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NHS chief in obesity costs warning

The health of millions of children, the sustainability of the NHS and the economic prosperity of Britain all depend on a radical upgrade in prevention and public health, according to the chief executive of NHS England.

Simon Stevens told the annual conference of Public Health England in Coventry today: "Obesity is the new smoking, and it represents a slow-motion car crash in terms of avoidable illness and rising healthcare costs.

"If as a nation we keep piling on the pounds around the waistline, we'll be piling on the pounds in terms of future taxes needed just to keep the NHS afloat."

He pointed to the fact that nearly one in five secondary school aged child is obese, as are a quarter of adults - up from just 15% 20 years ago.

Unchecked, the result will inevitably be a huge rise in avoidable illness and disability, including many cases of type 2 diabetes, which Diabetes UK estimates already costs the NHS around £9 billion a year.

In an NHS "Five Year Forward View" to be published next month, the organisation will set out some of the actions that could make a difference over the course of the next Parliament.

Proposals being debated include a shift in NHS investment towards targeted and proven prevention programmes, new incentives to ensure the NHS as an employer sets a national example in the support it offers its own 1.3 million staff to stay healthy, and recommending that financial incentives should be offered to employers in England who provide effective NICE-certified workplace health programmes for employees.

Another plan is to empower local councils and elected mayors to make local decisions on fast food, alcohol, tobacco and other public health-related policy decisions, going further and faster than national statutory frameworks where there is local democratic support for doing so.

Professor Jonathan Valabhji, national clinical director for obesity and diabetes, said: "Obesity is a significant and wide scale public health issue for all age groups and an issue the NHS as a whole is dedicated to tackling.

"We are seeing huge increases in type 2 diabetes because of the rising rates of obesity, and we clearly need a concerted effort on the prevention, early diagnosis and management of diabetes to slow its significant impact not only on individual lives but also on the NHS."

Duncan Selbie, chief executive of Public Health England, said: "PHE welcomes Simon Stevens's focus on obesity. He rightly highlighted the health and economic costs to society if as a nation we do not act now. His focus on reducing obesity in the NHS workforce and limiting high fat and sugary foods in hospitals is especially important as they are role models for the public."

Barbara Young, chief executive of Diabetes UK, called for improvements in the prevention and treatment of the condition.

She said: "The UK's obesity rate is worryingly high and this has fuelled the massive rise we have seen in Type 2 diabetes over the last couple of decades.

"Up to 80% of Type 2 diabetes cases could be prevented or delayed through lifestyle changes, and so we will never be able to turn back the rising tide of diabetes until we get to grips with the obesity epidemic.

"This is why we welcome Simon Stevens' focus on the threat of obesity, which is the greatest public health emergency we face today.

"We are now in a position where diabetes accounts for 10% of the entire NHS budget and if things carry on as they are, it will bankrupt our healthcare system. We urgently need policies and legislation that make it easier for people to make healthy choices.

"As well as needing more focus on supporting people to make healthy lifestyle changes, we need to make sure the NHS Health Check, which assesses people for risk of Type 2 diabetes, is properly implemented. Crucially, we need to make sure that people identified as being high risk are then given the support they need to make the lifestyle changes that can help prevent it.

"But there also needs to be better treatment and support for the 3.8 million people who already have diabetes.

"Too often, the treatment they get is not good enough and this is leading to high rates of health complications, including amputation and blindness. Not only are these personally devastating for those affected, but they are also extremely expensive to treat and this is one of the main reasons that diabetes is putting such a strain on NHS finances.

"So if we are really serious about stopping diabetes from bankrupting the NHS, we need to make sure that a focus on preventing Type 2 goes hand in hand with improving diabetes healthcare."

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