The Government is choosing welfare gimmicks above systemic improvement

Pulse editor Jaimie Kaffash on the Government’s new initiatives linking health and welfare

There have been two really troubling stories over the past week involving the Government’s welfare gimmicks. 

First up, health secretary Wes Streeting this week announced a new collaboration with Lilly around the use of tirzepatide, the weight loss drug.

There is currently controversy around these weight loss drugs. There have been reports that diabetes patients have been unable to get medication they need due to demand that has gone through the roof since they have been repurposed as weight loss drugs.

There are also concerns around the long-term effectiveness of the drugs. I am not an expert on the clinical aspects, but I do think the real effectiveness of weight loss drugs can only be measured after the patient has come off them, and there is no evidence yet that tirzepatide is successful by this measure. It could be argued – with good reason – that Mr Streeting’s deal with Lilly is designed to answer this question.

But much of this depends on the allied services. Today the Obesity Health Alliance has called on the Government to address problems in obesity services across the country, including patchy provision, workforce issues and reduction in local authority funding. These are essential to maximise the long-term effects of weight loss drugs. Without such improvement, the promotion of tirzepatide may actually have the effect of overwhelming services more.

I am also concerned about the effect on GP services. NHS England estimate around 2.8 million patients would be eligible for tirzepatide as draft NICE recommendations currently stand. If 70% of those people were started on the treatment, around 18% of GP appointments would be taken up just initiating and managing the medicine, NHSE has predicted.

But there is another, more intangible, reason for my concern – Mr Streeting’s linking of obesity and unemployment. The trials of these drugs will look into the effect on unemployment, among other things. 

To hammer home the link between obesity and unemployment, Mr Streeting wrote in the Telegraph: ‘The long-term benefits of these drugs could be monumental in our approach to tackling obesity. For many people, these jabs will be life-changing, help them get back to work and ease the demands on our NHS.’

This might be a way of marketing this partnership to the public (and writing about it in the Telegraph would support this theory). But it perpetuates a stigma that unemployed people are lazy and obese, and the only thing stopping them from getting into work is their size.

I find it quite worrying that Mr Streeting is making this link. Because I fear that this is yet another example of this Government’s thinking that health problems, and associated unemployment, are a matter for individuals. 

Because also this week, work and pensions secretary Liz Kendall has proposed ‘job coaches’ attend mental health wards in a bid to cut down the welfare bill. Now, this seems to me a ridiculous idea. The lack of mental health services around the country is well known. Those who end up being admitted tend to have problems well beyond problems with top ten interview tips.

If only these problems were so simple – that injections for obese patients and some high performance podcasts for mental health patients will reduce the welfare bill. 

Neither of these interventions will have the effect the Government claims. Of course, some individuals will benefit. But getting people back to work, and improving their health, is hard work.

For example, in terms of looking at the link between obesity and unemployment, they would have looked at factors such as the cost of cheap processed food compared with fresh food, the stress of unemployment, employers’ subconscious bias against overweight candidates, and actually whether it is true that more unemployed people are overweight. And, of course, above all else the lack of jobs.

It would also involve improving obesity services, restoring public health budgets and increasing the NHS workforce.

It’s the same for mental health patients. A true programme for getting mental health patients back to work would involve a root and branch review of services across the country, alleviating the external reasons for the increase in mental illness.

This Government remains in its infancy, but there is nothing to suggest that they are anything more than easy gimmicks. Health, and welfare, is far more complex than this.

Jaimie Kaffash is editor of Pulse. Follow him on X @jkaffash or email him at [email protected]