NHS - What We Waste

Newspapers like to report on instances of waste in the NHS. Yes, this happens and needs to be sorted out. But we contribute to the waste, and need to change our ways.

In 2014, the NHS reported that in 2012-2013, people failed to keep 6.9 million hospital appointments. At £108 per appointment, that equals £745,200,000. A further 12 million GP appointments were not kept. At the same time other people were unable to get appointments or had lengthy waits. If you have an appointment, keep it. If you can't keep it, or no longer need it - let the hospital or GP know as soon as possible - they may be able to fit someone else in.

Unused medications are another problem. As an example, in the diocese of Bath and Wells in the south-west of England, prescription medication worth around £12 million was returned to dispensaries. That money could have bought medication for people who would have used it. If you don't intend taking medication - tell your GP or consultant, or don't use the prescription.

Nutrient Thieves

Some foods, drinks, lifestyle factors and medications can deplete levels of certain nutrients as well as interfere with their absorption. Here are some steps you can take to protect yourself.

Tea and coffee: Known to interfere with absorption of iron and other minerals, including zinc, magnesium and calcium. Coffee has been shown to reduce iron absorption by up to 80% when drunk within an hour of a meal. Protect yourself: Drink water with meals and to take medications unless otherwise instructed. Take supplements with water or orange juice (often recommended for taking supplements as is contains vitamin C, which converts iron into a more soluble forrm).

Fibre: High fibre diets speed the passage of food through the bowels but may also reduce the amount of minerals absorbed, especially calcium. Protect yourself: If following a high fibre diet, ensure you get enough calcium from milk and dairy products, broccoli, nuts, seeds and pulses.

Antibiotics: These can interfere with the action of vitamin K in the body and can deplete levels of 'friendly' gut bacteria. Tetracycline antibiotics also bind to calcium found in dairy products - which can decrease absorption of both the antibiotic and calcium. Protect yourself: If taking long-term antibiotics (e.g. for acne), increase your intake of vitamin K (found on cauliflower, broccoli, dark green vegetables). After a short-course of antibiotics, it is a good idea to take a probiotic to replenish stores of 'good' bacteria.

ACE inhibitors: Medications used to treat high blood pressure or heart failure are thought to deplete zinc levels and can lead to a zinc deficiency. Protect yourself: If taking ACE inhibitors long term, increase your intake of zinc-rich foods such as red meat, sseafood (especially oysters), offal, whole grains and pulses.

Statins: As well as lowering raised cholesterol levels, statins switch off production of the body chemical, co-enzyme Q10. This reduction is thought to be a contributing factor to many of the side effects associated with statin treatment. Protect yourself: Try a daily coQ10 supplement. A dose of 100mg is recommended.

Corticosteroids: When taken orally long term, these drugs can cause thinning of bones and increase the risk of osteoporosis-associated fractures, partly by reducing calcium absorption in the gut and increasing calcium loss in urine. Protect yourself: Make sure you have good intakes of calcium and vitamin D, which are vital for bone density and to protect against osteoporosis.

Dr Sarah Brewer in Healthspan magazine, Autumn 2014

Employment Law

Age: an employer cannot turn you down because you are too old (or too young) - ageism is unlawful under the Equality Act 2010.

National Insurance and Tax. In 2014-2015 you can earn up to £10,000 a year without paying Income Tax and up to £153 a week before you pay NI contributions. As long as you earn more than £111 a week, you can build up your entitlement to a State Pension. Ring the NI Registration Helpline on 0300 200 3502 if you don't know your NI number. (Beware of unofficial websites that charge you for this!)

Flexible working: If you are a carer (defined as caring for a spouse, civil partner or partner, or another relative, you may have the right once ayear to ask your employer for flexible working, such as a change in your hours, or working from home. Your employer must consider your request and give an objective business reason if they refuse.

How long can I work? There is no default retirement age (Equalities Act 2010) and most businesses don't set a compulsary retirement age for employees.

State Pension: Currently the age for receiving the state pension can be between 61 and 68 years, depending on when you were born. But anyone can continue working past this age if they want or need to.

Part-time rights: You are entitled to the same treatment as full-time workers (unless your employer can justify exceptions). This covers pay rates (inlcuding sick pay, maternity pay, pension benefits, holidays) plus training and career development, and opportunities for promotion or career breaks. Some benefits are applied 'pro rata'. See gov.uk/part-time-worker-rights.

Redundancy: Legally, employers have to follow certain procedures. They can't force you to retire, but they can dismiss you if they have a fair reason, or make your role redundant. Visit the TUC website worksmart.org.uk for general information on your employment rights or gov.uk/redundant-your-rights.

Feature in Good Housekeeping, July 2014

British Mediterranean Diet

The essence of Mediterranean style eating is generous quantities of vegetables, fruit, beans, lentils, fish; moderate amounts of dairy produce and whole grains; and limited portions of red meat. Most of the fat is unsaturated. Snack on fresh fruit, veg, plain yoghurt and nuts (25p limit on nuts) instead of cakes biscuits and crisps. Choose plain, full-fat yoghurt (no sugar and you feel satisfied after eating). Use herbs and spices for flavour instead of salt and ready-made sauces.

This version focuses on British ingredients. Why buy peaches flown in from Italy or tomatoes from Spain when for many weeks of the year you can eat British-grown fruit and veg?

• Instead of red peppers, aubergines and peaches, choose British-grown fresh fruit and veg in season which are higher in nutrients (especially vitamin C) than those flown in out of season.
• Buy from local markets and suppliers - the produce is likely to be fresher, more nutritious and cheaper.
• Use rapeseed oil in place of olice oil for cooking and salad dressings.
• Sesonal produce has a lower environmental impact - requiring lower levels of heating, lighting, pesticides and fertilisers.
• Better taste - a ripe tomato or peach eaten in season has more flavour.

Eating British

• [Med rocket] British broccoli, cabbage, Brussels sprouts, curly kale. Both have high levels of vitamin C, potassium, fibre, calcium and carotenoids; British bonus cancer-fighting compounds.
• [Med peppers] British butternut squash, carrots, pumpkin. Both have high levels of carotenoids (important for healthy skin and immune system); British bonus lutein and zeaxanthin (antioxidants that protect eyes against macular degeneration.
• [Med red onion] British white and yellow onions, shallots. Both great sources of folic acid, fibre, potassium, and flavanols (anti-inflammatory and anti-cancer effects, help protect against heart disease); British bonus yellow onions produce the highest levels of quercetin, which helps thin blood, lower cholesterol and ward off blood clots.
• [Med aubergine] British red cabbage. Both contain folic acid, fibre and anthocyanins (pigments that help protect against heart disease; British bonus red cabbage contains high levels of vitamin C).
• [Med tomatoes] British locally-grown tomatoes. Both packed with vitamin C and lycopene (which may help reduce risk of lung, stmach and prostate cancers); British bonus local seasonal produce contains more vitamin C.
• [Med peaches, necatarines] British plums. Both rich in antioxidants and phytonutrients; British bonus plums contain hydroxycinnamic acid and ferulic acid, which help the body fight cancer.
• [Med grapes] British apples, pears. Both good for potassium and soluble fibre; British bonus apple eaters have a lower risk of heart disease and stroke, cancer and type 2 diabetes due to high levels of flavanols.
• [Med citrus] British strawberries, raspberries, currants. Both packed with vitamin C; British bonus strawberries contain ellagic acid, and antoxidant that helps prevent cancer.
• [Med nuts] British Kent cobnuts. Nuts and seeds are rich in heart-healthy monounsaturated fat, vitamin E, fibre, protein and minerals. You'll have to buy foreign at times.

Feature in Good Housekeeping, June 2014

Social Kissing

Many people are unsure about the rules of French social kissing or faire la bise. Social kissing was originally a form of greeting within your immediate family or close friends but became more widespread after the social revolution of May 1968. Every region of France has it's own customary number of kisses and starting side, which can even confuse the French.

• It is never obligatory in France to kiss a person you have not met before. It is still mainly reserved for relaxed occasions with family and friends of the same age, although growing more common between work colleagues who know each other well.
• It is acceptable, even commonplace, for straight men  to kiss good friends or relatives.
• In most regions, you exchange two kisses, starting on the right cheek.
• It merely requires the lightest brushing of cheek to cheek, but at the moment of brushing  you are expected to make a 'mwah' sound.

The French serrer la main or squeeze the hand rather than the Anglo-Saxon handshake so gently squeeze the proffered hand. French etiquette dictates that the older, more senior person or a woman, proffers thair hand first.

From They Eat Horses Don't They: the truth about the French by Piu Marie Eatwell. Published by Head of Zeus Ltd, 2013.