HEALTH IS MISUNDERSTOOD
WE NEED A HEALTH REVIVAL
Introduction
You have probably realised already that nothing a medical service can do will make its patients healthy. Indeed, medical services tend to make patients increasingly dependent and risk-averse. Meanwhile medical costs, and cost-benefit ratio, increase relentlessly with no prospect of sustainability. While medical supply is finite, medical demand is voracious and potentially infinite – particularly when free at the point of need.
Our treasured British National Health Service (NHS) is, above all, a medical service.
I spent my career working on this issue, first in academic research and then as a GP. I opened an experimental practice in 1973, then (displaced by redevelopment) moved to Lincolnshire and did the same again.
My approach was powerfully influenced by the Pioneer Health Centre (PHC) that existed from 1935 to1948, just a few miles from my first practice. I met all the surviving organisers and directors, and learned through them a clear vision of what health is. I differ however in how to build on that project. The PHC want to recreate the Peckham Experiment as a laboratory investigating health. I think they learned enough the first time to create a practical Health Service model, basing each centre on enlightened use of the institutions that already exist in most communities.
I created a pilot project based in Lincolnshire, known as Good HealthKeeping - GHK. It achieved a national membership of 4500 families in the noughties, during the clamour for single vaccine alternatives to MMR. However we never charged enough. Consequently it closed when I retired.
GHK assembled a considerable body of experience, much of it in the form of an intranet. This is to make our intranet intelligible and available, and to describe our method well enough to give you a head start, should you choose to?attempt something similar.
Approach
1.??All of medical knowledge is assembled for professional use, and arranged around the various diseases and disorders which afflict people. Historically, it was to enable practitioners of medicine to respond usefully (and profitably) to the problems brought to them by suffering individuals, who became their patients. However people kept away from doctors so long as they could manage to. A great deal of disease was tolerated, to the limit of endurance, to avoid the expense of treatment.
2.??That form of knowledge is entirely inappropriate for a health service, designed for all the members of a community – not just the sick ones. Clients of the service need insight, information and the practical means to enable them to manage their own lives confidently and competently, with the least possible professional help of any kind. The aim is for them to become patients as seldom as possible. This calls for an entirely different kind of knowledge. It is both ancient, and revolutionary.
3.??Insight
3.1.??A health service has members, rather than patients. Ideally everyone – or every household - belongs. The service must have a clear idea what it is aiming for – something the NHS lacks. It must state clearly what it means by health, so that its members are able to know where they stand on a realistic map of health, and therefore what to work on and aim for with a real prospect of success. This must sit comfortably within their normal stream of thinking and daily life. It must be attractive, practical and achievable.
3.2. Health, at its simplest, is the urge to create. That means the wish and ability to deal constructively with surroundings and circumstances. It is the talent to engage in a process, not a condition or standard of living. Whatever circumstances members find themselves in, health is the skill and capacity to make the best of them, and so grow along with them.
In human terms, health is the same as love (of the non-romantic kind).
3.3.??Health can be defined at greater length and deeper levels, within the framework of biology and of physics. These are scholarly rather than practical accounts, and are dealt with separately[1][2]
3.4.??Health is one’s most permanent feature. It enables conception, then confident development to adulthood. It is what keeps one intact and whole, resists any disturbance, injury or infection, and heals back to normal after lapses. It defines living things. Outside one’s body, it is what enables wholesome relationships with others, and with surroundings. Maintaining and cultivating it is the chief lesson to learn while growing up.
3.5.??Insight may be provided partly by literature (written and on-line) but requires access to people familiar with both this section and the next, and able to advise each member personally. We called these people Health Cultivators or Health Advisers. As well as ad hoc access – mainly by call-centre or social media chat rooms -?a periodic review or “health MOT” is valuable and highly motivating to the member. Ideally, a whole member-household group should undertake this review together, making it a time-consuming and costly process. In practice GHK undertook some 50 of these, for a very modest loss-making fee.
More practical was to provide a health counselling “clinic”, offering a 15 minute appointment with the lead adviser (the “doctor”) followed immediately by 30 minutes working on detail with a junior (the “nurse”) who could be a member volunteer. This system proved popular, earned a respectable fee for GHK, and was effective enough seldom to generate repeat attendance.
4.??Information
The GHK Intranet was written to provide this, starting from wherever drew the member’s attention at the moment. The development of HTML made this very easy. The document does not read like a book, but can be accessed by key word at any point on its quasi-spherical surface. Curiosity then leads the reader via hyperlinks, meandering gradually into the sphere, reading progressively more fundamental material as (s)he goes. A few longer, basic texts occupy the centre.
The surface pages deal with common problems that arise frequently, and which on the whole doctors understand poorly and deal with badly. All are symptomatic of unmet need, which is how the text treats each subject. Most of the material was gathered from practical experience, referenced a good deal from naturopathic manuals dating back many decades but eclipsed now.
Compared with the extent and complexity of medical knowledge, the technology of health is much simpler and more circumscribed. It is built of familiar, rather than strange elements. It makes common sense, and coincides quite closely – with important exceptions! - with the best of folklore and communal wisdom. It fascinates and motivates, rather than inhibit or deter.
5.??Practical Means
In Britain, for the most part, the Welfare State has ensured that a basic suite of necessities for life is available to everyone. However the distribution is not even, the healthy-enhancing quality of much of it is poor, and in any case its significance is not generally appreciated. Few of our politicians are wise and far-sighted enough to understand or value a truly healthy electorate, and none has ever enjoyed the mandate to create one.
Nourishment is the most obvious necessity for its consumer to become and remain healthy, But all food must be naturally grown, free of chemical contamination, fresh from harvest, whole and unrefined, and cooked as little as possible or not at all. A good proportion needs to be consumed still alive itself, to sustain life fully in the consumer. Tomes have been written about this, much of it misleading or unbalanced. A large part of GHK’s legacy is devoted to it[3], [2].
At present, food of this standard (organic or bio-dynamic) is insufficiently available, so still needs supplementation to overcome a previous lifetime of deficiency. Most food supplements are synthesised chemically, and consumed as pure substances rather than food. In my experience this is far less effective than the same nutrient incorporated into a proper food. A small minority of human food supplements is manufactured in this way, and are known as food-state or bio-food. These are cumulative in the body, and far more effective, though currently more expensive too. The two items of highest priority are the minerals (both bulk and trace), and anti-oxidants (free radical scavengers).
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Water for drinking is less considered, but equally important and more immediately vital. Contrary to the official line, it should be very pure (no fluoride) and fresh – which in this case, means recently mixed turbulently with air, including vortical motion, as would occur in a mountain stream. The science to justify this is well documented. Avoidance of stiffening and calcification with age of the skeleton, heart and main blood vessels depends on it. The technology to improve tap-water along these lines is available quite cheaply. (Water providers could instal it at every drinking point: mains water could then be for washing and irrigation only, a far lower and cheaper chemical standard.)
Air purity is better appreciated but harder to achieve. It should be electro-negative, as well as pure – best achieved by turbulence, or passage over turbulent water. It will be an important benefit of climate change mitigation, considerably reducing liability to asthma, degenerative and cancerous lung disease.??Smoking is the headline cause of air pollution – the victim can be blamed for it – but is only the last straw. The groundswell - manufacturing and transport emissions - is an industrial and government responsibility.
Light is essential to human vitality. Its quality should resemble full-spectrum sunlight as closely as possible, since that has been our expectation throughout human history.?Quantity of exposure is less important than rate and regularity.?Intermittent intense exposure burns skin that is not pre-conditioned, ages and disrupts it. Regular continual exposure tans skin, which is protective, and creates vitamin D, which is essential for bone health and a natural defence against cancer.
Seasonal Affective Disorder – SAD – affects some individuals seriously. Regular exposure throughout the winter to full-spectrum sunlight of summertime intensity, usually abolishes it.?The skull is translucent to part of the solar spectrum, which reaches key brain structures. This may be pivotal to the causation and prevention of SAD and is one way in which the body is vitalised.
Vision senses patterns of light. Healthy people can manage without, but vision eases access to beauty.
Sound may not be essential to health, but it certainly affects mood and therefore life quality. Music usually enlightens the spirit. It is a metaphor for how life works, and another route to beauty. Disharmonic or very loud noise (or music), as well as being painful, can have the opposite dispiriting effect – as in torture.
Shelter comprises clothing and housing. Besides protection, they provide shade and warmth, and manage ventilation. As a home, shelter enhances self-respect and privacy. Home is a basis for permanence, security and stability, making it much easier to provide all other requirements of life – particularly whilst growing up.
Social aspects of life matter – membership of a functional family group, education (not indoctrination), integration within a community that offers meaningful occupations, self- and other-respect.
Wages are relative. Money is a poor substitute for quality of social life - the direct benefits of social intercourse, sharing and voluntary exchange of crafts and services. Parenthood in particular is too valuable ever to be monetised.
6.??Obstacles
Culture
We are far too dependent on the Welfare State. We need scope to live our own lives in our own way, relying much more on our own effort and guided by mutual self-respect.
Medicine
As a whole, the medical and nursing professions distrust health: perhaps they do not see a role in it for themselves. On the contrary, a health service would make medicine and nursing much more attractive careers. Doctors and nurses would do what they were trained for, not be expected to do things they cannot. Medical services would shrink in time, however, because people would be healthier for more of the time.
Industry
Some powerful industries have come to rely on the massive market the NHS provides. They strongly influence medical training, so that doctors reach first for treatments provided by those industries. Health threatens one line of industrial profit, but opens up others. Industrialists has always in the past managed to adjust their activities as markets change: a shift towards health will be no different.
State
Consciously or not, the state has some investment in disease. Politicians understand it. Sick people are dependent, easier to govern, and may not require pensions for long. Statistics forecast their behaviour quite well. It will take experience of increasing health to make its advantages sink in: more self-reliance, longer employment, greater initiative, less need for state welfare and medical services. This feels like a threat to bad rulers: healthy people are less easily governed, and less predictable. It is music to the ears of good leaders.
7. Any Use to You?
I am very happy to share the GHK Intranet, free of charge or obligation, with anyone interested. Best email me in the first instance - through LinkedIn or direct: [email protected].
REFERENCES
[1]????Mansfield P “Health: The No-Man’s-Land Between Physics and Biology” J.Alt.Comp.Med. 21, 10, 2015 593-597
[2] Mansfield P “Common Sense about Health” Saarbrucken, Scholar’s Press, 2016.
[3] Mansfield P “The State of our Food” Guernsey, Sapco 2000 ISBN 506020218210
[4] McCance & Widdowson’s The Composition of Foods. Now published by the Department of Health but from 1945-2015 a periodic report from the Dunn Nutrition Research Institute, University of Cambridge. The data referenced was obtained by comparison of successive reports, and is no longer easily obtainable.