Archbishop calls for NHS bill to cover spiritual health

Humans are spiritual entities, says the Archbishop of York

• Q&A: The NHS shake-up
• NHS shake-up: The sticking points
• Is the NHS set for an autumn of discontent?
• Analysis: Why the NHS wants to move on

Spiritual health must be a feature of the NHS bill for England, the Archbishop of York has insisted during debate in the House of Lords.

Dr John Sentamu told peers: "I am one of those who believe that human beings are psychosomatic spiritual entities."
The archbishop then told how he freed the spirit of a young girl, left petrified by seeing a goat sacrificed.
During a debate on an amendment he said: "Illness can be physical or mental but it can also be spiritual."
The amendment, tabled by psychiatrist and crossbench peer Baroness Hollins, called for the words to be inserted into a clause about the duty of the secretary of state, the NHS Commissioning Board and clinical commissioning groups to improve the quality of services.
Making his case, the Anglican archbishop argued that schools now emphasised students' spiritual dimensions, and said hospital chaplains' work addressed spiritual issues, as well as the physical and mental.
Witches' coven He also told how when he first became a vicar in south London, he was invited to a home where there was "a presence", a phrase he said he did not understand at the time.
At the home, he said, he found a young girl who had been unable to move for nearly three weeks and would shout out in the middle of the night.
He was told the family had been to a witches' coven where a goat had been sacrificed. The young girl was petrified she would be next.
Visits from a GP, psychiatrist and psychologist did little to help, he said, but then he said a prayer, anointed the girl and lit a candle on his visit.

You can see the Archbishop's contribution 3hrs 23mins into this video

Shortly after, he received a phone call saying the girl was no longer terrified and was talking again.
"That was not mental or physical illness; there was something in her spirit that needed to be set free," he told his peers.
Dr Sentamu, 62, acknowledged the importance of highlighting mental and physical illnesses, but asked whether they needed to be spoken of "in almost separate categories" in the bill.
"I do not want to divide up a human person. Therefore, I believe that the bill covers people's needs without inserting the words 'physical and mental'.
He said he was "content" that the bill, as it stood, covered all aspects of the human person simply by using the word "illness" .
"The element of the spiritual well-being of people is not on the face of the bill but I am absolutely convinced that, as it stands, my needs would be taken care of because it talks about 'the prevention, diagnosis or treatment of illness'."
The Health and Social Care Bill, if passed, would see GPs and other clinicians given much more responsibility for spending the budget in England, while greater competition with the private sector would be encouraged.

• Q&A: The NHS shake-up

  The Health and Social Care Bill paves the way for a major shake-up of the NHS. How will the health service be changing?
  

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• NHS shake-up: The sticking points

• Is the NHS set for an autumn of discontent?

• Analysis: Why the NHS wants to move on

• How the NHS works in rest of UK

News

• Delays 'could kill off NHS bill'

• Fears as GPs offer private option

• Critics renew NHS revamp attacks

• More competition planned for NHS

• PM agrees major NHS concessions

• GPs want 'more NHS concessions'

Designer vagina

Designer vagina NHS operations unwarranted

Women seek labial reduction surgery for cosmetic reasons

Published on 24/08/11

Women with normal sized labia minora still seek labial reduction surgery for cosmetic reasons finds new research published today in BJOG: An International Journal of Obstetrics and Gynaecology.

Women with normal sized labia minora still seek labial reduction surgery for cosmetic reasons finds new research published today (24 August) in BJOG: An International Journal of Obstetrics and Gynaecology.

Female cosmetic genital surgery is increasingly popular and the number of labial reduction procedures in the National Health Service has increased five fold in the past 10 years.

This is the first study looking specifically at the labial dimensions of women seeking cosmetic surgery. It looked at 33 women who had requested labial reduction surgery and who had been referred by their general practitioner. The average age of the group was 23.

All of the women were examined by a gynaecologist and the width and length of the labia minora were measured and compared with published normal values.

The study found that all women seeking surgery had normal sized labia minora, with an average width of 26.9 mm (right), and 24.8 mm (left).

Three women out of the total number were offered surgery to address a significant asymmetry. Of the women who were refused surgery, 12 (40%) of the women still remained keen to pursue surgery by another route, 11 women accepted a referral for psychology and one participant was referred to mental health services.

The women were asked what they would like to achieve with surgery and 20 women (60%) wished to make the labia smaller to improve appearance. Other reasons included reducing discomfort, improving confidence and wanting to improve sexual intercourse.

The study also looked at how old the women were when they first became dissatisfied with the labia minora. Twenty-seven women (81%) were able to pinpoint this. Of these, 5 women (15%) reported this to be under the age of 10, 10(30%) between the ages of 11 and 15, 5 (15%) between 16 and 20, 4 (12%) in their twenties, and 3 (9%) in their thirties.

Reasons for this dissatisfaction included an increasing self awareness of the genital area, physical discomfort, comments from a partner and watching TV programmes on cosmetic genital surgery.

Sarah Creighton, UCL Elizabeth Garrett Anderson Institute of Women’s Health and lead author said:

“It is surprising that all of the study participants had normal sized labia minora and despite this nearly half were still keen to pursue surgery as an option.

“A particular concern is the age of some of the referred patients, one as young as 11 years old. Development of the external genitalia continues throughout adolescence and in particular the labia minora may develop asymmetrically initially and become more symmetrical in time.”

BJOG Deputy Editor-in-Chief, Pierre Martin-Hirsch, added:

“Many women who are worried may have normal sized labia minora. Clear guidance is needed for clinicians on how best to care for women seeking surgery.”

About 2,000 genital cosmetic operations are paid for by the NHS each year

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• Designer vagina trend 'worrying'

GPs should not refer women who are well but worried for female genital cosmetic surgery on the NHS, say experts.

Specialists at a Central London teaching hospital say they received 30 such referrals, mainly from family doctors, over the past three years.

This included eight schoolgirls - one as young as 11 - the British Journal of Obstetrics and Gynaecology reports.

Experts say doctors need clear guidance on how best to care for women who mistakenly believe they need surgery.

The British Association of Aesthetic Plastic Surgeons says medics need to determine whether a problem exists or whether an alternative solution may be preferable, but offers no advice on how to judge the problem, say the researchers from University College London's Women's Health Institute.

Continue reading the main story

“Start Quote

It's shocking, particularly because we are seeing girls who are really young”

End Quote Lead investigator Dr Sarah Creighton

They say it may be simpler to ban the procedure in the NHS altogether, leaving it to private practices. Some Primary Care Trusts do this.

And private provider Bupa says the procedure is purely cosmetic and does not offer financial cover for the procedure.

The NHS has no such restriction.

The experts who carried out the latest work said: "A private medical insurance company seems to be able to come to a conclusion when professional bodies are reluctant to act.

"National care standards are urgently needed."

Boom industry

Dr Sarah Creighton and colleagues believe the future demand for so-called "designer vagina" operations or labial reductions is potentially infinite and is driven by society's wider and growing desire for cosmetic surgery in general and changing expectations about what is a desirable appearance for women.

"It's shocking, particularly because we are seeing girls who are really young. They are asking for surgery that is irreversible and we do not know what the long-term risks of the procedure might be."

She said latest figures for England show about 2,000 of the procedures are paid for by the NHS each year.

"That's probably just the tip of the iceberg. It's a massive boom industry in the private sector."

For the study, they reviewed all 33 women referred to their clinic between 2007 and 2010 with requests for a labial reduction.

Most of the women were seeking help because they were concerned about appearance. Only a fifth wanted the surgery to reduce discomfort. One woman said she felt compelled to have the surgery after seeing a television programme on cosmetic genital surgery.

Continue reading the main story

“Start Quote

If the concerns are aesthetic, that should probably be seen in the private sector”

End Quote Paul Banwell British Association of Aesthetic Plastic Surgeons

A third of the women said they had looked at advertisements about the surgery before seeing a doctor.

Upon examination, all of the women were deemed to have "normal" genitalia by the doctors. But three were offered surgery to address "a significant asymmetry". The remaining 30 were refused any procedure.

All of the women were offered the options of sessions with a clinical psychologist to explore issues leading to their request for surgery.

Twelve of the women said they would be seeking a second opinion and would consider going private to get the surgery if they still could not get it on the NHS.

Paul Banwell, of the British Association of Aesthetic Plastic Surgeons, said the operation was merited for some women, particularly those with functional concerns like discomfort.

"But if the concerns are aesthetic, that should probably be seen in the private sector."

He said he often dissuades patients from having the surgery and explains to them that there is a spectrum of 'normal' when it comes to female anatomy.

"We welcome the opportunity to be involved in suggesting guidelines and help for healthcare professionals seeing patients who are interested in labiaplasty."

More on This Story

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• Designer vagina trend 'worrying' 23 SEPTEMBER 2008, HEALTH

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• British Journal of Obstetrics and Gynaecology

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'The myth of the chemical cure'

VIEWPOINT Dr Joanna Moncrieff Mental health expert

Taking a pill to treat depression is widely believed to work by reversing a chemical imbalance.

Medication is a mainstay of mental health therapy

But in this week's Scrubbing Up health column, Dr Joanna Moncrieff, of the department of mental health sciences at University College London, says they actually put people into "drug-induced states".

If you've seen a doctor about emotional problems some time over the past 20 years, you may have been told that you had a chemical imbalance, and that you needed tablets to correct it.

It's not just doctors that think this way, either.

Magazines, newspapers, patients' organisations and internet sites have all publicised the idea that conditions like depression, anxiety, schizophrenia and bipolar disorder can be treated by drugs that help to rectify an underlying brain problem.

People with schizophrenia and other conditions are frequently told that they need to take psychiatric medication for the rest of their lives to stabilise their brain chemicals, just like a diabetic needs to take insulin.

The trouble is there is little justification for this view of psychiatric drugs.

Altered states

First, although ideas like the serotonin theory of depression have been widely publicised, scientific research has not detected any reliable abnormalities of the serotonin system in people who are depressed.

Second, it is often said the fact that drug treatment "works" proves there's an underlying biological deficiency.

Psychoactive drugs make people feel different Read your comments

But there is another explanation for how psychiatric drugs affect people with emotional problems.

It is frequently overlooked that drugs used in psychiatry are psychoactive drugs, like alcohol and cannabis.

Psychoactive drugs make people feel different; they put people into an altered mental and physical state.

They affect everyone, regardless of whether they have a mental disorder or not.

Therefore, an alternative way of understanding how psychiatric drugs affect people is to look at the psychoactive effects they produce.

Drugs referred to as antipsychotics, for example, dampen down thoughts and emotions, which may be helpful in someone with psychosis.

Drugs like Valium produce a state of relaxation and a pleasant drowsiness, which may reduce anxiety and agitation.

Drugs labelled as "anti-depressants" come from many different chemical classes and produce a variety of effects.

Prior to the 1950s, the drugs that were used for mental health problems were thought of as psychoactive drugs, which produced mainly sedative effects.

'Informed choice'

Views about psychiatric drugs changed over the course of the 1950s and 1960s.

FROM THE TODAY PROGRAMME More from Today programme

They gradually came to be seen as being specific treatments for specific diseases, or "magic bullets", and their psychoactive effects were forgotten.

However, this transformation was not based on any compelling evidence.

In my view it remains more plausible that they "work" by producing drug-induced states which suppress or mask emotional problems.

If we gave people a clearer picture drug treatment might not always be so appealing

This doesn't mean psychiatric drugs can't be useful, sometimes.

But, people need to be aware of what they do and the sorts of effects they produce.

At the moment people are being encouraged to believe that taking a pill will make them feel better by reversing some defective brain process.

That sounds good. If your brain is not functioning properly, and a drug can make it work better, then it makes sense to take the pill.

If, on the other hand, we gave people a clearer picture, drug treatment might not always be so appealing.

If you told people that we have no idea what is going on in their brain, but that they could take a drug that would make them feel different and might help to suppress their thoughts and feelings, then many people might choose to avoid taking drugs if they could.

On the other hand, people who are severely disturbed or distressed might welcome these effects, at least for a time.

People need to make up their own minds about whether taking psychoactive drugs is a useful way to manage emotional problems.

To do this responsibly, however, doctors and patients need much more information about the nature of psychiatric drugs and the effects they produce.

Dr Moncrieff's book "The Myth of the Chemical Cure", published by Palgrave Macmillan, will be available in paperback from September

cream as well

'No doubt' sunbeds cause cancer

Sunbeds emit ultra violet radiation

There is no doubt using a sunbed or sunlamp will raise the risk of skin cancer, say international experts.

Previously, the International Agency for Research on Cancer (IARC) assessed sunbeds and sunlamps as "probably carcinogenic to humans".

But it now says their use is definitively "carcinogenic to humans".

Campaigners believe the move, announced in the journal Lancet Oncology, will increase pressure for tighter industry regulation of sunbed use.

The link between sunbeds and skin cancer has been convincingly shown in a number of scientific studies Jessica Harris Cancer Research UK

The new assessment puts sunbed use on a par with smoking or exposure to asbestos.

However, the Sunbed Association in the UK said there was no proven link between the responsible use of sunbeds and skin cancer.

The IARC is an expert committee that makes recommendations to the World Health Organization.

It made its decision following a review of research which concluded that the risk of melanoma - the most deadly form of skin cancer - was increased by 75% in people who started using sunbeds regularly before the age of 30.

In addition, several studies have linked sunbed use to a raised risk of melanoma of the eye.

The charity Cancer Research UK warned earlier this year that heavy use of sunbeds was largely responsible for the number of Britons being diagnosed with melanoma topping 10,000 a year for the first time.

In the last 30 years, rates of the cancer have more than quadrupled, from 3.4 cases per 100,000 people in 1977 to 14.7 per 100,000 in 2006.

Age limits

Proposals to ban people under the age of 18 from using sunbeds are under consideration by the government in England.

FROM THE TODAY PROGRAMME More from Today programme

A similar ban has already been approved in Scotland.

The Sunbed Association (TSA) supports a ban on under-16s, but argues there is no scientific evidence for a ban on young people aged 17 or 18.

Jessica Harris, Cancer Research UK's health information officer said: "The link between sunbeds and skin cancer has been convincingly shown in a number of scientific studies now and so we are very pleased that IARC have upgraded sunbeds to the highest risk category.

"This backs up Cancer Research UK's advice to avoid sunbeds completely for cosmetic purposes. They have no health benefits and we know that they increase the risk of cancer."

Ms Harris called for ministers to implement a ban on under-18s using sunbeds immediately, and to close salons that are not supervised by trained staff.

Kathy Banks, chief executive of the Sunbed Association, said: "The relationship between ultraviolet exposure and an increased risk of developing skin cancer is only likely to arise where over-exposure - burning - has taken place.

"However, research has shown that over 80% of sunbed users are very knowledgeable about the risks associated with over-exposure to ultraviolet and the majority of sunbed users take 20 or less sunbed sessions a year."

A Department of Health spokesperson said: "Sunbeds can be dangerous - we must ensure that people who use them do so safely. If necessary we will look at new laws to protect young people."