GPs are increasingly spending their time on a small proportion of patients with multiple illnesses, research has found.
Family doctors spend more than a third of their time on patients with three or more serious chronic conditions despite the group accounting for 16 per cent of the population.
The proportion of people with multiple illnesses has been climbing since the turn of the century and one in three have at least two serious chronic illnesses.
What used to be near immediate death sentences are now chronic illnesses to be managed. Therefore some have that several rather than being dead.
This is also what leads to that long running observation that smoking, fatties and booze save the NHS money. Because those do, still, cause the deaded in our beds. And thus save the NHS those years of care of multiple chronic illnesses. One of the oddities of health care economics is that a cheap and reliable cure for lung cancer would actually raise NHS costs over time…..
More evidence, as if it were needed, for the kill joys to take control of our lives – purely for our own benefit, of course.
A lot of that will be my brother-in-law, who imagines he has multiple chronic illnesses. He’s platinum with the ambulance service’s frequent rider program.
Multiple illnesses also mean more government handouts. So, scroungers will clog up the GP system to get them to sign off on screwing the taxpayer.
“This is also what leads to that long running observation that smoking, fatties and booze save the NHS money”
I would love to see the workings out behind that or is it just a guess.
How much does treating lung cancer cost? It might have been true when the treatment was just morphine to dull the pain but now it is treated – just not very well.
I wouldn’t worry – the way Starmer is going he’ll soon invoke George Bernard Shaw and having the chronically sick and useless humanely executed.
If someone has got multiple illnesses they *should* occupy more of the GP’s time that those that have got one or none. The article says that those with three or more – illnesses take up, on average, two-and-a-half times as much GP time as those without. Since those with no illness should take up zero (or a tiny bit for vaccinations), two-and-a-half times is pretty modest, suggesting that the GP is often dealing with two or more illnesses in one visit.
Someone is trying to make a headline out of a “well, duh!”
https://www.adamsmith.org/blog/healthcare/fatties-and-smokers-save-the-nhs-money
From my observations the benefits system is costing the NHS a fortune
Encouraged to lead sedentary lives and ‘discover’/develop problems like back pain and diabetes that keep them on the sick, well away from employment while the benefits roll in
If I make a small but relevant correction; GPs spend an amazing amount of time creating paperwork about a small number of patients with multiple chronic illnesses. Treating them, not so much…
“researchers” have discovered Mr. Pareto, then. Behind the ack of the sofa, obvs.
@Tim Worstall
The figures you quote are from 2003 – it is possible that the figures have changed since then.
In fact the NY times says
” The model relied on “cost of illness” data and disease prevalence in the Netherlands in 2003.”
and
“Lung cancer is a cheap disease to treat because people don’t survive very long,” van Baal said.”
Is that still true?
Ruth Strauss was ill with lung cancer (not caused by smoking so maybe not relevant) for a year before she died
https://www.bbc.co.uk/sport/cricket/46708911
No. Here’s the basic insight. The NHS is a *lifetime* medical system. We all also receive end of life care. The determinant of how much it costs the NHS to treat us over our lifetime is therefore significantly – tho’ not wholly – reliant upon how many years it has to treat us. People who die young save the NHS money therefore. Die 6 months young from something more expensive to treat and that costs more. Die a decade early from something of average cost to treat and it’s a saving.
@Tim Worstall
I understand your reasoning and it could be true that the £x cost of treating a smoker is less than the £y cost of treating them if they hadn’t smoked until older.
However as the figures we have for x and y are 21 years out of date we don’t know that to be true.
(Also some smokers may get disability benefits etc if they lose a leg).
Sadly the exact figures would take a long time to obtain.
That cost is also purely NHS budgeting. No account taken of sick days or leave for illness. No cost of accommodations for those electric carts (ramps). Etc.
In one sense, that’s reasonable. After all, the NHS budget doesn’t pay for them. On the other hand, a sicker person will not be as productive over his or her lifetime. In that sense we’re all poorer for it.
If we then want to add all the wider costs then great. We should also add in the savings of not paying the state pension to those who die younger…
The article that prompted this post is also quite silly. *Most* things have a power law, where you spend most of your time dealing with a small percentage of possible problems.
– police spend most of their time dealing with a small percentage of the population
– if you classify asteroids in size buckets, there are 10x as many that mass 1/10 as much
– etc.
So doctors spending most of their time dealing with a small percentage of possible patients is not surprising. In that sense, it’s not news.
That one can now have multiple serious illnesses and still linger for years (possibly decades) is news. But that also results in more cost of course, both because you’re treated for longer and also because the new drugs and treatments (the ones that help) will still be paying off the cost of developing them.
M: «police spend most of their time dealing with a small percentage of the population»
They spend a large proportion of their time on social media but for the rest that percentage of the population that they do deal with, while still small, has shifted its demographic focus rather.
Tim W
Like David, I am not convinced. People with smoking- and obesity-related health conditions now live longer. A smoker friend of mine recently died aged 77 from lung cancer. For 10+ years he had been in and out of hospital with respiratory and heart problems and then had chemotherapy and radiotherapy. Similarly, my fat brother-in-law is diabetic, and so he is intensively monitored – diabetes accounts for c.10% of the NHS budget. So more research needed….
@Theophrastus
Thanks for a real world example. If your friend had been 30 years old he might died a lot quicker and cheaper as 2003 figures show.
It isn’t just about lung cancer, though. It’s the cataract ops, the replacement hips, the heart ops, the dementia care.
Lung cancer used to kill about 30% of the population and did it at roughly the time they were retiring. Which meant 30% less of all that other stuff to be done.
Western Bloke
“Lung cancer used to kill about 30% of the population and did it at roughly the time they were retiring. Which meant 30% less of all that other stuff to be done.”
But they take a lot longer and more expensively to die now.
I personally don’t know whether smokers save the country money or not in 2024 – and I don’t think anyone else does either.
@ David
We pre-pay our possible extra care putatively caused by our flavour of Enjoying Life.
If we all die tomorrow we will save the NHS and the government a fortune.
(I’m assuming that most readers are above median age, a good proportion are pensioners and some have assets likely to attract IHT.)
But speaking personally – no thanks.
And really… stop pointing the finger at smoking as the major cause for lung cancer.
It isn’t, by far, and scientifically only a causal relationship between smoking and 4 types of lung cancer ( out of 36…) has been proven.
And as we come to understand more about how these cancers develop, it’s becoming clear that for any type of cancer the most common cause is, in fact, water. Closely followed by oxygen saturation.
All the other possible carcinogens really play second fiddle..
This Danish study from 2021 finds that smoking increases lifetime healthcare costs (but for women there’s a net gain to the public purse). The paper reviews nine other European studies, two of which found higher costs for non-smokers, and three of which found little difference.
This 2023 study finds that reducing obesity would lower lifetime healthcare costs in most European countries, including the UK.
I suggest that Tim has been more receptive to studies which support his desired conclusion.
@ Grikath
Sorry, but that is rubbish.
It was found that *excessive* doses of di-hydrogen monoxide could cause cancers in rats. To jump from there to claiming that water is a significant cause of cancers in humans is preposterous. All cancer patients drink water (usually flavoured) as do all other humans – if H2O was the major cause of cancer we should all have it.
…stop pointing the finger at smoking as the major cause for lung cancer
Smoking is the major cause of lung cancer. This is not remotely controversial.
…only a causal relationship between smoking and 4 types of lung cancer ( out of 36…) has been proven.
I don’t know where those numbers come from, but so what? The stats are dominated by common cancers, and it remains the case that the relative risk of getting lung cancer is vastly higher in smokers than in non-smokers.
Personally I’d have doubts about any statistics in this area. The people collecting & collating them clearly have had an agenda for a very long time.
It’s also a quality of life matter. I’ve been smoking since I was in short trousers & am still managing 20 a day. Double that in times of all night partying. And that I can all night party with associated wenching at my very advanced years must say something for the lifestyle.. What have I cost in healthcare? Apart from some considerable embroidery work after a rather spectacular & entertaining car smash, virtually nothing.
These miserable bastards would have us living our lives wrapped in cotton wool padding eating nothing but dry rusks. And no doubt gulping down daily handfuls of depression medication. The health lobby are not your friends. Mostly they’re lying cvnts acting in their own interests.
@Some of my best friends
Thanks for that.
@bloke in spain
One would expect that any one individual could cost a lot more or less than the average.
Some of my best friends: “Smoking is the major cause of lung cancer. This is not remotely controversial.”
No it ain’t, by a long shot.
There is Consensus™ that it is so, just like worbal gloaming.
In fact, the whole “smoking kills you” onslaught has been the preliminary trial run for the Consensus™ you see in the Climate™ field. Up to and including the Major Research being done by people directly or indirectly involved in the anti-smoking lobby, with that same lobby funding most of the “research” being done there, well before people were actually forced to disclose such affiliations following some Embarassment in several fields of….Research™.
Nowadays they use Interns and PostGrads to do the “work” , while staying safely “removed” from the actual work as Head of Department/Faculty, but the same people are still behind it.
And the fun bit is, that even though we now have a much better insight in the molecular cause of cancer as actual science progresses, they still keep tooting the same horn.
Even though next to none of the substances claimed to cause cancer can physically cause the de-coupling of the specific inhibitors that turn on the Machine That Should Have Been Shut Down.
And, surprise…. “Ye cannae change the Laws of Physics..”
Cause all sorts of mayhem in the cellular machinery, yes. Be the root cause for cancer? No.
Which brings me to John77: “if H2O was the major cause of cancer we should all have it.”
Which we do, actually, continuously, freshly generated each day. Sorry to burst your bubble there, dear Moonchild.
Most of it gets scrubbed by our immune system as part of Regular Maintenance, especially since most of the breakdowns are “predictable” in a molecular sense and our bodies are set to recognise those from even before birth, but there’s always the odd one out..
And the main cause of that is H2O, and its lovely tendency to naturally dissociate to give free oxygen radicals, or its tendency to form hydrogen peroxide during many cellular processes.
And boy… do those do a number on proteins, including the ones stuck to your DNA blocking the “Let’s Grow and Multiply” routines…
Which is why the antioxidant vitamins are so important, and why our liver specifically has a very impressive concentration of catalase: There’s quite a bit of that in our body at all times.
It’s the price of being alive, but there’s a constant low-level wear-and-tear assault going on because we need water to do our Thing.
And yes, the rats *would* get cancer more often when overhydrated: You flush out all the things needed to balance this inevitable oxygen-radical onslaught and keep it in check.
In breeds that are extremely sensitive to developing cancers to begin with… ( to ensure sufficient effect to be Statistically Valid… )
Good thing humans would never….. oh …..wait…. The “Stay Hydrated” Health Crowd does the same.. With all the short- and long-term effects you can expect from consistenly overhydrating..
But hey…. It’s just water, right?
Incidentally…. This is why Vapes are linked to lung cancer….
Properly set up, Nicotine is going to do what Nicotine does…
Supercharging you vape and introducing x^n times the amount of hydrogen peroxide into your lungs because water and glycerin dissociating above compared to “natural levels”….
*Maybe* , just *maybe*, ………..
I prefer the azides and terpenes , which , incidentally, are the same as your Pine Scent car hanger….. 😛
owait…. your average male deodorant contains Essence of Rat an Ferret Piss….
And don’t start me on roses… they;re a Reason they last longer….
Oh, John 77 ( and assorted commentariat…) Oh , You. Sweet. MoonChilds…….
almost forgot…..
https://www.youtube.com/watch?v=njKq7m9h9tA&list=OLAK5uy_nnHjKw7PBXIh3yI9gnj1QC8i_dz_zNH64&index=28
Anyes, that particular except of an album is dedicated to you…
Even after all these decades, Tull pegged it…
It’s possible that Grikath isn’t joking.
It’s not very difficult to count lung cancer cases in smokers and never-smokers. The difference in incidence is huge. There’s no possibility of a mistake.
The smoking lobby has been much better funded than the anti-smokers. That hasn’t changed the result.
“It’s not very difficult to count lung cancer cases in smokers and never-smokers. The difference in incidence is huge. There’s no possibility of a mistake.”
Spud, is that you?
When you count “smokers” as “has ever once been near tobacco” and declare that same tobacco as the sole possible factor…. yeeesss… you will get a result like that. Quelle surprise. Much shockingly.
Might work in Sociology. Not so much in actual science.
See also : Death by CoVid v/s Death with CoVid.
Same principle, and I trust we’re all still aware of what results the lack of distinction between the two had, and to a point still has, on our lives..
Just in case this isn’t a wind-up:
In a prospective cohort study, you identify cigarette smokers and never-smokers by asking them. Then you wait for a few years to see who gets lung cancer. This sort of study has been done a lot. Smokers get lung cancer more than ten times as often as never-smokers. Heavy smokers get lung cancer more than light smokers. Ex-smokers get lung cancer less than current smokers but more than never-smokers.
See for example the British Doctors Study. Have a look at the first line of table 1 here. How do you explain that?
Smoking obviously increases the risk of cancer.
But so what? It’s no one else’s business if X smokes and gets cancer from it.