Why, When, Where And How Doctors (And Nurses) Do More Harm Than Good



I was hired to give a lecture on doctor-induced disease (iatrogenesis) at a conference for NHS staff held in London on 30th November 2004. But at the last minute I was banned from the conference on the grounds that `certain parties felt that (I) was too controversial to speak'. The organisers were told `that if I spoke they would not attend'. Indeed, my office was told that if I turned up there wouldn't be a conference at all. (For more details see the article entitled `Freedom Of Speech Disappears In The NHS' on this Web site).

No one will confirm who objected so strongly to my attendance. But the list of lectures which were considered acceptable includes one entitled: `Drug Safety: a perspective from the pharmaceutical industry'.

The conference was primarily concerned with the problems caused by prescription drugs but, astonishingly, one of the main, specific, stated aims of the conference was to decide what could be done to educate patients in order to reduce the incidence of `medication errors and adverse reactions to prescribed drugs'. It seems bizarre to me that patients should be regarded as one of the main causes of drug-induced death and illness. Some drugs are taken inappropriately but the big villains are drug companies, doctors and nurses - not patients.

The damage being done by doctors is (as I have shown in my books) so great that whenever doctors go on strike, the death rates among patients go down. Doctors are now one of the big three causes of death and illness. There is a frightening amount of evidence to show that patients with many diseases (including two of the other big killers - cancer and heart disease - may not infrequently be better off, and have a greater chance of survival, without any medical treatment at all).

If I had been allowed to turn up and give the lecture I was paid to give I would have used only brief guidance notes. But since I was banned, and not allowed to give my lecture, I have turned my own notes into a short essay. Here it is.


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Doctors, nurses, drug companies and hospitals are now one of the three main causes of death and serious illness in Britain, America and other so-called `developed' countries. Millions of people would be healthier - and would live longer - if their local hospitals were closed down and the staff found more useful jobs within the community.

As a cause of death and serious illness, iatrogenic diseases (disorders caused by doctors and hospitals) are up there alongside cancer and circulatory disorders (such as strokes and heart attacks).

As I proved some years ago (in my book Betrayal of Trust - now available free on this Web site) one in six of the patients in hospital is there because he or she has been made ill by doctors. Four out of ten patients who are given drugs develop side effects - often significant, frequently disabling and sometimes lethal.

No one in the medical profession has ever disputed my research or this figure. Indeed, when I did a radio broadcast to talk about another book of mine (Why Doctors Do More Harm Than Good) the producers of the programme invited a representative of the British Medical Association into the studio. When I made the point that one in six patients in hospital is there because doctors have made him or her ill, this doctor's response to my attack on the profession we share was unforgettable. `The positive thought we can take from this,' he said in his best bedside manner, `is that five out of every six patients in hospital are NOT there because they have been made ill by doctors.'

Honest.

Scary, isn't it?

No one cares.

The medical profession in general, and the medical establishment in particular, turns a blind eye and does nothing about the problem which they know exists. The quality of care in hospitals is falling as a result of overprescribing, an over emphasis on high technology medicine, political correctness, new employment laws (which makes it virtually impossible to sack an incompetent nurse or doctor), over bureaucratisation a failure to understand the importance of simple hygiene, and endless varieties of intrusive and unhelpful legislation.

The pharmaceutical companies (whose products are largely responsible for having turned doctors into potential killers as well as healers) misleads doctors and patients by claiming that `we've never had it so good' and falsely arguing that people are living longer than ever and that this is thanks to the drug industry. If you exclude infant mortality rates - which have improved, thanks to such things as cleaner drinking water and better sewage facilities, there has been very little improvement in life expectancy. The general improvements in health which have taken place have been due to better nutrition, cleaner air, better working conditions, etc rather than to the availability of super drugs.

Politicians do nothing lest they upset the pharmaceutical companies (which bluff by threatening to move their operations to other countries if anything is done to damage their profits).

And hospital administrators do nothing because they don't know - and possibly don't want to know - the truth. Administrators have soaked up all the power but they have refused to accept any of the responsibility.

Why Do Doctors (Nurses and Hospitals) Do So Much Harm?

1. Most medical treatments are untried and unproven to be any good at all. The evidence for this apparently provocative claim can be found in books of mine such as How To Stop Your Doctor Killing You and Betrayal of Trust. The former is available through the webshop on this site. The latter, along with a number of other publications, is available free on this site.

2. Drugs are wildly overprescribed, both by hospital doctors and by general practitioners. It is now over 30 years since I first exposed the dangers of benzodiazepines and 15 years since a Tory Government admitted that it had introduced new legislation as a result of my campaign. But still benzodiazepines are over-prescribed and still they are prescribed badly, without thought and without awareness of the often disastrous consequences for patients. Vast numbers of other drugs, including antibiotics and painkillers as well as antidepressants, are frequently overprescribed. Vaccines are also a major cause of illness and death. I have dealt with the problems of vaccines in my book Superbody. The side effects associated with many of the most popularly prescribed drugs are listed on this Web site. (Go to the button headed `Medicines A to Z'.)

3. The NHS is now dangerously overstaffed. Billions of pounds are wasted on salaries, expenses and pensions for unnecessary administrators. Those excess administrators are soaking up so much money that they are indirectly responsible for thousands of deaths. A spokesman for one hospital which had spent 1,000,000 more than its budget allowed said that the hospital was `thinking' about what to do (putting it this way enables the administrators to avoid responsibility) and that what had happened was no one's fault (see what I mean). She said that the hospital was considering selling some equipment or closing some beds in order to deal with its debts. The hospital was not, of course, contemplating getting rid of any of the administrators whose incompetence had led to the problem. Most administrators seem to believe that hospitals would be much more efficient and cost effective if there were no patients at all. I am sure that they are right. Signs of administrators at work are everywhere. For example, it is the fashion these days to put carpets on hospital corridors. Naturally, this is dangerously unhealthy (since carpets are far more difficult to clean than other forms of flooring) but at least it means that administrators are not disturbed by the noise of patients being wheeled about. Today Britain's National Health Service employs 1.4 million people. There are 200,000 more employees in the NHS than there were when New Labour took over. But there are less people actually caring for patients. Since Blair and Company took over the NHS the number of administrators has grown to exceed both the number of nurses and the number of beds. How, in the name of everything holy, can a hospital need more administrators than nurses or more administrators than beds?

4. The present system ensures that the nurses who run hospitals, who make the rules and who provide the `leadership' are the ones who are least capable of, and least interested in, working directly with patients. The nurses who run our hospitals are the ones who are least interested in the art of caring, least passionate about nursing as an art and most anxious to climb up the career ladder by exhibiting their prowess at managing meetings, mastering the double-speak that has invaded hospitals and giving good mouth. Nursing lost its way when it became impossible for a nurse to rise in the hierarchy without becoming an administrator. Nursing went wrong when nurses started collecting diplomas and degrees. How can you have a degree in caring? A few decades ago patients were cared for in hospitals which were run by matrons and ward sisters - nurses who still knew how to turn a patient, make a bed and empty a bedpan. Most patients cannot, of course, remember how efficient hospitals were in those days and so, because they don't know what to expect or what to look for, think they are being well looked after. Most people have low expectations, are inherently grateful for anything that is done for them, are frightened and don't know what to look for. (This is the only possible explanation for those letters to local newspapers extolling the virtues of the local hospital.) These days the brigades of fat bottomed nurses who `administer' our hospitals are too self-important even to look at patients, let alone speak to them. You can occasionally spot these nursing administrators darting along the corridors, eyes averted lest they accidentally soil their vision with the sight of someone in pyjamas or a nightdress. Most of the time these nursing harridans lie hidden behind office doors, planning their career progress. Many of them seem grossly obese - a consequence no doubt of doing too little work and spending too much time drinking coffee and munching biscuits. If the salaries of these grotesque beasts were smaller, and they spent less time in meetings, there would be plenty of time and money to make sure that agency nurses were unnecessary. (There is very little continuity in nursing care in modern hospitals. Patients are lucky if they ever see the same nurse twice.) Those who are left at the dirty end of the profession, wander around almost uninterested in their work. Often slovenly and untidy, they do not seem to care for their patients at all. It is frequently difficult, if not impossible, to tell who is in charge. The modern nurses' office (or `station') will usually be positioned in a spot where the nurses can hide away from the patients to make their phone calls, eat their biscuits and gossip. Inevitably, if the patients cannot see the nurses, the converse is also true: the nurses cannot see the patients. Calls for help or bedpans go unnoticed.

6. Thanks largely to the EU, doctors (both in general practice and in hospitals) are now working strictly limited hours. Many GPs no longer provide the 24 hour, 365 day service which was an integral part of family practice just a few years ago. The modern GP works the sort of hours usually associated with school teachers, librarians and accountants. Many hospital doctors now work only short, fixed weeks. It is rare to see a doctor (or a physiotherapist or, indeed, anyone else who isn't a patient or a visitor) in a hospital at weekends these days. Patients are left lying in bed all weekend. No one, it seems, has heard of deep vein thromboses or pressure sores. One result of the shortage of doctors has been that nurses have been given the right to prescribe and to perform surgery - and to take on these responsibilities without any medical supervision and without the sort of training required for doctors. To the problem of bad prescribing by doctors has now been added the problem bad prescribing by nurses. Most nurses (like most doctors) know very little about the drugs they prescribe and know next to nothing about side effects. We need fewer - not more - people handing out prescriptions.

7. Infections are now a major killer in our hospitals. Thousands of patients are killed by antibiotic resistant infections. The MRSA bug kills and seriously injures far more people than road accidents kill. Hygiene standards are appalling. Wards are often filthy and nurses and doctors often fail to wash their bloody, bug stained hands when moving from one patient to another. Hygiene in hospitals is just a word (which most members of staff probably cannot even spell). Watch the cleaners at work and you'll see them slide a mop down the centre of the ward. It's known in the mop wielding business as `taking the mop for a walk'. They then wander off into their staff room for a tea break. And then serve patients their food. (Staggeringly, the same people who clean the ward then serve patients their food. No one seems to see anything odd in this. The cleaners do not, of course, wash their hands between these two activities.) Cleaning staff (sorry, I think they now have to be called `housekeepers') do not appear to have been told that they too must obey the basic rules of hygiene. I have seen a cleaner go into a private room containing a patient with MRSA without bothering to put on gloves, a mask or a gown. The Government would save far more lives if it took down speed cameras and, instead, put up cameras in hospitals to check that nurses, cleaners and doctors washed their hands properly. Such a simple action would save billions of pounds and thousands of lives a year. Nurses who are spotted moving from patient to patient without washing their hands should be fired and banned from ever working in health care again.

8. Much of the medical establishment still steadfastly and stubbornly refuses to acknowledge that `alternative' or `complementary' medical techniques have a great deal to offer. Gentle therapies, and gentle practitioners, are deliberately demonised by the drug industry controlled medical establishment.

9. The food in hospitals is diabolical and contributes enormously to the death rate among patients. The Government should give up trying to stop people buying chocolates and crisps and should, instead, do something about the standard of the food served in its own hospitals. It is, for example, quite absurd that hospitals should continue to serve meat dishes to patients. Since the evidence linking meat to cancer is just as convincing as the evidence linking tobacco to cancer, it would make as much sense for nurses to walk around the wards handing out cigarettes. (There are summaries of many of the main scientific papers proving the link between meat and cancer in my book `Food for Thought'.)

10. By allowing all NHS doctors (including those who are supposed to be working full time for the NHS) to charge extra fees for seeing private patients, the NHS has created (and is itself now addicted to) a two-tier health system. This problem is explained at some length in my book Why Everything Is Going To Get Worse Before It Gets Better.

11. Doctors still tend to treat test results rather than patients. Too often doctors remain astonishingly ignorant of the fact that test results are often misleading. (See my book How To Stop Your Doctor Killing You for more on this.)

12. As I proved in my evidence to a House of Lords select committee recently (there are more details of this under the Animals heading on this Web site) animal experiments are done not to help patients but to improve drug company profits. The drug industry's reliance on animal experiments has led to the deaths of countless thousands of patients.

13. Since 1982, I have been arguing that the drinking water from our taps is now unsafe to drink because it contains pharmaceutical residues. People who drink tap water are drinking second-hand drug residues. (There is more on this in my books Food for Thought and How To Stop Your Doctor Killing You.)

14. Patients sometimes die untreated because doctors will not (or dare not) try treatments until all the investigations have been completed. The threat of litigation means that doctors insist on waiting for convincing evidence before trying anything. Inevitably, this means that it is not infrequently too late to act by the time treatment is started. If, for example, there are two or three possible diagnoses available and only one of the diseases can be treated then it would seem to make sense to start the treatment for the disease which can be treated, even though laboratory evidence in support of that diagnosis might not be available. But this isn't what happens.

15. Doctors and hospitals are often appallingly and inexcusably slow. Heaven alone knows how many patients die while doctors are waiting for a meeting or an X-ray result. I have on my desk a letter sent by a GP to his female patients inviting them for a smear test to see if they have cervical cancer. They would, he told them, expect to have the result of their test in 13 weeks. The unnecessary worry caused by a delay of this length will, I suspect, mean that the smear testing activities of this doctor do far more harm than good. Women suspected of having breast cancer are told that they have to wait as much as 17 weeks for an NHS test. By the time they have the test they may well be incurable. (This does nothing to damage NHS success rates. A patient is only officially recorded as suffering from cancer on the date when she is diagnosed. The 17 week wait isn't counted.)

16. The separation of authority from responsibility, and the devolution of clinical power, means that doctors are no longer in charge of what happens to their patients. Doctors work in teams (as equal members alongside such dross as social workers) led by administrators. Today, it is the administrators who are in charge. And administrators are, it seems, unsackable. Whenever a hospital runs short of money it is the facilities for patients which are cut - never the number of overpaid, underworked administrators. It is difficult to avoid the conclusion that modern hospitals and health centres are run for employees in general, and administrators in particular, rather than for patients.

18. Dignity is not a word which the modern nurse understands. Not, at least, when applied to patients. Many hospitals still have mixed wards - with male and female patients forced to abandon their natural dignity in the interests of hospital economy (so that the administrators can take yet another huge pay rise). The New Labour Government repeatedly promised to make sure that mixed wards were done away with. Inevitably this promise, like all the others it has made, has been abandoned.

What Can Be Done?

My fear is that everything will continue to get worse. Medical students and young nurses are being taught within a system which is geared towards defending administrators and drug companies and wherein patients are regarded (if they are regarded at all) as a nuisance.

NHS staff are not allowed to listen to anyone (such as me) offering a realistic, honest view of what is going wrong. Remember, that I was banned from giving this lecture by people who knew that they could not argue with me because my evidence is solid.

Doctors, administrators and drug companies must know that there is a problem (that, presumably, is why the conference I was banned from attending was organised in the first place) but they would much rather sweep the problem under the carpet than have me lift the carpet, expose the full extent of the problem and threaten their cosy existence. Any system which cannot cope with real criticism is corrupt.

Doctors have to take back their traditional responsibility - and the authority (and power) that should always accompany responsibility.

Doctors exist only for two reasons: to look after people who have acquired a disease, and to prevent healthy people from falling ill. That's it. The rest is unimportant.

But today's medical profession has been bribed by drug companies, bullied by, and overwhelmed by bureaucrats and social workers, and forced by politicians to abandon most of their ethical principles (including, for example, the traditional principle of confidentiality). Through the weakness of their leaders, doctors have been turned into ethically impoverished mercenaries.

It is, perhaps, hardly surprising that most doctors now hate their jobs and regard them as little more than a way of making money. Many doctors would prefer to do something else for a living - if they could find something as lucrative. Vocation has been abandoned and replaced by expediency.

I have outlined my solutions to the problems facing the medical and nursing professions, and the NHS, in my book Why Everything Is Going To Get Worse Before It Gets Better.

Things will only change for the better when patients and the honest professionals who do care are prepared to stand up and make their voices heard.

Tell your friends, neighbours and colleagues to read this article and the other pieces on this Web site. Spread the word. Things don't have to be as bad as they are. But only we can make a difference.


Copyright Vernon Coleman 2004


For more information see Vernon Coleman's books (available through the webshop on this site) including How To Stop Your Doctor Killing You, Superbody, Food for Thought, Bodypower, Mindpower and Why Everything Is Going To Get Worse Before It Gets Better (which contains a chapter on health care). All Vernon Coleman's books are available on loan from public libraries. If your local library does not have the books you want to read, just give title and author to the librarian and ask that the books be ordered.