Is the Nation Sufficiently Healthy to Recruit an Enlarged Army?

Recent political events surrounding the new Trump administration in the USA have raised issues about the recruitment an enlarged armed forces throughout Europe. Almost inevitably this will ultimately lead to questions about the lack of health and fitness of our young people for military service - and this in turn may raise even more serious questions about the quality of our health services.

A 2024 study from the USA Pentagon, reported on Miltiary.com, showed that 77% of young Americans would fail to qualify for military service - without a waiver being made for being overweight, using drugs or having mental and physical health problems. A similar study in 2017 had showed that 71% of Americans would have been ineligible to serve. So this is not only a huge proportion of the population, it is a problem that is rapidly growing - a 6% increase in 7 years.

This reminded me of the problems Britain experienced during the Boer War (1899-1902), and the period leading to the First World War (1914). Throughout the Boer War, a prolonged and intense conflict in Southern Africa, there were constant concerns about the fitness, strength and suitability of the recruits to the army. Huge numbers of men had volunteered to fight but many were rejected. In 1902 it was estimated that 60% of the male population were physically unfit for military service.

In response, a Committee on Physical Deterioration was set up by the British government. The Fitzroy Report (produced in 1904) described the poor physical condition of army recruits, and recommended an urgent improvement in both living and working conditions, not least those arising from overcrowding, poverty, pollution, and parental neglect. Perhaps these findings should not have been a total surprise. It followed two centuries of extreme social upheaval - the Agrarian and Industrial Revolutions. And the report did lead to important, quite rapid social change.

The latest report from the Pentagon states that "When considering youth disqualified for one reason alone, the most prevalent disqualification rates are overweight (11%), drug and alcohol abuse (8%), and medical/physical health (7%)”. So it is not social conditions that are now causing the problem: it is drugs, including medical drugs, and a health system that is just not working. 

Moreover, the problem of recruitment to the armed forces remains in Britain.

        "The British Army has consistently fallen short of its recruitment targets ... each year since 2010, as highlighted by the recent Ministry of Defence data. The figures reveal a cumulative deficit of 22,350 in the Basic Training Starts (BTS) Targets for British Army ‘Other Ranks’, compared to the total recruitment goal of 119,530 set over the period from 2010 to 2023."

And the reason for the failure to recruit are similar to those found in the USA.

        "The total number of rejections over the last five years was 125,861, with 23,763 Commonwealth applicants turned away due to “lack of vacancies” and 76,187 rejected on medical grounds over the period." 

So over the last 5 years, ‘medical reasons’ have emerged as the foremost reason for the British armed forces to reject those who wish to join. And what we need to remember is that this rejection of 76,187 applicants follows nearly 80 years of a National Health Service, "free at the point of need", and now costing the country over £200 billion annually.

So what does that say about the quality of the medicine provided by our overly-costly NHS?

But then we may never know, as this is not a question our military, our health services, and our government, is ever likely to ask!

Sickle Cell Disease. A new treatment costing £1.65 million being offered by the NHS

Sickle Cell Disease is rightly considered to be a horrible condition. It is thought that about 15,000 people have the condition, in England alone, affecting people mainly of Black African and Caribbean heritage. It can cause intense, recurring pain, and it can be life-changing, and even life-threatening.

The NHS has announced that a new, "groundbreaking", individualised 'gene editing' therapy will be offered to patients in England on the National Health Service (NHS). Good news, then? 

The main problem is that the treatment is going to cost the already over-stretched, almost bankrupted NHS £1.65 million per patient. It is expected that 50 people per year will be offered the treatment - total expenditure of an astonishing £82.5 million per annum.

If the treatment works, this may represent excellent value - at least for 50 people every year. But the NHS spending this amount of money represents what is known, in economic jargon, as "an opportunity cost", that is, the opportunity to spend this money on other things.

Other things, for example, like spending money on the treatment of the remaining 14,950 people who currently suffer with sickle cell disease!

Conventional medicine always does this. It comes up with new, 'groundbreaking' treatments that are so expensive they are either not used, or used only by people wealthy enough to pay for their own treatment, or used with a tiny number of people at public expense.

So I have an alternative suggestion!

Earmark this £82.5 million for sickle cell disease. Divide the money between the 15,000 patients who suffer from the disease, and allow each patient to spend their £5,500 on homeopathic treatment!

Homeopathy has been treating Sickle Cell Disease for many, many years; often with complete success. Do a web search - "homeopathy, sickle cell", and see for yourself. Even if each consultation with a homeopath costs £100 per month (with remedies), not one of these 15,000 patients will have to spend more that £1,200 on their treatment. 

The remaining £4,300 could then be spent by the 15,000 sickle cell patients on celebrating their freedom from the disease.

It is time for some new, "groundbreaking" thinking about how the NHS spends public money - on treatment that actually works