How do we wean doctors (and the nation) off of drugs?

A PROFESSION ADDICTED TO DRUGS?

It should come as no surprise, as in every other walk of life, scientific research and its findings, can be influenced by factors other than what is good for the patient! Doctors are addicted to drugs: sometimes for themselves but mainly for their patients. The economic success and profitability of pharmaceutical companies depends not on the health of the nation but on an increase in ill-heath and a multiplicity of diseases, for which ever more 'miracle' drugs are required. 

We have to trust that prescribing is done in good faith and in the belief that it is in the best interests of the patient. In short, to use a phrase made popular in the Covid debacle, just "following the science". Unfortunately life is not quite that simple or straightforward. The financial performance of the pharmaceutical company may weigh more in the board room.

DRUG PUSHERS?

Doctors, and increasingly pharmacists, are the essential key to the chemical company profits. Many preparations can be obtained 'over the counter' but the more important and lucrative ones must be prescribed. This is why drug companies have historically paid great attention to GPs and other doctors, showering them with benefits in kind. 

GP's in particular are subject to a 'pincer movement' of pressure from the companies that make the drugs with their often exaggerated claims and from the patient himself, seeking a cure from whatever condition he or she is suffering from. This creates a triangulation of interests, expectations and financial benefits that may in fact be illusionary and harmful. 

PSYCHOLOGICAL DEPENDANCY?

The very idea of miracle pills and miracle medicine, blinds both patient and doctor to underlying causes, probably harder to address. In a situation where there is no cost implication to either prescriber or recipient - directly at least, because the cost is borne by the state and paid for out of general taxation -  no disincentive operates. 

This rather obviously, has both positive and negative consequences. Treatments are not circumscribed by the patient's ability to pay but nor is there any reason to question whether the drug is either cost-effective or even necessary.

GOVERNMENT RESERVATIONS

It would appear the government may be coming to the same opinion. England's most senior doctor, Prof. Sir Stephen Powis, NHS medical director, has recently stated that doctors must stop "doling out a pill for every ill, as it leaves millions of patients hooked on drugs they do not need."

He continued, "Figures suggest around 10% of prescriptions are not needed." This equates to nearly £1 billion to the national health!  Even this figure underestimates the real figure, as it excludes the cost to individuals, either as their statutory contribution or that spent on drugs not requiring a prescription. Nor does it include the huge saving that would flow from healthier life styles, particularly as it relates to diet, exercise and obesity.

DRUG INDUCED ILLNESS

During 2021, 1.14 billion prescription items were dispensed by pharmacists in England - a 3 per cent rise on the previous year!  More than eight million people take more than five pills per day. The total number taking chemical substances of one sort or another, either legal or illegal, is obviously much higher. Much of the NHS effort and budget is taken up dealing with the adverse effects of these with many thousands ending up in hospital as a direct result. Iatrogenic disease (i.e. conditions caused by medical interventions) constitute up to a fifth of hospital bed occupancy.

Among the European Union Member states, WHO concluded that the healthcare-related errors occur in 8% to 12% of hospitalizations. A report named “organisation of memory” estimated 850,000 adverse drug reactions (ADRs) occur in hospital each year.  This figure does not include hospitalisations that result from reactions to chemicals taken or prescribed in the community, so those figures must understate the problem. Over one in five hospital admissions for the over 65's, result from adverse effects of medications costing the NHS at least £2 billion. A third of over 80's take eight or more medicines daily!

A DRUG FOR EVERY ILL

Let us look at just some of the categories of over-use and over-prescription by category, taken from government sources:

Anti-biotics

"Overall prescribing rates were 659, 654 and 607 per 1000 registered patients for 2013, 2014 and 2015, respectively. 27 Feb 2018".

Discovered by Fleming just before World War II, anti-biotics have undoubtedly saved millions of lives. However the dangers of over-prescribing them for conditions against which they were ineffective, such as viral colds, are well known. Misuse of these wonder drugs both in animals (to off-set battery conditions and aid growth) and in humans has allowed germs to develop resistance to them. Increasingly common anti-biotics are ineffective against bacterial infections. This could be catastrophic in a real pandemic which clearly Covid was not. Doctors are eventually reacting to this fact and prescribing less but the damage has already been done.

Anti-depressants

"Between April to June 2021, 20.5 million anti-depressant drugs were prescribed. This is a 2% increase from 20.2 million items in the previous quarter, and a 7% increase from 19.2 million items for the same quarter in 2020/21."  

In other words over 80 million prescriptions in an adult population (over 18) of 54 million and on the increase year on year! Clearly a lot of people are diagnosed as suffering from depression. It points to a fundamental flaw in the nature of society, relationships and the human psyche. 

But leaving that aside there is a big question mark over whether the popular anti-depressants work or at least work as well as their manufacturers claim. They may even have the opposite effect and make both depression and suicide more likely. The disastrous long-term addictive consequences of Benzodiazepines such as 'Librium',  'Valium' and many other proprietary names, known sweetly as 'Mummy's little helpers', are well known but it seems lessons have not been learned. 

Practical measures to tackle the problem of depression which seems to be rife, such as changing life and work circumstances, talking therapies, friends, social activities, pets, exercise, diet and sleep, may be far more effective, but getting doctors to pursue these is still not generally applied. A pill seems to be a far more convenient option.

Dementia

"997,000 drugs for dementia prescribed, a 2% increase from 982,000 items in the previous quarter.  The total cost of care for people living with dementia is typically £100,000, but can cost as much as £500,000. The cost of dementia to the UK is currently £34.7 billion a year, which works out as an average annual cost of £32,250 per person with dementia."

Mental decline is a likely consequences of aging but is not inevitable.  Weakness of body does not necessarily entail weakness of mind. However the larger the proportion of older people in the population, the more prevalent it is likely to become. Once dementia sets in, the prospects are not good and it is understandable that doctors faced with it, will grasp at straws, as will the sufferers, as the above statistics prove. 

But no one is really sure whether the cholinesterase inhibitors used  (Donepezil (Aricept), Galantamine (Razadyne) and Rivastigmine (Exelon) are the most commonly used) are ultimately beneficial at slowing decline, improving memory or reducing associated psychosis. In large part they are still experimental. They certainly have significant adverse side effects across a range of psycho-motor areas. Sufferers are often persuaded ill advisedly, as to their efficacy, putting up with deterioration or pain in other areas as the necessary cost.

How much the misleading claims of drug companies raise unfounded expectations in doctors and patients is undetermined, but again no one really knows whether the huge cost to the NHS is really beneficial or effective.

Diabetes

"In 2020/21, there were 57.9 million drugs used in treating diabetes prescribed in England for a cost of £1.19 billion, 12.5% of the total spend on all prescription items prescribed in England. Some 7% of the UK population (4.9 million) are now living with diabetes; approximately one million people have undiagnosed type 2 diabetes, 40 000 children have diabetes and more than 3000 children are diagnosed every year."

The discovery of insulin and the role of the pancreas in the disease of diabetes  were life savers for the many struck with the condition. The effective treatment did not stop the trend of increasing in the numbers suffering from it. The pre-disposing features are well known. They include family and genetic factors, but obesity and diet are hugely significant. Britain has changed its eating habits over the last fifty years towards fast foods and an essentially American-style diet, which also has a distinctive disease pattern. The average body shape has changed as a consequence and lower socio-economic groups are proportionately worse affected. Now "63% of UK adults (aged 18+) are overweight or obese (2018/19). This equates to an estimated 35 million overweight or obese UK adults."  

It is clearly not in the interests of the fast food industry or the pharmaceutical industry to reduce diabetes, but it is in the interests of the public and government. The increase in diabetes has the potential to bankrupt the NHS and nation if not tackled. The question is whether doctors help or hinder that process?

Sleeping pills

"Last year, 15.3 million NHS prescriptions were made for sleep medication. Patients in England alone received 5.4m prescriptions for zopiclone and 2.8m for temazepam, the two most popular sleeping pills."

It is generally acknowledged that sleep, for all its biological mystery, is essential for both mental and physical health. It is a phenomenon common to virtually all species and so must be hard wired into the human biological make-up. The requirement for sleep varies between individuals (Mrs Thatcher was famously said to require only four hours a night) but the fact that so many prescriptions are required indicates a major problem of people not being able to get to sleep without chemical assistance.

What effort is made by doctors and patients to identify causes and try alternative remedies before resorting to drugs with potentially serious adverse health consequences?  I suspect very little.

Heart conditions

"On average, patients with heart failure take 6.8 prescription medications per day, resulting in 10.1 doses per day, not including over-the-counter (OTC) or complementary and alternative medications. (12 Apr 2017)   Around 920,000 people in the UK today have been diagnosed with heart failure. Both the incidence and prevalence of heart failure increase steeply with age, and the average age at diagnosis is 77.12 Sept 2018 Statins are one of the most commonly prescribed drugs in the UK: around 7-8 million adults in the UK take them, and over 71 million prescription items were dispensed in 2018."

We may conclude from the disparity between the number of people diagnosed with a heart condition and the number of Statin prescriptions, that these drugs are widely prescribed by doctors as a preventive measure as well as a treatment for high cholesterol and heart conditions. The problem is that the whole regime based on, and promoted by, drug companies, that saturated fat consumption leads to high cholesterol and that this in turn leads to ischaemic heart disease and strokes, is wholly misplaced and misguided. It has spawned huge profits for the manufactures but also created a whole range of medical disorders unnecessarily. 

As Dr David Diamond and others have conclusively demonstrated, the association is largely illusionary, as is the claimed benefit for Statins in the prevention of these conditions (around one percent not the forty or fifty per cent claimed) and is by far off-set by their adverse consequences. As he has shown, it is not saturated fats but excess carbohydrates and sugars that predominantly cause the problem, although of course other related factors are involved. 

Statins have made billions for drug companies around the world but particularly in Europe and North America, based it would seem on a convenient (for them) misnomer. Yet again doctors are the active participants and facilitators in a costly scam!

Pain relief

"PHE’s analysis shows that, in 2017 to 2018, 11.5 million adults in England (26% of the adult population) received, and had dispensed, one or more prescriptions for any of the medicines within the scope of the review. The totals for each medicine were:

antidepressants 7.3 million people (17% of the adult population)
opioid pain medicines 5.6 million (13%)
gabapentinoids 1.5 million (3%)
benzodiazepines 1.4 million (3%)
z-drugs 1.0 million (2%)

There are large variations in the standardised rates of prescribing across clinical commissioning groups (CCGs)."

It is over seventy years since George Orwell predicted the generalised application of 'Soma' to keep the general population placated and we are now well on our way to fulfilling it. The NHS has become an indispensable part of our 'Oceania' as became all too clear in the Covid debacle.

CONCLUSION

These statistics are truly startling.  It would seem, even leaving aside the recreational use of non prescription drugs and those not requiring a prescription, on average at least twenty prescriptions per person per year are made. Given the proportion not on medication of any kind, for those taking them, the figure must be much higher. The cost to the NHS and nation, both directly and in adverse effects, is truly staggering. 

For 2021 the figures were:

The cost of prescription items dispensed in the community in England was £9.61 billion, a 3.49% increase of £324 million from £9.28 billion in 2019/20.

The number of prescription items dispensed in the community in England was 1.11 billion, a 1.90% decrease of 21.5 million items from 1.13 billion in 2019/20.

Atorvastatin was the most dispensed drug in England in 2020/21 with 49.9 million items, while Apixaban was the drug with the highest cost of £356 million.

Sertraline 100mg tablets was the presentation with the largest absolute increase in cost between 2019/20 and 2020/21 of £78.9 million, from £21.0 million to £99.9 million. 

Government has been aware of the widespread, unnecessary and adverse effects of drugs for decades but has effectively promoted them with the active assistance of 'big pharma', the NHS and the medical profession. The situation is getting worse not better. Drastic action is required to reverse the trend. The survival of the NHS as well as the public's health depend on it.

WHAT IS THE ANSWER?

The question posed at the top of this article was, "How do we wean doctors and the nation off of drugs?  

First and foremost, both doctors currently prescribing them and patients demanding them must want to come off them. That is the psychological province of the will, of beliefs and attitudes conditioned by society at large and by the propaganda we call advertising. 

People must be properly and adequately educated about their bodies and how to keep them working healthily. It is a task that starts in the home, continues in school and hopefully continues thereafter. Much illness and disease is preventable but there will always be instances that are not and that will benefit from chemical interventions. A clear separation between the two is essential.

The relationship between drug companies, government, the NHS and the medical profession needs to be tightly controlled to prevent undue influence or conflict of interest. Better use of proprietary brands and control of prices is needed to cut the overall cost. 'Free at the point of use' should be limited to true need.

Prevention is obviously better than cure, but clearly far more needs to be done in this sphere where there is a proven link between life style habits and resultant illness. Alcohol, diet, smoking and stress are obvious areas.

There needs to be far more open debate and freedom of expression surrounding the claimed advantages of certain drugs and procedures, or of underlying medical givens.  The role of cholesterol in the incidence of  heart disease and the effectiveness of statins in their prevention is an obvious one. The necessity and effectiveness of vaccination regimes is another. The widespread use of drugs in mental decline is another. The prescription of pain killers in place of osteopathy (not available on the NHS) is another.

Sickness can be as much a social condition as a physical one. Financial and other incentives and disincentives need to be considered. The system should be so organised to be able to address causes rather than just treating the symptoms.

Covid highlighted the weaknesses in the GP service that have continued since. Patients have faced multiple barriers to seeing the doctor. This may have accounted for the reduction in prescriptions referenced above.  However the nature and purpose of the interaction needs to change, so that it is less of a drug prescribing service, to one that promotes natural and obvious remedies. These could be provided at a fraction of the cost for much greater savings long term. GP payments should be more closely tied to performance an outcomes rather than just numbers on a list.

Medicine likes to think of itself as a science. It also requires a high level of practical skill. But somewhere along the line the social and environmental inputs have been given less attention. Health after is largely a reflection of these. Drugs and vaccines have too long been regarded as 'magic bullets'. Somehow we need to break the spell if the problem of drug dependence and its multiplicity of adverse consequences is to be addressed.

CASE STUDIES

Only yesterday I sat on a bench with a woman in her late thirties I suppose (it is considered rude to ask a woman her age!) who said she had been very ill for a year with a range of symptoms including brain seizures. This she said had finally been put down to a drug wrongly prescribed and finally changed. She did not say what condition the drug was prescribed for, but claimed it had ruined her heart, for which she now had to take other medications. She did not 'look' well. A taxi arrived to take her and her shopping home. She said she spent most of her time in bed too poorly to do anything. Of course this is too unspecific to be much use but how representative is it of the general population and a much bigger problem?

A more reliable example is as follows. A seventy year old man suffered severe chest pains, diagnosed at the local hospital as a serious heart attack for which emergency admission and Primary Percutaneous Coronary Intervention (PPCI), also known as angioplasty or coronary angioplasty was applied.  A blockage or clot  located in the left coronary artery was dispersed and two metal stents implanted to restore normal blood supply, notwithstanding the damaged caused to the heart muscle. Subsequently four days were spent recuperating in the cardiac unit. Further procedures were proposed but declined.

Now as to standard drug regime in such cases, the following drugs were prescribed, to be taken on a permanent daily basis thereafter:

 

Iatrogenesis: A review on nature, extent, and distribution of healthcare hazards Https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060929/

https://www.nhsbsa.nhs.uk/statistical-collections/medicines-used-mental-health-england/medicines-used-mental-health-england-quarterly-summary-statistics-april-june-2021#:~:text=Key%20findings&text=20.5%20million%20antidepressant%20drugs%20were,same%20quarter%20in%202020%2F21.

David Diamond on Deception in Cholesterol Research: Separating Truth From Profitable Fiction https://www.youtube.com/watch?v=inwfSkSGvQw&t=9s

Drug dependence?


https://www.google.co.uk/search?q=pills+images&rlz=1C1ARAB_enGB463GB464&tbm=isch&source=iu&ictx=1&fir=A23GIBY4IPfygM%253A%252CDeuC4GJF1JE43M%252C_&usg=__xH6SFFLzwEfhUy8ZiEiyXOSzr5E%3D&sa=X&ved=2ahUKEwiwxOWF-svcAhUNXsAKHZVBB5MQ9QEwB3oECAYQEg#imgrc=A23GIBY4IPfygM:

Somewhere along the line something has gone badly wrong with the NHS system in which drugs are prescribed and either subsidised or paid for. This runs in parallel with a subterranean and illegal drugs economy. The two run into BILLIONS of pounds and both positively PROMOTE greater use.

This may be good for the drug companies and drug dealers but it is definitely NOT good for the tax-payer, the country or to a great extent, the consumer of these chemicals.

The extent to which they are used gives the lie to a physically, psychologically and socially 'healthy' society. Both individuals seeking 'magic bullets' for much more complex issues and those that prescribe are at fault.

Patients want pills and doctors or pushers prescribe them for either financial gain or because it is the easiest course. At root it is and educational and philosophical problem.

We have been conditioned to believe and expect that pain can be removed and illness cured by medical intervention when clearly this is not the case: That environmentally and personally we can abuse the natural order, only to be cure later if the need arises.

It now transpires that one in six are prescribed anti-depressant drugs even if they have been proved to be ineffective. Even children are now medicated as the norm - no less than 70 000 in Britain alone!

Not only is this crazy, it also points to the underlying problem with the society we have created and seem unable to modify.

Despite being aware of many of the social and environmental causes of ill health we continue on the same path. Why then should we expect things to get better?

I have a number of acquaintances who use illness to avoid employment and who use their bi-weekly bag of pills as barter for beer. Valium, Prozac and Viagra (to name but three) have a ready street value apparently.

We definitely need to wean doctors off drugs. We need to rationalise and cash in on the cannabis and other illegal drugs market which could at least support our schools and hospitals.

We need to differentiate between true disease (such as the MS referred to) and psycho-somatic conditions and the drugs that are prescribed prophylactically without justification and in turn create other complications requiring yet more intervention.

Our whole approach to health, disease and treatment in fact requires radical overhaul if we are not to slip into a drug induced comatosed state, into which increasing numbers have already, it would seem, have slipped.

"The Modern Sin of Telling the Truth."

Vernon Coleman.

https://www.bitchute.com/video/cw7f7FCRES02/?fbclid=IwAR2g-S0yxIPvP5686Hu1tr3Qcor3mnNLqBAN2TiriImZwUxuY_j0Nq1Z0ow

https://vernoncoleman.org/

Like all qualified medical doctors who have told the truth about covid-19, Dr Vernon Coleman has been repeatedly lied about and libelled on the internet and in the mainstream media. In March 2020, after studying the covid death figures and comparing the death statistics in the UK to that of previous years, Dr Coleman said that the threat of covid-19 had been wildly exaggerated and that there was no pandemic. In that first video, he warned that the pandemic fraud (or hoax) would result in the deaths of many old people (which it did), the introduction of mandatory vaccinations (which appears to be happening) and the disappearance of cash (now a serious threat). As a result of his video, his Wikipedia page was deliberately and dramatically changed by government employees and used to 'monster' him. All his lifetime achievements were removed. Without any evidence or justification he was, among other things, labelled a 'conspiracy theorist' and said to be 'widely discredited'. Google, which works with Wikipedia, reproduced the lies in an attempt to discredit him, so that nobody would believe his warnings. Biographies on www.vernoncoleman.com include references.

Warnings, Forecasts and Predictions

Dr Vernon Coleman’s track record of spotting health dangers is second to none. Since the 1970s, when his first two ground breaking books (The Medicine Men and Paper Doctors) were published, Dr Coleman has been gaining friends among patients and enemies among doctors and drug companies.

In The Medicine Men (1975), Vernon Coleman drew attention to the dangerously close relationship between the medical establishment and the pharmaceutical industry. In Paper Doctors (1977) he argued that most medical research is done for the benefit of researchers (and drug companies) and that the money would be better spent on using the information we already have and encouraging the public to avoid known health hazards.

Vernon Coleman, a Sunday Times bestselling author, is one of the few medically qualified authors writing on medical matters without bias and without any professional or commercial commitments or allegiances. 

His honesty has made him many enemies among the medical establishment and the establishment’s commercial alliances. His predictions, forecasts and warnings have often been made years (and, in many cases, decades) before anyone else has unearthed and understood the evidence or had the courage to speak out. In addition, in many of his medical books and thousands of newspaper and magazine articles he has drawn attention to the dangers of using specific over the counter and prescription drugs.

There are hundreds of other articles on health, politics and animal issues on www.vernoncoleman.com

See also:  

How do we wean doctors (and the nation) off of drugs?  

https://veaterecosan.blogspot.com/search?q=doctors+drugs

Is the NHS heading for the 'Rocks'?

A consideration of current issues with particular reference to Cornwall.



https://e3.365dm.com/18/01/1096x616/skynews-nhs-surgery-doctors_4197607.jpg?20180103135404


NHS on the proverbial 'rocks'?

If the BBC programmes of 'Question Time' and 'Any Questions' (TV BBC 1 and Radio 4 respectively) are any indication of the public mind, only two subjects dominate it: BREXIT and the NHS. For all the words spoken by panelists and audience members, nothing ever seems to be resolved and the caravan roles on unmolested.

Brexit will have to wait. 

BREXIT as a topic of conversation will have to wait for another time and place. Here I wish to share a few thoughts on the thorny subject of Britain's National Health Service, which if we are to believe the Leader of the Opposition, and many others, is undoubtedly heading for the metaphorical and proverbial 'rocks', for want of money and a few other things.

The programmes mentioned above make a point of travelling the country so we may conclude that the topic is equally of concern no matter where. I suppose this is only to be expected as heath, or lack of it, is of concern to individuals wherever they reside or whatever they do. It is often difficult however to extract the topic from political point-scoring or indeed to differentiate between the realities of treatment and provision. What are slogans or by vested interests.

Only money matters?

There are innumerable specialist subjects but the discussion usually centres on just one: finance and its implications. Almost uniquely, the NHS finance comes only from Government because a founding principal and politically very difficult to change, is "free at the point of use or need". Government gets its money from principally two sources: taxes and loans. With a soaring National Debt and resistance to higher taxes, Government finds itself in a real bind that cannot be avoided.

The NHS web site states when the NHS was launched in 1948, it had a budget of £437 million (roughly £15 billion at today’s value). For 2015/16, the overall NHS budget was around £116.4 billion. NHS England is managing £101.3 billion of this. However the actual amount spent on health products and activities must be well in excess of this as it does not include private spend either on health insurance, private medicine or surgery, non-government funded nursing or social care, alternative medicine and treatments such as osteopathy, and the huge amount spent on non-prescription remedies, supplements and 'health clubs'. This works out roughly at several thousand pounds per every person living in the UK, every year!

Safe in Conservative hands?


West Cornwall Hospital, Penzance. c. 1935

https://www.picturepenzance.com/media/west-cornwall-hospital.36220/full


Despite vociferous assurances to the contrary, there is a prevailing belief in the country that the Conservatives cannot be trusted to protect the NHS as a publicly funded and run service. Everything in Conservative philosophy and practise suggests that it prefers privately run enterprises and to the idea that individuals should pay for what they get, when they need it.

The hospital today. Evidence of progress or decline?
 
http://s0.geograph.org.uk/geophotos/04/98/29/4982973_bdfa8ed4.jpg


Of course the obverse of this thinking, means that the poor and destitute cannot access treatment, a situation that is almost the norm outside the European block and no doubt one of the many reasons why there is such a tide of humanity trying to get here. Even in advanced America, without insurance, medical treatment is prohibitively expensive. People have to suffer in silence. Essential medical procedures literally result in bankruptcy and penury.

In Britain the Dental Service is a case in point, where it is now almost impossible to obtain anything other than private treatment and the cost to the individual has soared. Even if successful in finding an NHS dentist, a significant contribution is required, and I can state from personal experience a lower quality of service is provided across the board.

"Stuffing mouths with gold"?


https://upload.wikimedia.org/wikipedia/commons/thumb/e/e6/Anenurin_Bevan%2C_Minister_of_Health%2C_on_the_first_day_of_the_National_Health_Service%2C_5_July_1948_at_Park_Hospital%2C_Davyhulme%2C_near_Manchester_%2814465908720%29.jpg/1200px-Anenurin_Bevan%2C_Minister_of_Health%2C_on_the_first_day_of_the_National_Health_Service%2C_5_July_1948_at_Park_Hospital%2C_Davyhulme%2C_near_Manchester_%2814465908720%29.jpg

Aneurin Bevan's quote that he "stuffed doctor's mouths with gold" to persuade them to join the NHS is almost apocryphal.  Of course it has been repeated to get them to adopt Government policy. Despite agreeing to be part of the NHS, doctors and dentists retained a semi-independent status which recent legislation has reinforced, making practices or groups of practices profit orientated businesses. A recent Times reports that at least one GP is remunerated with over £800,000 and more than 200 GP's are now paid more than £200,000. The old and familiar doctor/patient relationship has been undermined. Doctors are incentivised to make access and treatment more difficult and it has evidenced by greater difficulty in arranging appointments, whilst no longer obligated to carry out home visits. 

Given these circumstances it is hard to see why General Practise nationally is said to be in crisis, or why in a city like Plymouth it is said to be at the point of collapse. Why given the long training period, do qualified doctors shun GP practise? Why are so many GP's giving up and insufficient doctors taking their place? Could it have something to do with the nature of the interaction and what is expected of them? Has the doctor/patient relationship been dehumanised and unpersonalised to such an extent that neither doctor or patient are satisfied?

Where are you Florence?


http://l7.alamy.com/zooms/11704280786048d684b144417a34e81b/in-scutari-florence-nightingale-attends-to-a-patient-date-1854-5-g388tk.jpg


Nursing has undergone parallel change, usually a direct result of government policy. Nurses have always had an ambivalent relationship to doctors both as regards activity and status, to say nothing of rewards. We would have to go back to Florence Nightingale to understand it fully. In large part it was a matter social status and gender. For the last forty years it has fuelled the move to graduate status. 

Intellectual capacity and medical knowledge may be valuable but the overall effect for the patient and health care system may have been negative. Basic principles introduced by Nightingale that professionalised and raised the status of nurses, nevertheless placed the caring arts above everything, and this may have been jeopardised by modern nurses seeing themselves as junior doctors, rather than specialised carers. 


The horrors of Scutari when Nightingale arrived are beyond imagining.

http://historythings.com/wp-content/uploads/2017/08/teaserbox_2444371704.png

The practical effect has been to lower the education and skills of the people actually doing the caring in institution or home. Cut-backs to local authority budgets and the privatisation of care homes has resulted in closures, ever shorter contact time and derisory pay, besides increased private contribution if cash or property is owned.

Doctors and dentists paid more. Nurses paid the same, carers paid less.

The change may also increased expectation of financial reward, achieved either by working for Agencies or by changing career or employer completely. 

Private Eye (No. 1462) reports that more than 33,000 nurses gave up working in the English NHS last year alone, an increase of a fifth since 2012/13 alone. In each of the last five years more than a tenth have departed each year. 

This is clearly unsustainable and results in the employment of agency nurses at hugely increased cost to the budget and recruitment from overseas that may result in increased communication problems and lower standards. Needless to say this may also engender resentment and dissatisfaction that cannot be good for either nurse or patient.

The academic approach has resulted in student nurses having to pay full university fees and running up huge student loans before they qualify, whilst paid virtually nothing whilst on the wards. This must act as disincentive to join and reason to leave prematurely. Any savings are probably negated by the huge additional cost of hiring agency nurses that cost twice as much.

Reorganisation


http://www.livingmemory.org.uk/images/ThreeandSixpenny/output/OutPatients.jpg



"Top down' changes seldom work and make no sense whatever to the 'customer' or 'consumer'. In fact I doubt even one in a thousand would have the faintest idea what they meant in practise or be able to describe the difference before and after. All it did I would suggest, was seed confusion, disrupt existing relationships, create a plethora of acronyms and hierarchies, and waste a ton of money that could have been spent more wisely on much needed services. 

Nor has it stopped local reorganisation of this or that aspect of the service. A hospital closed here, an A&E unit transferred there. Meanwhile operations are postponed to allow for "winter peaks" and waiting times targets are missed. Significant numbers of people actually die as a result of ambulances or doctors taking too long to get to them.

Isn't just incredible that our system of representation permits this huge waste of public money, whilst the government pleads poverty for everything it doesn't want to do? 

Government waste of public money.

Government seems very good at wasting public money and it has to be asked if the NHS is exempt from this general rule? The following are just a few recent examples.

The government is well known for inefficiency and waste. We need only cite: 

• two rather useless non-aircraft carriers (£6.2 billion plus), 
• the HS2 Rail link (£60 billion plus), 
• the cost of military campaigns in the Middle East, Libya (£320 m) and Afghanistan (£34.7 billion in total), 
• refurbishing Buckingham Palace (£369 m) 
•  the Palace of Westminster (£4 - 8 billion!) 
• not to mention a billion pound bung to the DUP. 

As far as the NHS is concerned, the following are a few notable examples of mismanagement and huge waste:

Reorganisation 2012

The most recent Conservative reorganisation in the 2012 "Health and Social Care Act", said to have cost about £3 billion, is now apparently accepted as its "biggest mistake" by the party and government itself. I therefore do not even have to persuade you that it was - it's official! 

IT Systems

For example at least ten BILLION pounds was wasted on a computer system that has been ditched. Current stories suggest there is general confusion and a plethora of systems that don't 'talk' to each other.

This report dates from 2014: 

"An abandoned NHS patient record system has so far cost the taxpayer nearly £10bn, with the final bill for what would have been the world's largest civilian computer system likely to be several hundreds of millions of pounds higher, according a highly critical report from parliament's public spending watchdog."

Guardian Today: the headlines, the analysis, the debate - sent direct to you

 

Read more

"MPs on the public accounts committee said final costs are expected to increase beyond the existing £9.8bn because new regional IT systems for the NHS, introduced to replace the National Programme for IT, are also being poorly managed and are riven with their own contractual wrangles."

"Richard Bacon, a Conservative member of the committee, said the report was further evidence of a "systemic failure" in the government's ability to draw up and manage large IT contracts. "This saga is one of the worst and most expensive contracting fiascos in the history of the public sector.

Source: https://www.theguardian.com/society/2013/sep/18/nhs-records-system-10bn

Private Finance Initiative (PFI) contracts

PFi's, first introduced by John Major and continued by Tony Blair, were designed to use private capital to fund major projects which were then leased back to the government at high interest rates. It took the capital sum off the government books but has cost the country far more in the long term, not least because government could have borrowed the money at much lower rates. The recent collapse of Carrilion and failures in rail franchises have proved that private businesses cannot always be relied on and are prone to fail. If and when they do, it is the taxpayer who must pick up the tab. However in the process Executives of the Companies and investors extract large sums. They may also lose.

In 2016 the Independent reported as follows: 

"The NHS has more than 100 PFI hospitals. The original cost of these 100 institutions was around £11.5bn. In the end, they will cost the public purse nearly £80bn. The total UK PFI debt is over £300bn for projects worth only £55bn. This means that nearly £250bn will be spent swelling the coffers of PFI groups." See:http://www.independent.co.uk/voices/nhs-funding-pfi-contracts-hospitals-debts-what-is-it-rbs-a7134881.html 

Exorbitant pay of some GP's and Consultants

A recent Times reports that at least one GP is remunerated with over £800,000 and more than 200 GP's are now paid more than £200,000. By my calculation that amounts to at least forty or fifty million in salaries which is but a small proportion of the £8,883.8 million that was paid across 7,763 general practice service providers. The average GP salary is around £120,000. Nevertheless it is hard to justify huge remuneration in a publically funded system.

On the face of it Consultants are paid much less (between about £40,000 and £105,000) which seems strange given the level of expertise and responsibility, although these can be significantly enhanced for specialisms and private practise. More than half the total NHS staff employed are clinically qualified.  (See: http://www.nhsconfed.org/resources/key-statistics-on-the-nhs)

As can be seen bill for GP's and doctors is huge and may well have got out of hand. Clearly there is huge disparity between top and bottom and between the medical and other professions alligned to it. It is also complicated by the market forces at work at both home and abroad.

Drug over-pricing and over-prescribing


Apart from the exorbitant pay to some GP's and Consultants, the recent news has been full of stories about the NHS being ripped of for drugs and other medicinal supplies. For example one High Street giant charged £1,579 for a tub of moisturiser that was sold elsewhere for £1.73! 

In another example according to the Competition and Markets Authority (CMA) one firm Actavis UK, ramped the price up of hydrocortisone tablets, after the patent expired, to eye watering levels - equivalent to12,000 per cent - from 70p in 2008 for a 10mg pack, to £88 by 2016!

Before April 2008, the NHS spent around half a million a year on hydrocortisone tablets. By 2015, this had soared to around £70m a year. Clearly these are only a few examples it illustrates how limited resources are wasted and why funding never seems sufficient.

Here is a list of their published products which makes a far more general point maybe? Activis UK is of course one of many drug manufactures world-wide.

Products manufactured by Actavis UK Ltd

Actelsar (Telmisartan/Hydrochlorothiazide)
Cardiovascular System >> Hypertension

Beacita (Orlistat)
Nutrition >> Obesity

Cacit Tablets (Calcium carbonate)
Endocrine >> Osteoporosis, other bone disorders

Cyclogest (Progesterone)
Obstetrics and Gynaecology >> Premenstrual disorders

Delmosart (Methylphenidate)
Central Nervous System >> ADHD, narcolepsy

Diazemuls (Diazepam Rectal Soln)
Anaesthetics, Muscle Relaxants and Premeds >> Premedication

Electrolade (Sodium chloride,Potassium chloride,Sodium bicarbonate,Glucose,Electrolytes)
Gastrointestinal Tract >> Diarrhoea

Floxapen (Flucloxacillin)
Infections and Infestations >> Bacterial infections

Glidipion (Pioglitazone)
Diabetes >> Oral and parenteral hypoglycaemics

Hapoctasin (Buprenorphine)
Pain >> Pain, fever

Lecaent (Pregabalin)
Central Nervous System >> Anxiety

Lotprosin XL (Galantamine)
Central Nervous System >> Alzheimer's dementia

Lynlor (Oxycodone)
Pain >> Pain, fever

Nebusal 7% (Sodium Chloride)
Respiratory System >> Cough, congestion, respiratory distress

Nemdatine (Memantine)
Central Nervous System >> Alzheimer's dementia

Politid XL (Venlafaxine)
Central Nervous System >> Anxiety

Preblacon XL (Tolterodine)
Genito-urinary System >> Incontinence, nocturnal enuresis, nocturia

Raponer XL (Ropinirole)
Central Nervous System >> Parkinson's disease, parkinsonism

Raporsin XL (Doxazosin)
Cardiovascular System >> Hypertension

Reltebon (Oxycodone)
Pain >> Pain, fever

Salipraneb (Salbutamol/ipratropium)
Respiratory System >> Asthma, COPD

Sastravi (Levodopa + carbidopa + entacapone)
Central Nervous System >> Parkinson's disease, parkinsonism

Stesolid (Diazepam Rectal Soln)
Anaesthetics, Muscle Relaxants and Premeds >> Premedication

Stronazon MR (Tamsulosin)
Genito-urinary System >> BPH, urinary retention

Tenprolide XL (Quetiapine)
Central Nervous System >> Depression

Trangina XL (Isosorbide Mononitrate)
Cardiovascular System >> Angina

Trolactin (Dipyridamole)
Cardiovascular System >> Thromboembolic disorders

Vascalpha (Felodipine)
Cardiovascular System >> Angina

Victanyl (Fentanyl)
Pain >> Pain, fever

Vitile XL (Gliclazide)
Diabetes >> Oral and parenteral hypoglycaemics

Zeridame SR (Tramadol) 

See: https://www.mims.co.uk/manufacturers/actavis-uk-ltd?sortBy=A-Z

Over-prescribing of medicines

Over £16 billion is paid by the NHS drugs. That equates to about £250:00 for every person living in the country every year. In 2010/11, in England, £450m was raised through prescription charges.  In 2016, 1.10 billion prescription items were dispensed in the community. An increase of 1.89 per cent from 1.08 billion in 2015. 

The question emerges to what extent drugs are prescribed unnecessarily? We are now very aware that anti-biotics have been prescribed in this way for decades with very dangerous consequences for their efficacy where they are actually needed. Statins and other popular drugs have been prescribed when the medical justification is questionable, often with adverse side effects that require further different medication. 

There has been a huge increase in the prescription of anti-depressants and similar with questionable results. Drug firms are continuously seeking new possibilities and opportunities and doctors appear enthusiastic supporters as for example the use of Ritilin for child over-activity when changes in diet and past-times would be far more effective.

More reorganisation.



https://www.facebook.com/PeterStefanovicJuniorDoctors/photos/a.160601644322466.1073741828.156333781415919/546345255748101/?type=3&theater


I have lived long enough to experience several reorganisations of the Heath Service after its creation in 1948. The first was in 1974 when the health function of local government was significantly downgraded with the loss of preventive services under the direction of the 'Medical Officer of Health'. To some extent the 2012 changes reverted the situation but within the context of huge cut backs. 

Of course if the number of Health Visitors is reduced, it is reasonable to expect greater demands elsewhere in the doctor's surgery or A&E or need for intervention by Social Worker and even criminal system. Sadly Governments see only possible savings and not the costs that arise elsewhere. (Can we overlook the health implications of the historically high prison population (about 90,000) despite all the non custodial sentencing?)


So those at the head of government and the NHS are faced with an huge unwieldy organisation with limited room for manoeuvre, once described by one expert as "squaring the circle" - the need to reconcile uniform standards of management and clinical practice, with local involvement and accountability. High technology and expertise inevitably result in local hospital and facility closure. 

I am unconvinced by this trend that results in long journeys in non urban areas either in response to accidents or courses of treatment. The 'magic' hour following an accident or major health incident before specialist attention is available is often compromised with fatal consequences. If an ambulance is delayed or if the journey to hospital takes too long, what is the point of vastly superior facilities provided there?

A recent non-fatal incident to a young person I happened to 'stumble' on was attended by two ambulances and two helicopters (air ambulance and coastguard) besides several police vehicles. In a way it illustrates the modern situation: In the past the injured person would have been carried just a couple of miles to the local hospital by ambulance. The ambulance personnel would probably have been less highly trained and the equipment at the hospital less sophisticated but it is unclear whether the final outcome would have been any worse.

Now the distance of about 25 miles to the A&E centre increases the justification for air transport and highly trained personnel. Because the hospital covers a much larger area we might expect the facilities and medical staff to be more specialised yet far busier with longer waits often in ambulances.

How are we to judge how this all balances out for the injured person? However there is one clear conclusion: the present system is much, much more costly. The air ambulance is stated to be seven times as expensive as an ambulance but can do the job of seventeen - a rather dubious claim as presumably it is in addition to the ambulance fleet. It costs about £3 m a year, much of it covered but public subscription, so this is not a cost for the NHS apparently. As of 2007 (WIKI) it cost £350:00 a flying hour which presumably has increased. Two para-medics are employed and paid for by the NHS. The coastguard helicopter will doubt have similar operating costs.

It is a truism that you cannot put a value on saving a life and that helicopters offer advantages to accident victims, but just this aspect of the health service illustrates why it is so much more costly as it once was and why Government funding is never enough.

Unhealthy statistics.

Returning to the issue of 'heath' and the service that has theoretically to ensure it, all the indicators it is coping are not good. In fact they are very unhealthy. Almost every indicator of provision and performance - hospital beds, operation waiting time, A&E waiting times, ambulance response times, death rates and life expectancy - show significant decline.

Meanwhile the discrepancies in vital statistics between regions and social classes are as wide as they have ever recently been. Life expectation has for the first time dropped by a year and a person in the North West can expect to live ten years less than someone in the South East. 

The gulf is much greater of course if we were to compare the lot of the homeless drug taker on the street and the affluent retiree. And this nearly forty years after the 1980 Black Report  assessment of "Inequalities in Health". These facts impose an obligation on us to view the topic of health and the NHS in a much wider context.

The Socialist Health Association observed as follows, "It was clear that the Government would have preferred to suppress the whole thing, and it is greatly to the authors’ credit that this did not happen. However you do not need to read very much to see why the Conservatives wanted to suppress it."

That was at the beginning of the '80's. The underlying reason for the inequalities in heath remain and in some respects have worsened but this is something that government and society at large refuse to acknowledge or address. How can we consider the problems faced by the NHS unless we look at causes as part of a wider context?

Societal obligations v. Personal responsibility.


Seldom is the NHS issue addressed in terms of personal responsibility. Much of ill heath (a majority?) is down to behaviour and choice. This has huge health and cost consequences. How do you get people to adopt reasonably healthy life styles that tend to be inversely proportional to education, class and wealth. Is this because the poorly educated want to be ill and lead shorter lives or because they can't or don't know how to avoid it? Often healthy options are more expensive options but this is not always the case. Fashion, peer pressure and convenience all play a part. 

Obesity alone has the potential to bankrupt the NHS unless drastic steps are not taken to prevent it which has to start in the Primary School. Being overweight, relatively uncommon in Britain fifty years ago, is now a major issue with implications going far beyond the obvious visual and social ones. Many diseases are correlated besides the much talked about diabetes including a range of malignancies. As overweight people age it can be expected to place an ever increasing burden on NHS facilities and finances unless the trend is reversed.

But we need also accept that many disease or accident inducing factors are largely beyond the control of the individual. For example the parameters of our accommodation, of the air we breath and the food we eat are set by others and by organisations that may not be responsive to our concerns, indeed motivated to the opposite. The many who die or suffer injury from transport and other accidents may be totally innocent parties. 

"Informed consent"

Much of heath treatment is taken on trust that it is the best available without much in the way of personal choice. "Informed consent" may be an established and fundamental principle of treatment, but more in theory than practice. The unconscious patient cannot make it and a patient suffering from mental or debilitating illness may be less able to. The 'average' person is in no position to question medical knowledge, 

Academic qualifications may be important but leading a fulfilled and healthy life is more important. Ageing is not preventable unless by early death, but there is no reason why people should not stay healthy longer, as many now do. Effort must be directed towards providing decent physical and social environments to enable older people to remain independent. This is not beyond the wit of man. If not people remain in hospital longer because they cannot be discharged. With the breakdown of traditional family ties this becomes a bigger problem.

Penzance Public Meeting (Friday 26th January, 2018)


https://www.cornwalllive.com/news/health/fears-over-future-nhs-cornwall-1134800

The meeting arranged by former Helston MP and Health campaigner Andrew George included panel speakers Dr Malcolm Stewart (clinical director at RCHT), Dr Neil Walden (local GP and Penwith CCG locality lead), Marna Blundy (West Cornwall Healthwatch), Stuart Roden (Unite union regional officer) and Cllr Rob Rotchell (Cornwall Council) Health and Care Cabinet lead). It should be noted that the current Conservative MP for St Ives, Derek Thomas, had been invited but did not attend.

(For information and reports on it see the following:

• https://www.facebook.com/photo.php?fbid=1918187845177106&set=a.1486666811662547.1073741830.100009577272672&type=3
• https://www.cornwalllive.com/news/health/fears-over-future-nhs-cornwall-1134800.amp
• https://www.andrewgeorge.org.uk/hospital-trust-chiefs-criticised-large-nhs-public-meeting-penzance/
• https://cornwallreports.co.uk/nhs-consultation-at-penzance-ends-amid-chaotic-scenes-as-angry-crowd-demands-investment-in-health-not-cuts/
• http://www.falmouthpacket.co.uk/news/15904004.Save_Our_NHS_meeting_attended_by_over_200_people/
• An earlier meeting:https://cornishstuff.com/2017/01/11/penzance-is-revolting-public-stp-consultation-descends-into-shambolic-chaos-video/)

Today (3rd February, 2018) it is reported that "thousands" were marching in the rain in London in support of the NHS and against planned hospital closures in Lewisham and other cut-backs and privatisations. The demonstration began at Gower Street in Central London at midday, and marched to Downing Street at 1pm.

Meanwhile back in Penzance similar fears were expressed in response to the news of the government’s plans to cut £264 million pounds from Cornwall’s NHS budget. It is difficult to reconcile the Government's position that its funding is keeping pace with inflation when faced with the reality of these substantial cuts to an already pressed service.

At the second meeting (the first attended by three Cornwall NHS officials broke up in rancour and confusion apparently) I attended the subsequent one with about 200 others. Significantly the local Conservative MP, declined an invitation. It was a better organised and well run affair, including microphones that worked even! There appeared to be a consensus that if the proposed cuts were carried through it could only result in further deterioration of the service provided.

One pressing issue of concern was the planned closure of the "Sunrise Centre" for the treatment of cancer resulting in patients having to travel to Plymouth or Exeter, the practical implications of which were movingly described from the floor.
(See: http://www.cornwallcancercare.co.uk/sunrise.htm)





It is only fair to note that Cornwall MP's have made representations on this matter to the Minister of Health. In fact two, including the St Ives MP Derek Thomas, raised the matter at a recent Prime Minister's questions. Sadly for him, he rather muffed his lines and called it the "Sunset Centre" which some might think was something of a Freudian slip. Derek Thomas of all people has much to be thankful to the National Heath Service, one of his children having suffered a long and fatal disease.

Ever member of the panel expressed an opinion from their own particular perspective, although I doubt anyone was much the wiser about the organisation or realities of this complex system by the end of it. There was far more heat than light and emotion than fact. Apart from the closure of the Sunrise Centre, no one was really clear what the practical consequences would be other than less money must entail a worse service for those in need of medical intervention.

People were clearly attached to the NHS founding principle of "free at the point of use" and against cuts and prepared to demontrate in force, as they had done fifteen years before, but to what practical effect? In the intervening period Penzance has seen its cherished local hospital and A&E steadily down-graded to effectively a geriatric hospital and minor accident centre, whilst services have been concentrated at Truro Treliske.

It comes as no surprise to locals that Treliske is over-stretched, whilst ambulance costs and response times must have increased as a result of increased travel distances. As far as I am aware no study has ever been undertaken to determine if outcomes have improved or deteriorated as a result. If inconvenience and stress are indicators, the latter is far more likely I would say.

As usual the underlying complicated issues were hardly addressed. How could they be? A very frail-looking Dr Malcolm Stewart said he had suffered a serious medical condition since his appointment as Clinical Director at the RCHT requiring intensive NHS treatment and six months off work. It was not entirely clear - to me at least - what his job entailed or what he had achieved. I don't think I was alone in that regard. Ever since the Hippocrites, medicine has been surrounded by a certain aura of mystery and inviolability, that certainly Dr Stewart was going to do nothing to change. He left early to catch a train, to attend an important meeting elsewhere the next day, so was unable to answer any questions. This drew some adverse comments from the audience and panel.

Dr Neil Walden, a local GP endeavoured to present a more positive and optimistic impression including the fact that West Cornwall Hospital was to have up-graded diagnostic (Magnetic Resonance Spectroscopy ?) technology. Details of how this would impact treatment were not forth-coming but presumably can only be positive.

Marna Blundy (West Cornwall Healthwatch) was clearly a dedicated campaigner to retain high quality treatment and care inside Cornwall. How this was to be achieved within government policy and financial guidelines was not so clear.

Stuart Roden (Unite union regional officer) was perhaps the most pessimistic. He said that in his long career he had never known a time when the NHS had been under greater threat from Government "initiatives". 

Cllr Rob Rotchell  (Health and Care Cabinet lead at Cornwall Council) He generally supported the previously announced position that Cornwall Council was facing less funding from central Government, as well as increased pressure as a result of rising demand for services. This means that despite the £300 million savings we have already made, we still have considerable savings to find in the years to come. One practical consequence appears to be a December decision to cut £400,000 from its health promotion budget affecting heath visitors and school nurses.

Andrew George, for many years the sitting (Lib Dem) MP, said he supported Lib Dem Norman Lamb MP and 90 MPs calling for an NHS and Care Convention to be set up in the NHS' 70th year. He added "There is no doubt that more money is needed. However, it is untrue to claim that NHS Kernow faces £270 million cuts. He stressed that over the same period Cornwall and the Isles of Scilly are set to receive a £142 million increase in their allocation. As well as this, he said,  that Cornwall received more than £1.5 million to assist with winter pressures.

So we may ask are the scare stories accurate? Are the reported cuts in service such as paying for huge transport costs, currently in the region of £6 m true or false. In fact this is a problem issue nationally. Trying to distinguish between truth and hype.

NHS Privatisation in Cornwall

The practical implications of pending changes in Cornwall that would translate aspects of the NHS into an 'ACO' or 'Accountable Care System' were hardly explained or discussed despite its potentially dramatic implications. I doubt if more than a handful of the audience could explain what it entails - apparently a transfer of functions aimed at better integration of treatment and social care. 

What this means for the patient - or should we call them 'victims'? - remains to be seen. I suppose it all depends on whether you are a 'glass half empty' or a 'glass half full' sort of person? Opponents say it is privatisation and 'Americanisation' by the back door. Others see it as better and more integrated management of services and limited resources.

Cornwall Council has said: "An ACS does not change each organisation's statutory and legal responsibilities. Instead it describes a way of working together that allows for a one strategy, one budget and one plan approach which puts the person not the organisation first.

"As well as being in agreement about the approach, all are signed up to making progress and testing out the practicalities by working in shadow form during 2018/2019.

"The shadow ACS will operate within the existing statutory framework which means that the Councils, NHS England, the CCG and provider trusts will remain the statutory accountable bodies in the system.

"Work will be supported by an accord which describes the principles of collaboration agreed by all partners involved in the ACS".

Any the wiser?

Dr Iain Chorlton, Chairman of Shaping Our Future's Clinical Practitioner Cabinet, has said: "Our plans to transform health and care detail the need for greater integration between health and care services. The results of our ongoing engagement with the public, clinicians, health campaigners, and people working across health and care, show support for a more joined-up delivery."

See: https://www.piratefm.co.uk/news/latest-news/2454737/anger-over-new-health-care-plans-for-cornwall/

Seventy Years of Health?


https://static.guim.co.uk/sys-images/Guardian/Pix/pictures/2016/1/8/1452265364635/Guardian-6-July-1948-001.jpg


Had the initial philosophy been sound seventy years ago, all disease would now be cured and everyone would be 'healthy' presumably. Sadly that is not and never will be the case as long as humans are humans and society is society as we know it.

The NHS, beside being a gargantuan organisation and the biggest employer in the country, needs to be all things to all people that it manfully strives to do, but the question emerges how much money is 'enough' or put another way, will there ever be 'enough'?

The supply of money is only one side of the 'supply and demand' equation. If we create an environment that causes disease, or if people continue to make themselves unwell, can we expect an organisation to forever provide free treatment whenever required?

Just taking one example, diabetes has the potential to bankrupt the NHS on its own, yet as a society we have allowed the known precipitating factors to proliferate in a reckless negligence. As someone once famously said, "We are so busy pulling people out of the river, we don't have time to ask who is pushing them in up-stream."

Norms of behaviour and expectation underlie everything. The 'magic bullet' seems to have been the prevailing philosophy for decades that has turned GPs into 'pill pushers'. This is also a problem rooted in the philosophy of medical practitioners themselves and is now coming home in job dissatisfaction. People don't want to be told to change their way of life as the only permanent cure and doctors don't want to tell them.

Besides the facilities are not there because chemical cures have been chosen over more difficult options. Recent television programmes have proved the largely ineffectual nature of chemical and other prescriptions. The adverse effects of Statins; the over-prescribing of anti-biotics and bacterial resistance; the contribution of anti-depressants to suicide risk, are just three examples of many. Information on the relationship between inoculation and a huge surge in child autism has been energetically suppressed.

There is even a word for medical or surgical complications: "Iatrogenesis". Wikipedia states: "Globally, as of 2013, an estimated 20 million negative effects from treatment occurred. It is estimated that 142,000 people died in 2013 from adverse effects of medical treatment up from 94,000 in 1990. Clearly not a minor issue.

There are so many other issues not confronted or addressed that has a direct effect on the NHS:

• Addiction or over indulgence in illegal drugs, alcohol and smoking, primary amongst them. 
• Family break-up and homelessness. 
• Poverty and unemployment generally as a factor of economic policy and activity. 
• An ageing population. 
• An increasing population because people live longer and net immigration, often with their own unique health issues. 
• Sexual activity norms and related disease. 
• New expensive procedures and drugs. 
• Accidents generally and particularly linked to transport and other activities.
• Mental illness and depression itself caused by the above  
• And as I have said, the ever increasing expectation that medical intervention will cure the problem or lead to longer life. 

We need to realise that the philosophical underpinning of a society is absolutely fundamental to what can be expected of a heath service - more properly described as a National Disease Service.

At this meeting who mentioned strategies of prevention? That no one did, highlights a major part of the problem.

Pat Carey

34 mins · Wicklow, Ireland · 

Waiting in corridors, people sick in a bed
Some not so poorly, some look half dead
Doctors and Nurses all rushed off their feet
Clocking more miles than a professional athlete

Angry guy at reception, thinks he's fractured his arm
Screaming "get me seen now and then I'll keep calm"
"The staff are all busy" Is the receptionists answer
"Trying to save a man's life who's dying from cancer"

The girl who's hungover after way too much wine
Could have just slept it off and you would have been fine
But you came to the emergency department as you felt you were dying
Now the really ill wait for the bed you're occupying

People's tempers are fraying, after hours of waiting
Patients slagging off staff, who can hear all the slating
But they turn a deaf ear, as they have work to do
Carry on with a smile as they look after you

A mother says they should hang their heads in shame
For the wait she's endured, but who's really to blame?
On his own in the street, when your kid took a fall
But' we'll patch up your child and we won't judge at all

Your name gets called up and you're finally seen
Yet you carry on moaning about how long it's been
The nurse says she's sorry, all watery eyed
She was comforting a parent whose child had just died

Some folk are there, through no fault of their own
They've fell down the strairs or broken a bone
Some just have a cut or a graze to their head
Some OD'd on drugs, which one first gets a bed?

Ten hours into shift, staff not yet had a break
Hungry and thirsty and every limb has an ache
And the patients keep coming, though some needn't be there
But they won't turn you away, they'll continue to care

So next time you're all moaning about our HSE
Just remember it's not staffs fault it's in such a mess
They are doing a job that a lot couldn't do
Often working for pittance to help folk just like you

And remember if this was some other country
That don't get free treatment, then where would we be?
In times of an illness or when we feel in distress
We should all be so grateful for our HSE

A recent case study added 18.10.22

A letter to me: "Hi Tim.

Thanks for your letter. I think it took me around a week to smell the very fishy smell coming out of the covid narrative. I haven't conformed since and as you know, once you see it, you can't unsee it.
Around me, within a few hundred yards, we have several people collapse onto their faces. They don't even have time to put their hands out to protect themselves. In roads, their houses and public spaces. Most have been badly injured with broken noses and arms. And brain bleeds which cause lasting damage. None of them have connected the fact to their recent receipt of a mRNA shot.
The ward in St Austell hospital (24 beds) that is for people recovering after surgery is now almost entirely full of people who have collapsed. Hospitals and hospital staff know this and yet, it's a well kept secret amongst them.
I believe I may have been one of the earlier victims of selected DNR here in this country. On March 4th 2020 (the day before anyone had died of c19 in the country and before any announcements of lockdowns, I was found unconscious with a serious case of CO poisoning. (I had been unconscious for 4hrs and was in a very bad state). Paramedics turned up (after an hour and a quarter on a slow night), put me in the ambulance and then stayed park in a quiet country lane for an hour. No treatment. Nothing. Just chatter.
Eventually I was taken to Treliske. The A&E dept was like the Marie Celeste. No people waiting and empty beds. Then I was abandoned more or less. No doctor attended, no pain assessment (the pain in my head and spine was extraordinary) and most important of all, still no oxygen. I literally begged for oxygen but none came. My partner turned up and asked again for gas to the chattering nurses. Still none came. Eventually a doctor stood in the doorway and told me to go. My partner had left to go to work so I had no way of getting home. I was covered from hair to feet in vomit and faeces (this happens when you're dying) but told to sit in the waiting room with other people for hours until I could get someone to collect me.
I wrote to the hospital after two days about this. They investigated and eventually replied that 'A doctor should have attended. A pain assessment should have been done. I shouldn't have been left for hours in filthy clothes. I should have been given oxygen. For we apologise. We will learn from this'.
From that time I have had permanent throat ulcers, burning lungs, kidney disfunction, broken teeth, mouth lesions, many teeth extracted due to ulcers, hair loss, anaphylaxis etc etc. Signs of an autoimmune disease. Of course, the gassing could well be the cause but the negligence of the hospital contributed. They have admitted negligence but block me getting a diagnosis and therefore treatment at every turn.
My thoughts are that they took one look at my age (63 at the time) and DNRd me. I didn't die so they sent me home. Clearly the emptying of the hospitals had already started and the policy of no treatment too. I may well have been labelled as a covid death had I not survived. Possibly the first one in the UK. Not and honour I aspired to.
We know there is oppression of anyone who speaks against the narrative. I see bullying in your case with people 'ganging' up on you. I despise this mob mentality and only have admiration for anyone who speaks up. I learnt that challenging those with cognitive dissonance is pointless as their reaction is hostility and ad hominem attacks. I changed my approach to what I call 'sowing seeds' and use humour whenever I can to pre-empt the following anger or annoyance. This drip feed gives people the chance to go away and maybe, think a little.
As for the rest, they'll never wake up.
Anyway, all the best. "