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Health Insight November 1999
part 2
Conference season

Health was on the agenda for both Labour and the Conservatives at their annual party conferences. Frank Dobson, as Secretary of State for Health, told Labour supporters that the government had launched a number of new initiatives which would improve the effectiveness of the NHS. He highlighted the role of the NHS Direct helpline and the new walk-in clinics, saying that seventeen more of the latter would shortly be opened to bring the total to thirty-six. The hospital building programme and the upgrading of many GP premises also received Mr Dobson's attention, together with the launch of the national standards framework for mental health services. Similar frameworks are on the way for the care of older people and diabetics. Mr Dobson also hinted that further funding increases for the NHS were in prospect.

The Prime Minister devoted part of his conference address to health and was more outspoken that Mr Dobson, claiming that the British Medical Association was conservative in outlook and was opposing the government's intention to reform the NHS. Mr Blair promised that if Labour were elected for another term it would introduce a system of 'booked appointments' which would allow patients to book consultant appointments or admissions on dates that were convenient for them.

The Conservatives included 'a patient's guarantee' in a statement of policy principles launched during their conference. All NHS patients will be given a guaranteed waiting time based on their need for treatment; if the treatment cannot be provided by the NHS within a specified time, patients will be treated in the private sector. The statement also calls for a debate on how an increased proportion of the UK's GDP could be devoted to healthcare. The proportion is presently much less than that in most other developed countries.

Shadow Health Secretary Dr Liam Fox criticised the government's record on health, particularly what he called the manipulation of waiting list figures. He said the claim that waiting lists had fallen by 65,000 since Labour came to power was undermined by the government's own statistics which showed that 200,000 extra patients were still waiting to go on the waiting lists.

British Medical Journal 9 October
Health Service Journal 7 October

Getting the medical facts right

Two separate surveys have revealed widespread ignorance about key medical facts. A survey commissioned by the Royal Pharmaceutical Society of Great Britain (RPSGB), found great public misconceptions about antibiotics. One in three respondents thought antibiotics were a cure-all for sore throats and earache, and one in three that they could cure all stomach upsets. Christine Glover, RPSGB president, said, 'we know that people expect to be prescribed an antibiotic when they don't need one. This is clogging up doctors' surgeries, wasting the patient's time and vital NHS resources'.

A separate survey revealed widespread ignorance about the causes of cancer. More than half of men in the UK and thirty per cent of women wrongly believe that you can catch cancer from somebody who has the disease. Up to forty per cent of the 1,000 people questioned mistakenly believed that if men bruise their testicles or women their breasts it can trigger the disease; more than half were under the impression that living near electricity pylons increased cancer risk, when this has never been proven. Professor Gordon McVie, Director General of the Cancer Research Campaign, said, 'it's vitally important that we dispel these myths and make sure that real health messages do get through...our lifestyles have a big influence on our chances of developing cancer and we can all do something to help ourselves'.

Source: BBC Online

New in cancer research

A new gene therapy is being developed by The Royal Marsden Hospital and The Institute of Cancer Research which could offer the first real improvement in the treatment of brain tumours for decades. At present conventional drugs have a severely limited effect on brain tissue. The research team working on this project is aiming to overcome some of these drug access problems by injecting bacterial genes directly into the tumour.

Scientists at the Institute of Cancer Research and The Royal Marsden NHS Trust have carried out research into breast cancer, in collaboration with the National Cancer Institute in the USA. Cells are taken from the breast tumour with a fine needle and then analysed. The finer needle means the patient is not so bruised and it can be repeated at frequent intervals. This means that doctors can monitor a woman's progress by looking at changes in the expression of her genes from the cells taken during treatment.

Source: Joint news release (The Royal Marsden NHS Trust/Institute of Cancer Research)

Rural Scots will get better specialist care

Northern Scotland's rural communities are often many miles from hospitals and long journeys are required for those who need specialist healthcare. Six million pounds have been allocated to a new body, the Remote and Resource Centre, to enable it to develop innovative approaches to improve the situation. Research will be conducted over the next three years to investigate the feasibility of such ideas as providing chemotherapy to cancer patients in their own homes; or the examination of the eyes of diabetics, using cameras that transmit images to eye specialists who can make a diagnosis without leaving their hospital departments. Video conferencing on psychiatric patients, which already takes place, could also be expanded. It is hoped that the outcome of the project will be a range of new ideas that can be adapted by rural communities across the world.

Source: BBC Online

Consumers' Association attacks GMC

The way in which the General Medical Council (GMC) deals with patients' complaints about doctors has come under fire from the Consumers' Association publication Health Which? A survey of 264 patients with complaints, conducted for the magazine, found that seventy-nine per cent were dissatisfied with the way in which their complaints was handled, and 82 per cent were dissatisfied with the fairness of the process. Most said they were given inadequate information and support, and 78 per cent felt that the GMC was not impartial. Only six of the complaints led to action being taken by the GMC against doctors.

Complaints against doctors have trebled in the last five years but, on the basis of the survey, two-thirds of complainants are only seeking an acknowledgement that a mistake has been made, to ensure same thing didn't happen again. Only a quarter wanted the doctor involved to be struck off. According to the GMC's figures, 88 per cent of all complaints are rejected at the first stage of investigation.

Following the Health Which? report, the GMC has said it recognises that there are problems and that its system is not always 'customer friendly'. A review of procedures is being conducted and suggestions for improvement made by Health Which? are being considered.

Source: Health Which? October '99

GM foods: Pusztai's results are published

Genetically modified (GM) food remains a major news story in the UK. Indeed it continues to be a major issue in Britain's best known fictional village - Ambridge. Revered radio soap-opera The Archers has lately been almost entirely devoted to the trial of Tommy Archer, whose family are organic farmers and who destroyed a local experimental planting of a GM crop. Meanwhile the government is rumoured to be considering a possible embargo on further trials of GM crops.

A further twist to the GM controversy has resulted from the publication in the Lancet of the research study by Arpad Pusztai, in which rats fed GM potato developed intestinal damage. Dr Pusztai was sacked by the Rowett Research Institute for releasing his results to the press without approval and before they had been peer reviewed. The start of public concern over alleged risks to human health inherent in GM foods can be dated to this original press coverage.

The Lancet publication came as a surprise to many, including those of the journal's advisers who had recommended against publication as they considered the research to be seriously flawed. Lancet Editor Richard Horton has come under fire for ignoring this advice but he said it was common practice for journals to publish controversial papers with critical commentaries alongside. Publication would allow a proper debate on the issue to begin.

BBC Online
British Medical Journal 23 October

Nursing and Midwifery News

The context of nursing care is changing. Nurses, midwives and health visitors face new challenges as they begin to assimilate the recommendations of two new major policy documents:

  • 'Making a difference; strengthening the nursing, midwifery and health visiting contribution to health and health care' - Department of Health, July 1999
  • 'Fitness for Practice' - UKCC Commission for Nursing and Midwifery Education, September 1999.

'Making a Difference' explains the Governments strategic intentions for nursing midwifery and health visiting. It recognises that modern nursing and midwifery is not just a matter of personal attention to tender loving care but requires a work force which has a wide range of experience and one that can work with patients in an increasingly technological and complex clinical environment

The strategy is designed to improve the status, training, pay and job opportunities for Britain's half a million nurses, midwives and health visitors. It is driven by the need to increase nursing and midwifery recruitment and to retain skilled practitioners within the health service.

The 'Fitness for practice' document is the result of a years work by of a commission chaired by Sir Leonard Peach, which was charged with the task of producing a 'proposal for a way forward for pre-registration education that would enable fitness for practice based on health care need'.

The proposals of the commission sets out how education can be improved. The 33 recommendations suggest that there should be greater ownership of students by the health service, improved clinical placements both within the public and private sector and assessment of students skills by an outcomes based, competency approach.

Whilst implementation will require a lot of hard work and cause the inevitable teething problems, the two documents are complementary. The future of nursing and midwifery looks bright in the UK. Copies of the documents are available on the internet:
Fitness for Practice, Making a Difference

Paula Hancock, the British Council's Associate Consultant (Nursing) would be pleased to discuss the two documents and their impact on the profession with any one who is interested. She can be contacted by email at P.K.Hancock@Sheffield.ac.uk


Professor Mike Pringle and Peter Houghton have been appointed as the co-chairs of the expert reference group for the diabetes national service framework. Mike Pringle is currently Chair of the Council of the Royal College of General Practitioners and Peter Houghton is Regional Director of the Eastern Regional Office of the NHS Executive. The National Service Framework, which will be published in 2001, will ensure that top quality standards of care and treatment for diabetes are available in all primary care, local hospitals, and specialist centres.

Source: Press release (DoH)

Yvette Cooper, MP for Pontefract and Castleford, has been appointed as Parliamentary Under Secretary for Public Health. Before her appointment, Ms Cooper was economics columnist and leader writer on the Independent newspaper. Part of her public health portfolio includes responsibility for both prevention and treatment of cancer, and in this capacity she will be working with the new National Cancer Director, Professor Mike Richards.

Source: Press release (DoH)

Sarah Mullally is to take over from Dame Yvonne Moores as Chief Nursing Officer in England. She will take responsibility for delivering the government's strategy for nursing, 'Making a Difference', and will be leading 420,000 nurses, midwives, and health visitors into the Millennium.

Source: Press release (DoH)

In brief

Heart disease is a killer for women as well as men, according to research carried out at Dundee University. In a three-year study it was found that women in Scotland do not receive the same standard of treatment as men and consequently are more likely to die of the disease. In fact, one in four deaths among Scots women is from heart disease. Jill Belch, who led the research, said that the medical profession had concentrated on finding a cure for the disease in men while ignoring the risk among women. When attending hospital with chest pains, women were less likely to be put in a coronary unit than men, and it was rare for a woman to be presented for a heart-bypass operation. The researchers predicted a heart disease epidemic among British women within the next few years unless something was done.

Source: Guardian 26 October

Outgoing Health Secretary Frank Dobson enraged anti-smoking campaigners by revealing government plans to delay the total ban on tobacco advertising due to begin on 10 December. Mr Dobson said it was a 'sensible compromise' between the health benefits of the ban and the 'legitimate concerns' of the tobacco industry.

Source: BBC Online

High Street pharmacies are now selling health checks and tests, including those for anaemia, allergies, blood glucose and blood pressure. Researchers from the journal Health Which? made 13 visits to a total of 11 pharmacies, to find out about three tests (for cholesterol, osteoporosis and H pylori infection) with prices ranging from £12.99 to £24.99. Unfortunately, their findings showed that some pharmacists don't have the time, facilities, or expertise to give a professional service. Managing Editor Maggie Gibbons said, 'It's still early days for health checks in pharmacies, but as things stand we question whether it's really worth you spending time and money on the tests we looked at'.

Source: Press release (Health Which?)

The Blue Cross animal welfare charity actively promotes the benefits of responsible pet ownership. In an NOP poll for the charity the majority of GPs (77 per cent) canvassed said they believed that owning a pet could help people stay healthier. This is good news as almost one in two of the population in the UK own pets, according to the Pet Food Manufacturers' Association.

Source: Press release (The Blue Cross)

The full results of the first national NHS survey of patients has been published. The GP survey of 60,000 looked at access, waiting times, communication between patients and GPs, out-of-hours care, competence and helpfulness. Results show that people in paid work or full-time education want better access to services, often outside normal surgery hours, to fit in with their work commitments and home life. It was also found that younger people (under 45s) and those from ethnic minority groups were generally less satisfied than the rest of the population with the level of healthcare service they obtained. The survey results at Health Authority level are available on the internet

Sources: Press releases (DoH)

The NHS has been declared ready for the Millennium date change following completion of the independent assessment programme looking at Year 2000 preparations in NHS Trusts and Health Authorities. Over 300,000 different types of critical equipment and systems have been checked throughout hospitals, GP surgeries, and elsewhere within the service.

Source: Press release (DoH)

The Department of Health has denied that NHS hospitals are heading for their worst financial crisis in 10 years. Tim Jones, policy manager for the NHS Confederation, said he expects an increase of at least 20 per cent in demand for healthcare over the winter months and predicted that the cost of dealing with more patients will use up money earmarked for long-term investment. An NHS spokesman, however, said, 'Winter planning in the NHS has been going on throughout this year - deficits will not directly affect patient care'.

Source: Sunday Times 24 October

More than 2,000 nurses and midwives have returned to work in the NHS since the launch of the government's nurse recruitment campaign just eight months ago, making it the most successful recruitment campaign in the history of the NHS. Latest figures confirm that 2,030 nurses are already back in employment and a further 2,327 are to join them after completing refresher training. Fifty six per cent of those who have returned have chosen to take up part-time posts.

Source: Press release (DoH)

Secretary of State for Health Alan Milburn has announced an increase in the number of heart specialists by over 400 in the next six years and a £50 million boost to cardiac surgery to increase the number of heart operations by 10 per cent over the next two years. At a meeting of leading heart experts at the Department of Health, Mr Milburn said, 'Heart disease, together with cancer, is the country's biggest killer. That it why the NHS services that deal with it are one of my personal priorities for modernisation'.

Source: Press release (DoH)

Tea is the most widely-consumed beverage in the world, but how many drinkers know that it contains substances capable of bolstering our bodies defences to help fight chronic diseases? The plant nutrients in tea that have fired the enthusiasm of researchers are called flavonoids. Just one cup of tea supplies around 200mg of flavonoids. These are capable of mopping up and de-activating potentially harmful free radicals which, if left to roam the body, may spark chronic health problems such as cardiovascular diseases, cancer, cataracts, inflammation, arthritis and even Alzheimer's disease.

Source: Food Today (European Food Information Council Newsletter), September

The biggest hospital building programme in the history of the NHS has reached the half-way stage. Building of the fifteenth hospital to be funded through the Public Finance Initiative (PFI) was launched at a turf-cutting ceremony in Swindon by outgoing Secretary of State for Health Frank Dobson.

Source: Press release (DoH)

The trial continues of a Manchester GP, Dr Harold Shipman, who is accused of murdering 15 patients, most of them elderly women. The prosecution says Dr Shipman, who has pleaded not guilty, murdered the women 'for enjoyment'. Evidence in the trial, which is expected to last into next year, has been presented in great detail in the popular media.

Sources: media reports

Around 1,500 women and babies were offered blood tests after a surgeon was found to have passed hepatitis C to a female patient. The virus was transmitted during an operation in Boston, Lincolnshire, in 1997 through 'skin penetration of infected blood'. The risk of an infected doctor passing the virus to a patient in this way is estimated to be as low as 0.3 per cent. Special hotlines have also been set up. Hepatitis C virus attacks the liver. It is usually transmitted in infected blood, but may also be passed on during sexual contact.

Source: BBC Online

The UK's supermarkets are seeking to outdo each in other in their efforts to allay the fears of the public concerning food safety. The Iceland chain has announced it will no longer use the artificial sweetener Nutrasweet (aspartame) in any of its own-brand products. Nutrasweet is one of the most widely used sweeteners across the world and has been used in low-calorie drinks and foods for 20 years. Conflicting research evidence has raised the possibility that there might be a link between Nutrasweet and medical conditions including brain tumours and multiple sclerosis. The sweetener is made by Monsanto, also a leader in GM technology. The company has accused Iceland of 'spreading alarm when it should be reassuring customers'.

Source: Sunday Times 24 October

Despite claims by the Department of Health in September that the prospect of a strike by junior doctors had been averted, the British Medical Association's junior doctors' committee has said that a deal has not yet been finalised. Further details have yet to be settled. The junior doctors have the backing of all sections of the BMA in their campaign for reduced hours and increased pay.

Source: British Medical Journal 2 October

Back to the November 1999 index

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