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                 2012 Olympic Games –
       an opportunity for health improvement or a cost to the NHS?
              Derek Miller explains the likely impact of the 2012 Olympic Games on the NHS and
               examines whether the Games can act as a driver to improve the nation’s health.
   You cannot escape the headlines and              prevention and childhood obesity, but action      measurable. In achieving this goal London will
shocking facts on obesity. Childhood obesity        must be taken. So the plan is to use the          set the standard for future events.
is news and like the waistbands of the UK’s         Olympics as a focus and driver to improve the
children, it is set to get even bigger.             nation’s health. There are opportunities and      risk
     Statistics from the most recent large-scale    problems with this approach.                      However, the Olympics calls for significant
survey in the UK reveal that 25% of boys and              London’s hosting of the 2012 Olympic        investment. Originally forecasted to cost £2.4bn,
33% of girls aged between two and 19 years          and Paralympic Games presents a unique            the current budget is reported to be nearly
are overweight or obese – and there’s little sign   opportunity to deliver a lasting health legacy.   four times higher at £9.5bn. One of the main
the incidence is slowing. The cost of bariatric     However, experience from other host cities        factors is the change in the economic climate.
surgery is about £10,000, and as reported           demonstrates that health benefits cannot          When the Olympics were announced back in
recently few PCTs approve the procedure as per      be assumed. In its latest annual report, the      July 2005 the NHS was experiencing growth of
NICE guidelines due to funding constraints.         Commission for Sustainable London 2012            9.1% and general economic growth was 2.5%.
     Obesity currently costs the country around     (CSL) states that: ‘Whilst the London 2012             Since then we have seen the global credit
£2bn annually and shortens lives by nine years,     programme contains some commendable               crunch and recession. We may now see the
due to the associated health problems. Some         initiatives we do not believe that the overall    “W” shaped recession, with the private sector
health experts even believe we’ll soon see          objective of long term health has been            bottoming out, and then the slow down in
parents outliving their children.                   considered as a strategic issue’.                 public sector spending from 2010, and the
     The question on investment and returns for           No Olympic event in the past has achieved   NHS facing reductions in funding from 2011.
health is not easy, especially when evaluating      any lasting health improvement legacy that was

12                                                                                                            health service review November 2009
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sponsorship                                          volunteer for the Olympic Games then LOCOG                          • health promotion
The London Organising Committee of the               will be advertising in the near future. The                         The Go London strategy An Active & Healthy
Olympic and Paralympic Games (LOCOG)                 Department of Health requested information                          London for 2012 and Beyond sets ambitious
is responsible for preparing and staging the         on the potential costs to the NHS for the end                       targets:
2012 Games. LOCOG is a company limited by            of September; at the time of writing these bids                     •     lift 150,000 people out of inactivity by
guarantee that will negotiate the sponsorship        are still being considered (and there are no                              2012 – reducing the proportion of the
deals. A total of £2bn is planned to be              specific funds held by the DH for the Olympics)                           population who exercise for 30 minutes
raised from sources including sponsorship,           so the actual values are confidential. The total                          less than one day per week
broadcasting rights and selling merchandise.         bid is about £40m, and the split is as per the                      •     have 300,000 more active by 2012 –
Although not yet finalised, if it is the same as     following pie chart:                                                      increasing the number achieving three
most Games then there will be at least two                                                                                     sessions of 30 minutes activity per week
alcohol sponsors for beer and wine. It is unlikely                                                                       •     ensure 30,000 more people achieve the
that LOCOG will achieve its financial objectives

                                                                                                                               recommended level of exercise by 2012.
without such sponsors. But it does not give a

                                                                                                l Ser vice

good message regarding the misuse of alcohol.                                                                            There are numerous activities and schemes

     There are already concerns about some of                                                                            to achieve these targets; if you are in London

the deals, e.g. confectionery giant Cadbury is to                                                                        there will be one near you. Other SHAs are also

be a sponsor and will provide all confectionery                 h Pr o                                                   developing targets and strategies under the
and ice cream sold at venues and within the                                                                              Change4Life programme.
Olympic Park. This is hardly a help when one of                        use,
                                                               nce Mis
                                                       Substa l and
the aims is to combat obesity.                         Alc o ho
                                                                                                             Ambulance   • substance misuse, alcohol and sexual health
     To ensure the UK bid was successful a              Sexual                                                           The first part is having services in place to
number of commitments and promises were                                                                                  deal with the expected number of people who
made, which if growth in funding had continued                                                                           will misuse alcohol. At present 25% of A&E
at the 2005 rate would not present a problem.                                                                            attendances are due to alcohol. The plan is to
The commitments and promises include:                                                                                    have a party atmosphere for the 60 days of the
•     the Olympic family (of about 250,000                                                                               Games. Based on the UK model it is expected
      including officials, athletes, media,                                                                              that there will be about 68,000 people who
      support etc.) will be entitled to              Let’s take a closer look at each area of the pie                    are so intoxicated that they will require health
      comprehensive, free health care, mainly at     chart.                                                              intervention. To keep these people away
      UCLH foundation trusts for central London                                                                          from A&E departments booze buses and field
      and for athletes at Homerton Foundation        • Ambulance Service                                                 hospitals will be used.
      Trust and Barts & the London Trust             Before a local authority can give a licence for                          The other aspect is drug misuse and
•     the London Ambulance Service will              an event to take place there must be a specific                     sexual health. One of the known factors about
      provide 24-hour ambulance cover for the        number of ambulances available, depending on                        the Games in Sydney was the increase in the
      Games                                          the type of event, numbers expected and other                       number of street sex workers during the games.
•     spectators and visitors will benefit from      risk factors. The requirements are set out in                       The sex workers are likely to come from poorer
      the usual rules on care on overseas visitors   what is known as the Green (Safety at Sports                        countries where the rate of HIV/AIDs is much
•     NHS employees will constitute a capable        Grounds) and Purple (The Event Safety) Guides.                      greater (about 50% compared to the UK’s 5%),
      and willing pool of volunteers to be trained   There are over 860 events, including cultural,                      and most will be drug users. Needle exchange
      for specific roles in helping to serve the     at which dedicated ambulance cover will be                          and “clinic in a box” services will be created to
      Games                                          required.                                                           ensure that there is not a residual epidemic of
•     because health is seen as a top national                                                                           HIV/AIDs in London’s East End.
      priority, the UK Government is able            • hospital services
      to guarantee that health services              There are a small number of dedicated beds at                       With appropriate planning and direction, the
      associated with staging the Games in           the three hospitals for the Olympic family and                      London Olympics could show other countries
      London in 2012 will require no additional      athletes.                                                           how to develop a beneficial legacy and help to
      investment.                                                                                                        tackle obesity and other problems, by creating
                                                     • out of hospital                                                   a more active population. To achieve this, the
impact on NHS                                        Signposting people to the right facility                            risks highlighted above must be appropriately
The Department of Health is currently preparing      will be essential to mitigate the risk that                         managed along the way.
guidance on workforce and how the volunteer          A&E departments will be inundated with
scheme will operate within the NHS. The              inappropriate conditions (even more so than at
impact has not been considered in the business       present). There will be additional information
cases. If you are interested in becoming a           using NHS Direct to help in this.                                   Derek Miller - independent consultant

health service review November 2009                                                                                                                                    13