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Save the NHS - Stop smoking and drinking

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Save the NHS - Stop smoking and drinking

Old 7th Jan 2019, 04:53
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Save the NHS - Stop smoking and drinking

It has recently been stated that smoking and drinking are directly costing the NHS £7.3 billion/year. Smoking at around £2.6 billion and alcohol at around £4.7 billion

Tobacco revenue generates approx. £8.8 billion/year in tax revenue and alcohol a whopping £11.8 billion/year, see here: Tax & Duty Bulletins. Am I being cynical to think that the Government isn't going to put too much effort into reducing these income streams?

However the total "social" cost of alcohol is quite staggering: Estimates of the cost of alcohol - IAS
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Old 7th Jan 2019, 06:49
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The best way to save the NHS is to die quickly of something untreatable, at an age young enough to avoid most of the medical care that a person might need post retirement.

On these grounds, smoking ought to save the NHS a lot of money. But I think you are being too cynical in saying that nobody cares. It's remarkable how many people have given up smoking - in the 1980s and 90s people grumbled all the time about how giving up was impossible. These days it's rare to meet the yellow-fingered chain smokers who were still common 20 years ago. It's also odd to go abroad to a cafe or restaurant and have people light up next to you. The UK government has done a pretty good job over the past few years of firstly persuading people that smoking was bad for them, and secondly persuading people to accept legislation making it more onerous. Give credit where due.

Even when it comes to alcohol, rates of drinking are reducing particularly amongst the young. When I worked in A&E we used to get drunken pensioners falling down the stairs and breaking things as often as we got drunken students. The nursing staff commented on how students just aren't getting drunk like they used to.

Obesity and type II diabetes is a completely different matter.
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Old 7th Jan 2019, 06:54
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Agreed about the reduction in smoking (I gave up 6 years ago) in the population. Before I gave up my favourite retort to people who told me that smokers cost the country money was "Smoking costs NHS £1.5 billion, smoking generates £5.5 billion for HMRC". What surprises me is the level of revenue that HMRC manages to extract from the people still smoking!
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Old 7th Jan 2019, 07:04
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It seems like peak tax receipts for tobacco was 2012/13 where it was 9.7 billion pounds to HMRC. Since then tax receipts have been steadily falling yet taxation has been massively increasing. I smoked 20 a day for about 15 years before my children were born. In the last decade I’ve had possibly 3 or 4 cigarettes total. I do actually enjoy those but only through nostalgia. I wouldn’t bat an eyelid if they were completely removed from circulation forever.
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Old 7th Jan 2019, 07:05
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Originally Posted by LowNSlow View Post
It has recently been stated that smoking and drinking are directly costing the NHS £7.3 billion/year. Smoking at around £2.6 billion and alcohol at around £4.7 billion

Tobacco revenue generates approx. £8.8 billion/year in tax revenue and alcohol a whopping £11.8 billion/year, see here: Tax & Duty Bulletins. Am I being cynical to think that the Government isn't going to put too much effort into reducing these income streams?

However the total "social" cost of alcohol is quite staggering: Estimates of the cost of alcohol - IAS
Sadly, your cynicism is justified because both of the above have always generated tax income streams as you say. You get the impression, as mentioned in the link below, this is more about Treeza and less about patients.

However, when it comes to lifestyles and diet, the Gov't would actually get more credence,( in my non medical opinion ) by legislating the removal of salt and sugar from many foods along with retail outlets promoting their sale. Both are significant contributors to ill health.

And then there's the "fast food " outlets.

True, we've all used them at times, but, the way the food is cooked, let alone the nutritional content ( negligible ) should be more strenuously promoted as to the damage and again, health issues, consuming junk food will lead to.

https://www.bbc.co.uk/news/health-46777387
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Old 7th Jan 2019, 07:41
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Sort of related, today the government and NHS are talking about (yet another) new 10 year plan that will "save 500,000 lives".

Sadly in many cases what they really mean is "prevent people (who would like to go peacefully) from dying". It's not possibly to save lives, just to defer the inevitable, and there are many hundred of thousand of people in advancing years with no remaining quality of life who would rather be allowed to go than to be keep alive.
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Old 7th Jan 2019, 07:55
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Never smokes but sufficiently aware that smoking is a good deal. My shares in Imperial Brands (a move away from tobacco) continue to do well. You might call this cynical and unethical but no more so than investing in pharmaceuticals or defence industries or hydrocarbons.
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Old 7th Jan 2019, 09:56
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Having made a bit of use of the NHS recently I am very happy it is there but to saywe are going to focus on prevention is another idea from the University of the Bleedin' Obvious . I lived in Sweden 20 odd years ago and that was their main focus - prevent before cure . I know they are a European country and thus to many JB fans must be backward and years behind the UK , but it does work - for the most part the Scandis have very good life expectancy and from my experience there a lot of older people stay very active into their 80s .

Drink remains a problem-as it is in all far northern countries from Canada to Russia and everywhere in between but for the NHS to trumpet something like is clearly to aim Mrs M and doesn trequire alot of science to work it out.

the immediate problems with the NHS based on my recent experience are

1 High tech and expensive diagnostic devices should not just work 9-5 but should to a degree follow the simulator practice in airlines -its very expensive so maximise utilisation.
2 insufficient key staff-on saturday i visited a fantastic drop in centre in Bracknell- does lot of other things too. Must have cost millions but they cannot afford a single GP at the weekend so many qualified and experienced nurses sit around doing nothing because a lot of issues according to the rules require GP oversight or checking.

There are votes in buildings but not people it seems

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Old 7th Jan 2019, 09:59
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My luscious lady friend is a specialist clinical nurse. She assures me that the ticking time bomb is not smoking or drinking - both, as has been mentioned are reducing - but obesity. Type 2 diabetes plus knee and hip replacement operations are going to be draining the NHS in a serious way.
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Old 7th Jan 2019, 10:09
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Ah, but hip and kmee operations really do massively improve quality of life for those who suffer from constant pain which stops them walking any distance. Quite a lot of those patients are not even at retirement age.
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Old 7th Jan 2019, 10:32
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2 insufficient key staff-on saturday i visited a fantastic drop in centre in Bracknell- does lot of other things too. Must have cost millions but they cannot afford a single GP at the weekend so many qualified and experienced nurses sit around doing nothing because a lot of issues according to the rules require GP oversight or checking.

There are votes in buildings but not people it seems
GPs and their "union", the BMA, appear to have the NHS wrapped around their little fingers. There have been tremendous improvements in the GP services at our practise, that runs out of the local health centre, but all of that improvement appears to have come about through highly qualified nurses essentially taking over the work that was routinely done by GPs, so if you've got something that needs seeing to within 2 weeks then your go to services is a same day appointment with one of these excellent nurses, rather than the GP. At the same time, our GP practise has stopped working Saturdays again.

I don't know, but I would imagine that these nurses are doing what was GP work for possibly less than half a GP salary. Perhaps if the GPs became a little more flexible their services could ease a lot of the pressure from A&E.
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Old 7th Jan 2019, 12:49
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Originally Posted by RedhillPhil View Post
My luscious lady friend is a specialist clinical nurse. She assures me that the ticking time bomb is not smoking or drinking - both, as has been mentioned are reducing - but obesity. Type 2 diabetes plus knee and hip replacement operations are going to be draining the NHS in a serious way.
Exactly. My wife is a pre diabetic although she is actually below that hba1c threshold and is attending one of the Well Being courses.
Type 2 diabetes and associated illnesses are costing the NHS over 10% of its budget.
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Old 7th Jan 2019, 12:52
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I stopped smoking in 1976.....I haven't stopped drinking though.
The endocrinologist told me that I got diabetes somewhat early because I was overweight - and then added that with my family history, I would have got diabetes anyway, and it was just a matter of when. There are occasions when genetics wins......I've managed to live with it for 20 years now....He also told me that quality of life was important, so keeping alcohol consumption at a reasonable level was required..
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Old 7th Jan 2019, 17:03
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Originally Posted by Blues&twos View Post
Ah, but hip and kmee operations really do massively improve quality of life for those who suffer from constant pain which stops them walking any distance. Quite a lot of those patients are not even at retirement age.
I might not have made myself clear. It's the obesity that is causing premature wear to the joints.
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Old 7th Jan 2019, 17:28
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Originally Posted by RedhillPhil View Post
I might not have made myself clear. It's the obesity that is causing premature wear to the joints.
Taking a decision 12 ish months ago, If I remained at weight as was then I was a definite type 2 diabetes future patient plus the knees and back ache would be a constant. Have a sweet tooth which didn't help weight.

Working away a lot so took a clear decision to lose weight, not through mega exercise but eating better. Stayed in hotel but never had a breakfest in 10 months there, coffee and pastries when got to work, hot meal at lunchtime and a sandwich after spending some time in pool in the evening. Also became a constant weigher. This focused the mind.

Now roughly 10kgs less than i was a year or so ago, back and knees rarely pain me and really do feel a lot healthier. This year will start to do more exercise to back this up.

In respect of the "NHS save 500,000", guy in supermarket queue looked at Mail headline and just commented, not saving anybody just postponing the F******* inevitable for a bit.
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Old 7th Jan 2019, 17:33
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I've read your post again RedHillPhil, I see what you mean.
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Old 7th Jan 2019, 17:34
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It is the gym culture and the obsessive runners and joggers ruining their hips and their knees by imposing repetitive strains and stresses on them that they were never designed to cope with.

Primitive man was designed to run away from a bear/hostile tribesman at full tilt once a month, not every day for hours and hours!

The orthopedic surgeons are replacing worn out hips and knees on younger and younger patients these days and the implants are not designed to last forever - eventually they need replacing and each time it becomes technically more difficult and has higher morbidity. The hips and knees are very expensive and need prolonged rehabilitation, especially in young people who expect to be able to go back to what they were doing before.

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Old 7th Jan 2019, 18:04
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Pleased to read that from an expert, it's what I have been saying for years. I walk 35-40 miles a week but it's quite logical that the constant hammering the joints take when running can't be doing any good. On the smoking issue it is said that the average smoker forfeits nine years of life. That saves nearly eighty grand in unpaid pension. If they drop dead then they are doing the rest of us a service.
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Old 7th Jan 2019, 19:22
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The new emphasis on quick diagnosis is once again more political smoke and mirrors from the hunchback (conveniently diverting attention from the B word) What good is a fast diagnosis without fast treatment? No mention of that you will notice. As ever in politics it's not what they say or do that's important, it's what they don't say or do...
Personally I think its time to end the NI exemption on all those retired whose income is above the NI threshold of £162 a week. It's about time what is referred to as the "me generation" made a bit more of a contribution to what is becoming an exponentially rising expense for their old age medical treatment & care. Don't see that one being too popular down the "Con club" though!
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Old 8th Jan 2019, 08:08
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Originally Posted by Private jet View Post
Personally I think its time to end the NI exemption on all those retired whose income is above the NI threshold of £162 a week. It's about time what is referred to as the "me generation" made a bit more of a contribution to what is becoming an exponentially rising expense for their old age medical treatment & care. Don't see that one being too popular down the "Con club" though!
PJ, it took me a moment to understand what you said.

NI is levied on income. Are you saying it should be levied on pension income as well as earned income? I don't think that would be acceptable to pensioners. My MiL thinks taxing her late husband's widows pension is wicked and that tax wouldn't buy a packet of fags.

OTOH levying NI on those over retirement age who continue working might be more acceptable.
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