Allergy patients 'failed by NHS'

GPs and pharmacists do not know enough about allergies, putting patients lives at risk, campaigners say. Allergy UK said training on the subject was extremely limited and many people were going undiagnosed. And the pressure group said even when diagnoses were made, medics often had nowhere to send patients as there were limited specialist allergy clinics.

GPs agree it is an issue that needs to be addressed, but pharmacists argue they already receive enough training. Allergic reactions are caused by substances in the environment known as allergens, of which the most common are pollen from trees and grasses, house dust mites, wasps, bees and food such as milk and eggs.

The number of people suffering allergic reactions has been rising over the last 15 years with over 6,000 people a year in England admitted to hospital. A quarter of these involve anaphylaxis - a sudden, severe and potentially life-threatening reaction, which can cause dangerous swelling of the lips or face and lead to breathing problems.

After listening to the hundreds of people contacting them, Allergy UK believes doctors and pharmacists are too slow to pick up allergies, leaving people vulnerable to severe reactions. A spokeswoman said: "Doctors and other health professionals get little training about dealing with allergies. "It means patients are being put at risk."

The charity also criticised the lack of specialist allergy clinics. Many hospitals have some kind of service, but there are just six clinics in the country which deal with all types of allergy. The charity is planning to launch a website for health professionals giving information about allergies and the common symptoms. They are also offering training on allergies.

Professor Mayur Lakhani, chairman of the Royal College of GPs, said: "Allergies must be taken seriously and we would like to see a stronger emphasis on training in allergies in both undergraduate and postgraduate medical training. "At the moment we don't have the facilities to adequately investigate, manage and treat patients with allergies and we would like to see a programme of national action implemented in primary care."

But the Royal Pharmaceutical Society of Great Britain rejected the idea that pharmacists were not trained enough.
A spokeswoman said: "Pharmacists receive five years education and training, a large focus of which is on allergy."

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Now this is REAL socialized medicine

What REALLY bad service does -- even to the patient and peacable Chinese:

Doctors and nurses at a hospital in eastern China have told its administrators they will use police truncheons and wear helmets as a protection from attacks by angry patients. Staff at No. 1 People's Hospital, in Zhenjiang, Jiangsu province, also asked for 24-hour security guards and cameras after a spate of assaults that led to injuries and a number of resignations, the Beijing Youth Daily reported yesterday. "Until effective measures are taken to ensure their protection, doctors and nurses will attend work with helmets and police truncheons for use in self-defence," the paper quoted a staff notice given to the hospital's directors as saying.

Medical staff were suffering frequent attacks at work from patients and their relatives, ranging from cursing and death threats to serious beatings. The Health Ministry recorded about 10,000 attacks on hospital staff stemming from patient disputes last year, the China Daily reported. In December doctors and nurses at Shanxia hospital, in Shenzhen, Guangdong province, were forced to wear hard hats on their rounds after being jostled and spat at for days by relatives seeking compensation over a patient's death.

The Health Ministry last week called for police to patrol hospitals to protect staff and ensure a "harmonious" medical environment. "Harmonious society" is a catchphrase of the President, Hu Jintao, for easing tensions fuelled by corruption and a widening wealth gap.

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CONSTANT CUTBACKS ARE THE HALLMAREKS OF THE NHS BUT IT HAPPENS IN AUSTRALIA TOO

Two reports below from the Australian State of Victoria:

Patients booted out of Melbourne public hospital

SICK elderly patients will be among hundreds ejected from the Royal Melbourne Hospital in a management bid for government-sanctioned performance bonuses. Documents seen by the Herald Sun reveal the hospital is planning to discharge one patient from selected units by 10am each day for the next seven weeks. Up to 490 patients, including those from the acute geriatric medicine unit, will be discharged as the financial year draws to a close. Health Minister Bronwyn Pike says the practice is common in Victoria and overseas.

The documents, which describe patients as "system blockages", also reveal elderly patients are among the 65 per cent made to wait more than eight hours for admission. In an email to senior staff, the director of the hospital's division of medicine, Tony Snell, says the discharge tactic aims to secure bonus funding under a Department of Human Services performance scheme. "The aim is to get a significant amount of the available bonus pool funding," Dr Snell writes. "We seek your support in achieving these improvements in patient care (i.e., less delay in the emergency department), which will also improve our budget situation. "In order to achieve this we are targeting the key performance indicators of length of stay in the emergency department and waiting list reduction."

Ms Pike, who says she has not seen the email, backs the practice. "We want to make sure we don't have people on a bed with a suitcase packed waiting for the hospital to get the paperwork right, or that the patient has their medication with them," she says. "I fully support setting targets for the units, because it's saying to them this is best practice." Asked whether she would encourage other hospitals to set similar standards, Ms Pike says: "I know they already are and I'm very pleased. "Anyone who would suggest this is compromising patient care is insulting the doctors and nurses who work in the system."

A Royal Melbourne spokeswoman yesterday insisted patients would not be sent home before they were ready. "It's really just asking doctors to do their rounds earlier in the morning," she said. The spokeswoman said about a third of the 170 patients presented to the emergency department each day required hospital admission. The email says that in previous years, patients have had to wait 24 hours in the emergency department before admission. It says that 64 per cent of patients are admitted from the emergency department within eight hours. But last month, in the medical division, only 35 per cent were admitted within that time frame. "To improve this we need to increase morning bed capacity and move out patients more quickly from the emergency department," Dr Snell writes. "We are aiming to have at least one patient per unit discharged by 10am." Dr Snell and another staffer would also audit patients who had remained in hospital for longer than a fortnight to see where they could assist in removing blockages in the system.

A second email from a senior staffer orders that patients identified for discharge be moved to the transit lounge and vacant beds be filled immediately. The hospital's division of medicine has 10 units, which include acute geriatrics, haematology and diabetes.

Opposition health spokeswoman Helen Shardey says the Royal Melbourne had suffered a drastic bed shortage. "The funding is not coming in on a sustainable basis, so the hospitals are having to play these games all the time," Ms Shardey says. Latest figures reveal there were 2872 patients on the Royal Melbourne's elective surgery waiting list in December last year, up 100 in six months

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Reduced surgery in another Melbourne public hospital

SICK children and pregnant women will be denied surgery at a major Melbourne hospital next week. Monash Medical Centre has slashed its elective surgery list as the financial year draws to a close. Doctors believe the move is aimed at cutting costs but Monash insists it is part of normal scheduling.

Theatre schedules seen by the Herald Sun reveal a blackout on pediatric, obstetric and vascular surgery for the week beginning May 28. A high-level health care source said patients continued to wait for elective operations at Monash despite beds and doctors being available. "The surgeons are there with nothing to do," the source said. "It happens regularly and usually in the last quarter of the financial year. "It's because they've got their bucket of money for the year and now they're running out and it costs them money to push (patients) through."

Specialists were angered by the blackout. "It was believed to be due to the fact that it was a funding constraint," the source said. "It was implicit and it wasn't well received by the people who were affected."

A spokesman for Southern Health, which manages the Monash Medical Centre, said next week's surgery blackout was necessary due to an anaesthetists' conference. A spokesman for Health Minister Bronwyn Pike said emergency surgery would continue. "It's not related to funding," he said. There were 1767 people waiting for elective surgery at Monash at last count, in December.

The row at Monash came as Ms Pike defended Royal Melbourne Hospital's decision to discharge at least one patient from selected units each day until July. The Herald Sun yesterday revealed the directive, which was contained in an email that also described patients as "system blockages".

One patient who doesn't want an early release is Harry Tsogias, 40, who said yesterday he had been wrongly sent home once before. Rushed to Royal Melbourne's emergency department on April 14, unable to walk and in extreme pain, Mr Tsogias was diagnosed with sciatic pain in his right leg and discharged a few hours later. "I couldn't walk. It was so sore I was in tears," he said. "I was in a lot of pain and I was sent home." On May 10, he returned to the Royal Melbourne and was this time rightly diagnosed with an aggressive infection in his hip -- so advanced he needed surgery. After having parts of his infected hip bone cut out, he now faces the possibility of a hip replacement. "They gave me a very quick examination and sent me home," he said. "This could have been prevented."

Due to go home again this week, Mr Tsogias said he was not ready and accused the hospital of throwing patients on the street to free up needed beds. "I am not going anywhere," he said. "After what happened last time I don't want to go until I am 100 per cent cured."

The Royal Melbourne yesterday denied the Herald Sun access to patients in the transit lounge, where they are forced to wait. "They are kicking people out before they are ready to leave," said Mr Tsogias' sister, Anna Manidis. "Someone is not doing their job properly."

Royal Melbourne's executive director (clinical governance) Christine Kilpatrick said: "No patient is ever discharged prior to them being assessed by the medical staff and (staff) ensuring they are ready and safe." The hospital was under enormous pressure to free up beds, but there was no financial incentive to discharge one patient a day. "We don't have a dollar value on their bed," she said. "It is about making sure patients who are ready to leave prior to 10am have all their needs and services arranged."

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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