Rethink Health - July 2008

News through the Good HealthKeeping lens

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NHS at 60: déja vu

I am older than the NHS, though not sufficiently to remember anything else. I feel quite healthy and up-beat myself at 65+, so why does this anniversary depress me?

It’s because the service we have now is less like a service for health than it has ever been. Worse still, it continues with great confidence to head in the wrong direction.

Even during my own medical career, which started in the late ’60s, ideas have surfaced, been discredited and recurred like weeds a decade later – all discredit forgotten. Professor Morris’ expert team, for instance, examined ten screening methods popular until the ’60s, and showed that not one of them worked or provided value for money. That stopped routine x-rays for tuberculosis and blood tests for anaemia, but cervical cancer screening was resurrected years later to paper over the adverse effects of contraceptive pills and HRT. The manufacturers resisted any suggestion that these pills should go, and a discredited test was the best the politicians could offer instead.

Several more recent instances of this sort are reported below. None of them is new.

On balance, I believe that the NHS has been hijacked by promoters of drugs and medical equipment. Their responsibilities are to their shareholders, not to the unwell – let alone the few remaining healthy. Our politicians and public health officials have been disgracefully supine when approached with every vaccine and “preventive” medication as it becomes available: they enter the schedule almost immediately.

But movers and shakers are not solely to blame. We citizens have largely been given the service we deserve. Few of us are willing to put ourselves out for the sake of maintaining our health today, let alone preserve it life-long. We expect to be bailed out by some magic bullet or other, whether a pill or a benefit cheque.

However, I must exclude present company. Readers, you have thrust yourselves head and shoulders above the general run of things. You have thought for yourselves, taken some brave decisions and prevailed over opposition. You have spent that bit more on food to ensure its quality, taken trouble over parenting, kept up a bit of exercise. In short, you have embraced life. And you will harvest the benefits – self-respecting, resilient children, immune to infection with the mediocrity that surrounds us all, and blessed with parents who remain fit late into old age.

You are the only health service we have, and I salute you.

POLYCLINICS

In 1970 I helped run a Department of Health research project intended to prove that health centres were a good idea. My academic career came to an end when I realised that they were not: I jumped before I was pushed. I had found that any team of more that three people would drown in their attempts to stay in touch with each other. Three people just bump into one another every day. More than that need meetings and memos.

For health centres, now read polyclinics. They may be better equipped, but better hospitals have not reduced disease. Communication and continuity will only get worse. Patients will not be heard, and no-one will tell them what they need to know.

A healthy nation is not built from above down, but founded on millions of one-to-one relationships – parents with children, and doctors with patients – that inspire and motivate initiative and self-reliance. Remember that the next time someone in a check-out queue asks your advice!

Food Additives

A recent paper in the BMJ re-discovered something we have known for about 30 years – that colourings and some other food additives significantly worsen children’s behaviour. Though the European and British Food Standards Agencies have produced flabby responses to this body of evidence, they do both concede that there may be something to be done. Perhaps after all, says the BMJ editorial, the “alternative” treatment of additive withdrawal should replace the “standard” drug treatment. Amen, but please withdraw sugar too. For details of how, just ask. And read 'We Want Real Food' by Graham Harvey & published by Constable & Robinson, recommended by one of you.

Oestrogens: Patch good, Pill bad

A recent systematic review confirms that swallowing oestrogen makes blood more likely to clot, but shows that patches do not. Progesterone reduces considerably the amount of oestrogen you need, which must also be good.

Mediterranean Food keeps Diabetes at bay

It wasn’t a brilliant study, but fewer Spanish students became diabetic within 5 years if they ate the Mediterranean way than if they didn’t. What is Mediterranean? – ask.

Too Much Fluoride already

I have completed analysis of UK official research and conclude that fluoridation of water gives most consumers too much fluoride. We are considering how best to share this information, starting with a presentation in Brussels next week. “The prophet is not without honour, save in his own country”…? – we shall see.