The title of this blog was conjured from the place I live, looking down from the hill to the Teaching hospital that has been the source of most of my of my fears, misery and trauma. It also lends an air of an overview of life
That place is one that I avoid, like the plague. In fact I go to quite considerable lengths in this endeavour, often driving a circuitous route to do so, such is the effect it has on my state of mind. Yet it continues to intrude. Letters keep arriving for appointments for this Clinic or that Test for my lovely J to attend, in the very place that treated her so badly as to her never wanting to go there ever again
This made me think as to why the NHS wants to intrude in the lives of us all so much, as to book appointments out of the blue and then entreat us to attend with an attitude bordering on that of the bully. Often this is for mammography, blood tests or Retinopathy tests, all in the interest of disease prevention. But is it?
The NHS spends a huge portion of its budget finding things to test its patients for. Some of these are without doubt both important and non invasive but many are not. Cancer figures highly on the list and yet real outcomes have altered little in the years that most of these tests have been around and some, such as the exercise to perform mammography on women between 50 and 70 years has had little impact on the incidence of breast cancer. In fact the scheme itself has been shown to be positively dangerous for women who have cancerous growths because it can exacerbate the spread of these and speed progression. It also has an alarming number of false positives that cause fear and suffering to no good purpose. Other detection measures such as self examination and thermography are likely to be less intrusive and give back to women the right to make their own informed judgement as well as exposing them to less radiation, which in itself can be a cause of cancer. This is especially true of J who will have one or two X-rays a year to monitor her prosthesis together with a DXA scan for osteoporosis every two. Mammography itself exposes women to at least 1000X the dose of a normal X-ray, more if you have to return for a repeat in the event of an abnormality.
So why do we do it and more importantly why are bullying tactics employed for this, for blood tests we didn't know we needed, to check our cholesterol, eye tests we've already had at the optician but the NHS feels now only they can perform adequately ( the opticians used to do them but it was taken away). Letters now that not just request you ring for an appointment but tell you one has already been made! This is just the same as the clauses in contracts that you have to positively opt out of instead of opting in. Not only are they spending our money on dubious test procedures they are telling us often that we will fall prey to some awful disease or condition without them!
This is disease mongering and as Big Pharma seeks more markets for its often dubious products, some of which are a rehash of one that didn't quite work in its previous role but will be successful in a new persona for another ailment. So it invents diseases or conditions and the NHS which relies heavily on the Pharmaceutical giants for funding of projects, research and dubious jamborees for consultants and managers, swallows the bait. Just, it has to be said as do a body of GP's and without doubt the Government.
Statins are probably the worst example of this; a drug to treat the 'worried well' for a condition that largely has no symptoms and a hypothetical outcome founded in dubious research (by Big Pharma) to utilise an obscure poison found in a remote Chinese valley that they needed to offload on a gullible ( and well 'palm greased ) FDA to pay for the research they had undertaken. The result is now 450 million pounds of revenue from the NHS every year to pay for the prescriptions most (if not all) that are not needed and can cause the very problem they allege to ameliorate, heart failure. That figure does not include the support costs of maintaining a 'patient' on these drug protocols which usually means six monthly tests for checking results and possible effects that manifest. The obvious one of course is the depletion of CoQ10, an essential for a healthy heart (sic). These tests are likely to double the cost of treatment, all for a highly dubious and contested ailment that is founded in 'bad science'.
'Statinisation' is symptomatic of an NHS that now consumes vast sums of money mainly to no effect to tick the boxes of disease prevention and fulfill pointless targets. At the same time it bullies and entreats for people to lead a healthy life with a healthy diet with hordes of highly paid support staff labelled with dubious titles to support this goal. It is self defeating and many know it but none want to 'rock the boat' of profligacy.
We are in the midst of an epidemic of Diabetes, Obesity and Heart disease that all of these efforts have failed to even dent. I would venture most of the advice and interventions are in fact counter productive. Medics need to get back to basics and Nurses need to get back to Nursing. 'Do no harm' is the clue you idiots. Get back to curing the sick and the lame. Stop trying to prevent the demise of the hypothetical sick until at least you have conquered the goal of treating those that present to you with real and tangible problems. So far, and more and more of late, Medics in particular and the NHS in general has singularly failed in this endeavour. Concentrate your efforts in this area and maybe then we could look at other goals. You are all in a hole so my advice is to stop digging!