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Health Insight May 1999
Bowel Cancer Week

Another condition against which the government has announced new action is bowel cancer. The last week in April was National Bowel Cancer Week, organised by ten collaborating charities. Launching the week, public health minister Tessa Jowell said two pilot screening programmes were under way in Coventry & Warwickshire and Tayside. These could lead to more widespread screening in the future. Last year the government allocated an extra £10 million to bowel cancer services to speed access to diagnosis and treatment. In the UK there are 30,000 new cases of bowel cancer and 20,000 deaths every year but, Mrs Jowell said, it was one of the 'more curable' cancers. National Bowel Cancer week was intended to raise public awareness which in turn should encourage people to overcome their embarrassment and seek help at an early stage. Early diagnosis and treatment would save many lives.

Source: Press release (DoH)

National Audit Office takes NHS to task on IT

NHS trusts have shown a lack of coherence, direction and adequate evaluation in their implementation of the £152 million information strategy launched in 1992, according to Sir John Bourne, head of the National Audit Office which has published a report on the progress which has been made. The 1992 plan included proposals to give every patient an identification number to allow easier retrieval of records, a move to allow transfer of electronic patient information between health authorities and GPs, and the development of electronic records. However, the NAO says the NHS Executive had set aims for individual projects without establishing the means to measure whether these aims were being met. There was no coherent idea as to how the strategies of different NHS trusts would fit together.

Sir John said the revised 1998 strategy was an improvement although he felt that objectives and targets were still not specific enough and would be hard to measure. He said it was difficult to calculate the cost of the revised strategy but the government expected to spend more than £1b to support it. (The 1998 information strategy is available from www.imt4nhs.exec.nhs.uk)

Source: BBC Online

Immigration delays hit overseas doctors

Doctors from overseas coming to the UK for work and/or further training are facing problems because of a backlog of work in the immigration services of the Home Office. The BMA says many doctors are having to wait for months before they can start their work or training because their immigration status has not been confirmed. BMA Chairman Dr Ian Bogle said, 'The doctors are extremely fed up and hospitals are being put in a difficult position'. If a doctor was held up, it could cause chaos while the hospital found cover. Dr Bogle has written to the Home Office asking for more flexibility to be shown over doctors' status. The Home Office says the delays are due to refurbishment and computerisation work in the immigration services, which will be completed later this year.

Source: BBC Online

Over-sixties can have free eye tests

People over the age of 60 in England and Wales are now entitled to free eye tests. Similar arrangements will be made for Scotland and Northern Ireland. The announcement was made 10 years after charges were first introduced for NHS eye tests which had, till that time, been free since the NHS was launced in 1948. The introduction of fees caused a furore and the Royal National Institite for the Blind says it led to a marked drop in the number of people being tested particularly in less wealthy social classes. A recent survety showed that 25 per cent of over-60s had not had an eye test within the previous two years (the recommended period) and 10 per cent had not had a test in the last five years. Tests have remained free for children, those with a very low income, and people considered to be at high risk of eye disease, but the RNIB wants more at-risk groups to be included. For example, it says all people of Afro-Caribbean origin should have free tests as they have four times the risk of glaucoma.

In a survey of old people in Britain, conducted by Gallup for Age Concern, one in 20 over-65s claimed they had been refused treatment by the NHS. Many respondents said they had noticed a difference in the provision of treatment starting from their 50th birthday. GPs were said to be the worst offenders. Age Concern Director Sally Greengrass has condemned the 'don't care, won't care' attitude towards older people which she says is common in the NHS.

BBC Online;
BMJ 24th April

NHS–Prison Service partnership

A formal partnership is to be established between the NHS and the prison service, addressing criticisms from the Prisons Inspectorate that prisoners are not receiving appropriate care. Nursing care has often been delivered by prison staff who are not nurses, and doctors without a general practice certificate have provided primary care. Mental healthcare is also recognised to have been generally inadequate. A joint report from the NHS Executive and the prison service has recommended that a partnership should be established, although it stops short of recommending that the NHS takes over full responsibility for healthcare in prison. Prisons minister Lord Williams said, 'Prison healthcare has been wrongly isolated from the mainstream NHS for historical reasons – that is for no good reason at all. Providing health services to prisoners that meet their needs and are comparable to those available in the community is common sense, and it will benefit prisoners and the wider community'.

Source: BMJ 3rd April

Britain runs to fat

New figures published by the DoH show that the prevalence of obesity in the UK is rising dramatically; 17 per cent of men are obese, compared with 13 per cent in 1993, and in women the rise has been from 16 per cent to 20 per cent. Public health minister Tessa Jowell said the government was very concerned, given the clear links between obesity, heart disease, and certain cancers. She blamed an increasingly sedentary lifestyle, a poor understanding of what constituted a balanced diet, limited access to fresh fruit and vegetables, and poverty. The government planned a range of long-term initiatives starting with action in schools to ensure that children received a proper diet and were encouraged to walk or cycle to school. The new healthy living centres would run such activities as nutrition classes. Doctors would be encouraged to prescribe exercise to their patients as appropriate. The public would be given more information about diet and nutrition to help people make informed choices about their food.

Source: Press release (DoH)

Medicine by distance learning

The Open University is proposing to provide distance learning courses for UK medical students for the first two years of their six-year training. The course will be based on similar principles to the well-established distance learning degree courses that the OU has been running for 27 years. Initially it will enrol 232 students and will be open only to graduates with good science degrees. The OU is facing competition; there have been 20 other bids from established medical schools in England to provide distance learning in medicine. Janet Grant, the OU's professor of education in medicine, said, 'We are convinced that this is the way forward for medical education, and not just in England. Once the programmes are running they will be much cheaper and infinitely more flexible than conventional courses'.

Source: BMJ 3rd April

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