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  #1   ^
Old Thu, Feb-24-22, 16:25
Demi's Avatar
Demi Demi is offline
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Plan: HP/LC/IF
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Default Cut 'astronomical' bills to save the NHS frontline services

Not low carb per se, but well done Dr Unwin for speaking out on this important issue

Cut 'astronomical' bills to save the NHS frontline services

A "GRASSROOTS rebellion" is urgently needed to make sure taxpayers money is properly spent on the NHS, experts warn today.

The call for radical reform to cut out "astronomical" waste and get extra cash direct to frontline services is led by one of the staples of the service - a family GP.

As Britain finally emerges from two years of Covid restrictions, David Unwin, a family doctor for 35 years, has issued a demand for change that has top-level backing.

The call for radical reform to cut out "astronomical" waste and get extra cash direct to frontline services is led by one of the staples of the service - a family GP.

He says doctors should stop prescribing costly drugs when encouraging healthier lifestyles could cure many patients' problems instead.

Dr Unwin said: "If I was to remove a wart from someone's nose, I'd need them to sign a consent form. But if I was to start them on lifelong medication, like antidepressants or diabetes drugs, there is no issue of consent. That's crazy.

"Repeat prescriptions are like standing orders going out of a bank account. It very soon adds up. Look at the cost of prescribing. It's astronomical."

Chronic sickness, in many cases because of lifestyle, means the drug budget is the second highest area of NHS spending after staff costs. The annual prescription bill is £18 billion a year and rising.

Dr Unwin, a supporter of the NHS, said the bloated and bureaucratic service will never meet demand until we all take responsibility and reboot public health.

He is backing a new Daily Express campaign Stop NHS Waste highlighting inefficiency in a system riddled with red tape and drowning under the weight of demand.

It comes as Prime Minister Boris Johnson's "Living with Covid" plan comes into force today.

Under the new freedoms, there is no legal requirement to self-isolate if you have Covid and routine contact tracing will end.

Our campaign also comes ahead of April's National Insurance rise which will help to pump an extra £12billion a year into the NHS.

We are calling for that money to be spent wisely on the frontline as the focus shifts to clearing the eyewatering NHS backlog, which saw six million people stuck on waiting lists for pre-planned operations and treatment in December.

There are now two million older people on seven or more prescribed medications and not enough GPs.

NHS statistics show one quarter of the population has a long-term condition, with those aged 60 and over having two or more.

Antidepressants, statins and diabetes drugs are among the most commonly prescribed. Yet, incredibly, the NHS spends around £136million a year on prescriptions for pills, like paracetamol, that can be bought in shops for a few pence.

This newspaper is an enthusiastic champion of the NHS and social care. But it wants much better value for taxpayers and a dedicated minister to ensure every penny of our cash is spent on the frontline.

Dr Unwin says many GPs prescribe repeat medication for years because of time constraints and workload pressures.

He said: "GPs are crushed under the weight of demand, dealing with patients who are sicker than ever. And there is a real lack of emphasis on disease prevention.

"Until we get a check on that, demand is only going to rise. And no one is talking seriously about it.

"As the Daily Express reported on Friday, we now have a situation where 41 percent of young children are overweight. Their futures are fatty liver disease and diabetes.

"It means just 60 per cent are a normal weight and that's insane.

"Why isn't the Government doing something?

"No matter how much money we pour into the NHS, it will never be enough to supply demand from failing public health and we are utterly asleep at the wheel."

Last week Health Secretary Sajid Javid toured the UK promoting his Covid Backlog Recovery Plan, which he promised will "help the NHS reduce waiting times, give patients more control over their care and harness innovative technology to free up staff time".

In 2015, Health Secretary Jeremy Hunt pledged 5,000 more GPs by 2020.The target was not met.

In 2019 the Government said GP numbers in England would increase by 6,000 by March 2025. Excluding trainees, there are now 27,647 fulltime family doctors - 132 fewer than when the promise was made.

For tens of millions, a GP visit is their first contact with the NHS.

Some will need a little help, but many will make numerous trips to hospital and community services.

Dr Unwin argues it is far better to fix the problem at source so resources are managed better, costs are lowered and people ultimately become healthier and happier.

He said: "Colleagues tell me the phone constantly rings and those on the very front line think only of 'When can I retire early?' because they can't service this demand."

The Government hopes its £12billion-a-year, raised by the increases in National Insurance contributions, will go some way to tackle the backlog.

But Dr Unwin thinks investment in preventative medicine would be a better tonic for the NHS.

His eureka moment came in 2012 when a woman confronted him at his Norwood Avenue surgery in Southport, Merseyside,.

The GP said: "She was absolutely furious at being put on unnecessarily lifelong medication. She had gone low-carb and stopped her diabetes drugs, showing they were no longer needed.

"I realised I had been failing my patients for years by swallowing the conventional wisdom that we have to medicate our way out of chronic illness without stopping to think about its actual cause." His practice now spends an average £60,000 a year less on diabetes drugs than other local surgeries. And 112 patients are in drug-free Type 2 remission, achieved by teaching them how to control their diets rather than dishing out drugs. No other GP practice in Britain has achieved that.

Diabetes costs the NHS £15billion a year. But if every GP practice followed Dr Unwin's example, the NHS could save £277million - enough for almost 3,000 doctors.

NHS consultant cardiologist Dr Aseem Malhotra agrees wholeheartedly with Dr Unwin.

His father, Prof Kailash Chand, 73, deputy chairman of the British Medical Association, died in July after he had a cardiac arrest and the ambulance was delayed. Aseem said: "The root causes of failing healthcare are commercial determinants...compounded by overmedicated patients and unhealthy lifestyles. It's time for all doctors to prescribe lifestyle medicine." Dr

Unwin added: "We need to slash the rise of the drug budget. More importantly we need a fundamental shift in the way people live their lives if we want the NHS to survive.


£36billion - the amount being raised over three years through a 1.25 percent increase in National Insurance to help clear the NHS backlog.

42 - the number of new executives on salaries of up to £270,000 each as part of plans for integrated care boards to "deliver joined-up services" across the NHS.

7,591 - the figure for non-clinical staff currently employed by the NHS.

6.07 million - the number of patients waiting for pre-planned NHS treatment in England in December, which is more than onetenth of the population.

20,000 - the patients waiting more than two years for treatment.

27,647 - the total number of full-time family doctors - 132 fewer than when a promise was made in 2019 to increase the workforce by 6,000 by 2025.

£136million - the amount the NHS spends on pills like paracetamol that can be bought for a few pence from pharmacies or supermarkets. 65 percent of adults are overweight or obese in the UK. In 1993 the figure was 52 percent.

13 - the number of cancers linked to obesity.

£15billion a year - the annual cost of treating diabetes, equal to more than £1million an hour. £18bn annual bill for the cost of prescribing medicines on the NHS 1/4 of Britons have at least one long-term health condition 2m older people are prescribed seven or more drugs


NHS waste and reform is a topic which has become highly politicised, much to the detriment of frontline staff and patients.

We can't have an honest conversation about it without accusations of attempting to privatise the health service. It's unhelpful, counterproductive and patients suffer because of it.

I run Doctorcall, a private GP service. At the end of the day, if we didn't provide value for money and a quality service for our patients, we would close down quickly.

We are directly accountable and if we're not performing, patients will vote with their feet. That doesn't apply with the NHS - taxpayers have almost no say at all over how the NHS operates and is funded, yet they are the ones ultimately paying the bill.

An element of competition across different areas will only improve services - we should be looking to empower the patient, giving them as many options as possible within reason.

I would like experienced industry figures brought in to establish which backroom roles are necessary and which parts of the management team could be cut.

If savings are made from jobs with little or no value, money can be pumped back into frontline services. From a clinical point of view, a greater focus on preventative measures would massively reduce costs later.

With reports of almost ten million people waiting for some form of treatment, there really is no time to waste.
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  #2   ^
Old Fri, Feb-25-22, 05:31
JEY100's Avatar
JEY100 JEY100 is online now
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Demi, thank you placing the whole article here. It has had amazing support on Twitter, comments from other GPs how patients come to them on multiple prescriptions, most not needed, some in direct conflict, and especially adding medication for side effects from the first unnecessary medication. Poly-Pharmacy…a few geriatric specialists in the US do a review for each new patient, but that catches so few of the abuses.
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