When will the politicians face up to the fact that pouring more and more resources into the NHS will not solve our current health issues? The fundamental problem is that standards of public health are deteriorating while costs escalate. This is illustrated by the increased incidence of diabetes which has doubled in the past 15 years. All the indications are that this increase will continue. A report published in 2012 estimated the direct cost of patient care was £9.8 billion and the indirect cost related to increased death and illness, loss of work and the need for informal care was £13.9 billion (1). The vast majority of these cases are Type 2, which is the result of excess glucose in the blood. It is a particularly nasty disease. A 40-year old may expect to reduce life expectancy of at least 12 years AND will suffer many years of disability. Those with diabetes may be as much as 4 times more likely to develop heart disease, cancer and Alzheimer’s Disease as those without it.

The blunt truth is that current strategies are not working and there seems to be a general acceptance that things will continue to get worse. The NHS Choices website tells us that with respect to type 2 diabetes:

There is no cure for diabetes. However, treatment aims to keep your blood glucose levels as normal as possible, which will control your symptoms and minimise the risk of health problems developing later on.” (2).

Furthermore it continues:

“….. as type 2 diabetes is a progressive condition, you may eventually need to take medication to keep your blood glucose at normal levels. You may need to take tablets initially, but move on to injected therapies, such as insulin, at a later stage.”

This is a policy of absolute despair which is utterly and completely wrong! It is the excess insulin which has to be produced by the pancreas to cope with the high levels of glucose in the blood which damages the organs inside the body. This results in chronic conditions such as heart disease and Alzheimer’s Disease. So it is absolute madness to treat the patients with insulin, which only adds fuel to the fire.

There is no debate that the glucose in the blood comes from the diet. Therefore if we can reduce the amount of glucose originating from the food consumed, there will be less glucose available to be absorbed into the blood. So the solution is obvious. Change the diet by lowering the amount of sugar and other carbohydrate-containing foods such as bread, potatoes, rice and pasta which are the sources of the blood glucose. But unbelievably the NHS advice on healthy eating is to consume:

“A diet based on starchy foods such as potatoes, bread, rice and pasta”(3).

On top of this the growing demand for “low fat” foods over the past 40 years has made things even worse. Many of these have been formulated by removing fat from traditional products and replacing it with sugar.

The reality is that type 2 diabetes can be cured. This was conclusively demonstrated at the recent Low Carb Summit held in Cape Town. Numerous specialists from the USA, Canada, Australia, South Africa and the UK presented cast-iron evidence of successful treatment of type 2 diabetes with the simple strategy of helping their patients to reduce the amount of sugar/carbohydrates and to increase their intake of the healthy fats. Many of these were able to stop medication completely and as an additional benefit, actually lost excess weight without any difficulty.

One of the speakers was Dr Jay Wortman from Canada who suddenly woke up to the fact that he had all the symptoms of diabetes. He decided the only way forward was to eliminate as much sugar and starchy foods as possible from his diet in order to lower his blood glucose. He noticed an immediate improvement and within a few months his blood glucose was back to a normal level. What is more he lost weight at the rate of about one pound per day. He included plenty of vegetables as well as meat and dairy products in his diet. There are thousands of others with a similar story to tell. It is absolutely criminal that this information is not being presented to all those diagnosed with type 2 diabetes.

The message for UK politicians comes through loud and clear. We need a complete re-think about the current healthy eating policy. The advice to reduce fat and increase carbohydrates has been an absolute disaster and has been a major factor contributing to the incidence of type 2 diabetes. A radically different approach to dietary advice could improve the health of those who are affected and help to reduce the costs that are incurred in providing care and treatment.

But it is also essential to consider all the other costs associated with the NHS. Throwing money at the problem is not the answer. We have to be extremely hard-nosed about assessing the costs and benefits of any specific treatment or procedure.

In his recent Reith lectures on the BBC Dr Atul Gawande compared 2 similar communities of about 700,000 people in Texas in which the standards of public health were identical but the expenditure in one was double that of the other. The US as a whole spends more than twice the amount on health care per capita as other developed nations, but ranks 49th in life expectancy worldwide. UK politicians please note this is where we will finish up unless there is a fundamental re-think about how our health budget is spent.

The NHS spends far too much money on drugs and procedures that are ineffective. Many of them do more harm than good as shown by example here of treating diabetics with insulin. Does it really make sense to prescribe statins when 77 men have to be treated for 3 years for one to benefit? This only applies to those who have actually suffered from heart disease. For those who do not have heart disease and for all women the proven benefits are even less. This is before the adverse side-effects, which can be traumatic, are factored into the equation.

Unfortunately the politicians have fallen hook, line and sinker for the propaganda pumped out by the drug companies which are extremely effective in promoting medicines which fail to live up to expectations. Before making any further commitments about putting more money into the NHS, I recommend that all politicians, civil servants and health administrators read the book entitled “Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare”(4). This is written by Peter Gøtzsche who is professor of Clinical Research Design and Analysis at the University of Copenhagen. This book exposes in detail how thousands of individuals are killed every year by prescription drugs, which are promoted and sold even though there is reliable evidence of the dangers they pose. Many of these companies flout the laws and have paid billions of dollars in fines and compensation. Because the profits are so enormous, these are simply regarded as the costs of doing business. He quotes a former vice-president of Pfizer who has concluded that:

“It is scary how many similarities there are between this industry and the mob. The mob makes obscene amounts of money, as does this industry. The side effects of organized crime are killings and deaths, and the side effects are the same in this industry. The mob bribes politicians and others, and so does the drug industry …”

The case he presents is extremely compelling. It follows from this that much of the money spent on drugs is not only ineffective but also a contributor to the ill-health. There is tremendous scope for saving large sums of the current health expenditure by reducing the amount spent on drugs of dubious value.

Current policies are going nowhere. The case for a totally different approach is absolutely convincing. Do we have any politician with the ability and drive to take things forward? This issue will have to be tackled eventually so why not sooner rather than later?

REFERENCES

  1. http://www.diabetes.org.uk/about_us/news_landing_page/nhs-spending-on-diabetes-to-reach-169-billion-by-2035/
  2. http://www.nhs.uk/conditions/Diabetes-type2/Pages/Introduction.aspx
  3. http://www.nhs.uk/Livewell/Goodfood/Pages/Healthyeating.aspx
  4. Peter Gøtzsche (2013). “Deadly Medicines and Organised Crime: How Big Pharma Has Corrupted Healthcare” Radcliffe Publishing London