Health

The NHS is still in desperate need of reform

Along with many of my colleagues, I have been arguing for years that the current structure of the NHS cannot survive. Giving the health service endless money won’t make a significant difference, unless its core structures are changed. It is therefore very interesting to see that Matt Hancock, in the middle of the pandemic, has unveiled a package of major changes to healthcare, the essence of which is to reverse the Lansley reforms. One of the reforms the health secretary is taking aim at is the purchaser/provider split, which I have identified in the past as one of the ‘four crumbling pillars of the NHS’. The split involves regional panels

The power of cold showers

Hippocrates prescribed it to allay lassitude, James Bond favoured it as a token of his manliness, and in less indulgent times Gordonstoun school insisted on it: the cold shower. And now it’s having a moment with the wellness brigade. (The very word ‘wellness’ used to send me screaming from the room: a Californian import, I was sure. Then someone pointed out that the word has been in the English lexicon since the 17th century, so that told me.) The proven physical benefits of exposure to cold water are impressive. A boost to the immune system, improved circulation, and a wake-up call to the body’s brown fat, which is apparently A

My future hangs on the result of this blood test

A new year and another round of medical treatments in the French health system. On Saturday morning, needing a blood test pronto, I drove to the local branch of a chain of commercial laboratories, arriving before daylight. I joined a queue of the worried and unwell that had already spilled out of the door and into the icy car park. Except for a old chap behind me trying to cough up a lungful of warm porridge, and someone else’s lilting accordion ringtone, we were a silent, stricken field. After shuffling forward for 20 minutes, I celebrated the achievement of reaching the outer door and passing through into the interior warmth

My cure for the common cold

You really don’t want to know about my coughs and sneezes, particularly during the festive season, but bear with me because this it isn’t really about my sniffles. My argument applies to everyone, and it’s cheerful. All of us have a lifetime of experience of seasonal colds and flu, starting with the fact that they don’t always happen in winter. Mine is typical of many. Every year, often about this time, I get a fairly bad cold. Sometimes two in a year. I call it ‘flu’ and women call it ‘man flu’ but let’s not bandy names: it starts with a sudden sore throat and one or two uncomfortable nights.

The (absent) ethics of lockdown

Is it ethical to lock us down again? This is not a facetious question. Over the past eight months, we have heard a great deal about the policies used to manage the virus, but very little about the ethics. This is a mistake. We should be asking how we can critically and reasonably strike a balance between conflicting values and interests. Yet even now, with so much at stake, this basic question on the ethics of our policies is not being properly asked. When it comes to public health, the ethical balance is simply expressed: how do you achieve a certain public health goal with the fewest restrictions on individual

What happens when a US president dies?

Vice squad Donald Trump catching Covid-19 has concentrated minds on what happens if a US president dies in office. Normally, the vice-president will take over — which is why it matters who is on the ballot. In 1972, however, Americans had no idea who would end up president by the end of what should have been Richard Nixon’s second term. Nixon’s vice-president was Spiro Agnew, but he was forced to resign after pleading ‘no contest’ to charges of tax evasion. Nixon then appointed House leader Gerald Ford as vice-president. Ford became president when Nixon himself resigned before he was impeached over the Watergate scandal in August 1974. Ford lost to

Covid, lockdown and the economics of valuing lives

How much should we pay to save life? The question is often viewed as distasteful: you can’t put a price on human life. But resources are finite. Even if the only purpose of life was to prolong it for as long as possible, there would be limits to healthcare affordability. So if resources are limited, how can their application be made fairly? And how can this logic be applied in a pandemic? One element when establishing a fair method is to consider life years saved rather than lives saved. This recognises that someone of my age (55), who has already enjoyed two-thirds of his likely life span, should be a

The problem with fast-tracking vaccines

You have to admit it, Operation Warp Speed is a good moniker. It’s the name for the American interagency programme, initiated by the Trump administration, to produce 300 million doses of a safe vaccine for Covid-19 by January. Who couldn’t get behind this all-hands national effort to defeat the virus and end the pandemic, excitingly named after the faster-than-light space travel in Star Trek? While we wait for clinical trials led by the University of Oxford and AstraZeneca in the UK, America warps ahead. Warp speed allows the Starship Enterprise to put aside the laws of physics. Vaccine development also has its own laws, or rather guides, that describe the

Our immune system is the pandemic’s biggest mystery

What have we been witnessing these past few months? A worldwide crisis caused by the arrival of a new virus of exceptional virulence — or a crisis of awareness, in which incomplete information led to a wildly disproportionate reaction? Have lockdowns, face coverings and the rest saved millions of lives worldwide? Or have they had relatively little effect on the course of the pandemic, and ended up causing more harm than good? And why, so far, is Britain not seeing the surge of Covid-19 infections reported in Spain and France? What are we missing? We still know a lot less about Covid-19, and about viruses in general, than you might

My ‘virus’ turned out to be arthritis

‘Hallo! You was callin’ us about appoint…MENT!’ said the lady at the scanning unit of my local hospital in broken English. Nothing wrong with that. It’s just that when I received a letter bearing the logo of a private company informing me of the details of my forthcoming MRI, I got all excited, anticipating efficiency. Although I was having it done on the NHS, the appointment came through swiftly with no mention of the health service on the paperwork, which raised my expectations. I rang to confirm, but after holding for a while I was told to leave a message and someone would ring me back. A few hours later

Why should anyone be forced to shield?

The best way (and with politicians sometimes the only way) to know whether people are aware they’ve made a mistake is seldom to put that question point-blank. A reflexive ‘oh no I didn’t’ kicks in. Do you honestly think, for example, that government ministers are privately confident that as Covid-19 swept the country, hospitals were right to send elderly patients back untested to care homes, even with the limitations to our knowledge at the time? Of course not. But something stupid about British politics appears to constrain them from saying so. Possibly, before trying to persuade us, they have persuaded themselves they were justified; and we all do this to

Why should I have to wear a face mask to give blood?

Any day now I shall be frogmarched, or at least very firmly escorted, out of a blood donor centre in London. I know this is going to happen because I made the appointment weeks ago and I intend to keep it. But when I signed up to donate my pint of blood to the public good, I was not required to wear a muzzle during my donation. Now I am. I do not intend to do so. I find the idea of donning one of these face-nappies physically repulsive, and dislike the mouthless, submissive appearance they create in all their wearers. I also believe them to be futile. I know

The NHS is letting down thousands of patients

I’m embarrassed every Thursday. I don’t mean to sound ungrateful. The outpouring of love for NHS workers at 8 p.m. each week has been touching. Who wouldn’t want to be clapped and cheered? But quietly among ourselves, many of us in the health service have increasingly felt it’s misplaced. I’ve come to dread it. It makes me wince. The fact is that the NHS is currently letting down thousands upon thousands of patients. When the dust has settled, I fear that we will be responsible for the death or morbidity of countless people. Since the pandemic hit, entire NHS services have completely stopped. I fear that this will have catastrophic

‘Herd immunity’ is impossible without a vaccine

My great-grandfather did not fight in the war. He wasn’t a conscientious objector — he was a scientist helping to develop radar. It’s tempting to imagine family history repeating itself. I’m not alongside my colleagues on the NHS front line; instead I’ve been part of a large team at the Crick Institute, helping to develop tests for Sars-CoV-2, the causative agent of Covid-19. For the first phase of our struggle against this virus, we’ve had minimal testing capacity — no radar — and we’ve suffered the consequences. The director of our institute, Sir Paul Nurse, borrowed another wartime analogy when he imagined academic labs as a flotilla of ‘little ships’,

A military guide to surviving lockdown

“Wire your booze cabinet up to the mains so you can’t get into it!” says Jason Fox, the former Royal Marine Commando and Special Forces Sergeant who’s best known for barking orders on Channel 4’s SAS: Who Dares Wins. With wine o’clock starting earlier each day for many of us, as we crawl the walls in isolation, I’ve asked Jason for his take on lockdown drinking. “It’s not the answer really. It’s great fun and I enjoy having a drink, but I won’t allow myself to drink all day. It doesn’t make you feel better about yourself.” Having spent sizeable chunks of his 20-year career sardined in submarines with other

The curious age discrimination of coronavirus

The generational effect of the corona-virus is cunning and baffling. By often being so mild in the young and healthy it turns people into heedless carriers. By often being so lethal in the old and sick, it makes carriers into potential executioners of friends and neighbours. The virus is very dangerous for people who have certain underlying illnesses, which is probably the main reason it is so serious for the elderly. It is almost as if it does not kill people by itself, just worsens other disorders. This is unlike flu, where children are as much at risk as old people. By contrast, in this case, young people in good

How worried should we be about coronavirus?

So are we all going to die or is it going to fizzle out? In Naples the police drive along streets with loudhailers, warning everyone to keep indoors; in Britain the government declines to close schools, call off sporting fixtures and persuade people out of the pub. Something feels not quite right: either there is huge overreaction or under-reaction to Covid-19. Health Secretary Matt Hancock has not helped calm fears by announcing that the government has been working on a worst-case scenario of 80 per cent of the population catching the virus and 500,000 dying from it. It isn’t easy for the scientists, either. In a fast-developing disease there is,

My night in A&E left me worried about the NHS’s coronavirus response

I wish I shared the Prime Minister’s confidence about the ability of the NHS to cope with coronavirus. ‘I have no doubt that with the help of the NHS and its incomparable staff, this country will get through it – and beat it,’ he said on Sunday. Not if my experience in A&E last week is anything to go by. I wasn’t keen to visit A&E in the midst of the current crisis, obviously, and had it been my own health I was worried about I would have stayed in bed. But it was Sasha’s, my 16-year-old daughter. She was pushed down some stairs at a party (not deliberately) and

Coronavirus and the cycle of panic

If you have just cancelled your trip to Venice and ordered your £19.99 surgical face mask from Amazon, how about this for a terrifying vision: by the time we get to April, 50,000 Britons will have succumbed to a combination of infectious disease and adverse weather. Frightened? If you are, don’t worry: you survived. It was two years ago. In 2017-18 the Office for National Statistics recorded 50,100 ‘excess winter deaths’. The explanation, according to the ONS, was probably ‘the predominant strain of flu, the effectiveness of the influenza vaccine, and below average winter temperatures’. Coronavirus (Covid-19) is a pretty virulent virus all right, but not in the way you

My Parkinson’s diagnosis has shown me how kind society really is

Like Ozzy Osbourne, I was last year diagnosed with Parkinson’s disease, the degenerative condition that impairs the functioning of the body. In a series of recent interviews, Osbourne has spoken frankly about the impact of the neurological disorder. ‘That thing has knocked the shit out of me,’ he said, Brummie-style. I’m with Ozzy. It’s done the same to me. My difficulties began about 18 months ago, when my left leg developed an involuntary twitch, which soon extended to my other limbs. My gait became increasingly awkward, alternating between a strange quickstep and a longer, more laboured shuffle, complete with stoop and limp. The effect was like a cross between John