Wednesday, 6 March 2013

NHS response to criticism - blame the patient


Yesterday "The Doctors" were out in force. All over the airwaves, in every newspaper. Telling us that the reason we don't live as long as the Spanish is because of our terrible lifestyle decisions:

But the problem is only in part to do with hospital care – much of it is about the way we live. Our diet, our drinking and continuing smoking habits all play a part, according to one of the report's authors, Prof John Newton, chief knowledge officer of Public Health England, which assumes its responsibilities on 1 April.

The problem is that this really doesn't stack up when we look at the figures. The evils thing - the targets of nannying fussbucket disapproval - are smoking, drinking and being too fat.

First smoking. According to the OECD, the UK sits pretty close to the average (indeed slightly below the average) at 21.5% of the population smoking. The two top countries for happy and healthy life - Spain and Italy - have smoking rates of 26.2% and 23.2%. Clearly it's not the smoking.

So it's the drinking then? Well here - again - the UK is below the European average with a per capita comsumption of 10.2 litres of alcohol per capita. And those long-lived Southern Europeans? The Italians are Europe's soberest folk at just 6.9 literes per head. But the Spanish - they love the stuff and stick back 11.4 litre. Not sure it's the booze then.

Maybe is the obesity - all those Latin folk are slender and snake-hipped after all, aren't they? Well for Spain:

Adult obesity rates in Spain are higher than the OECD average, and child rates are amongst the highest in the OECD.

And Italy:

Obesity rates are low in Italy, relative to most OECD countries, but are very high among children. 1 in 3 children is overweight, one of the highest rates in the OECD.

Doesn't look like the fatness.

Just for completeness, it isn't taking illegal drugs either:

National rates range from 0.8% to 11% with the lowest rate recorded in Malta, followed by Bulgaria, Greece and Sweden. Italy has the highest rate, followed by Spain, the Czech Republic, and France. 

It really is a problem for our fussbuckets, isn't it? This I mean:

The performance of the UK in terms of premature mortality is persistently and significantly below the mean of EU15+ and requires additional concerted action.

You see the problem really isn't our lifestyles - or not so much as "The Doctors" would have us believe. The problem lies elsewhere. Perhaps we should point the finger at the scandal of Mid Staffs, the weakness of our primary care system and a health service that is over-centralised and producer-controlled?

But that wouldn't suit the producers - that would mean them stepping up and accepting responsibility for the failings of our health system. It would mean turning their cosy little world upside down and putting patients - you and me, the users of the system - in change. It would mean looking at how our neighbours run their health systems. As BoM points out:

What this study really highlights is that when it comes to health, we have a lot to learn from our neighbours. None of them have a nationalised health system, yet most of them enjoy longer healthier lives than us. Instead of pretending our healthcare system is the envy of the world, we should have the humility to look and learn.
 In the meantime we can anticipate another episode of doctors, "health professionals" and supine politicians who daren't challenge these nannying fussbuckets telling us that it's all our fault.

Faced with criticism, the NHS always blames the patient.

1 comment:

Anonymous said...

How dare you criticise all the lovely Drs and nurses in the NHS. They saved my life.