Thursday, 19 January 2012

NHS plans: Unions move to 'outright opposition



The unions representing nurses and midwives have joined others in stating their "outright opposition" to the government's NHS plans in England.
The Royal College of Nursing and the Royal College of Midwives had expressed concerns in the past, but said they were willing to work with ministers.
Surgeons operating
However, now they want the entire bill covering the changes to be dropped.
Health Secretary Andrew Lansley said the unions wanted to "have a go" at government about "pay and pensions".
The colleges' stance comes after a similar move by the British Medical Association last year.
It also mirrors the stance adopted by Unison, which represents a host of administration and support staff, such as porters.
But what impact this intervention has remains to be seen.
The Health and Social Care Bill is still working its way through Parliament, and the bill is in the Lords at the moment.
In many ways it is over the worst political hurdles and it seems the only way it could be stopped would be if the Lib Dems blocked it when it returns to the Commons - but that is considered unlikely.
On the ground, changes are already being made to pave the way for the new system to kick in, in 2013.
For example, while the doctors union is against it there has still been enough GPs coming forward to pilot the new plans in 97% of the country.
Anger
Under the plans, GPs are being put in charge of much of the NHS budget, while the health service is being opened up to greater competition from the private and voluntary sector.
In June the government announced a series of changes to the original proposals in the face of mounting opposition.
These included giving health professionals other than GPs more power over how NHS funds were spent, as well as watering down the role of competition.
The health unions initially gave the changes a cautious welcome, but they have been left disappointed by the finer details that have emerged during the parliamentary process.
One of the key developments was the news, which emerged just after Christmas, that NHS hospitals would be allowed to do 49% of their work in the private sector.
Peter Carter, general secretary of the RCN, which represents 410,000 nurses, midwives, support workers and students, said: "The RCN has been on record as saying that withdrawing the bill would create confusion and turmoil, however, on the ground, we believe that the turmoil of proceeding with these reforms is now greater than the turmoil of stopping them.
"The sheer scale of member concerns, which have been building over recent weeks, has led us to conclude that the consequences of the bill may be entirely different from the principles which were originally set out."
Cathy Warwick, of the RCM, said: "The government has failed to present sufficient evidence that its proposals are necessary. They have failed to present evidence that the upheaval will result in an improvement in services to the people of England.
"And they have failed to answer the concerns of the people who fear for the future of the NHS under these plans."
Savings plans
Both unions also expressed concerns that the changes were compromising the ability of the NHS to make the £20bn of savings it has been asked to make by 2015.
Mr Lansley said that nurses had previously been "right at the heart" of the process of planning reforms to the NHS to deliver better care for patients.
"The only thing that has happened in the last few weeks that has led to this situation with the Royal College of Nursing, is that the two sides of the Royal College of Nursing have shifted," he told BBC Breakfast.
"They used to be a professional association that was working with us on professional issues, and will carry on doing that, but now the trade union aspect of the Royal College of Nursing has come to the fore.
"They want to have a go at the government - and I completely understand it - they want to have a go about things like pay and pensions."
A Department of Health spokesman said: "The bill is needed to empower doctors, nurses, and other front-line healthcare workers across the NHS to take charge of improving care.
"We will continue to work with nurses and all other health professionals to ensure that the NHS delivers the best possible care for patients."
Shadow health secretary Andy Burnham said it was time to scrap the bill.
"A reorganisation on this scale needs a professional consensus for it to succeed. A year since the bill was introduced, it is abundantly clear that the government's plans do have failed to build that."

Analysis

The move by the two unions is unlikely to see the bill stopped in its tracks.
But it is clear the government's relationship with NHS staff is fracturing, possibly beyond repair.
Some inside government were saying the move by the royal colleges was being driven by their dissatisfaction over pensions.
That has undoubtedly played a role. So too has the drive to make £20bn of savings by 2015 - the equivalent of 4% of the budget a year.
This is putting more and more pressure on hospitals and waiting times in particular.
It means there is a toxic cocktail brewing inside the health service - and this spells trouble for the government.
It came to power saying - in private at least - that the NHS was its good news story, but all too often it is finding the headlines are negative.

Indian TB


Indian TB cases 'can't be cured'


Tuberculosis drugsSome strains are becoming resistant to antibiotics

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Tuberculosis which appears to be totally resistant to antibiotic treatment has been reported for the first time by Indian doctors.
Concern over drug-resistant strains of TB is growing, with similar 'incurable' TB emerging in Italy and Iran.
Doctors in Mumbai said 12 patients had a "totally drug resistant" form of the infection, and three have died.
The Indian Health Ministry is investigating the cases and has sent a team of doctors to Mumbai.
TB is one of the world's biggest killers, second only to HIV among infectious diseases.
Normally a patient with TB is given a six to nine month course of antibiotics to eradicate it.
However, new strains of the bacterium have developed which are increasingly resistant to the antibiotics most commonly used to treat it.
Partially drug-resistant TB can now found in countries across the world, and "multi-drug resistant" strains affect countries such as Russia and China.
'Serious threat'
The Indian reports will fuel concerns over the ability of doctors to contain the disease in years to come.

Start Quote

Anytime we see something like this, we better get on top of it before it becomes a more widespread problem”
Dr Kenneth CastroCenters for Disease Control
The doctors at the Hinduja National Hospital in Mumbai who discovered it said they had treated patients for up to two years with a battery of drugs, to no avail.
The patients came from slum areas of the city, they said, where close contact between people meant further spread was likely.
The American Centers for Disease Control (CDC) confirmed that the Indian strain did appear to be completely resistant.
Dr Kenneth Castro, director of its Division of Tuberculosis Elimination, said: "Anytime we see something like this, we better get on top of it before it becomes a more widespread problem."
Patients who do not finish their lengthy course of treatment also present the bacterium with the perfect environment for developing further resistance.
However, there have been repeated calls for the pharmaceutical industry to make more efforts to develop fresh antibiotics.

TB

  • Tuberculosis is an infectious disease that usually affects the lungs
  • It is transmitted via droplets from the lungs of people with the active form of the disease
  • Symptoms of TB include coughing, chest pains, weakness, weight loss, fever and night sweats
  • Tuberculosis is usually treatable with a course of antibiotics
Dr Ruth Mcnerney, a senior lecturer at the London School of Hygiene and Tropical Medicine and a trustee of charity TB Alert, said the new cases represented a "serious threat" to global efforts to control TB.
"What we're seeing is probably just the tip of the iceberg. We don't know how widespread this is because so few people are tested for drug resistance."
She said the high prevalence of TB in India, coupled with high population density within its cities, meant that the new type of TB could be a bigger problem than previous "totally resistant" strains.
"It's going to take a massive effort and change in political will to get to grips with this - not just from the Indian government but from everyone else. This is a global problem, not just an Indian one."

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Depression drugs ‘causing falls’



elderly fallFalls are the leading cause of accidental death in the over-65s

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Elderly people with dementia are more likely to suffer falls if they are given anti-depressants by care home staff, a study claims.
Many dementia patients also suffer from depression and drugs known as selective serotonin uptake inhibitors (SSRIs) are frequently prescribed.
But the British Journal of Clinical Pharmacology reports that the risk of injuries from falls was tripled.
The Alzheimer's Society called for more research into alternative treatments.
The risk of falls following treatment with older anti-depressants is well established, as the medication can cause side effects such as dizziness and unsteadiness.
It had been hoped that a move to newer SSRI-type drugs would reduce this problems, but the latest research, from the Erasmus University Medical Center in Rotterdam, appears to show the reverse.
'Worrying'
Dr Carolyn Sterke recorded the daily drug use and records of falls in 248 nursing home residents over a two-year period.
The average age of the residents was 82, and the records suggested that 152 of them had suffered a total of 683 falls.
The consequences of falls were relatively high, with 220 resulting in injuries including hip fractures and other broken bones - and one resident died following a fall.

Start Quote

More research is now needed to understand why this anti-depressant is having this effect on people with dementia and if there is an alternative treatment for depression that they could be prescribed”
Professor Clive BallardAlzheimer's Society
The risk of having an injury-causing fall was three times higher in residents taking SSRIs compared with those not taking the drug, and this risk rose further if the patient was being given sedative drugs as well.
Dr Sterke said that these risks needed to be taken into account when assessing whether anti-depressants were required.
She said: "Physicians should be cautious in prescribing SSRIs to older people with dementia, even at low doses."
Professor Clive Ballard, from the Alzheimer's Society, said it was "worrying" that such a commonly prescribed anti-depressant was causing increased risk.
He said: "It is important to highlight any aspect of care that might be causing risk to a person with dementia. We want to ensure that people with the condition are always receiving the best care possible.
"More research is now needed to understand why this anti-depressant is having this effect on people with dementia and if there is an alternative treatment for depression that they could be prescribed.
"One in three people over 65 will die with dementia yet research into the condition continues to be drastically underfunded. We must invest now.'

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Friday, 13 January 2012

meat 'linked to pancreatic cancer


Processed meat 'linked to pancreatic cancer'A link between eating processed meat, such as bacon or sausages, and pancreatic cancer has been suggested by researchers in Sweden.


They said eating an extra 50g of processed meat, approximately one sausage, every day would increase a person's risk by 19%.
But the chance of developing the rare cancer remains low.
The World Cancer Research Fund suggested the link may be down to obesity.
Eating red and processed meat has already been linked to bowel cancer. As a result the UK government recommended in 2011 that people eat no more than 70g a day.
Fried breakfastProf Susanna Larsson, who conducted the study at the Karolinska Institute, told the BBC that links to other cancers were "quite controversial".
She added: "It is known that eating meat increases the risk of colorectal cancer, it's not so much known about other cancers."
The study, published in the British Journal of Cancer, analysed data from 11 trials and 6,643 patients with pancreatic cancer.Increased risk
It found that eating processed meat increased the risk of pancreatic cancer. The risk increased by 19% for every 50g someone added to their daily diet. Having an extra 100g would increase the risk by 38%.Prof Larsson said: "Pancreatic cancer has poor survival rates. So as well as diagnosing it early, it's important to understand what can increase the risk of this disease."
She recommended that people eat less red meat.
Cancer Research UK said the risk of developing pancreatic cancer in a lifetime was "comparatively small" - one in 77 for men and one in 79 for women.
Sara Hiom, the charity's information director, said: "The jury is still out as to whether meat is a definite risk factor for pancreatic cancer and more large studies are needed to confirm this, but this new analysis suggests processed meat may be playing a role."
However, she pointed out that smoking was a much greater risk factor.
The World Cancer Research Fund has advised people to completely avoid processed meat.
Dr Rachel Thompson, the fund's deputy head of science, said: "We will be re-examining the factors behind pancreatic cancer later this year as part of our Continuous Update Project, which should tell us more about the relationship between cancer of the pancreas and processed meat.
"There is strong evidence that being overweight or obese increases the risk of pancreatic cancer and this study may be an early indication of another factor behind the disease.eating red and processed meat and your chances of developing bowel cancer, which is why WCRF recommends limiting intake of red meat to 500g cooked weight a week and avoid processed meat altogether."

Thursday, 12 January 2012


Routine aspirin 'may cause harm'


Healthy people who take aspirin to prevent a heart attack or stroke could be doing more harm than good, warn researchers.
An analysis of more than 100,000 patients, published in Archives of Internal Medicine, concluded the risk of internal bleeding was too high.
Aspirin and a glass of water
The UK-led study said only people with a history of heart problems or stroke should take the tablets.
Experts said any decision should be made with a doctor.
Aspirin helps people who have had a heart attack or stroke. It prevents blood clots from forming by preventing cells, known as platelets, from sticking together. By reducing the number of clots formed, the tablets reduce the risk of another heart attack or stroke.
There have also been suggestions that the drug can prevent some cancers, however, the drug is known to increase the chance of internal bleeding, including bleeds on the brain.
The discussion has been whether at-risk or even healthy people should also take aspirin.
Official guidelines were issued in 2005 by the Joint British Societies, which includes the British Cardiac Society, British Hypertension Society and The Stroke Association. It recommended 75 mg of aspirin a day for high risk patients over the age of 50. The Drugs and Therapeutics Bulletin said in 2008 that preventative aspirin should be abandoned unless there was already evidence of cardiovascular disease.
Good or bad?
Researchers analysed data from nine trials, from a total of 102,621 patients.
They said that while there was a 20% reduction in non-fatal heart attacks in people taking aspirin, there was no reduction in deaths from heart attack, stroke or cancer.
Meanwhile the risk of potentially life threatening internal bleeding increased by 30%.Prof Kausik Ray, from St George's, University of London, told the BBC: "If you treat 73 people for about six years you will get one of these non-trivial bleeds.
"If you treat about 160 people for the same period of time, you're preventing one heart attack that probably wouldn't have been fatal anyway.
"It suggests that the net benefit for aspirin is not there, it certainly doesn't prolong life. If you think about it the net benefit, actually there is net harm.
The study followed patients for an average of six years. An analysis led by Prof Peter Rothwell, from Oxford University, suggested that regularly taking aspirin reduced the risk of a series of cancers, when patients were followed for much longer.
Prof Rothwell said the new study was "very nicely done, but I don't think it develops [the argument] much further".
He added: "It really just emphasises the need for a more detailed analysis of how risks change over time."
Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said: "Aspirin can help reduce the risk of heart attack or stroke among those with known heart disease, and this group of people should continue to take aspirin as prescribed by their doctor.
"Our advice is that people who don't have symptomatic or diagnosed heart disease shouldn't take aspirin because the risk of internal bleeding may outweigh the benefits.
"If you're taking prescribed aspirin and have any concerns, don't simply stop taking it. Always talk to your doctor first."
Sotiris Antoniou, from the Royal Pharmaceutical Society, said: "People who buy aspirin should consult with their pharmacist to make sure that it is appropriate for them based on their individual likelihood of having a heart attack or stroke and their likelihood of experiencing a side effect such as stomach ulceration.
"If you are already taking aspirin, don't simply stop taking it, speak to the pharmacist about your individual circumstances."

breast implants


PIP breast implants: Pressure mounts on Lansley


A PIP breast implant Around 40,000 women in the UK have been fitted with PIP implants
The Health Secretary for England, Andrew Lansley, is facing calls for more decisive action to help women concerned about PIP breast implants.
The Independent Healthcare Advisory Services (IHAS) says women are more confused and anxious than ever.
Mr Lansley says private clinics that fitted implants have a "moral duty" to remove them.
But IHAS director Sally Taber says its members are "as much a victim of this fraud as the NHS and the patients".
In a statement on behalf of the trade body - which represents many of the companies involved - she said: "If there is any moral or ethical obligation outstanding it lies with the government's regulatory agency, the MHRA.
"But the overriding issue here is that it is in everyone's interest to work together to ensure that patients are treated with compassion."
Around 40,000 women in the UK have been fitted with PIP implants.
The implants by French firm Poly Implant Prothese were banned last year after they were found to contain a non-medical-grade silicone filler.
"Unclear" On Wednesday the Harley Medical Group - which fitted 13,900 women with the implants between September 2001 and March 2010 - said it would not replace them free of charge.
Its chairman Mel Braham said the company didn't have the resources, surgeons or operating facilities necessary.
Mr Lansley said the NHS would pay to remove, but not replace, implants if a private clinic refused or no longer existed.
But speaking in the House of Commons, he said it was not fair for the taxpayer to foot the bill and that if the NHS was forced to remove an implant "the government would pursue private clinics to seek recovery of our costs".
Ms Taber said whilst the intention was to offer guidance, Mr Lansley had confused patients.
She said: "With the current government position remaining unclear, patients want to know the timeline for the further investigations into PIP implants by the MHRA."
She went on to complain that IHAS has been unable to meet officials to discuss a solution, something the Department of Health strongly denies

Monday, 9 January 2012

neglect at Partridge Care Centre in Harlow


Evidence of neglect at Partridge Care Centre in Harlow 


uncoveredIn August 2011 Partridge Care Centre, in Harlow, was at the centre of a police inquiry after three people were taken to hospital with "diabetes related problems".Two women in their 80s died, although Essex Police dropped the investigation saying there was no evidence of "any relevant criminal offences".

The home's owner Rushcliffe Care Limited acknowledged there had been problems in the past, but claimed it had taken steps to make sure residents' "health and well-being are paramount".
But documents seen by BBC Essex show there were serious problems at the home before the police investigation.
Partridge Care Centre is a residential nursing home specialising in looking after people with a range of neurological conditions.
Eileen JarvisIt is run by Rushcliffe Care, which also owns 23 other homes.
The centre has rooms for 117 residents, although at the moment it is less than half full, and presently employs about 120 staff.
Former worker at the home Graham Flack said he had witnessed abuse and neglect of residents during his time there.

Partridge Care Home in Harlow
"There was an incident where a certain member of staff was sitting on a resident, who was quite challenging… I would say restraining someone like you see on telly via the police," he said.
"At the end of the day no-one deserves to be held or pushed in any form or manner. It was not nice, not nice."
Lesley Minchin's mother Eileen Jarvis suffered from dementia and required specialist care.
She moved into the home in February 2011, with instructions that she should not be left alone because she was likely to fall.
According to a letter from the centre's manager to the family, Mrs Jarvis was left unattended during a shift change.
She got up, fell and broke her hip. It was two hours before staff at the home called the emergency services.
Mrs Minchin said she had got to the home at the same time as the paramedics.
'Screamed out'
"She was screaming out in pain when I arrived there and they were trying to ask her where the pain was," Mrs Minchin said.
"She said she didn't know but was hurting. When they touched her leg, she just screamed out."
Mrs Minchin claimed many of the problems at the home were caused by a lack of employees.
"The staff, on the whole, were very, very good. There just wasn't enough of them," she said.
The Care Quality Commission has carried out a series of inspections at Partridge Care Centre since May.
In the most recent report published in December, the health watchdog said it had minor concerns over staffing levels.
"Overall we found that there were sufficient numbers of staff available in the home, however there was a lack of effective leadership and deployment due to the large numbers of agency staff working there."
The CQC also found failings in four of the five basic standards during this inspection, including concerns about whether residents were safe in the home and whether they are receiving appropriate treatment.
Written warnings
BBC Essex has seen a report written after a surprise visit to the home by two managers in May 2011.
They found that several staff were asleep while on duty, a serious disciplinary offence.
The managers found one resident lying on an unmade bed that was smeared with faeces. Another was found sitting on the floor and had soiled themselves.
Other residents were found wandering around on their own, yet more were found in bed fully clothed.
The building was said to have smelt of urine and one of the units had no lights on.
Further documents show that some of the staff involved were only given written warnings.
An internal audit carried out by staff at Partridge Care Centre in July found that most of the residents' rooms were dirty.
Of the 21 homes run by Rushcliffe Care Limited, eight of them are failing at least one of the basic standards expected by the CQC.
'Unsubstantiated allegations'
According to its accounts, in the past year the company posted a £1.6m profit.
In a statement, the company said: "Following a series of unfortunate locally mismanaged events at Partridge Care Centre over the past nine months, Rushcliffe Care Group have taken measures so that the health and wellbeing of the centres' residents are paramount.
"We are unable to comment on individual unsubstantiated allegations, which have been made, but we... take all complaints and allegations seriously and when brought to our attention they are dealt with promptly and fairly."
Essex County Council said it had suspended the placement of residents at the home after the hospital referrals related to diabetes in August.
In a statement, Ann Naylor, cabinet member for adult health, said: "The formal suspension of placements at Partridge Care Centre will remain in place, in consultation with Rushcliffe Care management, until such time that partners are fully satisfied that sustainable improvements in the wellbeing and care of residents have been achieved."

Saturday, 7 January 2012

Kindoki Witchcraft in South London



News: Kindoki Witchcraft in South London
BBC Radio 4 Today Programme
The BBC Radio 4 Today programme produced a remarkable investigative report on Kindoki (Witchcraft) that may have led to the death of a man, Nzuzi Mayingi, found hanging from a tree in Crystal Palace Park in July 2005. The man was part of a 400 strong congregation of a Congolese Christian Cult led by Pastor Dieudonne Tukala who also lives in South London.
It was alleged that Tukala declared women and children to be possessed by the devil. This led to one man beating and branding his 9 year old with a steam iron and led Nzuzi to commit suicide. The BBC report showed how the children were terrorised into admitting they were possessed. If they refused it was said that Tukala encouraged the families to send the children back to the Congo where he could pray for them to die.
Nzuzi Mayingi and his pregnant wife and son arrived in the UK as asylum seekers in 2002. They began attending Pastor Dieudonne Tukala's church in North London. Tukula diagnosed the wife, boy and unborn child to be Kindoki (possessed). Nzuzi believed this and, according to a church elder was encouraged by Tukala to beat his family and witnessed the child's wounds. Nzuzi eventually threw his family out onto the street. Members of the congregation pursued the wife with abusive calls calling them witches "who will choke on your dead husband's flesh".
Within 18 months Nzumi was dead. The family have fled to the north of England. The BBC investigation detailed other allegations of Tukala taking money, jewellery and credit cards.
4 hours after the BBC broadcast Scotland Yard said officers from its Child Abuse Investigation Command had arrested a man, 40, in south London on suspicion of inciting child cruelty.
Last June three people in another Kindoki case were convicted at the Old Bailey on Friday on child cruelty charges, after an eight-year-old African girl accused of being a witch was tortured in East London. This is part of growing concern in London by the exploitation of vulnerable Congolese and Angolan refugees by Christian fundamentalist evangelical cults.
  • An MP3 of the BBC broadcast can be downloaded 
  • Old Bailey (June 2005) case BBC report 
Trees in Crystal Palace Park
sdg 12/01/06

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