Crippling negligence claims show NHS not ‘the envy of the world’

Well January ended with a bang, and its a bang I’ve been banging on about for the last couple of years (!): The budget set aside for NHS negligence claims is growing so rapidly that it threatens to bankrupt the system. Several people I’ve mentioned this figure to have looked at me in disbelief and suggested I must be mistaken. Well now it’s all over the headlines, so…

“the estimated total liabilities, which is the cost if all current claims are successful, stands at £65bn, up from £29bn in 2014-15.”The Guardian, 2nd Feb

Yes, £65 billion – you read that right – must be set aside for negligence claims. Unsurprisingly, perhaps, managers have begged the government to limit payouts for such claims to protect the health service.

Part of the ‘problem’ is recent changes in the law which mean that the damages paid out in some cases have tripled. But patient groups have acted angrily to the idea that these were due to oportunistic claims saying the assessments were based on an independent assessment of future care needs – which could include round the clock care for those injured at birth – and were not “some kind of windfall”, leading the Telegraph to say:

Something is clearly rotten in the state of Denmark. Part of the problem, no doubt, is that “the NHS needs more money”. Well of course. The NHS always needs more money. Was there ever a time when the NHS did not need more money? But can we really afford to pour money endlessly into an apparently bottomless pit?

There were very few negligence claims in the 1980’s, but these have rocketed in the last three decades. (Click for further statistics about NHS negligence claims)

Surely the real question is why are so many mistakes are being made?

How come so many of the wonderful NHS staff are negligent in the first place? Is it really just about money? Or is the whole system flawed?

The following article by Jack Tagholm-Child is reblogged here in full as he makes some good points about the problems with ‘our wonderful NHS’ and suggests there are better alternatives out there. Isn’t it about time we started taking these ideas seriously?

The NHS Myth: On Health the Rest of the World Does it Better

Albert Einstein is broadly credited with the commonly used adage: ‘the definition of insanity is doing the same thing over and over ­again and expecting different results.’ On this account the way in which the British state provides healthcare to its citizens is, by now, surely insane.

‘The NHS is facing a winter crisis’ is a headline one gets used to seeing every year in the UK. Although, this year the term winter crisis has been used significantly more than other years. According to Sky, in the first four days of 2018 the phrase has been used more times, by UK Newspapers, than in the entire years combined from 2003 to 2008.

Indeed, the NHS does appear to be under even more strain than is usual. The number of attendees waiting 4, or more, hours in A&E has risen significantly – 15% in December of 2017, the joint worst figures on record.

Analysis from the Kings Fund suggests this extra strain is due to a confluence of factors: an ageing and growing population, and simply citizens using NHS services more. Extra funding being provided to the NHS became decoupled from the increases in use around 2010, and increases in funding have remained below increases in use ever since. This seems the likely cause of the current, particularly severe, stress on NHS resources.

Would allocating more money to the NHS alleviate the problem? Yes, for a while. But is it worth it? No. The problems with British healthcare provision is organizational, not monetary. Bourne out by the fact that health outcomes have consistently lagged behind other comparable countries, even in periods of ‘proper’ funding.

The NHS is like those famous American Muscle cars, can’t turn corners, unreliable, aren’t actually very fast and burn through fuel faster than a B-52. You could choose to keep spending vast sums running the thing, or you could buy a cheaper, more reliable and better performing European alternative. Coincidently, this is exactly what’s on offer – although it wouldn’t necessarily even have to be European.

The UK has chronically lagged behind its European, and American, and Australian, and East Asian counterparts, in its cancer, and other major disease, survival rates, for years. In fact, for decades. A 2017 study led by the Swedish Institute for Health Economics found that between 2000 and 2007 the UK had a lower 5 year adult survival rate for 9 out of 10 types of cancer than the European Average – the UK being above average on Skin Cancer.

Another study, in 2015, by the London School of Hygiene and Tropical Medicine, found the same. In the period from 1995 to 2012, comparisons between the UK and 5 other countries – Australia, Canada, Denmark, Norway and Sweden – found UK 5 year cancer survival rates to be nominally between 5% and 12% lower, depending on the type of cancer.

This is huge when you consider percentage survival rates for cancer’s are often, of course, low anyway. If a survival rate for a certain type of cancer is around 30% in one country and 20% in another – which is approximately the difference between the UK and the other countries, for certain cancers, in this particular study – then care in the UK is 33% less effective. Indeed, this is the case for stomach cancer, when you compare the UK to Australia.

If you’ll just bear with me through a few more numbers. According to the OECD’s most recent figures on certain cancer and cardiovascular disease survival rates the UK regularly ranks around 20th – Exactly 20th for bowel and cervical cancer, 19th for breast Cancer, 22nd for Heart Attacks, 27th and 25th for hemorrhagic and ischemic strokes respectively. Always notably behind comparable countries like France, Germany, Japan, The United States and so on.

There are, of course, lies, damn lies and statistics. However, when you are consistently ranked below all the most comparable countries, on almost all major diseases and their variations, over a sustained period of time, and by a multitude of sources, to not believe your fundamental mode of healthcare delivery may be faulty, at best, and require changing, is flat out delusional.

At this point one should stress, not that it ever makes any difference, the NHS is staffed by some truly outstanding individuals. They are not the problem – at all. It is simply the system of provision which is hindering health outcomes. Much like Communism is preventing North Korea from being like South Korea. They are the same people.

What desperately needs to be understood in the UK’s healthcare debate is that not having the NHS in its current form, is not the same as US style privatization. God forbid. Healthcare provision can be provided in a far more efficient fashion, and still be accessible to all. There are all sorts of different types of healthcare provision around the developed world, which straddle the line between being mostly publicly or privately provided.

It’s all about incentives. What is often under emphasized, in debates between the public and private provision of a goods and services, is that what makes the market in general so much more efficient is competition. There is nothing inherently magical about markets themselves, aside from the fact they tend to more easily facilitate competition. This can, on rare occasion, be done within the public sphere.

Here much of continental Europe shines the way forward. (One interesting note: it is curious that, in the main, those on the left in the UK, who are usually very complimentary about the European social model, form the most vociferous opposition to any moves towards what we might call a European model of Healthcare. They insist on an archaic form, and disproven ad nauseam by history, of total state control.)

France is perhaps the best example, as it blends a patient centric and choice based schematic – with a healthy dose of private sector involvement – alongside state coverage and provision. It manages to combine great healthcare outcomes – which come from the incorporation of competition, with healthcare for all – which only the state can guarantee. Indeed, one of the most comprehensive comparative studies of world healthcare systems undertaken, The World Health Organization’s 2000 report, ranked the French healthcare system the best in the world.

The French system is universal, in so far as it provides healthcare for all. The use of government in its delivery is considerable, but not excessive (40% of French hospital beds are provided by charities or for-profit companies.) But there is perhaps one key difference, which allows the French system to be so effective: employer provided insurance. Although the government will cover anyone who doesn’t have access to employer provided insurance – providing a minimum of healthcare access – many have extra insurance on top of their basic cover. So you have a government set baseline, with options for individuals to supplement their cover with private alternatives.

This is actually remarkably similar to the US system – although don’t you dare tell the French that. At any rate, what is key is that the patient is the focus and can choose his health providers – it’s all about choice.

Belgium, Austria and Germany all have similar healthcare provision, mixing a minimum baseline with private options for more cover. Even in Sweden, a bastion of social democracy, where healthcare is provided most like the NHS, a GP visit costs around £15. When a £10 charge for GP visits was even suggested in the UK all hell broke loose.

Countries often have blind spots, which the rest of the world struggles to fathom. We tend to believe in the UK, our healthcare system is the envy of the world – at least that’s what you hear in the media. Curious then that the majority of developed countries – which rank much higher in healthcare outcomes – use a different model. In the UK we have become addicted to the undoubtedly noble principles the NHS was founded upon. Unfortunately, noble principles don’t save lives. All the empirical evidence points to numerous better styles of healthcare provision around the world. Almost all providing near universal coverage anyway. So let’s do away with all the ideology and just copy what is known to work. Seems almost sensible.


Jack Tagholm-Child
A recent graduate, Jack studied Politics, Philosophy and Economics at the University of Exeter. A Eurosceptic from a young age, he is also interested in all matters relating to the maximisation of human flourishing. He can be found blogging at: https://jacktcsblog.wordpress.com/


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Should folic acid be added to UK flour? The arguments for and against

Although I do not eat wheat myself and have many patients who only remain healthy if they avoid it, the recent headlines calling for mandatory fortification of wheat flour with folic acid still gives me cause for concern. The problem with the recent media coverage of this issue is that there has been little in the way of counter arguments put forward with the headlines being rather one sided, such as:

Below are some select quotations from two articles, one in favour of folic acid fortification and the other against. At the end I put in my two-penneth worth adding my concerns about artificial folic acid vs natural folate, as well as issues of government intervention vs personal liberty. Let me know your thoughts after you’ve chewed it over. Continue reading

Fake News #1 – Low carb diets linked to risk of birth defects

↑ Click to read full article at MailOnline

Look at that headline! Sounds awful doesn’t it? But what this is really about is fortified bread. In many countries bread has added folic acid (an artificial, non-nature identical form of folate, also known as vitamin B9) to ensure mothers get enough of this essential nutrient to avoid neural tube defects (NTDs) – such as spina bifida – in their babies. Being on a low carb, paleo, ketogenic or gluten free diet means not eating bread, so mums might not be getting this particular additive. So what earns this story our coverted fake news award? Continue reading

January 2018 News Round-Up

Paleo diet for long term weight loss

Science Daily (18th Jan) reports on a study in which overweight women were placed on a paleolithic diet for two years, but without restrictions on the quantities they could eat. One of the authors said:

“The results are remarkable. Despite giving the women free reigns to an unlimited intake, the weight loss was stable after two years. A more significant fact than weight loss was the evident improvement in levels of fat in the blood, and signs of reduced inflammation,”

Continue reading

November 2017 News Round-Up

In_the_News_November

1. Paleo and Mediterranean Diet News
2. Sleep Hygiene and Body Clock News
3. Medical Fails, Bales and Controversies

PALEO and MEDITERRANEAN DIET NEWS

If a picture paints a thousand words, then the photo above, (Science Blog), could have been at the top of any one of the following news articles this month… Continue reading

October 2017 News Round-Up

Sleep and Health

With a return to GMT we all get to sleep in an extra hour, but the disruption to our circadian rhythm can have unexpected effects. The Telegraph covers five such [Oct 27th].

Lack of sleep can lead to weight gain. Researchers from King’s college, London, found that people who slept less than seven hours a night were likely to consume an extra 385 calories the next day. [Daily Mail, Oct 24th]

Lack of sleep may be a contributing factor in the development of Alzheimer’s [New Scientist, Oct 11th]

Afternoon heart surgery is ‘50% more successful’ as body clock makes heart muscle more able to deal with trauma later in the day. [Daily Mail, Oct 27th]

Finally, differences in sunrise from east to west may be linked to higher rates of breast cancer in the western side of each time zone. [The Conversation, Oct 20th]

Organic

In the largest study of its kind, a team of experts led by Newcastle University has found that organic milk and meat contain 50% more beneficial omega-3 fats than conventional produce [Health Minute, Oct 25th]

Protein

Almonds. Good for you. Says so here: [LiveScience, Oct 19th] Plus, Men’s Fitness [Oct 10th] report on a study showing that nuts help keep weight off.

Older people are eating too little protein and the daily requirement for this age group should be increased [Professor Health, Oct 20th] In an attempt to help this problem food scientists have developed a range of bread, yoghurt, spaghetti, ice cream and chocolates “enriched” with ground-up beef (!) [The Times, Oct 23rd]

Low-Carb Diets

Blooming obvious, and I’ve been saying it for years, but (deep breath…) A low carb diet can help manage diabetes. (Surprised scientists at London Met’s school of Human Sciences) [Knowridge Oct 23rd]

The 5 continent PURE study which included over 135,000 individuals tracked for 7.5 years found a high-carb diet was significantly less healthy than a diet high in fat. Neither total fat nor saturated fat were associated with heart disease. Read an in-depth review at Diabetes.co.uk [Oct 5th].

Vegan News

Vegan diets frequently lack important nutrients. [Health Minute, Oct 24th] leading the Finnish researchers to say “vegans need to get nutritional guidance”

The Angry Chef is worried that young vegan bloggers oversimplify what it takes to be a healthy vegan [Tree Hugger, Oct 4th}

modern veganism, as portrayed by trendy, photogenic millennial food bloggers, is more about virtue-signalling than it is about true health or welfare concerns

RoundUp Round-Up

With the EU poised to ban the herbicide US researchers report that glyphosate exposure is on the rise with urine levels at an all time high. Study authors note potential harm from chronic exposure [MedPageToday, Oct 25th]

Vitamins

Vitamin K and D together help knee osteoarthritis arthritis [MedPageToday, Oct 25th] whereas vitamin D alone showed no benefit.

In separate news, lack of vitamin D in childhood seems to increase the risk of type 1 diabetes, whilst mum’s vitamin D during pregnancy appears to reduce the chance of asthma in her child. Both at Daily Mail [Oct 24th]

A2 Milk Study

A new study shows that A2 milk eases or eliminated symptoms in dairy intolerant individuals. [Rural News Group, Nov 1st] – Those of you who attended our Diet and Health event on Milk and Dairy will remember we had a presentation from the A2 Milk Company.

Gluten-Free Diet

Holiday travel when you are coeliac can be a culinary nightmare. So its interesting to discover that Italy – home of pasta and pizza – is one of the most understanding and accommodating when it comes to a gluten-free diet. [Telegraph, Oct 24th]

Bone Broth

A bunch of articles as the craze for Bone Broth bubbles on…

  • Four health benefits of Bone Broth [Healthyway, Oct 20th]
  • A kickstarter project aims to make a bone broth ‘kettle’ to speed up the process. I’m sceptical. See what you think [Food&Wine, Oct 6th]
  • A chef talks about how broths stopped him going insane, and what makes a good broth [Munchies, Oct 22nd]
  • Bone Broth Braised Short Ribs – RECIPE [Dr Axe, Oct 28th]

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September 2017 News Round-Up

In_the_News_SepPoor diet is a factor in one in 5 deaths (The Guardian, Sep 14th)

What a cheery place to start. Let’s see if there are any tips out there this month to help us make our diets more healthy and happy…

Foods that help you feel fuller may prevent overeating

A new study found that amino acids arginine and lysine found in pork shoulder, beef sirloin steak, chicken, mackerel, plums, apricots, avocados, lentils and almonds (see graphic below) trigger newly identified cells in the brain to signal satiety (fullness).

Well that’s interesting as these are some of my favourite foods! The Telegraph (Sep 28th) and DailyMail (Sep 27th) both covered this.

Note the absence of wheat or other grains in that list: grains are deficient in lysine.

Diet determines if alcohol damages liver

We have written about this before, but here is another study finding that alcohol does not damage the liver in and of itself, but depends on the dietary components it is consumed with. News Medical (Sep 25th) reports that mice fed a high saturated fat diet along with chronic alcohol had protection from alcoholic liver damage.

All of this is great news for those who like a drink with their low-carb meals. To warm the cockles of your slightly sozzled hearts a little more, check out the Unexpected benefits of Red Wine (Telegraph Sep 13th), or if you need further convincing check out this post by our friend Dr Kendrick who unpacks the research around moderate alcohol consumption.

Keto-diet may reduce age related degeneration via newly discovered detox pathway

Wow. Like Wow! It appears that a high fat, very low carb (ketogenic) diet actually removes toxic byproducts of sugar metabolism from the blood by a recently discovered (!) non-enzymatic detoxification process. These products are associated with the damage observed in age-related diseases such as diabetes, Alzheimer’s and cancer. Again WOW.  We love it when entirely new human biological entities are discovered (News Medical, Sep 18th)

In an unrelated study, a ketogenic diet was found to increase the healthy lifespan of mice and prevent memory loss. (Medical Express, Sep 5th) Zero-carb mice diets are getting many researchers excited, leading The Guardian (Sep 5th) to ask “could a drug that mimics a zero carb diet help us live longer?”

For an in-depth look at the ketogenic diet check out this Mercola article.

Sleep wake rhythm crucial for fat cell function

Evidence is emerging that fat burning is upregulated by good sleep habits via the expression of NFIL3 (a ‘fat burning protein’). This goes someway to explaining the increased risk of obesity among shift workers and suggests we could all benefit from good sleep hygiene. (DailyMail Sep 1st)

“sleep-deprived people – those who get less than five and a half hours a night – consumed an average of 385 calories per day more than those who had more than seven hours.” – according to researchers from King’s College London

A good night’s sleep – worth it’s weight in gold?


▲ Infographic to help get this complex scientific data across in a happy way.

Underscoring the importance of a good kip, The Telegraph (Sep 19th) reports on research that found well rested people scored 15 points higher on a happiness index questionnaire than those who had poor sleep. Whereas the same survey found only a two point happiness increment when household income rose from £12,500 to £50,000. So put down the lottery card and go to bed.

In a similarly dodgy recent survey, researchers found that Brits would rather give up sex for a year than reduce their sugar intake. (!?) I decided not to create a witty infographic for this one. (DailyMail, Sep 15th)

On a more serious note: eating in sync with your body clock may be beneficial for maintaining a healthy weight (Medical Express, Sep 8th). This can be done by shifting major calorie intake earlier in the day, and avoiding a high calorie meal close to bed time.

Mediterranean low-carb diet reduced heart fat more than low-fat diet plan

Plus a shed load of other benefits seen in this recent head to head study. (DailyMail Sep 18th) Also see Diabetes Daily (Sep 17th)

Good fats, Bad fats – the Express goes to war on excess weight

“Three cheers for the Express”

A quick search of the Express’ diet section might leave you wondering if the majority of their readership is obese and/or gullible. Amongst the dozens of ‘lose-fat-fast’ articles were a few half decent pieces this month, which deserve three cheers, so here goes: First up they tackle Omega 6:3 ratio head on, giving sunflower oil a good kicking (hooray!) Whilst in another article they sing the praises of coconut oil (hooray!) Neatly rounding off their ‘fat blasting’ theme they champion egg based breakfasts for fighting the flab (hooray!)

‘No way to prevent Coeliac disease’ according to short sighted experts

Although the prevalence of coeliac disease is recognised as 1% worldwide, among first degree relatives that risk rises to 5 – 10%. If you are a worried parent of a child who falls into this group The Mayo clinic has issued advice on what you can do to prevent it. And that advice is: nothing. They declare that there is nothing that can be done. (Medical Express, Sep 22nd)…

…(speechless).

I know, it beggars belief. The OBVIOUS thing to do is adopt a gluten-free diet. You can not get coeliac disease if you don’t eat gluten. Period. Sorry, but the emperor has no clothes. Sorry to be the one pointing it out. I know you’re not supposed to say it, so sorry again. But there it is. If you can’t see it Mayo Clinic experts then take an eye test…

 

 

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