Simon Stevens says the NHS is in financial crisis

– but can we expect individuals to take responsibility for their health? Well it hasn’t worked so far.

Thursday, 23rd October 2014, 1:52 pm
Dr Sally Norton

Simon Stevens is right.

If we don’t challenge the causes of illness then the NHS is at risk of becoming bankrupt. When providing a cure is financially not viable anymore then the only choice is to identify the cause of the imbalance and tackle it at the roots.

It was never enough to look for a cure for cancer – it was always the aim to stop smoking through education; through warning on packaging; through removing temptation. How is it any different for obesity?

Simon Stevens is asking government to get involved – to offer corporate rewards for health in the workplace. Agreed. …. And he should be challenging manufacturers and retailers too.

I am getting more and more cross. Every time I discuss weight loss and health issues someone will say in a rather accusatory tone “surely it is down to the individual to take responsibility for their own weight and wellbeing”.

Perhaps, in an ideal world……. but this is the real world and we need to face facts.

I’m an NHS weight loss surgeon. The person in front of me, seeking help, is perhaps family, friend or colleague. Should my response then be “Well …. of course you do understand I can’t help you as it was your personal choice, your weak will, your lack of ability to resist temptation and now you are going to die early from a weight related disease – oh and by the way there’s a Caramel Latte for you as you leave the premises to help with the shock?”

Of course not – because I don’t believe that is true.


I will provide weight loss surgery where appropriate, to treat or prevent the many obesity-related diseases, but at the same time I believe we should be insisting that employers, manufactures, retail outlets, governments and especially our hospitals, are doing all they can to help us keep weight off in a healthy way. I will share your responsibility to maintain a healthy weight. As doctors, we need to give you the holistic care you expect to help you lead a longer, happier life but, at the same time, we must try to preserve the NHS from bankruptcy by facing the realities of the obesity crisis and tackling it from the roots up.

The fact is,

Two thirds of us are overweight or obese and we are making sure that our kids are following in our footsteps.

The bottom line is, that however much we want to eat more healthily and take more exercise, we are surrounded by temptation wherever we turn. Portions are getting bigger and bigger and manufacturers are busy dreaming up increasingly calorie packed offerings that they market to us with well-researched psychological manipulation. We seem busier than ever but in a sedentary way - often trapped in offices with limited opportunity for activity, and everything is geared towards convenience ….. drive-throughs, escalators, home deliveries, gadgets to reduce physical effort.

So, yes, personal responsibility is important but we need help. It is blindingly obvious that we can’t beat this on our own. We need manufacturers to do their bit by providing us with easy access to healthier food choices instead of tricks such as coercing us into buying double sized chocolate bars that we all know won’t be shared but instead will change our perception of a normal serving. We also need to make health and wellbeing part of our daily lives, and that, for many of us, involves the workplace.

Simon Stevens has suggested that companies should be encouraged to help us tackle our weight and health. This has provoked all sorts of derisory comments about how we would be affronted to have our employers forcing us on to the scales every Monday for an office weigh-in. Of course, there are good and bad ways to do this, but the bottom line is that many of us spend a vast proportion of our lives at work and if our work environment doesn’t encourage us to be healthy then we just don’t stand a chance. How can we be stuck in a sedentary job, eating poor quality food, hunched over a computer, under stress from 9-5, five days a week and expect to have the time or energy to work on our weight, health and fitness in the remaining hours?!

So, instead of being affronted by this perceived ‘nanny-state’ initiative we should grasp it with both hands. Let’s make the most of this opportunity to improve our health, weight and wellbeing at our employer’s expense – and we may even find work more enjoyable as a result.

Any employer shuddering at the thought of introducing this initiative can take note of the boom in workplace wellness programmes in the US, where companies have seen the benefit of caring for their staff. UK employers lose over £20 billion a year due to absenteeism, but the costs of presenteeism (reduced productivity at work due to ill-health or poor fitness) may be 3 x higher. Being overweight or obese increases the number of sickness days taken by 50% – equating to approximately £14 billion a year in lost revenue and may increase presenteeism rates 15-fold.