Well, I guess in an 8,528 word speech there are bound to be some surprises, and one of those is that apparently there’s a hot new idea around called ‘prevention’. And according to Sajid Javid, we GPs are going to be at the ‘heart’ of this ‘new focus’.
Don’t worry if you’re already all at sea with this radical concept, because it’s bound to come with toolkits, links and mandatory training, so you’ll be fine.
That said, I have spotted a couple of flaws.
First of all, one of the aims is to ensure that more people are ‘blowing out the candles on their 100th birthday cake’, which of course requires good eyesight, excellent FEV1 and perfectly fitting false teeth. No problem though, because Mr Javid wants all these extra years, thanks to our preventive efforts, to be spent ‘in good health’.
Which is fine, apart from the fact that we’ll have to overcome the laws of physiology and degenerative disease. And I wonder what he wants us to do post that 100 birthday, when presumably all the delayed CKD, dementia, T2DM, Parkinson’s et al suddenly kicks in, or is the idea that we shoot them once the candles are extinguished?
Worse than that, though: the prevention strategy is aimed at ‘stopping people becoming patients in the first place’, which presumably means preventing those pesky heart attacks, strokes etc. Which in turn means, let me think, putting lots of people on antihypertensives and statins.
Trouble is, Saj, every time I do that, I actually convert a well person to an ill one: they get neurotic about their checks and levels, they suffer real or imagined side effects, and they get medicalised by the endless cycle of bloods and follow-ups. And with an NNT of 100+, to stop one person becoming a patient, I create countless others.
I’m not saying all prevention is bad, of course. But what I’d really like to stop is ideas which are not new, and are not good. Besides, have you seen the price of candles?
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield
READERS' COMMENTS [7]
Please note, only GPs are permitted to add comments to articles
fine – presumably when we have failed to stop joe public smoking, eating too much, etc etc etc they will need “specialist treatment” and we will be able to refer them all to those clever doctors, who wear white coats in hospitals, who will – at a price – slove all the problems that we simple GP’s are not able to !!
bollocks !
People get older, get diseases and die. This is a fact and it will never change. I suggest that Saj diverts the whole NHS budget towards genetic research in a search for immortality. But have a work with Ricki first because he’ll have to pay a lot of pensions.
what a load of old socks
javid seems to have collated all the ideas in his welcome pack that were under the heading
“we could do this but it will be the end “
So, does this plan also include all the social problems that are drivers of inequality? Like, a living wage instead of a minimum wage, housing security, banning zero hours contacts, adequate safety net for when people cannot work because of ill health and parenting classes so there is less abusive or neglectful parenting? Oh, and a mental health service fit for purpose so people can have therapeutic interventions suitable for their problems, as 6 sessions of CBT for complex PTSD does not seem to be terribly effective?
And perhaps rather than endless scripts for statins we can incentivise healthy eating, ramp up sugar tax, incentivise cycling and exercise, and all the social interventions outlined by David Rossiter above – all of which have a better NNT that the frankly paltry effect of statins on those with only moderate dyslipidaemia. Perhaps then we can join Japan and Hong Kong with their park-life tai Chi and healthy old age expectations
And I thought the Health Prevention campaign was based on the premiss that if we spread enough Covid fast enough through schools and publlic crowd events, we can prevent so many people living into their 60s and becoming at risk of being able to take their pensions!
The UK is scared of death. Period.