Abstract
As we enter winter, the health service enters its annual crisis. This has been going on for decades and appears to be getting worse. The 15% devaluation of the pound since the EU referendum increases pressures on resources.
Even so, the causes of the crisis are well known and well established and should be solvable with good forward planning; perhaps the idea of establishing task forces in different UK countries or NHS regions to come up with solutions.
Issues are quite simple, the main one being lack of capacity within the hospital system, and worse a lack of capacity within local authority/social caring arrangements for people who are fit to leave hospital but need help and support prior to going home. Quite often it is the aging population 1 which is blamed for causing the crisis by ‘blocking the beds’.
The collapse of the NHS is an emergency; any solution to this local authority arm of the problem will inevitably need appropriate funding and staffing. It is imperative that this arm of the equation in the winter crisis in hospital stalemate is unlocked. Blaming the elderly or other groups such as smokers or the obese for the NHS crisis is unfair. As are restrictions imposed by commissioners, for example, imposing breathalyser tests on smokers preoperatively, and the inappropriate use of pain threshold scales to limit nonurgent surgery, often contravene the official guidelines of NICE. 2 Other measures such as cancelling operating lists and reducing capacity in the rest of the system only cause more problems with compound interest, in medical complications and personal suffering.
The avoidance of disability should be a priority in long-term healthcare planning. There have been numerous excellent reports in this area, especially that from the House of Lords report, 3 which made many recommendations, most of which have been sidelined or not acted upon.
Longevity provides many opportunities, one of which is the well advertised downside of blocking the beds in the hospitals in the winter!
Keeping fit and avoiding disability is something creating a great deal of interest within the general population, but less so in the medical profession. 4 This may be a consequence of general practitioners and their teams being overwhelmed.
There is a clear need to expand and integrate some of the paramedical disciplines such as physiotherapy and nutrition and dietary advice.
There are trials in some areas of GP practices referring patients to use Weight Watchers which appears to have been successful in reducing weight, with the added bonus of reversing type II diabetes in some patients.
These projects perhaps point the way towards the future whereby healthy initiatives avoiding disability are encouraged, hopefully by primary care, which in many areas appears somewhat detached from the reality of keeping the ageing population fit and free of disability.
Juvenescence 5 is an intriguing book that highlights the economic consequences, scientific possibilities and future projections within the world of longevity and indeed economic activity itself.
The science of longevity is catching up with the aspiration of most humans to live extended lives in good health. 5
The authors are both investors and entrepreneurs, and at 437 pages long, it is an invaluable addition to those practising in post reproductive health.
If everyone read and followed our life style recommendations, this book would help solve the healthcare crises in most developed economies. 5
Refreshingly unlike most medical textbooks, the book also looks at the science behind increased longevity with suggestions that some individuals may well live to work to the age of 120–130 within the next 20 years, something that perhaps will make today's politicians in charge of the winter NHS crisis suffer sleepless nights. Although the overall message in the book is a happy and positive outcome, the contentious issues surrounding longevity and ageing are highlighted. As the authors Jim Mellow and Al Chalabi predicted the economic crisis in 2008 and other similar events in previous books, they may well be right again this time.