The NHS risks being overwhelmed by an old-age health crisis, the new Chief Medical Officer warns today.
Chris Whitty says drastic action is needed to cope with a surge in the number of patients aged over 65.
He points out that countryside districts and coastal towns with older populations are often poorly served by GPs, hospital clinics, ambulances and out-of-hours providers.
In his first interview since becoming England’s Chief Medical Officer in October, Professor Whitty proposes a series of radical solutions to our ageing crisis. Speaking to the Mail he explains how:
Professor Whitty has proposed a series of radical solutions to our ageing crisis
- Doctors’ training will be reformed so they are able to better care for patients with several chronic conditions;
- Medical schools will be located in rural and coastal areas to ensure more doctors serve these ageing communities;
- Cervical cancer and many liver cancers will be eradicated in 60 years and other types will be much easier to treat;
- Ministers must avoid letting big tobacco firms lure children onto e-cigarettes;
- Trendy cannabis products on sale on the high street may be unsafe.
Professor Whitty, 53, is the Government’s top health adviser and his brief stretches from planning the response to coronavirus to drawing up key medical policies. But one of his most pressing concerns is how to meet the needs of the growing numbers of older patients with multiple illnesses.
Eighteen per cent of the population is over 65 but by 2038 this figure is expected to reach 24 per cent, nearly one in four.
It is predicted to be 40 per cent in North Norfolk by then and 37 per cent in the Lake District.
Other ageing hotspots are expected to be Rother in East Sussex (41 per cent) East Lindsey in Lincolnshire (37 per cent).
Chief Medical Officer Professor Chris Whitty, the Government’s top health adviser and his brief stretches from planning the response to coronavirus to drawing up key medical policies
Professor Whitty says: ‘The ageing of the population of rural areas will occur much faster and there will be a much higher concentration of people who are older who therefore have more health needs in the rural areas.
‘We have to think about this both for now and also accordingly for the future, this is a future issue.
‘If we did nothing on this we will get to a situation where the burden of disease for the country – the number of people who are actually suffering from lots of long-term medical conditions – will go up and service delivery will stay where it is. The gap between what people need and what people get will widen.
‘We have under-appreciated how much in the future this is going to be an issue. This is predictable and it’s solvable, provided we take a long run at it.’
Professor Whitty, who took over the role from Dame Sally Davies in October, stresses that the increase in over-65s will result in many more patients suffering from multiple long-term conditions.
These could include dementia, cancer, diabetes, cataracts, heart disease and osteoporosis – bone thinning – and some of this diseases will aggravate one another.
Patients can end up having five or six different hospital outpatient clinics for each illness which Professor Whitty says is ‘neither good medicine, nor is it convenient for patients’.
To end this, he wants to reform doctors’ training so they are more generalist than specialist.
He has been discussing the proposals with the Royal College of Physicians, the Royal College of Surgeons, the Academy of Medical Royal Colleges as well as NHS England.
He says: ‘We’re talking particularly about hospital doctors, we need to make sure they retain their generalist skills.’
Professor Whitty also wants medical schools to be set up in some of the rural and coastal locations where populations are ageing the quickest.
He hopes that this will eventually result in more doctors – hospital consultants and GPs – practising in the areas of greatest need.
‘One of the things we need to look at it how we can incentivise GPs and other doctors to want to work in these areas both for current and also future need,’ he adds.
‘There’s just a service delivery challenge that we need to think about and work out what methods we can use to address that. Some areas are more remote than others – providing services in the Lake District will be more problematic just because of the geography.
‘It’s sufficiently predictable and sufficiently far in the future that if we start doing things now, we can start to address it. If we wait until the problem has hit us, which it undoubtedly will, it will be a lot harder to sort out.’
‘Don’t repeat tobacco mistake over vaping’
Ministers must not let history ‘repeat itself’ by allowing children to get hooked on e-cigarettes, the Chief Medical Officer warned.
Professor Chris Whitty said that although the devices are ‘definitely safer’ than tobacco cigarettes, there remain question marks over their long-term harms.
And in a swipe at big tobacco firms – many of whom have moved into the e-cigarette market – he said he has ‘serious concerns’ about their ability ‘to addict people young’.
Several companies including British American Tobacco and Imperial Brands are investing heavily in vaping devices because tobacco smoking in the Western world is declining.
But some of their products appear to be brazenly marketed at children and popular e-cig flavourings include bubblegum, chocolate mint and butterscotch.
Professor Chris Whitty said that although the vaping devices are ‘definitely safer’ than tobacco cigarettes, there remain question marks over their long-term harms
Professor Whitty told the Mail: ‘We need to make sure history does not repeat itself.
‘The test of whether a product is being targeted at children is if it starts to be increasingly used by children and that will lead to action. If e-cigarettes are increasing in children then we should assume that they are being marketed towards them or at least pushed on them in some way, and deal with that very, very strongly.’
Figures from NHS Digital last August showed 25 per cent of pupils aged 11 to 15 had used e-cigarettes, the same as in 2016.
But the figure had increased compared to 2014 when 22 per cent had tried them.
Professor Whitty said: ‘No-one would claim that e-cigarettes are safer than not smoking at all and so if you don’t smoke, don’t use an e-cigarette. He added that there is a ‘question mark’ about the long term effects of the flavours of some e-cigarettes.
‘If you’re just using them for a short period to come off cigarettes that isn’t such a concern, but obviously if they’re using them for long periods it can be, because we don’t know what the effect will be and we wont know for many years,’ he said. He also said he has ‘serious worries’ about tobacco firms’ ‘continuing ability’ to get youngsters hooked on ordinary cigarettes.
‘There are still children who are smoking and it’s not happening by accident. That’s an area we really need to look very seriously at.
‘The model of action for the cigarette industry is very straightforward. If you get people early, they get addicted to something which is going to kill them and then once they’re addicted, they say it’s all about choice.’ Professor Whitty is also looking at whether the thousands of cannabidiol (CBD) products on our high streets are safe amid concerns some may contain trace amounts of the the harmful tetrahydrocannabinol (THC).
Sales of the cannabis extract have doubled in the last two years. It is a legal substance derived from the marijuana plant and unlike the illegal THC – also obtained from the plant – doesn’t make you high.’
First major illness hits in our 50s
Britons are contracting their first long-term health condition almost nine years earlier than previously thought.
A study by the all-party parliamentary group on longevity found that men are typically diagnosed with their first significant problem at 56 and women at 55. The previous estimates for both sexes was 64.
Men are typically diagnosed with their first significant problem at 56 and women at 55
Today’s report warns that many of the conditions, such as type 2 diabetes, stroke and heart disease, are preventable. It calls for the NHS to treble its spending on prevention.
‘The NHS must do more to prevent ill health and manage its demand,’ the report says. ‘It spends less than 5 per cent of its budget on prevention and this should be trebled.’
The cancers that could just ‘disappear’
Some types of cancers will ‘simply disappear completely’ within 60 years, Professor Whitty predicts.
He believes cervical cancer and some liver cancer will be eradicated by vaccination within the next two generations and most lung cancers ‘will just go off the radar completely’ provided our smoking rates continue to fall.
Survival rates for breast and prostate cancers, which are already at 80 per cent, will continue to improve, he says.
The majority of patients will be ‘cured’ with a small operation. ‘We’ll get to a point where some cancers are a nuisance, in fact for some cancers we’ve already got to that point’, he says.
‘Some of them we’re almost there, like testicular, for example. Breast cancer, we’re already at situation where ten years survival for women is just about 80 per cent; the same is true for prostate cancer in men. I expect that to continue to improve. Most people who get that diagnosis will lead a good life and be alive and well a decade later.’