General practice crisis deepening
We recently drew attention to the deepening crisis for general practice (see 'Primary Care in Crisis' Triple Helix Summer 2014). According to the Royal College of General Practitioners, while nine out of ten patient contacts within the NHS are managed by general practices, just 8.39% of the overall budget for 2012-13 NHS was targeted to general practice. That is down from 10.95% in 2005–06. No surprise, then, fewer doctors want to be GPs. It's all part of two bigger questions: what is the NHS for and is the current funding model fit for purpose?
RCGP media release, 27 September 2007
Locked in police cells
Too many people with acute mental issues end up in police cells. Full wards, staff shortages, or drunkenness are some of the reasons why, says the Care Quality Commission (CQC). In some areas there are good emergency facilities for mentally ill people but standards are not universal. Between 2012 and 2013, 21,814 people were detained by police under Section 136 of the Mental Health Act. Police cells are not appropriate and people feel they are being 'punished for being unwell', said the charity Mind.
BBC Health, 22 October 2014
Binge drinking and pregnancy
Women who binge drink and later find themselves pregnant are increasingly seeking abortions, scared their babies will suffer foetal alcohol syndrome (FAS). For the British Pregnancy Advisory Service (BPAS) this is a misapprehension: isolated incidence of binge drinking, it insists, causes 'minimal' damage to babies. There are no UK statistics to back up this claim, but in the USA 0.2 to 1.5 cases occur for every 1,000 live births. Eutychus would want to say the moral of the story is this: eliminate the worry altogether, never binge drink. BPAS media release, 3 October 2014
Pill to help drinkers quit
Still on the subject of alcohol misuse, health officials have approved a once-a-day pill that is claimed will help alcoholics stop drinking. Nalmefene is already used in Scotland and reduces the 'buzz' drinkers get. That 600,000 people stand to benefit from the drug says a lot about the scale of alcohol misuse in England. Treating that number of people would cost about £600m a year, according to the National Institute for Health and Care Excellence (NICE). That's probably a fraction of the real cost of alcohol abuse in England, but is this good medicine? A pill will not address underlying issues that shape alcoholism.
Guardian, 3 October 2014
Children and suicide
ChildLine, the telephone counselling service, reports a frightening increase in consultations with children talking about killing themselves, up by 116% in 2013-14 compared to the previous year. Most of the children involved were aged between 12 and 15. Sue Minto, head of ChildLine, blamed social media. Youngsters, she said, were finding it hard to escape from cyber bullying. Today's children 'live in a highly pressurised world where the internet never sleeps and even if they turn off their phone, it's still there waiting for them.'
BBC News, 31 October 2014
Forgotten souls
Complex emotions come into play when people are faced with taking possession of the ashes of a loved one. The National Association of Funeral Directors (NAFD) has published new guidelines about care of unclaimed ashes. Cremation is increasingly an option in the UK, but surprising numbers urns containing ashes go uncollected - seemingly forgotten. One funeral director in Southampton reports he has 405 sets left unclaimed. Another has ashes dating from 1910. The NAFD says the profession feels 'a deep sense of duty', hence a reluctance to throw away human ashes.
National Association of Funeral Directors
Dementia deaths among women
New figures from the Office for National Statistics say dementia is the leading cause of death among elderly women in England and Wales. This disease is now associated with three times as many deaths as breast cancer, and many more than either heart attacks or stroke. These figures do not necessarily point to an upsurge in dementia: doctors, clearly, are becoming more aware of dementia and are recording it more frequently on death certificates, although it is an underlying cause of death, not a primary one. In many cases pneumonia carries off a big proportion of dementia sufferers.
Office for National Statistics
Ebola and duty to care
Are health workers obliged to put themselves on the line to help Ebola patients? Yes, says the president of the World Bank: they have taken an oath to help patients. No, says Canadian medical ethicist Dr Daniel Sokol, who opines it's not unrealistic to expect some healthcare staff to refuse to go to work in places where Ebola patients are being treated. 'If several cases of Ebola emerged in the UK, it would be naive to assume that no healthcare worker would refuse to work,' he says.
BBC News, 29 October 2014
Many hepatitis C carriers unaware they have it
Public Health England says one in five people with Hepatitis C don't know they have it. The same report says 90% of the 13,570 diagnosed with the disease injected drugs like heroin, cocaine and amphetamines. Two in five drug takers using needles had Hepatitis C, but half were unaware of it. Over 200,000 people in Britain have the infection, with sharing needles a prevalent cause of its spread. Dry blood spot testing which does not puncture veins (difficult in regular needle users) is proving a useful new alternate method for detection.
Public Health England, 5 November 2014
Tall tales
An Edinburgh study involving 220,000 people released in November, suggests short men are more likely to die from dementia than taller men. Men 5ft 5 inches or shorter were 50% more likely to develop and die from dementia than those 5ft 8 inches and taller. Being tall, particularly in men, seems to be a valuable biological characteristic. Height, says the study, is an important indicator of development difficulties in children, such as stress and malnutrition.
Daily Telegraph, 3 November 2014
