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Interesting long form interview with Neil Oliver

Hello, everyone, and welcome to another episode of Waking Up with Neil Oliver. My guest today is someone that has been right at the top of my list of candidates for interview from the very beginning of doing any of this, Dr. John Campbell, who is, I think it's no exaggeration to say that he's something of a YouTube sensation. Before that, John was a nurse for many years. That's really what he is, a nurse and an educator and communicator, nursing for 20 odd years, nearly 30 years. Also an academic with a degree and a master's degree and a PhD, hence Dr. John Campbell. He's also been a bit of an innovator in as much as he has been communicating his message to the wider world since 1991. Recording first of all on VHS cassettes for anyone that's old enough to remember such artifacts, and then DVDs, and more recently, as I've already mentioned, online via YouTube. And when I last checked earlier today, Jon had in excess of 2.6 million subscribers, so that makes him pretty phenomenal from my point of view. He very much is interested in and has always talked about physiology, how the body works, and also how the body doesn't work, what happens to make the body go wrong. And there's an interesting line in an introductory message that John has on his YouTube channel, where he says that one of the main driving passions that he maintains is pushed by the notion of what is true, what is true. And I would say that over the years of the COVID adventure slash debacle, that desire to find, to identify the truth has become especially pertinent and timely. And so with that in mind, in pursuit of the truth, I cannot wait any longer to introduce Dr. John Campbell. Good afternoon, John. Good afternoon, Neil, and thank you for having me. And we're currently in a very wet and windy Carlisle, so it's great to be inside with you. Yeah, I was fascinated to learn that your base is Carlisle. I grew up mostly in Dumfries, which is just less than 30 miles, I think, from Carlisle. You're in the English side, I'm in the Scottish side of the border, but it's interesting to me to know that you're in a place that I know very, very well. And I think before we get into matters COVID and matters scientific really, because of the way in which we all encounter you, which is sitting in that home office and working with the numbers all the time, working with those documents, it kind of feels as if you've appeared out of nowhere. You're just suddenly in our lives, those of us that follow you and listen to your output. But I'm fascinated to know more about your background and more about how all of this came to pass. I suppose I can start with, I suppose, by saying, what was it that nudged you in the direction of nursing and medicine and science as a career? I have actually been around for a while, just a little over 60 years now actually. I was actually born in Scotland, up in Ayrshire, when we moved to England when I was a child. I actually went into psychiatric nursing when I was 18. I just applied for a job at the local, it was an institution in those days, a local psychiatric hospital. And I did the normal three year training to be a registered a mental nurse, as we called them in those days. And then I carried on and did the training in adult nursing after that. But I always liked teaching. So I sort of started started pursuing some academic interests, even, even way back then when I was a young staff nurse, and I worked as a staff nurse basically for about 10 years, some work overseas, mostly in the UK. And after that, I decided to go into full time nurse education. What was it about nursing? Was there a background? Was it in your family? You know, as an 18 year old, to contemplate psychiatric nursing, it's quite a challenging step. You know, I've actually often wondered that myself. I left school when I was about 17 and actually started working in a lab. And it was it was interesting, but I knew it wasn't really for me. I like working with people, a more sort of interpersonal sort of, sort of thing. So, you know, I thought some aspect of nursing would be interesting and psychiatric nursing, then there was a lot more men in psychiatric nursing. So it felt like a more kind of natural fit. So I went into that. But once I started doing it, I just became fascinated. with the mind and the way that the body works and the way it goes wrong.

It's just a field of infinite interest and complexity, combined with the way that you interact with people. So you've got some of the science side, but you've got this personal interaction. And especially as a student nurse, as a young staff nurse, you're actually working hands on with people all the time. So you develop a lot of skills. And because I'd always been interested in science, I started finding out ways to try to tie the skills, what you're actually doing, tying that together with the underpinning science, the underpinning physiology. So I just really kept doing that. And then after 10 years of that, I did a full time course to be a nurse tutor. And I'm afraid I did that for 27 years. And a gentleman called Mr. Blair in the 1990s decided that nurse education should go into higher education. So we actually moved into universities after that. And in university, they seem to think academic things are important. So I went more down the academic route. I'd already done a first degree in science by that time. So I went on and did a couple of research degrees, a master's degree, and then eventually the PhD, which was really pretty well a pure research degree. In terms of media, I was always frustrated that that I wanted to work in poor countries. I had worked in poor countries in the past. And I knew I couldn't do that because I was working in the UK and obviously got family commitments and work commitments. So what I did is I started making, as you say, these old VHS videotapes. And we used to send these to various, various places. And we made we made about, probably made about 30, 40 hours of recording, just recording all the basic lectures, then of course, DVDs came along. So we jumped onto DVDs. And then YouTube came along. And we started doing YouTube in 2007. So fairly early adopter of YouTube. And then the subscribers from there did start to increase. We were getting, by the time COVID came along, between 2007 and 2018, 2019, we got up to about 20, 30,000 views a day. And I'd done some more formalized video based education for the NHS by then as well that was used to train up the nurse. Was it always just straightforward educational content or did you ever, you know, were you ever giving your opinion? And were you ever, you know, you know, broadening out, you know, when you talk about being pulled into or drawn towards psychiatric nursing because of your interest in people, did you ever, were any of, was any of your output at that point, you know, more broad ranging or were you always in your own mind just teaching? Yeah, it was basically just teaching, it was taking what I do in the classroom and kind of bottling that into videos into a form that could be used around the world. So what I started off doing was I started basically doing all the systems of the body. So I did all the basic physiology. And then I did a lot of the pathophysiology, the way that the body goes wrong, the main heart diseases, lung diseases, kidney diseases, liver diseases, I did all that. And then I started trying to relate that more to patient care and looking at the way you carry out investigations, the way you assess patients, the way you plan care, the way you implement care, and the way you evaluate care. So it was very much just objective things you would do in the classroom, really keeping on fairly safe ground. When you say that you were involved, you know, you got into psychiatric nursing when you were 18. How have you seen that world of nursing change across the decades of your involvement in the profession?

Yeah, it has changed quite dramatically. I mean, when I started psychiatric nursing, it was basically a total institution. And this was in 1975, actually, when I started doing this. And a lot of the patients were institutionalized. Quite honest, a lot of the staff were institutionalized.

It was a generation of old time porters and staff nurses and charge nurses that had been there since pretty well since the end of the Second World War. So it was it was quite institutionalized. And of course, that that all changed after I left psychiatric nursing and went into general nursing. That did all change and the institutions aren't aren't really there anymore. The big change for me was I went into nurse education in about 1989, 1990. And then before that, we had almost like a kind of an apprenticeship system. So basically, I trained as an apprentice, we just went to work on the wards, we did three months here, three months there. We had the odd few weeks, what we called in school, where we did some academic basic work. But then, in about the early 1990s, we had this new thing called Project 2000. And we went on to diploma nursing and degree nursing. So the aim was to make it more academic. That was the idea that this sort of new approach, it probably didn't work, as well as some people would like to give the impression that it worked. The people that were coming into nursing were basically the same, there were people that liked practical things, primarily, rather than academic things. And then of course, we moved into higher education also in the 90s. And that was quite good at first, but then we had to comply with a lot of university protocols and ways of thinking at university organisational structures. And I personally found that quite difficult. I'm not really a structures person, but you had to spend quite a lot of time doing that rather than actually thinking about the actual work that you were doing. But I always tried to keep up the academic things and the open learning things and producing materials that can be used on a fairly wide basis. When you look back from now and you compare the nursing training that you had, as you see, as a job going into an institution or a hospital and just doing the job and learning in that way, compared to the way in which it became much more of an academic pursuit. What do you think has been gained? What do you think has been lost on account of that transition from one to the other?

I think probably the main thing is it's actually influenced the type of person that goes in for the job. So I've worked with some completely exceptional clinical nurses who might not be very academic, who might not be very good at writing essays. So so now you can qualify in nursing, but you need to be quite good at writing essays to do that, as well as doing the practical work. Now, you could argue that that's improved the academic level, which is true. But when I was a young staff nurse, we had two grades of nurse, we had enrolled nurses that were considered to be the sort of bedside nurse. And we had the the staff nurses who were considered to be the sort of more high flying nurses that would be managers and teachers and things in the future.

And I really feel out that we've lost out on that quite badly for a long time. But we are now starting to have a nursing apprenticeship again. So there's actually two ways to go into nursing now. You can go through the academic route, or there is now an apprenticeship route as well. So it's good to see that that's coming back, because we need to encourage practical skills. And the fact that you can write an academic essay really has very little to do with how good you're going to be in clinical practice. There are two actually different things. You could argue, to put this educationally, that it's a non-valid assessment, that you're actually testing for something that you're not actually wanting people to do the job for. And I think there's an increasing realisation of this, but there's a lot of people in nursing who want to still keep it academic, they see that as being more prestigious. But in actual fact, the academic content is somewhat nebulous. It's not like the established sciences like physics, chemistry, biology, or, or even anthropology or sociology, where there's a recognised academic level. In nursing, you just kind of, the academic level is somewhat subjective, different institutions will have different academic levels that they expect the students to get up to. And sometimes, unfortunately, the clinical aspects are somewhat divorced from that, which is really quite unfortunate.

What about the transition from the world, I suppose, of what would have been nursing in my childhood of where the ward was run by a matron and the each hospital or institution was a world unto itself to some extent, where now the whole hierarchical structure and the management structure of the NHS, you know, again, which of the two worlds would you would you prefer if you had to choose between the two?

Yeah, I think that's a pretty short debate. The old systems are often much, much better. So for example, in the psychiatric hospital I worked in, that there was there was one person and his assistant did the wages for all the staff. And you know, everyone knew where they stood, if there was a mistake, which there wasn't, you knew who to go and fix it. There was one person would do all of the placements and supervise all the nurse education. In terms of nursing, there was a there was charge nurses or ward sisters, and there was nursing officers and there was a senior nursing officer that later became a matron. But everyone knew where they stood, whereas now, it's partly my fault, because I don't really understand systems very well. There's a very great sort of level of complexity. And, and there's other constraints as well. So you really don't know anymore, what opinions you're allowed to hold, whether you're allowed to hold individual opinions, probably more so in education in higher education than in clinical nursing. But it is a much more confusing world. And you certainly see a lot of people around and you're not quite sure what job they do.

All we seem to hear now, it's happening right now as we speak in terms of striking and all the rest is dissatisfaction in the profession of nursing and right across the board with doctors as well and hospital doctors and GP doctors and the rest of it. It does seem as though some of the or a great deal of the job satisfaction has somehow been eroded by all the systems. As you say, you don't really understand systems, but all the systems that have been put in place seem to have, I don't know, taken the joy out of care.

I think I think you're right. I mean, the interpersonal relationship between a nurse and a doctor and their patients, it still can be, it really is quite a precious one. So I had patients that I'd look after for days, weeks, sometimes even months, and you establish a relationship with those patients. And as well as that, we still have this token idea of a named nurse or a named doctor, but very often it doesn't work out very well these days. So you don't really get to know your patients anymore. And my medical practice, for example, is actually quite good, given the constraints that we have. But every time you go, you tend to see a different doctor, you don't really have a family doctor anymore, you don't have the continuity. And that's absolutely vital to understand, to be able to assess your patient, you can't really assess a patient with a telephone triage, you're not seeing the clinical features, you don't know the background to that patient. And each consultation becomes more like sort of a flowchart algorithm rather than interpersonal reaction. I think what we really need is more personalised care, and introduce more interest in the individual, put back what you might call a bit of love into patient care. Strikes me as a great sadness that it must be surely that at heart, nursing is care, it is an interpersonal relationship, it is between one human being and another. And to take that, to alter that to the point where it feels as if we are looking after the NHS now. I'm always troubled by this incessant use of the expression, our NHS. It has become a bit like it's the institution itself has to be looked after by the population now, rather than rather than the other way around, where the NHS should be a population of people who are who are caring for the people.

Well, I always think it's the Gettysburg address, health care should be of the people for the people by the people.

This is how it should be. And I think it should be more localised as well. I've actually one of the best places I worked at was a local cottage hospital. And the staff there knew pretty well everyone in town, and people are coming at various stages of life, and very often they're coming at the last stage of life. And it was open, and it was just a thriving, natural part of the community.

It wasn't like an ivory tower that you visited, it was just part of the community that was sometimes necessary, and the staff there were integrated in the community. I've often wondered why the health service is so strained now. I mean, we do have a larger population, that's certainly true. But also what we're doing now is we're offering a lot more treatments. So even when I was a young staff nurse, a lot of terminal care would consist of giving analgesics, looking after people at home. Whereas now, because there are more treatment options that are available, people often seem to feel that because there's a treatment option available, it has to be used. So we're tending to use a lot more treatment options, and we have a lot more specialist people that will work in these areas. So I think part of the strain in health care is that we're just trying to do an awful lot more than we used to do. Now, very often that is a good thing to do, because there's more advanced treatments and people can be cured, but quite honestly, in the past would have died. But by the same token, you've got to consider that just because a treatment is available doesn't always mean it's desirable. So I think we need a more individualized approach. So for example, two people might have the same cancer, one might decide to go down the chemotherapy route, one may decide not to go down the chemotherapy route. But because the sophisticated treatments are there, and the sophisticated specialist surgeries are there, much more of it is done. So there seems to be a much wider range of interventions being carried out now. And mostly that's good, but it needs to be done with more individualized discernment, I think. Now, fundamentally, you do not strike me as someone who sought the limelight as such. Obviously, you're a teacher, so that puts you in front of groups of people. But it doesn't seem to me that you would take readily to being a very recognisable figure. So how do you feel about having emerged as such a key figure, viewed online by millions of people every week? How has that affected your own psychology? It is really quite bizarre. It was unanticipated. I mean, I think I think teachers to some degree are, you have to be a little bit egotistical to be a teacher, you're kind of walking into a class and saying, right, no, listen to me now, I'm going to teach you things. Even if you do it, even if you're doing a much more sort of what we call an ndrogogical approach, it's still the teacher that's in charge, even though that it might be a student centred learning. So I think, I think, teachers do to some extent like to hear the sound of their own voice. And that might be partly why I did all the recordings. But I think that the main motivation for doing all the recordings and recording all the basic physiology and pathophysiology was when I did lessons, sometimes you think, oh, that went quite well. And other times when you did lessons, you think, oh, that wasn't so good. But when you had a lesson that went well, you thought, you know, I'd really like to be able to just bottle that so I could bring it out anytime. So a lot of the things I'd worked out, I worked out ways of teaching them, ways of doing it. And that's what you do in teaching, you have some complex material. And physiology is complex, it's a very conceptual subject. So you have this material, you've worked out a way to teach it. And I just wanted to sort of condense that into a video. And so it will kind of be there forever. So that was the main desire. The fact that it was me in front of it, I didn't really feel one way about it or another. It's just what I do. I didn't particularly seek limelight. I wasn't particularly trying to avoid it. It came fairly natural. So now what I try and do is just analyze data, make sense of it and communicate it. So the main pride really, the main challenge is the communication. Do you still feel as if you're teaching? Is that your underlying philosophy, that you have acquired information and that you can educate? Because a lot of your content, especially more recently, has felt much more personal. And I can see on your face the extent to which the information that you have gleaned has affected you internally. Yeah. So really, when the pandemic started, I started covering the pandemic, hoping to make sense of that. And so it's been an interpretation of the pandemic, really. And of course, that has become subjective. And I must say, I agree with your assessment, it has become a much more emotional exercise. Because when I first started off covering the pandemic, looking back, I tended to believe what the chief medical officer and the chief scientist and the prime minister said, surely they have our best interests at heart. And you believe, I believe the official notifications from the government. And to begin with, I think their intentions were quite good, but then other vested interests did creep into that fairly quickly. We know we had scandals over personal protective equipment and how those contracts were awarded. But as time has gone on and there's been further evidence has accumulated. So now, for example, we know that the risk from COVID-19, the risk of dying from COVID-19 is massively less than it was. And we do know that there's more side effects from the vaccines than were previously thought. So this has changed the risk benefit analysis. And the trouble is the government guidelines don't seem to have changed with the risk benefit analysis. So I really feel that having gone from just believing what the government says, now, it's really hard to believe very much of what the government says because they seem to have been, they seem to be stuck in this sort of rut almost that they can't get out of without admitting that they've been wrong in the past. And because I've spent all my life working with patients, we know this is about men and women, boys and girls. You know, this is actually personal to me, to my family, to you, your family, and all the people that we represent and we live within the community. And there has been a great sort of disappointment really, in my breakdown of trust, of the official narrative. And that has been quite, to be quite honest, that's been quite traumatic. I've gone from a position where you think our leaders have our best interest in heart, to now wondering really where the heck some of these decisions are coming from. Because when I look at the ongoing evidence, I often come to very different conclusions than the official guidelines say. So if you look on the official guidelines now on the NHS, it still says the COVID vaccines are safe and effective. I mean, well, basically, we know that's not true.

We know that the vaccines are essentially, that there's a very small effect in the reducing transmissibility. We know there's particular changes in giving vaccines, particularly for certain members of the population. The idea that we will be giving mRNA vaccines at the moment to young men, to me, is completely unconscionable, because we know we have quite significant side effect risks from that. And we know that their risks of getting severe disease are almost negligible. Because to me, healthcare has always been about the individual.

We assess, plan, implement and evaluate care on the individual. Healthcare doesn't treat communities, it treats the individual. And if I'm treating you, Neil, as an individual, then I'm doing what's best for you. I'm not going to vaccinate you, to stop you making someone else sick, because healthcare is about helping the health of the individual. And we just seem to have completely lost sight of that. And that's apart from the fact that the science is saying that the vaccines now don't significantly reduce transmissibility anyway. Official sources just seem to have lost their way somehow, and I do find that very, very disappointing. Yeah, I mean, there have been guidelines set in place since the end of the Second World War, that an individual, any given individual was not to be treated for the betterment of the wider population. That was not to be the guiding principle. They were to be treated as that individual. And it was an egregious wrong to contemplate doing something to an individual to make things better for everybody else. And that seems to have been set aside completely in this push for the mass vaccination. I was going to say, I think there's two things there. Firstly, we know that the we know the vaccines are not having any significant effect on transmission. And even if they are, it's a small effect for a short period of time. So scientifically, there's no validity now to say get vaccinated to protect people around about you. At the peak of the pandemic, there was genuinely uncertainty as to what was happening. Looking back, I think the government should have had a lot more certainty than it had. I think the news that we were given was selective. I think mainstream media followed a particular narrative and really didn't give us any other choice. So we were sort of channeled into thinking in a particular way. But even then, I agree with you that the idea that you will give a treatment for the benefit of someone else is not basically what we do in healthcare. I mean, there are exceptions, of course. I mean, you get very noble people who give a bone marrow, for example, for transplantation, which is a medical procedure on them to help someone else. But that's the choice they make as an individual. And the key thing is they're making that choice based on full, informed consent. So if you're noble enough to give a bone marrow transplant, I'll say to you, well, this is a minor operation really for you. It's going to involve some discomfort.

We're going to take a sample of your bone marrow, but this could save someone else's life.

And you can say, you know what, you know what, I'm up for that. I'm happy to go through that discomfort. I'm happy to take that level of risk to save someone else's life. But you're making that as an informed, autonomous adult individual based on full information. So, I think people could make that choice, but it has to be based on full information.

So, if you say to a young man, well, you've got a sick grandfather at home, if I give you this particular vaccine, this might reduce the possibility of you giving the disease to your grandfather for perhaps a 10-week period, and it might reduce that probability by about 10%.

Now, if he says, well, yes, I think that's acceptable, then, okay, that's the risk he might take, if he knows that the possible adverse effects of the vaccine. But the point is, we've had this one-sized-fits-all sort of approach to this. And this means that everyone's treated the same. So the guidelines at the moment for vaccination, for example, don't differentiate on terms of age. They basically advise everyone to get it. And that's okay if it's based on completely open data. But the point is, the data is not free and the data is not open. Therefore, it is virtually impossible. It's pretty impossible for me to give a full risk benefit analysis, having followed this all the way through.

To give enough information for someone to make a fully informed decision at the moment, I don't think it's possible because we don't have the information to make that.

We don't have enough information to give them the information for them allowed to make a free informed decision. I can't imagine there are many people who've been as across as thoroughly across data, particularly ONS and official government data. You must be right up there in the top rank of those who were paying attention all the way through. Was there a moment, was there a week or a particular announcement or something that you noticed that tipped it for you where you thought I am no longer trusting that everyone has my best interests at heart and now I'm having to contemplate a different reality altogether? Or was it just a process of was it just a gradual accretion of doubt?

I mean, I think there are people that are much better at the data than me. I mean, I've talked to Professor Norman Fenton, for example, who's actually a proper, a proper statistician. But I think, I think the question marks in my mind started to arise perhaps at the end of 2021. So personally, I had the first two vaccines in 2020, but my last vaccine was now about 14 months ago. So we're back into the end of 2021. And by then the data was starting to accumulate, but then I decided on balance, I would have the third dose of vaccine. It was just a few weeks after that, by the beginning of 2022, I think there was significant doubts arose in my mind at that time. That's when the data started to come in, that there was probably more dangers to the vaccines than we've been told. Some of the side effects weren't being openly discussed. I mean, the side effects reporting system we have in this country, the yellow card system, for example, there's a lot of vaccine injuries and some vaccine deaths reported on that. But it's estimated that only between, and this is actually the agency themselves recognise this, between 2% and 4% of less severe side effects are reported. And only about 10% of severe side effects are reported. That's from the Medicines and Healthcare Products Regulatory Authority's own information. So we're getting massive underreporting of the data. And as well as that, especially when Omicron came along, I used to have a poster behind me that said stop COVID-19. I realized quite a long time back that that wasn't possible to stop it, that this virus was going to become endemic. And that means, as I understand this, everyone is going to be exposed, everyone's going to be exposed. And the great thing about Omicron is Omicron caused less severe disease than the previous waves. Now if Omicron hadn't come along, and the Delta wave had continued, the pandemic could have been a lot worse than it was. But when Omicron came along, everyone became infected. It really started concerning me that all the government releases and the mainstream media, virtually none of them, in fact no government release really I can think of, is talking about natural immunity. So the human immune system is capable of recognizing nine billion different foreign agents from outside. And this virus is just one of those. And as well as that, if you breathe this virus in, because it's a respiratory virus, that's going to stimulate immunity in your nose, your pharynx, your mouth, your trachea, it's what we call the mucosal compartment. You get mucosal compartment immunity. And because everyone in the country is aware of nd the country is exposed to this respiratory virus, we can assume that essentially everyone in the country now has got a level of natural immunity. And just from the sort of basic philosophical idea, the idea that induced immunity by giving injections, which, by the way, will not generate mucosal compartment immunity, the idea that that is better than the natural physiological immune system. Just seems a bit, almost a bit arrogant really to me. We have natural immunity to hundreds, thousands of viruses and bacteria out there. Really, why should this one be any different? Because it's becoming endemic, and we can't keep, even if the vaccines worked, which that's good evidence that there certainly, I think we could say there's a diminishing return nd on the vaccines. Why were we ignoring natural immunity? Now, some people who write in to my channel are a bit cynical about this, Neil, they say you can't make money out of natural immunity.

Knowing what you know now, you know, the journey that you've been on, if you had your time again, would you take that first dose?

You know, I've often thought about this, that is a really good question. At the time when I had my first dose, for my age group, the possibility of death, we thought from the information was about one, one and a half percent from COVID. Looking back, I don't think it was anything like that high now. Given the information that we had then about the risk of COVID, because we believe that the vaccine will prevent the transmission, given the information I had at the time, I think it was probably the right decision to have that first dose of vaccine, and arguably the second one. If you knew then, but if you knew then what you know now, but if you knew then what you know now, what would your, what would your choice be? Yeah, I've often thought about that. And I really can't be definitive about this, because there was a risk in those days, we're in the alpha wave, people were dying from COVID at that time. And if I knew then exactly what I knew now, on balance, I probably would not have had any of the vaccine doses. I am sceptical about well, this is a lot of people are sceptical about the PCR test.

But the way in which the PCR tests were being used during the COVID pandemic, when you look back now, do you think the figures were correct? That everyone who got a do you think that people that got positive results back from the PCR tests that they were doing and sending away, and as I was at the beginning, I mean, I had to do PCR tests to get into a building that I needed to get into to work. Do you have faith in those figures? If you take the PCR tests first, Neil, the PCR test takes some of the RNA, the ribonucleic acid from the virus, and it doubles it and multiplies it. Now, I can't quite remember the figures, but if you use about 20 cycles of the PCR test to multiply the amount of virus by about 20 times, that probably is accurate.

If you're going on and using multiples of 30 or 40, then it can give false positives. There's no question about that. So to answer your question definitively, I think we would need to know exactly how many cycles of PCR they were using to get those results. And I don't believe we have that information. If they've been using very high numbers of cycles in the PCR test, then you're quite correct. That would give false positives. But I don't know that we have that information. And this is part of the problem. There's a lot of information. There's so much information out there. It's hard for anyone to keep track of it all, of course. But also there's a lot of information we would like that is simply not in the public domain. So just to give you one example of that, in the original Pfizer and Moderna trials, the participant level data, data that gives the age, the sex, the co-morbidities of the individuals who took part in the trial, that participant level data is not in the public domain. If that was in the public domain, then people like Professor Fenton could go off and analyse it and give us a lot more information. So we need much more to be in the public domain. I'm sure that's true. So to answer the question on the PCR, we would need to know the cycle thresholds at various times in various places. That would then allow us to adjudicate how many of these tests were false positives. Were there false positives due to high cycle levels, then certainly there are, certainly there was. Do you think we'll ever get that information? I mean, is it lost in the fog of war, so to speak, or do you think information is being withheld? I suspect someone's got it. I don't know where it would be, but I suspect the information on how many cycles the PCR, the government, I'm sure the information on how many cycles of PCR the government laboratories were using at particular times in the pandemic is available from the government laboratories that were set up. I'm sure that, I think it was the Lighthouse laboratories they set up from memory. I'm sure that information is there. So it'd be good to have it. I was going to say in terms of people dying from COVID, I wasn't working clinically during the height of the pandemic, but of course I've got many friends who were. And with the Wuhan original wave and the alpha wave, and the delta wave, this virus did get down into the lower parts of the respiratory tract. It probably got there through systemic absorption, we now believe. But that did cause characteristic clinical findings that weren't seen in other infections. So one of the classic ones that was seen, for example, is what's called ground glass opacity. So when someone's got pneumonia, you look at the x-ray, then where they've got pneumonia, it goes white. It's called a whiteout because the x-rays are being absorbed. So in COVID acute respiratory distress syndrome, people were experiencing these severe clinical reactions and it was dropping their blood oxygen levels. Then when you looked at the x-rays, you did see this ground glass opacity. That's when steroids started to be used, these very cheap, readily available steroid drugs. And they significantly reduce that inflammation and help my colleagues save a lot of lives. So there is particular pathologies that are associated with the coronavirus disease. And there is no question that that killed people. Now, we could argue about how many people, because we've always got this argument of they did they die with COVID or from COVID, because at that time, of course, there was an awful lot of COVID about. And we know that the main risk factors now for that are increasing age. It was older people that died and still do die from complications. But of course, older people die anyway. That's the nature of the life cycle. So it was killing older people and also people with comorbidities, particularly obesity. We now know that people with obesity are more than twice as likely to die to die from COVID. So I actually believe, and this is why I found your question about would I be vaccinated against, would I be vaccinated against really quite, again, quite hard to answer, because I'm convinced that people were dying of COVID related disease and are now in China. The degree to which that was interacting with comorbidities, in a sense, is a bit of a red herring, because the COVID very often was the thing that actually facilitated the death, it accelerated the death. So the reason I actually came down and said, no, I wouldn't be vaccinated again was actually because I think I probably had COVID already in 2020. I just never tested, we didn't have the tests at those times. So I believe I already had some natural immunity. What did you make of the clampdown that there was on early treatment? You know, I've spent a lot of time talking to people like Tess Lorry, Pierre Corry, Jackie Stone, in South Africa, about, you know, the use of early repurposed drugs, early on before you'd rather than sending people home, you know, to, you know, to turn blue, you know, before bringing them back in and putting them on ventilators, and so on. What was what is your reaction now to the way in which early treatment with repurposed drugs was verboten? Yeah, the people you mentioned that, of course, Pierre Corry, leading leading United States respiratory physician, Jackie Stone, physician in Zimbabwe, worked at the very height of the pandemic in Zimbabwe, and Tess, of course, a medical doctor and a researcher. They've done quite incredible work. I actually interviewed Pierre Corry very early on, and we did two interviews. The first interview I did with Pierre Corry was on prednisolone, the use of steroids. And that's still on YouTube, it's still available. And he testified, of course, to Senate on the use of steroids, and as a result of that, they were instigated largely throughout the United States. And then, of course, he testified to Senate again on the use of ivermectin. So when you've got doctors of the caliber of Jackie Stone, Tess Laurie, Pierre Corry, saying, just a minute, there's a treatment here and I think it might work, whether it works or not doesn't matter. When people of that caliber are saying, look, I've got a treatment here, I think we should investigate it, then the mere fact that they're saying, we think you should investigate, it means that it should be investigated, not that all arguments should be, should be shut down altogether. So really, whether it works or not isn't the issue. The issue here is can we have open and honest debate? We used to have something called a medical opinion, where doctors were allowed to give their opinion. And it appears Pierre Couey wasn't allowed to give us an opinion. And the other thing about ivermectin was that there's over four billion, over four billion, over 4,000 million doses, I think, the figures of ivermectin have been given throughout the world. And it's known to be one of the world's safest drugs. So what I always want to know, if someone asks me if a particular treatment is a good idea, I say, well, look, what benefit could you get from this treatment? And what are the risks? Now, given that ivermectin may have some beneficial effect, again, it's hard to tell. I'm pretty convinced it does. But whether it does or not, the fact that it's safe means that it's okay to give it a go. Why not? You know, if there's not many risks and there's a potential benefit, then let's go for it. Why on earth would you not be allowed to mention, as you say, an award-winning drug that's been given billions of times and has an unbelievably good safety record? The fact that that was not allowed to be talked about, I can only describe that as sinister. I think sinister is the right word to use there, Neil, because we're just not allowed to discuss it, we weren't allowed to debate it. So what I'd like to do is give evidence that ivermectin is effective, give evidence that it might not be an argument and come to some kind of conclusion on that. But the fact that we weren't allowed to discuss it on YouTube, on Facebook, up until recently, in fact, on Twitter, that's changed now completely, of course. But not being able to discuss what is essentially a scientific matter is really, I agree, that is really quite a sinister thing that this is not open to public debate. And the other thing about ivermectin, of course, is, if we take that as the example, I think I worked out once that the WHO price was about two or three cents per tablet. It's essentially free and it's got very low risk of side effects. So why not instigate some sort of clinical trial where we looked at that? Now, there is a trial going on in the UK that was started on ivermectin a long, long time ago. I can't remember the details of it now, but it hasn't reported yet. So again, it's just a bit strange that it hasn't reported yet. And Santoshio Moro's institution in Japan, early in the pandemic, were prepared to...Santoshio Moro was one of the scientists who won the Nobel Prize for the original discovery of ivermectin with William Campbell. They were willing to investigate this clinically, but of course the pharmaceutical industry didn't want to do this. Now, again, cynical people would say this is because they can't patent it. You can't make any money out of drugs which have been around for more than 15 years. And who knows? Whatever way, the pharmaceutical industry didn't want to trial it. Neither can you get emergency use authorization if there are alternative credible therapies for the disease in hand. There were monetary reasons for wanting to quash any suggestion that anything else that was available would have been safe and effective in relation to COVID-19. The emergency use authorization from memory, that's true in the United States. I don't know how true that is in the United Kingdom. The fact that the pharmaceutical industry weren't prepared to trial a drug that they couldn't make any money out of, and they conveniently were able to say it didn't work, and they were conveniently able to ban that from mass media, just meant that the debate couldn't take place. That really is, because we repurpose loads of drugs. Aspirin, for example, used to be a painkiller, now we give it as a blood thinner. Repurposing drugs is absolutely normal in healthcare. Something that you've obviously been on talking about repeatedly recently is excess deaths. How do you interpret the media and the government and the scientific silence around excess deaths? I've heard you quoting figures of two and a half thousand excess deaths a week. And at the height of the pandemic, you know, the daily death toll was read out, you know, like a tolling bell. And now no one's known in the mainstream, and no government figures are standing up and saying, hold on, what's going on with all the excess deaths? How do you read that? Yeah, there's no question. Last week for the Christmas week, there was 20.01 more deaths than we would expect for the same week in England and Wales. The equivalent figure in Australia is about 16%. Most European countries have had more deaths than we would expect. In America, it's harder to judge, but it looks like they've got this problem as well. So more people are dying than we would expect. So the official government line and the BBC line on this other mass media line is to say, well, this is due to disruption in healthcare. This is due to people not being able to access healthcare. This is due to organizational problems. And there's no question in my mind that there is some truth in that, but there's other factors as well. So one factor I'd like answered is we need complete data on the excess deaths broken down by people who've been vaccinated and not vaccinated for COVID with the mRNA and the adenovirus vector vaccines, and the degree to which one, two, three further doses of vaccine are associated with excess deaths. And that data is very, very difficult to get. One of the reasons I'd really like this data, Neil, is there was a study of people that died, often young people that died in Germany. It's, I guess, what would cause spontaneous deaths. And in Germany, they did a post-mortem series on these. And they actually looked at the heart muscle, the myocardium, and they found focal areas of damage in the myocardium. And they're actually able to look at these areas of damage in detail, and they found residues of spike protein in there, but not the other proteins from the virus, not the envelope protein or the eukaryocapsid protein, indicating that it was probably the vaccines that had caused this myocardial injury. Now, the authors of the paper weren't definitive about it. We need a bigger series of this to be done. But as far as I know, this work is not being replicated. So when something in science like this comes up, the whole point of publishing this is not to say that's a slam dunk we now know. The whole point is that people around the world can say, really? That's interesting. I better see if I can reproduce these findings. And given that young people are dying from spontaneous cardiac deaths, in my mind, this always should have been an emergency. We should be investigating this. The pathologist should be investigating this. There should be investigations. Then at the end of these investigations, we can say, you know what, those provisional findings in Germany, we haven't substantiated that with our research. Well, do you know what, those original findings in Germany, well, they do seem to be bearing water, evidence is accumulating, therefore we will take action to prevent further cases arising. But, you know, we just, it doesn't seem to have stimulated the required interest in the scientific communities as supported by governments. The worst of it for me is that we know that people are dying, all age groups, and it looks like heart attacks and things to do with the cardiovascular system, let's say, seem to be key in this story. And the government and the media have joined hands to say, well, it's probably because people weren't able to access health services for a couple of years. And there's an end of it. Rather than say, however, we really, because of the nature of this emergency, because we've got thousands of people dying a week that shouldn't be dying and haven't died like this before, we really ought to cover all the bases. But they're not. It's like, okay, people couldn't get to their GP for two years. That'll be it. And now move on. Again, that strikes me as sinister. Why can't they just open up and engage in a conversation that looks at all the options? Yeah, I mean, it's somewhere between simplistic and sinister, isn't it? To say that, well, we know the cause already before we've done the investigations is simplistic nonsense. Of course, you don't know the reason for these things until you actually do the investigations. The mere fact that we've had a difficulty in getting health care in some parts of the society for a period of time and now we're seeing excess deaths, that's what you would call a temporal correlation. We need to decide the degree to which that is causal, and part of it probably is causal. But I also believe that there's several other factors. And the fact that we have now, if you take here in Australia, for example, with both instigated mRNA vaccination programs, could this be a factor in the excess deaths? Well, I don't pretend to know that. That's why we should have the investigation, the fact that there's a reasonable risk of this, as indicated by the German data. It means that the government should be investigating this, it should be giving research funding, because we have plenty of people can study this. It should be investigated as a possible cause, and then we'll know for sure. But we just don't have that trust in government that can do this. Basically, I don't trust the government to take that on at the moment, because there seems to be so much interest, vested interest in not saying that they've been wrong over the past couple of years. And some people think they're a bit concerned about upsetting various components of the corporate world as well. I'm some of those people, John. I'm some of those people who think that. The whole point about the science. I mean, there is a scientific process. You know, someone says, is this the case? Then you collect more data, you reanalyse that data, and then you come to firm conclusions. At the moment, my conclusion at the moment, based on the data I have, is that the vaccines are accounting for some of the excess deaths that we're seeing. The mere fact that this is a possibility means that it should be investigated. And as you say, Neil, last week the excess deaths were 1,500 in the UK, give or take. The week before that it was about 2,500 excess deaths in the week leading up to the 23rd of December. Just imagine there was a terrorist attack and 2,000 people were killed. Well, we don't need to imagine. We've had that, haven't we? We've had that in the 9-11 situation. And look at the response. But the fact that people are dying in diffused parts of the country and it's not all in one place means that somehow it's being ignored but we have this huge excess deaths and we're not seeing the Chief Scientific Officer, the Prime Minister and the Chief Medical Officer standing on TV like we saw in the pandemic saying well we've got a bit of a crisis here but we are addressing it and we are working out what is going on. It is the silence that is deafening. When it comes to Big Pharma, obviously, somebody working as a nurse and throughout your career, you'll have been inhabiting the same ecosystem as Big Pharma. What did you think of Big Pharma before all this? And what do you make of that entity now? I've always, for some time, and I've taught this for some time, I've realized that the pharmaceutical industry is interested in selling us their drugs. So one of the classic cases in this was an Australian doctor called Barry Marshall, back in about late 80s, about 1990, I think. He discovered that stomach ulcers were caused by a bacteria, Helicobacter pylori, and he discovered that this was curable. We could actually cure, eradicate this Helicobacter pylori. Now what that means is, instead of someone having chronic gastritis over a lifetime, and having to take medicines every day for that, you could take medicines for a week or two and eradicate it. And to begin with, that didn't go down very well at all with the pharmaceutical industry. And Michael Mosely made a video, a Horizon video on this called Ulcer Wars, where he highlighted this. And Barry Marshall actually, to prove his case, actually drank some of the helicobacter pylori, made himself sick and then cured himself. And it was only after that that this started to gain wider acceptance. So way back in the 90s, I realized that the pharmaceutical industry is not so much interested in curative treatments, rather than if you sell a drug every day for the rest of your life, they're going to make more money out of that. So that was made me a bit cynical of them. Since the COVID pandemic has come along, I've become more cynical. For example, the original papers on the vaccines, we still don't have the participant level data. One of the other things that's concerning, and to tell you the truth, took me in to some extent, I feel a bit fooled by this, that they gave their results in terms of relative risk, rather than absolute risk. And the papers are written in a way which makes the products look good, rather than what a scientific paper should do, which is analyze. Analyze the product. So I got the feeling that papers were being written in a way that was particularly sympathetic to the pharmaceutical industry and not sufficiently analytical, not sufficiently adversarial. And that means I feel we have the risk of what you would call a publication bias. So bodies around the world like the Knight Institute in the UK, for example, would look at the evidence, but that evidence comes from peer-reviewed literature. And peer-reviewed literature, the best peer-reviewed literature is randomized double-blind controlled trials. It's good. The trouble is they cost about $10 million each to put on. Who can afford to put those on? Well, it's the pharmaceutical industry that can afford to put those trials on. I can't afford to run a trial at $10 million any more than you can. So they are selecting what is studied, having an influence, I think we can say, at least on the way it's published. Journals are being, in my view, selective in what they're publishing. So for example, they were very happy publishing on the efficacy of a vaccine. They weren't happy publishing on the potential efficacy of, as we've said, ivermectin hydroxychloroquine. Whether they work or not, let's analyze that. So we have this publication bias, and that means that a lot of the evidence that we have to draw on is itself already selective. So rather than being able to look at the whole world of creation, the whole world of nature, we can actually look at the part of the world that money has been spent on doing these trials to give these high quality, in inverted commas, high quality publications. That's so many of our public health decisions are based on. And that, to me, is arguably somewhat incestuous, rather than having a completely free range of scientists to investigate what they think appropriate, coming up with things that are beneficial, even if those things happen to be low cost. There is talk now—you will be well aware of it—of moving vaccination wholly into the realm of mRNA, so where before there has been a different way in which vaccination has been acquired and how it has been introduced to people's bodies, there is now talk about it being mRNA all the way. With that, and also with what has happened in the last two years, what do you think is the status of the culture of vaccination here in this country and around the world? My kids are all teenagers now, but we got them all, the MMR and all the childhood vaccinations, everything that was going, that our kids got. How much damage or how much of a hit do you think that faith in vaccination has taken? Just to validate what you have said there, Neil, the British government have recently announced a collaboration with Moderna, and they are building a plant to produce 250 million mRNA vaccines a year in the UK. There is a similar plant to generate 100 million doses per year in Australia, and a similar plant to generate 100 million doses per year in Canada. Now, I think we have to distinguish, really, between traditional vaccines and the mRNA vaccines. So, the traditional vaccines, what you're normally doing is you are taking the virus or the bacterium. You kill it, usually, or you attenuate it, or you mush it up in various ways, so you're actually giving dead virus or bacteria, what we call antigens. The immune system then recognizes that, and it makes antibodies and stimulates the immune cells to combat that. Because that is foreign material, it will be eradicated by the body's immune system really fairly quickly. It's not going to hang around in the immune system. The word vaccine comes from vacos for cow, because the original vaccine, the Edward Jenner vaccine was cowpox given to a young boy called James Phipps, who was the first person to receive it, and it protected him against smallpox. That's where it all came from. After that, we developed lots of antigens that we give to protect us against the live version of that antigen. Whereas the mRNA vaccines are completely different. In fact, some people think they shouldn't even be called vaccines. They're actually giving this messenger RNA, and it's given in a small lipid nanoparticle, and that will go into our cells because the lipid envelope around the mRNA vaccine will dissolve into the lipids around about our cells. It will go into the cells, and then it's the cell's own genetic information that is actually making the antigen, and it will export that to the cell surface. So what we're doing here is we're actually kind of conning the body into making an antigen that the immune system will recognize, and in the case of the mRNA vaccines that's making part of the spike protein. Now my current thinking on this is that if the systemic absorption of the mRNA vaccine, so what's supposed to happen, you inject it into your arm and if it stays in your arm, it'll give you a sore arm, but your arm cells in the immune system there will take in this mRNA and will make the antigen, that antigen will then be expressed on the surface of our cells and the immune system will recognize it. But if the systemic absorption of the mRNA nanoparticles, then that means they're going to go everywhere. And all of the cells in the body have these fatty phospholipid cell membranes. So I can see no reason, this is my thinking at the moment, why these lipid nanoparticles cannot go into any cell in the body. For example, if the systemic absorption of the vaccine dose, it could go through the heart, be absorbed into the myocardium. And I don't see any reason why, just as the cells in your arm can take in the messenger RNA and produce an antigen, that shouldn't happen in the cells of the myocardium. And again, my thinking is that the myocardium cell, the myocardial cells would then produce this antigen, put it onto the surface of the myocardial cell. That would then be recognized by the immune system, which would generate an immune response. But with the immune response, we also get an inflammatory response. When we get an inflammatory response in medicine, we call that itis. So if it was the myocardium, inflammation of the myocardium, myocarditis. Myocarditis can result in irregular electrical activity in the heart, which can result in potentially life-threatening cardiac arrest situations. So I don't see why this would not occur with any mRNA vaccine, because the whole point of the mRNA vaccines is it stimulating the body to produce an antigen. And that antigen, by definition, is going to cause an immunological and an inflammatory response. So to me, racing ahead with factories to build 250 million doses in the UK, 100 million doses in Canada, 100 million doses a year in Australia, before this vaccine has been thoroughly trialed, I just can't quite work out why they would want to do that. Why would they risk so much money for a vaccine technology which is essentially unproved and there's good theoretical reasons, as we've just discussed, to suggest it could cause systemic inflammation? The other point that you've made there is people are confusing mRNA vaccines with other vaccines, and they are completely different. So the vaccines that you gave your kids, I gave my kids, I had a tetanus booster before I went to Africa a few months ago. These are giving things that are associated with the viruses and bacteria, just giving those as usually as a dead product, although some vaccines are like yellow fever, for example, the antigen is essentially alive. But normally it's dead or attenuated. Therefore, the body will get rid of it quickly. It's not using the body's own genetic apparatus to produce them. It is a completely different thing with a completely risk benefit analysis. That was part of the problem. We know that there's very small risks associated with traditional vaccines. And we also know that childhood vaccination has saved, there's no question in my mind about it, saved millions of lives around the planet. I mean, smallpox, for example, was eradicated through vaccination. Smallpox was a terrible, terrible disease. So there's no question these traditional vaccines have saved millions and millions of lives and continue to do so. Measles vaccine, measles is an awful disease. Measles kills lots of children around the world. And to vaccinate against that with an attenuated measles virus, I still believe it is a remarkably good idea. So, because we know these vaccines are quite safe, when the mRNA vaccines came along, we thought, well, this is a vaccine, and we know that vaccines are quite safe. But this is a completely different class of vaccine. Because we are stimulating the body into making the antigen, rather than giving the antigen, it's a completely different thing. Okay, again, then, John, how much damage do you think will have been done to vaccination as a procedure that previously we had all just taken for granted, particularly in relation to our kids, but as you also mentioned for going on holiday and going to different parts of the world, how much damage do you think has been done to the trust that was built up over 100 years? Yeah. Again, two things there. I think that trust has been substantially damaged, if there's any question about that. The word vaccination has been tarnished. But as well as that, because the World Health Organization have focused so much on COVID procedures, the other vaccines are particularly in poorer countries, like the measles vaccine, like the tetanus vaccine that we mentioned. A lot of children have not been vaccinated against that, and there's going to be a lot more disease around the world as a consequence of that. But the trust issue is a significant one. Now, I think most people, most parents, for example, are able to differentiate between the modern mRNA vaccines and the traditional vaccines.

But this idea that we have that more and more vaccines, for example, and pretty short in the United States at the moment, they're producing an mRNA flu vaccine.

And again, to me, the risks of systemic absorption there would be the same as with any other potential mRNA vaccine. Why would people want to go on to an improved technology before there's been very, very extensive animal and clinical work done on that? So at the moment, most of our vaccines are not the mRNA vaccines, apart from the COVID ones. But as more and more potentially become our mRNA vaccines, I just find that really quite an alarming prospect. And I do greatly regret the damage that has been done to the beneficial aspects of our vaccination program in the UK, which is, has been very good. Damage has been done. Yeah.

Yeah, I can tell you, John, if I was, you know, in a different time of life, and I had three, you know, toddler or younger infants now, and I was confronted knowing what I know now, or suspecting what I suspect now, with having to get them treated with mRNA vaccines for everything, for the whole suite of childhood ailments, I wouldn't. No, I wouldn't put them under the needle.

No. If we're going to use mRNA vaccines for other antigen production, there must be complete, transparent, overwhelming evidence of safety. And at the moment, we haven't got that, so I wouldn't even contemplate it. Most of, well, as far as I understand it, all the other vaccines have got a recognised safety record, and the data is more transparent. But I think most people know not to conflate mRNA vaccines with the other vaccines. I think the level of education in the public on that is fairly good. But you're right, it does make you question, and it's this whole issue we've been talking about, the sense of betrayal and the lack of trust. It means that it's harder to trust anything, anything from the government. The facts have come out like we know that the regulators receive substantial amounts of money from the corporate world, for example. That just doesn't sit right at all. And yet we are told that all the decisions they make are objective and based on science. That may be true, but it's not a good look, not a good look at all. We have, we have, I think, as you rightly say, a crisis of trust in many areas of health care. Well, thank you, John, you've been very generous with your time. I'll just ask you one final question before we before we wrap up. And it's been an absolute pleasure to talk to you. The NHS is obviously a troubled and troublesome entity at the moment and has been for a long time. If you rule the world, how would you begin to turn around the fortunes of health care in Great Britain? How would you start to fix the NHS? That's a real tough one. One of the things we need to do is get the right people into the right jobs. So I think we need substantial changes in our approach to nurse education, doctor of education, physiotherapist education, pharmacist education, the people that we take into those trainings. They need to have the ability to do it academically, of course, but we also need to make sure they're right sort of caring personality types for that. So I think there needs to be much bigger emphasis on getting the right personality type, the right amount of caring. And as long as the basic intelligence is there, then hopefully as educators we can do the rest. And that's going to take time to feed through. The idea that in this country we can't train enough dentists, doctors, nurses, pharmacists of our own, from the young people in the United Kingdom to me. The fact that we can't get our act together and produce enough of these people to me is just bewildering. We have the academics, we have the institution, we have the clinical experience. Why the heck can't we train our own nurses and doctors? That is just completely, utterly bewildering. In terms of the large organizational problems with the health service, I think one one aspect might be making it much more local to introduce a sort of a local pride. Even when I was a young staff nurse, we had a pride in our local hospital. We had respect for our consultants. That local thing was there and people would come in on a voluntary basis and support their own hospitals, support their own institution. Whereas now we have this kind of national one size fits all gender. But as well as that, I think we need to be honest that there are lots of treatments available now, lots of specialist treatments available, often requiring specialized staff, often requiring quite sophisticated treatment. And at the moment, who gets these sophisticated treatments is somewhat arbitrary. I mean, certainly if you live in Africa, you're not going to get them, or parts of Uganda, where we've been working with Community Health recently. You're not going to get them. So I think we need to be really quite honest about what treatments we can afford, and also what treatments are appropriate. If we take surgery, for example, to me, surgery should be people that have diseases, people that are sick. The idea that certain forms of surgery might be available to people that aren't ill is questionable. There's aspects of healthcare that perhaps are delivered under healthcare now, which maybe should be under a different category, because as no nation can afford all of the potential healthcare interventions that are available to all of the people. So we do need honesty and debate about which interventions can carry on, and which interventions, to be quite honest, we can't afford and sometimes aren't always appropriate. Obviously, that should always be done by negotiation with the individual as far as possible. But I think we have to be humble about it and realize that there are limitations. And at the end of the day, we have to realize that you and I are mortal. What about the many layers of management? Are there simply too many suits and not enough nurses and doctors uniforms? There are certainly publicized cases, aren't there, of utterly bizarre job titles in the health service that reflect the current, shall we say, zeitgeist, the current political with a small p climate, which do seem to be really quite absurd. I think we do need to consolidate aspects of management. We do need to look at the way things are done, all the way down from the senior civil servants that organise these things, all the way down to the lower levels. We do need to prioritise clinical care, but there again, there is administration needs to be done. But the point is, I don't pretend to understand these structures, because they are so complicated. But I do know from personal experience that we get a lot of people that carry out activities which are complex that they understand, that really it's just people generating complexity to make themselves indispensable in some aspects. And we need to have someone who has the authority to cut through that, sometimes to be quite draconian in that. But people do tend to build their own little empires, their own little power base, and they can be very good at making themselves look indispensable. Whereas we need someone who's got the authority to say, well, no, actually, I think that you are dispensable, whereas this group here is not dispensable. So we need someone who knows the system really very well, has these management organisations, and the potential for cost saving and streamlining is significant. There's no question about that, and it needs to be done, I think, as a matter of some urgency. John, it's been an absolute eye-opener and privilege to talk to you. I would just say that you, of all the many people that I've been listening to for the last two or three years, your journey has been so instructive, the way in which you've always just called it as you've seen it, so refreshing and so reassuring. And apart from anything else, I look on at you and consider you to be someone that I just trust. I trust that you will tell me what you understand to be the truth. So, John Campbell, it's been a privilege talking to you. Thanks very much for your time, Neil.