Britain’s favourite TV doctor, Dr Hilary Jones, discusses a range of topical health issues that affect us all during our lives. He presents a strong case for the prevention of diseases through lifetime choices that may even help us to live to 100…
Last year you passed your quarter century as the familiar face of ITV’s morning show ‘Good Morning Britain’—looking back, do you have a sense of the influence the show has had with regard to health awareness?
We’ve discussed many serious topics and we’ve been able to make a difference to people who watch the show—and there’s been a lot of fun as well. On the serious side, we’ve been involved in a campaign to recognise signs of meningitis, and we’ve just carried out a campaign that helps secondary schools how to do CPR [first aid/cardiopulmonary resuscitation] and we hope that’ll make a big difference because the success rate of CPR in countries like Norway (where they teach CPR in schools) is more than double the success rate in the UK. We’ve also raised awareness of the hazards of carbon monoxide poisoning, and we’ve raised awareness of breast cancer and prostate cancer. And we’ve had many responses from viewers who tell us we’ve helped them recognise symptoms. So the programme has contributed to saving lives. And that, of course, makes you feel that this is a really good use of the medium of television.
You’ve said previously that you’ve been a strong supporter for the National Health Service and that you have concerns about the state of the NHS today. What sort of reforms would you like to see happening that would strengthen the NHS?
We need to keep ‘the best bits’ and get rid of the bits that aren’t performing very well, support the good teams, stop doing the statistics on how it’s performing and invest money into putting more frontline staff upfront with patients—because without the doctors and the nurses the NHS is nothing, and the newly elected government needs to remember that.
The NHS does a great job and most people are aware of this and the enormous pressures it’s under; there are huge and increasing demands on the NHS for more and more treatments, ranging from the very serious treatment of cancer to the treatment of other significant but non-life threatening conditions. And as far as doctors are concerned, we just want to be able to get on with the job with less interference and micromanagement.
It has been suggested that there should be more and better access to GPs. Do you agree with that?
Yes, and we need that very much. The trouble is that GPs are like everyone else—they do deserve a life and if they’re already working very long hours, and you have to ask, where are these extra GPs coming from? It takes at least six years to train a doctor and another three or four years to specialise in general practise. So it’s 10 years away before we can have more GPs. What we could do—as I have suggested to a Cabinet Minister—is stop the haemorrhage of doctors leaving the profession as soon as they qualify, which they may do because they don’t like the future prospect of long hours and the stress of responsibility.
Moving onto some hot topics of the day, we’ve been informed earlier this year that breastfeeding for longer is more likely to increase intelligence in adulthood and lead to higher adult earnings, according to a 30-year study of almost 3,500 newborns in Brazil (published in The Lancet). The link between brighter babies and breastfeeding is well known—but this latest study shows that when babies grow up, they continue to benefit. Do you think this research proves the point unequivocally? And do you think this report will set a new trend for a longer duration of breastfeeding?
It adds to what we’ve always expected, that ‘breast is best’. Breast milk contains all the essential nutrients that a baby needs. But in reality, only two percent of mums in the UK are still exclusively breastfeeding at six months, which is very low. With regard to the research findings you’ve asked me about, this may put some mums under pressure, but I don’t think mums should worry too much if they wean the baby early or bottle feed, because we need further research to corroborate this one study.
Turning to the topic of the diabetes crisis in the UK, a recent report has raised concerns amongst researchers about antibiotics acting as a trigger for the development of type-2 diabetes. Do you think this report is also likely to raise concerns amongst doctors and their patients where antibiotics are being prescribed?
I do have a vested interest in all things related to diabetes because my eldest son, who is also a GP, is a type-1 diabetes sufferer, a condition that he developed at the age of seven.
The epidemic that we’re seeing is in type-2 diabetes, which we’re beginning to see in children because of the obesity problem, and we’re going to see vastly more numbers of diabetics—by 2020 it’s estimated that the figure will have reached something like 5.2 million sufferers. It’s very worrying—not only for the health complications of the sufferers, but also the huge added financial burden to the NHS, and really an unnecessary and preventable one for all concerned.
To answer your question, regarding possible triggers that may affect the onset of diabetes—some antibiotics and also statins have been mentioned—we need to look at the side effects of drugs. Antibiotics are necessary but are probably over-used. There’s no doubt that they have been and still are over-prescribed. If a patient is insistent and the doctor has 30 patients waiting, the doctor knows a prescription works wonder in getting them out of the door! But we do need to say no, in many cases, and explain that this is in everybody’s interests in the long term.
Are you optimistic that a cure for cancer will be found, or would you say that the many complexities of different cancer types makes that unlikely?
I’m an optimist by nature, but I would hesitate to make a statement about a cure being found because, for instance, the cells in the human body have a finite lifespan—it’s said that most cells can only replicate themselves 60 or 70 times and after that you begin to see an increased number of mutations and at that point there is an increased possibility of cancer developing, just through cells getting out of control. I think that will always be the case, whether our average lifespan is 70, 80, 90, or 100—we have to die of something and so cancer is more likely, though not always, to be seen in the elderly. I also think that it’s in the younger sufferers that we are more likely to see advances towards a cure, through earlier diagnosis…
Yes, the early diagnosis of cancer does seem to be making advances—researchers have recently found that an odour-sniffing machine is as good at detecting breast cancer as is a mammogram—and experts believe many other devices capable of spotting other diseases that could lie ahead.
It is very interesting. Scientists looked into the development of the technology as a result of pets being able, apparently, being able to detect cancers of the bladder and breast. Machines that can detect tiny numbers of molecules even under the skin is a very interesting development—although this won’t be possible for all cancers, not even all breast cancers, but it’s certainly a new direction that we can explore.
You may agree that the goal to literally Live to 100 is becoming more achievable as every decade passes. Do you believe this is due to improved nutrition and healthcare compared to, say, 50 years ago?
Yes, better nutrition, better housing … at the time of the First World War there were literally just a couple of hundred people who live to 100, but now it’s several thousand. Longevity is improving, as is the quality of life—there are plenty of people who are over 100 who still enjoy being active and being mentally alert and have a great sense of humour. I rather like what the oldest German said at the age of 107: ‘If I’d known I was going to live this long I’d have looked after myself!’
A society in which people live for much longer must bring its own set of problems in terms of caring for the elderly?
Agreed. I think that dementia is the thing that people worry about most after cancer. We worry about it not only for ourselves but also in our ageing parents, and at the moment there is too little social care for the elderly … and of course it can take a long time for the early stages of dementia to be recognised. The media tend to gear everything towards the younger generations, but older people have a lot to offer and they are amongst my favourite patients, because they always have something to give back.
Do you have a view about voluntary euthanasia in special circumstances?
Absolutely, I have very strong views. We need to give people the choice of a good and timely death and the choice not to have to live in extended pain and misery. That seems only humane and decent. I don’t have the concerns that some people have that voluntary euthanasia could be abused. I think the practice has gone on unofficially for a very long time and provided the individual concerned has signed a living will and has made their views perfectly clear when they were in good health and spoken to their relatives explaining what their wishes are, I think it is quite wrong to strive to keep somebody alive when they’re in pain and have nothing to look forward to.
Would you agree that living a longer healthier life is very much a matter of good luck and inherited genes, as well as applying common sense and being aware of what’s good for us and what’s bad for us?
Genetics is important, clearly, because we inherit so many characteristics from our parents—not just the colour of our hair and our eyes, it’s also our vulnerability to illness such as heart disease, respiratory disease, asthma, eczema, and so on. But just because there’s a family history that doesn’t mean we should be fatalistic, in fact knowledge of our family history empowers us to take important measures if we know we have certain vulnerabilities. For example, someone who knows there is a family history of heart disease can redouble their efforts to make sensible choices—not to smoke, to eat healthily, to normalize their weight, to avoid stress and to exercise regularly. But there is a randomness about disease—there are many cancers that can develop for no apparent reason in younger people, it is sometimes just bad luck. Maybe one day we will be able to have a blood test that will reveal what diseases we are vulnerable to. That may sound scary but that knowledge gives us the empowerment to do something about it, most probably though sensible lifestyle changes.
Regarding what’s ‘good’ for us, I know you rate daily exercise and healthy eating very highly.
Taking plenty of exercise is the cheapest and most effective way of practicing preventative medicine. There is a long list of benefits and across the board there isn’t an organ in the body that doesn’t respond to regular exercise. I’m keen for younger people especially to feel the joy of feeling fit because people tend to miss it when they’re not fit, and so there’s the motivation to do something about it.