On the off-chance that I haven’t bored you enough already with the story of my latest medical escapade, I’d like to share what I learned while ‘inside’ the NHS. It’s a message that I believe affects us all, no matter how confidently healthy, no matter how cocooned with private health care, and no matter how meticulous you are about your own diet and exercise.
I was admitted to Pembury hospital with an inflamed appendix on a rainy Sunday afternoon in September. Some time during the 48 hours it took to get me into the so-called emergency operating theatre (one of eight in our brand new, world class, multi-billion-pound hospital) the organ perforated and I went into sepsis. Needless to say the consequences were significant. Instead of a quick, neat, in and out, keyhole procedure, I ended up with complicated open surgery, a 4-inch scar, an extended hospital stay and protracted recovery.
It wasn’t supposed to work like that. They had every intention of getting me into the theatre on the Monday morning. In the end I saw 3 different anaesthetists on 3 different shifts because I kept being moved down the queue for surgery – pipped to the post by someone who was in more urgent need than me.
–I’m not the only one who struggled to work that one out. I’d always believed you couldn’t get much sicker than a ruptured appendix. It’s life and death, right?–
Wrong. Although I was on morphine, oxygen, I.V. antibiotics and a saline drip there were, apparently, a busload of people whose need was greater than mine, and allocating a second theatre for emergency procedures was clearly not on the agenda. Twice I was told that the person in front of me was diabetic, as though that somehow explained the problem. I received heartfelt apologies for the multiple delays but they were hard to hear; I’ve never been in so much pain. Not surprisingly, once they got me on the table, the operation took much longer than it should have done.
As I recovered – in a surgical assessment cubicle as there were no beds on the wards – I observed an emergency room overrun with patients whose problems were largely created by obesity and diabetes. As my brain started to tick again I realised that many of the people who had jumped my queue were not really emergency cases – they had been sick long before they became acute, struggling with metabolic disorders that predispose to inflammation and infection and 999 calls. I found it infuriating that these very poorly people were not being given clear, evidence-based nutrition and lifestyle advice to aid their recovery, because it was glaringly obvious that they needed it.
And don’t get me started about the food situation! When I was finally able to eat something the best they could rustle up for me was a pile of lukewarm mashed potato and baked beans. Unsurprisingly, many of the patients were supplementing with food of their own, most of it junk.
It was a frightening experience, and a first-hand encounter with the way our health services are overwhelmed by the state we’re collectively in. And I mean collectively, because that was the paradigm shift: while I was trying to recover on that dismal, windowless ward it dawned on me that we are all in this together. If we can’t reverse the growing numbers of obese and diabetic patients in the system the rest of us will always be at the back of the queue. Or, to put it another way, my usual good health was a disadvantage in A&E. If I had been sicker in the first place, I would have been treated more swiftly. How ironic is that!
It’s easy to criticise. I want to be clear that the system is failing – not the people. The individuals I met were universally impressive – caring, conscientious people with an obvious vocation, visibly struggling to make the best of scarce resources and an overwhelming challenge. Unfortunately, it’s a challenge that cannot be resolved with drugs and surgery – which is a problem for the NHS because that’s what they offer.
We desperately need another model of health care. A health service that is geared to the survival of the fattest is in no one’s best interests.
We all know that the problems of obesity and diabetes (and Alzheimer’s and cancer if you want to widen the net) are forecast to swamp the NHS, it’s headline news. But it’s not some future disaster scenario: it’s already happening. The NHS we grew up with doesn’t exist any more, its fundamental character has changed. The ideal of making you well has been abandoned for the concept of ‘disease management’. I don’t know why; maybe because it seems an impossible task, or maybe because the economic model that supports its continuation works better if lots of people are using the service. And in many ways it doesn’t matter. What really matters is you – and the people you love.
Never has it been more important to take care of yourself – to be careful about what you eat and drink, to manage your stresses and get enough sleep, to take time out to explore niggling symptoms and rectify minor imbalances before they become major problems or, heaven forbid, full scale emergencies. But it goes further than that, it’s no longer a personal problem. The World Economic Forum recently stated that the single biggest threat to global economic development is chronic disease.
Can you believe it? With all our civilisation and sophistication we are getting sicker and sicker, so much so that it’s threatening the global economy. We also know that the majority of chronic disease is lifestyle related, and until we face that inconvenient truth our health services will continue to be swamped.
Sadly, the state of the NHS is unlikely to improve in the short term. The primary problem is a lack of vision: an unwillingness to aim towards a future where the majority of people are in full health without the need for medication, and a refusal to explore all the options to make that happen. The other issues are a result of this myopia, whereby the perceived need for drugs and technology, beds and staff for an increasingly sick population is a nightmare of ever increasing proportions that requires huge corporate profits, beyond the purse of any government, to sustain itself.
But not everyone is so pessimistic. In the world of what is still quaintly and often scathingly called ‘alternative’ medicine, there is a deafening chorus of defecting doctors and heretical health professionals screaming that the answers to chronic illness are already in our hands, and they are well within the ability of individuals to control. More and more people are finding simple and effective solutions to their health problems outside of the recognised health service.
And if we can do it for ourselves, it makes sense to try and do it for others in our lives. It’s amazing how often clients tell me their biggest hurdle in switching to a healthy diet is that their kids won’t eat it. And yet, I’m not surprised. If your children see you working yourself into the ground, drinking too much to relieve stress, and microwaving convenience food because you’re too knackered to cook, they will copy you. Honestly, if we can’t get through to the next generation we are lost. I know it feels difficult, but it’s nothing compared with what it will be like watching your children and grandchildren battle with chronic illness combined with inadequate health care.
I’m sorry for dumping yet another worry at your door – but I don’t apologise for trying to make you wake up and see that we are facing a national (not to say global) crisis – nor for urging you to do everything you can to keep you and yours out of the loving hands of the NHS because once you’re in A&E you will wish you had.
It has never been easier to make healthy choices: there are more healthy cook books out there than you can shake a wooden spoon at (The Real Meal Revolution is a good place to start, Hemsley + Hemsley too); supermarket shelves are crammed with organic and exotic vegetables, carefully farmed meat and dairy, all sorts nuts and seeds, pulses and beans, good fats and cold pressed oils; and the internet is crammed with information, most of it reliable and easily checked, on how to stay well. There are other things you can do to spread the message: tell restaurants that you want more healthy options, plan simpler menus when you’re entertaining, stop stocking the fridge with food you don’t want to eat. Even if you don’t know where to start there is sure to be a tribe of nutritionists and other health professionals right on your doorstep who will happily point you in the right direction.
The fact that you are reading this blog means you are probably better informed than 90% of the population when it comes to looking after yourself, and that’s great, but it’s not enough. If you want to ensure a healthy future for you and your loved ones it’s time to get serious about bringing more people along with you.
You could start by sharing this.