Politics Thread!

[KlaxonCow]

Which begs the question

http://en.wikipedia.org/wiki/Begging_the_question

I humbly accept the rebuke.

(I'll have to learn a new way to phrase that kind of thing. But "this implicitly mandates us having to also ask the question..." sounds a bit horrid and awkward, doesn't it? I'll have to think that one over for a while.)

[zip accident]

Which begs the question

http://en.wikipedia.org/wiki/Begging_the_question

I humbly accept the rebuke.

(I'll have to learn a new way to phrase that kind of thing. But "this implicitly mandates us having to also ask the question..." sounds a bit horrid and awkward, doesn't it? I'll have to think that one over for a while.)

"This suggests the question ..." has been used, and treads on no logician's toes.

[(o)(o)]

This is codswallop. Addressing lifestyle issues (as far as they can be addressed - personal responsibility is the final arbiter) is within the scope of the NHS

It is to some extent. But there are big constraints on what the NHS can do. Not only financial constraints

Because it's cheaper to fix problems than prevent them.

Here's just one study that proved otherwise http://www.theguardian.com/society/joep ... s-nhs-cuts

people don't respond well to being lectured by their doctor.

One minute you are saying more education is needed - the next "people don't respond well to being lectured".

But the largest part of healthy lifestyles has nothing to do with the NHS. It's things like what we eat, drink and smoke and how much we exercise. The NHS can't do much about these..

I've just given you two examples of NHS initiates addressing these very issues. FUCK SAKE.

And, yeah, TTIP is a load of scary crap though.
There was a protest thing about it in my email asking for funds because they moved a meeting to avoid a protest or something. Ashamed to say I didnt get around to donating to help move the protest.

I appreciate that you are cognitive of the issue! The main thing is to get public awareness of TTIP and it's implications.

[pogo]

One minute you are saying more education is needed - the next "people don't respond well to being lectured".

Education as in schools, public information broadcasts, information in shops including on food packages.

The problem with doctors doing it is people tend only to see their doctors when they are ill, when they don't want to be told "if only you'd cut back on junk food". The time when they need the advice on preventative medicine is when they feel healthy, but people tend to avoid doctors when healthy, even ignoring invitations to come in and discuss their health.

So the message has to reach people away from the NHS. This makes sense as the message is about much more than medical sickness. It's living a long and healthy life, enjoying an active lifestyle. You don't need a doctor to tell you this; you maybe need a dietician or a physical trainer. But much of it's common sense that everyone knows, they just need the right opportunities and incentives.

You're right it will save money for the NHS. So the NHS should do what it can. But there's only so much the NHS can do.

[(o)(o)]

One minute you are saying more education is needed - the next "people don't respond well to being lectured".

Education as in schools, public information broadcasts,

.. over Tannoy systems, presumably.. ?

information in shops including on food packages.

The problem with doctors doing it is people tend only to see their doctors when they are ill, when they don't want to be told "if only you'd cut back on junk food". The time when they need the advice on preventative medicine is when they feel healthy, but people tend to avoid doctors when healthy, even ignoring invitations to come in and discuss their health.

So the message has to reach people away from the NHS.

So now you're saying the NHS is just "doctors" ??

What planet do you live on.

[(o)(o)]

You don't need a doctor to tell you this; you maybe need a dietician or a physical trainer.

Incidentally the NHS employ dieticians*, physiotherapists, and can prescribe exercise via a local gym, and tons of other stuff.

*I saw the resident dietician in my local GP surgery a while back for advice when my bloods came up pre-diabetic.. so this is the NHS doing preventative medicine.. and it was money well spent as she learned a lot during the appointment.

[pogo]

You saw a dietician because you were already a patient, and presumably the doctor recommended it as part of your treatment. The point of preventative medicine is to reach people who aren't patients, who don't feel ill and won't visit a doctor. The point also is to keep them away from doctors, by keeping them healthy.

The NHS is not set up to do this. It's designed to provide specialised care for individuals, not advice to the population at large. The school system can help, as can public information campaigns (not over tannoys: broadcasts like this which ran as a tv advert). Information in shops including labels on foods can help.

But it's mostly common sense advice that everyone knows but find it hard to follow. That's why incentives matter. Make unhealthy things like smoking expensive and socially unacceptable. Encourage and subsidise healthy things, such as walking, cycling, swimming, sports. Other countries do much better so it is possible.

[gravy]

Type 2 diabetes is kind of interesting as treating it currently accounts for around 10% of the NHS budget (coming close for 1% of GDP ) but the NHS doesn't have much influence on preventing that figure from continuing to increase over time.

At some point it could become unaffordable to treat, wonder what happens then.

[pogo]

Healthcare is always rationed some way or another. That's why we have NICE. Previously we had a postcode lottery. The US system has rationing by ability to pay (often mediated by insurance).

It won't become unaffordable, we will cope by some combination of more efficient treatment, more money and by rationing it or other treatments. But I'm not too worried: it won't increase indefinitely, to 100% of the population. Maybe it will get as bad as the US but I doubt even that, I think although our standard of general health is poor it's mostly moving in the right direction. It will stabilise by which time we'll hopefully have worked out how to afford it.

[gravy]

Here's the trend over time in the US



As you can see the increase is dramatic but there's still plenty of headroom for it to rise more.

It is preventable but it's kind of a similar problem to climate change: At the point where you can make the most difference things seem okay so more energy is put into denying there's a problem by a lot of people. You probably need some strong state involvement in regulating what people eat but good luck to any party that try to get elected on that basis.

Still glad you're pretty sanguine about this not being a big deal. It's a major worry in the health care industry but what do they know eh?

[VNVObit]

You saw a dietician because you were already a patient, and presumably the doctor recommended it as part of your treatment. The point of preventative medicine is to reach people who aren't patients, who don't feel ill and won't visit a doctor. The point also is to keep them away from doctors, by keeping them healthy.

The NHS is not set up to do this. It's designed to provide specialised care for individuals, not advice to the population at large. The school system can help, as can public information campaigns (not over tannoys: broadcasts like this which ran as a tv advert). Information in shops including labels on foods can help.

But it's mostly common sense advice that everyone knows but find it hard to follow. That's why incentives matter. Make unhealthy things like smoking expensive and socially unacceptable. Encourage and subsidise healthy things, such as walking, cycling, swimming, sports. Other countries do much better so it is possible.

Preventative medicine is also about managing conditions to reduce the risk of deterioration/recurrence so .

Agree NHS not set up to do it but it is the responsibility of the Department of Health to do it (and there would be budget savings in the long run) and they are actually are set up to do it. There just seems to be a lack of appetite to do it (Austerity?, Short Term focus? probably contributory reasons)

This government is not prepared to deal with food labelling (preferring self regulation ) Encouraging cycling and other activities , well only if they don't interfere with motorists (I'm cynical about this as I cycle in London and have heard so many empty promises from our Tory mayor).

There are a number of positive things that would result in having an effective campaign
Reduced costs for NHS
Reduction in hours lost through sickness

It would also probably improve productivity as healthy people tend to be more alert and less prone to lethargy
(ask anyone who's gone from couch potato to 5km, or similar, how their working life has changed)

[gravy]

The situation we're in pretty much down one of the more horrid aspects of capitalism. Corporations exist to make profit and if they can do that in a way that delivers great profits they will irrespective of the longer term consequences. And the bigger the long term disaster the more protected they are from suffering the consequences.

The banking collapse followed that pattern.

And the tobacco industry.

Food companies will sell shit to people that make them ill long term that the state will have to pick up the tab for. And they'll plough billions into any research they can use to make the case that everything is okay.

From a corporate point of view it's actually okay to kill your customer as long as it's a death by a thousand cuts, they live long enough to give you money for decades and you don't have to pick up the bill to deal with the damage that you've contributed to.

[Darkflame]

Type 2 diabetes is kind of interesting as treating it currently accounts for around 10% of the NHS budget (coming close for 1% of GDP )

Theres some evidence that Type2 diabetes leads to Alzheimers too.
Which naturally has even most costs, both financially and somewhat to our humanity.

[pogo]

Preventative medicine is also about managing conditions to reduce the risk of deterioration/recurrence so .

Agree NHS not set up to do it but it is the responsibility of the Department of Health to do it (and there would be budget savings in the long run) and they are actually are set up to do it. There just seems to be a lack of appetite to do it (Austerity?, Short Term focus? probably contributory reasons)

I disagree though that just the Health Dept should have responsibility. E.g. one of the biggest contrasts between us and Europe, especially Northern Europe, is that many more people cycle in places like Denmark and Holland. And that's down to the planning system, making cycling a priority not an afterthought. Planning also deals with making cities, towns and suburbs more walkable.

Education, so schools, should play a part as many of the bad habits people pick up, especially smoking and excessive drinking, are picked up when young. On top of their planning role local authorities have a part to play as they run or facilitate many baths, leisure centres and sports clubs. Restaurants and shops can help by providing health information, such information on calorie counts and allergens, to help people make healthier and safer diet choices. And so on.

[VNVObit]

Preventative medicine is also about managing conditions to reduce the risk of deterioration/recurrence so .

Agree NHS not set up to do it but it is the responsibility of the Department of Health to do it (and there would be budget savings in the long run) and they are actually are set up to do it. There just seems to be a lack of appetite to do it (Austerity?, Short Term focus? probably contributory reasons)

I disagree though that just the Health Dept should have responsibility. E.g. one of the biggest contrasts between us and Europe, especially Northern Europe, is that many more people cycle in places like Denmark and Holland. And that's down to the planning system, making cycling a priority not an afterthought. Planning also deals with making cities, towns and suburbs more walkable.

Education, so schools, should play a part as many of the bad habits people pick up, especially smoking and excessive drinking, are picked up when young. On top of their planning role local authorities have a part to play as they run or facilitate many baths, leisure centres and sports clubs. Restaurants and shops can help by providing health information, such information on calorie counts and allergens, to help people make healthier and safer diet choices. And so on.

Department of Health are ultimately responsible for the NHS budget. If you want to reduce then you need to take steps to engage other departments to enable preventative measures to be taken.

Disagree all you like but the end of the day if they were serious about dealing with the NHS budget they would focus on reducing demand through a coordinated plan (something that seems beyond governments and civil service) that would in the normal course be run by the department of health. Outsourcing (current Tory policy) does nothing to quell demand but focuses on creating new private markets (in an area that would be less of a free market than either energy/telecoms).

Planning is a product of government policy (e.g. increase in permitted planning for residential dwellings). Do you think planning authorities just think up "oh it'd be a good idea to have more cycle lanes". They don't they respond to political pressure from politicians. The London Mayor espoused improved cycling infrastructure and hasn't delivered on it. Belated including in contracts the need for better cyclist awareness (last chapter on a recent tender guidance for housing development) in light of an upsurge in cyclists deaths at well known black spots created on his watch despite advice otherwise (Bow Roundabout, Kings Cross, Vauxhall Bridge).

You can't make shops responsible for providing health information on packaged goods when it is the responsibility of the manufacturers/producers. And they have been fighting tooth and nail to avoid any more information than is already required.
I doubt very much that other than providers of effectively readymade food (McDonalds, Burger King) that Restaurants could provide the information required on prepackaged goods (Can you imagine the likes of Gordon Ramsey compiling that information?)

As for education, well its health education and not just for people in schools and colleges so still think its the responsibility of the Health Department.

As for cycling infrastructure in Holland



It was the result of pressure on politicians as a result of unacceptable death tolls on the road. It is part of transport policy within Holland (not some planning authority).