Being Lame

“An ounce of prevention is worth a pound of cure” – Benjamin Franklin

I am sure I’m not alone in being alarmed by the recent statistics from NHS Digital that 6.3 million British adults aged 40-60 (41% of that category) do not manage ten minutes of brisk continuous walking in an entire month.

Unhappily, as I look around my patients, family, friends and workforce this data is confirmed by steadily increasing waistbands. In this age group people seem to be polarized into two camps, either Lycra clad gym worshippers undertaking decathlons or those doing nothing. Unfortunately, there does not seem to be a sensible middle ground. The 2012 Olympic legacy has been squandered, with an emphasis on elite sport rather than increasing activity levels among the general population.

As GPs and practice nurses, we know only too well how difficult it is to change peoples’ behaviour. Research from the MRFIT study back in the 70s and its follow-on intervention studies (ARMS), show how much effort individual’s need to put in to change their lifestyle. This is still very much the case 30 years on.

The introduction of the smoking ban and subsequent fall in the number of people smoking is an example of the impact that can be had when Central Government takes its responsibility seriously. It is disappointing that since then there has been no similar intervention on other significant causes of ill health such as alcohol, obesity and lack of exercise as championed by Jamie Oliver recently in the Sunday Times.

It is not unexpected that a politician would be interested in a policy that may take longer than the next election to show benefits, but this argument falls apart with alcohol pricing. The impact of town centre shops in Ipswich not selling high strength alcohol is having a significant effect on antisocial behaviour and featured in the GP Five Year Forward View. The evidence for minimal alcohol pricing is robust and would address problematic heavy drinkers most, only adding a few pence to middle class Prosecco drinkers with immediate benefits in terms of social disorder, domestic violence and A&E attendance.

Cuts to Public Health England’s budget and failure to invest in simple sports facilities for the general public will also be costly for us all in the long run.

As ever, headline grabbing hospital interventions trump health promotion. Where are our Victorian forefathers who designed the London sewage system – all still mostly ‘fit for purpose’ 100 years later.