David Cameron's twelve reasons why the NHS budget must continue to grow in real terms
- There are now more pensioners than under 16s: The biggest pressure is of course our ageing population. The fastest growing age group in Britain today is those aged 80 years and over. For the first time ever there are more pensioners in this country than there are children under 16.
- The growth of long-term conditions: As people live longer they're more likely to live for more of their life with at least one long-term condition like Diabetes, Parkinson's disease or Alzheimer's. It's estimated that by 2025 over six million older people will be suffering from a debilitating long-term illness. The number of people with dementia will have increased to around one million; with osteoporosis to over four million; with hearing loss to around ten million. These are increases of up to fifty per cent from today.
- Lifestyle illnesses are increasingly expensive: While we're living longer we're also becoming less healthy in many ways. Obesity, drug and alcohol abuse and sexual health problems are all on the rise, putting massive pressure on NHS resources. Alcohol misuse costs the NHS £2.7 billion a year. Obesity is estimated to cost it a staggering £4 billion a year.
- Infectious diseases like swine flu: There are still big infectious diseases to fight - and not just the sporadic scares like swine flu.
- The return of TB: Tuberculosis is an ever-growing pressure on our health service. We used to think TB was a disease of the 19th century, not a threat to the twenty-first but the number of cases has increased by 25 per cent since the turn of the millennium.
- HIV infection rates: HIV is the fastest-growing serious health problem in the UK, with an estimated 80,000 people living with it.
- 200,000 to 400,000 people with Hepatitis C: And perhaps the most shocking rise in modern disease has been Hepatitis C - since 1997 the number of cases reported each year has almost trebled. While the latest official figures show that 60,000 people in England have been infected, the Department of Health estimates that the real figure is more like 200,000. But the Hepatitis C Trust believes that you can double that number - with nearer 400,000 people in England being infected.
- Robot and nanotechnologies: Today, medical advances, driven by the hi-tech revolution, are increasing at an exponential rate. Genetics, nanotechnology and robotics are being integrated into the work of the NHS. Da vinci robots, costing millions, are routinely used for pelvic surgery. Microscopic robots that can be injected into veins to perform minor procedures from the inside.
- Possibilities of genetic diagnosis: Those at risk of inherited disease may be referred for genetic diagnosis by their GP, at a cost of £5,000 a time.
- Stents costing £60,000-a-time: Patients undergoing operations might have stents - tubes like internal medical scaffolding - put into their airways and blood vessels, with a hand-made stent for the aortic arch costing £60,000 alone.
- Brain-controlled artificial limbs: Right now scientists are working on artificial limbs that are controlled by thought alone.
- Diagnostic breathalyzers: Breathalyzers that can diagnose disease with one puff.
I readily agree that it is a persuasive list but it would also be possible to draw up similar lists for many other public sector budgets - budgets that have not enjoyed the growth of resources enjoyed by the NHS.
My greater objection, however, is the question of affordability. Britain borrowed £8bn last month against an expected borrowing requirement of £500m. The BBC reports that the government's overall debt now stands at £801bn, or 56.8% of GDP, its highest level since at least 1974. As I blogged earlier: For all the rhetoric about the cupboard being bare and an age of austerity the reluctance of the Tory leadership to make difficult decisions is becoming worrying.