Around the world, the number of adults in bad health has fallen from 10.4% to 8.6% as health care steadily improved. But in the UK, the number in bad health increased from 5.8% to 7.4%.
Moreover, recent evidence shows that life expectancy in the UK is falling fast – it is, indeed, falling faster than anywhere else in the world. And it will continue to fall.
How much more evidence is needed to prove that the NHS has failed miserably, is continuing to fail miserably and will continue to fail miserably?
But there is a viable and valid alternative: a health care system which could replace the NHS and provide everyone in the country with much better health care – without costing a penny more.
The solution below is taken from my entirely accurate small book: NHS: What’s wrong and how to put it right. (Sadly, I doubt if NHS administrative staff will like it much.)
‘The only way to do something about the health care crisis is to provide the public with enough information so that they demand that politicians act. It is only politicians (given support from the public) who can possibly ever replace an organisation which is basically corrupt and dangerous and which has failed its customers (the patients).
The key figures which need to be widely shared are these:
First, the amount of money which taxpayers spend on the NHS was, for 2021-22, £193 billion (this figure does not include benefit payments of various kinds).
Second, the number of people living in the UK is currently 67,886,004.
A moment with a calculator shows that taxpayers in the UK are paying the NHS £2,838 a head for looking after each man, woman and child in the country. That covers the third rate service offered by general practitioners and the second rate service offered by hospitals.
And this is where it becomes interesting because with just under £3,000 a head available to spend on health care, every individual and every family in the country could buy themselves excellent, comprehensive private health cover – cover that would entitle them to the services of a GP, available 24 hours a day and 365 days a year, and to treatment in a private hospital of their choice if needed.
How can this possibly be?
Simple.
The NHS is the most bureaucratic, over-staffed organisation in the world. Remove the many thousands of unnecessary (and very expensive) administrators and the costs plummet.
Here’s how it would work.
First, the Government would allocate £2,838 in health vouchers (like luncheon vouchers if you will) to every individual in the country. A family of four would receive four times that sum, and so on. The full £2,838 would be available for every man, woman and child – regardless of sex or age.
Those doctors wanting to work as general practitioners (or, as I prefer it, family doctors) would simply set up in their own locality and offer their services to patients. All family doctors in an area would, of course, be in competition with one another to provide the best service. There would be no need for any central administration.
And so, for example, Dr Z might say to his potential patients that he would make himself available for consultations, home visits and telephone calls for 24 hours a day, 365 days a year. He would announce that he was working in partnership with two other local doctors and that if he was not available (because he was having the evening off, or taking a holiday) then one of his partners would be available in his absence. There would always be a doctor available for a consultation or a home visit and the patient would choose whether he or she wanted to be seen at home or in the surgery. (This would save Dr Z a good deal of money because he wouldn’t need a big clinic or a great many members of staff. He could turn a room in his home into a consulting room and hire his wife to answer the phone in his absence – just as used to happen in the early days of the NHS. These days, of course, she could hire her husband to do these things.)
‘How much will this cost me?’ will be the first question a potential patient might ask.
‘I would expect you to pay me by direct debit,’ Dr Z might reply. ‘And I’d like a monthly payment of £20 per person. That’s £240 a year. For that I will provide all the medical services you require from me and you will receive all basic medicines – such as antibiotics and painkillers – at no extra charge. If you need very unusual and expensive medicines that will be covered by a small insurance policy costing just £10 a year. If you need an operation or specialist advice then I will arrange for you to be seen by a consultant specialist at one of the local private hospitals. This will be paid for through your hospital insurance scheme.’
‘So I will have to pay you even when I am well?’ the prospective patient will ask.
‘Yes,’ Dr Z will reply. ‘That is the way that doctors always used to be paid in sophisticated cultures. And it’s the way the NHS used to operate. You paid your taxes whether you were ill or well.’
‘How many patients will you be looking after?’ will be an obvious question from the prospective patient.
‘I will have no more than 500 patients,’ Dr Z will reply. ‘My practice will close when I have 500 patients. That will give me an income of £120,000 a year which will be, after my modest expenses, around the same as I earn at the moment from the NHS. You will benefit because with just 500 patients to look after I will know you and your family and I will have far more time to spend with you. And I will benefit because although I will be available at all times I will have a much smaller list of patients to care for, I will be able to enjoy the work I was trained for and I will have virtually no boring and time consuming paperwork to complete. There will, of course, be no complicated appointments system to manage and I, or one of my two partners, will see every patient either immediately or within hours of their wanting to see me.’
‘But what if I need to go to hospital for an operation or treatment?’ the patient will ask.
‘Your hospital cover will be provided by BUPA or PPP or one of the other big health insurance companies,’ Dr Z will reply. ‘They will all be required by law to offer hospital cover at the same price whatever your personal medical history or age might be. After paying me £250 a year (including the £10 for rare drugs insurance cover) you will have £2,588 a year for hospital cover. You will find that you will be able to buy excellent cover with that amount of money available. A family of four will have £10,352 available. If you like I can arrange the cover for you to make sure that you have the best local hospitals and specialists available. The bill for hospital cover will be much lower than the sum available and so there will be vouchers available for use if you want to access alternative or complementary medical services.’
And it will be as simple as that.
Everyone will benefit. It’s a win-win situation for every patient and every doctor.
The only losers will be the administrators who currently suck up most of the money allocated to the NHS.
They will have to find useful jobs outside the health sector.
Well, Doc Vernon, you've done it now. You've thrown out the most important group of no good worthless (well worse than that) bureaucrats, the Administrators and their minions. Good riddance!
Dieting Myths
12TH SEPTEMBER 2023 by Dr. Vernon Coleman
When I was a GP I found that a good many of my patients wanted (and needed) to lose weight. I developed a dieting programme which worked well. My book Meat Causes Cancer – and other Food for Thought contains basic information about food and nutrients but also includes everything I learned about slimming. (I was medical editor of Slimmer magazine for many years and medical consultant to a large slimming organisation.) Here are a dozen of the commonest myths about dieting.
MYTH 1. YOU CAN LOSE WEIGHT BY TAKING SLIMMING PILLS OBTAINED WITHOUT A DOCTOR’S PRESCRIPTION
Millions of people buy them but I doubt if any of these would-be slimmers obtain any appreciable long term weight loss through taking them. Magic slimming pills — often sold by post — are frequently expensive but, in my view, never worth buying. Most of these pills fall into three general categories:
a) Many of the most popular pills simply contain a laxative. By increasing the rate at which the bowels work these pills can, inevitably, produce a modest short term weight loss. But after a while — or if you stop taking these laxative pills — the chances are that your weight will go back up again. The major disadvantage with these pills is that if you take them for more than a few days you are quite likely to suffer from constipation when you stop taking them.
b) A second group of pills fill up your stomach so that you don’t feel like eating — or don’t eat as much when you do sit down for a meal. The major disadvantage with these pills is that as soon as you stop taking them you will probably put back on all the weight you have lost (if you’ve lost any at all).
c) Thirdly, there are those pills which contain a diuretic. A diuretic is a substance which encourages fluid loss. In my view these pills can be dangerous because they could damage your kidneys. And, of course, once you stop the pills you will put back on any weight that you have lost.
MYTH 2. THERE ARE FOODS AVAILABLE WHICH WILL BURN UP FAT AND HELP YOU LOSE WEIGHT WITHOUT DIETING
Over the years I have come across literally dozens of ‘wonder diets’. Many of them have been based on one or two particular foods which have been credited with remarkable, almost ‘magical’, qualities. The only way to eat a healthy diet is to eat a balanced diet.
MYTH 3. REGULARLY ATTENDING AM EXERCISE CLASS WILL HELP YOU LOSE WEIGHT, FIRM UP YOUR BODY AND GET THE SHAPE YOU WANT
It is, of course, quite true that exercise will help you lose weight. But exercise alone won’t enable you to lose vast amounts of weight. To get rid of one pound of fat you need to use up approximately 3,500 calories. You’ll be able to see how hard it is to get rid of 3,500 calories through exercise when I tell you that even if you exercise very hard — running or aerobics, for example — you will only burn up around 500 calories an hour.
During recent years I have heard claims that by doing the right types of exercise you can lose enormous amounts of weight. Exercise can help you to tone up muscles (and having toned up muscles will undoubtedly make you look slimmer) but I don’t think it will make a dramatic difference to your total weight or suddenly ensure that you have a pert bottom or breasts as big and as firm as beach balls.
By all means use an exercise programme as part of a get fit programme (though do make sure that you talk to your doctor first, make sure that any exercise programme you start has been prepared by an expert and always stop if you notice any pain or discomfort).
MYTH 4. YOU CAN GET RID OF UNWANTED WEIGHT SAFELY AND QUICKLY AND PERMANENTLY SIMPLY BY VISITING A SURGEON AND HAVING A WEIGHT REDUCING OPERATION
There are many special operations available these days for would be slimmers who want to lose weight more or less overnight. Some surgeons remove chunks of the intestinal tract though I don’t think this is a good idea. With the possible exception of the appendix you need what’s there. Here are two of the best known:
Liposuction
Fat is sucked out of your body (usually from the thighs) with a tube and a piece of equipment which bears a passing resemblance to a sophisticated vacuum cleaner. The fat then collects in a jar and can be thrown away. You leave the clinic slimmer and lighter. I am extremely sceptical about the long-term effectiveness of liposuction. I think there are better ways to lose unwanted fat.
Jaw wiring
The idea behind this particular operation is simply that if your mouth is closed you won’t be able to eat very easily — and if you can’t eat then you’ll lose weight. The surgeon performing the operation uses steel wires to bind your two jaws together. The operation may produce a temporary weight loss but many of those who have tried it have simply put all their weight back on again when they have had their jaws unwired.
Some people have even managed to have their jaws wired and not lose weight. One woman I know of discovered that by using her blender she could liquidise all her favourite foods and drink them through a straw poked in between the wires holding her jaws together.
MYTH 5. YOU CAN LOSE UNWANTED WEIGHT BY GOING ON A LOW FLUID DIET
The theory behind this diet is that many people put on weight because they drink too much fluid. I doubt if that is true. In my experience most people who are overweight are fat because they eat too much food. Fluid doesn’t usually pay too large a part in their weight problem. I am extremely sceptical about this type of diet. Indeed, it worries me. I am sure that anyone who goes on a low fluid diet would lose weight. But I worry that by going on a low fluid diet they might put a strain on their kidneys. Besides, I can’t see a low fluid diet offering anything more than a very short-term dieting success.
MYTH 6. A NO FAT DIET IS THE BEST WAY TO LOSE WEIGHT
As the name suggests a ‘no fat’ diet simply involves cutting out as much fat as you possibly can — avoiding fatty meat, dairy products and other foods which are rich in fat. At first glance this diet sounds very sensible. After all, fat is well known to be a killer — it is partly responsible for the high incidence of heart disease in the Western world.
However, I don’t think that cutting all the fat out of your diet is really the safe, effective way to lose weight permanently. Your body needs some fat. Without fat your hair will lose its lustre and your skin will soon become dry; more important you will become deficient in fat soluble vitamins A and D. You could even develop a serious mental disorder if you ate a diet which didn’t contain enough fat.
MYTH 7. A HIGH FAT DIET IS THE BEST WAY TO LOSE WEIGHT
I have to confess that I don’t have the faintest idea why this diet ever became popular. But it has, and diet experts regularly suggest that the best way to lose weight is to eat large amounts of butter, cheese, fatty meat, full cream milk and other fatty foods. I regard this as a potentially dangerous diet. I have explained elsewhere the hazards of a high fat diet. If you followed a high fat diet you would probably develop diarrhoea. This would probably lead to a loss of fluids, vitamins and minerals and the long-term consequences could be exceedingly dangerous.
MYTH 8. A LOW CARBOHYDRATE DIET IS THE BEST WAY TO LOSE WEIGHT
Too much carbohydrate will make you fat. But too little carbohydrate will lead to dizziness, tiredness, irritability and faintness. I don’t like diets which involve an unbalanced food intake. And a low carbohydrate diet is, by definition, unbalanced.
MYTH 9. A HIGH CARBOHYDRATE DIET IS THE MOST EFFECTIVE WAY TO LOSE WEIGHT
Some carbohydrates are essential but a high carbohydrate diet makes absolutely no sense at all to me. I cannot see the point of it. Your body needs a balanced diet to survive in good condition. Even if a high carbohydrate diet helped you to lose weight temporarily you would eventually have to go back to a properly balanced diet — and then you would probably put back all the weight you had lost. The only sensible way to lose weight permanently is to learn proper, sensible eating habits.
MYTH 10. THE LOW PROTEIN DIET
This diet bursts into prominence every few years. But I don’t like it at all. In my view the real danger is that in order to achieve a real weight loss you would have to reduce your protein intake considerably. You would, indeed, have to lower it so far that your body started to break down its own protein stores. This, in turn, would mean that muscles would start to disappear. How do you know that your heart muscle won’t be the first to suffer? In my view a low protein diet could be potentially fatal.
MYTH 11. THE HIGH PROTEIN DIET
In my view this is yet another potentially hazardous diet. I think the gravest danger with this diet is that it could put the kidneys under too much pressure. Anyone with a kidney disorder or a kidney infection might become seriously ill if they followed this diet. I think that in order to reduce the danger of kidney damage you would have to drink a lot of fluid — every day. And I rather suspect that the large quantities of fluid you would have to drink would probably mean that you might gain weight instead of losing it.