Monday, October 01, 2007

NHS failure on allegies

An epidemic of allergic diseases is sweeping Britain while treatments languish and people's lives are blighted, according to an influential House of Lords committee. Britain is "the laughing stock of Europe" for its neglect of treatments that work and are routinely used elsewhere, said Baroness Finlay of Llandaff, who chaired an investigation by the Science and Technology Committee.

Allergies - which include hay fever, asthma, some skin conditions and peanut allergy - are often poorly diagnosed by GPs, who lack facilities to which they can refer patients for proper testing. As a result, many allergy patients go untreated while others go through life convinced that they are suffering from allergies they do not have. Waiting lists for the few allergy clinics that exist are long, and would be longer still if the many neglected patients could be referred to them.

Teachers are poorly trained to deal with allergic emergencies, the food industry is lax about labelling foods that have the potential to kill and advice given by the Department of Health to pregnant women to avoid peanuts is baseless - and could even be making the situation worse.

Lady Finlay said that her committee was extremely alarmed by the advice to pregnant women, and to children from families with a history of allergy, to avoid peanuts. "Academics and clinicians have told us that a growing body of evidence suggested this guidance may not only be failing to prevent peanut allergy, but might even be counterproductive," she said.

It was possible that exposure to peanuts in the womb or when young could prevent peanut allergy rather than cause it. The evidence did not justify the advice the department was giving, and it should be withdrawn. In parts of the developing world where groundnuts were used in a "soup" for weaning babies, there had not been the explosion in the number of people allergic to peanuts, she said.

The committee recommended setting up a network of centres headed by an allergist and staffed by other specialists such as immunologists, dermatologists, paediatricians, gastroenterologists and chest medicine specialists. It also called for an overhaul of food labelling regulations to improve on "vague and defensive" information such as "may contain nuts".

Allergies cost the NHS in England 1 billion a year for drugs and treatment, and the cost to the economy of asthma alone is o2.3 billion a year. Millions of people suffer allergies: 3.3 million suffer hay fever at some time in their lives and 5.7 million have asthma. Food allergies kill about 20 people a year through the severe reaction called anaphylactic shock.

Lady Finlay called for increased funding for research. The recommendation was welcomed by Stephen Holgate, of the University of Southampton, a leading expert. He said: "We need new environmental research, trying to find out what it is about our environment that causes allergies. We need to set up proper studies. This is the fourth report in recent years to criticise UK allergy treatments."

The National Allergy Strategy Group said that the four reports had said much the same. "But the department has not acted to bring about change. Unless strategic health authorities and primary care trusts are directed to develop services, patient care will not improve." The committee said more use should be made of immuno-therapy, where people are exposed to small doses of the substance that causes a reaction to "desensitise" them.


Australia: Got breast cancer? Too bad

QUEENSLAND Health will struggle to diagnose suspected cancer victims identified through a new breast screening campaign because of staff shortages. The $1.5 million advertising campaign, which features veteran television journalist Jana Wendt, is aimed at increasing rates of regular screening among women aged 50 to 69.

But documents obtained by The Courier-Mail reveal women suspected of having breast cancer following the screen are likely to be exposed to lengthy delays in their diagnosis and treatment at Queensland hospitals. Queensland Health's latest "Allied Health Vacancy Data" shows the state has an acute shortage of radiographers, who are trained to operate medical imaging machines. In southeast Queensland alone there are currently 35 vacant radiographer positions listed as "critical", meaning their absence has caused or will cause service closures. The number of critical vacancies is three times worse than a year ago and has been predominantly caused by unfilled positions at the Gold Coast's Robina Hospital and Brisbane's Princess Alexandra Hospital. The Courier-Mail revealed in June that the advertising campaign featuring Ms Wendt had been shelved amid concerns BreastScreen Queensland could not cope with extra patients.

Health Minister Stephen Robertson yesterday said the service was now well-placed to cope with increased demand with only 10 vacancies and two clinics with unacceptable wait times. Mr Robertson said the Government was also addressing the shortage through a new pay deal. "There is an enterprise bargaining agreement currently in the process of being finalised that will ensure that we are nationally, and arguably internationally, competitive," he said.

The campaign is aimed at addressing figures showing only 58 per cent of Queensland women aged 50 to 69 have regular breast screens. Wendt said women often delayed screening but research showed it could dramatically cut the number of breast cancer deaths.


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