Nutrition - what's it all about...

Ok - although this is not a site for jokes I thought I would make an exception:

In the beginning God covered the earth with broccoli, cauliflower and spinach, with green, yellow and red vegetables of all kinds so Man and Woman would live long and healthy lives.

Then using God's bountiful gifts, Satan created Dairy Ice Cream and Magnums. And Satan said "You want hot fudge with that? and Man said "Yes!" And Woman said "I'll have one too with chocolate chips". And lo they gained 10 pounds.

And God created the healthy yoghurt that woman might keep the figure that man found so fair. And Satan brought forth white flour from the wheat and sugar from the cane and combined them. And Woman went from size 12 to size 14.

So God said "Try my fresh green salad". And Satan presented Blue Cheese dressing and garlic croutons on the side. And Man and Woman unfastened their belts following the repast.

God then said "I have sent you healthy vegetables and olive oil in which to cook them". And Satan brought forth deep fried coconut king prawns, butter-dipped lobster chunks and chicken fried steak, so big it needed its own platter, and Man's cholesterol went through the roof.

Then God brought forth the potato, naturally low in fat and brimming with potassium and good nutrition. Then Satan peeled off the healthy skin and sliced the starchy centre into chips and deep fried them in animal fats adding copious quantities of salt. And Man put on more pounds.

God then brought forth running shoes so that his Children might lose those extra pounds. And Satan came forth with a cable TV with remote control so Man would not have to toil changing the channels. And Man and Woman laughed and cried before the flickering light and started wearing stretch jogging suits.

Then God gave lean beef so that Man might consume fewer calories and still satisfy his appetite and Satan created McDonalds and the 99p double cheeseburger. Then Satan said "You want fries with that?" and Man replied "Yes, And super size 'em". And Satan said "It is good." And Man and Woman went into cardiac arrest.

God sighed ......... and created quadruple by-pass surgery. And then ........... Satan chuckled and created the National Health Service.

THE FINAL WORD ON NUTRITION After an exhaustive review of the research literature, here's the final word on nutrition and health:

1. Japanese eat very little fat and suffer fewer heart attacks than us.
2. Mexicans eat a lot of fat and suffer fewer heart attacks than us.
3. Chinese drink very little red wine and suffer fewer heart attacks than us.
4. Italians drink excessive amounts of red wine and suffer fewer heart attacks than us.
5. Germans drink beer and eat lots of sausages and fats and suffer fewer heart attacks than us.

CONCLUSION: Eat and drink what you like. Speaking English is apparently what kills you.

Gerry Robinson and the NHS

I have just watched the first episode of "Can Gerry Robinson save the NHS" on Channel 4 which I had Sky+ed. The problem he confronts is that individual hospitals are funded according to the number of patients treated, whereas doctors and nurses are paid the same regardless how many patients they operate on or see at a clinic.

Is the solution not almost too obvious? Why can't the medical staff have their pay linked to the revenue they earn for the hospital, whether individually or as teams? No doubt this would be met with a barrage of complaint claiming that this would diminish standards etc, but it seems to work in most other industries. Surely this reform would be the logicial conclusion to the concept of the internal market? That, and opting medics out of the European Working Time Directive.

"Too posh to push"?

According to an article in today’s Evening Standard (I can’t find the link), Dr Tim Crayford, president of the Association of Directors of Public Health, has said that he doesn’t want the NHS to spend money on caesarean sections for mothers who are “too posh to push”, and instead wants the money spent on providing things like Herceptin to cancer patients.

The Chairman of the Health Select Committee, Kevin Barron, has also weighed in threatening an inquiry by his committee if the Department of Health doesn’t review the issue. I bet they are quaking in their boots.

There are a couple of things going on here: first this story. I thought it sounded familiar, and when I searched “caesarean” on the Evening Standard’s website, I found an article from June 2003 calling for exactly the same restrictions from the All-Party Commons Health Committee - here. Even worse, today’s story is not exactly fresh either, as it is just a rehash of a story appearing on CareandHealth.com dated 22 December 2006.

More important by far is the issue itself. Are “posh” women really depriving cancer patients of life-saving drugs with their unreasonable demands for unnecessary treatment?

I guess I should declare my interest here: Sarah gave birth the NHS by c-section last year. As far as I know, it was only available to her because she was having twins (i.e. she had no other medical reason) but it was not strongly put forward by her doctors (I wanted to say “pushed hard” but the metaphor was unfortunate). It was her two cousins, one a GP and the other a senior NHS consultant who pretty much insisted she took this route, given the not insignificant chance of complications for the second birth. In the event Georgina (who came out second) was a breach baby, so if Francesca had been born naturally, the chances are that Sarah would have then had to go through a stressful emergency c-section right after giving birth. So I wonder, who are all these “posh” women having medically superfluous c-sections on the NHS? If they are so posh, why aren’t they going private?

The bigger issue is simply that this is a classic New Labour cynical manoeuvre - blaming a defenceless and innocent group of largely imaginary people to deflect attention from the utter failure of the Government to address its inability to turn higher spending into better public services. According to the various press article, a c-section costs the NHS around £2,800 - £780 more than a regular birth - a drop in the ocean. A single injection of Herceptin costs £400, a full course costs £21,800 (according to a 2005 article in the Daily Telegraph) - that’s a lot of c-sections.

Of course, the NHS provides a lot of unnecessary treatments, if your definition of "unnecessary" is to treat anything which is not life threatening. Damn it, they provide hot baths and cups of tea to patients who are presumably “too posh” to have cold showers and a glass of water - why not pump all that money into “saving lives” as well. The fact is that we all pay for the NHS (ironically, Sarah is, as I type, working on her personal tax return and will no doubt be submitting a cheque which will more than cover the treatment she received last year), and it is there to help all of us whether we are on death’s door or whether we simply would like a doctor to keep us fit, active, healthy or even just productive (and yes, Sarah was working again within about four days).

If the Rt Hon. Kevin Barron MP or Dr Crayford thinks that the NHS needs to provide Herceptin they should be calling the Government to account to find the money to pay for it instead of wasting it on teaching civil servants how to tidy their desks! (The £7m spent on this bizarre initiative alone would have paid for 321 women to be treated by Herceptin or 2500 c-sections - take your pick).

PS: A further example of the sort of waste I am referring to: our twins arrived seven weeks early on 28 July - when Sarah was under the knife, I jokingly asked if we needed to cancel the c-section planned for 1 September…. Don’t be silly, said the nurse, we’ll take care of that. But lo and behold, five weeks later, we got a call from the hospital asking if we were coming in for the operation… you’re joking? I said… apparently the “system” hadn’t been updated (more like there is no system) and they hadn’t noticed the two Baillieu babies lying in the neo-natal for three weeks. I hope they were able to slot someone else in that morning and that the staff didn’t wait around with no-one to slice open. If they’d known, they could have quickly stitched Kevin Barron’s mouth shut - now that would have been money well spent.

+++++++++++

UPDATE: There is a further article in today's Telegraph, which mentions an important statistic omitted from the Care and Health article - "Most caesareans are carried out because of medical complications, a slow progressing labour or the mother having had the surgery during a previous birth. The proportion performed as a result of a request by the mother is about 1.5 per cent of all births." - as I said above, Crayford and Barron are tilting at imaginary windmills.

A Tory meets the NHS - part 1

I have never spent so much as a single night in hospital since I was born. The inevitable effect of ageing mean that in the past two or three years I have seen more of the medical profession than is ideal, but all of those invited to poke and prod me have been private practioners, paid for out of my own pocket or that of PPP (my insurance company). I am not even registered with a GP and I have no idea what my NHS number is.

My wife, on the other hand, is an organised soul in touch with her thrifty(!) Scottish roots. In the early days of her pregnancy she saw a private gynaecologist, but on discovering that his fee for caring for her throughout the next nine months would be in excess of £10k, I was relieved that she was prepared to look at what was on offer from the NHS. The good news was that for twins the NHS offers an obsectrian who will see you during the pregnancy, and, more importantly, will perform a caesarian on the big day itself. Such service is not, however, available to the run-of-the-mill singletons, who, if they wish to have this must go private. Of course, there was a certain smugness in knowing that my brother shelled out the aforemention large wedge to secure the services of the renowned Gubbay Ayida for his wife's pregnancy, whereas Sarah got to see her for free.

Up to this point, it was all going so well.

The Chelsea and Westminster is a flagship hospital with impeccible New Labour credentials having assisted Cherie bring Leo into this world. It is clean, new and shiny - modern medicine, here we come.

The first visit for the all important 12 week abnormaility scan (when you first see the baby - or in our case - babies and the doctors check for Downs syndrome and other nasties) was basically fine. The slightly-longer-than-necessary wait, which is a quintessential part of any NHS visit, was bareable, although I fail to understand why a 10.30am appointment means that you will not be seen before 11am.

Having done my fatherly bit, Sarah faced her next appointment alone. This was the first disaster. The highlights were that the hospital had lost her notes and the consultant had no record of her appointment. She left feeling bewildered and upset.

Being pushy middle class types, we did not leave it there, but tracked down Ms Ayida's (the consultant) email address and sent a polite but firm letter complaining about the visit. To her massive credit, Ms Ayida rang Sarah the following weekend and spent 20 minutes with her on the phone going over her concerns, and it was decided that Sarah would keep her own notes and bring them to the hospital for each appointment. I later heard Ms Ayida said that she had never had a letter like that from a patient.

So what? A minor gripe in the scheme of things, I hear you say. But two simple things would make life so much easier, more efficient.

(1) The government's insistence on a single IT solution for the entire NHS means that a patient's notes cannot be held on an internal hospital IT system, and thus never be lost. How is it that the nice people at Blogger can make it so easy for me to share my thoughts with whole world, but it is impossible for a hospital to have a simple internal system for storing notes (like the nifty one they have at the private dental surgery I go to in the City)?

(2) Why do all appointments have to be face to face? Obviously samples have to be given, scans made and arrgghhs and coughs performed with the patient right there. However, most of those procedures are increasingly done by skilled techicians and nurses. Especially for maternity, but also for other patients, there is a lot that can be acheived by speaking to a consultant or senior doctor (who has the results of the tests, scans etc) - and guess what, this could be done over the phone.

Anyway, that is enough for now... it is nearly 9.30pm and the girls have not properly settled from their last feed at 8pm and soon will be wanting another one, as will their parents...

In my next post, I will cover the birth and post-natal care and why David Cameron's line that the NHS will be safe in his hands because his family is so often in the NHS's hands made my top lip quiver.