Week of January 6 - January 12, 2008

On January 2nd, 2008, David Cameron, the leader of England’s Conservative Party, addressed England’s National Health Service in Manchester, England, regarding the practical challenges people face in today’s world of medicine. Here are key excerpts:

Whether they are treating cancer, a chronic condition like Alzheimer's or Parkinson's, or working to improve mobility or quality of life for an elderly patient, doctors are now a regular part of life: a constant presence, not a remote authority.

In a phrase, in the 21st century healthcare is for life, not just for emergencies.

In the 1940s, you went to a doctor rarely, when you were very ill.

Yet today both GPs (General Practitioners) and hospital doctors work very differently to how they did in 1948 - even though the basic structure in which they work hasn't changed.

They deliver, not occasional intrusive treatment, but lifelong care.

Rather than the doctor being a benevolent dictator he's more a specialist adviser, helping you both to make complex choices about medical care, and to make useful changes to your lifestyle.

That's especially true in light of the most profound change of all: our ageing society.

This means more treatment, for longer; proportionately less of the sophisticated interventions that happen in a hospital and more of the long-term care and social care that happens in primary care settings and in the home.

CHANGES IN MEDICAL SCIENCE

Changes are happening to health and healthcare in the new century (with) the extraordinary rate of technological and medical development.

As one medical historian put it, "in medicine more has happened since 1948 than in all the centuries back to Hippocrates".

In 1948, penicillin had only been on the market for three years. The greatest threats to health were still the big epidemics: diphtheria, whooping cough, measles.

Today those diseases are almost history, defeated by the science of immunology.

And we've taken huge steps forward in other fields. Drugs in psychiatry. Anaesthesia and antibiotics in surgery. Steroids. Organ transplants. IVF.

And now, at the start of the 21st century, we are on the cusp of a further evolution - a revolution, really - as we face the amazing possibilities of genetics, nanotechnology and robotics.

It's as if, having scratched away using open-cast mining for thousands of generations, we've suddenly discovered the far richer seams that lie deep beneath the surface - and we're quickly developing the technologies to reach them.

The 21st century is going to be the most exciting time in the history of medical science - with many terrors too, of course - but I am hugely optimistic about mankind's potential to cure some of mankind's oldest fears.

So the trend in health and healthcare is the increasing sophistication of medical science.

PREVENTION

We are realizing just how central personal behavior is to our health and wellbeing.

Of course there are still big infectious diseases we must fight: HIV, drug-resistant TB, the danger of global flu pandemics.

But today, we also face new public health threats which were (once) totally unfamiliar: obesity, for instance, or widespread drug abuse and addiction.

These are the direct consequences, not of external circumstances like bad sanitation, or ignorance about contagion, but of personal choices made, by and large, in the knowledge of the dangers.

And we cannot rely on the first trend I identified to overcome these dangers.

We cannot rely on the increasing sophistication of science to save us from the consequences of our own decisions.

The body remains subject to the will of its inhabitant. That is to say, the personal choices that we make impact on our health far more profoundly that any remedial work doctors can do after the event.

We must not put our trust in science to do what we can only do for ourselves - stay in shape by taking exercise, avoiding toxins, eating and drinking in moderation.

As patients we need to be active, not passive.

CHANGES IN SOCIETY

Next I want to highlight a change that is happening to society itself.

In 1948 medical knowledge was carefully stored in the great teaching hospitals, where it was slowly crammed into the heads of the nation's doctors.

Today Google has three million medical articles online, there for public viewing and easy to search - far more information than any doctor can carry in his head.

And so much medical knowledge is being created by patients themselves.

I've done it myself.

If your child is ill, as soon as you hear the name of their condition, you get home and Google it on the internet.

You join the international support group.

You pick up ideas about drugs and treatments.

All too often you then bombard your doctor with questions about these things - but often these are the right questions to ask and sometimes you might even pick up an idea before they do.

More Information:

David Cameron, Member of Parliament for Witney, England

Source:

BBC News, 2008/01/02

Reviewed by Dr. B. Ancselovicz, Alzheimer's Weekly

Peter Berger, Editor

Copyright:

© 2008 Alzheimer's Weekly LLC. All Rights Reserved.