Health

End of the line: it’s time to rethink the queue

Flying to Kalamata this week, I did my own little bit to reduce the terrible queues at Heathrow Terminal 5. Heroically, I stacked up the grey luggage trays once they’d been emptied by passengers coming through security. As a result, there were more loaded trays for people to pick up, and a smaller tailback of passengers — including me — waiting to pick up their unloaded trays. It was just a tiny example of the hundreds of things that could be done to reduce queues in airports, hospitals, train stations, supermarkets… The British may be famous for their patient queueing but it doesn’t mean we actually like doing it. So

The NHS blood tube shortage should concern us

One of the great lessons from the early stages of the pandemic was the need to shorten supply chains and make them more robust. This was especially true for medical supplies. Just-in-time supply chains have been developed over the years to increase efficiency, but had never been tested in a global crisis when demand for certain medical products is high and supply is weak. The government ended up paying huge sums for PPE which, in some cases, was not even suitable for use. The shortage raises eyebrows because a plastic tube is, after all, a plastic tube It seems the lesson has not entirely been learned. There is now a shortage of

Am I alone in not wanting to download the Covid app?

As I begin, I’m tortured by the doo-do-doo-do of The Twilight Zone’s theme music. I’ve hurtled back in time. Suddenly I’m a wise-ass, liberty-loving journalist who’s had it up to my eyeballs with intrusive, ineffectual top-down nanny-ism, and I’m pooping on yet another pitiful feint at ‘doing something’ by the lumbering big state. OK, check. This feels dead familiar. But I went to a poncier school, my hair is way weirder, and it seems that my name is Boris Johnson. Consider this, then, an act of either plagiarism or ventriloquism. If with a tad more alliteration (I’m keener on assonance myself), Boris of a few years back would have written

Sajid Javid: My isolation diary

You always remember when a prime minister calls you to ask you to take on a new role, and you remember the reaction of your loved ones, too. My mum was delighted — like many Asian mothers she wanted at least one of her five sons to be a doctor and she was thrilled that I would be, as she put it, ‘working in healthcare’ after all these years. My wife was concerned about the pressures of the role and what it might mean for our family. And my daughter was worried that I might not look the pinnacle of health walking through the famous Downing Street door, due to

Organic food isn’t better for us – or the environment

It is mystifying to me that organic food is still widely seen as healthier, more sustainable and, most absurdly, safer than non-organic food. Following the publication of part two of Henry Dimbleby’s National Food Strategy last week, the organic movement was quick to suggest that organic food and farming offer a way to achieve the strategy’s vision. ‘The recommendations of the National Food Strategy offer genuine hope that by embracing agroecological and organic farming, and adopting a healthier and more sustainable diet, we can address the climate, nature and health crises,’ said Helen Browning, chief executive of the Soil Association, Britain’s most vocal organic lobbying organisation. Browning also highlighted the

What did the Romans ever do for us?

The mayor of London, Sadiq Khan, is planning to install a statue of John Chilembwe in Trafalgar Square. Mr Chilembwe was a Malawian Baptist famous for, among other things, leading an uprising where the head of a Scottish farmer was chopped off and put on a pole. He is much revered in his home country for all this and his face has appeared on banknotes. In truth, Mr Chilembwe didn’t incite the murder of many people, in the great scheme of things. If the mayor is searching for a murderer who did punch his weight, he could do worse than hoist up a statue of Francisco Macías Nguema, the former

Javid reveals his health priorities

Effective cabinet ministers are ones who work out what they want to do in a department on arrival, and then stick to that very small set of priorities whatever the political winds and storms. Michael Gove had this approach in the Education department, setting himself three priorities and then focusing on getting them delivered. Not only did he then replicate this approach in his subsequent Whitehall briefs, but he also inspired other ministers to do the same. Jeremy Hunt, who largely modelled himself on Gove when he became health secretary, also gave himself a small list of things he wanted to do in his time overseeing that brief. Now, it

Are Hancock’s health reforms doomed from the start?

Are the Conservatives going to repeat their mistakes of a decade ago on NHS reform? If a week is a long time in politics, perhaps ten years is such a lengthy period that it erases the memory entirely. The current Health and Social Care Bill is due for publication any day now and contains much of the same potential for an almighty political row as the Andrew Lansley reforms of 2011. Senior Whitehall figures and MPs have predicted that Matt Hancock’s new legislation could be ‘Lansley mark ii’, as I write in today’s i paper. In talking to MPs across the Conservative party, from backbencher to minister, and from lockdown sceptic to restrictions

Why are doctors still hiding behind Zoom screens?

Where have all the GPs gone? Doctors were among the first to be double-jabbed, ahead of teachers in the queue precisely so they could resume seeing patients in the flesh. But while schools have long been back, GPs have retreated behind their laptops never to be seen again (at least not in the flesh). The stethoscope has been replaced by a headset — to the despair of patients with ailments that are hard to diagnose over the phone or via a laptop. In theory, GPs can claim normal service has resumed. In the pandemic the number of appointments almost halved to just over three million a week — in spite

How does the ‘red wall’ story end?

At Redwall Abbey Does fiction provide any guide as to the ultimate fate of Labour’s Red Wall? — Redwall Abbey was the setting for a series of children’s novels written by Brian Jacques between 1986 and his death in 2011. It revolved around the peace-loving creatures of Mossflower Wood who were forced to fight invading vermin. The first of the novels, called Redwall, featured an orphaned mouse who had become a novice monk and was forced to fight off an evil, one-eyed rat. At the end of the final novel, published posthumously, an otter and hedgehog emerged triumphant over the ‘vermin’ — a loose band of creatures which included rats,

Hospital wards are filling up again – with fakers

How do I know that Britain’s Covid crisis is over? The fakers are back. The hypochondriacs, the psychosomatics, the pseudo-fitters, the attention-seekers and the lonely. They’ve started to return to the acute medical ward where I work. They’ve been gone so long I actually almost missed them. This collection of patients, who take up time and resources inversely proportional to the state of their physical health, simulate symptoms for gain (malingerers), simulate/induce their symptoms for the pleasure of the sick role (Munchausen’s syndrome) or genuinely experience symptoms such as pain, seizures or paralysis in atypical ways with no physically identifiable or treatable cause (now vaguely termed ‘functional disorders’). Members of

The mysteries of ‘long Covid’

Soon, as the rates of coronavirus deaths and infections plummet, we’re likely to focus more on those who suffer what is being called ‘long Covid’ — yet the truth is we know very little about what precisely it is. Long Covid began as a quiet murmur in the background: anecdotal stories about symptoms which extended beyond the predicted 14-day recovery time. There’s no agreed definition, so it’s hard to say how many sufferers there are, but a survey from the Office for National Statistics suggests it affects as many as one in ten of those who have had the virus. As the second wave retreats, the number of people left

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