology that is now way out of date, and there will a massive problem like when the NHS was hit with the thing a couple of months ago.

There will also be a massive campaign of civil disobedience with people refusing to use them.

Even if you think they are a good idea in principle, the practical problems and costs would make them a bad idea in practice.

Well we'll have to agree to disagree won't we.................

Boromedic

Drinking and smoking, more than covered by taxation. Less than 20% of the population smoke, and its falling. Drinking is on the up, and the morbidities associated are too, but that pales into insignificance when you look at increased lifespan, and increased chronic disease.

If you work with the data (which I do) and you look at trends for cost and burden - it gets quite clear.

Take type II diabetes for example - incidence creeping upto 6.5%, 20 years ago it was round 4%. Type II is for most caused by lifestyle. BUt its not the end of it - its part of a syndrome that often coincides with hypertension, obesity. Obesity will eventually cause both hypertnesion and diabetes. Then it causes musculoskeletal problems, increases the risk of many cancers and increases the risk of depression. Also increase the risk of kidney disease, stroke and heart attack. Every one of these is hugely expensive in terms of system resource and funding

2015/16 stats from NHS England:
The highest prevalence rates are for Hypertension (13.8 per cent), Obesity (9.5 per cent) and Depression (8.3 per cent).

 

Hypertension (7.9 million), Obesity (4.3 million) and Depression (3.8 million) are the conditions reporting the highest register numbers.

Those numbers are pretty staggering really. 8 million people in England alone with high blood pressure! 4 million obese - that's not just fat, that's seriously fat, as in proper biffer fat.

Chronic long term disease (hypertension, diabetes, atrial fibrillation, respiratory disease) is a big big burden on the NHS. Whilst there are parts of this that is inevitable (as we live longer) a lot of it is within the control of the individual.

It's interesting to read this data, and then put it into perspective with real first hand experience of these patients. The conditions you mention are a ticking timebomb that will eventually be an even bigger drain that it is at the moment. I used to see all of the things you mention on a daily basis, and over the course of years you gradually witness the decline of these patients due to their lack of lifestyle changes and their increased burden on the NHS and local services. A lot of people will change initially then realise its hard work to maintain and slip back to old habits, not to mention outside issues such as mass marketing ,junk food availability, cheap mass produced food full of vast amounts of salt and fats, lack of education, etc..

So many things need to be altered to help with the process, and not that I want to victim blame as some folk genuinely are naive to these things, but people need to be helped into changing their lifestyle (not a one size fits all shaming process, although this would help some), or if we're going to carry on as we are then they need to start taxing bad food like they tax fags and booze to help pay for it. People are sheep and are easily led, with a lot believing it's not their fault, and whilst I wholeheartedly agree that it's not 100% their fault they need to start helping themselves and some need a push to do it. 

darthed1981

Snap said:

Sorry, but nope.

Drinking and smoking, more than covered by taxation. Less than 20% of the population smoke, and its falling. Drinking is on the up, and the morbidities associated are too, but that pales into insignificance when you look at increased lifespan, and increased chronic disease.

If you work with the data (which I do) and you look at trends for cost and burden - it gets quite clear.

Take type II diabetes for example - incidence creeping upto 6.5%, 20 years ago it was round 4%. Type II is for most caused by lifestyle. BUt its not the end of it - its part of a syndrome that often coincides with hypertension, obesity. Obesity will eventually cause both hypertnesion and diabetes. Then it causes musculoskeletal problems, increases the risk of many cancers and increases the risk of depression. Also increase the risk of kidney disease, stroke and heart attack. Every one of these is hugely expensive in terms of system resource and funding

2015/16 stats from NHS England:
The highest prevalence rates are for Hypertension (13.8 per cent), Obesity (9.5 per cent) and Depression (8.3 per cent).

 

Hypertension (7.9 million), Obesity (4.3 million) and Depression (3.8 million) are the conditions reporting the highest register numbers.

Those numbers are pretty staggering really. 8 million people in England alone with high blood pressure! 4 million obese - that's not just fat, that's seriously fat, as in proper biffer fat.

Chronic long term disease (hypertension, diabetes, atrial fibrillation, respiratory disease) is a big big burden on the NHS. Whilst there are parts of this that is inevitable (as we live longer) a lot of it is within the control of the individual.

I said, yes you are right it is a problem, but you can't argue "oh its covered" for smoking and drinking, they make people ill and these people require expensive resources.  That's not an argument for how do we deal with strain on the NHS, that is an argument for how we PAY for it.  If the answer is "find the cash and its fine", well just find the cash then.  Tax bad things.

If your proposal is that we should apply similar taxes on unhealthy foods to those on smoking and drinking, then I heartily agree with you, and in fact feel that would be a great solution!  Apart from anything else, fat people who squeeze through their doctor's doors to get a prescription for salads can do it knowing they have contributed to their treatment already, its a win for everyone.

I never debated that an unhealthy lifestyle isnt an issue, but it is not THE ONLY issue, which is what you said in your first post, you know this as if the three issues you quote add up to 31.6% that means other things add up to 68.4%!  The only one directly 100% linked to overeating is Obesity of course.

Depression is down to a f**k tonne of factors, so to throw that stat in there is misleading at best.

In fact I'm not sure which bit of my reply you are arguing with, I agreed on the first line of my post "yes its definitely a problem" if I change this to "its definitely a big problem" - are we cool?

Snap

course we're cool!

but if you are looking at what is loading the NHS most, its not bad driving, drinking, or even smoking really. Course they are part of it, but general poor health due to bad lifestyle is probably more of an impact than anything, particularly for the future

ToneControl