The National Health Service – a suitable case for treatment? (II)

Warming to the subject of what the cash-strapped National Health Service can do with the resources that are currently available to it, and are likely to be provided in the near future, I believe that we must look further into the matter of what constitutes a medical ‘self-inflicted’ wound.

The two other most obvious categories, in my estimation, are obesity and infertility.

As the media so often tell us, obesity is one of the major time bombs facing the country in the near future, with enormous consequences for the NHS and the national economy. For the most part, however, obesity really is a self-inflicted wound. Yet people fall over themselves to blame anything but their own greed and appalling life styles. There is a mass of information, readily available and easily assimilated, showing how the combination of a modest exercise and a good diet can reduce obesity, and thus create a fitter and healthier population.

Laziness is clearly a major reason why people do not take enough exercise – and no amount of whingeing about the cost of gyms etc. can disguise the fact that the type of brisk exercise required can be undertaken at absolutely no cost. All that the person needs to do is walk briskly rather than use a car or public transport for travel over the shorter distances that characterise most of our journeys. This is good for everyone from comparatively early childhood to the onset of old age, and complaints that the modern busy life style has removed the time for walking or cycling rather than motor transport is total rubbish. If people woke slightly earlier and got out of bed, spent less time glued to their TVs or computer screens, and wasted less time in a mass of idle chatter during the day, they could easily make available the 30 minutes needed for walking to school, the bus stop, the house of a friend, and the shops.

Walking or some other form of aerobic exercise helps to tone the body and burns calories. If this is combined with a reduced calorie intake, the result is inevitably a medically advantageous loss of body fat and gain of fitness. More exercise is only half of the battle, though, or possibly less than half of it.

The greater part is therefore the food the majority of people eat. Most people consume considerably more food than they need, and this food is almost invariably of the wrong type. For lack of gumption, cooking skills and knowledge, altogether too many people are content to feed themselves from take-away/carry-out outlets (and these often have the gall to call themselves ‘restaurants’, and even advertise themselves as such), and the ready-meal sections of supermarkets. An immediate consequence of this tendency is the littering of our streets and verges with discarded polystyrene cups and food containers, but the more important longer-term result is a bloated obesity in people who have swallowed too many calories in the form of low-cost ingredients made more palatable by a ghastly admixture of salt, sugar, fat and a complex of additives intended largely to whet the appetite and extend the product’s shelf life.

So too many people are living on what is little better than rubbish, no matter what the manufacturers, advertisers and purveyors tell us, and paying way over the odds for this junk food. The people who consume these dire ready meals claim that they have to do so for reasons of time, convenience etc, but this is just an excuse for laziness and an unwillingness to learn and practise the art of cookery. Yet there is enormous enjoyment in planning, preparing, cooking and eating food prepared at home from ingredients which, even if bought in a supermarket, are fresher and less laden with additives than those which go into ready meals. Just as importantly, meals made from fresh ingredients are cheaper than their ready-meal counterparts – and this is a factor of great importance for those on lower incomes who seem to be the greatest consumers of ready meals.

Just consider the price of potatoes bought locally, even at a supermarket, with that of a potato product such as packet of crisps. Each packet contains only a very small weight of potato and costs proportionally far more than the equivalent weight of raw potato, which can be turned into any humber of wholesome and flavourful dishes.

So everything is available for people to exercise more and eat better food in more sparing quantities, and thereby reduce their tendency to obesity. People are lazy, though, and prefer the easy option represented by the take-our/carry-out and ready meal, all too often washed down with a sweet drink. The result is the so-called epidemic of obesity whose huge cost is borne initially by the NHS as it tries to treat people who will almost certainly revert to their own ways, and later by the entire tax-paying community as the obese become less productive and more prone to disease and the need for care.

This is not right, and a rethink of the NHS’s priorities should result in the offering of advice but not the provision of expensive and almost invariably wasted treatment.

Fertility treatment is something else that should not be offered by the NHS. There has emerged a tendency to consider fertility as a human right, but this most certainly it is not. It is, of course, a matter of personal tragedy if a couple wishes to have a family but has been dealt a raw hand and cannot have children naturally. But there is not and never has been any inalienable right for humans to have children, and fertility treatment should not be provided by an overextended NHS.

There are alternatives such as adoption or private medicine. Some want children of their own genetic inheritance, however, and private fertility treatment is expensive and therefore regarded as offering the better-off an ‘unfair advantage’ . I am sympathetic to this concept, but am still very far from convinced that the public purse should be opened to those wishing to bring yet more children into as world already burdened with altogether too many people.

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