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Archive for July, 2010

Andrew Lansley- Man in a hurry runs risk of losing control

July 16, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

A policymaker’s dream. A pragmatist’s nightmare. That has to be the verdict on Andrew Lansley’s white paper “Liberating the NHS”, published on Monday.

Andrew Lansley- Man in a hurry runs risk of losing controlIn one sense it aims to complete the work of the last Conservative government – and much that the Blairites also wanted for the health service. The last Tory government tried to free NHS hospitals from direct management by health authorities.

It aimed to get GPs to buy patient care. And it briefly attempted to absolve ministers from responsibility for the day-to-day management of the NHS by creating a short-lived ministerial supervisory board with an NHS executive beneath it.

But it rapidly got cold feet over the likely impact of the quasi-market it had created, fearing the destruction it would cause would be anything but creative.

Labour, having first ditched much of this, recreated it earlier in the decade in a far more sophisticated form – with independent regulation and inspection and a tariff for NHS care that, in theory at least, encouraged purchasers to put quality above price.

It never quite sorted out who should do the purchasing – primary care trusts or GPs, who have been running a form of practice-based commissioning that, in most places, has been severely constrained.

But had the Blairite plans come to fruition, the purchasing of care would by now have been separated from its provision. All hospitals by 2008 would have been self-governing institutions, positioned part way between the public and private sectors.

Primary care trusts would have been solely commissioners, while their district nursing teams and therapists and community hospitals would now be independently run, either on a foundation trust model, or as social enterprises, or contracted out to the private and voluntary sectors.

There would also have been a more vibrant public/private/voluntary market from which purchasers could buy all sorts of care, with patients being able to choose between them.

What Labour – or more accurately Tony Blair and Alan Milburn, then health secretary – wanted is what Mr Lansley now aspires to create: a self-improving system run as a regulated market of competing providers driven by patient choice and commissioning in a way that no longer needs direct management from politicians and the health department.

From there, the step to an independent commissioning board, with ministers doing little other than continuing to raise the money for the NHS, setting its broad priorities, and then holding the board to account, would have been seen as an interesting evolution, not a revolution.

But the NHS is a long way from that. The Blairite reforms first slowed, then under Gordon Brown, pretty much stalled.

Half of hospitals are still directly managed and a chunk will never pass the financial viability test to become foundation trusts. PCT provider arms have still to be sorted out. Social enterprise in the NHS barely exists. Private suppliers have yet to demonstrate convincingly that they can consistently do things better and more cheaply than the NHS. And the best GP commissioners are still relative beginners.

Yet in a dirigiste decision that smacks more of old Labour central direction than anything else, the Conservative health secretary has decided not to allow GP commissioning to evolve into something demonstrably strong and effective but to require that all GPs – whether willing or not – do the job or acquiesce in their colleagues doing it for them. All in one big bang.

Mr Lansley’s plans amount to an NHS revolution. Virtually no part of the service will be untouched by his announcements on Monday, which aim, in barely three years, not just to complete Labour’s unfinished business but to go much further.

Issues Labour grappled with unsuccessfully, however, remain unanswered.

What, for instance, are the failure regimes for the new arrangements? And thousands of managers whose jobs are to go are expected to retain financial control throughout the upheaval while helping GPs take on their new role. The odds are many will bail out while they have the chance.

As Sir David Nicholson, the NHS chief executive, said on Monday: “The clarity of the vision is all very well. The big issue is how do we manage the transition.” With immense difficulty, is the answer. Mr Lansley, a man with a plan in a hurry, risks losing both financial control and performance.

From: http://www.ft.com/cms/s/0/7f3bc0e4-8def-11df-9153-00144feab49a.html

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NHS hospitals will be looking to exploit a host of “exciting” opportunities to move into private health markets, bosses say

July 15, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Self governing NHS hospitals – known as foundation trusts – have had their private income capped to date, but this is to be lifted in the NHS overhaul.
NHS hospitals will be looking to exploit a host of "exciting" opportunities to move into private health markets, bosses sayThe Foundation Trust Network believes the move will spark a burst of innovation in the sector.  But campaigners said they were worried NHS services would be harmed.

To get foundation trust legislation through parliament in 2003, ministers agreed to a cap on private work to ensure the hospitals remained true to their NHS traditions.

This has stopped some of the leading hospitals in the NHS competing with private firms for patients.

But that will now change under the proposals unveiled in Monday’s white paper. Health Secretary Andrew Lansley said he wanted to create a “vibrant” industry of social enterprises by scrapping the rule and ordering all NHS trusts to become foundation trusts within three years.

Sue Slipman, director of the Foundation Trust Network, said the move would make a big difference.

“It is exciting for foundation trusts. We will have to wait to see what exactly happens, but there are huge opportunities to innovate.”

She said one of the most obvious areas for expansion would be in fertility services where treatment on the NHS is severely restricted.

“In the past these patients have had their NHS cycles and then left for private treatment. That is money that has been lost to the system.”

She also said mental health trusts may be interested in offering talking therapies to businesses for their workforce health schemes.

University College Hospital in London has already gone down this route with a private US health firm which has located a private unit on its site for cancer treatment.

The firm leases the space as well as paying for the NHS services it uses, such as intensive care, radiology and cleaning and catering.

The trust has also established a joint venture with a private firm to provide pathology services.

Sir Robert Naylor, the chief executive of the trust, said: “These initiatives bring in money which can then be reinvested in NHS services.”

Many NHS hospitals also operate their own private wings, although most of these only bring in a small amount of income. The exceptions are specialist centres such as the Royal Marsden cancer hospitals and Moorfield Eye Hospital.

But John Lister, of the union-funded pressure group Health Emergency, said he had concerns.

“Hospitals could overstretch themselves in chasing private patients which in turn takes away from the NHS side of it.  It also creates perverse incentives whereby they stand to make more money by getting patients into their private wings.

“They say money is reinvested in services, but I am not sure this is always the case. Some of these hospitals have huge surpluses, the money is moved around and does not end back where it should. If we get more and more of this, it will be a step towards the privatisation of the health service.”

From: http://www.bbc.co.uk/news/10619463

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Kidney cancer patients denied drug that can extend their lives by killer quango NICE

July 14, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Having wasted a few reports recently on extending the nanny state by battering voters into not eating fat food the killer quango NICE has now decided to prematurely kill cancer patients.
Kidney cancer patients denied drug that can extend their lives by killer quango NICEKidney cancer patients will not be allowed a new drug that could extend their lives by up to three months because it is too expensive, the NHS drug rationing body has said.

The National Institute for Curbing Expenditure has turned down the drug called everolimus, also known as Afinitor, saying it does not offer enough benefit to patients to justify the cost.

Each pack of the drug costs £2,822 and the manufacturer, Novartis, had offered the first pack free to the NHS and a five per cent discount on following ones.

But even with this, and taking into account new guidance on end of life drugs which allows Nice to approve more expensive drugs that extend life for patients with rare diseases, the treatment was still too expensive, the panel decided.

An estimated eight week cycle of treatment would cost £5,264 per patient.

The cost per quality adjusted life year gained, a complex calculation taking into account improvement in quality of life as well as extra length of life versus the cost of the new drug over and above existing treatments, is almost double what Nice would normally allow.

Around 4,000 people a year in England and Wales are diagnosed with advanced kidney cancer and those who would be eligible for treatment because they had already tried the other drug, called Sutent, and were still fit enough to attempt another drug, would be much fewer, Nice said in a statement.

Patient groups hit out at the draft guidance saying people with rare cancers were being penalised.

Last year patients with advanced kidney cancer campaigned after four drugs including Sutent were turned down. Nice partially reversed the decision and Sutent is now available.

Mike Hobday, Head of Policy at Macmillan Cancer Support, said: “We are disappointed by Nice’s decision not to make everolimus available on the NHS for people living with advanced kidney cancer, who already have limited treatment options following the rejection of three clinically effective drugs last year.”

“It’s unfair that patients suffering from rarer cancers are repeatedly denied treatments that could extend their lives. Drugs like everolimus can dramatically improve people’s quality of life. They can mean the difference between patients being given a few weeks to live and a few months – valuable time that can be spent with family and friends, which means a lot to cancer patients.”

Nick Turkentine, Chief Operating Officer for the James Whale Fund for Kidney Cancer said: “Once again Nice has disappointed the thousands of kidney cancer sufferers in the UK by not approving everolimus, a drug which gives terminal kidney cancer patients and their families some hope.”

From: http://www.telegraph.co.uk/Kidney-cancer-patients-denied-drug-that-can-extend-their-lives

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Being overweight doubles the risk of miscarriage after IVF

July 13, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Doctors have found the first clear evidence that overweight women face a heightened risk of miscarriage after undergoing IVF (in vitro fertilisation).
Being overweight doubles the risk of miscarriage after IVFObese women Women considering IVF should be counselled that being overweight or obese doubles their risk of miscarriage, say fertility experts

Overweight women are more than twice as likely to miscarry an IVF baby compared with those whose weight is healthier, fertility doctors say. The increased risk is so great they believe a warning should be included in counselling for couples before they embark on a course of fertility treatment.

Women who conceive naturally are known to have a greater chance of miscarrying if their body mass index (BMI) is 25 or higher, but the picture has been less clear for women carrying babies produced by in-vitro fertilisation (IVF), or another technique called intra-cytoplasmic sperm injection (ICSI).

“Overweight women wishing to get pregnant by spontaneous conception are already counselled to lose weight before trying for a baby,” said Tarek El-Toukhy, a fertility specialist who led the study at the assisted conception unit of Guy’s and St Thomas’ Hospital in London.

“Our findings have shown clearly that women undertaking ART [assisted reproductive technology] should be strongly encouraged to heed this advice in order that they can have the best possible chance of obtaining and maintaining a pregnancy,” he added.

Overweight mothers have a higher risk of developing other medical conditions that can threaten their pregnancy, including high blood pressure, pre-eclampsia, diabetes, premature delivery and post-partum bleeding.

El-Toukhy’s team examined the medical records of 318 women who each had one embryo implanted during fertility treatment at the clinic between January 2006 and December 2009. The women were divided into two groups: 185 had a healthy BMI between 18.5 and 24.9, while 133 had a BMI of 25 or above. Of the latter group, 19 were obese, defined as having a BMI of 30 or more.

The study, reported today at a meeting of the European Society of Human Reproduction and Embryology in Rome, found a miscarriage rate of 22% among women with a healthy BMI, compared with a 33% miscarriage rate for the overweight women.

After adjusting their data to take account of the women’s age, history of infertility and miscarriage, and lifestyle factors such as smoking, the researchers concluded that being overweight more than doubled the miscarriage rate.

“Although there is evidence that miscarriage rates are higher in overweight women who conceive spontaneously, there were conflicting views about the effect of increased weight on the outcome of pregnancies occurring after IVF and ICSI,” said Vivian Rittenberg, a fertility doctor who took part in the study.

Rittenberg said many studies that have examined the issue in the past have been hard to interpret, not least because doctors looked at miscarriage rates after implanting several embryos at once at different stages of development.

“We transferred only one embryo at a specific stage of development, and were therefore able to provide clear evidence of the deleterious effect of being overweight on the chances of miscarriage,” she said.

From: http://www.guardian.co.uk/science/2010/jun/28/overweight-doubles-risk-miscarriage-ivf

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Biggest revolution in the NHS for 60 years

July 12, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

GPs and Doctors are to be given sole responsibility for overseeing front line care to patients under Coalition plans described as the biggest revolution in the NHS since its foundation 60 years ago.
Biggest revolution in the NHS for 60 yearsAbout £80 billion will be distributed to family GPs in a move that will see strategic health authorities and primary care trusts scrapped.

The plan, contained in a white paper to be published this week, is designed to place key decisions about how patients are cared for in the hands of doctors who know them.

Tens of thousands of administrative jobs in the health service will be lost as a result.

At present, funds are given by the Government to primary care trusts, which pay for patients from their area to be treated in hospital.

Under these plans, GPs — who are currently not responsible for paying for hospital referrals — would receive the money instead and pay the hospitals directly.

The Coalition hopes the new system will be less bureaucratic and give doctors and patients more control over treatment.

GPs will also have to organise out-of-hours services, which may see family doctors offering 24-hour care once again.

The decision represents a victory for Andrew Lansley, the Health Secretary. He has been backed by David Cameron in his fight with the Treasury over his decision to give taxpayers’ cash directly to doctors.

George Osborne, the Chancellor, raised serious concerns about putting such a vast sum of money, thought to be between £60 and £80 billion, back in the hands of GPs.

Health spending has been ring-fenced by the Coalition and will not be subject to the severe cuts that will hit other Whitehall departments.

However, it is understood that Mr Osborne has been assured by Mr Lansley that there will be safeguards in place to ensure GPs do not “waste” the money.

The acting chief executive of the NHS Confederation, Nigel Edwards, warned that the changes will be difficult to implement: “In transition to this new system there are some quite significant risks,” he said.

“Obviously it is going to take time to implement this and the PCTs at the moment are the people who keep the lid on the performance and financial management of the system.”

The move to scrap the 150 primary care trusts and strategic health authorities, which cover a range of NHS trusts and supervise local NHS services, will come as a shock to Conservative and Liberal Democrat MPs.

The Coalition agreement explicitly vowed to “stop the top-down reorganisations of the NHS that have got in the way of patient care”.

Rather than talking about scrapping trusts, the document explained the role they would continue to play.

However, Mr Lansley will point to the commitment in the joint Tory-Lib Dem document which states: “We will strengthen the power of GPs as patients’ expert guides through the health system by enabling them to commission care on their behalf.”

Commentators are calling the changes “the most revolutionary in the NHS since 1948”. Mr Lansley hopes to have the changes in place by next April, although NHS managers believe that may be over-ambitious. Under the reforms, primary care trusts will not be scrapped immediately, but will be phased out as power is passed to doctors.

A new contract which makes GPs more accountable is likely to be part of the package of measures included in the white paper.

Responsibility will be handed to GPs working in local groups, who will commission services or provide them by working in rotas through co-ops. Mr Lansley believes that if GPs are responsible for their own budgets and have to commission out-of-hours care, most will decide to go back to offering weekend and evening cover themselves or in local groups.

The loss of jobs, which The Daily Telegraph has been told will run into tens of thousands, is also likely to lead to outcry from public sector trade unions. Ministers are already braced for industrial action over plans for severe cuts in the Whitehall workforce.

The fierce dispute over the plans has led to a delay in the publication of the white paper. However, it has been resolved in the past 48 hours.

A source said: “In the end, the Prime Minister clearly said to George Osborne that this was not one he should go to war on.”

Handing over so much power to GPs will revive memories of reforms by the last Conservative government to give control back to the local level through GP fund-holding. Labour, under Tony Blair, attempted a similar plan but fell short.

However, a senior government source told The Daily Telegraph last night that the Coalition’s attempt will succeed because of the political will behind it.

The source said: “GP fund-holding was voluntary. This is going to be compulsory. This is pushing through the whole lot of policy that either Tory or Labour governments have tried in the NHS’s history but have never gone through with properly.”

The reaction of GPs to the changes will be crucial if the Coalition is to avoid confrontation. Ministers will hope that they embrace the opportunity, but some are likely to oppose the moves. Labour failed to drive through public service reforms in the face of opposition from unions and vested interests, as well as opposition from the party’s own MPs.

But Mr Cameron is determined to put his stamp on reform. In a speech to civil servants yesterday, he said his time at No?10 would not be defined solely by cuts and the deficit reduction plan.

From: http://www.telegraph.co.uk/Biggest-revolution-in-the-NHS-for-60-years

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Nanny state advice on suntanning may mean vitamin D deficiency risk

July 09, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Concerns over the link between rising skin cancer rates and exposure to sunshine may have led to overly precautionary advice being given to the public about staying out of the sun at midday, according to a confidential “position statement” by leading health organisations.
Nanny state advice on suntanning may mean vitamin D deficiency riskThe current advice to the public from the leading research charity on skin cancer, Cancer Research UK, states to spend between 11am and 3pm in the shade and to cover the skin with clothing, hats and sunscreen if out.

But a confidential position statement being prepared by the charity in collaboration with other health organisations – and seen by The Independent – acknowledges the changing evidence and emphasises the importance of exposing the skin to the midday sun without any protection in order to maximise production of vitamin D.

Many experts are concerned that past advice designed to protect against skin cancer may have resulted in an increased risk of other illnesses linked to a lack of vitamin D, which the body can only produce when skin in exposed to bright sunlight.

New concerns about Britain’s policy on sun exposure led to this review of the evidence about the risks and benefits of staying in the shade and covering up during the sunniest part of the day.

The confidential document, seen by The Independent, says: “The time required to make sufficient vitamin D is typically short and less than the amount of time needed for skin to redden and burn. Regularly going outside for a matter of minutes around the middle of the day without sunscreen should be enough. When it comes to sun exposure, little and often is best.

“However, people should get to know their own skin to understand how long they can spend outside before risking sunburn under different conditions.”

The wording of the draft document is being seen by come commentators as a tacit admission by Cancer Research UK that it had got it wrong in the past about telling people to avoid the midday sun, to apply sunscreen and to stay in the shade in order to avoid exposure to the cancer-causing rays of the sun.

“Cancer Research UK is working on a new position statement on vitamin D and sunshine which it expects to agree with other health organisations,” said Oliver Gillie, a health writer who has championed the case for vitamin D. “Their new position is expected to break with 20 years of advice to seek the shade and is expected to suggest that people go out in the sun in the middle of the day for at least a few minutes. Several health bodies have agreed to the wording but others are still discussing the details.”

Organisations such as the British Heart Foundation, the Multiple Sclerosis Society, Diabetes UK and the National Osteoporosis Society are discussing what their public position should be on sunshine and vitamin D in the light of several new studies suggesting a link between various illnesses and a chronic lack of the vitamin.

The draft position statement says: “Cancer Research UK’s SunSmart campaign encourages people to enjoy the sun safely and avoid exposures that lead to sunburn. However, for most people, sunlight is also the most important source of vitamin D, which is essential for good bone health.

“It is important to ensure that skin cancer prevention messages are balanced with the need to make enough vitamin D, and reflect the latest scientific evidence.” Sara Hiom, director of health information at the charity, said that the draft consensus statement has not yet been finalised, agreed or released. “It is not our advice to the public and should not be interpreted in that way,” Ms Hiom said.

“Even once we reach a consensus we will not be advising the public to go in the sun in the middle of the day without sunscreen. This is because, for some people – those most likely to be at risk of skin cancer – a few minutes in the middle of the day is enough for them to burn and cause serious and lasting skin damage.

“The very fact that messages around safe sun exposure times cannot be generalised to the population means that our advice needs to be general and is, and will remain, to enjoy the sun safely, spend time in the shade around midday and know your own skin type.”

From:http://www.independent.co.uk/public-advice-on-suntanning-may-mean-vitamin-deficiency-risk

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Homeopathy wastes NHS money claim MPs

July 08, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

The House of Commons Science and Technology Committee said using public money on the highly-diluted homeopathy remedies could not be justified.
Homeopathy wastes NHS money claim MPsThe cross-party group said there was no evidence beyond a placebo effect, when a patient gets better because of their belief that the treatment works.

But manufacturers and supporters of homeopathy disputed the report, saying the MPs had ignored important evidence.

It is thought about £4m a year is spent on homeopathy by the NHS, helping to fund four homeopathic hospitals in London, Bristol, Liverpool and Glasgow and numerous prescriptions.

Homeopathy is a 200-year-old system of treatment that uses highly diluted substances – sometimes so none of the original product is left – that are given orally in the belief that it will stimulate the body’s self-healing mechanism.

Supporters believe the remedies help relieve a range of minor ailments from bruising and swelling to constipation and insomnia.

But the MPs said homeopathy was basically sugar pills that only worked because of faith. In medicine it is recognised that some people will get better because they believe the treatment they take is going to work.

The MPs said the NHS should not fund treatments on this basis. They argued the effectiveness was often unpredictable and involved a deception by the medical establishment.

They also warned it could lead to a delay in diagnosis if symptoms were cured but the underlying reason for them was not tackled.

The MPs also criticised the drugs regulator, the Medicines and Healthcare products Regulatory Agency, for allowing medical claims to be made.

The bar for licensing for homeopathic remedies is not set as high as for medical treatments, partly because they have been used since the NHS was set up in 1948 before the current system of regulation was brought in.

Committee chairman Phil Willis said this approval and the fact they were funded by the NHS in the first place lent the remedies “a badge of authority that is unjustified”.

But the report acknowledged there was a public appetite for homeopathy with surveys showing satisfaction rates of above 70%.

The British Medical Association said it was concerned about NHS funds being used on homeopathy and called for an official review into its effectiveness.

From: http://news.bbc.co.uk/1/hi/health/8524926.stm

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Pregnant women who fast for Ramadan risk damage to their babies, study finds

July 07, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Pregnant muslim women who fast during Ramadan are likely to have smaller babies who will be more prone to learning disabilities in adulthood, according to new research.
Pregnant women who fast for Ramadan risk damage to their babies, study findsScientists in the United States also found that the women were 10 per cent less likely to give birth to a boy if they had fasted during Ramadan.

The trend was clearest if the fasting was done early in the women’s pregnancy, and during the summer months, when long hours of daylight called for them to go longer without food.

Ramadan is the ninth month of the Islamic calendar and a time when Muslims across the world fast from dawn until sunset. Three in four Muslim pregnancies overlap with Ramadan and surveys indicate that the majority of pregnant Muslims observe the fast. This year, it falls between 11 August and 9 September.

Although pregnant women may request an exemption from fasting, they are expected to “make up” the fasting days missed during pregnancy after their baby is born.

Previous research has suggested that this requirement may discourage pregnant women from seeking the exemption, since they do not want to be the only member of their household fasting. Some Muslims also interpret Islamic law as requiring pregnant women in good health to fast.

Since fasting during Ramadan is one of the five pillars of Islam and is a central part of Muslim culture, many women may fear a loss of connection with their communities or would feel guilty if they did not observe Ramadan.

The study, which used census data from the US, Iraq and Uganda, also discovered long-term effects on the adult’s health and his or her future economic success.

Douglas Almond, of Columbia University, and Bhashkar Mazumder, of the Federal Research Bank of Chicago, the authors of the research, concluded: “We generally find the largest effects on adults when Ramadan falls early in pregnancy.

“Rates of adult disability are roughly 20 per cent higher, with specific mental disabilities showing substantially larger effects. Importantly, we detect no corresponding outcome differences when the same design is applied to non-Muslims.”

Sheikh Ibrahim Mogra, an imam from Leicester, said sharia (Islamic law) would never expect a woman to fast if it had an adverse effect on either the mother or child.

“Sharia would not want the mother to unnecessarily burden herself,” he said. “There’s no point being needlessly brave. When Ramadan falls during the winter months, more women will fast. But when it falls during the summer, when you might have to fast for 16 or 17 hours, it is understandable that fewer mothers will be fasting.”

From:
http://www.independent.co.uk/pregnant-women-who-fast-for-ramadan-risk-damage-to-their-babies-study-finds

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BMA fears patients are being exploited by unreliable and inaccurate private health tests

July 06, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Doctors’ leaders are demanding curbs on the boom in private screening clinics offering services ranging from simple blood pressure checks to full body scans costing more than £1,000.
BMA fears patients are being exploited by unreliable and inaccurate private health testsPatients are being exploited by “irresponsible” marketing of private health screening tests, the British Medical Association and the Academy of Royal Medical Colleges say in a letter to health secretary Andrew Lansely.

Screening tests can harm in two ways. First, there’s the positive result that triggers further investigation and treatment but which turns out to be a false alarm, thus subjecting the individual to unnecessary anxiety and pain. And second, there’s the negative result that lulls the individual into a false sense of security – until the disease that has been lurking undetected strikes.

In a joint statement, Hamish Meldrum, chairman of the BMA and Professor Sir Neil Douglas, chairman of the Academy, warn that there are “significant risks” with direct-to-consumer tests. They say private companies are highlighting the benefits of screening while ignoring or playing down the risks.

“Many are unreliable and inaccurate. Patients may be falsely reassured, or undergo unnecessary and sometimes invasive follow-up tests and treatments. Unnecessary procedures may have long-term or permanent complications. These problems often create unnecessary burdens for mainstream NHS services.”

The statement does not mention specific tests but one that is widely promoted is a blood test for prostate cancer which measures the level of prostate specific antigen (PSA).

Research shows that seven in 10 men with a high reading will not have cancer. Worse, two in 100 with a low reading will have significant cancer. So a lot of men will get treatment they don’t need, and some will not get treatment they do.

For those with a high reading, the next stage is a biopsy. This is a painful procedure in which a hollow needle is inserted into the gland close to the rectum and a sample of tissue removed to be examined for the presence of malignant cells.

As the PSA level is a poor predictor of prostate cancer, there is no NHS screening programme. Men are advised to be tested only if they have symptoms, such as difficulty urinating, or a family history of the cancer.

If cancer is found, it may lead to surgery – with its risks – followed by radiotherapy and chemotherapy, which have side effects. But the cancer may not need treating. Prostate cancer is often slow-growing, and many men die with it rather than from it. For them, screening and treating the cancer brings pain and anxiety – and no health benefit.

In the case of whole body scans, sometimes marketed as the “ultimate health check” or “health MOT” for a milestone birthday at 40, 50 or 60, the promise is that it can offer more accurate checks than are usually carried out by old-fashioned family doctors.

The problem is that most scans throw up abnormalities – and if the patient is paying £1,000-plus they are unlikely to feel satisfied with a report that says simple “all’s well”. The clinic may feel under pressure to highlight any abnormalities.

But distinguishing those that are benign from those that indicate serious disease is often difficult. The risk is instead of bringing extra years of life the scans will bring years of anxiety.

In their letter Dr Meldrum and Professor Douglas call on the government to introduce tougher regulations on the marketing of private screening tests to ensure it is factual and balanced. They say clinics must include information on the risks and limitations of the tests, the implications of the results, the procedures not included in the price and the evidence of health benefit.

Dr Meldrum said: “Some private companies are taking advantage of vulnerable people by claiming the health screening they offer will detect diseases early or reduce an individual’s risk of developing specific illnesses.

“However, the NHS has safeguards in place to ensure the public can be confident the tests are supported by sound research evidence. This ensures that anyone having a test is aware of the benefits, risks and limitations involved.

“Such safeguards often do not exist in the private sector which makes it impossible for people to distinguish between private testing services that may do some good, and those that are of no value or potentially harmful.”

Professor Douglas said: “There are significant risks with direct-to-consumer tests. Many are unreliable and inaccurate. Patients may be falsely reassured, or undergo avoidable and invasive follow-up tests and treatments.

“Unnecessary procedures may have long-term or permanent complications which can place a burden on the NHS.”

From: http://www.independent.co.uk/the-1631000-body-scans-that-ought-to-come-with-a-health-warning

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Britons’ two fingers to the nanny state as we are drinking more, getting fatter but living longer.Britons’ two fingers to the nanny state as we are drinking more, getting fatter but living longer.

July 05, 2010 By: Dr Search- Principal Consultant at the Search Clinic Category: Uncategorized

Health Direct wonders if you had a good weekend- as nearly a quarter of the UK popultaion is overweight and the number of alcohol related deaths has more than doubled since the early nineties according to the Office for National Statistics.
Britons' two fingers to the nanny state as we are drinking more, getting fatter but living longer.Britons' two fingers to the nanny state as we are drinking more, getting fatter but living longer.The latest edition of the Social Trends report also reveals that one-in-five men and one-in-seven women over 16 drink more than double the recommended daily allowance of alcohol once a week.

The ONS has been capturing statistical data since the 1970′s on the way that we live.

During that time, life expectancy has increased by almost 10 years for men, who on average live until they are 77.8 years old, and seven years for women, who lived on average until they are 82.

The number of heavy smokers has fallen from 26 per cent of men and 13 per cent of women to seven and five per cent respectively.

Mr Hughes said: “Health is undoubtedly an important indicator and life expectancy is a good indicator of the national health.”

Mr Hughes said: “The statistics highlight some of the main social changes over the last four decades. We are now living longer, less of us get married, and household sizes are smaller.”

“More of us have cars, women are having babies later in life, and more of our household spending goes on housing, water and fuel.”

Mr Hughes said: “It is interesting that more than two thirds of people aged 18 and over in Great Britain believe that they do not need a partner to be happy and fulfilled in life.”

The latest analysis of the way we live also shows that UK residents are taking nearly 40 million more foreign holidays than in the 1970s, with Spain remaining the most popular destination.

This year’s edition of Social Trends will be the last available in paper form, showing how even our statistical analysis is moving with the times, Mr Hughes said.

From: http://www.telegraph.co.uk/Britons-are-drinking-more-getting-fatter-but-living-longer-official-figures-show

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