Not so confidential

A leading Scots GP claims the NHS is profiting from allowing pregnant women's details to be sold to commercial companies, often without their full knowledge or consent. Glasgow GP Dr Margaret McCartney also warns that the NHS and professional bodies such as the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of General Practitioners (RCGP) are guilty of a conflict of interest by collaborating in the advertising of thousands of products to pregnant women and new mothers.

She also criticises Bounty, a promotions company which supplies 2.6 million Bounty bags a year to new mothers, including 812,000 newborn packs distributed through NHS maternity wards. Many of the mothers who sign up to receive Bounty Bags while in hospital are not aware they are agreeing to their email address and telephone number being used by commercial companies, she argues. In some cases they do not even realise the person collecting the information is not an NHS employee, while the inclusion of a child-benefit application form in the packs gives them an "air of officialdom".

Dr McCartney said: "The lack of knowledge about what signing over your details means is troubling in a hospital environment, which should take consent and confidentiality seriously. The hours after birth are hardly an optimal time to obtain formal consent. Do we want parents placed under advertising pressure and for NHS doctors, radiographers and midwives to be the conduit?"

Good health, but at what price?

A woman awaiting a transplant for a rare condition, atypical haemolytic uraemic syndrome (aHUS), an inherited condition that has destroyed her kidneys had her operation cancelled at the 11th hour because the Government refused to pay for the drug she needs to prevent the organ being rejected. Up to 70 patients are in the same position. They have been forced to put their lives on hold, and risk their condition deteriorating, while ministers and officials argue over whether the NHS can afford the drug, Eculizumab, which costs more than £300,000 per patient per year. The health minister, Earl Howe, rejected a recommendation from an expert committee that the drug be "routinely provided nationally".


Instead, Earl Howe referred the drug for further investigation by the National Institute for Health and Care Excellence (Nice), which took over responsibility for treatments for rare diseases. Nice has yet to explain how it is going to assess drugs for rare diseases. Nice's verdict on Eculizumab, brand name Soliris, is not expected before summer 2014. The drugs can be life-saving but are hugely expensive because they affect very small numbers of patients. They cannot therefore be assessed according to the usual cost-effectiveness threshold of £30,000 per patient per year (adjusted for quality of life) .

Experts fear the move could signal a tough new approach to the funding of expensive treatments for marginal groups. But that would undermine the role of a national health system to pool the risks for the whole population in order to fund individuals with exceptional health needs.

MP Madeleine Moon, chair of the All-Party Kidney Group, said: "It was heartbreaking to see the agony that people denied access to Eculizumab went through... The Government has made a heartless decision to allow existing trial and new patients access to the drug but not those who have been refused access on cost grounds by their hospital."

Professor Tim Goodship, chair of aHUS Action, said: "A transplant transforms people's lives. This opportunity has been dangled in front of them and then withdrawn. I feel it is just cruel."

We need a need-based health service

The NHS is failing to provide needs-based care in areas of blanket deprivation, GPs working in Scotland's poorest areas will tell MSPs. The GPs from The Deep End group, which represents 100 practices in the poorest parts of the country are expected to warn that the health service's approach is a "recipe for widening health inequality" when they appear before the Public Audit Committee.

The report warned that the distribution of GPs in Scotland does not reflect the higher levels of poor health and greater need in poorer areas and that "deep-seated inequalities remain between the least and most deprived communities" despite research showing higher rates of multimorbidity (more than one chronic medical condition) in patients from the most deprived areas.

This, combined with "dysfunctional links between general practice and other parts of the NHS", is "a partial explanation of 20 years of failure in addressing inequalities in health. The GPs called for more time for doctors seeing patients in deprived communities, as well as better integration with other services such as social work and addiction services. "The focus should be on sustainable development, with an emphasis on continuity and the productive power of long-term relationships."

Hospital bed-boarding

Patients are being put at risk in Scotland by a lack of consultants and a shortage of acute hospital beds the Royal College of Physicians of Edinburgh (RCPE) has highlighted. A growing number of patients are being forced to stay in wards not designed to cater for their illness in a practice known as “bed-boarding”. Doctors say this delays treatment and increases the time patients stay in hospital, making them more likely to contract a superbug, like MRSA, or suffer from blood clots.

Eight out of ten physicians questioned for the survey say bed-boarding takes place year-round, and every expert said the practice had a negative impact on the quality of care patients receive. Seven out of ten RCPE members say putting patients in inappropriate wards has a negative impact on death rates and that it increases the chances of a patient being readmitted to hospital due to them not getting the correct care during their initial stay.

Nursing the figures

It’s estimated 5000 NHS workers, including around 2500 nurses, have lost their jobs in the last three years. NHS chiefs spent £94million on temporary nursing staff last year – to fill the gaps left after they axed the 2500 nurses. The cost of using supply and agency nurses in Scottish hospitals soared by £4million compared to 2010, a report has revealed. And the number of staff hours taken up by temporary nurses rose by 1.5million to 6.3million.

Ellen Hudson, of the Royal College of Nursing Scotland, said: “It is vital that bank nursing is available to cover shortages when staff are off sick.However, the bank should not be used to cover long-term vacancies caused by recruitment freezes as it would be much better for patients if they’re filled with permanent staff.”

The RCN said the small increase in the number of nursing and midwifery staff was largely accounted for by the inclusion of nursing and midwifery “interns” in the workforce figures. The internship scheme is available to newly qualified nurses who cannot gain employment. They work a 22.5 hour week and the internship lasts one year. So is not a true reflection of the nursing workforce.

its an emergency

Major trauma, the commonest killer of children and adults under 45, accounts for 1,300 deaths every year in Scotland. Major trauma often involves patients arriving at hospital with multiple, complex injuries which could result in death or permanent disability, usually sustained in an accident such as a car crash or gas explosion, or from a violent situation such as a shooting or stabbing. More than half of all trauma patients have major head injuries.

Scotland is lagging behind other developed countries in its provision of care for victims of major trauma and needs to radically overhaul its approach. A report by the Royal College of Surgeons of Edinburgh said death rates for severely injured patients who are alive when reaching hospital is 40 per cent higher in the UK than in North America. But while England has reformed its healthcare policy to improve survival rates, the situation in Scotland has not yet been addressed.


Margaret Watt, chair of the Scotland Patients’ Association, said: “This is nothing short of scandalous. We have known for some time the health service in Scotland is lacking in specialist care. Trauma patients should have access to the best qualified, best doctors for the job. The report comes from specialists who work in the frontline and know what they are talking about. They can not be ignored. It will be no good politicians coming back and saying they will look into it. These recommendations are already long overdue. They should already be in place. They need to act now to ensure Scotland’s patients get the life-saving care they expect and deserve. Scotland used to be the world leader in health care – to lag behind the rest of the world is just not an option.”

A sharing, caring Scotland

A total of 2,025,400 people had put their names forward for the NHS Organ Donor Register as of 31 March - almost 40% of the population. Across the UK, the number of people on the organ donation register stands at 30%.

Three people in the UK die every day because of a lack of access to organs. The Scottish government also said the number of people who died while waiting for organs fell from 38 in 2010-11 to 36 in 2011-12. The tragic fact is that more than 600 people in Scotland are still waiting for a life-saving transplant.

Docs Get Ready to Fight

The British Medical Association is poised to ballot its members on industrial action for the first time in 40 years. Under the Dept. of Health plans, doctors' pension contributions would increase immediately by up to 2.4%, with continued increases over the next two years. It also wants to raise the retirement age to 68 and end the final salary scheme for hospital doctors. Although the DoH proposals are intended to apply to NHS workers throughout the UK, Scotland has its own devolved NHS pension scheme which is overseen by the Scottish Public Pensions Authority. However, if the Scottish Government decided to break with the reforms it is likely Holyrood would have to pick up the tab for any shortfall.

Dr Dean Marshall, outgoing chairman of the BMA's Scottish General Practitioners Committee, said doctors north of the Border had been let down by Holyrood's inaction and the Scottish Government's "complicity" with Westminster on the issue.

Dr Marshall said: "Is it fair for NHS staff to be taxed for the Government's failures to properly regulate the banking sector? And while the Scottish Government argues it does not agree with these plans it appears to be going along with the UK Government and is therefore complicit in taxing public-sector workers for the failures of the private sector. Scottish ministers could seek to do something different and I urge them again to find that solution – not just invite us to new talks"

Dr Marshall said doctors were unhappy that pension reforms were being "foisted" on them just four years after they agreed substantial changes to their package.

He added: "We agreed to tiered contributions where higher earners contributed more than lower paid workers. We agreed to the increased retirement age of 65 and we agreed to a cap on employer contributions so that the taxpayer would not pay for any future shortfall in the scheme. These changes worked and the NHS Pension Scheme is in surplus to the Treasury to the tune of £2 billion, and this is projected to continue into the future."

The old neglected again

Older patients are “not safe” on hospital wards in Scotland because of a lack of qualified nurses to care for them according to Royal College of Nursing (RCN) findings. The report suggests there is just one nurse caring for nearly ten patients on old people’s wards. A survey of almost 1,700 nurses found that 78 per cent said comforting and talking to patients was not done or done inadequately on their last shift because of low staff numbers. Some 59 per cent said promoting mobility and self-care was left undone or unfinished, with 34 per cent saying they could not provide patients with food and drink, and 33 per cent claiming they were unable to fully help patients to the toilet or manage incontinence.

The RCN warned there was a danger that “care becomes compromised” and said that many nurses say “they are too busy to provide the standard of care they would like”. The report said: “Older people in Scotland are being let down by a lack of professionally qualified nurses in hospitals, despite nationally agreed planning for the nursing workforce. Despite older people often having the most complex needs, the evidence suggests that they regularly suffer from a severe shortage of nurses and healthcare support workers (HCSWs), coupled with an inappropriate skill mix of HCSWs to nurses."
The RCN called for a “patient guarantee” to set out the number of nurses needed on older people’s wards.

It emerged the number of nurses in Scotland’s hospitals plummeted by thousands in just over two years, with further nursing posts lost during the last few months of 2011. The RCN said the number of nursing and midwifery staff employed in Scotland had fallen by 2,190 between September 2009 and the end of 2011.

According to the RCN Scotland director, Theresa Fyffe, the number of nurses employed was at a six-year low. She said: “As health boards come under increasing financial pressure to deliver the same services to more and more people, they are saving money when nurses leave by not replacing them or by replacing them with nurses and healthcare support workers at lower-paid bands."

The charity Age Scotland demanded dramatic improvements to care services in the community, to keep older people “safe and out of hospital”.

NHS rationing

What is the value of a few precious extra months of life? It's a very difficult question to answer, but if Scottish Medicines Consortium's is to be believed then, it is not worth £2.5 million.

Prostate cancer is the most common cancer in men in Scotland, with 2700 cases diagnosed every year. It kills two men every day. There are 19,000 Scottish men currently living with the disease.

Last October, Alex Salmond, the First Minister, signed up to a charter calling for better treatment for patients.

The Scottish Medicines Consortium has denied Scottish men a drug that prolongs life. It said the cost of abiraterone at £3000 a month did not justify the health benefits – even though it can extend lives by more that three months .

In a letter to the Scottish government, sufferer John Thomson writes "It is a disgraceful decision, cruel and unjust, that abiraterone is not available simply because of cost. How do you evaluate the cost of drugs against someone’s life?...This drug not only gives men an extra few months but also some quality to those last few months...It is unfair for some people to access the drug and not others. Money should not be an issue."

Heart care 'more likely for rich'

An estimated 182,000 people in Scotland have coronary heart disease (CHD), around 3.3% of the population. Rates of heart disease in Scotland remain the highest in Western Europe, despite new cases falling by nearly a third in the last 10 years.

There is evidence that rich people are more likely to receive NHS treatment for heart disease than poor people, according to the public spending watchdog.

In some more deprived areas around 25% of men over 75 have CHD but, according to Audit Scotland, people in deprived communities "are not always getting the same level of treatment as the rest of the population"

Treatments such as angioplasty, which widens the arteries, or heart bypass surgery, are over 20% less than expected in deprived areas. The least deprived areas saw over 60% more than expected. Audit Scotland said this "implies a lower level of access to these treatments for people in more deprived areas".

health and safety??

Hospital chiefs are discouraging “whistleblowing” nurses from reporting their concerns about patient safety and staffing levels, nursing leaders have warned. More than one-third of nurses in Scotland (37%) said they had been discouraged, or told directly, not to report their concerns to their NHS health board or employer.

The Royal College of Nursing (RCN) revealed more than 80% of nurses in Scotland said they had highlighted problems. But, in more than half of cases, no action was ever taken. The overwhelming majority (84%) of nurses in Scotland fear they will be victimised if they speak out about the problems.

Theresa Fyffe, RCN Scotland director, said: “It is extremely worrying that nurses are being explicitly told not to raise concerns, particularly after all we have learned about the consequences of ignoring issues around patient safety. The survey clearly shows nurses are committed to improving care for patients, but more than half, 55%, say no action was ever taken when they raised their concerns...We are very concerned that nurses are not being listened to particularly as we know more than 2000 nurses have been cut from the NHS workforce in Scotland since September 2009, and staff are feeling over-stretched and under pressure. In these circumstances it is more important than ever they are listened to when they raise their concerns about patient safety and about staffing levels.”

http://www.heraldscotland.com/news/health/third-of-nurses-told-they-should-not-whistleblow-1.1138132

making cancer victims suffer

New research by a leading charity reveals that hundreds of cancer patients are living close to the breadline due to their illness, with 73% experiencing a loss of income and increased costs such as hospital travel and higher utility bills. Cancer patients in Scotland are skipping meals and worrying about losing their homes because of a drop in income and higher living costs.

Around 30,000 people in Scotland are diagnosed with cancer each year, costing many of them thousands of pounds.

Elspeth Atkinson, director of Macmillan Scotland said: “Cancer is an expensive disease to live with, but this research shows just how close to the breadline many cancer patients really are."

Research has shown that more than half of all terminally ill cancer patients do not claim benefits they are entitled to. Complicated benefits forms, a lack of awareness of entitlements, embarrassment or simply feeling too ill or emotionally drained, prevents many people accessing welfare benefits.

http://www.heraldscotland.com/news/health/cancer-patients-forced-to-live-in-poverty-1.1130821

Cancer of Capitalism

Professor David Cameron, an expert in breast cancer from Edinburgh University, said new treatments were increasingly being developed which targeted specific subtypes of cancer, helping make them more effective.

"These drugs are expensive. Some of that is the real cost of developing them and some of that is if you are only going for a subset of cancer then your total predicted sales will be less," Prof Cameron told The Scotsman. "The business model of the company will be that in order to develop the money to develop the drug your subsequent sales in the patent lifetime have to be sufficient to cover all your costs. So actually, the cost for rarer cancer is likely to be higher and not lower."

Spare parts for sale

People should be allowed to sell their kidneys for £28,000 in an NHS-regulated organ market Dr Sue Rabbitt Roff, of Dundee University said in an article published online today by the British Medical Journal. She called on the health service to offer financial rewards to individuals willing to give up a kidney as a means of speeding up the rate of transplants and reducing the cost of treatments and dialysis to the NHS.

Dr Roff, a senior research fellow at Dundee’s department of medical sociology explained “We already allow strangers to donate kidneys out of the goodness of their hearts. They get their costs covered, they don’t know who the recipient is, there’s no publicity, no public acknowledgement of what they do. We’ve moved away from the notion it has to be a family member or a close associate who can give you a kidney. We’ve already moved into the zone of allowing the general public to make good-hearted donations. What I’m suggesting is, why don’t we add money to this equation in order to increase the amount of provision which is there...I came to this figure of £28,000 because that’s the average national income in Britain at the moment, so it seems a fair price across all the social strata..."

The British Medical Association said it would not support money being offered in exchange for kidneys.

Dr Calum McKellar, director of the Scottish Council on Human Bioethics said: “A legal, regulated market in human body parts would end up exploiting those who have very restrictive financial means, such as many students and foreigners.”

There are currently 725 people in Scotland waiting for a new kidney but the number coming up for transplant has plateaued at around 200 in recent years. How much smaller would be the number if those in various industries (chemicals, oil, tobacco, pharmaceuticals etc) had not poisoned and polluted our bodies for profit for decades?

Everything inside capitalism takes the form of a commodity, everything has its price, so it doesn't come as a surprise to Socialist Courier to read Dr. Roff's proposal.

Why Bother?

A senior consultant surgeon has spoken out against screening patients for bowel cancer in Scotland’s most deprived areas...because they are likely to suffer from other serious conditions which could kill them anyway.

Angus Macdonald, consultant colorectal surgeon at Monklands Hospital in Airdrie, said that in his experience in Lanarkshire, an area of high deprivation with one of the country’s lowest life expectancies, many patients with small tumours were more likely to die from other conditions before the cancer claims their life.

Health officials estimate that the NHS’s bowel cancer screening programme, for people between the ages of 50 and 74, could prevent 150 deaths annually. But Macdonald argues for some sections of the population it would not actually change the age at which a patient will die. “When you roll out a screening programme there is a very real possibility that you will identify cancers in the people who would normally have died from something else. We might operate on them and as a result we might actually shorten their lives.”

Research carried out by Macdonald, which is due to be published in the Journal of Colorectal Disease , adds weight to the principle of addressing the underlying determinants of ill-health such as socio-economic deprivation rather than of early detection and treatment of cancer as a principle health improvement strategy in such populations.

He said: “For the elderly time is precious. We’ll have some people coming up to their 50 years of marriage who have put together plans for over five or six years to save up for that once-in-a-lifetime holiday. When you tell them they have cancer they say they’ll cancel the cruise. I say, don’t. Go away and enjoy yourself if you can. It doesn’t matter if you have your operation just now or in two months, it is not going to make any difference at the end of the day.”

Dying Old

In The Herald Socialist Courier reads that 50% of the time that people spend in hospital over a lifetime occurs in the 12 months before they die. In a new book, Professor Phil Hanlon, a former adviser to the Scottish Executive, argues the elderly should be prescribed far fewer drugs and given fewer tests and procedures as they reach serious physical decline.

He said: “It is not that I would discard such people. I would simply give them a more human and humane approach, which would use less intensive NHS facilities. The big debating point is: would people die earlier? And the answer I would give to that is we do not know. You might actually live longer if you do not have all the stress associated with going to the hospital for treatment and healthcare-associated infections. We all get to that stage in life where your systems begin to shut down, albeit slowly, and medicine cannot reverse that. If you treat the person as if you are going to reverse that, you actually do them harm and that is what we do at the moment.”

Hanlon, who trained as a doctor, said: “The system is designed to deal rapidly with you, shunt you through and get you off the waiting list. All of that is not human and humane.”

Some estimates, he said, suggest one in five hospital admissions is at least in part caused by previous treatment. He envisages a more open conversation between health professionals, patients and their families about whether fewer tests and treatments would be desirable in what is likely to be their last 12 months of life. Decisions would be made on a case-by-case basis, however, he stressed.

Lindsay Scott, communications manager for charity Age Scotland, said: “As an organisation, we would look at this proposal from a discrimination point of view. It was the idea in the first place with the NHS that from cradle to grave everyone is treated equally.” However, he said some older people would support Mr Hanlon’s ideas. A survey of 300 pensioners in Scotland found 65% supported assisted suicide for people with a terminal illness and 54% would consider it as a means of ending their own lives.

Economic formulas not medical ones decide treatment

Previously reported here has been the inherent failure of the National Health Service due to the constraints of capitalism to offer full effective treatments . Another report confirms Socialist Courier's diagnosis .

Some of the UK's top cancer consultants warn that NHS drug 'rationing' is forcing patients to remortgage their homes to pay for treatment. The specialists accuse the government drugs advisory body of 'rationing' too severely and call for a "radical change" in the way decisions are made.

In their letter, the 26 cancer specialists say the decision shows how "poorly" NICE assesses new cancer treatments."Its economic formulas are simply not suitable for addressing cost-effectiveness in this area of medicine," they write. "We have seen distraught patients remortgaging their houses, giving up pensions and selling cars to buy drugs that are freely available to those using health services in countries of comparable wealth."

Defending its policy of restricting palliative medicines .

"There is a finite pot of money for the NHS, which is determined annually by parliament,"NICE's chairman said."If one group of patients is provided with cost-ineffective care, other groups - lacking powerful lobbyists - will be denied cost-effective care for miserable conditions like schizophrenia, Crohn's disease or cystic fibrosis."

Capitalism is at its terminal stage , time to apply euthanasia to such a heartless system .

nhs charges

A poll by Macmillan Cancer Support suggests nearly half of cancer patients in England are being forced to cut back on basic necessities in order to pay for their prescriptions.

Breast cancer survivor Amanda Whetstone says she regularly skips breakfast and lunch to save money to pay for her prescriptions.

"Although my cancer treatment - the surgery, chemotherapy and radiotherapy - has finished, I still need medication. As a result of my cancer I'm now on three different drugs. They cost me about £44 a month. That may not sound much to some, but I'm struggling financially. I'm now on statutory sick pay because I've been too unwell to work. My income is £360 per month and, quite frankly, I have barely enough money to live on.I budget for everything. I don't go out because I can't afford to socialise. I can't even invite friends over for a meal because I can't afford the food.I don't eat breakfast or lunch. The meals I do buy are ones that are on special offer.I can't afford fresh fruit or meat. I know that isn't healthy, but I simply can't afford to buy healthy food."

"Fighting cancer is hard enough without the terrible financial worry that comes with it.I feel penalised because I have a disease that the government doesn't consider should make me exempt from prescription charges."

health and wealth

We here at Socialist Courier have frequently posted stories that reveal the class link concerning health -- the wealthier you are , the better health you possess and the longer you live . Another report once again confirms this view .

The importance of money was illustrated by an ethnic breakdown of outcomes in the US. White Americans, who are on the whole wealthier and therefore more able to afford the insurance which underpins the US system, were up to 14% more likely than others to survive cancer.

Meanwhile the report states that the UK had 69.7% survival for breast cancer, just above 40% for colon and rectal cancer for both men and women and 51.1% for prostate cancer.

And "...there were also large regional variations within the UK, which were linked to differences in access to care and ability of patients to navigate the local health services. Both are directly linked to deprivation..."