They say “prevention is better than cure”. But despite grand promises of investment to the NHS, the Government is still cutting preventative services.
£10 billion?
In a speech on 5th October, Theresa May said that the Conservative party would be investing an extra £10 billion in the NHS. It sounds great, doesn’t it? But last week, Dr Sarah Wollaston – Conservative MP and Chair of the Commons Health Committee – pointed out that the figure is misleading.
Dr Sarah Wollaston MP
Dr Wollaston (pictured) told BBC Radio 4’s Today programme: “You can only arrive at the £10 billion by shifting money from public health budgets, and health education and training, and also by changing the date at which you calculate real-terms increases.”
In real terms, the figure is more like £4.5 billion, and it won’t go towards public health services. It isn’t obvious from the headlines, but areas like social care and prevention are not receiving a financial boost at all; they have been cut. And there are plans for more cuts next year, and the year after that.
When waiting lists are getting longer, and help becoming so much harder to find, this talk of “giving the NHS more than they asked for” is misleading and potentially dangerous. It would be easy for people to get the impression that money is available, but being spent unwisely when, in fact, the money is just not there.
Prevention is cheaper than cure
GP and hospital costs far outweigh the costs of preventative services. So why not spend money on early intervention for things like obesity, diabetes, mental health crises and smoking-related disease, before they get to the stage of needing expensive GP and hospital care? It seems ridiculous.
Take the Gateway pre-diabetes course. People with a high level of HbA1c – indicating a high risk of developing diabetes – are referred to us to learn how to better manage their diet and lifestyle, in a course of sessions over nine months. Results so far show that more than 80% of patients reduce their HbA1c level thanks to the course, with 66% of patients showing that they are no longer at risk by the end of the course. The total cost per patient is as little as £130.
Compare this to the cost of a lifetime of diabetes. As well as GP and outpatient appointments, people with diabetes require long term medication and supplies. Diabetes can cause a huge number of complications; illnesses which come with their own costs for the NHS. And let’s not forget the hidden costs for the wider public purse, which include the costs of absenteeism, disability and social benefits, and early retirement.
It’s important to remember that health spending isn’t just about GPs and hospitals. Often, these are the reactive costs – the costs that occur when the opportunity to prevent has already passed. Investing in the preventative elements, like social care and public health, is the best chance we have to reign in spending. And who knows, if it was ever properly resourced, we may even see savings.
We thought this video, made for LBC by Full Fact, an independent fact checking organisation, summed up the issues with the Prime Minister’s “£10 billion” statement quite nicely.
Thank you for focussing on this important issue, and for clarifying it. It is helpful to have the concrete example of the pre-diabetes work.