Our society is making us ill. Charging NHS patients won’t fix that

Making patients feel guilty about the cost of their medicine will worsen the nation’s health

NHS GP surgery


Health secretary Jeremy Hunt’s ideas for reducing the strain on the NHS increasingly reveal his desire to move it towards the disastrous American model of healthcare.

Making patients feel guilty about the cost of their vital medicine and charging those who miss appointments is likely to worsen the nation’s health, as people stop taking the drugs they need and decide against booking crucial appointments for fear of missing them – and all for the sake of recovering a few pounds.

When I spoke on Thursday at the International Festival of Public Health in Manchester, I asked not what the NHS can do for us, but what we can do for the NHS. Extra charges was not what I had in mind.

It’s clear that even if we succeed in reversing the takeover of our broadly efficient and fair, publicly owned and run NHS by the failed privatised model – as the cross-party effort led by Caroline Lucas is trying to do with the NHS Reinstatement Bill – the  NHS will come under increasing pressure: from an ageing population, from the rise of expensive medical technology and from increasing levels of disability and illness.

To relieve that pressure, we must ask what we can do to create a healthy society. And of course we should be doing that for reasons of humanity, above cost.

We have here in Britain, in the world’s sixth-richest economy, a society that’s making many of its members ill. A society that’s failing to provide clean air, failing to provide adequate housing, failing to provide a healthy diet, failing to provide safe jobs and decent benefits, failing to provide opportunities for exercise and failing to provide an education that prepares pupils for life.

A society in short that’s failing its people.

The majority of people it’s failing fall into one group: the poorer and more disadvantaged; but the unhealthy society is affecting everyone to some degree.

In the worst areas of London 8 per cent of deaths are linked to air pollution. Around the country that’s 29,000 premature deaths each year. And children whose schools are near busy roads are seeing the development of their lungs affected – an impact that will last for life.

Having some of the longest working hours in Europe is deeply unhealthy and destructive. They have an impact on diet – we eat on average twice as many ready meals as the rest of Europe; and 45 per cent of men and 34 per cent of women say they are restricted in getting active by work commitments.

Add in the human and health cost of commuting long distances – whether in fume-soaked cars or crowded trains and buses – and there’s no doubt our employment arrangements are detrimental to our health.

Nineteen per cent of households are in fuel poverty – primarily because of poor structure and insulation – which is linked to one in five of our horrific excess winter deaths, and contributes to the development of the lifelong condition of asthma in children. A study by the chief medical officer showed that investing £1 in keeping homes warm saved the NHS 42p in health costs.

We’ve seen walking and cycling all too often actively discouraged by road structures, and cuts to public transport (particularly rural and local buses). A study published in December 2011 estimated that around around 3,400 cases of cancer every year in the UK are linked to people doing less than government guidelines for physical activity each week. It costs the NHS almost £1 billion a year.

Except around the edges – anti-smoking programmes, gym memberships and healthy food vouchers on the NHS – there’s little that the health service can do to influence any of these issues.

What we need are the transport policies, the housing policies, the education policies, the food security policies to turn things around – to create a healthy society.

Not all of these changes are big-ticket spending items.

Introducing a 20mph speed limit everywhere people live, work and shop could make our streets far more pedestrian and community friendly – a place to stroll, to chat, to play.

Strengthening the power of unions and giving workers proper access to redress for unreasonable treatment would help to cut unpaid overtime, reduce stress and improve safety in the workplace.

Making the minimum wage a living wage (which would save the Treasury more than £2 billion a year), and banning zero-hours contracts would reduce poverty.

Some moves towards a healthy society of course do require spending. The simplest way overall to improve health would be to tackle poverty – ensure everyone can put healthy food on the table, keep an appropriately-sized, energy-efficient roof over their head, be free from the fear of penury.

That of course would mean reversing the disastrous policy of austerity that’s seeking to make the poor, the disadvantaged and the young pay for the errors and fraud of the bankers.

But coming down to a more modular level, there is plenty we could do.

We could invest in walking and cycling infrastructure – and in public transport, which probably involves at least some walking at each end.

We could implement statutory PSHE education in all schools. Evidence shows this reduces childhood obesity, improves diets, reduces sexually transmitted diseases and unwanted pregnancies, and hospital admissions for self-harm.

Implementing an intensive programme of home insulation and energy efficiency would cut excess winter deaths particularly among the elderly, reduce asthma rates in the young – and create jobs and cut carbon emissions.

These are – in one of the favourite terms of government these days – joined-up policies. They fit together into the whole of a healthy society – a humane, decent society in which people can fulfil their potential and live the long, healthy lives that public health measures and modern medicine have helped to make possible.

If we really want to save our NHS, every government decision should be weighed for its impact on the health of the nation.

Natalie Bennett is the leader of the Green Party. Follow her on Twitter

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40 Responses to “Our society is making us ill. Charging NHS patients won’t fix that”

  1. stevep

    We shouldn`t be working longer hours and working harder.
    Technology has reduced the need for labour-intensive work and long working days. So who`s benefiting from it? Not you or I.
    Technology has been used to benefit the wealthy few, not the many. If it did benefit the many, we would now all be enjoying shorter working hours, less work, more holidays, early retirement, better pensions and of course, improved health as stress levels from having to scratch a living, fell.
    We need to start thinking politically of what benefits us, not the wealthy few and formulate policies and manifesto`s accordingly. We could then begin to enjoy our lives, not just be wage-slaves to the elite until we`re too knackered to work.
    We did have that vision. It lasted from 1945-1979. The coup of the far-right in the early `80s put paid to it and enslaved us again.
    The NHS is one of the few things left of that vision of a better future. The right want rid of it. We must protect it and fight tooth and nail to maintain it`s original intention – to provide healthcare free at the point of use.
    We must have a Labour (or alliance of the left) manifesto commitment to progressive taxation to fund the NHS and the welfare state.
    Let`s build that vision – a country for the many, not the few!

  2. Peem Birrell

    >> investing £1 in keeping homes warm saved the NHS 42p in health costs

    Green economics?

  3. Rachel C

    And kept people warm and saved money on fuel bills too obviously. The savings for the NHS are additional, implying otherwise is just silly. Grow up.

  4. TN

    This demented communist bird still chirping away even after English voters rejected any kind of leftie politics in May. You’ve got no mandate to say propose “what we need to do”.

  5. GinaKFry

    Next few days start your new life…leftfootforward… < Find Here

  6. Jacko

    “Technology has been used to benefit the wealthy few, not the many.”

    What an absurd statement.

  7. Foxytrader

    I’m not sure of the wisdom of charging for missed GP appointments or “did not attends” (DNAs) as they are known but 3.5 MILLION appointments missed annually is just throwing resources away. Always insisting that fault lies elsewhere and that big government should take decisions for individuals isn’t helpful. People need to take responsibility for at least a proportion of their own health outcomes. Billions have been spent on health education yet we still see smoking, poor nutrition choices and obesity widespread amongst those most likely to use the NHS scant resources. If we perpetuate a dependency culture and absolve individuals of the consequences of their own actions by blaming central government for everything we do the NHS no favours whatsoever.

  8. stevep

    It`s true. What planet are you living on.

  9. Jacko

    Do you really want me to list the ways computers have benefited mankind?

  10. Tom Farmer

    That sums up how to create a happy nation.
    Thank you Natalie.

    We cannot allow ‘our’ politicians to get away with what they are doing to us as a nation – and planetary-wise with global warming.
    In the not too distant past, Politicians that abused their positions were brought to book. Disgraced and kicked out of their jobs
    That hasn’t happened for over 35 yrs. or more.
    Through our apathy and misinformation ((through the media) we have let them create a system that totally ignores the national consencus on any issue(s).
    Sorry, I can’t carry on with this. Too upsetting

  11. Ben

    The Green Party isn’t immune to a bit of dishonesty, like pretending to buy land and turn it into an orchard to prevent an airport runway expansion while actually just leasing it for a couple of years and then giving it back. Thousands of pounds donated in good faith is now lining the pockets of a land owner with no benefit to anyone else. http://www.theguardian.com/environment/2015/jun/25/heathrow-third-runway-greenpeace-land-sold

  12. Ben

    The Green Party was paying for cavity wall insulation, which was a fad, and now people are realising that it’s creating dampness in their homes by removing the air circulation in their cavity walls, and in turn damaging their health, there are companies specialising in removing it again.

  13. Ben

    Technology has meant less work for people since the days the Luddites were smashing up machines because the technology was taking away their livelihoods.

  14. Faerieson

    Try simply listing the ways that technology has not benefited the few at the expense of the many. Otherwise your comments appear decidedly knee-jerkish. I think you may find it harder than you imply.

  15. IreneGHyde

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  16. Imogen Kirk

    I just had to check my calendar! Which century are you in? She has a mandate – I voted for her party. But I embrace free speech and you are welcome to sit in your cave, grunting.

  17. Selohesra

    Its not a question of making people feel guilty for their medicine but getting them to acknowledge that they only have it free/subsidised thanks to the top 1% of earners who pay ~ 30% of income tax. Rather than banging on about evil bankers & businessmen they should be thankfull for what they have and exercise the responsibility to take medicine as prescribed and attend the appointments made

  18. DisqusSD

    That was Greenpeace, not the Green Party; they are totally different organisations.

  19. DisqusSD

    While the top earners do pay a lot of the total tax, as a proportion of their income they pay less than the poor http://www.theguardian.com/money/2014/jun/16/british-public-wrong-rich-poor-tax-research The 1% are not paying their way.

  20. DisqusSD

    Obviously insulation need to be appropriate for the building concerned. If the wrong system has been adopted the it needs to be corrected. I’m not aware of a Green Party policy that specifies one particular type of insulation over another, I’m sure advice would have been sort, from an expert. Do you have a link to the story you’re talking about?

  21. Selohesra

    And if the 1% upped and left taking their taxes to another country do you really think those left behind would be better off? – of course not – so just be grateful for their contribtion and use it responsibly

  22. Dave C

    That’s what the 1% have always said, tax me more and I will leave this country. Just remind me how many have gone and left when taxes rise? nada, zilch.

  23. blarg1987

    And how many of them now regret their decision and wish they could take it back?

    Smart money says quite a few and we did not reject any kind of left wing policy otherwise parties who have right wing policies would have gotten 100% of the vote in England which they did not.

  24. Martin Odoni

    Even if that were the Green Party, and not Greenpeace, how is this relevant?

  25. blarg1987

    Not necessarily true, as we would still tax any business assets and income of those assets in the UK, unless the government decides not to which is something it is looking to reduce.

    Income tax is only part of the full tax pie. If we strengthened the law so any transaction on UK sale sis taxed at UK rates, companies are not going to jump ship, as they would rather have a little bit of something rather then sod all of nothing.

    Do not get me wrong some wealthy individuals do contribute to the UK economy quite a lot, others however do not.

  26. Cole

    They may pay 30% of income tax but the 1% certainly don’t pay that proportion of all taxes.

  27. Cole

    You think we should really be grateful to those bankers who screwed up our economy? You’re possibly one of those daft people who think It was all Gordon Brown’s fault.

  28. Cole

    The Greens got 4% – an improvement on previous elections – but not a mandate for anything. Mind you the Tories only got 37%, which isn’t a mandate either,

  29. stevep


  30. AlleenFJones

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  31. Tynam

    Where by “mankind”, for the last forty years we mostly meant “white males in wealthy nations”.

    Computers are *just now beginning* to benefit mankind. (Despite the best efforts of the right. Ever notice that every the press runs scare stories about the supposed golden lives of benefit claimants, they say something like “owns an ipad” or “flatscreen TV”? Because only the wealthy are supposed to have those.)

  32. CassiePBurgess

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  33. Ben

    If you work in the creative industry the Green Party thinks you can live in poverty as it’s quite happy to take your life’s work and just give it away. http://www.theguardian.com/politics/2015/apr/23/green-party-plan-to-limit-copyright-attacked-by-writers-and-artists

  34. Ben

    I’m not talking about any particular story. I’m talking about a policy that seems to place a great deal of value on something architects and builders agree isn’t a good idea in terms of the property being free from dampness and future structural problems.

    If you want stories, here’s one: http://www.telegraph.co.uk/finance/property/advice/11149260/I-bought-cavity-wall-insulation-so-why-is-my-house-damp.html

    Here’s an article about older houses and how cavity wall insulation is a very bad idea: http://www.heritage-house.org/insulation-causes-damp.html

    I’m not a fan of austerity cuts and I do think the worse off in society get unfairly penalised. However, I have to vote for realism and a clear understanding of economics rather than a pie in the sky fantasy of increased spending everywhere while being hostile to growing the economy, nonsense like stopping road building, limiting copyrights on intellectual property and saying everyone can live on a Citizens’ Income which is just a more Communist way of saying The Dole http://www.theguardian.com/politics/2015/apr/23/green-party-plan-to-limit-copyright-attacked-by-writers-and-artists
    and tinkering around with things that just annoy people like 20mph speed limits http://worthingdaily.co.uk/news/20-mph-limit-worthing-rejected/

  35. DisqusSD

    As I said, the Green Party does not prescribe one form of insulation over another. I’m not an expert in cavity wall insulation but it does seem that there are different types and the ‘wrong’ type can lead to damp issues. I live in an old damp house myself, and I know that one factor that seems to get overlooked is ventilation. Old houses have been made much more airtight without much thought to ventilation. Modern, highly insulated and airtight houses, are usually fitted with a mechanical ventilation system that keeps moisture and indoor pollution under control. As I said before, any insulation work needs to be appropriate to the building concerned.

    In the second section of your reply you’ve mentioned a whole slew of policies and I don’t have the time to go into each of them in detail. The policies do take a very different approach, to the current neo-liberal agenda, and as such can be presented as unrealistic or ‘pie in the sky’, when framed against current ‘orthodox’ thinking. If you actually spent some time reading the policies I’m sure you’d realise that they are, broadly, very sensible and well thought out http://policy.greenparty.org.uk/core-values.html

  36. Ben

    Do you really think no one would replace them if they left gaps in industry?

  37. Ben

    Do you really think no one would replace them if they left gaps in industry?

  38. Ben

    I agree with the values of the party. After all, the Tories don’t care about individuals as people. They just see people as statistics and individuals as having a productive value. Everyone is expected to work from birth until death and those who can’t are labelled scroungers and allowed to fall by the wayside.

  39. Patrick Nelson

    There are billions of people on this planet and technology has been used to serve the interests of private companies rather than being used to help humanity as a whole. We are in a high tech age and most people live in poverty. What an awful state of affairs.

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