Thursday, July 19, 2007

NHS fails diabetics

The majority of NHS trusts are not giving people with diabetes enough help in managing the condition at home, a watchdog has warned. The Healthcare Commission said most primary care trusts were offering basic diabetes care such as yearly check-ups. But it warned that almost 130 out of more than 150 failed on home support.

Offering services to help patients manage their weight or plan an exercise regime are seen as crucial in reducing complications like heart problems. As such, they could also save the NHS millions of pounds each year. In 2002, about œ1.3bn - or 5% of NHS expenditure - was used to care for people with diabetes. Estimates from 2006 suggest this could even have crept up to 10% of total spending, the commission said.

Managing diabetes at home by controlling weight, or giving up smoking, have been touted as a key means of tackling complications of the condition. As well as heart problems, these include blindness, kidney failure and limb amputation.

Beefing up community services and the potential for self-management of long-term conditions such as diabetes is also one of the key planks of government policy. Diabetes is seen as a growing problem in the UK. According to the watchdog, the number of diagnosed and undiagnosed cases is likely to have risen by 15% between 2001 and 2010. Some 9% of this was due to increasing numbers of obese people, and a further 6% was the result of an ageing population, it suggested.

The Healthcare Commission said PCTs had to do better in supporting people to manage their condition.


Ethically-challenged NHS doctor

A doctor accused of wrongly causing a health scare over the MMR vaccine paid children 5 pounds each to give blood samples at his son's birthday party, a disciplinary hearing has been told. Andrew Wakefield abused his position as a doctor and showed "a callous disregard" for the distress and pain that the children - thought to be as young as 4 - might suffer, the General Medical Council was told.

The allegations emerged yesterday along with charges connected to research by Dr Wakefield and his former colleagues, John Walker-Smith and Simon Murch, that claimed the combined vaccine against measles, mumps and rubella carried serious health risks. The doctors appeared before the GMC's fitness-to-practise panel charged with serious professional misconduct, which they deny. All three are accused of performing procedures, such as colonoscopies, barium meals and lumbar punctures, on children that were "contrary" to the children's clinical interests and conducted without the proper ethical approval and consent forms.

The GMC accused Dr Wakefield of bringing the profession into disrepute by taking blood from children at his son's party at some point before March 20, 1999, when he joked about the incident while giving a presentation at the Mind Institute, California. Footage was shown on ITN last night of the episode. Dr Wakefield is seen on video saying: "And you line them up - with informed parental consent, of course. They all get paid 5 pounds , which doesn't translate into many dollars I'm afraid. But . . . and . . . they put their arms out and they have the blood taken. All entirely voluntary." [Laughter] He says that two of the children fainted, while one was sick over his mother, which drew laughter from the audience.

Dr Wakefield is then heard joking: "People said to me, `Andrew, look, you know, you can't do this, people, children won't come back to you. [Laughter] I said, `You're wrong'. I said, `Listen, we live in a market economy. Next year they'll want 10 pounds'"

The MMR controversy began after the doctors published their research in The Lancet in 1998, claiming that the jab overloaded the immune system, causing bowel problems and also autism and other illnesses. Further research has quashed these conclusions. At the time, all three doctors were employed at the Royal Free Hospital's medical school in Hampstead, North London. They conducted the study on 11 British children without approval from the hospital's ethics committee, the GMC was told.

The list of allegations against Dr Wakefield took more than an hour to read out. One of the key accusations is that he failed to declare that he was being paid for advising solicitors on legal action by parents who believed their children had been harmed by MMR. Another charge is that he ordered subsequent studies "without the requisite paediatric qualifications". He is also alleged to have allowed one child - Child 10 - to be given an experimental cocktail of drugs, known as "transfer factor", with the view to it being developed into a new measles vaccine. Dr Wakefield admitted being involved in proposals to set up a company to manufacture the drug. The father of Child 10 was to be the company's managing director.

It was alleged that he did not reveal that he had accepted 50,000 pounds from the Legal Aid Board for research to support legal action by parents who believed their children were harmed by MMR. He was also accused of being "dishonest" and "irresponsible" when submitting his views about MMR for publication.



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?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when is playing up, there are mirrors of this site here and here.


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