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Should Lifestyle Related Illnesses Be Funded By The NHS?

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Obesity has become a national problem for the NHS and is causing a significant amount of strain and pressure. Now, more than ever before many individuals are ‘causing’ their own death. The implications of obesity are severe and it has been found that throughout Europe 14% of premature deaths could be prevented simply by being a healthy weight. Throughout this essay I will particularly focus on the related medical conditions it can cause, principally type two diabetes and whether certain treatments which could be more cost effective should be prioritised and funded above other conditions. Furthermore, I need to consider ,if there is sufficient funding to allow weight loss programmes to run, along with weight-loss surgery which could significantly improve quality and quantity of life for obese patients. Due to Obesity being such a catastrophic issue that is currently causing up to 30,000 deaths each year in the UK it is essential that the NHS tries to combat this wide scale problem. Furthemore this trend is continuing to inflate. Along with this the cost of obesity is also steadily increasing as a consequence to the percentage of people in the UK who are now considered obese, this figure is higher than ever; A staggering 24.9 percent of the UK population.

Smoking and the NHS is another relevant topic in the media at the moment.Smoking is a lifestyle choice that can cause a significant amount of damage to an individual’s health, whether this be by diseases such as Chronic obstructive pulmonary disease(COPD), lung cancer or even heart disease. In fact, smoking has caused around 1 in 5 deaths since 2005(5). Most importantly, smoking continues being an ever more popular tendency. Since 2017 the average age of smoking amongst adolescents between the ages of 18-25 has dropped to just 18.9 years old.A figure even more revealing is that of the average age of a “young smoker” being a merely 15.1 years of age.In some respects smoking can be viewed as a social activity, and therefore has a greater and wider influence over young people who are much more susceptible to new trends and ideas. This could clearly highlight further problems for the NHS if young people are smoking earlier and more frequently than ever before.

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The final lifestyle related condition that this essay will focus on is alcohol consumption. It is another issue that has had much more recognition for its consequences in recent years and has also come under much scrutiny. Liver transplants are becoming an ever more recommended treatment option; often it is the only choice many alcohol abusers have left; but should the NHS have to pay for something an individual has clearly done to themselves?Liver transplants are not a cheap treatment plan and cost around £70,000 each, much higher than the public percepted cost of £5000. Around 236 liver transplants are carried out in the UK every year.

So realistically can alcoholism,smoking and obesity be viewed as a lifestyle related illness or is it as detrimental, as a mental illness and an addiction? In some respects should public health have to suffer in order to cover these elevating costs? Is it right that as a consequence patients who have not intently damaged their bodies physically, suffer due to a personal choice made by another person? In the UK there are now only 3 hospital beds per 1000 people(as of 2011).This is another issue that is has caused significant problems recently as there are not just difficulties admitting patients but also discharging them.Lifestyle related illnesses are currently costing around £11 billion of the total NHS budget. However,for public health not to fund these situations can clearly be seen as immoral and goes against the evident principles of the NHS (“Access to NHS services is based on clinical need, not an individual’s ability to pay). But, to what extent should the NHS fund these illnesses if it comes at the cost of another individuals health suffering?

Of the three lifestyle related illnesses that I will be discussing, obesity is coming at a prevalent cost to the NHS and may fastly become uncontrollable. There are many treatment options available to try and combat obesity all varying in cost and effectivity. One of the many issues that health professionals within the NHS face is whether or not surgery is necessary. Surgery not only has high and strenuous costs but also the risks associated are even more elevated for an obese patient. Although in many people’s opinion surgery is the only option which can have a long lasting impact. Potential risks linked to high levels of obesity are DVT ( deep vein thrombosis) and breathing problems caused by excess fatty tissue surrounding the neck area. However these are simply operative risks and there are many more possible postoperative complications that obese patients can suffer. From tests carried out in 2007, results showed that obese patients are 5 times more likely to suffer a heart attack compared to patients with a healthy BMI range and 4 times higher rate to have suffered a peripheral nerve injury. These forms of injury can cause difficulty in your brain’s capability to communicate with muscles and organs within the body and although not necessarily life threatening they can cause permanent loss of feeling to the area affected.In some respects the NHS also has difficulty in being able to assess these risk and complications and whether or not a different treatment plan would be better suited, it questions to what extent is surgery a justified and an effective form of treatment. Currently the costs of weight loss surgery vary between the region of £3,995 to £15,000.Generally the performance of a gastric bypass costs the most, not surprisingly this is the most common procedure carried out and does demonstrate that, for the NHS obesity is a high cost lifestyle problem to treat although evidence shows that gastric bypass is the most effective treatment. Possibly by helping to solve the problem now could in fact cost the NHS less. When a patient begins to lose weight consistently their associated risks linked to obesity decrease and it is certain that the NHS is who then covers these further costs as well.

More evidence for this idea is that some weight loss surgeries(principally gastric bypass) can completely reverse the effects of type 2 diabetes; a very common problem associated with a higher than average BMI. Also by completing some form of physical activity the risks of type 2 diabetes is decreased by 40%.Between 55% to 95% of patients (with a BMI of 35 or higher) blood sugar levels soon returned to normal after the procedure. Evidently the medication used to treat this condition also comes at a cost. The main medication used to treat type 2 diabetes is through the drug metformin and is available in two different doses ( 500 mg or 850 mg). The cost of metformin has risen to £81 million in 2013 /14 compared to the previous £37 million in 2005/2006.More significantly, diabetes is costing around 10% of the total NHS budget. The cost of diabetes is at an all time high for the NHS and is only one of many other effects that can be drastically reduced via weight loss surgery. Clearly the health benefits also satisfy the patient as well and not just the NHS. Even if public health was not to fund these surgeries the costs of diabetes could still be increasing at an even faster rate. The performance of weight loss surgeries does also bring in money for the NHS and at a high costs each time there will be a large percentage going towards continuing this funding.If funding was to be stopped or operations to be cancelled then in some ways money would also continue being drained from the NHS as well. Furthermore weight loss surgery is essential in ensuring that levels of obesity gradually decrease as the statistics for levels of obesity are rising and are continuing to. A predicted 9 out of 10 adults will be either overweight or obese by 2050.

Although this figure is one that affects adults,obesity is a lifestyle related illness that is significantly found amongst the younger generation as well. Even more so when the child has a parent who is obese themselves, actually the risk of childhood obesity increases by 10% with a parent who is categorised as obese. Obesity found amongst children,although less severe physical consequences than found in adults has much more of a social and mental impact “Obesity is closely linked with deprivation levels” says Alison Tedstone, in fact this association is much more significant in children. “Children in poor communities are much more likely to be obese”. This suggesting that for many families fast, convenient food that is much more likely to contain high levels of saturated fats is a cheaper option. Possibly there are underlying treatments which can help to prevent childhood obesity. Between 2011 and 2013 there was 62 patients under the age of 18 who had been treated with weight loss surgery, although this is not always an advisable option because of the risks that this can have. This figure is much greater than the reported one child in 2000. This can only pose questions as to why childhood obesity is becoming a greater problem and perhaps reasons behind that are due to insufficient help to manage this problem from an early age along with developments in society and our attitude towards different foods. Principles such as the sugar tax hope to ease these issues but there is no real evidence that their work is effective by any means.Consequently more effective principles are necessary.

Treatments for obesity come with much controversy mainly because there is a stereotype that obesity is simply an issue that could easily be prevented not just by the patient themselves but also by medical professionals. Often, for obese individuals there are range of complex factors which are determining their current weight. A branch of factors known as “obesogenic environments”(‘the sum of influences that the surroundings, opportunities, or conditions of life have on promoting obesity in individuals or populations’.) have been proven to have a major influence on the way in which individuals are able to form decisions about their lifestyle. Examples of these include forms of transport, conveniency of food and sedentary activities. In many ways the cultural developments found within our society have only contributed to these factors.The convenience for being able to exercise and purchase food is frequently a factor which many blame on causing their obesity. Professor Jebb remarked”The situation in which food is readily available for most people has arrived in a blink of an eye in evolutionary terms,” Now more than ever before our population are using cars as a form of transport rather than walking when this option would still be appropriate. The use of cars has risen by 10% since 2003 and the walking distance used for travel purposes each year has fallen to 192 miles from 255 miles. The sum of all these changes can come as no surprise to why obesity levels are heightening and hence why so much money is being poured into covering the costs of obesity. Due to this more convenient society obesity is much more common that it was just 50 years ago and more patients are being treated for the problems it is causing them. But it is not just obesity that is becoming more frequent to treat.


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