Free NHS treatment to be pared back by 2020, says new report

The continued unhealthy lifestyles of the British population, including the over -consumption of alcohol, mean that the NHS may have no choice other than to pare back some of the free treatment that we currently receive and penalise unhealthy behaviours, according to a new report commissioned by the Friends Provident, a company originally founded in 1832 to alleviate the hardship of Quaker families facing misfortune.

The report, Visions of Britain 2020, conducted with the Future Foundation (www.visionsofbritain2020.co.uk) condemns Government health campaigns as failing to persuade individuals to live healthier lifestyles. However, in contrast, legislation to curb smoking has been hugely successful. As a result, Visions of Britain argues that penalties are a likely solution to help relieve the current strain that unhealthy behaviours place on the NHS. The report predicts that it is only a matter of time before similar legislation to the smoking ban will be imposed to curb obesity. It also suggests that minimum pricing of alcohol is also on the way. The main conclusion of the report is that the rising cost of the NHS will necessitate a focus on preventative treatment. Given the failure of persuasion the government is more likely to legislate – curbing a range of behaviours to force healthier outcomes and reduce demand on the NHS. A voluble ‘New Puritan’ group will support these measures, something that will encourage legislators. Secondly, private companies will become more involved in the NHS than they are now. Their role may be in creating greater competition to reduce costs (for example through out-sourcing treatments). Thirdly, citizens will have to take greater responsibility for their own health as less treatment is provided. This may take the form of paying for treatments that are currently offered for free, or greater take-up of private medical insurance. It may also mean the provision of individualised preventative measures.

That the NHS will be reduced in terms of scope is almost inevitable. One of the experts consulted for the report, Dr Sarah Brewer said:

“Something has to give. One scenario is that people may well end up being charged for certain treatments or denied certain non-essential treatment, particularly if their unhealthy lifestyle was a contributory factor. The other scenario is the withdrawal of many free treatments.”

The report says that experts and consumers agree that unhealthy lifestyles should be penalised when it comes to treatment, with almost half (44%) supporting the introduction of a ‘fat tax’ and over a third (38%) agreeing that the NHS should not prioritise people who fail to look after their health. But, despite this apparent support for penalties, we still readily admit that we aren’t leading healthy lifestyles. Less than one in five claim to adhere to Government guidelines on calorie intake (18%) and exercise (19%). Just one in three (34%) follow official guidelines on alcohol consumption. Experts claim this apparent ambivalence to today’s guidelines will force Government to take a new, prescriptive approach.

Trevor Matthews, Chief Executive Offi cer of Friends Provident, said:

“Our report reveals that there will be a fundamental and permanent change in the provision of free healthcare in the next decade. The study identifies a disconnect between our aspirations for healthcare, and our behaviour.

We all need to adopt healthier lifestyles or else risk being faced with penalties in the years ahead.”

“We all know that we should follow a healthy low fat diet, eat at least 5-a day etc. But how many actually do anything about it? Unless an unhealthy diet and lifestyle is penalised in some way noone will change.”

As well as penalties, experts consulted for the report predict that a range of treatments will no longer be free in 2020, including:

• IVF and fertility treatment
• Subsidised dental treatment
• Obesity surgery and drugs
• Dementia treatment
• Complementary therapies

Dr Patricia Macnair, a medical practitioner consulted for the report said:

“There will be less and less money coming from the state to help people maintain their health, so something needs to give, and increasingly it will be up to us to take responsibility for our own health. In addition there will be endless paring away in subtle degrees at the funding for all sorts of different treatments - although this may be subtle the changes will be profound.”