I read Dr Gavin Francis’s “Recovery. The lost art of Convalescence” this week. I really enjoyed it and his approach to General Practice seems absolutely in line with what I was taught and tried to practice. His book is about convalescence as it says in the subtitle. The human capacity to self repair and self heal is at the core of my medical values and I agree with him, it’s a whole area which isn’t taught in medical school and is practiced only rarely.
It takes time to heal but it takes more than time. It takes care, personal support, good food and a good, natural environment.
The old model I grew up with still had convalescent hospitals, but they were already being closed down and sold off for housing developments. The hospitals I worked in still had traces of the “sanitarium” ideas of exposing patients to nature. For example, the respiratory department, which we called “the chest ward” had a covered terrace which enabled patients to spend time in fresh air, even if they were still bed bound.
However, I’m not of the opinion that everything was great in the past. It definitely wasn’t. That said, it seems to me that we’ve gone way too far down a road of “cost effectiveness”, “targets”, and so on which are more appropriate to the running of a factory which manufactures machines than to delivering care which promotes healing.
Gavin Francis mentions that the number of hospital beds in the U.K. has been reduced from 300,000 in the late 80s to 150,000 now. How’s that going?
All this in the face of every increasing numbers of elderly people in society and of people living with several concurrent chronic ailments. The numbers of GP consultations has sky rocketed, as have attendances at Accident and Emergency Departments, ambulance call outs, and hospital admissions.
Those who designed the NHS thought that over time demand would diminish as the health service made people healthier. Trouble is the health service was never designed to make people healthier. It was designed to deal with crises. And it’s done that brilliantly. Emergency care of acute conditions and trauma has developed tremendously in the last fifty years. But emergency care isn’t enough.
The economic and management philosophies which are dominating health care don’t seem able to cope with demand, reduce demand, or enable sufficient numbers of staff enough time and resources to stay healthy themselves while they deliver the best care they can.
All of the recommendations in Gavin’s book are very familiar to me. These are not new solutions, nor are they idealistic. They are achievable and reasonable but we need to shift the thinking from reductionist, mechanistic ones, to genuinely human centred holistic ones.
We won’t create healthier populations through health services but by addressing poverty, inadequate housing, job insecurity, inequality, poor nutrition, climate change, biodiversity loss and pollution.
We need the wisdom shared in “Recovery”, and we need to implement it. Maybe we should recommend it to health service managers and policy makers.
Heroes Not Zombies 
Yes, absolutely 🌿
Sue
Sue Heatherington M: 0777 571 0240 Sent from my iPhone
>
Within our, Canada’s, “universal” health-care system, there are important health treatments that, except for high-income earners to access privately, are universally inaccessible. Morally reprehensible is that the populace’s health seems to come second to maximizing health-industry profits.
Meantime, the only two health professions’ appointments for which Canadians are fully covered by the public plan are the two readily pharmaceutical-prescribing psychiatry and general practitioner health professions. Such non-Big-Pharma-benefiting health specialists as counsellors, therapists and naturopaths, etcetera, are not covered a red cent.
In Canada, somewhat similar to the U.S., people’s health comes second to maximizing profits, in particular those amassed by an increasingly greedy pharmaceutical industry. Resultantly, we continue to be the world’s sole nation that has universal healthcare but no similar coverage of prescribed medication, however necessary.
Not only is medication less affordable, but other research has revealed that many low-income outpatients who cannot afford to fill their prescriptions end up back in the hospital system as a result, therefore costing far more for provincial and federal government health ministries than if the medication had been covered. Ergo, in order for the industry to continue raking in huge profits, Canadians and their health, as both individual consumers and a taxpaying collective, must lose out big time.
A late-2019 Angus Reid study found that about 90 percent of Canadians — including three quarters of Conservative Party supporters specifically — support a national ‘pharmacare’ plan. Another 77 percent believed this should be a high-priority matter for the federal government. The study also found that, over the previous year, due to medication unaffordability, almost a quarter of Canadians decided against filling a prescription or having one renewed.
Thank you Frank. I don’t think any country has a perfect health care system, does it?
And you’re right. They are all distorted by money and power.