Sunday, 21 April 2013

Sex Drugs and Rock and Roll

Actually there isn't anything about sex or rock and roll in this blog, but now I have your attention, let me tell you about drugs – and I am not talking about the illicit ones – no these are drugs prescribed usually by doctors, increasingly by nurses, that we take to solve our health problems. Well last week my Mother ended up in hospital as a consequence of being given medication for one condition which then in classical Illichian style resulted in the iatrogenic consequence of promoting a completing different and more worrying medical condition.

Ivan Illich, was a former priest and latterly a philosopher who in the 1970s wrote brilliantly polemic books critiquing the major social intuitions of the industrialised world. The opening words of his exploration of the expropriation of health in his book Medical Nemesis are ‘the medical establishment have become a major threat to health’. Of course we know that is not completely true, there are other villains (not least might be ourselves and the life style choice we choose to make).

Allegedly, the pharma industry might also be thought of as villains. Last week Emmanuel Stamatakis, Richard Weiler and John Loannidis published their paper: Undue Industry influences that distort health care research. It makes for an interesting an frightening read. Their starting point is to remind us that a universal characteristic of most western health care systems is the over reliance on pharmacological approaches for treating and preventing chronic disease. This focus is often linked to high financial returns for successful drugs.

For example Lipitor (the cholesterol busting drug) – something I use every day- has over the past decade generated £85 billion in the US. This is an amount that is higher than the gross-domestic product of 129 of the 184 countries in the world.  The annual UK NHS budget is £104 billion Stamatakis et al argue that with such fantastic sums of money available, and the associated political lobbying power it is perhaps not surprising that the pharma industry can dictate the rules of the health care game to serve its own interests. They argue that the industry’s interests are often at stark contrast to those of patients and society.  

I am not entirely sure this is the case, although they may well be creating an Illichian iatrogenic dependency.  In a report published by the Kings Fund last week I found out that 60% of people think that the NHS provides UK taxpayers with good value for money, although less than 50% believe that NHS is doing everything it can to reduce waste and efficiency. However, 79% of the respondents dealt that the NHS should be protected from spending cuts. Amazingly 40% felt that there should be no limits on what is spent on the NHS.

Arguably, the reluctance that many people have to even thinking about reducing the resources available to fund the NHS or to accept that there should be limits placed on spending perhaps indicates the priority the public place on health care. Thankfully, my Mother has been rescued from the clutches of both the medical profession and the pharma industry, and is back home and feeling much better.