The NHS is not giving enough priority to diabetes

Astonishingly, this isn't about a lack of money.

As someone who has run NHS bodies and been an NHS groupie for more years than I care to think about, I wept with joy at the tribute to our health service in Danny Boyle’s breathtaking opening ceremony for the London Olympic Games. For me, those that work tirelessly for our health services are an even greater pride to Britain than our amazing athletes.

But as brilliant as those working in the NHS undoubtedly are, the sad fact is that as an institution it is failing when it comes to diabetes healthcare. Diabetes is one of the greatest health challenges we face but its rise seems to be inexorable and the seriousness with which it is tackled simply doesn’t match the seriousness of the condition and its complications.

There are now 3.7m people with diabetes in the UK and 7m at high risk and the fact that rates of devastating diabetes complications such as kidney failure and stroke are now at record levels is one of the reasons that 24,000 people with diabetes die early every year. To put it simply, diabetes is big a big, growing and serious problem to which insufficient priority is being given. 

The astounding thing is that it is not about money. How often are these words heard? Not often. The NHS already spends 10 per cent of its annual budget on diabetes – that £10bn is more than the total amount of money spent on the London Olympics over the last seven years. For this kind of investment, you would expect Jessica Ennis-esque levels of healthcare performance but much diabetes spending is going on the wrong things.

About 80 per cent of NHS spending on diabetes goes on treating the devastating diabetes complications, such as blindness, amputations and kidney disease, the vast majority of which are basically avoidable, while not enough is being done to prevent complications from occurring in the first place. For example, less than half of the people who should have been screened for diabetes under the NHS Vascular healthcheck have been. 

Risk assessment and early diagnosis are key to giving people treatment as early as possible that can help prevent complications developing or help them avoid developing diabetes if they are at high risk. Barely half of people with diabetes are getting the basic checks they need to manage their condition. Fixing both of these things could save the NHS Olympic scale cash through fewer hospital admissions and less complex treatments. It would also ensure that those with diabetes have a better quality of life and in many cases mean the difference between life and death.

As the London Olympics comes to a close I hope one of the lasting legacies of these games will be greater participation in sport and physical activity. Not only would this lead to better health and well-being for people across the country, but could also play a crucial role in reducing risk of Type 2 diabetes.  But if the growing problem of diabetes is to be truly tackled – and the ticking time bomb at the heart of the NHS defused – then we need the NHS and Government to declare and make diabetes a priority in the way that as a nation we prioritised the effective delivery of a wonderful Games. 

Barbara Young is chief executive of Diabetes UK

 

Barbara Young is chief executive of Diabetes UK.

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Brexit is teaching the UK that it needs immigrants

Finally forced to confront the economic consequences of low migration, ministers are abandoning the easy rhetoric of the past.

Why did the UK vote to leave the EU? For conservatives, Brexit was about regaining parliamentary sovereignty. For socialists it was about escaping the single market. For still more it was a chance to punish David Cameron and George Osborne. But supreme among the causes was the desire to reduce immigration.

For years, as the government repeatedly missed its target to limit net migration to "tens of thousands", the EU provided a convenient scapegoat. The free movement of people allegedly made this ambition unachievable (even as non-European migration oustripped that from the continent). When Cameron, the author of the target, was later forced to argue that the price of leaving the EU was nevertheless too great, voters were unsurprisingly unconvinced.

But though the Leave campaign vowed to gain "control" of immigration, it was careful never to set a formal target. As many of its senior figures knew, reducing net migration to "tens of thousands" a year would come at an economic price (immigrants make a net fiscal contribution of £7bn a year). An OBR study found that with zero net migration, public sector debt would rise to 145 per cent of GDP by 2062-63, while with high net migration it would fall to 73 per cent. For the UK, with its poor productivity and sub-par infrastructure, immigration has long been an economic boon. 

When Theresa May became Prime Minister, some cabinet members hoped that she would abolish the net migration target in a "Nixon goes to China" moment. But rather than retreating, the former Home Secretary doubled down. She regards the target as essential on both political and policy grounds (and has rejected pleas to exempt foreign students). But though the same goal endures, Brexit is forcing ministers to reveal a rarely spoken truth: Britain needs immigrants.

Those who boasted during the referendum of their desire to reduce the number of newcomers have been forced to qualify their remarks. On last night's Question Time, Brexit secretary David Davis conceded that immigration woud not invariably fall following Brexit. "I cannot imagine that the policy will be anything other than that which is in the national interest, which means that from time to time we’ll need more, from time to time we’ll need less migrants."

Though Davis insisted that the government would eventually meet its "tens of thousands" target (while sounding rather unconvinced), he added: "The simple truth is that we have to manage this problem. You’ve got industry dependent on migrants. You’ve got social welfare, the national health service. You have to make sure they continue to work."

As my colleague Julia Rampen has charted, Davis's colleagues have inserted similar caveats. Andrea Leadsom, the Environment Secretary, who warned during the referendum that EU immigration could “overwhelm” Britain, has told farmers that she recognises “how important seasonal labour from the EU is to the everyday running of your businesses”. Others, such as the Health Secretary, Jeremy Hunt, the Business Secretary, Greg Clark, and the Communities Secretary, Sajid Javid, have issued similar guarantees to employers. Brexit is fuelling immigration nimbyism: “Fewer migrants, please, but not in my sector.”

The UK’s vote to leave the EU – and May’s decision to pursue a "hard Brexit" – has deprived the government of a convenient alibi for high immigration. Finally forced to confront the economic consequences of low migration, ministers are abandoning the easy rhetoric of the past. Brexit may have been caused by the supposed costs of immigration but it is becoming an education in its benefits.

George Eaton is political editor of the New Statesman.