At the Melting Pot on 20 February my head found itself drifting to the complexity of general practice where I have worked for 25 years.
With individual patients, trying to deal with obesity is often unfruitful. It’s easy to talk about lifestyle, especially when GPs, among others, have been paid to measure and advise. But as a practitioner, all I felt I could do was impart some fairly obvious advice, offer drugs (now mostly withdrawn or ineffective), or refer for drastic surgery. Unsurprisingly, I’d be left wondering if any of this was helpful.
Surely, if there was a simple answer, there wouldn’t be such a thriving diet industry? When an obese person tips into diabetes, the health consequences are significant. However, diabetes, at least in the early years, is reversible if a healthy weight can be regained. So, given the limited tools at my disposal, was there anything I could do to make a difference?
How do we make decisions in health care? How should we?
In making decisions about health care allocation, and in particular whether a new drug should be made available on the NHS, current procedures examine the cost-effectiveness of any new drug or procedure, considering the health gain it provides for the cost.