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The Guardian - UK
The Guardian - UK
Politics
Denis Campbell Health policy editor

Cost of England’s four biggest killer diseases could hit £86bn by 2050

A health worker walks between curtains on an NHS hospital ward
The four diseases currently account for 59% of all deaths in England. Photograph: PA Images/Alamy

The cost of England’s four biggest killer diseases could rise to £86bn a year by 2050, prompting calls for a crackdown on alcohol, junk food and smoking.

The ageing population means the annual cost of cancer, heart disease, dementia and stroke combined will go from the £51.9bn recorded in 2018 to £85.6bn in 2050 – a rise of 61%.

The four conditions together account for 59% of all deaths and result in 5.1m years of life lost.

Experts say the findings, published in the Lancet Healthy Longevity journal, show that the new government must take determined action to improve the population’s health in order to stop the costs of ill-health becoming overwhelming.

Martin McKee, a professor of European public health at the London School of Hygiene & Tropical Medicine, said: “These projected costs should terrify the Treasury.”

As the number of over-65s increases in the coming years, the cost of dementia alone will double to £23.5bn, and the financial impact of strokes would rise by 85% to £16bn, the research found.

Similarly, the cost of heart disease would increase by 54% to £19.6bn and that of cancer – which is the costliest of the four conditions – by 40% to £26.5bn.

The estimates cover their overall economic costs, through lost productivity and relatives providing informal care, rather than just the money the NHS and social care systems spend on them.

In its general election manifesto, Labour pledged to “deliver a renewed drive to tackle the biggest killers; cutting the lives lost to cancer, cardiovascular disease and suicide, while ensuring people live well for longer. Much avoidable ill-health can be prevented.”

Wes Streeting, the health secretary, has made turning the NHS into more of a prevention service one of his priorities.

The research was led by Dr Ramon Luengo-Fernandez, from the Nuffield department of population health at the University of Oxford, and was funded by Alzheimer’s Research UK. He and colleagues reached their conclusions after examining projections for population-level ageing up to 2050 and detailed NHS records showing how often almost 4.2 million people access healthcare.

He said ministers should try to ensure people stayed healthier for longer and developed life-shortening conditions much closer to the end of their lives, rather than, as many do at present, decades earlier.

“We can never prevent all cases [of these diseases] – we must all have to die of something eventually,” Luengo-Fernandez said. “What, in my opinion, we should concentrate on is preventing disease at younger ages, so that when disease occurs, say dementia or stroke, it occurs at the end of someone’s lifespan, for example in their 90s, rather than at age 60 or 70.

“Better diet, physical activity [and] no smoking would go a long way in achieving this. If we managed to reduce smoking rates from over 50% to about 13% nowadays, I see no reason why we cannot achieve these successes in other areas.”

A big rise in the amount of physical activity people undertook could improve health, reduce the burden of illness and limit the associated costs of that, he said. Devoting more resources to primary care, including GP services, would boost the earlier detection of cancer and reduce the cost of treatment.

Cancer Research UK has estimated that the number of new cancer diagnoses a year is likely to rise from 420,000 now to 506,000 by 2040. The number of people diagnosed with any form of dementia is also due to increase significantly.

The biggest rise by 2050 will be in the social care costs of looking after people with the four conditions. It is due to increase by 110% to £13.5bn a year for dementia, by 109% to £7.1bn for stroke, by 91% to £4.4bn for heart disease and by 88% to £2.9bn for cancer.

McKee called for a crackdown on the industries that produce cigarettes, alcohol and unhealthy foods, and a renewed assault on poverty. “For over a decade the UK has been competing with the United States for last place among industrialised nations in the health stakes. This paper shows why this cannot continue,” he said.

“If the country is to escape from a doom loop of low productivity, driven to a considerable extent by ill health, and rising demand on the NHS … it must prioritise not just the causes of disease, but the causes of those causes, including high levels of poverty and the actions of industries, like alcohol, tobacco, and junk food, that profit from this misery.”

A Department of Health and Social Care spokesperson said: “We recognise that the health of the nation and our economy are inextricably linked. That’s why we’re taking bold action to fix our NHS and tackle the causes of sickness.

“Prevention is better than cure, which is why government will shift the focus of healthcare from simply treating sickness to preventing it in the first place.

“Whether it be phasing out tobacco sales, implementing restrictions on advertising junk food, or doubling the number of scanners to get the NHS catching cancer on time again, we are committed to ensuring that people live well for longer and that we unleash the potential of our economy.”

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