Sort out diabetes and save the NHS

Diabetes is common and often undiagnosed. 2.3 million people in the UK know they’ve got it, another million don’t know they’ve got it and the incidence rises every year as we become older and fatter. Treatment can be complicated, and requires a lot of support, education and training, and close monitoring in times of illness.

It’s the commonest cause of blindness in the working population and can also lead to foot ulcers, nerve damage, infections, amputations, heart attacks, strokes, kidney failure, depression, serious pregnancy complications, erectile dysfunction and premature death. Poorly controlled diabetes knocks 10-20 years off your life and it costs the NHS over £1 million an hour to treat. So it’s vital, for both patients and NHS survival, that we treat it well.

The latest National Diabetes Inpatient Audit* is not encouraging. It looked at diabetic care in 93% of acute hospitals in England on a single November weekday in 2010, and found that people with diabetes had an average age of 75 and occupied 15% of beds. Their median length of stay was 8 days but only 9% had been admitted specifically for diabetes management. The majority (86.7%)

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The Health Bill Balls

Should you feel sorry for Andrew Lansley? The Health Secretary has been polishing ideas for his Health and Social Care Bill for seven years and has spent nine months travelling around England explaining the changes to NHS staff, patients and MPs. But in the last few weeks the BMA has voted for the Bill to be withdrawn and reconsidered, the Lib Dems have voted overwhelmingly in favour of amendments, a study by the Nuffield Trust has found that only 23 per cent of GPs believe the reforms will improve the level of care already provided to patients, and 220,000 people have signed an on-line petition opposing it.

The headline concepts of the Health Bill are hard to argue against – get staff involved in designing and commissioning services, give power to patients and focus on better clinical outcomes. Lord Darzi, the Labour health minister, proposed just that and by the time Labour left office clinical outcomes were improving and patient satisfaction was at an all time high.

Labour’s good fortune was to invest heavily in the NHS without having to pick up the tab for the debt. Despite improvements in services, overall productivity hardly

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Invested Interests

Under pressure from the BMA over concerns that the NHS is heading for a price-war, the Government has amended the Health Bill and removed references to the tariff paid for different services being the ‘maximum price’. This would have allowed private companies to undercut the NHS by cherry-picking easy cases. The price regulator Monitor can still ‘specify different prices for different providers’ based on ‘unavoidable’ cost differences. But it supposedly can’t mimic the absurdity of the Labour reforms and pay private companies more than the NHS to bribe them to take over services.

The BMA’s initial stance on the health reforms was ‘constructive engagement’, having been seduced by the idea that clinicians (especially GPs) would be leading the NHS. Alas, most GPs aren’t keen to be the whipping boys for a very optimistic £20-billion savings programme that will force them to openly ration services. Health Secretary Andrew Lansely’s safety net is to open up the NHS to ‘any willing provider’, and if GPs don’t take up the mantle of commissioning and providing health services, there are plenty of private companies who will. Under pressure from its membership, the BMA has become increasingly hostile to the ‘marketization of

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Since this column was published, I’ve had a number of responses from those worried about the safety of HPV vaccination. If you distribute, say, 16 million doses of a vaccine then, by chance alone, some people will die or have serious illnesses after they had the vaccination. It does not mean the vaccine caused these and indeed the same amount of death and serious illness occurs in people who haven’t had the vaccine which is why America’s Centre for Disease Control concluded the two aren’t related and hasn’t withdrawn the vaccines. These scare stories surface with every vaccination programme and the damage they cause is huge (e.g. MMR).

The dangers of drugs sometimes only surface when they’ve been on the market for a while and the pharmaceutical industry has an unfortunate track record of trying to bury bad news. But the CDC is on the case with vaccines and their advice re Gardasil’s benefits and safety is below:

Information from FDA and CDC on Gardasil and its Safety
Gardasil Background

Monitoring the Safety of Gardasil
Summary

Consumers, parents, healthcare professionals, and others have raised questions regarding the safety of the human papillomavirus (HPV) vaccine, Gardasil. FDA

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