everybody loves a good story this is a
nation of storytellers after all from
Beowulf to Shakespeare to Harry Potter
storytelling has powerfully influenced
the history and the culture of this
country stories are how we make sense of
a complex world they help us to
understand each other and they define
our values and I’m not just talking
about fiction since the time of King
Alfred the Great this country’s most
compelling leaders have influenced the
behavior of their citizens by telling
some of you may have seen the new film
darkest hour about Winston Churchill and
how he rallied this country in the early
months of the Second World War he
achieved this largely through his
effective use of narrative we’re facing
our own kind of darkest hour these days
and that’s the NHS crisis you don’t need
me to tell you that the situation is
fairly desperate
we have overflowing hospital wards
battle field triage conditions and the
emergency departments it can take a
minor miracle to get a GP appointment
these days but what if it didn’t have to
be this way what if the power to save
the NHS was within our control yours and
mine
what if we didn’t have to rely on
politicians and NHS managers to bail us
out here’s the thing medicine is also
about narratives stories
my job as a doctor is to listen to the
stories my patients tell me and together
we figure out what’s going on with their
health it’s absolutely the best part of
my job so my interest in storytelling
goes beyond my work as a GP in addition
to being a medical doctor I also have a
master’s degree in the history of
medicine and it was my history degree
that taught me to think critically about
the stories we tell about health and
medicine in particular recently I’ve
taken an interest in the narratives that
are used when we talk about the NHS
crisis my mother-in-law has a
subscription to The Times and she very
kindly clips all the articles that she
thinks will interest my husband and me
so every couple of weeks we get this
bundle of cuttings and it’s a real treat
to sit down with a cup of tea and read
through articles about all sorts of
things but always including the latest
news about health and the NHS it was by
reading all in one sitting like this
that I started to notice certain key
themes and phrases that crop up again
and again and again when you read about
the state of the NHS it started to
become almost a game with me and I
started looking at other newspapers and
media outlets to find out what story
they are selling us and it’s just the
same the historian and me became
bothered because although the facts
themselves are largely accurate they’re
being sort of massaged to tell us a
story that I think robs us of a bigger
truth and since the NHS crisis shows no
sign of improving I’d like to suggest
it’s a story that doesn’t serve us well
so I’d like to invite you all to think
like historians for a few minutes let’s
analyze the dominant narrative the story
of the NHS crisis
as it is presented to us by the media
then we’ll look at some facts and we can
decide together if we think there is a
better story to be told so I want you to
start by looking at the word shortage
this is hands-down our favorite way of
describing the challenges we are all
experiencing in the NHS we have a
shortage of doctors especially GPS we
have a shortage of nurses and midwives I
had hospital beds and funding generally
where all the doctors gone retiring
early to cash in their pensions or
abandoning us all for a nicer life in
Australia if you believe what you read
but do we actually have less doctors
than we used to know we actually have
more doctors per person than ever before
in fact the number of doctors increased
by 50% between 2000 and 2012
that’s a faster increase in any other
country in Europe it’s a fact that’s
being left out of the story of shortages
how about funding are we spending less
money on the NHS these days no no no how
about health spending per person no
that’s gone up to okay let’s take
another look at this word shortage what
does it really mean well a shortage just
it’s a lack of balance quite simply
between supply and demand so it’s clear
now that despite our increasing supply
of doctors
and our increasing supply of NHS funding
it’s not enough to cancel out what must
be an overwhelming increase in the
demand for NHS services so now when we
see the phrase NHS shortages we know
that at the root we’re talking about an
increasing demand for health care so
what does the media tell us is the cause
of this overwhelming demand for health
care well mainly they try not to talk
about it at all but when we do if you
pay attention there is one phrase
that’ll jump out at you and it’s this
older sticker in one stack of articles
cuttings from my mother-in-law this
theme appeared in four out of five
articles about the NHS crisis just from
a two-week period so let’s look at the
facts in a UK 18% of our population is
over the age of 65 20 years ago that
number was fifteen point nine percent
that’s an increase of just an absolute
increase of just two percent two point
one percent in 20 years so really enough
to label our population is older people
over the age of 85 represent a tiny
fraction of our population just 2.4
percent now the projections for 30 to 50
years from now are far more dramatic but
since we’re just talking about the cause
of today’s crisis can it really be
blamed on a demographic shift at 2% and
what’s the problem with an older
population anyway well in this country
health care spending increases
dramatically over the age of 65 so that
18 percent of our population
accounts for 40% of our healthcare
spending
that’s disproportionate but please
recognize that the majority of our
health spending 60% is spent on people
under the age of 65 as a GP most of the
so anyway why does health spending
increase as we age well
older people are more likely to have
health problems in this country if you
rounded up all the people that were 80
and older only one in seven of them
would actually be entirely healthy but
not once not even once have I seen a
newspaper article or a politician ask
the question of whether it’s the way you
were aging in this country that’s part
of the problem so let’s spend a few
minutes with that now
in 2005 the magazine National Geographic
published an article by Dan Buettner
called the secrets of a long life it
described five geographic regions of the
world so-called Blue Zones
where people are up to ten times more
likely to live to the age of 100 than we
are the blue zones tell us a true story
in which older people are not heavily
medicated and demented and dependent on
carers but instead are physically active
cognitively healthy contributing to
their communities well into their 90’s
and beyond let’s return to the UK now
back to the story of older sicker we’ve
talked about older let’s talk about
sicker in the UK we have 15 million
people living with a chronic disease
that’s people of all ages about one in
four of us this includes things like
asthma diabetes
depression high blood pressure according
to the British Medical Journal if we
include chronic pain in that list
suddenly the percentage goes up to 43%
of us who are living with a chronic
disease we are so unwell chronic disease
is our leading cause of disability and
death and this is where things are going
to start to get a little uncomfortable
according to The Lancet 40% of our NHS
workload is preventable let me say that
a different way almost 50% of our
demands on the NHS are caused by our
toxic lifestyles the main culprits
unhealthy diets too much alcohol not
enough physical activity smoking
loneliness there’s plenty of data to
back up these statistics more than 80%
of cardiovascular disease but things
like stroke heart attacks it’s
preventable more than 40% of cancers are
preventable that number may be as high
as two-thirds almost all type-2 diabetes
is preventable things like mental
illness and dementia we’re increasingly
learning that those things can be
prevented too so let’s go back to the
blue zones these five very diverse parts
of the world very different genetics and
plant-based diets constant steady
physical activity low levels of stress
close relationships with family members
and their communities the people in the
Blue Zones live longer they live better
and they do so with much less need for
medical care so that’s why I get
bothered by the older sicker story we
are being sold I think that when you
stick the word sicker right up against
the older like that
I think the sicker part just kind of
slides under the radar and before we
really have time to think about it the
story moves on to safe things like GP
shortages and budgets and so we are
being seduced into believing that
there’s nothing much that any of us can
think newspapers and politicians like
the older sicker story because it stops
us from feeling guilty and making people
feel guilty doesn’t sell newspapers and
it doesn’t win elections but we don’t
need to feel guilty we can feel
empowered we can take more
responsibility for the lifestyle choices
that are within our control we can be
more aware that the wrong choices are
harming the NHS but the right choices
can save it can save us and let’s
remember the number one rule of any
great story is that it starts with an
ordinary hero Harry Potter Luke
Skywalker a pretty ordinary person just
like you and me full of flaws and
imperfections but this ordinary hero
accepts a call to action and is willing
to undergo a transformation in order to
achieve incredible things and save the
the UK is a nation of 65 million heroes
I see it every day in my community and
my work you don’t need an American to
tell you this but I’ll say it anyway
you are brave you are kind you are
resolute
this is actually a great time for a new
movie about Winston Churchill not that
he used this shining example of healthy
lifestyles but I think we could all
stand to be reminded of just how
outrageous was his faith in the sheer
grit of the British people and Churchill
was bright we absolutely can turn the
NHS crisis around we have no time to
lose so let’s stop wasting time with
feeble narratives saving the NHS by
turning the UK into a Blue Zone now
that’s a great story thank you you
nation of storytellers after all from
Beowulf to Shakespeare to Harry Potter
storytelling has powerfully influenced
the history and the culture of this
country stories are how we make sense of
a complex world they help us to
understand each other and they define
our values and I’m not just talking
about fiction since the time of King
Alfred the Great this country’s most
compelling leaders have influenced the
behavior of their citizens by telling
some of you may have seen the new film
darkest hour about Winston Churchill and
how he rallied this country in the early
months of the Second World War he
achieved this largely through his
effective use of narrative we’re facing
our own kind of darkest hour these days
and that’s the NHS crisis you don’t need
me to tell you that the situation is
fairly desperate
we have overflowing hospital wards
battle field triage conditions and the
emergency departments it can take a
minor miracle to get a GP appointment
these days but what if it didn’t have to
be this way what if the power to save
the NHS was within our control yours and
mine
what if we didn’t have to rely on
politicians and NHS managers to bail us
out here’s the thing medicine is also
about narratives stories
my job as a doctor is to listen to the
stories my patients tell me and together
we figure out what’s going on with their
health it’s absolutely the best part of
my job so my interest in storytelling
goes beyond my work as a GP in addition
to being a medical doctor I also have a
master’s degree in the history of
medicine and it was my history degree
that taught me to think critically about
the stories we tell about health and
medicine in particular recently I’ve
taken an interest in the narratives that
are used when we talk about the NHS
crisis my mother-in-law has a
subscription to The Times and she very
kindly clips all the articles that she
thinks will interest my husband and me
so every couple of weeks we get this
bundle of cuttings and it’s a real treat
to sit down with a cup of tea and read
through articles about all sorts of
things but always including the latest
news about health and the NHS it was by
reading all in one sitting like this
that I started to notice certain key
themes and phrases that crop up again
and again and again when you read about
the state of the NHS it started to
become almost a game with me and I
started looking at other newspapers and
media outlets to find out what story
they are selling us and it’s just the
same the historian and me became
bothered because although the facts
themselves are largely accurate they’re
being sort of massaged to tell us a
story that I think robs us of a bigger
truth and since the NHS crisis shows no
sign of improving I’d like to suggest
it’s a story that doesn’t serve us well
so I’d like to invite you all to think
like historians for a few minutes let’s
analyze the dominant narrative the story
of the NHS crisis
as it is presented to us by the media
then we’ll look at some facts and we can
decide together if we think there is a
better story to be told so I want you to
start by looking at the word shortage
this is hands-down our favorite way of
describing the challenges we are all
experiencing in the NHS we have a
shortage of doctors especially GPS we
have a shortage of nurses and midwives I
had hospital beds and funding generally
where all the doctors gone retiring
early to cash in their pensions or
abandoning us all for a nicer life in
Australia if you believe what you read
but do we actually have less doctors
than we used to know we actually have
more doctors per person than ever before
in fact the number of doctors increased
by 50% between 2000 and 2012
that’s a faster increase in any other
country in Europe it’s a fact that’s
being left out of the story of shortages
how about funding are we spending less
money on the NHS these days no no no how
about health spending per person no
that’s gone up to okay let’s take
another look at this word shortage what
does it really mean well a shortage just
it’s a lack of balance quite simply
between supply and demand so it’s clear
now that despite our increasing supply
of doctors
and our increasing supply of NHS funding
it’s not enough to cancel out what must
be an overwhelming increase in the
demand for NHS services so now when we
see the phrase NHS shortages we know
that at the root we’re talking about an
increasing demand for health care so
what does the media tell us is the cause
of this overwhelming demand for health
care well mainly they try not to talk
about it at all but when we do if you
pay attention there is one phrase
that’ll jump out at you and it’s this
older sticker in one stack of articles
cuttings from my mother-in-law this
theme appeared in four out of five
articles about the NHS crisis just from
a two-week period so let’s look at the
facts in a UK 18% of our population is
over the age of 65 20 years ago that
number was fifteen point nine percent
that’s an increase of just an absolute
increase of just two percent two point
one percent in 20 years so really enough
to label our population is older people
over the age of 85 represent a tiny
fraction of our population just 2.4
percent now the projections for 30 to 50
years from now are far more dramatic but
since we’re just talking about the cause
of today’s crisis can it really be
blamed on a demographic shift at 2% and
what’s the problem with an older
population anyway well in this country
health care spending increases
dramatically over the age of 65 so that
18 percent of our population
accounts for 40% of our healthcare
spending
that’s disproportionate but please
recognize that the majority of our
health spending 60% is spent on people
under the age of 65 as a GP most of the
so anyway why does health spending
increase as we age well
older people are more likely to have
health problems in this country if you
rounded up all the people that were 80
and older only one in seven of them
would actually be entirely healthy but
not once not even once have I seen a
newspaper article or a politician ask
the question of whether it’s the way you
were aging in this country that’s part
of the problem so let’s spend a few
minutes with that now
in 2005 the magazine National Geographic
published an article by Dan Buettner
called the secrets of a long life it
described five geographic regions of the
world so-called Blue Zones
where people are up to ten times more
likely to live to the age of 100 than we
are the blue zones tell us a true story
in which older people are not heavily
medicated and demented and dependent on
carers but instead are physically active
cognitively healthy contributing to
their communities well into their 90’s
and beyond let’s return to the UK now
back to the story of older sicker we’ve
talked about older let’s talk about
sicker in the UK we have 15 million
people living with a chronic disease
that’s people of all ages about one in
four of us this includes things like
asthma diabetes
depression high blood pressure according
to the British Medical Journal if we
include chronic pain in that list
suddenly the percentage goes up to 43%
of us who are living with a chronic
disease we are so unwell chronic disease
is our leading cause of disability and
death and this is where things are going
to start to get a little uncomfortable
according to The Lancet 40% of our NHS
workload is preventable let me say that
a different way almost 50% of our
demands on the NHS are caused by our
toxic lifestyles the main culprits
unhealthy diets too much alcohol not
enough physical activity smoking
loneliness there’s plenty of data to
back up these statistics more than 80%
of cardiovascular disease but things
like stroke heart attacks it’s
preventable more than 40% of cancers are
preventable that number may be as high
as two-thirds almost all type-2 diabetes
is preventable things like mental
illness and dementia we’re increasingly
learning that those things can be
prevented too so let’s go back to the
blue zones these five very diverse parts
of the world very different genetics and
plant-based diets constant steady
physical activity low levels of stress
close relationships with family members
and their communities the people in the
Blue Zones live longer they live better
and they do so with much less need for
medical care so that’s why I get
bothered by the older sicker story we
are being sold I think that when you
stick the word sicker right up against
the older like that
I think the sicker part just kind of
slides under the radar and before we
really have time to think about it the
story moves on to safe things like GP
shortages and budgets and so we are
being seduced into believing that
there’s nothing much that any of us can
think newspapers and politicians like
the older sicker story because it stops
us from feeling guilty and making people
feel guilty doesn’t sell newspapers and
it doesn’t win elections but we don’t
need to feel guilty we can feel
empowered we can take more
responsibility for the lifestyle choices
that are within our control we can be
more aware that the wrong choices are
harming the NHS but the right choices
can save it can save us and let’s
remember the number one rule of any
great story is that it starts with an
ordinary hero Harry Potter Luke
Skywalker a pretty ordinary person just
like you and me full of flaws and
imperfections but this ordinary hero
accepts a call to action and is willing
to undergo a transformation in order to
achieve incredible things and save the
the UK is a nation of 65 million heroes
I see it every day in my community and
my work you don’t need an American to
tell you this but I’ll say it anyway
you are brave you are kind you are
resolute
this is actually a great time for a new
movie about Winston Churchill not that
he used this shining example of healthy
lifestyles but I think we could all
stand to be reminded of just how
outrageous was his faith in the sheer
grit of the British people and Churchill
was bright we absolutely can turn the
NHS crisis around we have no time to
lose so let’s stop wasting time with
feeble narratives saving the NHS by
turning the UK into a Blue Zone now
that’s a great story thank you you
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