I’ll be at the Sandhurst Family Fitness ‘Funday’ in the Memorial Park tomorrow afternoon at 1.45pm. The Funday has been successfully running for a few years. It is organised and run by a commitee of local representatives from the Sandhurst GP practices, Sandhurst Town Council and local health and fitness businesses. Come along and get fit in the sun!

Today, the Bracknell constituency witnessed its first political hustings of the 2010 General Election. The mental health charity Rethink invited the Parliamentary candidates to Coopers Hill this lunchtime to take questions from local people. The future provision of local mental health services was obviously of great interest to those who had arranged the meeting, however, other important issues, such as the importance of honour and probity in politics, featured prominently. It was a good opportunity for all candidates present to explain their respective party’s positions on a number of key issues. I, for one, will take any opportunity in the forthcoming campaign to engage ‘face-to-face’ with the electorate of Bracknell constituency.

Today, I had the opportunity to visit Broadmoor High-Security Hospital in Crowthorne (aerial photograph above). As part of a Conservative Party delegation that was led by Shadow Secretary for Justice, Dominic Grieve MP, I was able to get a very good insight into the valuable work undertaken by the hospital. Unfortunately, the national perception of the psychiatric establishment is far from the reality. People are sent to Broadmoor to receive healthcare not punishment. Often a patient has already served a sentence in a ‘normal’ prison and then has been passed on to Broadmoor for treatment. Hopefully in the future, the hospital’s good work in the treatment of mentally-unwell individuals who have committed horrific crimes will become more appreciated.

Every part of England has different healthcare needs. The demographics of each region can vary significantly, both in ethnicity and age. Any doctor will tell you that different social groups need different types of healthcare provision. Experience tells us that there is no ‘one size fits all’ system that will work for a country as diverse as England. Being a GP locum who works in both affluent and socially-deprived areas, I know too well that local clinical priorities need to reflect these differences. And this is the rub for the old Labour party. For those Socialists who aspire to deliver an ideologically-driven, uniform healthcare service are missing a key point: that it does not allow for human behaviour. With increasing local control over healthcare services becoming the political mantra, there will come regional differences in the provision of care. Local people will want local health services to suit them, not a set of centrally-imposed, national guidelines. In semi-rural communities, such as those served by the new Hexham hospital (pictured above), an older population will want a greater emphasis placed upon rehabilitation and elderly medicine. In contrast, an urban centre such as Slough, where I often work, would demand a proportionately greater spend on drug and alcohol addiction and those conditions more associated with the relatively large ethnic minority populations. So, yes there will be differences in healthcare provision throughout England. Detractors will call it a ‘postcode lottery’. Supporters, such as myself, will argue that until local people take ownership of their own individual health and play an active role in determining the health services offered locally, the health of the nation as a whole will not improve. For I believe that taking responsibility on every level is the key to good health. I already accept that if I am selected as a Parliamentary candidate, one of my many responsibilities would be to campaign hard to deliver and protect those healthcare services most needed by the community I represented. My impression is that it will not be long before we are all referring to our LHS (Local Health Service) not the NHS.

There is an irony in a fat government advocating more government to help fat people be less fat. In the same way that I believe that less government is often good government, I also believe that more personal responsibility and less state responsibility will lead to less fat people. There are undeniably many components to why someone becomes fat, however, one of them is personal choice. I have philosophical problems with the state telling an individual that he has made a ‘poor’ choice in becoming fat. If that individual has made an informed choice to eat more than he needs, and let us all admit that most people who are obese have done just that, then that person should be allowed to make that choice without fear of castigation by the state. He should, however, in making that choice, be made to pay for his decision. For being obese has profound cost implications for the state. Not only are there increased costs in health, there also long-term expenditure implications for the social security budget. Nor should we forget the implications for the individual and any of his dependents.

If I was in government I would look at the increasing obesity epidemic and ask myself what could the state do to increase personal responsibility. Levying a fat tax on food has been suggested, maybe even an additional supplementary tax based upon BMI (body mass index) could be pursued. These policies might go some way to reducing a future of obesity for our children. For the present, however, a decision must be made to invest in treatments that work.

The aetiology of obesity can often be complex. The provision of medication to aid weight loss (and in extreme cases surgery) should always go hand-in-hand with a proven commitment on behalf of the individual seeking treatment. Furthermore, many psychological factors are known to contribute to an individual’s excessive weight problem, so the involvement of properly-funded psychiatric services should be part of any programme to reduce obesity. The ultimate solution to the problem rests, however, with each obese individual. No government of whatever hue can change that reality. It may be tough politics, but dealing with obesity is a tough problem that will involve tough and unpopular decisions.