A summary of my presentation given at the Health and Wealth debate at the UKPHA conference, March 2009:
Health inequality is measured by comparing the mortality of the poorest (spearhead) regions with the national average. Many health indicators use mortality as a measure of success of healthcare be it a PCT a region or even a country. However no account is taken of the quality of those extra years of life. If the NHS focuses on extending life then that is what it will get. Longer but not necessarily healthy lives. In fact the number of people living with a disability has increased year on year and yet our nation is no happier than since the 1970s.
By ensuring that people have a quality of life, dignity, hope and wellbeing will lead to better health and longer lives as a product. Focussing on prolonging life will focus on disease treatment and have limited effect on shifting the mortality curve to the right. Its time for quality of life to have a greater status as an indicator of success of healthcare.
Sustainable healthcare is based around prevention. Prevention allows whole populations to live longer healthier lives. Prevention consumes just 3% of the NHS budget. Treatments can save lives but on itheir own will have little effect on life expectancy of populations. At current levels treating every condition is a luxury our environment cannot afford. Pharmaceuticals are the largest contribution to the carbon footprint in the NHS and along with other treatments consume £105 billion or 97% of the healthcare budget..
At what point do we stop extending lives? Like economic growth extending life year on year is taken for granted as a measure of success. But is success a population that is no happier? Is success an environment being destroyed by the consumption of drugs? Is success more people bedbound with severe health problems and minimal quality of life?
This is not a debate about rationing nor a debate about witholding treatment. This is a discussion about how we can live longer as a result of a happier and more fulfilling and active life.
