NHS funding and transport – prevention is better than cure

Yesterday’s open letter to the Independent highlighted the funding crisis facing the NHS. As the population both grows and ages, we are going to need more and more health care and the nature of the NHS must change from treatment to prevention. It remains structured for a time when fatalities were caused by infectious rather than chronic conditions and the public memory was filled with sudden deaths from German bombs. Our public health debate focusses on obesity, e-cigarettes, alcohol abuse and the rising cost of social care. However it fails to grasp one of the biggest pressures on the NHS – our transport system.

It’s obvious that if you are sitting in a bus, car or train for 1 to 2 hours a day, you’re not exercising. Walking and cycling has dropped since 1995 meaning that we are not using valuable commuting time to lose weight and improve fitness. Small changes to this trend would bring huge benefits to the NHS. For example, if just 1.7% of car journeys were made by cycling or walking, this would save the NHS over £2.5bn a year, just from increased exercise. Imagine how much more could be saved if policy had the ambition for a greater number of exercising commuters? Distance isn’t the barrier – for most urban destinations cycling is more accessible than public transport. Cycling is even a more convenient way to get to urban primary schools than the car. Yet how many of you drive your kids to school?

The benefits to the NHS budget of modal shift don’t stop at exercising. Road transport is the biggest cause of air pollution, of which the worst emissions are nitrogen dioxide and particulate matter. The latter is black carbon that enters your lung cells when inhaled, sitting patiently before triggering cancer. Or they pass into your circulatory system, scratching the inner lining of the walls of blood vessels, causing scar tissue to build up. This restricts blood flow rather like cholesterol, leading healthy people to have heart attacks and strokes later in life.

Exposure to particulate matter is the second biggest threat to public health. It kills more people annually than obesity and alcohol abuse combined, costing the NHS around £16bn a year. Public Health England is virtually silent on his matter.

Furthermore, over 1,700 people die every year on our roads in traffic accidents, and over 21,000 are seriously injured. The economic costs of accidents are over £33bn each year including trauma care but not including long term care for the maimed. Reducing the number of drivers on the roads would lower this burden on the NHS.

Debate is silent on all this. Instead Labour activists focus on ownership of transport companies. The government’s key transport policy is to increase spending on motorways and A roads to £28bn which will only increase pressure on the NHS. No party has outlined demand management policies to encourage modal shift to active transport. The public’s top transport concerns are fuel duty and potholes; they don’t yet link transport and health.

Prevention is better than cure. Yet for as long as both the public and politicians don’t pay attention to the costs that transport policy places on public health, we can expect the NHS bill to continue to be high. At your next party meeting, could LabourList readers please raise this issue with their local MP/PPC? It deserves much a much higher political priority than railway nationalisation.

Mark Rowney is a member of Battersea CLP and a transport policy expert.