Medicine

[audioplayer src="http://rss.acast.com/viewfrom22/jeremyhunt-scatastrophicmistake/media.mp3" title="Dr Clare Gerada and Fraser Nelson discuss the row over junior doctors" startat=34] Listen [/audioplayer]It has long been rumoured that when Jeremy Hunt took over as Health Secretary, Cameron told him to do one thing with the NHS: keep it out of the headlines. Given that the NHS is an enormous institution, the public take an avid interest in it and it is frequently rocked by scandals and financial difficulties, this was no easy task. Until a few weeks ago, Hunt had managed it with aplomb. And then the junior doctor fiasco happened. It has been cataclysmic, one of the worst public relations disasters to rock a government department for years, and it shows no signs of abating.

Do you ever wake up worried that you have tiny fibres growing beneath your skin, all along your spinal column? Possibly wriggling little fibres, placed there by the government or by aliens? By aliens I don’t mean asylum seekers but proper aliens, quite probably creatures with bifurcated tongues and scaly lips from the Planet Zog. If so, you may well consider yourself to be suffering from ‘Morgellons’. This unfortunate condition had its heyday at the turn of the century, with hundreds of thousands of people reporting to their GPs and clinics in the USA and here, pleading to have these little fibres sorted out somehow.

As a result of a ruptured appendix, I am infertile. The appendicitis was followed by gangrene and peritonitis, which permanently blocked my fallopian tubes and left me having to do IVF for a chance to have my own child. I have never felt shame about my situation but I have felt isolation and grief, both of which would be very much more bear-able if people were prepared to talk openly about in-vitro fertilisation — to dispel the taboo that still surrounds it. IVF in its various forms is incredibly common these days. More than 2.5 million babies born in the past seven years began their life in a Petri dish.

When I was pregnant, nearly everyone who’d had children asked me and my husband whether we’d booked our antenatal course with the National Childbirth Trust. Men tended to ask with a gleam of sadistic glee in their eye, and the question was almost always followed by a hurried disclaimer: ‘Ignore most of what they say, but it’s worth it for the friends.’ It seemed like an expensive and boring way to make friends: the courses are usually 17 hours long and they cost several hundred pounds. The NCT offers heavily discounted rates to people who can’t afford it, but for most of its pupils, the full fee is an accepted cost of having your first baby.

Tell kids the Tooth Fairy is fake, and their lips are sure to tremble. Reveal the list of their birthday gifts the day before the party, and they may well despair. Those who don’t want to hear such things can try covering their ears with a ‘la-la-la-not-listening,’ but the blabbers, in most cases, aren’t violating anyone’s rights. But what about a nurse who blurts the gender of a baby to parents who didn’t want to know? Or adoptive parents who tell kids their birth origins even though it may mess the kids up? And how about terminally ill patients who would feel hopeless if they knew they were dying? Ethicists in the ‘80s first applied the right to not know something to people with genetic ‘scary stories’.

The idea of dyeing a rhino’s horn pink is not absurd. It’s everything else about the 21st-century rhino-human interface that’s ridiculous. The pink-horn notion is a serious proposal and it’s as sane as the whole thing gets. There are plenty of other wacky notions out there. One is to drill a hole in a rhino’s horn and fill it with poison; the idea of the dye is to mark the horn as a poisoned one. Cutting the damn things off has also been tried. There are experiments that involve a horn-cam placed on a living rhino. If you’re involved with rhino conservation, you’re waist-deep in brochures for drones. That’s the trendiest idea on the table: long-range surveillance without the need to step outside. Well, that’s the theory.

The drugs giant AstraZeneca (AZ) has signed a deal with heart researchers in Canada which pushes forward the project to prevent – and even reverse – heart disease and diabetes by identifying the genes that put people at risk. There's been a lot of talk about 'personalised medicine' that offers us our own therapy tailored to our own weaknesses – specifically, the genetic time-bombs lurking our DNA. Until now, GPs have looked at our family history of heart disease, cancer, diabetes etc and (at least inwardly) shrugged. There's only so much they can do. The AZ deal with the Montreal Heart Institute will produce one of the largest genetic screenings to date.

The age of enlightenment was a beautiful thing. People cast aside dogma and authority. They started to think for themselves. Natural science flourished. Understanding of the natural world increased. The hegemony of religion slowly declined. Eventually real universities were created and real democracy developed. The modern world was born. People like Francis Bacon, Voltaire and Isaac Newton changed the world for the better. Well, that's what most people think. But not Charles, Prince of Wales and Duke of Cornwall. In 2010 he said: 'I was accused once of being the enemy of the Enlightenment,' he told a conference at St James’s Palace. 'I felt proud of that.' Then he added: 'I thought, "Hang on a moment". The Enlightenment started over 200 years ago.

As the FT reports, Apple and IBM have got into bed together. The deal they've struck has major implications for the growing number of people using wearable tech (and indeed mobile phones) to monitor their health. Here are the details. IBM has entered into partnership with Apple and other manufacturers of medical devices to make health data from wearable tech available to doctors and insurers. One outcome will be personalised treatments for diabetics. But that's only part of the picture. This is how it will work. If you're self-monitoring your heart rate, calories and cholesterol levels – as more and more of us are – you will now be able to use an IBM app to store it in a cloud.

Apple’s new smart watch, unveiled by Tim Cook yesterday, had incredible potential. But its functionality has been hindered by technical hitches – and, especially, overzealous legislators. Their cloying presence must have been felt at every product meeting. Engineers working on Apple’s watch did so with the rasping breath of the US Food and Drug Administration (FDA) on the back of their necks. The result? Apple is nowhere near giving us a device that allows comprehensive self-monitoring of health – thanks to federal regulations. Public health services everywhere tell us that prevention is better than cure.

When republicans meet, we console ourselves with the thought that our apparently doomed cause will revive. The hereditary principle guarantees that eventually a dangerous fool will accede to a position he could never have attained by merit, we chortle. With Charles III, we have just the fool we need. I don’t laugh any more. Britain faces massive difficulties. It can do without an unnecessary crisis brought by a superstitious and vindictive princeling who is too vain to accept the limits of constitutional monarchy. If you want a true measure of the man, buy Edzard Ernst’s memoir A Scientist in Wonderland, which the Imprint Academic press have just released. It would be worth reading if the professor had never been the victim of a royal vendetta.

There’s something wrong with the relationship between patients and their GPs. I’ve spent much of this winter in my local surgery, what with one thing and another, sitting among the stoic and snivelling, drifting between different doctors. They’re pleasant, if perfunctory, but with each visit I became more sure that something fundamental is awry. The docs seem ill at ease, as if their collective nose is out of joint, and I don’t think it’s overstretching or underfunding that’s the problem. My unprofessional diagnosis is that there’s a change under way in the balance of power between patients and medics; the status of GP as unimpeachable oracle is under threat, he feels the first tremors of what may be a seismic shift, and he doesn’t like it.

Every so often you read a piece about alternative medicine that asks: how does it work? How does homeopathy work, how does acupuncture work, etc. There was a piece in the Telegraph recently that asked: how does naturopathy work? There was a complicated answer about 'healthy electromagnetic frequencies' and so on; 'bioresonance', 'modalities', and a marvellous quote about how 'Every cell in the body puts out a certain electromagnetic frequency, that can be measured – a healthy stomach cell sounds different to a healthy brain cell...' Presumably those words have some sort of meaning to someone. But the problem with this piece - and with an awful lot of other pieces on similar topics - is that there's no point answering the question 'how does X work?