During my time at Medical School, it was often supposed that the NHS was the second biggest employer in the world. Recent data shows us that although it is "only" fifth on the list, it is undeniably a huge employer in global terms. The biggest employer is the US department of defence with 3.2 million followed by the Chinese army with 2.3 million. Third place goes to the US retail giant Walmart which employs 2.1 million and fourth place is the domain of McDonalds with 1.9 million. But the NHS really is the fifth largest employer on the planet with a staggering 1.7 million employees.
Thus, 5.5 million people are employed in a military capacity by the US and China in case of war, 4 million people are employed globally supplying us with much of the food we should be seeking to avoid and, here in the UK, 1.7 million people are employed to deal with the health of the nation - or lack of it.
Recently, a major study linked obesity to ten cancers. In brief, the study concluded that carrying this extra weight could be contributing to more than 12,000 cases of cancer annually in the UK. Furthermore, if the current trends in obesity continue, this study (which consulted 5 million people) warned that an extra 3,700 people will be diagnosed every year. The medical profession has known about a link between cancer and obesity for some time but this is the first time we have had some concrete figures. And sobering figures they are too. There is, of course, always the counter argument. Some people might read this and suggest that everyone is going to die of something so what is all the fuss about? Up to a point, they have a point.
The problem of course is that we have a health service which currently has no strings attached. You and I can eat ourselves to death, drink ourselves to death and smoke ourselves to death and take a cocktail of illicit substances which will ultimately take their toll on our physical and mental health. We can choose all of these lifestyle options safe in the knowledge that the NHS will be there to pick up the pieces and treat us accordingly. There is surely no other business model quite like it in the whole world?
I used to wonder whether there is more cancer now simply because we have become more adept at detecting it compared to a few generations ago. It's a nice thought but doesn't really hold much weight. The evidence relating diet and lifestyle to chronic illness has been building for some time now and the debate is now being settled. In addition to this, the convenience food of today which is often highly processed does not have the nutritional quality of the diets of our grandparents after the war. We will only ever be the product of what we choose to put in to our bodies and the extent to which we exercise our bodies (and that includes our minds). Given that we are all now more sedentary than our grandparents' generation, we ought to be eating less than they did, not more.
I find it intriguing that large swathes of NHS resources are being spent "fire-fighting". Much more needs to be done to address the cause of those fires if we are to retain an NHS which continues to be envied all around the world. Whether the UK population as a whole values the NHS in quite the same way as their grandparents did is open to conjecture. It is also debatable whether those employed within it approach their patients in the same way today as they did in 1948 when it all started. What is not open to debate though is that a radical rethink is needed from top to bottom if we are serious about sustaining it true to it's founding principles of being freely accessible to all.
Only last year, a "think tank" has advocated a new tax on alcohol in an effort to combat the addiction which continues it's inexorable rise. It's an interesting approach. An extra 2p will be charged for every unit of alcohol sold to fund abstinence-based treatment for people with alcohol addiction (of whom many). In simple terms, this would mean that a bottle of wine costing £5 today would go up to £5.18. To the vast majority, such a modest increase would be barely discernable.
The current statistics on addiction do not make for pretty reading. In England alone, 300,000 people are addicted to opiates or crack cocaine. A further 1.6 million are dependent on alcohol and, perhaps most worrying of all, 1 in 7 children under the age of 1 are living in a household with a substance-abusing parent. These children often become the addicts of tomorrow. The decision of David Cameron to highlight the importance of family was long overdue. The State can educate us all up to a certain point but ultimately we all need to assume responsibility for our own health and our own lives. Clearly, there will always be those for whom State provision is essential for a variety of reasons but it is also clear that as a nation, we have become too State dependent in recent times to our own detriment. One of the biggest dangers of this dependence is that an already powerful State becomes moreso - and the history books reassure us that such an outcome is seldom healthy.
The imposition of a new tax is worthy of consideration because from a purely pragmatic standpoint, there will have to be an element of firefighting to deal with those currently affected. More important though is the need to get the message through at a family level. The best way to effect this change is to engage entire communities. In the setting of palliative care, great strides have been made in recent years with the advent of initiatives such as "Compassionate Communities" as espoused by Dr. Allan Kellehear. Put simply, he suggests in very strong terms that palliative (or end of life) care is everyone's responsibility. Of course, palliative care is just one branch of the NHS but I would hope that we would all agree that is is an incredibly important one. It is now universally accepted within healthcare that a lack of conversation relating to death and dying make it harder for people to achieve a "good death". If we accept this, the logical approach is to apply the same arguments to people in their active lives.
If we don't talk about the importance and value of healthy eating and exercise, we are also less likely to achieve a "good life". If the current pressure being exerted on the NHS continues (and all the indications show that things are only likely to get worse), it is clear that there needs to be a lot more talking about health at a community and family level. But that argument must also apply to healthcare professionals too for they also have a personal responsibilty for their health. For the total strain on NHS services to be addressed properly, it is going to take everyone to get involved. This means that in addition to the 60 odd million people which it serves, the NHS staff of 1.7 million will all have to accept their responsibility for the lifestyle choices they choose. Failure to address this will usher in a new type of NHS in which we will have to pay for every service which we access. I hope it won't come to this for us all to take those decisions.
Thus, 5.5 million people are employed in a military capacity by the US and China in case of war, 4 million people are employed globally supplying us with much of the food we should be seeking to avoid and, here in the UK, 1.7 million people are employed to deal with the health of the nation - or lack of it.
Recently, a major study linked obesity to ten cancers. In brief, the study concluded that carrying this extra weight could be contributing to more than 12,000 cases of cancer annually in the UK. Furthermore, if the current trends in obesity continue, this study (which consulted 5 million people) warned that an extra 3,700 people will be diagnosed every year. The medical profession has known about a link between cancer and obesity for some time but this is the first time we have had some concrete figures. And sobering figures they are too. There is, of course, always the counter argument. Some people might read this and suggest that everyone is going to die of something so what is all the fuss about? Up to a point, they have a point.
The problem of course is that we have a health service which currently has no strings attached. You and I can eat ourselves to death, drink ourselves to death and smoke ourselves to death and take a cocktail of illicit substances which will ultimately take their toll on our physical and mental health. We can choose all of these lifestyle options safe in the knowledge that the NHS will be there to pick up the pieces and treat us accordingly. There is surely no other business model quite like it in the whole world?
I used to wonder whether there is more cancer now simply because we have become more adept at detecting it compared to a few generations ago. It's a nice thought but doesn't really hold much weight. The evidence relating diet and lifestyle to chronic illness has been building for some time now and the debate is now being settled. In addition to this, the convenience food of today which is often highly processed does not have the nutritional quality of the diets of our grandparents after the war. We will only ever be the product of what we choose to put in to our bodies and the extent to which we exercise our bodies (and that includes our minds). Given that we are all now more sedentary than our grandparents' generation, we ought to be eating less than they did, not more.
I find it intriguing that large swathes of NHS resources are being spent "fire-fighting". Much more needs to be done to address the cause of those fires if we are to retain an NHS which continues to be envied all around the world. Whether the UK population as a whole values the NHS in quite the same way as their grandparents did is open to conjecture. It is also debatable whether those employed within it approach their patients in the same way today as they did in 1948 when it all started. What is not open to debate though is that a radical rethink is needed from top to bottom if we are serious about sustaining it true to it's founding principles of being freely accessible to all.
Only last year, a "think tank" has advocated a new tax on alcohol in an effort to combat the addiction which continues it's inexorable rise. It's an interesting approach. An extra 2p will be charged for every unit of alcohol sold to fund abstinence-based treatment for people with alcohol addiction (of whom many). In simple terms, this would mean that a bottle of wine costing £5 today would go up to £5.18. To the vast majority, such a modest increase would be barely discernable.
The current statistics on addiction do not make for pretty reading. In England alone, 300,000 people are addicted to opiates or crack cocaine. A further 1.6 million are dependent on alcohol and, perhaps most worrying of all, 1 in 7 children under the age of 1 are living in a household with a substance-abusing parent. These children often become the addicts of tomorrow. The decision of David Cameron to highlight the importance of family was long overdue. The State can educate us all up to a certain point but ultimately we all need to assume responsibility for our own health and our own lives. Clearly, there will always be those for whom State provision is essential for a variety of reasons but it is also clear that as a nation, we have become too State dependent in recent times to our own detriment. One of the biggest dangers of this dependence is that an already powerful State becomes moreso - and the history books reassure us that such an outcome is seldom healthy.
The imposition of a new tax is worthy of consideration because from a purely pragmatic standpoint, there will have to be an element of firefighting to deal with those currently affected. More important though is the need to get the message through at a family level. The best way to effect this change is to engage entire communities. In the setting of palliative care, great strides have been made in recent years with the advent of initiatives such as "Compassionate Communities" as espoused by Dr. Allan Kellehear. Put simply, he suggests in very strong terms that palliative (or end of life) care is everyone's responsibility. Of course, palliative care is just one branch of the NHS but I would hope that we would all agree that is is an incredibly important one. It is now universally accepted within healthcare that a lack of conversation relating to death and dying make it harder for people to achieve a "good death". If we accept this, the logical approach is to apply the same arguments to people in their active lives.
If we don't talk about the importance and value of healthy eating and exercise, we are also less likely to achieve a "good life". If the current pressure being exerted on the NHS continues (and all the indications show that things are only likely to get worse), it is clear that there needs to be a lot more talking about health at a community and family level. But that argument must also apply to healthcare professionals too for they also have a personal responsibilty for their health. For the total strain on NHS services to be addressed properly, it is going to take everyone to get involved. This means that in addition to the 60 odd million people which it serves, the NHS staff of 1.7 million will all have to accept their responsibility for the lifestyle choices they choose. Failure to address this will usher in a new type of NHS in which we will have to pay for every service which we access. I hope it won't come to this for us all to take those decisions.
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