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18.09.14

Obesity will bankrupt NHS if unchecked – Stevens

Obesity will bankrupt the NHS if a serious effort is not made to tackle the problem, the chief executive of NHS England has warned.

Simon Stevens, who took up the post this year, told the annual conference of Public Health England in Coventry that the health of millions of children, the sustainability of the NHS and the economic prosperity of Britain all now depend on a radical upgrade in prevention and public health.

“Obesity is the new smoking, and it represents a slow-motion car crash in terms of avoidable illness and rising healthcare costs,” Stevens said. “If as a nation we keep piling on the pounds around the waistline, we’ll be piling on the pounds in terms of future taxes needed just to keep the NHS afloat.”

He pointed to the fact that nearly one-in-five secondary school aged children are obese, as are a quarter of adults, which is up from 15% from 20 years ago. Unchecked it will result in a huge rise in avoidable illness and disability, including many cases of type 2 diabetes, which is already estimated to cost the NHS about £9bn a year.

Local authorities currently have responsibility for tackling obesity as part of their public health remit. Money for public health has been ringfenced by the government but individual authorities are free to spend it according to the needs of their locality. However some experts fear that obesity, which is hard to tackle and needs the involvement of town planners and education departments as well as health, may not get the funding it needs.

Stevens’ proposals on the way forward for the NHS will be published next month. In it he will suggest several actions to tackle the problem:

  • A shift in NHS investment towards targeted and proven prevention programmes. The NHS is now spending more on bariatric surgery for obesity than on the national rollout of the intensive lifestyle intervention programmes that were first shown to cut obesity and prevent diabetes over a decade ago.
  • New incentives to ensure the NHS as an employer sets a national example in the support it offers its own 1.3 million staff to stay healthy, and serve as ‘health ambassadors’ in their local communities. While 75% NHS trusts say they offer staff help to quit smoking, only about a third offer them support in keeping to a healthy weight. Three-quarters of hospitals do not offer healthy food to staff working night shifts.
  • Financial incentives for employers in England who provide effective NICE-certified workplace health programmes for employees.
  • A ‘devo-max’ approach to empowering local councils and elected mayors in England to make local decisions on fast food, alcohol, tobacco and other public health-related policy and regulatory decisions, going further and faster than national statutory frameworks where there is local democratic support for doing so. Stevens points to the public health leadership of Michael Bloomberg, former mayor of New York City, who took action against junk food marketing and attempted to ban super-size cartons of colas.

(Image: c. Dominic Lipinski PA Wire)

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