What’s wrong with a pedalo ride if it makes you well?

http://www.theguardian.com/commentisfree/2015/sep/01/pedalo-medicine-lifestyle-nhs-healthy

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Last time I went to see a doctor, he grabbed a prescription pad and sent me off for some pills. He didn’t suggest a ride on a pedalo or a gentle canter on a horse. He didn’t offer me a robot. He didn’t offer me a summer house. He didn’t even offer me aromatherapy, or shiatsu, or some new clothes. All he gave me was a measly piece of paper with a prescription for some antibiotics.

If I’d lived in Cornwall or the Scilly Isles, I might have found myself listening to someone playing a pan pipe, and feeling fingers dipped in geranium oil massage my tension away. If I’d lived in Northamptonshire, I might have got a holiday, or had shiatsu, or a personal trainer, or some nice new clothes.

Related: NHS health budgets funding holidays, Nintendo consoles and a pedalo ride

If I’d lived in Stoke, I might have learned the piano, or worked out at home to a Wii. But I live in Hackney, and GPs in Hackney don’t offer horse riding or rides on pedalos or vacuum-cleaning robots. Or at least they don’t offer them to me.

Some GPs do. Some GPs, at some clinical commissioning groups (CCGs), seem to think that spending money on pills and x-rays and operations is a bit boring, and that there are much more interesting ways to spend your tax. Some GPs, in fact, seem to think that a publicly funded health service is very much like a fairy godmother. In this kind of health service, the doctor doesn’t tell the patient what to do; the patient tells the doctor the things they feel like doing – galloping over a field, say, or bobbing around in a boat on the sea – and the doctor forgets about the prescription pad and hands them a wodge of cash.

This, at least, is the view of the medical magazine Pulse. The editor of Pulse, which has gathered together the information about the spending habits of CCGs, thinks things have gone a bit far. Nigel Praities doesn’t exactly say that doctors are behaving as if they had just won EuroMillions and discovered they have only a few hours to splash the cash. “It is easy to see,” he says instead, “that a holiday or a summer house could have a powerful effect on an individual’s wellbeing, but can the NHS really afford these luxuries at a time of austerity?” You can’t, in other words, keep doling out cake when the NHS is still struggling to offer crusts.

The NHS wasn’t designed for a world where people’s lifestyles make them ill

Actually, cake is part of the problem. We’re eating far too much of it. We’re also drinking too much cola and eating too many crisps. Doctors can tell us what they like, but we just keep stuffing down the cake and crisps. That’s why we’re getting diabetes. Nearly 3 million people in this country now have diabetes, and it’s costing the NHS £14bn a year. That’s £25,000 a minute. That’s £1.5m an hour. And diabetes is just one of the conditions, according to economists, that will make the current budget of the NHS, now about £115bn, look like loose change.

We may prefer the idea of pills – but for most of our health problems, pills don’t work. Pills don’t stop people getting diabetes; pills don’t stop people getting backache or depression; pills don’t do much for people with dementia, or people who have the health problems that often go with being fat.

The NHS was designed to deal with the kinds of illnesses that come about suddenly, and which threaten to kill you. It was designed to get people into hospitals, where they could be cured. It wasn’t designed for a world where people’s lifestyles make them ill.

Related: Obesity and sedentary lives put 5m Britons at risk of type 2 diabetes

There isn’t yet a medical name for the biggest health problem we face as a nation, but we might as well call it inertia. We are drifting into chronic illness. And if you want to stop people drifting, you need to give them a sense of control. That’s why some CCGs give some of their patients “personal budgets” and let them choose, within guidelines, how to spend it. These guidelines are geared to “health outcomes”, and they are agreed. A “personal budget” is, as the word implies, a budget. A budget spent on music lessons doesn’t cost more than a budget spent on pills. A budget has a limit. You can get the ride, but you probably can’t get the horse.

We are practically getting to the point where buying every person in this country a horse would be cheaper than trying to use medicine to keep them well. You could probably throw in the stable, too.

Antibiotics, as I discovered when I saw the doctor the other day, are great for an infection, but for many of our biggest health problems medicine has failed. For many years, I had a pain condition that wouldn’t go. I saw GPs, and rheumatologists, and neurologists, and physiotherapists, but it was acupuncture that got me well. Acupuncture and psychotherapy. Funded, unfortunately, by me.

If something isn’t working, ditch it. Chuck out the prescription pad and try something new. Let them ride on pedalos. Let them build summer houses. Let them gallop across moors. Let them do whatever the hell they like within their “personal budget”, but let’s all go a bit easier on the cake.