Queen’s Speech

Lord Truscott Excerpts

Tuesday 15th May 2012 Lords Chamber

[Lord Truscott]

My Lords, the National Health Service in its current form is unsustainable, unsatisfactory and urgently in need of reform. We are paying more for our health services, yet becoming unhealthier as a nation. Britain’s political parties are aware of the health challenges, but none is prepared to tackle the NHS’s long-term lack of sustainability head-on for fear of being crucified by the electorate, yet the result of this failure of political nerve will inevitably lead either to further cuts, rationing and declining public health under Conservative Governments or to effective bankruptcy under the Opposition.

The challenges are well known. Britain is among the worst in Europe for heart disease, and Glasgow is the heart attack capital of the world. As many as a quarter of a million Britons will die from alcohol abuse over the next two decades, while smoking causes over 100,000 deaths annually. Meanwhile, the UK has the highest levels of obesity in Europe, with one in four British adults being labelled obese. The cost to the NHS of obesity-related illnesses is expected to increase to £2 billion by 2030. By 2035, spending on diabetes, the majority of which is wholly avoidable and linked to diet, will cost the NHS £16.8 billion. Add to that an ageing population, with both sexes living to an average age of 87 by 2030, and this country is facing a health crisis of monumental proportions. The current younger generation will be the first generation in modern history to live shorter lives than their parents, although they will have the burden of paying for them, if they are lucky enough to have a job.

The NHS employs more than 1.7 million people, just under half of them clinically qualified. The NHS is the biggest employer in Europe. In fact, only the Chinese People’s Liberation Army and Indian Railways employ more people. The NHS already costs the general taxpayer over £106 billion a year, and that bill may triple by 2025. As much as I like and respect my current NHS GP, Dr Victoria Muir, our National Health Service is not delivering for the British people and the existing model, paid for from general taxation, is unsustainable.

There needs to be a fat tax levied on the purveyors of cheap, so-called fast foods, which are costing the rest of us so dear. It will not be penalising the poor; by saving their lives, we will be doing them a favour. In an ideal world, people would voluntarily change their lifestyles, but we all know simple invocation does not work. We need compulsory healthy cooking lessons in schools and the imposition of a minimum 50p per unit on alcohol, as recently proposed in Scotland. While avoiding the pitfalls of US Medicare and of Americanising our health services, we should move to a comprehensive social insurance system of health funding, retaining the principle of universal care at the point of need, but where people are also encouraged to take responsibility for their own lifestyle choices. The present health system guarantees that, however feckless the individual, the general taxpayer will pick up the tab.

Our current health service is an unfair lottery, where patients get not what they need, but what the NHS tells them it can afford, and where preventive care is either poor or non-existent because it is not seen as a budgetary priority. The best drugs available should be prescribed, rather than those deemed affordable by the NHS. This can be achieved by adopting a continental-style health insurance scheme, which would not only improve the quality of choice and care but empower patients, rather than commissioning GPs, to choose where and when they are treated, and by whom.