THE Starmer government is partnering with pharmaceutical giant Eli Lilly to run a five-year trial in Manchester that involves giving the weight-loss drug Tirzepatide, branded Mounjaro, to unemployed people in what has been called “jabs for jobs,” with a view to wider use of the drug — according to Health Secretary Wes Streeting to “reduce the burden” on the NHS of people classified as overweight.

The plan and Streeting’s comments bring with them the chilling, and chillingly clear, prospect of benefit claimants being put under pressure to take the drug under threat of benefit sanctions if they refuse, and of patients being refused NHS treatment if they refuse to “reduce the burden” by taking Tirzepatide to lose weight.
 
Streeting has denied that the plan is “dystopian,” despite accusations that the government is stigmatising those it considers overweight — and clear advice from unemployment charities that weight is not a significant issue for those seeking work.

Liverpool University professor Simon Capewell called Streeting’s plan an “unethical” move that targets people for economic reasons “rather than prioritising the person’s own interests and health.” Obesity expert Dr Dolly van Tulleken said the plan wouldn’t work and treated people as an economic tool rather than basing treatment on their best interests, as well as raising “serious ethical, financial, and efficacy considerations.”
 
Lilly stands to make huge profits from the plan, with a reported charge for each weekly dose of around £30, in perpetuity since those who stop taking Tirzepatide typically regain most or all of the weight they have lost, according to the study published in the peer-reviewed medical journal JAMA. The US National Institutes for Health (NIH) report that since a proportion of the original weight loss is muscle mass, this can leave them worse off than they were before.
 
The whole idea that forcing people to take weight-loss drugs will somehow reduce NHS burdens is at best unproven. In reality, it flies in the face of expert analysis — public health experts have said that the use of pharmaceuticals to induce weight loss in fact widens health inequalities, leads to “creep” in the use of such drugs and adverse clinical outcomes, such as the side effects and the loss of muscle instead of fat.
 
The prospect of being denied treatment based on supposed blame for the condition needing treatment, or for the complexity of treatment, fits perfectly with NHS England’s Integrated Care Systems (ICS) drive to ration treatment and push it out of hospitals.

ICSs are causing healthcare rationing in a growing number of countries, as noted by even the International Journal of Integrated Care. These systems create perverse incentives that reduce access to care, and Labour fully supports them. It is intrinsically dangerous to patients and at odds with the principle of universal care at the point of need on which the NHS was created.
 
But this latest development has an even more sinister side, both in the drug of choice and in its manufacturer. So far, clinical trials using animals, but not yet assessed for humans, show that Tirzepatide can have serious side effects including thyroid cancer.

In addition, other side effects include pancreatitis (which is noted on the medicine’s label), that are more common and intense for those who are already ill — the very kind of people targeted by the government to “reduce the burden on the NHS” and to get people off sick leave. A clinical presentation by senior doctors to the US Association of Clinical Endocrinology in July this year noted that in some cases, these complications have been fatal.
 
According to the NIH Library of Medicine, of the 2.3 per cent of people who said they had suffered adverse psychiatric events after taking Tirzepatide, almost a fifth reported increased suicidal thoughts.

According to the NIH, clinical trials of the drug’s effects on pregnancy showed an increase in birth defects in animals, but its effects on pregnant women and their babies have not yet been assessed and thus are unknown.
 
A study by the US National Centre for Biotechnology Information found that a significant proportion of those taking the drug experience serious, lasting and potentially fatal side effects. Additionally, up to half of the users suffer from other unpleasant effects.
 
Drug manufacturer Lilly also has a track record of lawsuits and fines that have cost it billions of dollars, raising serious questions about its suitability as a partner in the government’s scheme, even if there were not already serious ethical concerns about the whole scheme and its inherent coercion from the start.
 
The firm was sued by thousands of people who claimed Lilly’s anti-psychotic drug Zyprexa caused diabetes and massive weight gain of up to almost 32kg in their first year of taking it.

Lilly, which had given doctors a far lower estimate of potential weight gain, paid out $1.2 billion to claimants, but was then sued by US states for illegally marketing the drug for unapproved uses, incurring a further total penalty of fines and damages of almost $1.5bn. The court case revealed that the firm’s chief executive had emailed colleagues telling them to “seize the opportunity” to push the drug for unapproved use.
 
Lilly was fined for pushing an osteoporosis treatment for use with breast cancer and telling its salespeople not to tell doctors that there was no evidence that it worked against breast cancer, but instead to tell medics that it was the best drug available.
 
The firm is currently the subject of a huge lawsuit in the US by people who say that it causes blindness, cancer, degenerative diseases, thromboses and other life-threatening problems. Legal documents allege that Lilly knew of these risks and did not properly warn doctors of them.

Lilly was also accused by US lawmakers of massively hiking the price of insulin and tried unsuccessfully to sue the Canadian government for allowing the courts to invalidate improperly constituted drug patents.
 
This is the firm that Streeting and his boss, Prime Minister Keir Starmer, trumpeted getting into bed with and whose drug — with its potentially fatal side effects — they plan to force on thousands and ultimately millions.

Continuing its targeting of the vulnerable, the government has also announced that it will make people in hospital with mental health issues meet “work coaches” — who have the power to impose punitive benefit sanctions on them — to “help” them into work.
 
Labour has already announced policies that it knows will cost thousands of lives and has been exposed failing even to do assessments of the impacts of other policies. Both Starmer and Streeting have accepted large donations from private health companies and investors.
 
Labour’s first three months in power have been fraught with ethical issues, especially toward those who are sick, unemployed or both.
 
Labour has spent its tenure so far flagging its intentions to “reform” the NHS based on Lord Darzi’s recommendations for hospital closures and community care that are based squarely on profitability, or what Darzi calls “return on investment,” rather than what is clinically best for patients.

Streeting’s “10-year plan” confirms this intention together with a new wave of Private Finance Initiative projects like those of the Blair era that have placed crippling repayment burdens on many NHS trusts.
 
Streeting’s “better cost-cutting through chemistry” vision is another way to enrich private health companies and Big Pharma. The devil in the detail strongly suggests that this will put patients in danger.
 
Claudia Webbe was the Member of Parliament for Leicester East (2019-24). You can follow her at www.facebook.com/claudiaforLE and twitter.com/ClaudiaWebbe.