A conservative-led local council in England is mulling plans to cut welfare benefits if recipients are obese or deemed to be unhealthy. The council says it is a measured response to a pressing health care issue, while critics charge is it just another attack on welfare recipients.
Westminster Council, along with a local government-led think tank, says that it wants to take data that it collects through local peoples’ everyday activities, such as going to council-owned gym facilities and through routine medical evaluations, to determine whether those who are obese or live unhealthy lifestyles should have their welfare money threatened in order to give extra incentive and lift the burden of NHS costs from the wider public.
The report in question, called A Dose of Localism: the Role of Councils in Public Health, comes as England prepares to transfer, as of April, how it monitors responsibility for community and public health from the NHS to local authorities.
The proposals suggest that for general practitioners and local authorities to meet the financial challenges created by their new public health role, they will have to tackle growing obesity rates that continue to inch ever upward even while national budget cuts squeeze local authorities of their funds.
The suggestion to link benefit payments to claimants’ approach to their lifestyles has its origins in GPs having been given powers to prescribe health programs that involve exercise.
As such, the report suggests:
Relocalisation of council tax benefit and housing benefit combined with new technologies provide and opportunity for councils to embed financial incentives for behaviours that promote public health. The increasing use of smart cards for access to leisure facilities, for instance, provides councils with a significant amount of data on usage patterns. Where an exercise package is prescribed to a resident, housing and council tax benefit payments could be varied to reward or incentivise residents.
In effect, if claimants do not follow the advice of their doctors and continue to pursue an unhealthy lifestyle, they could see their state-funded welfare assistance cut.
A spokesperson for Westminster Council, stressing that this is just one among several proposals, termed this a “carrot and stick” approach.
A Measured Response to Obesity’s Serious Health Costs?
According to the latest edition of the Health Survey for England, it is estimated that 24% of men and 26% of women are obese, while 65% of men and 58% of women are either overweight or obese. Obesity is a known risk factor for a number of health problems including heart disease and increasing the risk of type-1 diabetes.
This comes as Diabetes UK publishes findings from its compiling of an international league table that suggests type-1 diabetes rates are unusually and seriously high among Britain’s children. The results show that 24.5 in every 100,000 UK children (those under 14) are diagnosed with the disease each year, compared with just 12.2 in every 100,000 in France. This puts the UK fifth in the highest figures table, only behind Finland, Sweden, Saudi Arabia and Norway.
To be clear, obesity rates and lifestyle choices are not thought to specifically account for this high rate, however rising obesity figures have been a cause of great concern for a number of years now, not just in terms of health but also in the monetary costs of providing medical assistance to the various and often aggressive problems obesity and being seriously overweight can cause.
The Department of Health estimates that there is a significant burden on the NHS with direct costs because of obesity set at around £5.1 billion per year.
Seen through this lens it may be an attractive idea for local governments to use their authority to ensure that benefit claimants are taking steps to correct lifestyle choices that could lead to obesity and therein save the nation a considerable sum of money.
However, there are other ways to look at this so-called “carrot and stick” approach that very much seem to put the emphasis on the stick rather than the carrot.
Fat Shaming and Shirking the Real Issue?
The logic of the proposal is that of the incentive: if benefit claimants want to receive their full payout and have been prescribed exercise programs to combat lifestyle related health issues they must adhere to that program.
However, critics warn this misses several points and is nothing but an excuse for a Conservative local government, who as a national party have always been critical of the welfare state, to claw back money to balance their budgets while demonizing the under-privileged.
British Medical Association GP committee chairman Dr Buckman, a GP in north London, called the proposals “some of the silliest things I’ve heard in a long time”.
“When I was first told about this I thought it was a joke,” he said.
He added: “The best way [councils] can intervene is to stop restaurants and fast-food chains providing the kind of food that make people put on weight, and interfere with the way foods are sold in shops.”
Obesity support organisation Big Matters spokeswoman Susannah Gilbert said: “It would be fairer to use the money to support people rather than to penalise people.
“Any plans for health should be holistic,” she added. “Some people have emotional issues to do with food.”
Indeed, the proposal seems at the very least to run the risk of accusations of nanny state-like cajoling that fails to tackle key problems like the (perceived) high price of healthy foods like vegetables and fruits, and the lack of preventative measures to stop the underprivileged from entering the spiral that leads them to poor health and potential obesity. Indeed, pulling out the safety net of their welfare benefits risks being seen as a callous act that fails to take into account that many welfare recipients, due to health reasons that may have in fact caused their obesity, cannot work and therefore rely on that money to live.
That said, the proposals have not been uniformly panned, with several groups suggesting that it is right that those who can help themselves should be encouraged to do so, but they have wanted that a blanket approach risks unduly burdening those with genuine health complaints.
Image credit: Thinkstock.
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