Health care has been in decline for more than half a century.
Moreover, despite all the advances in technology, the health care available in the future will not be as good as it was 50 years ago.
Indeed, I’d go further; having been writing about doctors, hospitals and medical treatments for many decades, I am now convinced that the majority of patients today are receiving worse treatment than was available in the 1950s.
There are some exceptions, of course. The very few patients who have had successful transplant surgery could argue, accurately, that back in the 1950s they would have died. And there are one or two new drugs available that are life-saving.
But those are exceptions. I’m talking about the quality of medical care available for 99% of patients, 99% of the time.
Doubters will, of course, claim that life expectation today is much greater than it was and that, therefore, medical care must have improved.
This is a fallacious argument.
If you look at the figures it is clear that life expectation rose over a century ago when the number of babies and infants dying fell considerably. A little over a century ago it was commonplace for a woman to have half a dozen babies but for only two of them to survive. It was these infant deaths which lowered life expectation figures. If lots of babies die before they are one-year-old then the average life expectation is brought down dramatically. If one person dies at birth, and another dies at 100, their average life expectancy will be 50 years. But if most babies survive then the average life expectation rises equally dramatically. Back in Victorian times, and even earlier, humans who survived infancy and childhood commonly lived into their 70s, 80s and beyond.
The absence of relatively clean drinking water, and proper sewage systems, meant that serious infections were big killers in the 19th century. And it was infectious diseases such as cholera which meant that infant mortality figures were appallingly high. The death rates fell notably when fairly clean, uncontaminated drinking water supplies were introduced and proper facilities built for dealing with sewage.
In the early part of the 20th century millions of people lived in damp, cramped conditions and had very little decent food to eat. Drug companies, and their supporters, like to claim that their products are responsible for improved life expectation but the figures prove that to be a falsehood. Drugs have changed our lives in many ways but, with the probable exception of antibiotics such as penicillin, first introduced just in time for the Second World War, they have not had a major impact and it is not difficult to argue that many of the preparations put on the market have done considerably more harm than good. It is, for example, difficult to claim that benzodiazepine tranquillisers have done anything to improve the quality of human life. Prescription drugs such as benzodiazepines and some painkillers are the causes of the biggest dependency problem in the world.
Even the good drugs, the antibiotics, are now often not as useful as they once were. Overprescribing and the wholesale, routine use of antibiotics on farms have meant that antibiotics which once saved lives are now often useless.
I qualified as a doctor almost exactly 50 years ago and after a year working in hospitals went straight to work as a general practitioner. I practised much in the way that doctors were practising half a century before that. If patients wanted a consultation they just turned up at the surgery during opening hours. I did a morning surgery and an evening surgery. I gave my own injections and took my own blood samples. I happily inserted catheters and syringed ears. Patients didn’t have to make another appointment to see a care assistant with little training. If you couldn’t get to the surgery you telephoned, or sent a message, and the doctor visited. If you needed help outside surgery hours you got in touch and the doctor would visit. Medical care was provided 24 hours a day and 365 days a year. Accident and emergency departments, called casualty departments then, were used largely for victims of road accidents, falls, fights and fires. Why would anyone trek all the way to a hospital when they could have a doctor in their home within minutes? Patients who were elderly or frail or housebound or disabled were often visited routinely once every couple of weeks. District nurses drove themselves round their local community to dress wounds and check on patients discharged from hospital. It now sounds like something out of a history book but I can’t be the only one who can remember how things were and why they were better 50 years ago than they are now. It wasn’t perfect by any means but it was a damned sight better than things are today.
Today, you’re about as likely to get a home visit from a doctor as you are to win the lottery. And your chances of having a doctor visit you at home at night or at the weekend or on a bank holiday are nil – unless you live in a big city and have an arrangement with a private doctor who does house calls. Having a GP always available at the end of a telephone was reassuring; it was good to know that professional help was always available. If a patient had to go into hospital they knew they had someone they could trust if they didn’t understand what was happening to them – they could speak to their GP or he would visit them in hospital to help explain things.
Everything has been going wrong for decades – but the slide downhill has accelerated recently. Medical care was never better than it was when people wore hats. Decency disappeared when bare heads became the norm. I’m obviously not saying one caused the other for that would be a simplistic example of post hoc ergo propter hoc, but it’s an easy way to define a change. When medicine became more science than humanity, the quality of care started to diminish significantly. Fifty years ago, doctors always strove to keep patients alive. Today, `Do Not Resuscitate’ notices are placed on patients’ beds as often as temperature charts. It has got so bad that I have heard reports that DNR notices are put on the notes of any patient over the age of 60 or even younger. Those youngsters who cheer this should be aware that in 10 years’ time the age allowed could be reduced to 40 then, in no time at all, to 30. Remember the film Logan’s Run in which 30 was the cut off end of life age.
The ethics committee at Great Ormond Street Hospital, once the standard for quality in the care of sick children, was reportedly criticised by a High Court judge for deciding that a nine-year-old girl should be `managed’ rather than `treated’ and for making this decision without talking to the parents. Lawyers representing the hospital had allegedly asked that Great Ormond Street Hospital not be named. I bet they did.
Today, elderly patients in hospitals are routinely left to die, unfed, unwashed and without fluids. In the UK it’s a government approved programme for the `care’ of the elderly.
Dentistry has hardly improved – or even changed – in half a century. It’s still primarily a drill and fill business – and yank out the tooth if filling it is too much trouble. Science has added virtually nothing, and tooth care hasn’t much changed from the days of the barber surgeon.
In the last year or so, GPs have claimed that it would be better and safer to conduct all examinations by video rather than in person. It was even seriously suggested that young GPs found their work so onerous that they could not be expected to work more than one day a week – even though they were working 9 until 5 with an hour off for lunch. These days, patients who have serious symptoms are often told that they cannot be seen in person by a doctor or even a nurse.
The truth is that video consultations are pretty useless and very dangerous. You can’t examine a patient by video. You can’t listen to their chest or check their heart or blood pressure. You can’t examine lesions properly. You can’t palpate an abdomen. You can’t look down throats or into ears. You can’t even use your sense of smell – useful in the care of diabetics.
Hospital infections, too often untreatable, are now too common to be remarked upon. Fifty years ago a ward sister or a matron would have forty fits if a patient on their ward or in their hospital contracted an infection or developed a pressure sore or any other sign of bad nursing. Hospitals employed almoners whose job it was to make sure that patients didn’t have to worry about anything. If an elderly patient was admitted to hospital as an emergency the almoner would make sure someone went round to feed her cat. If a patient was worried about her bills being paid while she was in hospital then the almoner would deal with it. If you don’t remember those days you probably think I’m joking but I promise you I am not. People working in health care used to understand the meaning of the word `compassion’. Today, many health care staff would probably laugh or sneer if you told them of such realities.
Even in small things, hospitals have gone backwards.
So, for example, many hospitals no longer allow flowers on the ward. The real reason? They make a little more work for the staff. But for several thousand years it has been known that having flowers on a ward cheers up the patients and improves their recovery.
Similarly, when I was young, it was commonplace for someone to come onto a women’s ward every day and do the hair and make-up of the patients. That doesn’t happen anymore.
When I was a young doctor all patients requiring hospital treatment were subjected to a full medical examination. They also had a full history taken. Woe betide any young doctor if a patient was seen by a consultant without there being a full medical history in their file.
How can it be an improvement to know virtually nothing about the patients you are looking after? Back in the 1960s we derided doctors who thought of patients as being `the liver in the end bed’ or `the kidney problem in the bed third on the left’. But that is what health care has become once again.
Everywhere you look there are problems. Hospitals and general practices are managed by people who don’t understand the first thing about medicine. In Europe the EU has stopped doctors working more than a basic working week and so in hospitals there are frequently no doctors at all available at weekends or at night.
In the UK, the NHS has always been a money wasting machine. The amount now spent on the NHS is so great that if that money were simply handed out to the public, everyone in Britain would be able to buy themselves top level private health care. How can that be? It’s simply because there are more administrators than hospital beds in the health service and vast amounts of money is wasted on pointless bureaucracy. Like all large, bureaucratic organisations the last people to be fired are the bureaucrats. They just keep hiring and building their empires.
The NHS is regarded worldwide as the pinnacle of socialised medicine. Many around the world look upon it with envy. But that is only because they look at it from a distance: as observers rather than as consumers. The NHS has been a disaster in every possible sense. Most people who work for it say they wouldn’t want to be treated in their hospital. It’s not difficult to argue that the NHS now kills more people than it saves. Britons would certainly be better off if the NHS were closed and replaced with a cheaper, fully comprehensive private care service for everyone. More lives would be saved and the cost would be far smaller. The NHS is hopelessly wasteful and bureaucratic and lethal.
Overall satisfaction with health care is low and falling annually. People complain of long waits, staff shortages, lack of money and money being wasted. It is a deadly tale of indifference, incompetence, greed, selfishness and weariness. The incidence of doctor induced disease (iatrogenesis) soars every year.
It has long been recognised, incidentally, that waiting lists of all kinds were and are deliberately created by doctors to enhance their private incomes.
This is a weakness of the system which allows some consultants to work in the NHS and at the same time to have private practices. Their NHS income is the bread, butter and jam and the private income is the extra piece of cake. Consultants deliberately keep their waiting lists long because they know that this is the great selling point for private care. I once worked at a hospital where, during a consultant’s annual holiday, a registrar and I worked hard and got rid of the waiting list completely. It wasn’t particularly difficult. Naively we thought that the consultant would be pleased when he returned from his holidays. He was furious. `Why the devil should people come and see me privately if they can be operated on tomorrow in the health service?’ he demanded. He was the norm and not the exception.
Life expectation now is actually falling for women, waiting lists are growing and waiting times are soaring, the amount of illness is rising constantly and the number of patients made ill by doctors has made iatrogenesis an epidemic – up there with cancer and circulatory disease as one of the three major killers in our world. One in six people in hospital is there because they have been made ill by doctors. In half a century, the quality of medicine offered has slumped. And there have been virtually no breakthroughs in the last 50 years. There are plenty of new drugs – but most of them are merely variations on long established themes. Health care is now controlled by lobbyists working for big drug companies, and lies and myths rule our lives in a thousand different ways. The future, we are assured, is inoculation. Jabs for this, jabs for that, medicines in syringes and medicines in foods. Screening programmes are known to often do more harm than good but they are immensely profitable and so they are popular with businesses and doctors. Medical education is controlled by drug companies, and so when doctors are looking for a treatment they think first of pills. Lifestyle changes rarely even figure in their calculations. Laws which control the hours doctors can work mean that even quite large hospitals often have no doctors available at weekends or at night.
Long stay hospitals have been closed with the result that patients who need long-term care spend their days wandering the streets. Celebrities now promote health products and eating habits without having any knowledge or understanding of the harm they are doing. New regulations mean that small hospitals have closed with the result that patients have to travel for hours to visit a hospital.
Charities have become commercially linked with drug companies and use their lobbying skills to influence public policy in favour of their partners. Food companies promote bad eating habits because they are more profitable than good eating habits.
In the UK it can, and does, take weeks or even months for X-rays and scans to be read and for blood results to be recorded, distributed and interpreted. It is for this reason, more than any other, that Britain has the worst cancer survival rates in Europe.
All things considered the modern history of medicine is a deadly tale of indifference, incompetence, greed and selfishness. All of this is important because it was long ago established that when a doctor is sympathetic and compassionate his or her patients will get better quicker – it’s a human version of the placebo response which can add a quarter to a half to the effectiveness of a treatment. That has pretty much been lost.
In the UK, the only response to the chaos from the politicians and the collaborating public in recent years has been to demand yet more money for the health service, which actually has far too much money but just wastes most of it on unnecessary layers of administration and throws away billions because administrators pay far too much for just about everything from pens and loo rolls to drugs, and to demand that NHS leaflets and so on all be translated into more languages.
When I published the prices the NHS pays for office equipment, washing powder and so on – and proved that the NHS was paying more for stuff bought by the ton than I would pay if I bought the stuff at a supermarket – the NHS responded not by dealing with the waste but by demanding to know where I had obtained the computer print-out containing the NHS prices. They were only interested in covering up the waste – not doing anything about it.
Complex financial schemes, private finance initiatives and absurd bonus schemes for executives have cost the NHS billions. It is hardly surprising that services are deteriorating and that some services, such as dentistry, are likely to be abandoned completely.
The future, I fear, is bleak.
Today, health care is set to deteriorate even faster than before and the relationship between patients and health care professionals doomed to collapse still further.
Alternative branches of medicine will doubtless blossom and bloom. But for most people the future will involve telemedicine, preventive care and self-care. We all have to learn to look after ourselves and our loved ones.
Doctors haven’t yet grasped this, but computer programmes will take over from medical practitioners. Back in 1984, a colleague and I wrote the first home doctor programme for computers and ever since then computer programmes have been improving. They are now being fitted into robot physicians and surgeons. In ten years’ time there will be very few jobs for human doctors. Students thinking of entering medical school might like to look for another profession. A career in plumbing might offer better prospects. I am being very serious.
This has not happened by accident. It is all part of the United Nations global plan for the future – Agenda 21, New World Order, Great Reset. We are now living in the future they designed for us.
And unless we speak up, soon and loudly, the future will simply get bleaker and bleaker.
Copyright Vernon Coleman July 2021
Vernon Coleman’s international bestseller `How to stop your doctor killing you’ is available on Amazon as a paperback and an eBook.