The diabetes ‘cure’ that Britain can’t afford

For the human pin cushions among us – namely, those who keep type 1 diabetes in check with multiple injections a day (nine for me yesterday) – reports that a revolutionary ‘artificial’ pancreas has been developed and approved for NHS rollout ought to have been cause for celebration. But I won’t put the champagne on ice just yet.

The hybrid closed-loop system – which allow a continuous glucose monitor to ‘talk’ to an insulin-dispensing patch pump – has been described as the biggest treatment breakthrough since the discovery of insulin itself. Over the next five years, hundreds of thousands of people living with type 1 diabetes could be offered this next-generation technology to help them manage their condition.

Unfortunately, the NHS doesn’t have enough trained staff to administer the rollout.

“Each [system] takes an hour and a half to set up,” explained a clinician of my acquaintance. Their clinic, which already runs on hot air, is down two doctors and three nurses, with no visibilty on when that might change. “How do they expect us to do this?”

The British Medical Association told me that when Nice recommends new treatments for the NHS, “then these need to be appropriately funded by Government, whether that is in staff time or for equipment/hardware”.

The hardware isn’t the problem here. Health union Unison pointed me to the official figures showing that there are currently some 112,000 job vacancies within the NHS in England alone – nine per cent of the workforce as a whole.

Given the NHS staffing crisis, it looks like that groundbreaking, lifesaving tech might have to wait. This isn’t just a tragedy for the diabetics who can’t access the kit that Nice says they should get. It’s an economic problem for the NHS, too.

A new report published in the journal Diabetic Medicine has projected that, over the next 25 years, the NHS’s annual spending on all types of diabetes in the UK will increase from £9.8bn to £16.9bn.

Authored by the York Health Economic Consortium and developed in partnership between charities Diabetes UK and the JDRF, along with Sanofi Diabetes, it highlights how a very large percentage (79 per cent) of that spending goes on treating complications. Avoidable complications, in many cases.

I’ve been banging on about the staffing issues in NHS for as long as I’ve been writing this column. And yet whenever the issue is raised, the favoured reaction of politicians seems to be to stick their fingers in the ears and shout “la, la, la” very loudly.

Failing that, they’ll bang on about all the wonderful work that has been done to recruit people and how this is now at record levels – they do love that word ”record”… – without addressing the fact that the number of vacancies still remains stubbornly high.

This is before we get to the issue of the Government’s latest immigration crackdown, which includes raising the salary threshold for skilled workers to £38,700 before a work visa can be issued, and scrapping the “shortage occupation” list.

While it appears the NHS will be exempt – and thank goodness for that – it will still be affected. Here’s how.

There are now, per Unison, more than 150,000 vacancies in social care. It does appear that people will be able to come and work in this sector. But they will be banned from bringing relatives with them – obviously a significant deterrent to coming in the first place. If you can’t bring your kids, why on earth are you going to come to do a difficult, and poorly paid, job in Britain? This is hardly the only country with a shortage of workers in the sector.

Staff shortages mean that appointments get delayed, operations get cancelled, and the waiting lists Rishi Sunak keeps promising to cut inevitably rise. Meanwhile, state-of-the-art new tech, which could both improve the quality of life for type 1 diabetics and save billions of pounds on treating complications, goes unsupplied. Complications then arise, which divert still more precious resources.

It’s a vicious circle – and proof that this government, desperate to be seen to be making cost savings, having spent billions on unusable or overpriced protective equipment during the pandemic, has no idea what cost-effective looks like.