Doctor, I feel slightly funny

The nation is healthier than ever, yet the NHS is permanently struggling to cope. The comedian Dr Phil Hammond explains why patients, politicians and drug companies have a lot to answer for

There's a theory that the real problem with the NHS is not too few doctors, but too many patients. Some politicians like to pin it on the fact that we've become a nation of accident-prone, alcoholic, smoking lard-buckets. If only we could all learn to eat, drink and be merry responsibly, then half the health budget wouldn't be frittered away on potentially preventable diseases. Sociologists prefer to blame the politicians for creating mass involuntary euthanasia in the UK. It's called living in the North of England. The rich live 10 years longer than the poor and the gap is widening under Labour. Until it narrows, no health service will ever cope.

There's a theory that the real problem with the NHS is not too few doctors, but too many patients. Some politicians like to pin it on the fact that we've become a nation of accident-prone, alcoholic, smoking lard-buckets. If only we could all learn to eat, drink and be merry responsibly, then half the health budget wouldn't be frittered away on potentially preventable diseases. Sociologists prefer to blame the politicians for creating mass involuntary euthanasia in the UK. It's called living in the North of England. The rich live 10 years longer than the poor and the gap is widening under Labour. Until it narrows, no health service will ever cope.

An additional strain on the NHS is that it is full of patients who have little to gain from being there. The beauty of the NHS – that you can be scraped off the pavement without having to check for your Barclaycard – is also its weakness. Any service that is free at the front door encourages life's little problems to become medicalised. A GP friend was phoned at 3am by the relative of a man marching drunk down the high street with his glass eye balanced on the end of his penis. It's a fine trick, and worthy of an audience, but it doesn't have to be a doctor.

Another GP has a T-shirt with "CAMERA" on it; the Campaign for Real Ailments. Much of his workload consists of defusing the anxiety of an increasingly worried well population who don't have any discernible disease, just an awareness of what might, or might not, be "risk factors". Alas, in the doomed pursuit of a risk-free life, their new health awareness makes them pathologically anxious and they end up on anti-depressants. Great for the drug industry, but not great medicine.

The explosion of anti-depressant prescriptions is a global phenomenon. Depression is a serious and stigmatising condition that can be helped, at least in the short term, by drugs. However, the relapse rate after stopping medication is high and many people are now demanding anti-depressants when they're "a bit pissed off" rather than clinically depressed. In a consumerist, libertarian society, it could be argued that individuals should be given the right to judge for themselves what subjective benefits they get from drugs, but rarely are we provided with balanced, truthful information on which to make our informed choice.

We shouldn't be surprised that the drug industry wants to hype up the benefits of its wares and suppress the downside, the sadness is that we all fall for it. Lazy health editors reproduce industry press releases verbatim, and headline writers love a new wonder drug that often turns out to be nothing of the sort. In America, children as young as a year old are on anti-depressants and, in the post 11 September world, anxiety has now been identified as the new growth area for drugs. A column in Pharmaceutical Marketing recently emphasised the importance the industry attaches to shaping medical and public opinion. "You may even need to reinforce the actual existence of a disease and/or the value of treating it. A classic example of this was the need to create recognition in Europe of social phobia as a distinct clinical entity and the potential of anti-depressants to treat it." The suspicion here is that companies are creating drugs first and then finding diseases to match them to. Not so much a pill for every ill, but an ill for every pill.

It's easy to blame the drug industry, but they don't force us to medicalise our lives. As the comedienne Lily Tomlin put it: "Reality is just a crutch for people who can't cope with drugs." Every day, we swallow millions of pills of dubious benefit, because we like the colour or the name. Look at the range of tablets available over the counter – the exotic tinctures, linctuses, powders, pearls and salts. With most there's little evidence that they can out-perform a placebo but we can't help ourselves. Or can we? Most prescription medicines fall into the rule of thirds. A third of patients take tablets properly, a third sporadically and ineffectively and a third either don't cash in the prescription or throw the tablets away. I was once accosted by an angry patient who claimed (rightly) that I had changed his tablets to a different brand. How did he know? Because the first lot sank when he threw them down the loo, and the new lot floated.

Each year, the NHS wastes billions of pounds dishing out tablets to patients who have no intention of taking them. Not only does it waste resources, but it means patients pick up all the side effects of medicalisation without any benefits. Just being given the label "high blood pressure" can have a profound effect on your life. Men can become depressed, take time off work and give up sex. And because consultations in the NHS are unethically short, no one has time to explain and gain consent from patients about the risks of being medicalised.

Screening is a classic example of this. Everyone likes to promote the benefit of catching a disease early before it turns nasty. Politicians love it because they like controlling us, the drug industry loves it because they make the tests and equipment, and doctors love it because we're paid money by politicians for hitting screening targets. So there's a huge vested interest in over-hyping something that in reality has much more marginal benefits. We have to do 4,000 cervical smears to save one life, of which 250 will be abnormal and around 125 will progress to laser treatment. We create a huge amount of anxiety and assorted other side effects for a small benefit. Likewise, if 100 women over 50 have breast screening, after 10 years one life will be saved, and many more will be made worse by the anxiety of abnormal tests and aggressive treatment. Would more lives be saved if we put all the screening money into the treatment of established diseases? It's a question no politician dares ask.

I'm 40 now and I haven't been to the GP for 22 years. I've no interest in finding out what my blood pressure, cholesterol, body mass index or prostate are doing. I'm happy to take the risk. It's your choice, not Alan Milburn's or your doctor's. The absurd paradox in medicine is that although we live longer and healthier lives than ever, we're more concerned and anxious about our health. From an evolutionary perspective, we're just African apes on the briefest of joy rides. So let's enjoy it. If you feel well, you don't have to let medicine screw it up. Death aside, most risks never happen and your body has an extraordinary capacity to survive life without doctors. Let's save the NHS for the genuinely sick.

Dr Phil tours the UK with his show '89 Minutes to Save the NHS' in October and November. The new edition of his book 'Trust Me, I'm a Doctor' can be bought at the discounted price of £8.99. For more details call 020-7381 0666