To whom it may concern
If you are reading this I am presuming you are sitting comfortably somewhere inside 10 Downing Street. Congratulations on your recent victory in the 2019 General Election. I extend those congratulations to whoever has won the election, however, I am certainly not in a position to ‘celebrate’ the victory of any one party, given I represent an organisation which adopts a position of strict political neutrality.
I am sure you, like the rest of the country, are glad it’s all over and are looking forward to spending Christmas with friends and family.
I write to you as chairman of the British Society of Lifestyle Medicine and on behalf of its Trustees. The BSLM is a registered charity, set up in 2016, and draws our membership primarily from GPs, clinicians and allied health professionals.
We were founded to promote the role of Lifestyle Medicine in improving people’s health and wellbeing. Our focus is on the lifestyle-related, longterm conditions which are now the leading causes of illness and mortality in western societies.
We believe our healthcare system needs a fundamental rethink and that policymakers need to shift their attention to these conditions and how best to treat, manage and even reverse them. That said, traditional approaches to medicine are still vitally important. Doctors will always need to prescribe medicines and refer people on for treatment and even for surgery in some instances.
But for many conditions such as diabetes, obesity, heart disease and mental health issues we need to address the fundamental root causes of these conditions. And unlike communicable, infectious diseases, the causes of these conditions are human in origin. They lie in the lifestyle choices we make as individuals, as well as ‘upstream’ societal factors such as the environment, poverty, inequality, social isolation and lack of hope.
While the NHS was an important issue during the General Election campaign, we were dismayed to hear little discussion about these critical, underlying causes of chronic conditions which are becoming more and more widespread. Why does it matter? Because these conditions are causing untold suffering to millions of people and are placing huge burdens on our societies, economies and healthcare systems. And much of this could be avoided.
A new approach
We believe a new approach based on the principles of Lifestyle Medicine offers us the best hope of alleviating some of this suffering and lifting some of the burden. This new approach is possible and within our reach. And crucially it is one founded on solid evidence and scientific thinking.
In the past, improvements in hygiene, sanitation and public health, as well as progress in the development of antibiotics, helped humanity to gain the upper hand in the battle against communicable disease. Now, as non-communicable, lifestyle-related disease becomes more prevalent, we will need new tools at our disposal.
What will those tools be? Firstly, they will involve a rethinking of the patient clinician relationship. In the consulting room, a new emphasis needs to be placed on the individual in front of us, what matters to them and how together we can address the lifestyle factors which are contributing to their condition: the physical, emotional, environmental and social determinants.
Individual lifestyle factors which are emphasised in the practice of Lifestyle Medicine include physical activity, sleep, stress reduction and mental wellbeing, diet and nutrition, and the reduction or cessation of harmful substance use, such as tobacco, drugs and alcohol.
It’s important to note that Lifestyle Medicine does not seek to replace current healthcare systems or medical models. Instead, our objective is to position Lifestyle Medicine as a mainstream part of any modern and forward-thinking healthcare system.
For this to happen, the principles and practices of Lifestyle Medicine must become deeply embedded in medical training and continued professional development.
What's the solution?
So, as you begin your term of office, we know that the NHS and the health of our citizens will be among the most pressing issues you face. During the General Election campaign, the issue of resources was front and centre in many of the discussions around the health service. In some respects, this meant a wider and deeper discussion around health and wellbeing was avoided. An opportunity was missed to think creatively and differently about healthcare, and to test out new ideas. There was little if any talk about the underlying causes of diseases and conditions which are afflicting growing numbers of citizens.
What then is the solution? Where should your focus be and that of our health departments if we are to counter the rise in lifestyle related disease?
Firstly, we need realistic but system-wide approaches to countering the rise in lifestyle related disease. Lifestyle Medicine needs to be part of that; and it needs to be embedded in clinical practice, with clinicians able to draw on the science and the art of Lifestyle Medicine as well as its formal tools and procedures. A great example of the latter is the group consultations programme which has been doing some terrific work in recent years - by offering patients a new way to access treatment and support from healthcare professionals within a supportive group setting involving other patients with the same condition. A great way to reduce the pressure of demand on a limited supply.
Secondly, public policy must address the link between modern environment and lifestyle. Health behaviour cannot be divorced from its socio-economic context, and the link between poverty and non-communicable disease cannot be ignored. There are modifiable risk factors which require the urgent attention of policy makers. These go beyond general health to cover factors including climate change, clean air and water, access to green spaces, sports, leisure and recreation opportunities, transport, financial wellbeing, education, food and agriculture. This is not an exhaustive list.
The British Society of Lifestyle Medicine believes that government as well as individuals and communities are part of this solution. So as you assume your responsibilities today, please take a moment to consider what you can do to improve the health and wellbeing of the British people. I hope this letter has given you food for thought and made you aware of the scale of the challenge we face. It is my belief that solutions are within our grasp and that opportunities are there for the taking. It’s up to us if we genuinely want to make a difference.
We would be delighted for an opportunity to discuss these issues further with you - or any other member of your government whose role involves addressing the health and wellbeing challenges we face as a society.
Rob Lawson BSLM Chairman & BSLM Trustees
British Society of Lifestyle Medicine
BSc MBChB MRCGP FRCGP Dip BSLM/IBLM
BSLM Trustee & Founder
Having qualified in Medicine in 1975, Rob has gained extensive experience as a GP in Scotland. His principal interests have been primary and secondary prevention of disease and the specialty of Lifestyle Medicine. As well as leading his NHS team to the highest awards for quality (2003-2013) he founded a charity in 1991 providing weekly activity and support in venues around East Lothian for sufferers of long term conditions including heart disease, Type 2 diabetes, stroke, lung disease and frailty. He has retired from NHS practice to concentrate on the applications of Lifestyle Medicine to healthcare. In 2016 he co-founded BSLM, a registered charity, to promote the principles of Lifestyle Medicine to healthcare professionals and the public. On a personal note he is a cancer ‘survivor’. He can be contacted at firstname.lastname@example.org.