Doctors try to justify strike in open letter

Doctors have published an open letter in the national newspapers to try to quell a growing backlash against their industrial action.Doctors try to justify strike in open letter The full page statement, paid for by their union, the British Medical Association, explains why they are striking and taking a day of action.

The BMA announced yesterday that doctors would postpone non – urgent operations, outpatients’ appointments and GP consultations on June 21.

Tens of thousands of patients will be affected and the action will cost the NHS at least £40 million.

The letter doctors have published in the national newspapers

The move has led to accusations of them being “greedy” and leaving patients “waiting in pain” for surgery.

Department of Health figures show that a typical NHS doctor retiring now at 60 will receive a pension of more than £48,000 a year for life.

In addition, they receive a tax – free lump sum of about £143,000, a pension scheme that would cost more than £1 million in the private sector.

The letter, signed by Dr Hamish Meldrum, the Chairman of Council, tries to reassure patients that they emergency cases will be looked after and outlines their reasons for action.

“We will be postponing non-urgent cases and although this will be disruptive to the NHS, rest assured, doctors will be there when our patients need us most and our action will not impact on your safety,” it reads.

“We feel this action is vital in order to address the unfair treatment of the NHS pension scheme.  Despite agreeing to major reforms in 2008, that made the NHS pension scheme fair and sustainable, doctors are now being asked to work much longer, up to 68 years of age, and to contribute much more of their salary, up to 14.5 per cent, for their pensions.

“These contributions are up to twice as much as those of civil servants on the same pay, for the same pension.  We are not looking for preferential treatment from the Government but we do want fair treatment. This is the first industrial action by doctors since 1975 and it is not a decision we have taken lightly.”

The industrial action was called after a ballot of 104,000 BMA members returned overwhelming support for action.

But the day of action has been roundly criticised.

Andrew Lansley, the Health Secretary, said the public would not understand or sympathise with the decision to take action.

Even Andy Burnham the shadow health secretary, urged doctors to “pull back”.

The Patients Association said people would be forced to wait for operations while in pain.

A further day of action would be considered after June 21.

Julia Manning, the chief executive of 2020health, a think tank, said: “This is a massive own goal for doctors that tarnishes them all with a ‘greedy’ brush. Many of my friends in medicine will be horrified and embarrassed at the thought of their colleagues striking.”

Obese and smokers denied health treatments to save NHS money

The NHS has been accused of trying to save money by blocking access to surgery for smokers and obese patients as new figures show how they are routinely being denied treatments.Obese and smokers denied health treatments to save NHS moneyData shows that more than a quarter of Primary Care Trusts in England have brought in new restrictions based on patients’ lifestyle criteria in the last year.

It reveals that people are being denied IVF treatment, breast reductions and fat loss operations based on their weight and whether they smoke.

In the case of one trust, NHS Hertfordshire- a controversial ban imposed last year on knee and hip operations for anyone with a body mass index (BMI) over 30 as well as smokers, has been extended to cover all routine surgery.

The new Hertfordshire policy, introduced in January, makes exceptions only for neurology, cardiac and cancer operations.

Freedom of Information responses from 91 PCTs, obtained by doctors’ magazine Pulse, show 25 have brought in new restrictions on treating obese patients or smokers since April 2011.

Dr Clare Gerada, head of the Royal College of GPs, said some of the restrictions, particularly for IVF, were “dreadful”.

She added: “It’s becoming the deserving and the undeserving. I think it’s discriminatory and I find it astonishing. The Government should determine what should be applied universally.”

The figures showed that the Peninsula health technology commissioning group, covering Cornwall, Devon, Torbay and Plymouth, is now banning both men and women from undergoing IVF treatment unless they have been non smokers for at least six months.

Men and women must also have a BMI of between 19 and 29.9 before they will be given certain fertility drugs.

The two PCTs covering County Durham and Darlington will not treat people for varicose veins unless they have a BMI of 30 or under, the figures also show.

The figures also showed that the three PCTs covering North Essex must not accept referrals for joint replacement surgery from people with a BMI of 40 or over.

Furthermore, all patients who smoke in the region must be referred to stop-smoking services before they will be considered for stomach surgery, breast reconstruction, breast reduction, scar revision surgery or nipple inversion treatment.

In Lincolnshire, as of June last year, patients must have had a stable BMI of 18 to 25 for at least a year before they will be considered for breast reductions.

Meanwhile, hip and knee replacements will not be given to patients who have a BMI greater than 35, or current smokers.

In Bedfordshire, access to hip and knee replacements is denied to patients with a BMI of 35 or over until after they have lost 10% of their initial body weight or moved below a BMI of 35.  Before July last year, there was no BMI cut off in the region.

Steve Nowottny, deputy editor of Pulse, said: “Rationing in the NHS is nothing new – but PCTs and clinical commissioning groups are increasingly taking the decision to ration care based on patients’ lifestyle choices.

“In some cases there may be genuine clinical justification for rationing treatment on these grounds. But there is a growing suspicion that some PCTs are now blocking access to surgery for smokers and the obese simply to help achieve ever greater efficiency savings.

“Such a policy has disturbing implications – and GPs are increasingly uneasy about the NHS providing a second-class service to patients with less healthy lifestyles.”


Vitamin D supplements recommended by NHS health experts

The chief medical officer for England, Dame Sally Davies, is to contact medical staff about concerns young children and some adults are not getting enough vitamin D.Vitamin D supplements recommended by NHS health expertsGovernment guidelines recommend some groups, including the under-fives, should take a daily supplement.

However, recent research found that many parents and health professionals were unaware of the advice.

There has been an increase in childhood rickets over the past 15 years.

According to Dr Benjamin Jacobs, from the Royal National Orthopaedic Hospital, links to heart disease and some cancers are also being investigated.

The Feeding for Life Foundation report, published in October last year, suggested one in four toddlers in the UK is vitamin D deficient.

However, this may be an underestimate as only vitamin D from food was included, and not any vitamin D obtained through sun exposure.

Vitamin D supplements are recommended for all people at risk of a deficiency, including all pregnant and breastfeeding women, children under five years old, people aged over 65, and people at risk of not getting enough exposure to sunlight.

Vitamin D is mainly obtained from sunlight. However, too much sun exposure increases the risk of skin cancer.

According to one recent study, nearly three-quarters of parents and more than half of health professionals are unaware of the recommendations.

The Department of Health has asked the Scientific Advisory Committee on Nutrition to review the issue of current dietary recommendations on vitamin D.

Dame Sally Davies: “We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements. Free supplements

“Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children.

“Many health professionals such as midwives, GPs and nurses give advice on supplements, and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.

“It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at-risk groups.”

It has long been known that vitamin D prevents rickets and children were once given food supplements like cod liver oil.

However, this practice was stopped in the 1950s because it was thought unnecessary.

In the last 10 years, doctors have been seeing more cases of vitamin D deficiency, leading to a debate over the use of food supplements and concern that many medical staff are unaware of the problem.


Cost of sleeping pills to NHS almost £50 million

The cost of a good night’s sleep to the NHS has almost hit £50 million, with more resorting to pills due to job worries brought on by the recession.Cost of sleeping pills to NHS almost £50 millionFigures released by the NHS Business Services Authority show England’s 152 primary care trusts (PCTs) spent £49.2 million on sleeping pills in 2010-11, up 17 percent in just four years.

That meant pharmacies dispensed more than 15.2 million prescriptions to aid sleep, roughly one for every three adults.

The NHS in England is now spending £1.20 per head per year on sleeping pills, according to the figures, obtained by The Co-operative Pharmacy via a freedom of information request.

Mandeep Mudhar, NHS business director at the pharmacy chain, said the recession was likely to have made people more anxious, increasing sleeping problems.

He said: “Sleep patterns can be affected by physical or psychological factors and the continued economic downturn is a likely cause for the increased use of sleeping pills because of the heightened stress, anxiety and worry levels people face as a result of job insecurity or money worries.”

He continued: “While usage has risen steadily, the costs to the NHS have risen disproportionately, with costs going up at a greater rate.”

He advised against long-term use of some sleeping pill.

“Some sleeping drugs are only recommended for short term use because they can lead to psychological dependency and lose their effectiveness over time,” he said.

“We would urge people who are suffering with insomnia or their use of sleeping pills to discuss their concerns with a pharmacist or their doctor.”

Sex after heart attacks not the preserve of TV programmes

Racy TV plot lines where middle aged men die in their lovers’ arms are putting heart attack survivors off sex, say doctors.Sex after heart attacks not the preserve of TV programmesCardiologists say heart attacks are so rarely bought on by sex that survivors need not worry about abstaining.

Television series like Downton Abbey and Mad Men, and films like Body of Evidence, feature dramatic scenes where philandering men suffer heart attacks in bed brought on by the exertion and excitement of it all.

But cardiologists say heart attacks are so rarely brought on by sex that survivors need not abstain.

Less than one per cent of people who die due to fatal heart attacks do so during or shortly after sex, they say.

According to the American Heart Association, anyone fit enough to walk up a few flights of stairs should be fit enough to have sex, as they are equally strenuous.

In Downton Abbey, Lady Mary, played by Michelle Dockery, is left aghast when a Turkish diplomat dies in her bed after they have made love.

In Mad Men, advertising boss Roger Sterling suffers a heart attack after spending the night with a pair of twins, whom he shares with a colleague, Don Draper. He survives, and the experience does not change him.

In Body of Evidence, Madonna stars as a woman accused of having rough sex with an elderly millionaire to kill him and inherit his fortune.

Last year the sex-triggers-heart-attacks theory was given scientific backing by a study, published in the Journal of the American Medical Association. It found that heart attack risk was almost three times higher in the hour or two after sex than at other times.

A new study, published in the American Journal of Cardiology, has found that far too few cardiologists give heart attack survivors advice on resuming their sex lives.

The survey of 1,879 heart attack patients found less than half of men and about a third of women recalled receiving instructions about when it was safe to do so.

Dr Stacy Tessler Lindau, of University of Chicago Medicine, said those who did not receive advice were far less likely to resume their sex lives than those who did.

She said: “Doctors need to understand the significant role they play in helping acute myocardial infarction [heart attack] patients avoid needless fear and worry about the risk of relapse or even death with return to sexual activity.”

Dr Harlan Krumholz, of Yale University School of Medicine, added: “This study may help doctors address issues that they’re traditionally reluctant to discuss.

“We’re showing that addressing sexual health may make a difference to long-term outcomes.”

However philanderers should still beware. Another study, published in the journal Circulation, found that three out of four men who died of cardiac arrest ‘in flagrante delicto’ did so while having an affair.

Obesity a derogatory word claims nanny quango NICE

The word ‘obesity’ could be considered ‘derogatory’ and public health professionals should use it with care, according to the nanny quango NICE.Obesity a derogatory word claims nanny quango NICEA quarter of adults in Britain are now obese, a figure that is due to more than double by 2050. Those from poorer backgrounds are much more likely to be obese than the more affluent.

But a government quango is now advising public health experts drawing up anti-obesity plans around the country to avoid using the ‘obese’ word itself for fear of upsetting people.

Health campaigners have night attacked the softly softly approach, describing it as “extremely patronising”.

Under draft guidance issued by the National Institute for Curbing Expenditure (Nice), those who are obese should merely be encouraged to get down to a “healthier weight”.

The guidance states that public health professionals should know “the appropriate language to use”, advising them: “Referring to ‘achieving a healthy weight’ may be more acceptable for some people.”

The document continues: “Directors of public health and local government communications leads should carefully consider the type of language and media to use to communicate about obesity.

“For example, it might be better to refer to a ‘healthier weight’ rather than ‘obesity’ – and to talk more generally about health and wellbeing or specific community issues.”

Ironically, the advice is contained in a paper that makes no bones about its subject matter: it is called Obesity: Working with Local Communities.

But Nice officials concluded that while the term was fine for health professionals to use among themselves, they should handle it with care in public.

They warned: “The term ‘obesity’ may be unhelpful – while some people may like to ‘hear it like it is’, others may consider it derogatory.”

However, Tam Fry, of the National Obesity Forum, said: “This is extremely patronising. They should be talking to people in an adult fashion.

“There should be no problem with using the proper terminology. If you beat around the bush then you muddy the water.”

Obesity is a medical term, defined as having a body mass index (BMI) of 30 or more. BMI is calculated by dividing one’s weight in kilograms by the square of one’s height in metres.

Mr Fry went on: “Obesity is a well defined, World Health Organisation standard that everybody can understand.”

“It is the point where the individual is so overweight that they are at risk of other health problems.”

Squeamishness over use of the word is not new. When the National Child Measurement Programme was launched in 2008, Department of Health officials decided against using the words “fat” or “obese” in letters to parents. They were simply told their son or daughter was overweight.

Such fears of upsetting people are not shared by Anne Milton, the Public Health Minister. Two years ago she said that people should be told they were “fat” rather than “obese” because she felt the word was more hard-hitting.

She said: “If I look in the mirror and think I am obese I think I am less worried [than] if I think I am fat.”


New Ambassador for Alzheimer’s Society

The Alzheimer’s Society has announced that actress Carey Mulligan as its newest ambassador.

Carey attended a special event in north London being held to mark the beginning of the charity’s Dementia Awareness Week™ (20 – 26 May).

Carey joined people with dementia and their carers at the ‘Rest-Bite’ service in Kentish Town. The Bafta-winning star has chosen to support Alzheimer’s Society as her grandmother Margaret, known as Nans, was diagnosed with Alzheimer’s in 2004.

Watch Carey talk about her grandmother’s dementia
Speaking at the event, Alzheimer’s Society Ambassador, Carey said:

‘I am committed to helping Alzheimer’s Society in any way I can. My family and I rely on the help of organisations like Alzheimer’s Society to help us understand the disease and guide us in the care of my grandmother. It’s been a privilege to meet so many people with dementia.’

Carey’s appearance came as Alzheimer’s Society published new statistics which found that 44 per cent of people currently know or used to know someone with dementia. It also found that the majority of people (61%) are worried about either themselves or someone they know developing dementia in later life. Yet despite their fears less than a fifth (16%) of people want to know more about the condition, with 18-24 year olds the most keen to learn more (25%) in comparison to only 15 per cent of over 55 year olds.

Carey said:

‘I hope to do all I can to help defeat dementia and that’s why I wanted to get involved in Dementia Awareness Week™. By speaking about my grandmother’s dementia I hope to shine a light on the condition. This Dementia Awareness Week™ we are asking people to ‘remember the person’ by looking beyond someone’s diagnosis of dementia and engaging with them.’

Jeremy Hughes, Alzheimer’s Society Chief Executive, said:

‘We are extremely excited to have Carey’s support. There are currently 800,000 people living with dementia in the UK and this is set to rise to one million in ten years yet there is still much stigma surrounding the condition. By speaking out about her experiences Carey is helping us to reach new audiences and will hopefully get more people talking about the condition.’

Dementia is a condition that slowly shuts down the brain and affects one in three people over the age of 65. Alzheimer’s Society has produced a booklet and video of the five things you should know about dementia to help people learn that little bit more – key lessons include dementia is not a natural part of ageing and it is possible to live well with dementia. The booklet can be downloaded and the video viewed at

Persistent cough could be lung cancer warning

The public should be vigilant about persistent coughs as they could be a sign of lung cancer, a new government advertising drive is warning.Persistent cough could be lung cancer warningThe campaign, which is being run in TV, radio, print and online media, recommends that people with coughs lasting more than three weeks should visit their GP.

Research has shown the public are much more aware that lumps and bleeding are warning signs of cancer than a cough.

But the ads make clear persistent coughs should also raise alarm bells.

The push is being backed by celebrities including comedian and actor Ricky Gervais, TV star Linda Robson and Manchester United manager Sir Alex Ferguson.

Lung cancer affects 33,000 people in England every year, with the majority of cases occurring in people over the age of 55.

But when diagnosed at an early stage, as many as 80% are alive five years after diagnosis – compared with 7% if it is spotted late on.

Ricky Gervais, whose mother died of lung cancer at the age of 74, said: “It’s devastating when you see someone you love dying from lung cancer.

“It’s a horrible, horrible disease. My mother’s death was very sudden and you can’t help wondering if things would have been different had it been spotted earlier.”

New IVF postcode lottery meaningless ruling by NICE quango

Gay couples and women over 40 will be entitled to the same free IVF treatment as heterosexual couples on the NHS for the first time under new guidelines published today.New IVF postcode lottery meaningless ruling by NICE quangoSame sex couples will be given the same rights as heterosexual couples under guidance issued by the killer quango National Institute for Curbing Expenditure (NICE).

The NHS will also extend the upper age limit for IVF by three years to 42, following advice that suggests many women in their late 30s and early 40s could conceive after treatment.

Fertility experts questioned whether health authorities could afford to widen eligibility criteria, when only a quarter currently fund three cycles of IVF for infertile couples, as recommended by Nice.

Gedis Grudzinskas, emeritus professor of obstetrics and gynaecology at Barts and the Royal London Hospital, said that while the new guidance reflects “social changes” there were questions over whether NHS trusts could afford it.

“How do we reconcile the changes in society and equality of access to healthcare, with the economic predicament?” he said.

The new guidelines call on health authorities in England and Wales to fund fertility treatment known as intra-uterine insemination (IUI), using donor sperm, for people in same-sex relationships.

The move follows a relaxation in the law, made under Labour in 2008, to put same sex parenting on an equal legal footing.

The recommendation follows implementation of the Human Fertilisation and Embryology Act 2008. It abolished requirement for fertility clinics to take into account a child’s need for a father or a male role model before agreeing to treatment. Gay couples or single women now need only show they can provide “supportive parenting”.

Demand from gay couples paying privately for fertility services has subsequently boomed, say clinics. Official figures show the number of lesbian couples undergoing IVF rose from 178 in 2007 to 417 in 2010.

One cycle of IVF can cost up to £8,000 privately. Because success rates are low – typically 20 per cent for a 38-year-old – couples can spend tens of thousands on treatment.

Meanwhile Josephine Quintavalle, founder of Comment on Reproductive Ethics, described the same-sex move as “absurd”.

She said: “We are not prepared to accept what constitutes fertility from a biological perspective. Fertility treatment is very important but in this case what we are trying to do is rewrite biology.”

Under the Nice guidelines, women aged 40 to 42 deemed to have no chance of conceiving naturally should be offered one full IVF cycle. In this age group one in eight will give birth after one cycle.


Health Direct website for NHS patients booking doctor appointments online

NHS patients will be able to book GP appointments online and get test results online within three years from a new health direct website.Health Direct website for NHS patients booking doctor appointments onlineThe moves are part of a new Information Strategy designed to “take the hassle out of the health service”.

Online communications between patients and their doctors is already happening in some places.

But the strategy sets out plans to ensure there is universal adoption of digital technologies.

The Department of Health is also encouraging the NHS and private companies to develop new health apps for smart phones and tablet computers.

Repeat prescriptions will also be available from 2015 too.

The deadline mirrors the goal of giving patients access to electronic medical records – something thatwas part of tony bliar’s vision for the NHS in his NPfIT £12 billion dream.

Health Secretary Andrew Lansley said: “Our NHS reforms are about making life easier for patients.

“By allowing people to access the NHS online, we will put an end to the 8am rush to phone your GP to try and book an appointment. Reforms like this will take the hassle out of the health service.”

Dr Laurence Buckman, chairman of the British Medical Association’s GPs Committee, said: “There are GP surgeries which have been pioneering online booking and repeat prescriptions for a while now so we would support the wider implementation of this, as long as it doesn’t impact on patients without IT access who can continue to book appointments in the usual way.

“However, we would caution against the potential use of email for consultations, because compared to a telephone or face-to-face consultation it is difficult for GPs to assess someone quickly and safely this way.

“When it comes to patients being able to view their records online, we believe patients should have access to their health records but we’d want to be satisfied that their records would remain secure before this was implemented – for example it would be important to be certain that it couldn’t be an abusive partner or a parent trying to access their teenager’s records. All patients need to be confident that their records are held safely otherwise they may not feel comfortable talking to their GP about confidential issues.”

Given that the government has an appalling record on leaking and losing your records from everything from DVLA to the tax office we caution against rushing out and signing up for similar treatments.