20th October 2023
(With lessons from, and for, all other health services around the world)
The Quality and Outcomes Framework
The Quality and Outcomes Framework (QOF) was to be the glittering triumph of Evidence Based Medicine. Many of the commonest and most deadly diseases afflicting humanity would be picked up early, then treated. Almost entirely by using medications which had proven benefits.
People at risk of cardiovascular disease would have their cholesterol levels checked. Then, if high, put on statins. They would have their blood pressure measured and put on antihypertensives. Other drugs to be added as required.
Anyone with diabetes would be prescribed blood sugar lowering medications. The entire list of QOF indicators is long, the funding large. The workload vast. General Practitioners gain QOF points for achieving certain targets, or ‘thresholds. For example, the percentage of their patients with high blood pressure where it is successfully lowered to achieve the required level e.g., < 140/90mmHg – or less1.
In my view this is not medicine, it is accounting. It is also stultifyingly boring. Yet, at the same time, stressful, as you desperately attempt to record ever possible point, during a consultation. And patients wonder why their GP never looks up from the computer screen. They are probably playing QOF bingo.
Each point is worth a couple of hundred pounds, and several hundred points are on offer. The average UK practice, which has just over nine thousand patients, can earn around £135K (~$200K). Money which goes directly to the GP partners. It makes up a significant portion of their income.
The aim of all this? The aim is to reduce death and damage from nasty things such as heart attacks and strokes. With diabetes, the aim is also to reduce heart attacks and strokes… additionally kidney failure, and amputations, and blindness. All exceedingly worthwhile. There are many other QOF areas.
You could argue that GPs should have been bloody doing this anyway. It’s their job, after all?
Well. Possibly. Pushing that issue to one side (Conflict of Interest statement, I am a GP) I am more interested as to whether it has worked… whether it could ever have worked. Or why it is yet another reason why the NHS is falling over sideways, burdened with an ever-increasing workload, which is of almost no use whatsoever.
The supporters of QOF, and there are many, would argue that all this activity must do good. We have all the evidence we need from rigorously controlled clinical trials, no less. We know that lowering blood pressure is highly beneficial, as is lowering cholesterol and blood sugar levels. We simply know these things.
We do, we do, we do we do.
Or maybe – we don’t.
QOF was introduced in 2004. In 2017, a study in the BMJ reported the following:
‘England’s incentives that pay GPs for performance have not delivered better care for people with long term conditions, a systematic review of evidence has found.
The study said that there was “no convincing evidence” that the Quality and Outcomes Framework (QOF) influenced integration or coordination of care, self care or patients’ experiences, or improved any other outcomes for these patients. Rather, QOF may have “negative effects,” the reviewers said, and abolishing it may allow practices “to prioritise other activities which could lead to better care.” 2
A system that has added up to payments to GPs, since its introduction, of something in the region of £20Bn ($25Bn). The end result? It may have had ‘negative effects’. Which is a polite way of saying … not only does it do no good, but it is more likely to be causing harm.
In truth, it has cost a great deal more than £20Bn. One thing the NHS never, ever, considers is the time and money it takes to do such additional work? It is something economists call opportunity cost. What else could you be doing, if you were not doing this (useless) thing?
How much time has it swallowed up? I have no idea. I have not seen anyone attempt to quantify this. Or, if they have, I have failed to find it.
From my own experience I would estimate that, at a bare minimum, QOF takes up an hour each day. An hour of GP time is worth approximately £100. This figure is not GP pay. Despite what you read; we do not get paid that much. It includes building costs, other staff costs e.g., receptionists, heating, lighting – and all the other stuff you need to run a small business.
Now for a quick, back of a fag packet calculation. There are around thirty thousand GPs. Which means that, over and above the money directly paid out for meeting QOF ‘thresholds’, there are an additional three million pounds that need to be covered each and every day to do QOF work. Which is close to a billion a year. Another twenty billion or so, since introduction in 2004.
For which princely sum the NHS has gained, absolutely nothing at all. Apart from burnt out GPs, enormous waiting lists to see GPs. Annoyed and upset patients who end up going straight to overflowing A&E departments because they can’t be bothered to wait and see their own GP.
Here, right here, we see another reason why the NHS is going so badly wrong. And the underlying problem that drove the thinking behind QOF is mirrored in other health services around the world.
Other countries may not have the formalised system of QOF, but they too have guideline after guideline for managing long-term diseases. And meeting guidelines takes up vast amounts of time and effort. As mentioned in the previous article, it has been calculated that if Primary Care Physicians (GPs) in the US, were to follow all the treatments guidelines, it would take twenty-seven hours a day, all day, every day.
A stitch in time
QOF, and all other guidelines are based on the same principle which I shall call ‘the stitch in time strategy.’ Pick up diseases early, treat them early, and this will prevent downstream illnesses and death. Huzzah. This idea seems to mesmerise both doctors and politicians.
In truth, if you choose not to think about it too carefully it does sound good…must work surely. And, if it did, I would call it… a good thing. Bring it on. But no-one made any effort to find out if QOF was going to work, before rolling it out nationwide. There was no pilot study. There was no study of any sort. It was simply assumed that we had all the facts we needed We had all the evidence required. Such hubris.
There were those, and I was one of them, who were concerned that we were about to embark on the most gigantic healthcare experiment ever. One that could, potentially, do far more harm than good. I had many concerns, but I will just stick to one here.
Whilst we had evidence (from drug company sponsored clinical trials) demonstrating that certain actions e.g., taking an ACE-inhibitor after a heart attack, reduced the risk of future heart attacks. We did not know whether or not giving four different drugs – together – would result in greater benefit. Or, if the interactions between all four drugs might cancel out any benefit. Indeed, possibly cause harm.
Currently, after any heart attack, standard therapy includes four different medications. Often five, and if you have a raised blood sugar level, which many people are found to have, you get a couple of additional of drugs to lower blood sugar at the same time.
Has there been any trial looking at the cumulative benefit, or harm, of taking so many different drugs together? Compared to taking only one, or none? Nope. Never. The term for giving a large number of drugs simultaneously is polypharmacy.
Here is a recent study published in Nature:
‘Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study’
‘Polypharmacy is a growing and major public health issue, particularly in the geriatric population. This study aimed to examine the association between polypharmacy and the risk of hospitalization and mortality,,,
Polypharmacy was associated with greater risk of hospitalization and death… Hence, polypharmacy was associated with a higher risk of hospitalization and all-cause death among elderly individuals.’ 3
My main current job involves working in a unit looking after elderly people who, for one reason or another have ended up in hospital. Usually as a result of a fall, and a resulting injury of some sort. Our job is to fix them up and get them back home again.
In this unit we use drug charts called a wardex. These have sixteen spaces available for regular medications. Last time I looked, fifty per cent of patients needed two drug charts, because they were taking more than sixteen different medications. Ergo there was no room for them all on a single wardex This explosion in the number of medications prescribed is mainly a result of GPs trying to meet QOF thresholds.
It is now widely accepted, by anyone who has looked at this issue, that polypharmacy increases mortality. However, if I dare to take patient off a single drug then, when that patient goes home, there are often howls of protest. I have had several letters of complaint.
It seems that we are stuck with a system that costs billions, takes up a huge amount of GP time, and effort, and has achieved nothing other than ‘negative effects.’ It has also created mass polypharmacy which I know (from a great deal of other research) does harm.
2: https://www.bmj.com/content/358/bmj.j4493.full 3: https://www.nature.com/articles/s41598-020-75888-8#:~:text=Hence%2C%20polypharmacy%20was%20associated%20with,cause%20death%20among%20elderly%20individuals.
Dr. Malcolm Kendrick 
A brilliant piece about a broken system, one which I work in and one which I know is harming people every day. I do my best to mitigate that harm by trying to educate people to get themselves well without the drugs but that is getting increasingly harder to do, to the point where I know it is time to get out. Statins, PPI’s etc are making well people sick it’s very depressing and criminal really 🥲
Do not despair. There are more than you might realise now finally taking charge of their own eating, life-style and health. The Internet has enabled millions to learn for themselves. Place the seed in their mind and many will flourish.
I wish this were so, I know there are definitely some taking charge of their health but out of every one person I meet doing this and interested in learning more there are 10 others who just want the pills sadly. There’s also one of me against at least 10 colleagues who also believe meditation is the answer to all ills when it clearly isn’t 🤯
Wendy – is that meditation (which might well work to some extent) or medication? I suspect you meant the latter.
Coming home from superb care for a heart attack, I was presented the goodie bag with 5 drugs. A simple google search led me to believe that every one of them had nasty side effects – the thought of the effects when all were taken concurrently was terrifying.
Of course, you should have been talked through each of the meds and allowed to read the inserts before they were prescribed. Informed consent!
My mother (now 96) had a small heart attack, and was sent home with meds. She’s now stuck between the hospital and her doc as to what she should be taking. Has stopped most of them, including the statins.
There’s a total disconnect between hospital treatment and the GPs, never mind read the insert! I had a GP describe the insert as ‘legal protection for the pharma companies’.
What a great GP, she’s lucky
After my small heart attack and bout with the cardiologist, I refused the catherization (for stents) and all drugs he suggested. I have been taking herbs for over 2 years and doing rather well.
My father is 2 years post heart attack with stent insertion and only medication he takes is the aspirin and he’s doing great. He loves the responses (open mouthed shock usually) from doctors and nurses when he tells them he isn’t taking what they think he is/should be taking
love this 🤔😯🥰😃😃😃😃😃😃😃
Back around Christmas I developed a nasty-looking foot infection. Not wasting a single hour, I walked to my local surgery (in southern England) and was given an appointment with a nurse in a bout 3 hours. Rather than go home I sat and read.
The (senior) nurse was very helpful. After hearing my account and examining the foot she prescribed an antibiotic which I took diligently and which worked perfectly.
She also checked my BP and told me it was “a bit high”. Could I buy a BP machine, check it daily, and inform them?
I thought it over and decided against. I feel fairly good for 75, and can still walk for 10 miles and more fairly briskly; I have also cut out first grains and then more or less all carbs. So far so good.
Moreover, the meds they would have prescribed are not even claimed to make much difference. I have seen it said that a glass or two of red wine or whisky every evening would do more to reduce BP.
So I bought some potassium citrate and take half a teaspoon every evening with my glass of ascorbic acid. It tastes fine. I have no idea whether it is helping, but I am happy to escape the stress that would accompany any involvement with the NHS.
Besides… “three score years and ten”. I’m already 5 years past that, and I don’t think life owes me anything. I’d far rather go on living as I choose and enjoying life than start to feel like an invalid. I like Dr Kendrick’s idea that the best way to go is a massive heart attack! 😎
Prudence,
I am just one year younger than you, and as I have hypertension, at some point I agreed to measure my BP at home. I like doing that because I used to tense up before going to the doctors for a BP check – so the results were on the high side. I have also tried various supplements that are supposed to help lower BP. The best I have found is Coenzyme 20 mg of Q10 (Co-Q10). This has lowered my BP by about 13 points on average. Of course it may not work for you – it probably depends on whether your body is short of Co-Q10!
My partner (a youngster of 72) does not have hypertension, but decided to try some anyway. She has found that it gave her significant amounts of extra energy – so she takes it too.
I like your approach to the NHS – I get regular letters through the post inviting me to various screenings, and I discard them all.
Correction – I meant to write 200mg of Co-Q10.
Thanks for the suggestion of Co-Q10, David. How do you get such a small dose? Amazon offers a variety but all at least 100 mg.
I have recently become a convert to the gospel of meat – good healthy meat from organic grass-fed beef and lamb, that is, plus occasional line-caught fish, pork, polutry, etc.
It’s hard to read Dr Sean Baker’s book “The Carnivore Diet” without being enthused. Although “Baker” is a funny name for a carnivore!
Naker’s thesis is that if you get your daily meat in sufficient quantity you hardly need any other food, and you are unlikely to suffer any deficiencies as you are “eating what you are”.
Sorry about the typos. That’s what I get for writing enthusiastically at this hour of the morning, while sipping my first cup of coffee! “poultry”, “Baker”, etc.
Prudence,
Sean Baker is actually Shawn Baker if someone is looking for the author online.
https://carnivore.diet/dr-shawn-baker-md/
Not sure why there isn’t a “reply” button under your comment about Shawn Baker and carnivore . . . . this is in answer to that comment of yours: check out Dr. Anthony Chaffee’s video’s – he’s very good and also has lots of carnivore information online. Good on ya for trying it!
Thanks, MarciaT! Full disclosure: I’m not currently sticking to nothing but meat – and Baker himself says there is no obligation to do so. I feel better at 75 than I did 20 or even 30 years ago. I eat a good deal of cheese, and I love double cream with my coffee. But I mostly avoid carbs as far as possible.
MarciaT, the Reply button appears only for the first couple of levels of comment. Maybe they wanted to avoid the comments being stacked too deeply and moving further and further to the right of the page.
Could you do a zoom talk with me about BP medicati
When I was rung up to be told I had yet another set of pills to take, after a single casual blood pressure reading of my own, I declined. My kitchen table already looks like a pharmacy (at both ends).
I’ll take my chance now, observing closely my own diet; sugar, alcohol and caffeine intake.
Not to forget the simple survey I made of the NHS staff at the hospital, recently, which as usual gave me 20 out of 25 clearly overweight (80%) some morbidly overweight.
Same here in Kentucky. Rare to see a fit-looking person working at the hospital.
Oddly, all the ‘Hospital Volunteers’ standing around, (unpaid), waiting to help, organise everyone, and push things around seemed to be entirely 100% peak fitness and not overweight !
“…20 out of 25 clearly overweight (80%) some morbidly overweight”.
For my money, the inevitable result of following government eating guidelines. Masses of carbs, much of it refined, and seed oils that are now looking like the very worst single “food”. And not nearly enough red meat, which governments are now actually trying to prevent us from eating.
It’s always been clear that some obese people got that way because they were too poor to buy healthy food, and had to subsist on bread and other cheap carbs. But now, thakks to government advice, millions of people are doing that to themselves deliberately.
As well as sweeteners which actually put insulin up . I was brought up on fats mainly grass fed – and full fat butter milk – dont need any pills .
sheep to the slaughter, led by a propaganda machine, so total as to block out anything that doesn’t fit. Scary and difficult to see a way around it, short of total collapse or revolution (my preference is the latter).
You’ve said that the poor are getting more stupid, {lower IQ} so killing themselves with bad food is a good thing ?
I don’t seem to have made myself clear – always a risk when trying to be reasonably concise.
Dutton and Woodley’s thesis is that under the conditions prevailing until about 1850, poor people suffered ill health and tended to die younger than the relatively few rich. Generation after generation, the better-off tended to have more children who survived to have children of their own. As there is a correlation between intelligence and wealth, those who survived tended to be the more intelligent. Thus for centuries average IQ rose, as the less intelligent simply fell out of the gene pool.
With the appearance of the (excellent) improvements in public and private hygiene, nutrition, and employment conditions in the 19th century and early 20th century, child mortality almost disappeared, so everyone grew up able to have children. As the poor tended to have more children, the average IQ now started back down. Dutton and Woodley contend that the results of this trend are already noticeable.
It’s vital when thinking about a subject like this to separate “is” from “ought”. Before making plans to improve things, it’s useful to understand exactly how they are. Children dying is always dreadful, and I regret it as much as anyone. But its effects on average intelligence are an important matter that must be studied without emotional bias.
This seems rather contorted logic here. I feel that it is rather conjectural.
Ah, but is there a correlation between wealth and intelligence?
Apparently not.
https://www.sciencedirect.com/science/article/abs/pii/S0160289607000219#:~:text=The%20ratios%20show%20people%20with,large%20numbers%20who%20are%20wealthy.
https://www.investopedia.com/financial-edge/0912/how-intelligence-relates-to-wealth.aspx
I was prompted to check out the assumption because I know some very wealthy people who are as thick as bricks in IQ terms, but have the ability to sell themselves and network effectively. Or those who have inherited wealth, or inherited connections, but I wonder how long they’ll keep it/them.
Conversely there are many smart people who are not wealthy, perhaps because they can’t market themselves, or can’t be bothered to network (brown-nosing, it was called in my youth) or are just content with not accumulating stuff.
Nor is health and IQ correlated. Or perhaps it is inversely so, as I know plenty of people from the pandemic who were telling me “I’m not the smartest chook in the pen, but I’m not taking the vaccine” whilst the intelligentsia are still taking them.
Eggs, you are right. But it’s not anything as simple as a direct correlation between wealth and intelligence. As I see it, anyone with IQ higher than a certain level finds piling up wealth boring – but the propensity to get rich and powerful is a personality trait, which can be satisified more thoroughly by intelligent people. Dutton and Woodley are interested only in the correlation between intelligence and survival (plus the ability to have children and raise them to the point where they can have children of their own).
But I don’t want to waste everyone’s time trying to sell someone else’s thesis. Anyone who is interested can follow up the links I gave.
If there’s one take-home message from the Kill Shot debacle, it’s that high IQ and wisdom do not correlate at all. Higher IQ groups suicided themselves hand over fist, here in the US. Lower IQ groups were more reluctant. Who are really smarter? Darwin might have an opinion on that one.
Rather than high IQ being the suicidal factor, I think it’s more tilted towards the intellectuals, a sub-set of the high IQ group. Well, certainly in their eyes. The intellectual is guaranteed to blindly trust other intellectuals (the “experts”) who are fully qualified as such because of the number of pieces of paper they have amassed, evidenced by the endless lists of acronyms after their names. I know very wealthy intellectuals in their sixties still studying for more acronyms (e.g. PhD in philosophy, financial planning qualification). One is horrified that their son listened to Joe Rogan, and I’m sure Tucker isn’t on their radar either.
The working class (in its usual concept of lower paid or less ambitious workers, although even intellectuals are actually working class as they work too, but this lack of distinction obviously eludes them as they are clearly NOT working class, ridiculous concept, ….) on the other hand, often having previously been subject to ‘management’ by intellectuals, have an innate scepticism of experts. I’ve lost count of the number times I’ve heard ‘I’m not that smart, I’m only a plumber (teacher, housewife, fireman, retiree etc.) but I’m not taking that shot’, but it’s enough for me to be fairly sure that the 94% vaccination rate claimed by the Queensland government was just another in the endless list of lies.
Not totally sure about that. Technically, I’m probably an intellectual – public school and Oxbridge, multiple degrees – parents with multiple degrees and academic memberships, BUT, that tells me that these experts are no better than me – not gods – so I do my own research and agree or disagree as the evidence shows.
Thank you
Could you tell me who the “howls of protest” come from? The patient’s GP? Or the patient and/or concerned relatives/carer’s? Thank you. Vicky Hutchings
And of course, if your illness isn’t worth many points, you get poor – if any- treatment. Eg hypothyroid.
Yes, assuming you can get the correct treatment for hypothroidism, which I can’t.
[email protected]
You say, ‘Patients go to overflowing A & E departments because they ‘can’t be bothered’ to wait and see their own GP.’ It’s not that we can’t be bothered, Doctor. It’s because we are sick. We are sick right now, and we are scared!
At my parents GP surgery it is impossible to get an appointment with a doctor. They are told to telephone between 8:30 and 9am to get an appointment but no matter how many attempts are made it seems impossible to get through until after 9am when of course strangely all appointments are gone, but they can bend over backwards to give you a jab. If you go to the surgery it is always empty of patients except for the odd patient seeing a nurse for a “health check”. Of course “points mean prizes”. I have come to the conclusion that it is a benefit to not be prescribed poison.
Yes! RE empty surgeries, I challenged my local surgery over this and was informed that all available GPs were on telephone calls! So GP surgeries are now call centres, how long before it’s a GP in Manilla or Delhi answering the phone? 20 years of systematically underfunding the NHS (whether Labour or Tory Govts) has finally succeeded in destroying it. It’s all about privatisation and nothing else.
I see no reason why the NHS is not already operating from the Caribbean. Maybe it is?
How would we know?
Thank you very much. I am not a Doctor but I couldn’t agree more. In my layperson opinion there is no way that trials (even if they were accurate) could be done that allows for all the variations of multiple drugs that a person might be taking. Very informative article about the hoops that GP’s have to jump through with the QOF.
Good one doc – truly the road to Hell is paved with good intentions – does it help to give them (or the complainer) a copy of ‘Polypharmacy, hospitalization, and mortality risk: a nationwide cohort study’?
IMO. One problem, amongst many, with peoples blood pressure is that everyone is different. My GP, whoever that may be this week, has absolutely no idea what my ‘normal’ blood pressure is. They just look at the latest ‘standardised’ chart for my age group and make an assumption. I measure my own BP fairly regularly, because I can, so I know what is normal, for me, I also can predict fairly accurately if I’m coming down with something by changes in my BP.
Why don’t GPs, at the very minimum note a patients BP every time they have a consultation ? For me, this is a basic no-brainer, yet I’m not aware this is standard practice.
We need to move from a reactive service to a proactive service.
There is actually a very broad band-width of higher (or lower) blood pressure against increased mortality. Putting it another way, variations from normal levels are not suddenly as dangerous as you might imagine. Putting in another idea, if you have very high blood pressure ( or very low) your doctor should be looking hard at why this is first and foremost.
Yes particularly mineral balance – potassium magnesium is often low and salt levels rec max can be far too low for say someone working out and/or living in – hot countries compared to an old lady stuck in a cold flat in Aberdeen – plus too low salt and the BP can go up due to dehydration -and not enough sodium for heart pumping or bicarbonate for duodenum and chlorine for HCL .
My BP is better than ever due to 4 grams of potassium – 1 gram of mag – more than a teaspoon of Himalayan salt – if i ever get a little reflux after big meal a teaspoon of sodium bicarb before or after meal – 2 hrs leaves me fine.
I cant believe how many doctors believe that salt is a poison . And unless added by manu or restaurant or patient there will be almost none in food .
i know a vegetarian who fears salt and is ill and tired. The mucous membrane needs salt to kill flues and colds – potassium can remove any excess . Kidney patients need to check this with doctor since disease in kidneys can be a problem with too much potassium
I found this book about salt very useful:
It explains the shoddy basis for the original war on salt, and I certainly use salt pretty freely now.
One awful aspect of the health system is that it hardly ever gives up completely on a bad idea – however flawed it clearly is.
Dr K pointed out somewhere (years back) that a saline bag (as used in many hospital situations) contains 9 grams of salt per litre!
ITS CHARLES ALLAN BTW – this new WORD layout gave me temp name ?
Before the covid collapses I noticed young athletes collapsing on pitch – and I suspected lack of salt could be a factor even up to a heart attack. In the fifties my
mother on a hot day would bring out tomato puree mixed with water and tons of salt to replace fluid which you would lose in sweat but also if you did not have enough salt to retain it. Tomato – potassium salt = sodium
But to keep the macro mineral ratio you need 4 grams of potassium – 1 gram magnesium . Calcium should be OK with milk cheese vit D3 and vit K .
Before fridges I would take sometimes 10 grams a day of salt when you added it all up – salted corned beef , crisps with the blue salt bag , salted bacon , salted soups salted fish etc and had low BP . Potassium pushes excess salt out or its stored in the marrow since its a matter of life and death.
Its crazy when trained medics are saying only .5 gram of sodium in total ?
Avocado and beetroot juice for high potassium
It’s great for Big Pharma to class everyone in groups. e.g. just being a certain age – regardless of anything else. Same for BP.
I’d rather not have my bp measured every time I go to the docs (I’m going fairly regularly to have wound dressing changed atm).
Do doctors still have any leeway to make decisions relevant to the patient? It must be incredibly frustrating to not be able to utilise your knowledge and experience.
The NHS needs to be scrapped.
Somehow, every intervention in our lives is justified by cost to the NHS. ULEZ is justified by it (fraudulently), EV’s, veganism, bug eating – all because the climate is bad for our health. I used to buy a box of 100 Cocodamol between my wife and I which usually did for aches and pains, headaches, period pains etc. over perhaps 6 months or more. Not available any longer because, somehow, they are addictive which will cost the NHS money in therapy; which is how it was presented to me by a pharmacist. I mean, we had only been taking them infrequently and irregularly for 40 years and didn’t have the shakes, the yips, cravings, the DT’s or anything associated with addiction. Nor can I have them prescribed by my GP as a sensible, cheap health intervention two sensible adults (one a health professional) can reliably manage (following some numpty swallowing them like smarties) because they are available OTC.
Nurafen+ is still available in Ireland and the UK over-the-counter. Cocodamol (I had to look it up) is codeine and paracetamol (acetaminophen or Tylenol to US people). Nurafen+ is 12.5mg codeine and 200mg ibuprofen (which is the amount in 1 standard ibuprofen tablet). You are limited to packs of 32 from a pharmacist (24 in Republic of Ireland) according to google. If you can’t get the Cocodamol any more it might work for you. It works out to around 50p a pill last I checked. They say (I get the lecture each time I buy it, but in one ear…) I think it is no more than 6/day for no more than 3 days because of the potential for addiction. It is very rare for me to take more than one (at night, several times a week) so I’m not too worried about it. Hope that helps.
Brilliant article, thank you for highlighting the issues so eloquently. I’m a long in the tooth practice nurse and agree wholeheartedly.
I have just watched Andrew Bridgen trying to convince an uninterested parliament to take mRNA vaccine harms seriously so your report adds to my feeling of total helplessness. The problem is that we have obviously not yet reached “peak stupidity” and at 82, my chance of seeing any beneficial change is fast disappearing over my own horizon.
I also watched Bridgen, at least there was more people there than last time!
I like your comment on “peak stupidity”!
As an example, I have just been to a meeting of a local club I am in, all of them were complaining about having had Covid in the last few weeks (according to their Lateral Flows), I just asked how many of them had been vaccinated, they all said yes. I didn’t like to say I had refused to have that mRNA stuff injected in to me, instead I have been taking 3,000 IU of Vit D a day in the winter months for the last 3 years, as suggested by Dr K (two years ago?) and some others, and guess what not so much as a snuffle, or Covid.
What is it Mark Twain said
“It is easier to con a man, than convince him he has been conned”
We are not at “peak stupidity” yet.
PS I am a young 71
Well I caught Covid in Dec 2020, apparently pneumonia in one lung (I’m now 78 and an ex-smoker), five days of antibiotics and I’m right as rain! Wild horses wouldn’t drag me to get the so-called vaccine. What a scam! Driven by fear and propaganda. Shameful.
Is this the same mp who said people could live on 30p a day/ 30p a meal whatever?
That was Lee Anderson (30p Lee)
For about £10 from Amazon you can purchase a copy of “At Our Wits’ End: Why We’re Becoming Less Intelligent and What it Means for the Future” by Edward Dutton and Michael Woodley. It’s a good read if you are inclined to think that maybe our average intelligence has been creeping down for quite some time.
Their argument is purely evolutionary. Until about 1850 (roughly) natural selection still operated powerfully on humans everywhere. A lot of babies and children died, mainly because of malnutrition, disease, and dirt. That happened more to the children of the poor, who were also less likely even to get married and have offspring.
Thus, century by century, the average intelligence rose until the 18th and 19th century, when there were a lot of very clever people and very rapid material progress.
With the advent of modern medicine, hygiene, better nutrition, etc., far more people survived to reproduce. Their children tended to be less intelligent, and survived to have children of their own.
The overall effect, the authors argue, is that average intelligence in Britain may have fallen by as much as 10-20 IQ points since, say, the time of Dickens. It’s sad to think that our overall ability may be falling fast just because life has become safer and easier – but that’s how natural selection works.
You can sample Dutton’s ideas on Youtube, e.g. https://youtu.be/w1m4geIdgrQ.
Warning: don’t be too put off by his posh speech, superior attitude, and general air of not suffering fools gladly. (Such a contrast with our own dear Dr Kendrick, who seems kindly and tolerant almost to a fault).
So it’s only the poor who are stupid? Survival of the richest! What utter bollocks!
No, barovsky. Don’t jump off the handle before you absorb what is being asserted! Dutton and Woodley are saying the opposite: that it’s the stupid who end up poor – and, in a poor and backward society, who tend to have fewer (or no) children. That causes average intelligence to rise.
To my mind, if you want to do science or even learn anything from it, you have to be prepared to park your emotional reactions at the door. Emotionally, the whole theory of evolution through natural selection is unspeakably cruel. Which would matter to us if we were either responsible for it, or able to change it. But we aren’t. The best we can do is try to understand it.
To quote you: “It’s only the stupid who end up poor”, so how’s that differeent? It’s still bollocks, only now you’re compounding this quasi-Malthusian bollocks in a vain attempt to justify this classist nonsense.
As I understand it, the theory of Evolution has a number of issues with it. One is altruistic behavior. Apparently, Darwin talked about it as a big hole in his theory. A good book on the subject is “The Price of Altruism”.
The other is jumps in development of species that can’t be explained by Darwin’s theory. One of the reasons why Intelligent Design theory is gaining traction.
Altruistic behaviour undermines the theory of evolution? How does that work? You offer it as what? A reason why there’s no such thing as evolution? What century do you live in, the 18th or perhaps even earlier?
Then you go on to mention what is actually called punctuated evolution, occasional leaps of a species development/transformation which, given that we’re clueless about 99% of what our DNA actually does can be accounted for quite well by Darwin’s theory, even if he’d never heard the term. I’m writing a novel about the idea actually, that it’s extreme change in the environment that triggers these ‘jumps’ eg. from Neanderthal to Cro-Magnon, just as random changes in the DNA throw up alternatives, the successful one survive, the failures don’t. It’s a brilliant system, isn’t Nature wonderful. Intelligent Design my arse!
Footnotes in the text are 1, 2, 3, but there are only two footnotes at the end of the article.
Never mind, I see #2 and #3 got run together.
Very interesting
How did we get on such a system ? Just assumed it was obviously good. How can it be possible that it does anyone good to be on 16 medicines?
It dioes Big Pharma and its shareholders a lot of good. Just as the general obesity is good news for the food industry, and the wars in Ukraine, Gaza, etc. are good for arms manufacturers.
This article called to mind a couple articles in the BMJ back in April, 2005:
“Preventive medicine makes us miserable” by Fiona Godlee
https://www.bmj.com/content/330/7497/0.7.full
“Who needs health care—the well or the sick?” by Iona Heath
https://www.bmj.com/content/330/7497/954.full
One of the sections in the second article is “Medicalising healthy populations,” which seems to me a natural result of how preventive medicine is currently practiced.
This type of thinking calls to mind one of Dr. Kendrick’s article back in 2003 in Red Flags Daily (still sorely missed) talking about how the medical establishment thinks we are, at best, “temporarily able.”
http://www.thincs.org/Malcolm3.htm#aug%203
Still waiting for the published paper(s) from the covid booster clinical trial(s)?
I’m especially interested in the efficacy & safety evidence for:- the timing (3 mths vs 6 mths after dose 2 & any time in between);
– 2 viral vector doses followed by multiple mRNA doses.
And the trials for receiving covid & flu vaccines at the same time.
Andrew,
Whilst not the published papers that you are waiting for, you may be interested in the many different reports produced by Phinance Technologies under the banner ‘Humanity Projects’. Such ongoing projects being:
Excess Mortality
US Disability
US Absence Rates
UK Disabilities (PIP)
UK Absence Rates
SAE in mRNA Clinical Trials
VSAFE Data Project
VAERS Data Project
UK Yellow Card
Fertility Project
There are detailed statistical reports for most of the above (not all because some reports are still being compiled) using a number of different metrics; and, for some of the above, there are numerous different reports, e.g. Excess Mortality has separate yearly, quarterly & weekly reports for separate countries/ regions (USA, UK, Europe, Australia, Germany, Ireland).
Many of the reports are interactive, which allows the user to select and filter specific data (e.g. by age or other specific factors). Each report includes graphs and statistics showing a baseline average (generally starting between 2010 & 2016 up to 2019) and comparative data for 2020, 2021 & 2022 (& 2023 for some reports). Most reports also include the vaccine take up level for the cohort analysed.
The content of all the reports is too great to simply summarise in a few words so I recommend that you go through the reports and use the interactive filters to get a better understanding of what is presented in these reports. Most reports (in addition to the analysis) also include a Conclusions section. Copied below is the Conclusion section from the “UK PIP Analysis – Causes” report. PIP stands for Personal Independence Payments (which replaced the previous Disability Living Allowance).
“Our analysis of UK PIP clearances from new claims points towards an extraordinary rise in disabilities that started in 2021 and accelerated in 2022. When looking at the yearly rise in total claims we observe that in 2020 there was no significant change from the 2016-2019 average, while in 2021 the number of claims jumped to 99,642 (20.5%) above average and in 2022 it jumped to 372,540 (76.7%) above average. These correspond to changes that represent many standard deviations above normal values.
At Phinance Technologies we are not doctors and, in particular, not specialists in the different medical fields that underlie the causes for disability claim, so we need help in understanding the full implications of our analysis. We encourage and challenge doctors and medical researchers to use our data in order to understand the phenomenon at hand.
Even though we suspect that a large culprit for the change in behaviour in new PIP claims are the Covid-19 inoculations, our data shows clearly that other factors might be playing a role, such as the pandemic lockdowns in late 2020 and early 2021.
When investigating which underlying causes increased in 2021 and 2022, we observe confirmation of the many anecdotes that we experience in daily life in society around us. From increased neuropathies, cardiac failure or aneurisms, to auditory problems and even the strange rapid increase in adult autism, the data has clues to help all health practitioners to provide a better service to their patients.”
Here is a link to where all the reports are listed (with links therein to all individual reports):
https://phinancetechnologies.com/HumanityProjects/Projects.htm
I think the problem with QOF in your description is called “Gaming the system” i.e. doing things the system allows (encourages) for some gain but not what was intended.
Sometimes called “rule bending” in systems engineering circles. It is a common problem when money is involved for meeting targets.
Read Donella Meadows book “Thinking in Systems” if you want to understand this general problem, its origins and solutions.
The only solution I have ever seen suggested to solve this problem is to change the rules.
OR? Perhaps we should just pay doctors a decent fixed salary?
Exactly. People creating these systems seem to be lacking in enough imagination to imagine perverse incentives, gaming of the system, and unintended consequences. Thanks for the book recommendation, I’ll check it out.
“OR? Perhaps we should just pay doctors a decent fixed salary?”
That has been tried in at least one prominent medical center that I know of and they have bragged about it implying that doctors therefore don’t have to worry about “business” considerations and can devote their time to medicine. However, that doesn’t appear to work too well either, at least from my point of view. Most of the docs I know of that work there are sullen and insouciant and otherwise nothing to brag about so it probably doesn’t work too well from theirs either.
Unfortunately it has become unfashionable to think in terms of duty or vocation. There is a powerful social feeling that everything should be measured purely by money, to the extent that anyone who is rich is thought to be good by association. (And what does that say about the poor?)
At the national level, we need to target broad health outcomes such as longevity, infant mortality, QALYs etc: outcomes that are meaningful to ordinary people, not these narrow, short-term accountancy-type micro-goals that have nothing to do with health. With our medical and health knowledge constantly expanding, we need to encourage approaches that are diverse and adaptive. I suggest we look at Health Bonds: http://socialgoals.com/health.html.
Would it perhaps be better to abandon “national level” goals, which as Dr Kendrick observes are more the province of accountants than doctors?
Why not return to the notion that each doctor should do his or her best for their patients? If the outcome is optimised for each patient, you don’t need to be a mathematical genius to see that the overall effect will also be good.
This is not to say that there shouldn’t still be people doing research into national trends and outomes – just that they shouldn’t be in a position to dictate how doctors and nurses treat patients.
QOF? Isn’t this what used be called preventive medicine? But doesn’t preventive medicine depend on a range of factors such as a healthy diet, healthy living conditions, a less stressful life and so on, all of which actually fall outside the province of the NHS and are actually societal needs, economic, politics, democracy. It seems that QOF is nothingh more than a justification for selling pills and making drug companies oodles of moolah. Ultimately, it’s nothing more than the bureacratisation of medicine made to a fit a ‘health’ system designed to dispense drugs. I call it ‘tickbox treatment’, it makes money for a handful of giant corporations, meanwhile I can’t get to see a GP, instead I get ‘diagnosed’ over the phone and the last time it nearly killed me.
Doctor Kendrick, what a depressing state of affairs, how did we let this happen? Are we sheep to be herded, no more than (temporary) mobile receptacles for corporate profits? Ultimaterly of course, this is neoliberal capitalism, this is what happens when the wolves guard the henhouse. Appalling!
It’s the tyranny of the bureaucrats. They’re more interested in trying to quantify everything for their accountancy, rather than looking at real life.
I think it’s deeper than that cavenewt, the bureacrats implement the ideology but they don’t invent it, it’s the ideology of capitalism, thus even though the NHS was never truly a public institution, that is to say, responsible to and controlled by the public that financed it, it was vital that the IDEA that public ownership didn’t work had to be promulgated, thus pushing pills is just consumerism by another name, the GPs are salesmen and women and the patient is no longer a patient but a consumer, thus we consume ‘health’ just like we consume cornflakes and it kills us just like our diets do.
Good to see you here and making excellent observations.
Thank you!
Howzit zrpradyer, good to hear from you. Yes, still semi-functioning and following the good doctor’s words in a world gone totally insane.
Yes, you rock barovsky.
“But doesn’t preventive medicine depend on a range of factors such as a healthy diet, healthy living conditions, a less stressful life and so on…?”
Precisely so! And since there is still uncertainty about what is a healthy diet (and in my view the authorities have got that quite wrong), and much in our society seems expressly designed to maximise stress…
It’s high time the enormous funds apparently available were invested in useful research on the healthiest diet and ways of living, as well as the overall most effective ways of maintaining and restoring health – rather than maximising profits for Big Pharma, Big Medicine, Big Food, and Big Finance.
My late father, a GP, used to say that the only worthwhile preventative medicine was giving up smoking.
He’s more than probably right.
I would add eating right – which most people don’t have a clue about – and supplementing appropriately, getting plenty of sleep and exercise, getting as much sunshine as possible in summer, and avoiding harmful stress. And ideally doing work that is useful and fulfilling to you personally.
Yes…but Pizza and chips ! Not to mention all the other tasty high carb snacks and fast foods. Unfortunately it seems that most people don’t have the self discipline to eat healthy most of the time. I don’t believe cost comes into it – a plate of vegetables and meat/ fish a few times a week is not overly expensive in this day and age – especially when compared to bought cups of coffee or alcohol and so many other non essential ‘stuff’.
Too many people have become addicted to pleasurable sensations in the moment and sedentary states in front of their tvs or other screens (and I’m not innocent of that either).
Ah alcohol – that was one of the things that made me realize, back in the day, that the FDA and the rest of the alphabet soup agencies looking out for our health – were doing anything but. When liquor stores stayed open during lockdowns (and when Krispy Kreme gave a free donut every day for the rest of the year when you showed your vaccine card) I knew the whole covid thing was a scam – no one was talking about staying healthy. In fact it seemed as if there was a concerted effort to keep us as sick as possible. Still is. At the moment, we’re visiting in the UK from the states, and I am stunned by the number of fast food ads on tv. Simply gobsmacked.
Even corned beef hash is fairly healthy – especially with an egg or two on top. A tin of corned beef, fried with onions, add some boiled potatoes and mash up, then add peas, etc. to taste.
My grandfather Tom helped to give poor children at least one square meal a day in Rothesay, a century ago. One big pot of minced beef – the cheapest meat, but nourishing – and another of plain boiled potatoes.
That meal would be excellent and my dad was in the desert war eating two tins of corned beef a day and not much else – it was stamped from the 1st WW lol.
The problem today is sugar sweets , aspartame , toxic vegetable oils instead of grass fed fats – more additives . I ate the meal you described even today (add fried toms) but the corned beef is no longer from SA wild cattle – organic – it is CAFO soya and rapeseed fed – GMO mainly .
MarciaT, I seriously wonder whether something like Covid could ever have claimed enough victims to be identified as a disease, were it not that so many are undernourished and otherwise stressed. Our society stands condemned of failing to care about the people as a whole, by letting the wealthy do whatever they like. In fact it’s barely a society at all.
Yes, but if the definition of healthy eating is wrong – as Malcolm Kendrick (among others) has shown, all talk about healthy eating is just nonsense.
I am happy to eat a meal rich in saturated fat and salt. The health ‘experts’ are still trying to reverse their previous guidance without anybody noticing!
In reply to your comment, “I seriously wonder whether something like Covid could ever have claimed enough victims to be identified as a disease, were it not that so many are undernourished and otherwise stressed,” I certainly think that’s one reason covid claimed so many victims – along with sending people who tested positive home (to their families so they could all get infected?), treating it with Tylenol and fluids instead of things like steroids, which Pierre Kory suggested would help people with lung problems – he suggested it in a congressional hearing that YouTube pulled, treating hospitalized patients with remdesivir (or as nurses say, Run – death is near) which in itself caused huge medical problems, and then add the onslaught of fear messages from all branches of the media – to wit, check out Matt Orfelea’s mash-up:
Anyone watching that news night after night would be understandably terrified, no?
thanks doc for that.
I’m on Medicare and have private insurance in the US. My GP is completely private and does not accept insurance but he refers me out to specialists who do. This allows him to actually practice medicine. I can call and see him the same day if needed. At 76years I take an older cheap blood pressure medicine and an acid reducer. That is all for prescriptions. He knows and accepts that I won’t take statins. He has sent me for 2 heart calcium scans. Score of 0 and 1 respectively. We have a truce on diet. I also take over the counter Vitamin D and magnesium. Politically, we are both recovering anarchists so government guidelines are just suggestions. By contrast some of my older friends are or were patients of large insurance driven medical practices. One of them was taking a large number of pills and finally could barely walk. One our friends finally took him to a specialist at a medical in another city. Seeing all the prescriptions, the doctor exclaimed, “you must be tough because the interactions should have killed you!” Took him off most of it and he recovered. Another was having stomach pains and reflux. Every time he went in he was told repeatedly that he was eating too fast, swallowing air and eating spicy food. He was then given an acid reducer and got worse. He finally self referred to a well known specialist, who LISTENED to him and then said “Let me smell your breath.” It was a bacterial infection of the esophagus. When he asked why no one had bothered to do any tests, the specialist gave the true answer to all of this. To the young doctors and staff in a big practice, you are just old man who complains and they have to see you for as little time as possible. You are just a number. They have a guideline of how to give you another pill and get you out the door. That was 20 years ago.
Your topic today is important even for those not subject to the NHS guidelines.
Thanks, Dr. Kendrick. And no system, formal or otherwise, for improving metabolic health, yet here in the U. S. they call it “health care.” It is nothing of the sort. We have polypharmacy here in the U.S., too, maybe everywhere? What bothers me most is that they have normalized giving “vaccines” in pregnancy. I remember when we had one in the oven, pregnant women were told not to take anything.
I had a physician tell me that if you are on one medication OK. If you are two medications we can probably predict the interactions. If you are on three or more medications you are a guinea pig.
Yes, unfortunately even in the USA, it seems that the drug manufacturing companies have taken over the medical systems. Also, with all their advertising, they convince patients that there’s always a new drug out there that will make them feel like they’re 21 again. Such a sad commentary on the hijacking of the medical systems that were supposed to make us healthier.
It makes sense once you realise that pharma sells disease. Once people buy the disease the drugs are easy.
It amazes me when listening to US radio on the internet , how many advertisements for doctor prescribed drugs there are.
In my country Australia, such advertising is not allowed.
It’s allowed right next door to you, in NZ. The only 2 countries that allow direct to consumer advertising of drugs.
I find that a useful way of looking at the USA nowadays is that it is a country in which only corporations can be first class citizens. Individuals are barely tolerated, and then only as revenue streams. (Political parties are corporations).
Yes indeed, it is accounting. (Conflict of interest, I am an accountant). It’s basically a budget, along the same lines that millions of organisations and billions of people are urged to use and obey if they are not already doing so. And to use them like straight jackets, unyielding restrictions on what you must and mustn’t do.
They are dictatorial instruments, issued from on high (by corporations) with no flexibility. You must meet this sales target, that head count number, these profit margins. Or a maximum spend on food per week, $22.50 on fuel per week, $500 a year on car repairs ….
There is a specific requirement not to think outside the budget. All thinking must be devoted to achieving or bettering the target numbers. Considering improving the overall outcome (I could take on three more people, sell less but have much improved margins and make more money overall) is strictly forbidden.
Budgets are bunk. Companies tweak share prices by announcing they are cutting so much cost from the budget. What were those costs doing there if they weren’t needed? Every business, family, health decision needs to be decided on its own merits rather than having to unthinkingly follow a set of rules. Sure, you need to recognise what are the real constraints such as your income, the mortgage or rent or the safety of the car, or diet – and live within them.
I worked in the funeral industry which oddly had #targets# to meet. Bizarrely, managers took monthly statistics seriously and would issue upbeat reports of our successe now and then.
Long ago, when I worked as a technician for one of the biggest and most successful computer manufacturing companies in the world, I was always irked to see that my department and everyone else involved in making computers, fixing them, or getting them to work better were designated “cost centres”. Only sales was considered a “profit centre”. But we all knew that salesmen made nothing and, often, knew very little.
In Australia, when going into hospital, my boss would take her medications with her filling a carrier bag. Yes polypharmacy is here too. The result was that she had a psychotic episode and was admitted to a psych ward. Fortunately there was a consultant physician – a rare bird – who got her off interacting medications – many!
Management has taken over everything. Practitioners of anything at all have become secondary: it’s their management that’s seen as key.
The world has gone insane.
It’s high time someone applied a systems approach to analysing the mess. Roy Bonney’s comment https://drmalcolmkendrick.org/2023/10/20/what-is-wrong-with-the-nhs-part-two/#comment-271337 is constructive, IMHO.
Read David F Noble’s book ‘Forces of Production’, a brilliant analysis of the rise and the role of computers in the workplace and how ‘management’ uses the computer take away control of the production process from the worker.
Thanks, barovsky, it looks good. “David F. Noble challenges the idea that technology has a life of its own which proceeds along a singular path”. A century ago people like Bertrand Russell, John Maynard Keynes, and others were predicting that everyone in Britain could maintain their standard of living with a 3-day work week. (Anyone who wanted to wok longer or have more jobs would of course be free to do so).
Things have turned out very different because a handful of rich people were in charge of everything, and made sure that society was optimised for their own profit and wealth.
I have now been retired from general practice over a year. I remember thinking when QOF began that it was based on 2 huge assumptions – that early detection of a condition always meant that you could alter an outcome, and that the treatments we had for these conditions were effective and should be started sooner rather than later. Added to this was the confusion of risk factors and causes.
Once I had learnt the rôle hyperinsulinaemia played in hypertension, type 2 diabetes, and heart disease, I basically stopped following the qof guidelines and pushed low carbohydrate diets, especially low sugar, stopping statins when I could persuade the patient, probably for the last six years as a GP – I had a lot of success with those that would listen, but it was against the background of QOF acceptance, a large battleship to turn around.
At 69 and 72 we are condemned to having everything passed off as ‘age related’. Gym goers, walkers, healthy eaters our GPs simply cannot see beyond a birth date and prescribe accordingly. Statins sent my husband crazy and his blood sugar soaring, but it was just his age….
My dear old Dad, who lived to 91, gave up on his GP because she spoke to him whilst tapping her keyboard and never took her eyes off her screen. As he was fairly deaf and latterly wearing a mask he had no clue what he was taking what for (totaling about 10 tablets by the end). It was only by chance that my brother and I found out he was latterly on palliative care for heart failure.
I think a lot of new GPs do fall into the trap of believing drugs solve all because they have not been taught to think outside the box. But your blog does explain such a lot! Thank you!
My dear old dad went to the Doctors ‘feeling a bit down’ after his wife died, and came back with some pills. I looked at them and saw they were Prozac.
How sad and how angry it makes me. Prozac???? How to turn a person into a drooling vegetable and I see the NHS still advocates the use of Ritalin for kids with ‘too much energy’. Clearly collapse is looking like the best alternative to this madhouse.
Many years ago my ex-father-in-law in Washington DC in the final stages of bone cancer was understandably very depressed and frightened. The solution according to the hospital, no doubt to shake him out of his depression, was electroshock ‘therapy’, this was literally days before he died. My wife and I were outraged and confronted the doctor over this medieval torture, who was unmoved by our protests. Thankfully, my father-in-law went into a coma first and died before they could put a few thousand volts through his brain.
I equate no drugs as being effective and safe medicine. Most doctors are quackologists invested in the medical mafia as brain dead numbskulls sucking off the big pharma and AMA teat. Their new updating classes include being constantly baffled and mystified. What failures.
Frustration abounds.
It’s even difficult to respond because there are so many variables. Restating a response 5-6 times. changing my mind, retyping and deleting because I can’t even organize all of my thoughts, what may be the most relevant and encouraging response.
If only people were not conditioned to expect wellness from healthcare but through sessible daily practices, number one being turn off the telly and move your body and eat whole unprocessed foods. Grow up. Don’t expect someone else to fix the mess you get yourself into.
But then again, I expect adults to have adequit literacy, my moral failing.
My sprightly, normotensive, slim, very energetic, non diabetic 89 yo mother in law recently, after much imploring by her GP practice, attended for a nurse led check of her general health.
Routine bloods revealed only a random cholesterol of 6.0.
Despite having no history of cardiovascular disease, the nurse practitioner prescribed atorvastatin 20mg daily to be taken henceforth, with no mention of dietary alternatives, possible side effects etc.
My M in L, recalls hearing mention of “QOF” though this meant nothing to her at the time.
My fiercely independent M in L, after checking a few facts on line, tore up the prescription, made a brew and lit one of her regular two fags a day.
This surely is a truly dreadful example of primary care at its very worst for all sorts of medico-legal and other reasons, and completely concurs with your blog.
What a mess we are in……
The nurse is probably ‘instructed’ to recommend statins, or else! My GP has finally given up on pushing the damn things to me, instead I now get a regular stream of texts and emails to get the C19 ‘vaccine’, replies not allowed so no way to vent my spleen on the unholy alliance of the NHS and Lambeth Council.
How can a cholesterol of 6 be a danger to someone who has made it to 89 without statins?
How? Only if you view human beings as being nothing more than statistical apparitions.
I think because it’s too low, from one of Dr. K’s books I recall a 90 y/o female should have a cholesterol level of around 7.0-7.5?
I don’t know how to increase it though. Eating more cholesterol and saturated fats knocked mine down 20%.
Sticking to her winning formula looks like the best bet.
“…made a brew and lit one of her regular two fags a day”.
A little of what you fancy does you good. 😎
“The supporters of QOF, and there are many, would argue that all this activity must do good”
It’s the old “it stands to reason” business. I reply that that’s an idiom in English that means ‘neither logic nor evidence supports this point’.
I had no idea about this, thank you for your work I have subscribed to your blog but never felt qualified to comment as I am not a doctor. I worked for 40 years in eye care most recently as an Optometrist for 20. After a colleague was found guilty of death by clinical negligence, sadly a little boy died. The Optometrist had made a mistake in looking at the wrong photo. She recorded that he was very upset by ophthalmoscopy so because he had good vision the mum had no concerns,in particular no headaches …Anyway I was looking for another use of my Life Science degree when I was diagnosed with Huntington’s disease. None of this was why I wanted to respond to your article. While I felt like I was going mad and was told by doctors I was going mad that the involuntary movement of my tongue that caused me to continually bite it was stress. My husband WITHOUT FEELING ILL AT ALL was prescribed BP meds told he was diabetic and of course his cholesterol was high I’m proud to say he resisted the statin he reads your blog too. When I was diagnosed I decided to see 2 GPs one who had been with me through the horrible diagnosis time and 1 who had had a patient with HD before I can barely bring myself to make any more demands on them simply they both are exhausted and stressed to a point that I know professionally they would rather I didn’t see. Thank you again don’t stop writing Debbie Smith
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Debby – very tough dragnosis – please check out Dr. Anthony Chaffee – don’t dismiss him but listen to/read what he has to say – Shawn Baker is another one. Even if nothing they say can help with Huntington’s, (but I believe I’ve heard them mention it) what they offer will help with many other things.
I’m in Australia and don’t know exactly how our medical system works (and maybe don’t want to) but at least I can get a GP appointment within a day or two of a phone call (my usual guy only works 3 days a week but there are 4 others at the clinic I can see).
Actually, I’ve given up on my regular guy for the following reasons. (following is a post from my Facebook page, copied & pasted to save retyping):
Saw my doctor today on a minor matter, so thought I’d do my smart aleck impression and asked him if he knew that the TGA (Australia’s version of the US FDA/drug regulatory body) had lifted the ban on prescribing ivermectin. He didn’t know. Asked him if he would now prescribe said drug off-label for covid if I got it? No. You don’t think it works? No. Are you aware of dozens of studies that show it works? No. Have you heard of the FLCCC alliance (a group of front-line critical care US doctors exclusively using said drug to successfully treat covid)? No. Had he watched Dr John Campbell’s video channel (over 2 million subscribers) and read the 3-4000 comments to every post from people, many of whom had tried it and found it to be effective? No. I was enjoying the look on his face by this time. So I said I’d do what I did a couple of years ago and buy said drug online from the many suppliers out there. He was obviously glad to show me the door. I never liked him anyway…I inherited him when my previous GP retired. I showed him up to be an ignorant clod…a bit of fun. So now I need a new GP. C’est la vie!
I had no idea that GPs are paid extra for box ticking
They are not paid extra for box ticking, that is how they are paid. This all came about with the change of contract in 2004 following a vote, for which 87% voted yes, where for agreeing to a ‘few changes’ in how we earned our money, the government would take away the responsibility for out of hours and weekend cover. As recruitment for replacement partners was getting harder and harder (over 100 applied for my post in 1990, 10 years later we had one applicant for 2 jobs) most felt that having to work days and nights was not attractive and was putting off young applicants, so we voted yes.
I now realise how much of a Faustian contract this was, in that the ‘few changes’ virtually took over our day job, while the night and weekend cover, which at the start was done by local GPs, who were used to night work, earning a few extra quid, gradually eroded in quality as these GPs retired, and the new ones didn’t want to take it on.
In retrospect, when most GPs worked their own nights, and were responsible for their own patients in the day, patients got a better quality of care and reciprocated by not abusing the night system.
I remember suggesting to our local health board that because working a full day, followed by a night on call, followed by another full day could be quite tough, why not allow the night doctor to have the next day off? Of course! If you agree to a pay cut…
So in the end, because nights were tougher for small practices with fewer partners, and because part time work was permitted in the new contract, we voted, and here we are now.
As I pointed out elsewhere here, when ‘private’ GPs refused to be part of the new NHS, this created the conditions for this to happen. It illustrates the fact that the ‘public’ NHS is nothing of the kind! ‘All that’s solid melts into air.’
I had no idea that GPs are paid extra for box ticking and unnecessary prescriptions. I will follow up your refs. I am 76 and take no meds. Unvaxed of course, as I’ve been subscribing to you and Zoe Harcombe for years. I lost a friend this year who’d been taking a bucket of meds for 35 years and her flu and covid vaccines. V sad. She was only 60.
Thank you for continuing to shine a light on the vagaries of our health care system. I continue at age 73 to take only aspirin vitC and vitD, and was grateful for reading all your books, and pandemic blog advice.
I fear you are a lonely voice, much as Andrew Bridgen speaks to an empty Houses of Parliament, with a full spectators gallery !
Please continue with your astute and much needed observations.
Body autonomy must not be ceded to the corrupt WHO, or politicians, and the malign influence of big pharma and Bill Gates.
Can you provide one clear example of macro evolution – that is one species evolving into another – no one else can – even prof Dawkins tried but got tongue tied.
There should be trillions at different stages of transition from the single cell but Darwin said they all appeared in the fossil at the same time fully formed.
There are no simple cells and they could not have formed in sea water.
There is certainly micro evolution which is designed into each species eg Darwins finches are still finches and in 3 three generations their beaks can change to different shapes depending on the fauna.
His iguanas are just swimming iguanas which most creatures can do.
The canine species are are dogs – like wolves , foxes hyenas etc and look at the diff between a tiny poodle and an afghan hound – same kind ( bible) or species – they can breed unless they have lost too much DNA like a donkey /horse.
How did a deer pig sheep or whatever evolve into a whale – what would finely reprogram its DNA – blind chance ??
Selection of the fittest does not change the DNA – stress will not change the DNA
The surviving antelope is still an antelope with the same DNA.
Darwin had excuses for his fantasies but modern biologists have no such excuse.
Even one example should be easy enough with the evidence you can gather
We discover more about the mystery of what we are, all the time. Yet we don’t know who we are, let alone how we got here.
We are insanely complicated. From the quirkey chances of quantum mechanics to the oddity that space equals time, and gravity changes both!
Perhaps we dont really know if we changed from apes. But are you then suggesting that god therefore had the answers and so has to be behind it all? And so we should worship the speed of light, or someone who made atomic obitals?
As it happens, stress WILL change DNA, as many studies for two decades now show.
It’s called the “Inheritance of acquired characteristics.” Taken to the extreme, your dad knew French…and so therefore might you.
Except that as far as I know knowledge isn’t stored in DNA!
Interestingly, there’s lots of research now that ‘knowledge’ resides in the electrical nature of cells, rather than the cruder biochemistry of DNA. Micro-circuitry. Gives us memory and actual building processes, not just ‘instructions’. Obvious when you think about it.
There are plenty of chains of macro evolution from fossil evidence – things have evolved from Darwin!
http://novataxa.blogspot.com/2013/01/modern-whale-phylogenetic-blueprint.html
The issue with the clarity you desire are the incredibly precise conditions required for fossil formation such that so few specimens are preserved. For instance, last month the discovery of the oldest wooden structure was announced, c. 476,000 years old. As the previous oldest known structure was about 450,000 years newer, it means that evidence for every single wooden artifact made by humans since then (and indeed before then, it’s unlikely that we’ve found “wooden structure No.1”) either rotted away or remains to be found.
Wooden structures are fairly basic, and it’s not surprising that we’re still using the same techniques today. The Australian version of the NHS is also rather touchingly still using stone age techniques for brain surgery. It’s difficult to distinguish between mesolithic trepanning techniques and neurosurgeons today for access to the brain. Those who practice modern keyhole techniques are struck off the list (cf Charlie Teo).
Sad but true
Not really’, the whole earth is a mass of fully formed fossils including the top of mt everest . They are formed by flood water drowning and covered in water laid sediment – the flesh rots and is replaced by flood cements . Mt St HELENS has fossil trees made of stone – 40 odd years old – it happens quickly .
Sorry i wrote that post to barovsky since he was sceptical.
But radiation – disease – poisons – genetic damage from inbreeding can change DNA – Covid vax can change / knacker one’s DNA – but not to another species because the genome is delicate . Dawkins throwing the watch against a wall analogy to change it to a clock – i think- will never overcome the laws of probability nor will the monkeys and typewriters – mathematicians know that their are improbabilities which are impossible.
As for inter generation micro evolution – I can believe in this and the species can express this over their descendants in addition to the nurture aspect . But its not macro DNA change from a Dinosaur TRex to sparrow.
Example – if parents went to Africa their tanning DNA could strengthen in their lifetime – eg it would move out of the JUNK DNA box that God gave every species and fully activate with micro evolution . I suspect the next generations would get as dark as the natives if they stayed but if they retd to uk the process would reverse.
I think some boffins repeated a learning experiment with generations of worms but
they wont evolve into moles . Bacteria can mutate against an antibiotic but it has this inbuilt but often through losing DNA .
Answers in Genesis is good on this
I am not a Christian – so I don’t read or trust Genesis!
However one of the big problems with evolution by selection of the fittest, is that that can’t work for the evolution of new proteins. If the mutations happen one at a time, the first one or two will simply disable the original protein and the remaining 200 steps (say) will all have the same fitness natural selection can’t drive the process in a useful direction! Yes, DNA portions can get spliced around, but the probability that such a splice will be useful is extremely low.
Yes, the chance of a splice being useful is extremely low. But what are the conditions that create the chances? How many chances per second are occurring, and over what timescale – ten million years? One new protein in ten thousand years is a hundred in a million years, a hundred thousand in one billion.
The sedimentary layers are stuffed full of fossils right up to the tops of mountains – there are still no transitionals – they seem to disappear.
The experts tried to relate a deer ear bone with a whale fossil – with nothing in between ?
Carbon dating is only sometimes accurate to 5000years – radio dating is fake science – more like blind faith.
You have not given any method to design the DNA of any species into another . They can do it in a lab – eg with crisper to get covid but this would be intelligent design – otherwise the species fixed at creation.
This will get me a big thumbs down from many here, but it is interesting to read some of the scientific output from the Discovery Institute. I am not a Christian of any description, so I find it convenient that they separate religious arguments, and publish books that focus on the evidence. See for example:
Just saying!
In your previous comment you say “I am not a Christian – so I don’t read or trust Genesis!”
What new logic is this?
Sorry peter i was replying to Barovsky and hit the wrong button
Can we say iatrogenic? Now do psychiatry.
Thanks, how do you even now they are entering the truth. Truth is dying everywhere these days.
Hi Malcolm,
have you seen this interview??
https://rumble.com/v330ry6-dr.-ardis-reveals-the-venom-is-in-the-vaxxs-food-water-drugs-etc.-and-how-t.html?mref=45hop&mrefc=10
Might be of interest
ps hope your prostate treatment was successful
Best regards, Alan Nott
Is it possible that the QOF complexities put GPs off from diagnosing long-term conditions Dr Kendrick?
I have two chronic conditions which I had to battle like a demon to get diagnosed.
I have axial spondyloarthritis, which was finally diagnosed by going private. One MRI and there it all was. Bright spots of inflammation all over my spine and hip joints. That took 8 years of me being told it was my age, my lifestyle (god only knows what that meant as I’m fit and active), my hormones, my mattress etc.
I am also hypothyroid which no GP seemed to want to diagnose or treat. Again, years of being told it was my age, lifestyle, hormones, lack of sunlight, lack of aerobic exercise specifically (again bewildering), stress etc, etc, etc.
My son has severe bile acid malabsorption and that took 10 years to diagnose. Another chronic disease. 10 years of being told he was anxious, it was all in his head, it was stress, it was irritable bowel syndrome blah, blah, blah. He thought he was a bit nuts and lived for years with the fear of shitting himself in public. When he was finally diagnosed by a fantastic professor at Leeds University Hospital, he was told it was one of the more severe cases he had seen. I wanted to write to every Gastroenterologist we’d previously seen who’d told him it was all in his head to let them know what mental and physical torture they’d put him through.
Surely, in all of the cases I’ve mentioned it would have been medically & economically helpful to identify the chronic diseases early. They all have long-term implications, which are lessened by early diagnosis. This saves the NHS money in the long run and ensures a healthier individual, who from an economic perspective is therefore a more useful member of the working population.
I genuinely don’t believe that the NHS is full of doctors who don’t care. I really, really don’t, but I do wonder what is making the diagnosis of some conditions so very tricky. I can’t help thinking that if doctors have to monitor all these chronic conditions through the QOF and it is a time-consuming PITA, it may become off-putting to diagnose such conditions?
Type 2 diabetes, heart failure, asthma, copd, hypertension, rheumatoid arthritis, ischamic heartdisease, stroke – these are all long term conditions that GPs diagnose with ease, perhaps BECAUSE they earn qof points.
It’s not just QoF points they get, they also get easy points from their pharmaceutical representatives as all these conditions are easy to prescribe for.
Thanks Malcolm for a clear and insightful post. I’m a GP in the Isle of Man and here is how QOF works (or doesn’t work) for me:
Like most GPs, I only have 24 hours in my day, and all of them are already allocated to something: GP work, eating, sleeping, showering, washing the dishes, family time, walking the dog, R&R (rest and relaxation) etc. There is already too much admin and paperwork at the surgery for me to fit it all into the working day, so I log on remotely from home a couple of times a week to catch up. This displaces some of my R&R time, which is what I would be doing if I wasn’t remotely working from home, but hey, it’s better than dealing with patient complaints because their prescriptions haven’t been done or their results haven’t been looked at.
Last week I was allocated an hour of surgery time in which to do QOF paperwork. This displaced an hour of patient F2F contact time. Leaving aside the fact that an hour wasn’t anywhere near enough – a day would have been more like it – I already had a mountain of non-QOF paperwork to do, which I was planning to take home at the weekend. So guess what? I did my non-paperwork QOF in the QOF allocated time, and had an extra hour of R&R at the weekend instead. And the QOF didn’t get done, so f*** it. I’ll do it some other time. Or maybe never. And never mind the money, I don’t really care about that. An easy choice, but mandated by the fact that, like I said, there are only 24 hours in my day, and anything extra has to displace something else.
We
Two points …. I have a really excellent GP surgery in my village and we can get an appointment pretty much the same day if necessary. How come if we can, others can’t? This seems to be the sharp end of the NHS and I would like to see them given much more freedom to provide relatively small services which would enable our local community to stay away from the hospitals. My father was in general practice in the 1960/70’s – admittedly private – but, inter alia, he had his own microscope and an x-ray machine – this enabled him to diagnose all sorts of stuff and act on it and therefore avoid the need to refer. I do know some large practices have extra facilities and it would be interesting to know if their local hospitals are ‘flooded’ by patients who can’t get an appointment.
IMO.
It’s simple, the NHS is NOT national, there are no common standards to be adhered to, it depends on where you live and available funding. It’s a lottery.
GPs and their Surgeries are essentially private enterprises, albeit with public funding and no competition. This is part of the problem. To improve GP practices there needs to be some sort of standardisation across the country: Patients per doctor, pay scales, working hours, treatments offered, etc. This would require more doctors and more funding, so it won’t happen under the current regime.
Of course, I might be talking absolute rubbish. But as a ‘customer’ this is my experience and it’s dreadful.
So, it’s not National, it’s nothing to do with health and it’s a disservice.
An east asian philosophy over 3,000 years old is that doctors are paid a retainer by healthy people. If they fall sick, the doctor isn’t paid – but still must treat them.
I am not for one moment suggesting this be introduced to the NHS as the instruction manuals would deforest South America, but it could be the cornerstone for its replacement, the founding principle of which would be “Absence of Bureaucracy is Presence of Health”.
Doc:
You may want to read this: “Explaining the health care disaster in Canada (2011)”
https://winface.com/node/6
(and ignore any warnings about the website – neither google nor Microsoft approves of my opinions. )
Bit of humour …
https://www.conservativewoman.co.uk/that-reminds-me-ygtda-your-guide-to-doctors-abbreviations/
Dr Kendrick: my favourite quote from “The Cloth Thickens” is on page 285 “Of cause, you have to find a doctor who is willing to measure your Lp(a) level in the first ace. And good luck on that. Just watch them furtively looking up Lp(a) on Google first. 😃🥰♥️. I chuckle every time I read it. Should I, a bit mean seeing I have given him a bit if a hard time and now he’s decided to return to Canada as he misses family. It could be his going away present. But to be far he hasn’t been practising medicine very long. I thing it is only 8 years, if I recall correctly.
Dr K, you write: “In this unit we use drug charts called a wardex. These have sixteen spaces available for regular medications. Last time I looked, fifty per cent of patients needed two drug charts, because they were taking more than sixteen different medications”.
In Doctoring Data you wrote: “In one of the units I work, where elderly patients undergo rehabilitation, the average number of medications that the patients are taking is 10.2. That is up from 9.6 from last year “(p 201).
Doctoring Data was published in 2014. So that suggests that in the past 10 years (2013 – 2023) the average number of prescription medications taken by the elderly patients has increased by at least 67%.
That is a very large increase over a relatively short span of time. Is this an indication of an alarming trend, or are there too few observations to form a conclusion about prescribing trends ?
You are too kind Doctor. I would just repeat what my old father-in-law used to say (rear gunner, shot down twice, ditched once) “It’s a racket…”
The only thing I can add myself is that I suspect that a large number of these medications do nothing at all..there is, after all, once bought and issued a risk that something may go wrong with these drugs. So there’s an incentive to not be too keen to actually supply something that does a great deal.
My goodness
Hi, I appreciate this comment isn’t quite on theme (although there has been a couple of Covid comments) but it is relates to some of your earlier blogs.
I had meant to send it sometime ago but forgot, and I though it might interest you and your readers now.
When Covid started I did a lot of background reading on mRNA technology and yours, and various other people comments on vitamin D (notably the Cannell papers you suggested) and I decided to go the vitamin D route rather than the vaccination route. As it happens it seems to have worked in the last three years I have not had so much as a snuffle, never had a positive lateral flow or any indication I might have had Covid.
But something else perhaps more interesting has happened.
Just before Covid kicked off I developed a couple of blotches on the side of my head, my wife insisted I went to the Doc’s with them. He had a good poke at them and said they were just age marks (I was 68 at the time) and to just keep an eye on them. Then something interesting happened over the spring months in the first Covid wave these marks disappeared.
Then over the following summer I gave up on the vitamin D and they came back.
So just out of curiously I repeated the experiment and yes, in the winters with vitamin D they disappear; and summer no vitamin D they come back.
It struck me that you have said in some of your earlier blogs you work with old people, many of which I suspect have age marks, it might be an interesting experiment to give them vitamin D and see if these marks disappear as they do for me.
If this is the case then the existence of age marks could be used as a simple indicator of a possible deficient of vitamin D in the older age groups.
Just a though?
My partner and I went down the same route!
I think if the vaccines were available at the start of the pandemic (of course they couldn’t be – that would have given the game away) we would probably have taken them.
However back in spring 2021 we were locked down but were told that wearing masks was not a good idea, do I used to visit the supermarket an mix with everyone else. At one point I asked an assistant how much COVID problems there had been among the staff – the people who were mixing with hundreds of potentially infected people every day.
The reply was that nobody had been ill (never mind killed) by COVID. I couldn’t believe this, so I asked someone else and got the same response.
I never took the disease seriously after that.
Here it is: ‘My NHS hell waiting for surgery and information’
https://www.bbc.co.uk/news/health-67239548
I headed off to read the litany of incompetence, knowing what was coming. But after a time I switched off and simply scrolled down to the blessed end.
I remain sad. That all the research, expertise and learning about our human health, results in just as much inefficient misery as ever. Surely we humans can do better than this?
Unfortunately, IMO, this example is far from a one off , an outlier. This is the way the NHS currently ‘works’. Incompetence and bureaucracy working hand in hand and delivering a service that is not fit for purpose and a real danger to the patient. Communications amongst staff and with patients fractured and inadequate and a complete lack of empathy to the predicament of the patient.
My recent experiences with family have seen all this first hand, unfortunately. No-one seems to own the overall responsibility of a patients welfare, it is all split amongst different teams who have their own agendas and responsibilities.
Without patients there is no rational for the existence of the NHS, but the overriding feeling is that the NHS treats patients as an unfortunate nuisance and a hinderance to its ‘make work’ tasks.
Lack of communication?
It is similar to the dispersion of files in social services…Any expert is expected to pick up the files and thus be up to date with the case. It’s a natural response to wanting to avoid personal blame. As is hiding from being contactable by simply not answering the telephone.
This is a massive refutation of the EBM-Guideline approach to care. Treating numbers rather than patients. Ignoring and failing to reverse underlying diseases.
Massive fail!!
What’s wrong with the NHS. From goodlawproject:
During the pandemic, 9,000 beds and mattresses were bought – at a cost to the NHS of £24m – for Nightingale hospitals which lay largely empty. After months of investigations, we can now reveal that 6,000 of these beds were not fit for clinical use, and have been sold at auction for only £410,000.
Since August, we have been working with the Daily Mirror to find out what happened to these specialist beds. In some cases, beds bought for thousands of pounds were being flogged for as little as £6 each.
The NHS previously told the Mirror that “There was a small number of beds that was specifically tailored for the Nightingale that could not be repurposed and they have been sold to private sellers to recover costs for the taxpayer”.
But this doesn’t tally with the new data we have obtained.
We have been hearing shocking evidence from the Covid Inquiry about the failure of Boris Johnson and his ministers to prepare for the first wave of the pandemic. After a decade of crippling austerity, the NHS was forced to scramble for capacity, resources and staff to fill seven new Nightingale hospitals.
In the end, these hospitals were barely used. According to the latest official figures, setting up, running and then decommissioning all seven Nightingale units in England has cost the public purse more than £530m.
According to Jo Maugham, Good Law Project’s Executive Director, “the evidence shows we bought the wrong stuff from the wrong people at the wrong prices and for the wrong reasons. And we did it time and time and time again.
“Where are the Ministers, who should be apologising for this appalling waste of public money? And why is there so little interest in trying to recover it, for the NHS and for schools?”
https://goodlawproject.org/two-thirds-of-beds-bought-for-nightingale-hospitals-were-unfit-for-use/
I’m afraid, like most things in life, initiatives are usually designed around ‘how easily can we measure something?’ rather than ‘what are the five most important things to actually measure?’
Climate politics is a classic example: the claim is that carbon dioxide increasing is ‘dangerous for the planet’. It’s awfully easy to measure atmospheric carbon dioxide, after all. The ASSUMPTION is that, as a greenhouse gas, carbon dioxide levels are the single key trigger for ‘climate change’, ‘global warming/heating/boiling’ etc.
Anyone remotely au fait with the complexity of climate knows that plenty of other things in life are rather more important than whether carbon dioxide levels are 280ppm, 500ppm or even 1000ppm. Anyone capable of applying first year undergraduate biochemistry to photosynthesis knows that the Michaelis-Menten enzyme kinetics equation points to the fact that plants will photosynthesise more rapidly if carbon dioxide levels increase. Anyone who follows soil science also knows that carbon dioxide levels in healthy soil are several thousand ppm. Which does suggest that plants are quite comfortable inhaling vast amounts of carbon dioxide without dying.
It’s usually a good idea to identify that being able to eat and source water is more important to human life than breathing in a little more carbon dioxide (and as we expel hugely more carbon dioxide from our lungs than we inhale, safe to say that we won’t be endangered by inhaling a little more). So when we go and look at food production statistics the past 100 years, we tend to find that, whoopy do, we aren’t all starving to death for any reason greater than power politics. Nothing to do with grain production, corn production, vegetable production, beef production, fruit production etc.
We learn that people who understand permanent agriculture can turn a stiflingly hot desert covered in minimal dead soil and copious amounts of rocks into a green oasis with productive food forests in under 10 years in an area of 200mm rainfall a year where summer temperatures reach 50C. So it’s safe to say that we in Britain aren’t in any danger of not being able to eat very soon….
We learn that if we slow down water flow from where it falls to when it reaches the sea, far more infiltrates the soil, far more returns to deep aquifers and far more soil ecology develops due to the retained moisture. It’s very little to do with rainfall, soil health: far more to do with how moistures is retained and collected across wide areas of potentially productive land.
We learn that mulch is one of the best ways to preserve moisture, particularly in desert environments. We might not need it in Britain, but across the subtropics, it’s a godsend. That mulch will also turn into soil in time too.
We learn that, far from being dangers to the planet, cows, pigs and chickens can help with pest control, can fertilise soil, can improve pasture quality if managed properly and can be used as the most efficient producers of compost from raw materials known.
But measuring all these multifarious contributors toward planetary health (and I’ve only mentioned a few of them) can’t be encapsulated in one single measurable number.
Well, if you want a simple number like that, how about: ‘% of the globe with access to reliable supplies of clean, healthy drinking water’?
Or how about: ‘% of children with a healthy gut microbiome’? You know, a proxy for a healthy diet plus no contaminated drinking water.
All this ‘carbon dioxide’ nonsense is just like equating ‘treating patients’ with a ‘healthy society’.
Lazy politicians coming up with simple, arbitrary numbers so they can say: ‘You can’t blame me – I found something we could measure’.
Ask those politicians how many of them get a tape measure out and ask to measure up a woman’s essential numbers before deciding whether to ask her out on a date. And ask those that did how many actually got the answer ‘Yes’ from the women concerned….
So what is the answer to this dr malcom. Is it to take charge of our own health, or go with the gp who works with the frame work ,and get loads of medication. Or should doctor’s not go with the frame work and use there own initiative to do whats right and use less /little amount of medicins. I think there is alot of scaremongering about the dangers of not taking the meds
My apologies. I have just looked up the definition of intellectual and see that it includes:
“a person who engages in critical thinking, research, and reflection about the reality of society”.
Which means that yes, you are an intellectual.
My misconception has arisen over the decades from comments about various archaeologists, economists, anthropologists, doctors, bureaucrats and most recently of course the ‘intellectuals’ in charge of the covid episode. All of whom are highly qualified and lack critical thinking skills, or entirely lacking a moral compass (or both). But because they are regarded as ‘intellectuals’, everybody (who is not a true intellectual) blindly obeys them and even tries to force their corrupt opinions on everyone else. So for me the word, like so many others, has come to mean the opposite of its original intention.
Thanks for putting me on the right track.
In my little internal word, an intellectual is something of an insult. To me, it means, someone who considers themselves to be of superior thinking ability. I like Michel de Montainge’s comment on the matter of intellectual superiority.
‘I prefer the company of peasants because they have not been educated sufficiently to reason incorrectly.’
Absolutely! Somebody asked me a few years ago if I was an intellectual, almost as in ‘are you a member of the club’ (I was half expecting a secret handshake; fortunately he was driving) and yes, I was offended for precisely the definition you give.
So has the definition changed, like vaccine or herd immunity did during covid, or awful, since Queen Anne described St Paul’s cathedral dome (when the word meant ‘full of awe’), or have self-proclaimed intellectuals generally as a class become more arrogant and obnoxious? The really funny bit though is that none of the self proclaimed intellectuals that I know showed any ability to think critically during covid; wearing masks, killing their skin biomes twenty times a day, isolating themselves in terror and, of course, fighting to get to the front of the jab queue. Life is so boring for them now.
During covid, both the peasants and the intellectuals supported Michel’s hypothesis. Vive la difference!
“Somebody asked me a few years ago if I was an intellectual”, clearly the response to the word is one of disparagement but surely the meaning of the word scientist has also been totally debased in the past 3 years, so much so, that I now look at all pronouncements by scientists with suspicion even though I know scientists are not directly responsible but they are definitely culpable by default, by being subborned by money, by ‘fame’, cowardess, ambitious or whatever. Then you realise that just like ‘intellectuals’, we’ve put ‘scientists’ on a pedestal, indeed doctors too. Then there’s the generic term, the ‘expert’, we’ve been taught to defer to these ‘experts’, to trust them and their pronouncements largely I think because we lack the critical abilities which enable us to unpack an issue, even if we’re ‘not’ experts! The media and the ‘education’ system are to blame for this state of affairs, the first for not developing critical thinking and the second for turning information into an act of passive consumption, in other words, a commodity, hence news as ‘infotainment’.
Absolutely. I see that YouTube will now only accept posts about medical issues from experts, as appointed by a panel of experts at YouTube. I suppose that if I wanted to put a label on myself it would be ‘critical thinker’, but when I looked that up I saw that the experts have already taken over that term too, describing it as an attribute of an intellectual! And, being an intellectual is an attribute of a critical thinker. And, heaps and heaps of people are obviously getting paid lots of money through grants, writing books and therapy sessions for being experts in this drivel. Then I remembered a T shirt I saw – “I think, and I fix things”. So put me down as a problem solver.
But isn’t ‘problem solver’ one definition of being human? So we’re all intellectuals which, by definition means there’s no such thing as an intellectual, it’s a construct.
Speaking as a retired GP myself, I advise those that still have to see an NHS doctor, see one of the older one near retirement, preferably one that has nothing to do with the Royal College of GPs. Yes, they may be disillusioned, but they are also less likely to be bothered about breaking guidelines, having seen how they have failed the patients over the years. These older doctors will have tended to have thought about a problem before referring it on, and will usually be more patient centred and willing to stop drugs. However, if they believe that heart disease = statin deficiency, run a mile!
My grandmother was an Ob/GYN who graduated from her medical university around 1948 or 1949. I still remember her teachings. She used to tell me that people like two old things in life: old wine and old doctors.
One time I consulted her about a patient of mine who was about to undergo a “simple operation”, as I put it. She told me: “Sasha, there are no simple or difficult operations. There are operations that are successful or unsuccessful”.
She was a great lady.
Dr Kendrick is justified in saying that, especially as he is a hard-working GP who also takes on demanding tasks such as running this blog and attending to his current lawsuit. So for him, intellectual speculation is definitely more of a hobby.
For an elderly retired pensioner like me, however, “intellectual” is a reasonable description. While I fully realise that my thinking is extremely creaky and inefficient, and my knowledge is minuscule, I enjoy thinking for its own sake. Thus, to the extent that I am anything, I seem to be an intellectual.
Others who could perhaps fall into that category include philosophers – as Nietzsche remarked, a professional philosopher is a contradiction in terms – and amateur scientists (who used to be called “natural philosophers”).
I know opinion is sharply divided by people like, for instance, my favourite French intellectuals Camus and Sartre – whom some may see as simply charlatans – but I find their writings interesting and helpful.
The human intellect is such a recent development, and is so little used, that it’s not surprising it works only slowly, intermittently, and creakily. But for my money it’s worth our attention.
“My main current job involves working in a unit looking after elderly people who, for one reason or another have ended up in hospital. Usually as a result of a fall,”
I have an anecdote.
My elderly wife was on statins for decades. Nightly leg cramps eventually resulted in muscle loss in her left quadriceps. She also developed knee problems from the battering on the knees because of muscle weakness.
Wife got off statins and increased her vit D intake from 1,000 IU daily to 10,000 IU daily. After 2 months of this increased supplementation, wife fell down the stairs. 12 steps–6 ft. of vertical drop. No fractures–just bruises. Totally healed 3 wks later. However, her 25OHD was 112 ng/ml (280 nanoMoles/Liter). She discontinued her vit D supplementation for 3 weeks and will dial it back to 5,000 IU daily.
I found a 2021 article about the glycocalyx, cavitation, and atherosclerosis that you all might find interesting.
Arterial flow velocity is sufficient to cause cavitation damage to arteries if the glycocalyx is damaged. Bandage thrombi are body’s response to arterial damage.
https://link.springer.com/article/10.1007/s13239-020-00516-5
Let me add to the off topic posts – maybe something for you to blog about in the future?
Assuming these poor people have such a massive CVD problem and the PSK9 treatments on the market so far or the new gene editing treatment improve their health, what is the mechanism. The article makes it sound like it is the cholesterol production being switched off. However, in those extreme cases of FH, is is really the cholesterol or rather the coagulation system that is the culprit? So how does a treatment designed to interfere with cholesterol production affect coagulation?
Here’s an interesting story …
– “the behind-the-scenes machinations of Covid vaccine maker Moderna to shape and censor the public debate around the jabs”
– “Moderna is monitoring a huge range of mainstream outlets, as well as unconventional ones, … uses … artificial intelligence to monitor vaccine-related conversations across 150 million websites in nearly 200 countries.”
– “Moderna’s global intelligence division, which is run by Nikki Rutman, who spent nearly 20 years as an analyst with the Federal Bureau of Investigation”
!!! WTF !!!
Big Pharma or big brother ?
https://dailysceptic.org/2023/11/20/moderna-is-spying-on-you/
Malcom, I missed this when you published it last month so have only just read it today.
When describing the rollout of QOF (without any proper studies or trials) you say the following:
“It was simply assumed that we had all the facts we needed We had all the evidence required. Such hubris.
There were those, and I was one of them, who were concerned that we were about to embark on the most gigantic healthcare experiment ever. One that could, potentially, do far more harm than good.”
If I hadn’t known that you were speaking about QOF then I would have sworn that you were describing the rollout of something else (starting in December 2020), which was sold as being for the overall improvement of public health!!!!
Dear Dr. Kendrick,
Thank you for all your work. If you have not seen the videos below I think you will be interested. They are the best I have seen and things will cannot continue as they have done in the last few years, or so I believe.
https://rumble.com/v35c96u-dr.-bob-gill-the-great-nhs-heist.html
Dr Bob Gill on “The Great NHS Heist”, and
his full documentary, “The Great NHS Heist”
He takes the lid off the fundamental changes in privatising the NHS that have already taken place and more changes to the NHS to follow, creating a disastrous American model.
https://rumble.com/v3t1ff2-this-is-truly-shocking-excess-deaths-what-they-arent-telling-you-stay-free-.html
Start the video at 48:45 mins. Takes the lid off excess deaths 2020-2023.
Edward Dowd, handled $14 billion for Blackrock for several years, he is a data analyst seeking trends. He has now published his “Cause Unknown” about the relationship between excess/sudden deaths following periods of mandated Covid vaccination. Its on Kindle and as a hardback book.The book takes an unusually long time to get so I didn’t want to wait and got the Kindle version. Amazing. I’m looking forward to having the hardback.
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Cancer after vaccines with Professor Dalgleish
Follow the money …
“To paraphrase Major General Smedley Butler, the decorated US Marine who exposed the bankers’ coup to install a fascist dictatorship in America in 1933, the ‘War on Microbes’ is a racket. Seek and ye shall find – and pharma riches will follow, could be its motto. If it’s not, it should be because there’s no doubt that the 21st century business model for the biodefence industry depends on steadily churning out new vaccines for every manner of new viruses, or variants of old viruses however questionable the need or the science is. ”
Part 1: https://www.conservativewoman.co.uk/ebola-a-vaccine-created-catastrophe-part-1/
Part 2: https://www.conservativewoman.co.uk/ebola-a-vaccine-created-catastrophe-part-2/
https://rationalwiki.org/wiki/Malcolm_Kendrick
It’s all a lie, okay?
If you are being attacked by Rationalwiki you know you are on the right track
Is that right, yoy write for RT
I wrote three or four articles during the lockdowns. The mainstream media were uninterested in anything critical of the agreed strategies. Mask wearing lockdowns and suchlike.
Crikey!Rational wiki ! Thats such a venous description it all but smashes into his house and carries him off!
Commonly referred to as a hatchet job.
Actually it sounds pretty much like the truth. It just depends how you view it ….
Anyway, it’s a good thing. wikipedia has removed Dr K’s page altogether. As Oscar Wilde commented, “There’s only one thing in life worse than being talked about, and that’s not being talked about”.
Gosh, only just found this post