Ten years of high living while managing the Ministry of Sound was the best fun a young man can have. But combined with my college boozing, social smoking, ice-cream bingeing and the mental repercussions of my mother’s tragic suicide, those heady 4am moments on the dancefloor will apparently lead, with grim inevitability, to a broken body, a crushed spirit and an early grave.
These worries, which haunt me every day, were confirmed last month by a blockbuster observational study of 700,000 American veterans by the US Department of Veteran Affairs which spelt out the obvious.
There’s an early death for people who smoke, toke and booze too much, who are stressed, cantankerous and knackered, and prefer junk food to jogging. It surely did not need to be proved, but it is in our nature to deny the consequences of our habits when they are often so hard to kick. So a big hand to the authors of the study report for forcing us to acknowledge the obvious.
Looking back at my young self, this sounds like terrible news. But there is hope. Xuan-Mai Nguyen, the lead author, reassures us that we can turn things around later in life by embracing her “eight healthy habits of longer, healthier life”. Taking the right decisions on drugs, sleep, weight, exercise, smoking, stress, friendships and boozing could mean up to 24 extra years for the most committed health-hackers such as me, their calculations project.
Widespread adoption of this advice could save this entire country from crashing headlong into a financial early grave caused by exploding healthcare costs.
Hot on the heels of this cheerful optimism was a grim, head-in-hands report from the Health Foundation that spells out the financial impact of Britain’s national experiment in a consequence-free lifestyle mindset.
It explains what I call the “British disease conundrum”. Better NHS treatment means that Britons are living longer; but lousy lifestyles mean this disastrously translates into extra time for people to clock up more costly chronic diseases – frequently more than one, often many more.
To give you a flavour of the report, the biggest driver of disease among those who are living longer is obesity. And the starkest statistic from the report is that there will be nine million people in England living with major illnesses such as dementia, diabetes, cancer, depression and kidney disease by 2040, but fewer people to pay the taxes to treat them.
All the extra doctors, nurses, artificial intelligence, fat jabs and shiny new hospitals that British taxpayers could muster are not enough to deal with this booming disease “catastrophe”. The health system’s costs and workforce deterioration are set to blow up the whole country’s economy. Unless we do something about it.
And that’s where the optimism of Nguyen comes into play. If we do not have enough money to treat all this sickness, shouldn’t we change some of our habits to prevent this disease in the first place?
But there is a stumbling block in our national psychology that we all know only too well. My father, the previous Lord Bethell, was an intellectual bon vivant who heroically fought off the advice of doctors. He would tell us his GP had given him a prescription for Sancerre, that exercise weakened the heart and that scientists could not agree whether butter was good for you or not.
As a country, we are playing out the same delusion, pretending that the answers are confusing, contested and inimical to our national identity. A recent IEA report ridiculously claiming that alcohol advertising did not promote alcohol sales reminded me of my father at his most hilarious, shortly before he prematurely died after a long, expensive illness.
The answers are staring us in the face. The answer is not just more doctors, we need to change our national health doctrine.
“These eight lifestyle factors don’t involve medications. Doctors don’t necessarily need to be involved,” says Nguyen, which is great news because the NHS simply cannot take on all the responsibility for treating and preventing illness. What is required is a new social contract. We are so proud of our NHS commitment to “free at the point of delivery”, but it has created a mindset that resembles my live fast, die young approach to life at the Ministry of Sound. Whatever you do, the NHS will pick you up and put you back on your feet. This is both a wonderful promise, but also the root of the problem.
We need a new social contract that does not make a false promise about the efficacy of modern medical treatments for disease and does not scapegoat the NHS for the excesses of the population. Instead, the government should consider its role to support people to live healthy lives.
The political mood is ripe. Polling strongly suggests the electorate, rather than obsessing about the nanny state, like the narrow minority of libertarians, is totally up for it. Economists at the Office for Budget Responsibility and the Bank of England are tearing their hair out about the current healthcare crisis and are desperate for solutions.
To give some specific examples, we have known since 1954 that smoking is clearly a killer. Not even the smokers want to smoke. So we should implement the Khan review, subtitled “Making smoking obsolete”, immediately. The junk food cycle explained by Henry Dimbleby is costing us a fortune, so we should reach for every possible tool to change the environment, including free school meals, taxes on ultra-processed foods and more thoughtful support for British farmers.
We need to embrace the “eight secrets of longer, healthier life” in order to break out of the British disease conundrum. There is hope we can make up for the mistakes of the past.
Lord Bethell is a former Conservative health minister and member of the House of Lords
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