The right prescription: interview with Dr Hilary Jones

TV medic, Dr Hilary Jones, has been the face of health advice for more than thirty years.

After starting his broadcasting career at British Medical TV in 1986, Jones joined the most successful TV breakfast station ever, TV-am, in 1989, before moving to GMTV to team up with Lorraine Kelly when it won the breakfast franchise in 1993.

For decades, he has been the face of the health service for viewers across the UK. But it was ten years before his first TV appearance that Jones happened to chance across an advert that changed the course of his career.

The listing was for a vacant medical position on Tristan da Cunha, a collection of remote volcanic islands, sitting in the middle of the South Atlantic Ocean between Africa and South America.

To say the place was isolated would be an understatement. In fact, with more than 2,000 kilometres separating the grouping from the closest inhabited land, Saint Helena, the islands are the most remote inhabited archipelago in the world.

On one side, South America sits 3,400 kilometres to the west. On the other, South Africa lies 2,400 kilometres east. Alongside the uninhabited Gough Islands – home to a weather station and crew – the group includes the Nightingale Islands and the descriptively named Inaccessible, which is home to an extinct volcano, sheer sea cliffs and a few beaches, covered in treacherous boulders. Of the whole group, only the main island of Tristan is inhabited, with fewer than 300 residents.

It seems an odd place to start a medical career. Speaking to Holyrood in the Scottish Parliament, where he has just delivered a session on the menopause for staff, Jones explains what drove him to swap London for the South Atlantic. “After I qualified I spent two years in intensive care units, working there and also in casualty. I just wanted some adventure. Every young guy wants to get out of the concrete jungle of a hot London hospital and have some adventures and I saw this advert for a single medical officer on Tristan da Cunha.

“The ship goes out there three times a year, there’s no airstrip, and it’s outside of helicopter range so you’re just there. So I was everything. The vet, the anaesthetist and the surgeon. Luckily I wasn’t called on too much. At least, nobody died when I was there.”

And so it was that Jones ending up spending a year on a rocky outcrop in the middle of the ocean, acting as the only doctor within a 5,000km range. “I was quite newly qualified and foolhardily confident in my abilities. Looking back, I wouldn’t do it now!” he says. “But it was a great experience and it did help to shape my medical career. I loved every minute of it.”

After that, fate took Jones to another set of islands, slightly closer to home, with a job coming up on Sullom Voe in Shetland.

“I went to Shetland and I was looking after the workforce at Sullom Voe and also some of the locals in the general practice, and that was fun too. Shetland is challenging in terms of the weather and again, that was an interesting experience. I went into general practice thereafter. Tristan da Cunha is actually pretty temperate, a bit like our climate here, but Shetland, well…” he pauses, “it’s pretty windy.”

After that things settled down, at least for a while, with Jones becoming a principal in general practice in the early 1980s.

And while his TV career took off by the end of the decade, Jones has continued to work part time as a GP and part time as a medical broadcaster, though he seems pretty comfortable with the mix between neighbourhood GP and TV celebrity.

“The patients I see have always known me as a GP before I was in the media, so no, it’s not as if I get coachloads of day trippers coming to see me for a second opinion, which wouldn’t be appropriate. So they are two disciplines – in the surgery, you’re dealing with one person and it’s a one-to-one investigative process, to make a diagnosis and arrive at treatment, but in the media, you’re talking to potentially 10s of 1,000s of people all at once, with potentially much broader issues relating to public health. Giving people advice on how to interpret a news headline about a new drug or a new treatment for this, showcase a human interest story on that. Every day is different in the media.

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“I’m a GP so I try and explain things in layman’s terms, make it accessible and keep it simple. You know, give people three main tips, ‘if this is what you’re worried about today, this is what you need to know’. Bang, bang, bang, 1,2,3. And if we can influence people to keep healthy, that’s great.

“Certainly our programmes have had lots of letters in the past saying, ‘I listened to your programme on Lorraine or GMB, and had it not been for the programme, my husband’s prostate cancer wouldn’t have been diagnosed’, or ‘my bowel cancer wouldn’t have been diagnosed’, or ‘our child with meningitis, the diagnosis wouldn’t have been made – we were insistent, we did what you said, and we followed our instincts and said our child isn’t right, we asked if it could be meningitis, and it turned out to be the case’. So it’s lovely to get those kind of letters basically thanking us for making good use of a broadcast medium which is TV.”

But while there is obviously an advantage in transmitting health advice to a mass audience, is there a danger the message – delivered in a short TV segment – could be misinterpreted and lose something in transmission? How good is the media at handling health issues?

“I think the media probably are too focused around entertainment rather than education and I think it’s gone too far that way. There’s so much more we could do using the powerful medium of TV, and radio, and print media, to raise awareness about health issues. It doesn’t have to be stodgy and didactic. It can be entertaining at the same time. Infotainment, if you like, which is what the soaps do, they incorporate health issues in storylines, and people can identify with those storylines quite well. Whilst it might be overdramatic and it might be a little far-fetched at times, nevertheless, it’s raising awareness and it’s getting people talking. If you start that conversation, then often you get people to the doctor’s surgery and get the help they need.”

But while Jones keeps up with health developments through medical journals, conferences, and by talking to experts in the field, the nature of working in broadcast media requires him to react quickly to changing stories. On GMB, he says he gets help from producers, but if a new health story comes in without warning, it can’t be easy to offer instant advice to anxious viewers.

And the journey from studying arts subjects at high school, to a medical degree, to becoming a TV doctor – via a stop-over in the South Atlantic – is a pretty unusual one. Did Jones ever imagine he would end up where he is?

“I was lucky enough to go to a school with a really good drama department,” he laughs. “So I was at school with Mel Smith, who people will remember as a director and comedian, Hugh Grant went to my school, and so did a number of other quite well-known actors.”

Did that help with TV? “Well, I actually played Prince Hal to Mel Smith’s Falstaff in Henry IV, Part 1, so we got used to performing on the stage, and I do think that helped with communication skills and, kind of being a little bit more comfortable in front of a camera.”

In fact, his broadcasting career only took off properly after Jones wrote to ITV asking for a job.

“I went into general practice after doing those jobs overseas and I realised I was sometimes giving the same advice to individuals countless times in a week,” he explains. “I thought, well, what if we can broadcast these messages to a broader audience? So I wrote to TV AM and said, ‘give us a job’ and the CEO at the time said, ‘that’s a good idea, come up for an interview’, and it went from there. That was 28 years ago. I pitched it myself.”

In 28 years, Jones has clearly seen huge change in both television and in the world of medicine – some positive, and some negative.

“The changes that I’ve seen over the course of my career are both good and bad. In terms of the health service, I think we can still be immensely proud of what it achieves, day in day out – seeing a million-and-a-half patients every day in the NHS, I think it’s underappreciated, and undervalued.

“If people go abroad and experience healthcare abroad, they suddenly realise that we shouldn’t take the NHS for granted. If you go to hospital in Spain, you’re given a bill at the end of your stay and if you’ve had your appendix out and you see the bill for two-and-a-half grand and you think, my goodness, but you think how grateful am I that that’s been paid for by my contributions.

“People know the value, but I think people here probably don’t know the value of the treatment they get, and a lot of people aren’t taking enough responsibility for their own health. We’ve got this epidemic of obesity, we have a lot of lifestyle problems that cause us to develop conditions that we could otherwise avoid. So we need to do more for ourselves, but also, we are understaffed in terms of nurses and doctors. They are the NHS, really, and they are underresourced and we need more staff to look after the overwhelming flow of patients who need help.

“We’ve got better diagnostic technologies, we can diagnose quicker, but we don’t have enough beds, so it’s all very well having diagnostic facilities and the way we ought to treat people but if we don’t have beds and we don’t have enough doctors and nurses then we’ve got problems.

“So there are many changes for the better, but for the worse, I see the health service becoming a little less personal, so it’s more difficult to see your own doctor, it’s more difficult to see the same doctor twice, and that impinges on continuity of care which is really important. For example, if a child’s got meningitis in the early stages, and they go into hospital and they see doctor number one, and doctor number one says, ‘I think it’s a virus, take the child home, and give them some paracetamol’, and three hours later the child is worse, so the parents bring the child back to hospital and see doctor number two, so it starts again. This continuity of care is potentially quite dangerous and the lack of time that doctors can afford with each patient is potentially quite dangerous, so there are a number of things that could be improved at a fundamental level.

“It’s all very well talking about IT and Artificial Intelligence, which is the buzzword at the moment, but you still need that personal hands-on care. You can’t do it over the phone, you can’t do it on Skype, we need the personal care.”

The challenges facing the NHS, underlying these issues, are pretty well known. An ageing population and increasingly complex demands in particular have been identified as causes of growing strains on a service which recently turned 70. So to what extent is this a resource problem?

“Yes, it’s largely a resource problem. We spend much less on healthcare in this country than we do in most European countries and we’ve been operating the NHS on a shoestring budget, offering a Rolls Royce service, and it can’t go on forever. So these are the changes that I’ve seen, and I think that we could become tighter on looking after resources. For example, when casualty units are inundated with people who’ve had too much to drink, that needs to stop. People are using ambulance services for trivial reasons and that needs to stop. People coming to this country for treatment which they’re not entitled to, at taxpayers’ expense, that needs to stop. Medical students who train at taxpayers’ expense for seven years and then never practise medicine, that needs to stop. In the military services, people do a short service commission and they have to at least do three or four years after their training, why don’t we do that with medical students? So I think there are some simple solutions that we could employ that would make a huge difference and enable our beloved NHS to continue.”

Four principles lay at the heart of the creation of the NHS when it was founded – that it should be free at the point of use, available to everyone who needed it, paid for out of general taxation, and used responsibly. Listening to Jones run through some of the strains placed on health resources – either through people failing to take responsibility for their own health, or by sheer misuse of finite resources – it is tempting to wonder if there’s a danger we take the NHS for granted.

Jones nods. “Yeah, we do take it for granted. Our expectations of the NHS are greater and greater so there are people who want treatment for all sorts of things which it was never really intended for in 1948. In 1948, children died because they couldn’t afford to get treatment but these days, no child is going to die because of their financial situation and we’ve got enormous amounts to be grateful for. But we have to make tough decisions about where the money is spent.”

But with the NHS turning 70 this month, it’s perhaps natural that Jones should reflect on the state of the health service.

“You know, this is a great opportunity to celebrate everything it’s achieved and for people to say, let’s hang on to our fantastic NHS. Let’s throw some more resources at it. Let’s put a bit more of our taxpayers’ money into it and protect it because it is under threat in all sorts of areas. Social care as well as emergency care and everything else that goes with it, general practice too, all threatened. We can protect it and improve it provided there’s the political will and support from the public.”