1) This failure of the NHS to implement an effective safety policy to minimize “medical error” is costing £millions if not £billions in reparation costs and legal costs. This could be substantially reduced.
2) The failure to update diagnostic techniques in diseases because “the methods defined 40-50 years ago are considered adequate” is another area where substantial savings could be made. In this regard I am thinking of Type 2 diabetes(TD2). We are always told that early diagnosis is essential to improve the possibility of full recovery yet in practice the current protocol and guidelines continues to rely on methods that are based on hyperglycaemia and HbA1c. Dr JR Kraft (The Diabetes Epidemic and You) has shown on the basis very solid research that early diagnosis should be based on hyperinsulinaemia which predates the appearance of hyperglycaemia and thus provides a greater probability of full recovery.
In turn this would result in considerable financial savings. The current system simply ensures that patients will inevitably end up by having to use insulin as one expert recently claimed. Furthermore if insulin resistance is involved, this addition of insulin to an already hyperinsulinaemic condition, which in itself is damaging to the patient.
All this because fasting blood insulin levels are not measured. While back in the ‘60s and ‘70s when only RIA tests were available with all the legal requirements involved with radio isotopes I can understand hospitals reluctance to become involved with such methodology. Additionally at that time when an apparently suitable methodology was available it seems reasonable.
However science moves on with the development of the ELISA test; kits can be obtained. Thus, the possibility of a much earlier diagnosis of TD2 is possible with a better chance of full recovery (providing that the Ancel Keys contribution is put to rest) with substantial savings in pharmaceutical costs and a minimization of the problems associated with hyperinsulinaemia (such a CVD and cognitive problems such as Type 3 diabetes (aka Alzheimer’s). As commercial medical laboratories can measure insulin blood levels for a mere £39, the NHS, as a non-profit organization could probably do the test for £20 or less.
3) This example raises the issue of what other areas are similarly affected by failure to progress. As a patient one is sometimes left with the impression that Big Pharma’s need for sales and the status of its KOLs is more important than patients’ health. I am reminded of the initial response of the experts to Dr Barry Marshall’s discovery of Helicobacter pylori as a major cause of GI ulcers.
4) The failure of the NHS administration to improve its administrative own practices to a more patient friendly approach is vitally needed.
Thus in conclusion I do not think throwing money at the NHS is the way to go. Human nature being what it is, throwing money at a problem merely removes the imperative to improve and be fiscally aware.
Rapid Response:
Re: Margaret McCartney: Our politicians are wilfully failing the NHS
Our politicians are wilfully failing the NHS
Certainly the politicians have failed the NHS but the NHS itself has failed both patients and the nation in several ways.
This brought to light by a recent article in the BMJ entitled “Italy recognises patient safety as a fundamental right” http://www.bmj.com/content/357/bmj.j2277?utm_medium=email&utm_campaign_n...
1) This failure of the NHS to implement an effective safety policy to minimize “medical error” is costing £millions if not £billions in reparation costs and legal costs. This could be substantially reduced.
2) The failure to update diagnostic techniques in diseases because “the methods defined 40-50 years ago are considered adequate” is another area where substantial savings could be made. In this regard I am thinking of Type 2 diabetes(TD2). We are always told that early diagnosis is essential to improve the possibility of full recovery yet in practice the current protocol and guidelines continues to rely on methods that are based on hyperglycaemia and HbA1c. Dr JR Kraft (The Diabetes Epidemic and You) has shown on the basis very solid research that early diagnosis should be based on hyperinsulinaemia which predates the appearance of hyperglycaemia and thus provides a greater probability of full recovery.
In turn this would result in considerable financial savings. The current system simply ensures that patients will inevitably end up by having to use insulin as one expert recently claimed. Furthermore if insulin resistance is involved, this addition of insulin to an already hyperinsulinaemic condition, which in itself is damaging to the patient.
All this because fasting blood insulin levels are not measured. While back in the ‘60s and ‘70s when only RIA tests were available with all the legal requirements involved with radio isotopes I can understand hospitals reluctance to become involved with such methodology. Additionally at that time when an apparently suitable methodology was available it seems reasonable.
However science moves on with the development of the ELISA test; kits can be obtained. Thus, the possibility of a much earlier diagnosis of TD2 is possible with a better chance of full recovery (providing that the Ancel Keys contribution is put to rest) with substantial savings in pharmaceutical costs and a minimization of the problems associated with hyperinsulinaemia (such a CVD and cognitive problems such as Type 3 diabetes (aka Alzheimer’s). As commercial medical laboratories can measure insulin blood levels for a mere £39, the NHS, as a non-profit organization could probably do the test for £20 or less.
3) This example raises the issue of what other areas are similarly affected by failure to progress. As a patient one is sometimes left with the impression that Big Pharma’s need for sales and the status of its KOLs is more important than patients’ health. I am reminded of the initial response of the experts to Dr Barry Marshall’s discovery of Helicobacter pylori as a major cause of GI ulcers.
4) The failure of the NHS administration to improve its administrative own practices to a more patient friendly approach is vitally needed.
Thus in conclusion I do not think throwing money at the NHS is the way to go. Human nature being what it is, throwing money at a problem merely removes the imperative to improve and be fiscally aware.
Competing interests: No competing interests