A Message for the Health Secretary

Not more Technology, Mr Hancock

Health Secretary, Matt Hancock, has unveiled his new plans for the NHS.

He believes the answer to the problems plaguing the NHS is better technology and has made improving digital technology a major focus. He has claimed that we can use artificial intelligence “to transform the way we diagnose and treat chronic disease”. He has even suggested the NHS should be more lie Tesco and embrace technology.

Haven’t we heard this all before? I can remember listening to a long line of Health Secretaries who have come up with the same simplistic solutions of “more technology” for the NHS and groaned yet again as I heard it.

Now, I am not against technology. Some of the complex surgery and diagnostic procedures done today could not be done without the highest quality technology. But technology can never solve our current medical crisis. It needs something else and something far more fundamental.

A clue to this lies comes from the other side of the Atlantic. In the USA they enjoy the most expensive medical system in the world (spending nearly twice as much on health care as most European countries) and it is bristling with the latest technology. But how well is their health system faring?

Not well at all, as it happens. Life expectancy is lower than any of the major European nations and obesity rates significantly higher. And let’s not forget the USA has a major health advantage: it has lower rates of smoking and drinking then most European nations. But why are they doing so badly? What is it about the American lifestyle that is so damaging to health that even the most expensive medical system in the world cannot remedy it?

The massive Global Burden of Disease, Injuries and Risk Factor project, which investigated the causes of disease and premature death between 1990 and 2013 in 188 countries, gives us the beginnings of an answer. This study found that poor diet was the biggest factor, shortening life by an average of 9.7 years. Smoking was in 4th place, shortening life, by average, by 5.8 years. This points the finger squarely at the notoriously poor American diet (though we are not far behind). The very high rates of obesity make the case even stronger.

Living on a diet of adulterated food is like putting poor quality fuel in your car. Your car might still go but it won’t work very well. Even if you take it to the best garages with the latest technology it still won’t work very well as long as you keep using the same fuel.
To put this in a medical context, I will quote Dr Walter Willett, chair of Nutrition at Harvard University’s School of Public Health who said “the inherent problem is that most pharmacological strategies do not address the underlying cause of ill health in Western countries, which are not drug deficiencies” In other words if you mess up your health with a poor diet then modern medicine doesn’t have a cat in hell’s chance of putting it right as it doesn’t have the right tools to do so.
Of course diet is not the only factor affecting health, but it does happen to be the single most important. And I also appreciate that the government have proposed some measures to help deal with the obesity crisis. (For other factors affecting health see leaflet on Toxicity: an important cause of many cancers).

No, Mr Hancock, even if you have the most up-to-date technology, it will not save the NHS. No amount of money spent on health care can compensate for an unhealthy lifestyle. Health is always going to be the loser when the market is flooded with sugar and junk food.

In fact many of the solutions to the problems of the NHS are obvious and straightforward.

In the last 30 years the number of beds in UK hospitals has gone down by over half, from 299,000 to 142,000 and the number of acute beds has gone down by 43% since 1987. Programs like Hospital have highlighted the disastrous effect of these measures.

Governments have spent millions of pounds taking advice from management consultants on how the NHS should be run. The government should be asking for their money back. It beggars belief, that at a time when the population is ageing and suffering with more chronic illness than ever, hospital beds were actually being cut back.

And there is also chronic shortage of doctors. Mr Hancock’s predecessor, Jeremy Hunt, pledged to bring more doctors into general practice. But the elementary step of increasing the number of medical students being trained was somehow forgotten. The numbers being trained decreased between 2012 and 2017. Fortunately, and at last, this is being addressed.

But even if we have enough doctors and enough hospital beds it will not solve the problem of increasing chronic disease and with it, increasing demand. Is there a way to resolve this? Can we become healthier as a nation? Can we take the strain off the NHS? In fact, we do have answers. And the answers can be found simply by observing those places where these problems don’t happen. And when we discover them we can find out what are they doing differently?

In fact, extensive research already exists in this field and we know that many societies have had excellent health with minimal health costs. Researchers, like Weston Price, examined many healthy societies in the 1930s and these parallel long-lived societies in the world today. One thing, above all, stands out in these cultures. They all lived on high-quality, natural, unadulterated food. They didn’t eat processed foods. They farmed as if tomorrow mattered.

They knew that the quality of their health depended on the quality of their soil and took great care to look after it. They understood the importance of living with nature rather than fighting against it. Diseases like cancer, heart disease and arthritis were unknown to them.

We also know that their excellent health was due to food not other factors. How can we be sure? Because their health deteriorated rapidly once they changed their diet to modern processed food.
But how can we achieve this in a modern, industrial society. The answer is we can’t, but what we can do is move in this direction. And, of course, we have the American experience to warn us of the consequences of going in the opposite direction.

At the moment our policies could not be designed better to push the NHS into crisis. Huge subsidies are given to industrial farming, particularly for crops like sugar, corn, wheat and soya. (These grains are broken down into protein to fatten up animals and adulterated starches which are added to processed foods).
And if the quality of our soil is critical to our health, how are we treating it? In 2015, a United Nations report estimated we have only 90 harvests remaining. This is known to be the result of industrial farming which is progressively depleting our soil of its nutrients. After that time our soil will be too poor to support crops. The cost of soil degradation is estimated at £1.4 billion per year. The cost to our grandchildren could be immeasurably greater: they could starve. But industrial farming is exposing us to another catastrophe: bees and other pollinators are being wiped out by pesticides. British beekeepers have estimated that we could lose all our bees within a decade. Without these pollinators most of our fruit and vegetables would become a memory. But like plastics in the environment, will we leave it until it is too late before we act?

But it doesn’t have to be this way. Our food, our health and our environment are all intricately linked. If we want good health we already know what we have to do to achieve it. We also know what we need to avoid. It is just a question of whether we have the political will.

If we want a healthier future the answers are not difficult to find, but big decisions need to be made. We have to make health a priority and not leave it at the mercy of the food and agricultural industries. We could and should stop subsidising sugar and other cash crops. We need to stop flooding the food market with sugar and junk foods which are causing an epidemic of obesity and diabetes which could destroy the NHS. We should tax those foods which damage our health and therefore drain the NHS and use that money to support it.

The promotion and advertising of harmful foods could be stopped or curtailed. We could subsidise organic farming and support all types of farming that protects the future fertility of the soil and pollinators. We could promote and advertise healthy foods. We must stop subsidising industrial agriculture with its destructive impact on our health, our environment and our grandchildren’s future. Too much is at stake to do otherwise.

Sadly I have little confidence that our politicians will go down this road. If they do not then we can expect crisis after crisis in the NHS and crisis after crisis in the environment. However as individuals we can make choices, choices that sustain our health and sustain the environment.