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A faulty production line

Preventive measures should become the focus of the NHS

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Health can be simplified into balanced healthy diet, regular exercise, uninterrupted six to seven hours sleep, and emotional well-being.

In my over 30 years’ experience in general practice, I see GPs fall into two camps - those who think the above has a minimal impact and those who are convinced of its importance in staying healthy. Poor national health is a ­major factor in increasing GP workload and rising costs, and with prevention plans and improved health advice, both could be considerably reduced.

I accept the argument that ‘you can’t fix a trauma or acute heart attack with diet’ and advance in medical innovation is one of the hallmarks of increased longevity. But in my view many chronic conditions are less successfully treated with medicine; diet and lifestyle more generally have an important role in arthritis, type 2 diabetes, autism, asthma, heart disease and certain cancers.

Orthodox doctors, of which I am one, focus too much on that wonderful saying, ‘If all you have is a hammer, everything looks like a nail.’ And the hammer that we have is the script pad or scalpel. We tend to gloss over the importance of lifestyle modification.

The best treatment for diabetes 2, heart disease, certain cancer and osteoporosis – all of our modern-day killers – is not to get them in the first place. The people who practise good lifestyle principles reduce their risk for all significant diseases by over 70%, whereas a drug like statin might reduce your risk of a heart attack by 10%, with a potential for a bucket of side effects.

So lifestyle principles across the board are much more powerful than anything a GP can do for his patients. Much more than 90% of modern diseases are preventable through education. A heart attack can cost £20,000 to treat. If it can be prevented, that has huge cost implications.

Preventive measures should be more of a focus for the NHS England. A change in approach, with more responsibility placed on people to manage their own health, could save billions of pounds each year. Medicine is not enough on its own; people need to take responsibility for their own health.

 NHS England must consider, therefore, a mandatory prescription of the following given to all the attendees in GP surgery,

1. Take care of your abdominal fat.

2.  You cannot be healthy if you smoke, if you drink too much alcohol. You cannot be healthy if you snort cocaine.

3. Good quality eating and less of it.

4. Have a regular habit of at least 30 minutes brisk walk .

5. Reduce stress - the best drug on the planet is happiness, peace and contentment.

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Readers' comments (3)

  • Very wise words. However the problem is the NHS is flat-out dealing with patients who already have serious chronic problems. We do not have the resources to push for a healthy lifestyle and the success rate when we do is very low. The only way to improve peoples lifestyles is to have this marketed by the government and the multimedia along with the marketing of healthy products. Unfortunately it does not appear that this is likely to happen as there are too many vested interests. Think of the negative effect this would have on confectionery, high-fat products, and of course big Pharma. The loss of GDP would be huge. That is why it doesn't happen. Look at Maslow's hierarchies of needs. In fact we don't really need very much to survive, but the whole economic and capitalist structure of the world would fall apart, if people stopped buying products that they don't need. We live in a crazy world.

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  • If the BMA could come up with a good business plan that would allow GDP to be maintained, bearing in mind that there 'could' be a reduction in NHS and Social Care costs, then the government may start to listen. However even if most people become fit and happy with low body fat, they still die in the end and this natural process is by no means guaranteed to be quick. People will still develop chronic disease, but at a later age. What is more worrying is that if the increased number of elderly people are not working delivering GDP, the increased cost of pensions alone would be massive. With the advent of more robotics / computers replacing jobs and incomes dropping it is unlikely there will be jobs for the elderly to do. Difficult to make a good business case. Life is not ideal.

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  • No matter how much prevention you do, no matter how much exercise and healthy eating, one day you will get ill. The date will be delayed, no doubt, but it will happen for certain.
    You will need healthcare at some point and the healthier you are and the longer you live, the more money will be required, overall.
    Sounds illogical and daft, but it would be a lot cheaper if everyone died at 30, rather than live to a 100.
    Of course, we all want to have a long and healthy life and that is wonderful for itself, but it won't save billions.
    It will cost billions.

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