Political failures and corporate greed have brought the NHS to its knees, and led to my mother’s death The time where we could accept cautious evolution has passed – our NHS today needs a revolution

“I love you too much, you have a heart of gold. Look after your Papa.” These were the last lucid words my mother said to me as I hugged her tighter than I’d ever done in my life. A week later she was gone.

One year ago at 2:32pm on the 29th November, Dr Anisha Malhotra took her last breath. A GP that had dedicated over 25 years of her life to the NHS was ultimately failed by it.

Four weeks earlier my mother had been admitted with a temperature and excruciating back pain. She was diagnosed with discitis, which proved to be resistant to antibiotics. A secondary heart attack as a result of the stress on her already frail body was enough to tip her over the edge. But what happened in hospital, which eventually led to the premature death of a 68-year old lady in the most horrible of circumstances, and the profound emotional trauma of family members witnessing it, was entirely avoidable.

i's opinion newsletter: talking points from today Email address is invalid Email address is invalid Thank you for subscribing! Sorry, there was a problem with your subscription.

Lifestyle-related disease – a result of consuming too much ultra-processed food and inactivity – had left her overweight, resulting in hypertension and severe osteoarthritis. Years of popping ibuprofen like Smarties to deal with joint pain made her anaemic, and loss of appetite made it particularly difficult to get enough nourishment from her vegetarian diet. Weak bones from malnourishment and lack of activity brought her to hospital twice last year in the space of four months.

‘The system is struggling to provide even basic quality care to many patients.’

An overstretched system

Although remarkably strong in spirit she was extremely frail and weak by the time she was admitted to hospital for the final time. But rather than allow her to die with dignity, an overstretched system meant a missed heart attack was only noted by her medical team eleven days after it was reported.By then it was too late to save her. Excess intravenous fluids led to heart failure. It took several days of diuretics to make her comfortable and allow her to be taken off oxygen. But by then she’d slipped into a deep coma, never to wake up again.

There can be no doubt years of austerity and NHS underfunding have led to a shortage of nurses and doctors unable to keep up with increasing demand. But even if that were to be resolved overnight it would be at best no more than putting a sticking plaster on a severed artery, because the system is struggling to provide even basic quality care to many patients.

Lifestyle factors and ‘too much medicine’

The two major reasons for this are simply not being addressed: maldistribution of resources through “too much medicine”; and diet-related disease. Former medical director of NHS England, Sir Bruce Keogh, has previously stated that one in seven operations and treatments should never have been carried out on patients in hospital.

The Academy of Medical Royal Colleges waste report stated that “one doctor’s waste is another patient’s delay”. For my mother that meant waiting for two extra hours (because of understaffing) to be prescribed oxygen and diuretics whilst in crashing pulmonary oedema, an experience that can only be likened to drowning but remaining alive at the same time. And this is despite my father, a doctor, watching by her bedside totally helpless to relieve the suffering of his life partner of 45 years.

The root of our healthcare crisis

This can and must not be taken as attack on the NHS itself. Instead, it’s an indictment on what is at the very root of our healthcare crisis: those vested interests that have brought it to the brink of collapse. The increasing burden of diet-related disease is at the heart of increasing demand on the NHS, yet there is absolutely nothing in the Conservative manifesto on policy changes to deal with the public health crisis.

It also does not address the tainted, industry-biased research which continues to cause significant harm to patients, with side effects of medications one of the leading causes of death. If 93 per cent of medical research is of questionable reliability and not relevant to patients it’s going to lead to bad outcomes, and that’s what we’ve got. But such lack of action is perhaps not surprising.

A BMJ investigation earlier this year highlighted that the Conservative party has received £4.3m from “free market” think tank, the IEA, that has opposed public health initiatives to tackle obesity, such as calorie labelling and advertising restrictions on unhealthy foods. This organisation has received funding from tobacco companies and the sugar and soft drinks industries. *See footnote for clarification

‘It is now time all doctors also took some responsibility’

Following the cash-for-questions scandal in 1994, the then Prime Minister, Sir John Major, set up the Committee on Standards in Public Life. A subsequent report made it imperative that all those in public life, including MPs and Doctors whose primary duty is to serve the needs of the people, uphold the seven so-called “Nolan principles”: selflessness, objectivity, integrity, accountability, honesty, openness, and leadership.

The excesses and manipulations of industry that put personal greed and wealth before health would not be possible if it were not aided and abetted by regulators, politicians and powerful scientists.

It is now time all doctors also took some responsibility for and action against system failures that make their jobs unmanageable and, most importantly, deny patients timely and quality care. Corporate greed and systematic political failure have brought the NHS to its knees.

The system is broken and money alone cannot fix it. The time where we could accept cautious evolution has passed – our NHS today needs a revolution. No one should suffer like my mother, and no family should have to witness it.

Dr Aseem Malhotra is an NHS Consultant Cardiologist and Professor of Evidence Based Medicine

In the original version of this piece, Dr Malhotra stated that the think tank, the Institute of Economic Affairs, had donated a total of £4.3m to the Conservative Party over the years. Regrettably, this was not correct.

Although it is true that the IEA paid £2,800 to cover travel and hospitality for three politicians incurred between 2014-2018, the IEA considers these payments to have been expenses which were connected with the MPs’ attendance at IEA events, not donations.

The IEA has informed us that the remainder of the £4.3m consisted of personal donations made by two individuals acting in their personal capacities, unconnected with their roles as Trustees of the IEA. The IEA therefore takes the view that the article was not correct in asserting that it, the IEA, had donated to the Conservative Party either over the years or at any time.

We are happy to update the article by reporting the IEA’s position, for the benefit of our readers.

