If I were to ask people to list the biggest threats to our nation’s finances, I would imagine that diabetes, if it appeared at all, would be fairly close to the bottom.
We tend to think of diabetes as a relatively mild condition and so it is unlikely to be something we consider as posing a serious threat to either the health, or wealth, of the country. But while the view that diabetes is a relatively benign problem is widespread, it could not be further from the truth.
It was revealed recently that there are now more than 3.2 million people in the UK diagnosed with diabetes, an increase of more than 160,000 on the previous year. This is the biggest annual increase since 2008 and means that six per cent of all the nation’s adults are now living with a diabetes diagnosis.
At this point, I should declare an “interest”: for I am one of the 3.2 million. Until I was diagnosed with Type 2 diabetes more than 20 years ago, I had no idea what the health consequences could be, but I now understand how receiving good healthcare and support are vital in giving patients the best possible chance of avoiding complications and early death. And because the complications of diabetes are expensive for the NHS and curtail people’s economic productivity, preventing them is also really good news for the nation’s finances and can help avert an unsustainable increase in spending.
The number of people in the UK with diabetes is only likely to increase, as the sharp rise we have seen over the last decade shows no sign of levelling off. In fact, current projections suggest that, by 2025, there will be five million people in the UK with diabetes.
This has profound implications for the future ability of the NHS to look after people’s health, as diabetes is expensive to treat. We are already spending £10 billion a year on it – that’s a staggering 10 per cent of the entire NHS budget – and this is projected to rise to £17 billion within 20 years.
This is a rise that we simply cannot afford and makes the case that we need to improve the way we approach prevention of Type 2 diabetes, which is closely, though not solely, linked to lifestyle, being overweight, eating unhealthily and not being active enough. It accounts for 90 per cent of diabetes cases. We need to make sure people understand why maintaining a healthy weight is so important, but the NHS also has a role to play by ensuring the NHS Health Check, which everyone aged 40 to 74 should receive, is implemented more effectively.
This would help identify the seven million people who are at risk of Type 2 diabetes, so that they can get the lifestyle advice and support they need to help prevent it. It would also help to diagnose more of the estimated 630,000 people who have Type 2 diabetes but do not know it.
But as well as the frightening scale, the majority of the cost of the condition is due to its extremely serious complications. It can lead to life changing developments such as stroke, kidney failure and amputation and, shockingly, every year in the UK there are more than 20,000 people with diabetes who die before their time.
If one puts the scale and the seriousness of diabetes together, it quickly becomes clear that we heading towards a health crisis of huge proportions.
However, at the moment, the NHS often takes the wrong approach, as about 80 per cent of diabetes spending goes on treating complications that could, in many cases, have been prevented if the person had received better healthcare in the first place. It doesn’t take a rocket scientist to see that spending vast sums on complications – but failing to invest in preventing them – is bad economics, not to mention tragic for the people who have to endure them.
The first thing we need to do is to get better at offering education to people with diabetes. No matter how good someone’s healthcare professional is, the individual has to manage his, or her, condition for the vast majority of the time. As someone with Type 2 diabetes, I know how tough this can be. This is why education programmes can be a real lifeline and, by giving people the tools they need to manage their own condition, they can actually save money in the long run.
It is not just at the start of the diabetes journey where this short-termist approach holds sway. There is a postcode lottery as to whether an individual gets the annual checks that every person with diabetes should have, while care in hospitals is also patchy. In many cases, for example, people with diabetes have to have an amputation because the hospital does not have the systems in place to treat a foot problem quickly enough to save the limb. And this happens even though putting these systems in place has been shown to save money in the long-term.
To conclude, I hope I have illustrated why I have grave fears about the potential impact of diabetes on the health and wealth of the nation. These problems are not a secret. The Public Accounts Committee, based on a National Audit Office inquiry report, concluded that diabetes healthcare is not good enough and provides poor value for the eye-watering sums of money we spend on it. However, for once, this is not about more funding, but about using the ten per cent of the NHS budget already devoted to caring for people with diabetes more efficiently.
Diabetes treatment needs to change. We need an urgent political consensus around the self-evident truth that better standards of care for people with diabetes is not just in their interest – it is also in the interest of the nation as a whole.
* For more information about diabetes visit www.diabetes.org.uk