Maintaining control of Guernsey’s health care costs

July 16th, 2010 by Peter Roffey

With Health & Social  Services Department (HSSD) funding under huge stress some may question whether it’s worth spending money, every five years, on a major survey examining locals’ lifestyles, habits and state of health. Wouldn’t that cash be better spent on front line healthcare? The reality is quite the opposite. The tighter the money, the more important it is to prioritise those areas where the cash is spent. That can’t be done by relying on simple gut feelings about the island’s most pressing healthcare problems. What is needed is real, empirical, evidence and that only be provided by in-depth research. If that costs money well it’s still much better, and more cost effective, than prioritising in ignorance.

The latest results of the “Healthy Lifestyle Survey” make fascinating reading – although it’s a shame that data from 2008 have only just been released. The findings can be summarised as follows :- “Smoking sharply down, booze still a real issue, obesity a growing [sic] problem”. How should the HSSD and the rest of us react to that raw data?

Well obviously the smoking results are great news from a health care perspective. Tobacco use is still the greatest cause of preventable ill-health in Guernsey and the trend towards fewer smokers will reduce the instances of a whole range of serious illnesses. First they’ll be a reduction in heart attacks and later the change in behaviour will impact on cancer statistics.

There is still a worryingly high level of young people smoking in Guernsey. That is no shock as youngsters always have an irrational feeling of immortality but even in this age group numbers are declining. The right reaction is NOT for HSSD or the rest of the community to ease off on the anti-smoking strategy. When you’ve got momentum on your side it’s best to keep pushing.

Alcohol is a trickier subject in many ways. Firstly because, unlike tobacco, alcohol taken in moderation isn’t harmful. Indeed there is real evidence that it has some health benefits. The problem is that few habitual users stick to the official definition of “moderation”. I know my consumption of red wine regularly exceeds the recommended number of units and it’s clear from the survey that I am far from alone.

Another problem is that alcohol is deeply ingrained in our culture and has been for far longer than tobacco. What do we do if we want to celebrate? Or mourn at a wake? Or relax after a stressful day? Or socialised with friends? For most of us the answer is simple – we have a drink.

That’s fine, but immoderate drinking brings real health risks and binge drinking brings social problems. While its no excuse there is no doubt that for some people alcohol removes natural inhibitions towards indulging in anti-social, abusive or violent behaviour.

The right strategy to tackle that is open to debate. Should there be a minimum price for alcohol or will that just punish moderate drinkers on low incomes? Is education the key or a reversal of the new, more liberal, opening hours? The real answer must be a cultural change. In many European countries there are very relaxed licensing regimes without the “British Disease” of widespread binge drinking. How to change our “wet culture”? Answers on a post card please.

Perhaps the most worrying trend to be confirmed by this latest survey is that society is getting relentlessly fatter. I don’t highlight this to preach – I live in a glasshouse on this issue – but because it has massive implications for healthcare in the island. Recent figures showing a rising

level of type-2 diabetes in Guernsey are just one sign that the obesity chickens are now coming home to roost.

The problem is that if it’s hard to pitch a “sensible drinking strategy” correctly it’s even tougher to get that balance right for diet. Any deputy who suggests a chocolate tax or sugar duty [the UK used to have one many years ago] will soon get a pasting from the public who will regard this as the ultimate in the nanny-state.

There are obvious and uncontroversial measures such as promoting an active lifestyle, sporting activities, and educating children over sensible eating. The problem is that Guernsey already does all of these things very well but obesity levels continue to rise. I suspect that when this hidden health time-bomb really explodes then Guernsey will accept new anti-obesity measures which today would seem extreme. I hope that cultural change isn’t delayed too long or else the damage will be done.

  1. No Comments

Have your say