Good health for all costs; are we ready to start paying?

Wegovy is not the only product available in this category but it is the one making the headlines this week. Taken in the form of a jab that you administer yourself, it works by telling the stomach it is full and it is time to stop eating.

On Monday, Wegovy became available on the NHS in England. Scotland will have to wait another month before the Scottish Medicines Consortium announces whether we will follow suit.

The stock market has had its say, sending shares in the drug’s maker, Novo Nordisk, soaring.

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In England, the rollout has been limited to 50,000 people taking part in an NHS pilot scheme. Wegovy is also available privately and online. Again, supply is restricted. On Boots Online Doctor, customers are told that only those already on a similar drug can buy Wegovy. It is not cheap, with a course of the lowest dose starting at £199 a month.

But set that against what it costs the NHS to treat obesity-related conditions such as high blood pressure and cancer (£6.5 billion a year in England alone), and you can see why the Prime Minister, Rishi Sunak, and other politicians have hailed this new batch of weight loss drugs as a potential “game-changer”.

Think of all that money saved, the ill health and sheer misery avoided. It is the stuff of science fiction - take a drug and watch the pounds fall off. Despite what Peter Kay said, the future wasn’t garlic bread; it was a drug to help us say “no thanks” to another slice of the stuff.

Now, of course, anyone taking Wegovy or other weight-loss drugs is told that medication is only one part of a programme that must also include exercise and long-term changes to diet. The drugs are not a quick fix.

But who are we kidding here? That is how they will be seen by some. It is also likely, given the demands on the NHS budget, that most people will have to pay for the medication themselves.

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Quite right, you might say, but it is another example of the widening health gap between the well-off and the not-so-well-off. Good health costs. It is not just about having enough money to buy five fruit and veg a day. It is about living in a well-built home, eating good, nutritious food, having access to green spaces. As you grow older it is having the funds to go private with that hip or knee op. Money improves life and extends it. Look at Glasgow, where living in Bearsden can buy you 10 more years than living in Shettleston.

File the paragraph above under B for bleeding obvious. We knew all this even before the pandemic came along and exposed further the gross inequalities in health. But it is still worth reminding ourselves of the reality. Good food, and good health, is a political issue and we should never forget that. Here we stand in 2024, with one part of society rushing to get its hands on weight loss drugs while others queue at food banks. No child should be going to bed hungry, no parent either, but that is what is happening.

I was moved this week by something I read in The Herald’s Secret Teacher newsletter. It was written in praise of Magic Breakfast, the charity that delivers free breakfasts to children who need them.

In this case, the teachers went into school a little earlier than usual to set up the cereals, juice and other good stuff. The dinner ladies, likewise, arrived early doors to warm the bagels and sort the toast out.

The result, said Secret Teacher, was nothing short of magical. “With their bellies filled, kids labelled ‘disruptive’, prone to bad behaviour, became more settled, able to listen and learn.”

Other effects were noticed. “Pupils were feeding a hunger for something more than just food.” There was talking, laughter, a sense of community. Mobile phones stayed in pockets and bags.

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Our teacher reckoned there was a lot to be said for providing free breakfasts to all pupils in Scottish schools. I would agree. Usually this space is given over to taking some politician or other to task over what they are getting wrong. There is a lot to complain about, as I’m sure you have noticed.

But one thing we are getting right in Scotland is early years provision. The First Minister, Humza Yousaf, yesterday added to the work already done with a promise of free childcare for more ages.

In what was meant to be the grand finale to his Programme for Government, he also announced the expansion of free school meals “in the year ahead”. There has been some confusion on this, given the Programme itself said it would take till 2026 for it to happen. We await clarification.

Giving a child the best possible start in life makes all the difference. No doubt about it. But healthy habits need to be maintained, starting with cooking and eating good, affordable food. Yet how many pupils leaving school know how to make even the most basic dishes?

I would like to think the generations of Scots to come will be healthier, and happier, than their predecessors. That they won’t need such things as weight loss drugs. One can but hope.

If nothing else they can learn from the example of Boris Johnson, the man so keen to tell us of his adventures in weight loss. Under the medication he was on - which was not Wegovy - the pounds started to disappear. Four or five a week.

“Effortlessly, I pushed aside the puddings and the second helpings. Wasn’t it amazing, I said to myself, how little food you really need.”

But then things began to go wrong; he was feeling sick and could not face any more injections. He blamed flying around the world and changing time zones. Whatever the cause, he has gone back to “exercise and willpower” to lose weight. We know from photographs that he likes an early morning run. That’s the exercise sorted. As for the other stuff, good luck with that.