If everyone stopped being so pathetic and learnt how to do a bit of surgery at home, the NHS would be saved in no time

In less enlightened countries such as Holland and Denmark, removing a bone spur from the shoulder blade is regarded as best left to a trained surgeon. But that’s socialised healthcare for you, mollycoddling people until the last vestige of self-reliance has dribbled away

Matthew Norman
Sunday 01 July 2018 15:04
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NHS to scrap 'unnecessary or risky' procedures

“Getting old ain’t for sissies,” said Bette Davis, and what goes for humans goes appears to go also for the NHS.

With an almost unbearably poignant sense of timing, the health service chose its 70th birthday as the ideal moment to reveal more about its galloping senescence.

A sissy it ain’t. Riddled with arthritis, permanently fatigued, racked with minor ailments, it struggles heroically on with the big stuff. For those with serious illness, it remains generally good, and in some specific areas world class.

On the non-life-preserving side, however, things are visibly falling off it. Like an old timer who can no longer pull on a sock, it cannot do at all what used to come so easily. Reluctantly, it has to face its limitations.

So it was yesterday that, while thousands joined the professional marcher Jeremy Corbyn to stroll through London wishing it a happy 70th and protesting against its decline, news of future restrictions reminded us of the biblical calculation about three score years and 10 being the natural lifespan.

From next year, 17 types of procedure will no longer be routinely available. The official reason is that they are “ineffective” and/or “risky”. The real explanation, as if this needs saying, is clinical economic grounds.

If you have excruciating piles, stockpile the Anusol and buy a rubber ring. No surgery from next year for you. If you suffer from disablingly heavy menstrual bleeding, the only physician available in future will be Dr White. No hysterectomy for you, either.

Varicose veins? Hobble about as best you may. Breast reduction surgery? Stop whingeing about the crippling back pain, and keep popping the Nurofen Plus until all that ibuprofen causes an upper gastrointestinal bleed, and you find yourself vomiting “coffee ground” blood.

Snoring at eight times the decibel level of the entire Boeing fleet of 747s simultaneously engaging full-reverse thrusters? Buy the missus a pair of earplugs, decamp to the spare room and cross your fingers that the marriage survives.

As for IVF, a procedure pioneered by British doctors is ever more beyond Britain’s strained purse. Couples saddled with the lingering heartache of childlessness must tolerate the misery or travel – either to one of the vanishingly few regions (now barely more than one in 10) offering women under 40 the recommended three cycles, or to a cut-price fertility clinic abroad.

So much for the government’s promise of that splendid, albeit mystically unfunded, extra £20bn per annum sticking plaster for the NHS. The real Brexit dividend in health will be a revival of wartime stoicism.

With the chance to nip across the Channel and make use of a first world health system about to disappear, the only option will be to follow Churchill’s injunction. Whatever the agony, keep buggering on.

On reflection, there is another way. Until now, this has been the preserve of mountaineers, arctic explorers and other suicidally intrepid types who are forced to amputate their own gangrenous limbs.

Now would seem the time to extend the principle of DIY surgery to the majority of the population without private health insurance.

The excision of benign skin lesions is also on the banned list. Clearly this will be a nuisance to anyone with a solar keratosis the size of Wyoming on their nose. But how hard can it be to score some liquid nitrogen off the dark internet, and freeze it off at home?

Some procedures will be more challenging. In less enlightened countries such as Holland and Denmark, removing a bone spur from the shoulder blade is regarded as best left to a trained surgeon. But that’s socialised healthcare for you, mollycoddling people until the last vestige of self-reliance has dribbled away. Go to Youtube, and you’ll find an easy-to-follow video tutorial, and guides to manufacturing your own local anaesthetic.

Obviously, there are dangers inherent in DIY operations, as with the more traditional kind. But the benefits of auto-surgery at home probably outweigh those. Edible food is one. The zero risk of contracting MRSA or some other antibiotic-resistant bug is another.

The key to making this a bloodless revolution in surgical practise is to start training people as early as possible. Happily, grommets for glue ear, a condition which commonly affects the under-sevens, is also on the list. Small kids love playing doctors, which is why Operation is such a popular board game. Anyone who mastered the iPad at 18 months must be capable of inserting some tiny tubes into the inner ear midway through primary school.

There are other medical areas in which children should be instructed. If general health was a mandatory part of the curriculum, and nine-year-olds learned the importance of avoiding refined sugars and staying physically active, in half a century the plagues of type 2 diabetes and the other obesity-related illnesses which cost the NHS billions might be wiped out. If so, the NHS of 2068, assuming there is one, would be able to reinstate surgery for such agonising complaints as carpal tunnel syndrome.

Until then, the solution is as stark as it’s crystal clear. As dear old Aeschylus, the Bette Davis of Greek tragedians, so nearly put it: non-physician, heal thyself.

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