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.
***
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.