The NHS in its present form is an unsustainable money pit, which the incoming Government will struggle to turn around. Healthcare spending in the UK as a share of the gross domestic product (GDP) was 5.1 percent in 1990. By 2022, healthcare expenditure had risen to 11.3 percent of GDP. (Fourth highest in Europe:12.8% of GDP in Germany, 12.4% in France, 12.2% in Austria).
Much of the Financial burden is preventable with lifestyle changes, but that’s unlikely to change any time soon. Effort by governments (of any persuasion) no encourage and support people to follow healthy lifestyles often brings accusations of ‘Nanny State’.
Apart from the fact that younger people start work and paying taxes much later in life than in the past, though people are living much longer, they incur illnesses in later life which former generations didn't live long enough to incur and spend many more years in retirement and declining health.
Life expectancy in years at birth:
1939: The year I was born, Male 61.4. Female 65.6 so on average, I was not expected to live to retirement at age 65. I'm 85 today. I think I owe my longevity to living through the war years into the 1950s on a meagre but healthy diet. Food rationing didn't end until 1954, the year I started work aged 15. Sweets and chocolate was rationed to 7 ounces (200g) per week. No processed food, no 'junk food', no ready meals.
Life Expectancy:
1948: The year the NHS was created: Male 65.9 Female 70.3
So when the NHS was created, the likelihood was that on average, few would live beyond retirement age.
2000 Male 75.6 Female 80.
2022: Male 79.25 Female 83.12
The UK's population is both larger and older than a hundred years ago, but most of the difference in size is due to an increase in the older population. Between 1901 and 2010, the population under 40 increased only modestly
, from 28.5m to 31.5m. But over the same period, the number of people aged 40 and older has more than trebled, from 9.7m to 30.8m. In 1901, around 5% of the population was aged 65 and older, compared with 17% in 2010. The proportion of the population in this age group is projected to rise to 23% by 2035.
But those extra years are beset with ill health, much of which is preventable.
For the three years 2020–22, although male life expectancy was 78.8 years,
average healthy male life expectancy was only 62.4 years – ie, 16.4 of those years (21%) would have been spent in poor health. Female life expectancy was 82.8 years, of which
20.1 years (24%) would have been spent in poor health. Although females live an average of four years longer than males, they spend a higher proportion and more years of their lives in poor health. Similarly,
disability-free life expectancy is almost two decades shorter than life expectancy, and is higher among males (61.8 years) than females (60.5 years).
Much of this ill health stems from lifestyle – obesity, poor diet, processed food, foods high in fat, sugar and salt, ‘junk food’ smoking, alcohol, lack of exercise leading to cardio-vascular disease. This places a heavy burden on the NHS. (A 330ml can of fizzy drink typically contains 35 mg of sugar – seven teaspoons full, contributing to childhood obesity).
Obesity:
Britain has one of the highest obesity rates in Europe. Two in three adults are overweight or obese and the
NHS spends £6bn a year treating obesity-related ill-health. That is forecast to rise to £10bn a year by 2050.
Prevalence of obesity (BMI ≥ 30kg/m²) in UK in 2022 is: Women: 28.3%, Men 26.94%. (For comparison: USA: Women 43.82%, Men 41.64%. France: Women 10.18%, Men, 9.82%).
https://data.worldobesity.org/tables/ranking-obesity-by-country-adults-1.pdf?
Hospital admissions directly attributable to obesity in 2023:
8,716 hospital admissions directly attributable to obesity, an increase of 13% on 2021/22, when there were 7,733 admissions.
Hospital admissions where obesity was a factor:
Just over 1.2 million (1,236 thousand) hospital admissions where obesity was a factor, an increase of 8% on 2021/22 when there were 1,142 million admissions, continuing a trend in increasing admissions seen over the past decade.
Type 2 Diabetes:
The number of people under 40 being diagnosed with type 2 diabetes in the UK has risen 39% in six years, fuelled by soaring obesity levels and cheap junk food.
Figures from
Diabetes UK show cases of type 2 among under-40s have increased to almost 168,000 from 120,000 in 2016/17. Diagnoses are rising at a significantly faster pace than among over-40s, for whom the increase was 25% in six years. Many cases go undiagnosed.
Smoking is a leading cause of preventable illness and death.
In 2023, there were 408,700 hospital admissions in England attributable to smoking, 5% higher than 2021/22 when it was 389,800. 74,600 deaths in 2023 were attributable to smoking, a decrease of 3% from 2018 (77,000) and 9% from 2009 (82,000). 710,000 prescription items to help people stop smoking were dispensed, a decrease of 4% from 2018/19 (740,000) and 71% from 2009/10 (2.48 million).
The most recent figures show that women in England are amongst the most likely to smoke during pregnancy with 10% still lighting up at the time of their baby’s delivery, which doubles the risk of stillbirth, substantially increases the likelihood of miscarriage and triples the chances of sudden infant death. Across the country, there’s significant variation in the number of pregnant women who smoke, ranging from 2% in Kensington & Chelsea to over one in five in Blackpool.
Alcohol related illness:
Alcohol-related illness costs the NHS a substantial amount each year.
The most recent estimates indicate that alcohol-related harm amounts to approximately £3.5 billion annually in England1.
This figure has increased from around £2.7 billion in 2006/7. The impact includes expenses related to hospital admissions, emergency services, and other healthcare resources
Heart Bypass operations:
The first heart bypasses were done in the 1960s. In the UK, the first coronary angioplasty was done in 1980, followed by the first coronary stent insertion in 1988. Angioplasty is a minimally invasive method of widening a coronary artery.
It diverts blood around narrowed or clogged parts of the major arteries to improve blood flow and oxygen supply to the heart. Around 20,000 coronary artery bypass grafts are carried out in England every year. Most of these are carried out in men, and around 80% are used to treat people who are at least 60 years of age.
Hip & Knee Operations:
Knee replacement has become one of the most common major surgical procedures, with almost 35,000 operations performed each year in the United Kingdom.
In 2019 There were 93,911 knee replacement procedures and almost all patients were 50 years old or older (97.4%). Patients aged 50-69 accounted for 49.6% whereas 51.8% for those over 70 years old. 59.4% of all hip replacements were carried out on female patients 40.5% were male patients.
NHS performs over 30,000 total hip replacements each year, reducing pain and increasing mobility, at a total cost to the NHS of £140 million a year.
It behoves the incoming government to ensure that money poured into the leaking bucket of the NHS is spent more efficiently, as well as for all of us in this unfit nation to take some responsibility for our own health. Better to prevent people from getting ill, than simply getting more and more doctors, nurses, beds ad infinitum to treat self induced chronic ill health. Or so it seems to me.