The English Diet and Other Drivel.

Not been too well of late, so I'm having to catch up with a few things. Quite debilitating back pain was the problem; something I've had for some years due to a 'hard life' but which responds to physiotherapy relatively quickly. My thanks once more to Robin McKenzie again for his excellent protocols, they have stood me in good stead, when my back succumbs to the disc problems I am plagued with from time to time.

Posture corrected then, I can (hopefully) satisfy those who waited with breathless eager anticipation for my latest post, filled with my rapier like wit and surgical dissection of the sensible from the profoundly stupid, and there's been a lot of that recently.

The 'English Diet' came in for praise, on the back of a 'study' from Oxford University, and it's pretty much 'wibble'. Based upon the 'Dietron Model' a sort of Monte Carlo simulation (more wibble). It hypothesises, that data gleaned from self reported information from people, (that no doubt told many lies about what they ate), could be in any way be useful to a scientist in his/her pronouncements about that which might make a difference to the health of each of the nations that make up the United Kingdom. House of cards built upon quicksand is the only conclusion that I can come to. It's a corruption of a meta-analysis, that's purely self-reported and observational with a huge array of confounding factors that are ignored. Why anyone takes this sort of rubbish seriously when most, if not all of the conclusions have been proven by good scientific studies, to be untrue really makes me cringe.

It is suggested that saturated fat is taxed and that fruit and vegetables be subsidised and of course salt is restricted. All in the name of better health for the nations that border England. It continues the myth that if we all eat 'healthy food' like (highly volatile) seed oils, rice, pasta, whole grains (brown food), fruit and vegetables (full of starch and sugar) we will possibly live forever! This is of course the advice we've been given for about thirty years with no appreciable benefit thus far other than an increase in the profits of the food cartels and supermarkets, and an inexorable rise in the output of 'Big Pharma' to counteract the consequences of this blatant rubbish. I have debunked most of this before and written extensively about the dogma that masquerades as science, but so long as these 'faux' studies are given air time and media coverage without challenge, ever will it be so.

Moving swiftly on, I note that illustrious body the British Medical Association (BMA), the Doctors Union has pronounced on smoking in cars, especially with children in them. The eminent Dr. No has done a first class 'hatchet job' on the evidence, so I don't need to, except to say that the BMA would be better expending its time and its members funds on other pursuits such as protecting patients, and their membership from attacks by the GMC than involving itself in this sort of support for the Neoliberal agenda to curb personal freedom. This attempt by Vivienne Nathanson to once more proselytise, using the 'child harm' card is typical of most of the 'politicised' class of Doctor, invoking the hysteria that allows the actual evidence to be forgotten, in the face of the dogma. This is the ethos of medical ethics 'at the top'; ignore the vast harms that are perpetrated every day in health care in favour of a distraction to grab a cheap headline in the Sun or the Daily Fail Mail.

Salt, specifically sea and rock salt, is in the news and has been shown to be little different to 'normal' salt. Except of course for the additives, which they obviously didn't include in the analysis. Pretty much the same the conclusion arrived at when organic food was debunked in the media as being no different than say McDonalds'. Of course if one blasts things in a bomb calorimeter all you are doing is analysing the basic constituents and ignoring micro nutrients, which are an important constituent of the human diet that are generally lost in processed food. The same of course is true in salt.

Sea salt, is generally lower in iodine and richer in magnesium than is table salt, but the main thing is that it's natural product used by man for eons, both as preservative, condiment and ingredient, even as a means of payment ( 'sal' means salary). Iodised table salt, whilst having some advantages for thyroid function is also full of additives to make it 'free-running', and anti-caking agents so it doesn't 'stick'. My personal view is that sea or rock salt is better (rock salt is 'old' sea salt), and like many natural products you use less. As for 'low sodium' salt, well, we just put more on our food because you can't taste it! In fact the evidence still shows that sodium reduction has virtually no effect and can even be counterproductive for overall mortality.

And GlaxoSmithKline is having to dig deep to settle its dispute with the US Federal Drugs Administration (FDA). The largest payout in 'Pharma's' history. Even bigger than Pfizer's payout in 2009. It's unlikely to dent the drug giants A+ credit rating. Well there's a surprise then!



And finally  from my new friends, over at the Low Carb Diabetic; this is priceless. They have suffered greatly of late from the sort of complaints that beset bloggers and had their blog removed/blocked on occasions and had a lot of grief from the mainstream idiots aligned with, well you know who they are.

A Pause For Thought?

Cameron, Lansley et al, have announced their intention to have a 'natural pause' in the Bill to reform the NHS. A 'future forum' including that 'porcine' (honorary) Professor, Steve Field is being launched upon the country, to listen to the views of the NHS constituent about the changes that have been proposed (excuse me whilst I choke). Once this period, which coincides of course with the Easter Recess anyway (yes more holidays for the politicos), is over, the Bill will be sent to the Lords for perusal and possible modification.

The problem I have with the current and past reforms, is that they continue to concentrate on structure instead of quality, organisational change rather than the ethos and tenor of what universal health care should be. For far too long the NHS has stood for invasive and pernicious campaigns to to persuade us  (and now nudge us) into a new horizon of well being with moralistic and ill conceived measures about smoking, drinking, sex, and diet, indeed anything enjoyable. With social engineering at its heart, the anxieties of society are constantly addressed by campaigns to reduce cancer, heart disease and diabetes with little result other than a significant  elevation in the Nations blood pressure.

This has in turn led to poor quality health care, dispensed '9 to 5' (weekends and holidays excluded), in Hospitals and Surgeries, to a somewhat hostile patient cohort, who are now being appealed to by the NHS constituent, to 'save the NHS'. Those who have delivered this inferior and authoritarian 'we know best' standard of that which passes for Medicine, cannot really now expect the public to 'go to the barricades' and fight for them to keep their bureaucratic temples intact.

The NHS has presided over ever increasing levels of interventions into our lifestyles and behaviour, very few of which are founded upon any evidence or indeed have had any success. Doctors have become the 'health police' rather than the healer, and as they have distanced themselves from their patients they have prospered enormously in monetary terms, but lost credibility. They are now pawns in the Neo-Thatcherite construct started by Blair and continued by Cameron and his academy of 'toffs'. An NHS that has treated society with such contempt, despite its huge cost to that society deserves to founder.

I do not like the changes proposed very much. They amount to little more than a bureaucratic reshuffle; a movement of the deckchairs, because the fundamentals remain. But the opposition that has formed against it almost worries me more. If Allan Milburn, the BMA and the King's Fund  ( and David Owen for f***s sake) are against something then I'm afraid I will possibly have to review my position. In fact as the number of unprincipled and opportunistic politicians grows, who oppose this Bill, the more I become alarmed that I may have missed something! Hardly surprising in view of the number of pages it runs to (299 clauses!). Perhaps there may be some nugget of redemption in this pointless, needless and irrational Bill after all? Oh yes, the Quango's are going! But no, they are being systematically saved, if not by name then by transfer, such as the Food Standards Agency to the Dept of Health.

Doctors and the BMA never wanted an NHS, of that be certain. They wanted an elitist cohort of Physicians that dispensed wisdom and medicine to the 'proles' at a price that they set, not one set by some 'oik' in a Government Department who went to a ...Grammar School?  They persisted in this view until the Thatcher years, when Maggie offered them more power and control at the expense of a bureaucratic nightmare of invoicing procedures and budget management, when they decided that it was all too much, a bit like the 'poll tax'. Then along came Blair, all fired up to change the mindset and the BMA embraced him. All at once the BMA discovered it's desire to participate in Government sponsored (and guided) health care resulting in massive financial benefits to the membership and less hours! Well that was a surprise then?

Incentivised, at a level they could not have dreamed possible, most Doctors and Hospital Consultants doubled their pay, and reduced their involvement in patient care. 'Out of hours' was handed to private companies and A & E to trainees and locums (60% of all Hospital Doctors are locums).  The patient became the supplicant expecting little and rarely being disappointed. Many died, were maimed or at best received poor care and continue to do so. Yet the gravy train for Doctors, now irretrievably committed to peddling 'Big Pharma's' often substandard or even useless products, rolled on, with further and more intrusive protocols, even for the 'worried well', moving medicine further and further away from diagnosing and treating disease, to fruitless and dogmatic (usually wrong) prevention interventions that were founded in poor or even bad science.

At no point in this train of events was it thought necessary to involve the patient, save for 'patient, public involvement' rhetoric that only sought the views of an unrepresentative minority, of charities and professional middle class campaigners, with the time and money to be involved in the 'tea and biscuit' culture of meta-quango's, discussion forums and pointless conferences. Constantly harangued, largely ignored, the public in general wants little to do with the NHS or even their Doctor, now ensconced in expensive and shiny Health Centres, except when they are sick or fearful. Then they are treated to an endless list of questions, unrelated to the condition they have presented with, to ensure the practise fulfills the QOF protocol and a test regime more interested in their 'lipid profile' than their pain. Is it any wonder that as 'modern medicine' lurches toward wholly preventative measures, instead of treating "the poor and the lame, the sick and the dying" (1), that we are becoming more and more disenchanted with that which we are financing.

There now seems to be a further erosion of NHS principles, driven by privatisation of Primary Care that has more to do with dogma than need, the desire to furnish capitalism with further subsidy, and the utilisation of the latest 'mousetrap' from Pharma, whose greed continues to know no bounds. Older drugs, and medicines that were 'fit for purpose' before, keep falling off the end of the list, for no reason other than a desire to use the new and shiny one approved last week, irrespective of efficacy. Once in fact, all of those in the NHS have had their piece of the cake, there is little left for the actual patient, except indignity, poor care and nonsensical intrusion into their lives. And yet, are not all of these people there for one purpose and that purpose only, to pursue the practise of Medicine?

Change is in fact needed and drastic change at that. Justice for the harmed, together with Candour. Genuine scientific protocols to improve lives, not the treatment of symptoms for the enrichment of a pernicious industry that no longer is fit for purpose; 'Big Pharma'. A cessation of intrusive, patronising and ultimately fruitless endeavours to engineer social change, with fear. Medicine without the boundary of 'out of hours', peopled by real physicians, who actually know what they are doing. Yes let's have a real and vibrant 'Big Society' in the NHS that recognises its goals are set by its patients, not by its political masters and I include in these the BMA, the GMC and the bloody 'think tanks'. In fact I'd rather like to put a tank on their lawn, and see if I could get Niall Dickson, John Appleby and Penny Dash with just the one round. That would be fiscally responsible would it not?

So whilst you politicians are are all pondering, as to what cosmetic changes you can make to a Bill that is widely reviled, and the GP's squeal about how they will be able to cope with all the extra work, without some extra payment (again!), spare a thought for the poor sodding patient, because they're the reason we have an NHS. They aren't the one's that fucked it up, you are!

"Perfection of means and confusion of ends seem to characterize our age." 
(Albert Einstein) 


(1) Quotation courtesy of Morton Thompson - 'Not as a Stranger' C1954.