Health and Social Care in England

Lord McColl of Dulwich Excerpts

Thursday 11th July 2013 Lords Chamber

[Lord McColl of Dulwich]

My Lords, I am grateful to the noble Lord, Lord Patel, for securing this debate. There are two subjects on which I would like to comment. First is the underlying cause of the ever increasing demands on the NHS; they are due, of course, to the ever increasing number of patients with diabetes, eye disease, high blood pressure, strokes, heart attacks, cirrhosis of the liver, cancer, worn-out knees and hips, and so on, as the noble Lord, Lord Patel, has already said. But it has to be pointed out that most of these conditions have a single cause, and that single cause is obesity. The obesity epidemic is the worst epidemic to afflict this country for 90 years; it is killing millions and costing billions and the cure is free: simply eat and drink fewer calories. A great deal of obesity is due to that poison called alcohol, a cause not only of obesity but of many diseases.

This enormous problem has been bedevilled by the Department of Health, Health Ministers and opposition spokesmen, and that quango NICE, all misleading Parliament by stating that all the calories we eat is spent on exercise. This is totally untrue. Exercise is good for the heart, helps keep the cholesterol at a safe level and improves the feeling of well-being, but it is not effective at reducing weight. One has to run 10 miles to take off a pound of fat. Really obese people cannot exercise, and they do not need to in order to lose weight; all that they have to do is to eat and drink fewer calories. NICE has informed me that it is going to correct its misleading advice, but it will not be published until January next year.

Secondly, this enormous obesity epidemic is obviously bankrupting the NHS. It is often said that it is old people who are costing the NHS so much, but in fact it is people who are dying who are so expensive. It so happens that most people who are dying are old, but young people who are dying are just as expensive.

Where is the extra funding to pay for the ever increasing demands going to come from? Perhaps we should try listening to other people and learning from their experiences. Perhaps we could listen to Prime Minister Attlee, who was a very perceptive and brilliant man. Within a year of the inception of the NHS he realised that there was a major problem. In October 1949 he announced, in another place, “We propose to bring in prescription charges in order to discourage people from using the NHS excessively and unnecessarily”. I suspect he really wanted to put the charge on going to see the GP but he realised that that would be political suicide.

We might learn a lesson from the radical changes in the dental services which occurred under the previous Government. A large number of dental treatments had to be paid for by the patient. All credit to the Labour Government for grasping this particular nettle. As the noble Lord, Lord Patel, has already said, we could learn from the French, who pay the doctor up front and, if they cannot afford it, are reimbursed. There is an attraction in the patient paying up front because he is not asking for charity, he is employing the doctor. It changes the relationship. The system in France has worked well.

As Labour Governments have pioneered these kind of changes, they might care to join a cross-party movement to work out a new funding arrangement. One suggestion was to charge patients £5 or £10 to visit the GP and then reimburse those who cannot afford it or who have chronic or recurrent illnesses. All hospital treatments would be free. Another suggestion, which has been discussed for many years, is to have a compulsory health insurance scheme for those who can afford it. It would seem sensible at this time of financial crisis for a cross-party group to be set up to try to work out a solution, free of petty party politics and the shibboleths which have so bedevilled the National Health Service for so long.