Editors' Blog

August 2008 - Posts

• A nation of chocolate-guzzling layabouts

  There are those who will always find a way to scam the system. The latest ‘ingenious’ plan is a website selling fake doctors’ notes, allowing ne’er-do-wells to use them to take days and weeks off on the sick. To be fair to the website, it does emphasise that these notes are ‘for novelty use only.’ It then elaborates: ‘We don't sell real sick notes. You would need a real note for: sick notes for sick pay or medical certificates to claim Statutory Sick Pay (SSP). Hmm. If anyone has a novelty use for a fake sick note please let me know! (It doesn’t count as novelty if it’s intended to get out of homework, office duties or domestic tasks). For only £24.99, billed in South African rand of course, you can choose from doctors at medical centres in London, Manchester, Birmingham, Glasgow - or any other area. You must send off your name and address and that of your doctor, as well as details of what ails you, dates you must be off school or work, or this can be left blank for you to fill in yourself at your leisure (which of course you’ll now have plenty of). The notes appear to be written on NHS notepaper and have an authentic stamp, and have been described by the authorities as almost identical to the real thing. They are also signed and printed with real doctors names. So, what about honest, hardworking GPs whose names are forged on these? This hasn’t come up yet, but I suppose they haven’t caught anyone out using this. Watch this space. An added dimension is the part about getting a doctor’s note to cancel your gym membership. On this one you must specify how long you want to be incapacitated. The recommendation is two years. It seems to me you could be storing up a wealth of bad karma with this website. An NHS counter-fraud squad spokesman has warned that anyone caught using fake GP notes is open to prosecution. But it’s a bit of a sticky wicket, because selling sick notes is not illegal, so you could type one up and sell it without being prosecuted. But it is illegal, if you use it to receive a payment or advantage, like paid time off work. So, this means that the website owners, MDM Enterprises, a South African registered company, can carry on regardless, but conscience-free punters might find themselves on the wrong side of the law should they use a fake note to take a duvet day. And the NHS logo and letters are trademarks owned by DoH, so the NHS can take action to ensure these aren’t misused. I’m much too conscientious (or much too plagued by conscience) to ever take advantage of such a dodgy scheme, so I shall have to console myself by eating copious amounts of dark chocolate (100 grammes per day for two weeks to be precise) at my desk. Happily a new study published in the Journal of Nutrition has shown that such chocolate gluttony can cut deaths from heart attacks and stroke by six per cent. Phew. Posted Aug 29 2008, 03:01 AM by Gemma McKenna with no comments

• Mapping the nation's girth and mirth

  Today, it seems, is a day for mapping the nation's wellbeing - and there's good and bad news. A new ‘fat map' of the UK, produced by Dr Foster Research, shows that levels of obesity are rising and areas of the South East are now succumbing to the 'epidemic'. Meanwhile, a team from the Universities of Sheffield and Manchester have mapped the happiest places in the UK using data from the British Household Panel Survey, adding in factors such as employment, health and educational qualifications. The fat map was compiled from data collected by practices for the QOF and shows the prevalence of people with a BMI of 30 or more. Perhaps unsurprisingly it shows that the north of England and former areas of heavy industry in Wales have some of the highest prevalence (this was the case in a similar exercise two years ago). But, the south is beginning to creep up - notably areas on the outskirts of London. The 'happy map' shows that the UK's happiest people are to be found in Powys, Wales while the most miserable are apparently in Edinburgh. Powys also scored fairly highly on the fat map so, in a very unscientific piece of analysis, could one conclude that being fat makes you happy? Sadly not. For while Powys came top of the happy list, the former coal-mining area of Rhondda Cynon Taff in south Wales was second from bottom and, with 11.1 per cent of the population in this area  obese, it is one of the top five fattest places in the UK. So, what can we conclude from all of this? Well, very little from the happy map. Even the researchers say that the variations between different places is not statistically significant. (Although the fact that social cohesion seems to play a role - on average unemployed people are happier in areas of high unemployment than in areas of high employment - is very interesting). The fat map is of a much greater concern. It seems that despite huge public health efforts over the past few years and greater awareness among the public about obesity and the importance of a healthy diet and adequate exercise, the number of overweight people continues to rise. This is both worrying and depressing. The DoH has said it is launching a new strategy this autumn called Change4Life that will help people make fundamental changes in the way they live their lives. It will include advice about diet and exercise. This is all well and good, but the challenge is ensuring people apply this information in their lives and make the choice to be healthier. Without a willingness from individuals to change, all the information in the world won't make a jot of difference to rising obesity levels.   Posted Aug 28 2008, 03:30 AM by Emma Bower with no comments

• Are we heading for a Great Depression?

  Last weekend, I noticed that, by 8.30pm, it was already well on its way to being dark. As ‘summer' draws to a close, it is hard to feel that we have experienced a season that was substantially different to winter: warm-ish and relentlessly wet. The onset of winter is a cheerless prospect, particularly for those of us who have not enjoyed sunny holidays abroad, and with claims that the miserable summer has (in Scotland, at least) triggered a surge in ‘Seasonal Affective Disorder' (SAD) it seems that health professionals will soon be inundated with a host of melancholic patients looking to the NHS to ease their depression. (Admittedly, the recent warnings about SAD seem to come from a company that sells light therapy products, but the idea that poor weather has a negative impact on mood is not one I find hard to believe.) Unfortunately, even those who have escaped SAD (by way of their trips to Mauritius or irritatingly buoyant dispositions) may still fall foul of our much-publicised credit crunch. In times of recession, there is evidence that life expectancy falls, mental health deteriorates and stress plays havoc with our cardiovascular and immune systems. Psychological distress can also more than double the risk of developing type 2 diabetes in men. According to national charity the Shaw Trust (which provides training and work opportunities for people who are disadvantaged in the labour market) the combined effects of plummeting share prices, job cuts and fuel prices could lead to a ‘sharp increase' in the incidence of mental ill health conditions in UK workforces. It has set up a website, tacklementalhealth.org.uk offering guidance including advice to talk openly with employees, create a no-blame culture, and ensure staff take adequate lunch breaks. Other charities are also on hand to help: earlier this month, Age Concern launched a national campaign to improve the lives of older people with depression. Entitled ‘Down But Not Out' it proposes a three-point plan which strives to encourage older people with depression to seek help; to ensure older people with depression are correctly diagnosed; and to enable these people to get the treatment they need. The intention is to push ministers to remove ageist barriers that stop older people getting effective treatment, while working in partnership with health professionals to raise awareness of the prevalence of depression in older people and to challenge the ageist attitudes that prevent diagnosis. This will be followed by a public awareness campaign, later this year, aimed at older people with depression, and their families. Given our ageing population, it is hopeful that ministers will sit up and listen, particularly as the World Health Organisation further depresses us with its prediction that ‘by 2020, major depression will be the second biggest cause of death and disability in the world.' There is evidence that this message is filtering through: last year, health secretary Alan Johnson announced that, by 2010, £170m a year would be invested in ‘talking therapies', which are described by NICE as ‘just as effective as drugs'. (Some experts beg to differ but I'll leave that issue for a future blog, though please feel free to comment below.) Meanwhile, those of us who are prone to the blues should be doing our utmost to help ourselves - which includes getting out more, according to the Mental Health Foundation. The charity warns people not to risk their mental health by isolating themselves, as they try to cope with the credit crunch. Its poll of 2000 British adults found that a third are cutting back on socialising with friends, due to limited funds. The charity urged people to look for cheaper - but still social - activities. Foundation spokeswoman Celia Richardson said that though people need to adapt to the economic climate by spending less, some of these new habits may prove mood enhancing: for example, walking and cycling, plus growing fruit and veg in the garden. She advises people to find cost-effective ways of socialising such as ‘playing games with family and friends like charades in the living room or Frisbee in the park'. Personally, I would normally turn to Scrabulous, the popular online word game which has become the most addictive of Facebook's applications. However, to add insult to injury, SAD and credit crunch gloom, this was removed at the weekend due to a long-running legal dispute with the makers of Scrabble. Now there's a depressing thought. Posted Aug 27 2008, 03:41 AM by Sarah Wild with no comments

• Goodbye Beijing... Hello London

  Thank god the Olympics are over. No disrespect to the extraordinary Team GB who've performed amazingly - in fact the best performance in 100 years — but I am relieved that my life can now return to normal. When I say normal, I mean the way it was two weeks ago, when I still had a 50% share ownership of the remote control in my house, and the main subject of conversation with my partner was not the latest results in archery or some other sport I never realised existed before the Olympics started. Pistol shooting anyone? My irritation has just been made worse as I hear I actually missed the best bit of the Games which took place during the closing ceremony on Sunday. While I was listening to the best man's speech at wedding number 5 on Sunday evening (still three weddings to go for this year — is there an Olympic category for attending weddings? I would easily get the gold medal) Leona Lewis was performing with Led Zeppelin guitarist Jimmy Page - they were of course brought onto the stage by a red double-decker London bus - and David Beckham made a highly anticipated appearance before Boris Johnson was handed the Olympic flag. Oh well I'll just have to look forward to our own Olympics in four years. Or not, as the pressure is now on to find out if London will actually be ready to host the games on time. Enough of my cynicism and onto the serious aspect of the events of the year. While I was forced to watch Chris Hoy cycling for one of his gold medals the other day, I realised that if I  — being probably the least likely sport enthusiast living on the planet — could be impressed and moved by such performance, the effect of the Olympics on teenagers aspiring to become sport champions can only be positive. Yes, members of Team GB are now considered role models for young people in Britain as they witnessed their heroes' outstanding performance. And it seems that they need idols to look up to. The Conservatives yesterday issued a dossier showing that on six counts — including alcohol abuse and smoking related illness — teenage health had got "steadily worse" since 2000, with the deterioration even more evident among early teens. The Tories accused the Labour government with creating a "teenage timebomb", where the number of young people admitted to hospital has annually risen by 23% since 2000. The shadow health secretary, Andrew Lansley, called teenagers a "forgotten generation". He told the Guardian: "It's a sad indictment of our broken society that so many are turning to things like drug and alcohol abuse at such a young age." The hosting of the Olympics in four years time could be a godsend and it seems the government has already spotted the opportunity it will bring to tackle the problem as Gordon Brown pledged that the run-up to the London Games would see a "transformation of the sporting culture in schools," with pupils offered a diverse range of Olympic events, including controversial contact sports such as boxing. Girls will also be encouraged to get fit and take up competitive sport, with Olympic champions from the Beijing Games, including Rebecca Adlington and Victoria Pendleton, leading the campaign. Let's hope that the thousands of young children who have been watching the Olympics on TV at home and thinking this may be the chance of developing their sporting skills will have the opportunity to follow their dream. Posted Aug 26 2008, 02:37 AM by Emilie Reymond with 1 comment(s)

• Let's put our (considerable) national weight behind the Olympics

  Sixteen gold medals, ten silver and ten bronze! To date we are doing surprisingly well in the Olympics and our national pride is at a (temporary) high. I feel it is perfectly acceptable to say ‘we', despite my lack of actual participation. But it seems there are many who are keen to get involved in a more strenuous way. According to a gadget helpline (helpfully named Gadget Helpline), people have been calling to find out how to set their cycling and rowing machines to keep up with Olympians. One caller admitted he had broken his rowing machine trying to out-do Team GB. This has spurred sports scientists to warn people to be aware of their personal limits, a message that is oft repeated in relation to food and alcohol but rarely needed when referring to sport. Admittedly, setting one's treadmill to ‘Paula Radcliffe' is not sensible (even for Paula Radcliffe who was still limping around the marathon course when I stopped watching circa 3am on Sunday morning). Nor is challenging Michael Phelps to a ‘battle of the breakfasts'. However, it is nice to see people taking an interest in something that is essentially good for both body and soul. Those who are organising London's 2012 Olympic effort must be relieved to see the rekindled interest in sport, since this is the very reason behind most people's support for the Games. It may well empty the nation's coffers once and for all, but the hope is that the legacy will be better health as well as an improved sporting infrastructure. NHS Choices is sensibly jumping on the bandwagon, cashing-in on Olympic fever by launching an Olympics ‘portal'. This urges people to get fit, offering tips and encouragement from elite athletes such as Dame Kelly Holmes, paralympic medalist Ian Rose plus 18 year-old table tennis star Darius Knight, who explains how sport has saved him from ‘a life on the streets'. The site also provides video clips of sixty Olympians, past and present, who share their practical advice on how to lead a happy and healthy life. This is all inspirational stuff that may genuinely help England on its way to meeting the ambitious goals set out in the DoH's ‘Healthy Weight, Healthy Lives' strategy, a game plan that aims to make England the first major nation to reverse the rising tide of obesity and overweight in the population. The initial focus is on children and, by 2020, the plan is to reduce the proportion of overweight and obese to 2000 levels. Perhaps we should stop moaning tirelessly about the spiralling costs of the 2012 Games, instead putting our energies into creating an atmosphere of positivity, bearing in mind that the Olympics could prove cost-effective should it have a helpful effect on people's weight. No amount of national nannying can force people to look after their health if they truly don't want to, but the Olympic influence really might encourage some to follow in the footsteps of their sporting heros. Though preferably not literally. Posted Aug 20 2008, 03:32 AM by Sarah Wild with no comments

• We need new prescribing tricks

  When I turned on the TV yesterday evening, it was not my intention to watch BBC One’s Panorama programme on the postcode lottery for NHS treatment. After a working day filled with nothing but the NHS and its travails, my idea was to relax by watching ‘New Tricks’, a drama series with moments of high comedy about three old coppers (policemen) reinvestigating cold cases of murder most foul that had stumped younger colleagues. Tuning in a bit early, I did catch the tail end of the Panorama programme. I missed the bit featuring best-selling author Terry Pratchett talking about buying his own Alzheimer’s drugs but I did see a pleasant woman from the Scottish Medicines Consortium (equivalent to NICE in England) explaining why in Scotland some drugs treatments were available on the NHS that patients in England cannot get. ‘Ah, that’s what happens with devolution,’ I told the cat (nobody else being remotely interested). That brought the whole issue of local decision-making on healthcare provision to mind. Devolution and its not always equitable consequences may be acceptable at a national level, but can be far from palatable at PCT-level, especially when decisions on whose treatment will and will not be funded boil down to which drugs patients are allowed to have. Physically dispensing a drug does not need the costly premises and equipment infrastructure required to provide say, a highly specialised form of surgery in the local community. I do think that if a given sum of money will pay for the drugs to treat a large number of patients with non-life threatening, albeit-painful conditions or it will fund a hugely expensive new drug for many fewer cancer patients, the former may be the right decision (though I might feel differently if my nearest and dearest were affected). What does upset me is the gross unfairness of denying a drug to a patient in one PCT’s area that the same patient, if resident in the next-door PCT area, could get. Why can’t we have a national rulebook (OK, one each for England, Scotland, Wales and Northern Ireland) on what can and can’t be prescribed on the NHS that everyone MUST stick to? I dare say there are 1,001 reasons why conjuring up a new system for equitable availability of prescription medicines isn’t on, but will somebody or some pressure group please get the topic on to the agendas of the main political parties, given their annual national (UK-wide) conferences are just around the corner? Posted Aug 19 2008, 11:14 AM by Carole Slingsby with no comments

• I don't want my surgery open on public holidays

  So practices should open on bank holidays should they? What a brilliant idea from NHS24! Not content with forcing practices to open at times of tiny demand, and deliberately misinterpreting survey results to support their decisions, we now have government bodies asking for practices to open on public holidays. Once again we are seeing the trickle down effect of ministers' aggressive behaviour towards GPs and their staff. The big boys put the boot in first and the rest just can't help themselves. I could list numerous practical reasons why this is an idea that should be stopped in its tracks. But I'll restrict my argument to one very fundamental reason - I'm a taxpayer and I object to my money being spent inappropriately and inefficiently on services that would never stand up to any serious cost-benefit analysis. In a different political climate this suggestion would probably never have seen the light of day. But the government's anti-GP agenda has created a climate in which practices are available to take on every piece of work that the rest of the NHS is struggling to do. I don't want to see my surgery's staff and resources stretched to open at times when I - and the vast majority of the practice population - don't need it to be open. If I think I need to see a doctor on a bank holiday then I'll weigh up my options in the usual way: can it wait until tomorrow or is it so bad that I have no choice but to visit my local A&E. Posted Aug 18 2008, 09:18 AM by Colin Cooper with 1 comment(s)

• Is obesity as great a threat as terrorism?

  Is obesity really as great a threat to the nation's welfare as terrorism? I must admit that I had to stop and take another look when I saw that headline on the BBC News website yesterday. The claim was made by Professor David Hunter, a public health expert from Durham University. He says that while the government has had some success in tackling the burden of obesity it has not gone far enough, and current interventions are on a ‘piddling' scale. Professor Hunter advocates ‘bold action', including compulsory regulation to force food manufacturers to address levels of fat, salt and sugar in their products. He does have a point. While recent initiatives, such as the announcement of grants for corner shops to sell more fruit and vegetables and the introduction of ‘fat camps' for overweight children, are to be applauded, surely the quickest way to combat the obesity problem is to deal with it at source. I'm not in favour of the nanny state, but it seems to me that many food products contain far too much fat, salt and sugar - and that much of this probably isn't really necessary. A cursory look at some of the products on sale in my local supermarket last night revealed some ready meals containing 87 per cent of the recommended daily intake of fat in one serving. The salt content was at similar levels. Things have come a long way since processed and pre-packed food first went on sale - it's much easier to find out how much fat and salt there is in many products now (especially in those supermarkets and products that follow the government-recommended traffic light scheme). And some companies are starting to reduce salt levels in food. But voluntary codes of conduct don't seem to go far enough and these are big companies who, at the end of the day, are in the business of making a profit for shareholders, not saving the nation's health. Without legislation is seems unlikely that these organisations will take further steps to reduce levels of salt, fat and sugar - and the 'obesity time bomb' will keep ticking away, most likely having a detrimental affect on the health of far more individuals than terrorism.   Posted Aug 15 2008, 02:02 AM by Emma Bower with no comments

• Art imitates life (badly)

  After ten years in journalism, I quite fancy working in a hospital. Not any hospital, of course, I was thinking Chicago's County General, where ‘pressure, joy and guilt are often overwhelming' (to quote Channel 4's ER website) and the doctors are ‘determined to save lives' (and fabulously good-looking as everyone knows). If that fails, I'm considering the hotel trade, along the lines of Hotel Babylon. There always seem to be celebrities passing through, cocktails on tap and dramatic love trysts going on behind the scenes, so I can't see how it can fail to be a good move. I must admit this bears little resemblance to my memories of working in a hotel as a student, where star-ratings were reserved for the wine, all food was microwaved and the longest-serving member of staff had worked there all of eight months. But I daresay I was just unlucky. After all, art imitates life doesn't it? I think the answer is that it does...but often inaccurately, a point made loud and clear by the British Heart Foundation (BHF) last week. It stressed that TV and Hollywood portrayals of heart attacks give viewers a false impression, showing dramatic scenes of actors clutching their chests before falling to the floor in extreme pain (think Jim Robinson in Neighbours). The truth is that few heart attacks happen like this: most people experience symptoms such as pains in their arm or jaw, which can be quite subtle and easy to ignore. Symptoms may be different in women than in men with the former developing breathlessness and an ‘indigestion-like' pain, the latter tending to experience a ‘tight band of pain across the chest'. However, the results of an online YouGov survey of 2000 people showed that one in five did not know what the symptoms of a heart attack are and more than a third (38%) believed the Hollywood myth of crippling chest pains. To counter the misleading stereotypes and raise awareness of when people should call 999, the BHF aired a two-minute film ‘Watch Your Own Heart Attack', which appeared, just once, last Sunday on ITV 1. This enterprising advert starred actor Stephen Berkoff and was preceded by a series of teaser trailers featuring celebs ranging from Ainsley Harriot to David Cameron. Fortunately, those who missed it can watch it online via the BHF's website, which also contains plenty of other information about heart attacks which could be signposted to patients. For example, details of how heart attacks are diagnosed and treated, how patients can recover from a heart attack and steps to take to prevent one occurring in the first place. Perhaps this film is the first in a line of similar contributions from other health charities, since TV producers take liberties with everything from consultants' physical attributes to mental illness: people with schizophrenia or even depression are regularly shown to be either ‘unbalanced and suicidal' or ‘unhinged and homicidal'. In the US, protests have been staged at the premiere of Ben Stiller's new movie ‘Tropic Thunder', which features a mentally disabled character called Simple Jack. The frequent use of the word ‘retard' has angered disabled groups who are calling for the movie to be banned. This is unlikely to happen, given the squillions of dollars tied up in the film, so I would advise campaigners to get innovative in redressing the balance.  I, for one, am grateful for the escapism provided by TV and do not want art to reflect every tedious reality of life. However, where lives are put at risk or archaic ‘typecasts' reinforced I think it is time for campaigners to make use of all the mediums at their fingertips and to get high profile celebrities on board to ram their messages home! Posted Aug 13 2008, 03:48 AM by Sarah Wild with no comments

• GPs finally embrace extended hours

  "Boost in number of GPs opening at evening and weekends"... Well that's a headline I was not expected to read quite so soon. After months of fighting between the government and GPs over the extended hours row, it seems that something that could be qualified as a phenomenon - yes I always exaggerate, I am French - has happened in the past month. Indeed, The Daily Telegraph reports today that figures to be released by the Department of Health are expected to show a "very significant" increase in the number of surgeries offering weekend or evening appointments. So what exactly qualifies as a very significant rise? Do half of surgeries now offer out-of-hours appointments? More than half? 80 per cent? By the end of June less than 30 per cent of practices were offering extended hours. What exactly happened between the end of June and July that might have triggered the rise? The cynic in me is thinking that maybe a lot of GPs have gone on holiday in July and for some inexplicable reason only the pro-extended hours doctors and practice managers have been left and they all want to offer out-of-hours appointments to patients. How else can you explain such a change of heart? Just a few months ago, the results of a survey by the BMA showed that 65 per cent of GPs opposed the extended hours. Have GPs suddenly realised that the satisfaction of their patients depends on their surgery's opening hours? Actually they would be wrong according to this year's GP Patient Survey which showed that practices offering core hours only were as likely to get top scores as practices offering extended hours. So what is it then? What is making practices suddenly move towards extended hours? According to Ben Bradshaw the answer is quite simple: good old com-pe-ti-tion. The health minister recently said that where a practice is offering extended opening, the practice next door is twice as likely to also provide out-of-hours appointments. After all, the grass is always greener on the other side of the fence. Posted Aug 12 2008, 11:15 AM by Emilie Reymond with 1 comment(s)

• I’d hate to work for NICE

  What must it be like to work for NICE? Do the staff and their advisers feel a true sense of public service in what they do? Do they feel good in the belief that they are contributing to the health and well-being of the nation, doing a tough but worthwhile, and ultimately appreciated, job? Well, I sincerely hope so, because there can be few public bodies that endure more outright hostility from the national media, patients, drug companies, and even ministers. The controversies of recent weeks are the norm for people working at NICE, and they must have expected that when they joined the team. But what must really hurt is when they put all that time and effort in to an important decision, take all the flack for it, and then find that the guidance is not implemented. Because it seems that no matter what NICE decides, at local level the NHS can largely make up its own mind. Is there any national guidance on how long it should take for local guidance to be drawn up? A report from the Rarer Cancer Forums published today showed the traditional postcode lottery in PCT decisions on funding treatments before they have been appraised by NICE. In response, the DoH has promised to speed up the national approval process. But in reality, will it actually make any difference or will the local powers-that-be just drag their feet for a little bit longer? Posted Aug 11 2008, 10:03 AM by Colin Cooper with no comments

• Are GPs-to-be right to work for private firms?

  This week's exclusive GP splash reveals that 52 per cent of GPs-to-be would work for private firms. The result came as quite a shock to us because older GPs are so vehemently opposed to private firms running polyclinics. It's an issue clearly dividing contributors to our forums. One writes: ‘In salaried status you have a guaranteed income, study leave, sick leave etc and other benefits an employee has. As a partner you will take what comes, what is ‘left over' from running the business and over the last two years that has meant less and less.' Another says: ‘3 years ago I would have sworn never to work for a private firm. But when you note how few jobs are available, one would do anything. I cannot emphasise enough that if the senior partners really want to see general practice survive then they must rally behind and find solutions to help newly qualified GPs so a united front can be created. Otherwise I'm afraid it's adios family practice in the next 5  - 10 years or less.' Another writes: 'As a GP in a partnership, I think we need to do more to encourage partnerships. There's a sea of new talent out there which will go to waste if we didn't offer partnerships.' It's a fascinating debate and we want to hear more of your views because there are many sides to every story. It is often easier for established GPs to get their voice heard because they have the contacts and experience to do so. That is why GP has launched GP35 - a panel of 35 GPs aged under 35 to represent the future face of general practice. Are you a young GP who would like their voice heard in GP newspaper? As part of the GP35, we would occasionally ask for your view on a general practice issue. The aim is to find out the issues that matter to our younger readers. Ideally we'd like to take a photograph of you and publish it with your comments. To register your interest, email neil.durham@haymarket.com. Or are we being unnecessarily ageist? Posted Aug 08 2008, 10:03 AM by Neil Durham with 6 comment(s)

• The Olympics could be good for our health

  I, for one, am very much looking forward to the start of the Beijing Olympics tomorrow. Like most people I will be following the high profile athletics. But, every time the Games come round, I suddenly find I have a huge interest in many sports I wouldn't think about in the interim - the gymnastics, weight lifting and synchronised diving are particularly popular in my house. Of course, London will be hosting the 2012 Olympics and, between now and then, the government is planning on using the Games as part of a public health drive to make the nation more active. Sport England is receiving an extra £41 million of government funding each year and its aim is to get 1 million more people doing sport by 2012/13. It also has ambitious targets to boost the amount of sport available to children and young people over the next four years. The NHS is already playing its part in this. For example, North East London SHA, which looks after the area of East London where the Olympic Park is located, is already promoting the benefits of sports and exercise and has launched a series of local initiatives such as walking groups and a cycle to work scheme. Meanwhile, practices in 11 PCTs in London are taking part in pilot to promote exercise, which involves practice nurses handing out activity packs to patients detailing local places to exercise or walk and offering advice on activity levels. If successful, this could be rolled out across the country. I think using the Olympics in this way is fantastic. Levels of obesity are rising at an alarming rate and anything that can be done to encourage individuals to live healthier lives has to be encouraged. The London 2012 bid team recognised this early on, and the NHS has been a key partner since London won the Games two years ago. There has been much talk about ensuring London 2012 leaves a lasting legacy - what could be a better than a more active, fitter population? If this objective can be achieved it would go a long way to improving the health of the nation, reducing health inequalities and halting the rise in obesity. And, who knows, it could even uncover a new talent in gymnastics or weight lifting who I can cheer on in 2016.   Posted Aug 07 2008, 02:28 AM by Emma Bower with no comments

• Stupidity is a long-term condition

  Not all health professionals are fans of so-called 'expert patients'. While they might welcome the concept of self-management in theory, in practice they know that many ‘expert patients' simply come to the surgery clutching print-outs from dubious health websites and demanding new miracle drugs that they have seen publicised in the Mail on Sunday. Ministers love expert patients because they believe them to be cost-effective and because self-care is the DoH's current buzzword of choice: the effective ones apparently take responsibility for their own health; communicate better with health professionals; visit GP and hospital services less; and generally save the health service time and money, while improving their own health and boosting their quality of life. In truth, empowering people to manage their own health is probably the only way in which a state-funded NHS is likely to survive in the long term. However, ministerial efforts to roll out self-care could be hampered by the essential stupidity of many human beings. Let's face it, there are some patients who are barely capable of sentient thought, let alone taking care of their own health needs. This argument is backed up by a recent study from Lloydspharmacy which revealed that one in five patients take their prescription medication ‘wrongly'. The poll of almost 2,000 people found many misread labels and so take the wrong dose or take drugs at the wrong time. This doesn't sound too foolish - and one can particularly empathise with the confusion of elderly patients faced with polypharmacy. But the study also revealed some more worrying examples. These included one patient who reported difficulties using his asthma inhaler: it turned out that he had neglected to remove the cap before inhaling his dose. Another man whose asthma was triggered by his cat admitted that he sprayed the poor creature with his inhaler in order to relieve his own symptoms. Meanwhile, a patient complaining of daytime drowsiness explained that he had been taking his prescription sleeping pills... first thing in the morning! Not only are these people a danger to their own health (and to that of their pets!), they are a burden on the taxpayer, wasting their prescription medicine. Data from The NHS Information Centre shows the number of prescriptions written in 2007 in England is double the 1997 figure: around 796 million prescriptions were written last year, up 59 per cent from 1997. Alarmingly, Lloydspharmacy reported that  55 per cent of the 500,000 people participating in its free ‘medicines use reviews' received a recommendation from the pharmacist that they change their medicine-taking routine in some way; 25 per cent were referred back to their GP which, in many cases, led to the patient switching medications or ending treatment altogether. This surely highlights the need for patients to receive more thorough initial guidance from those who prescribe and dispense their medicines. It cannot be denied that many people lack basic common sense, but some may be genuinely confused by dosing instructions while others are scared to ask their doctor or nurse a ‘stupid' question during the 7-10-minute consultation they have been allocated. Some health professionals assume too much knowledge on their patients' behalf. (I admit to confusion over a GP's instruction: when asked to remove your clothes for an examination, should one err on the side of prudishness or whip everything off, only to discover you were simply supposed to roll up your right sleeve?) Perhaps the real issue is that people have become too reliant on a patriarchal health system to think for themselves, a suggestion that brings us back to the importance of empowerment and of encouraging people to take responsibility for their own health. The more health professionals treat patients like partners, the more likely they are to act like them. Probably. Posted Aug 06 2008, 03:32 AM by Sarah Wild with 1 comment(s)

• Is the government's child obesity approach namby-pamby?

  The government is launching a new programme to prevent obesity in children. Great news. The principle is quite straightforward: all primary school children in reception class and Year 6 are currently weighed and measured. So ministers have urged PCTs to send parents the results in order to inform them if their child is clinically overweight, without waiting for them to request the information. The scheme, which starts in September, mean the results for over 1 million children a year will be sent automatically to parents, with recommendations on what to do if the child is overweight. School nurses and GPs will not be told the individual scores. The objective is obvious - tackling what is now becoming an epidemic. But in a surprising move, the government has decided to ban using the words "obese" and "fat" from the programme as it fears these words will create a stigma around overweight children and cause families to ignore the results. Suddenly a highly commendable scheme is turning into a controversial issue, with the government's decision to avoid using the word obese dubbed as "prissy and namby-pamby" - these are the exact words used by the National Obesity Forum. Well, they (the NOF that is) have a point. Under the new plan, parents will be told if a child is underweight, a healthy weight, overweight or "very overweight" - which basically means clinically obese. Even the Americans have decided to stick with using the word obese in anti-obesity campaigns as it makes parents react, which is the desired effect of this type of programme. So perhaps the government should stop "tiptoeing through the daffodils" (another brilliant metaphor used by the National Obesity Forum) and - I never thought I would say that - follow the American example?  Posted Aug 05 2008, 10:38 AM by Emilie Reymond with 1 comment(s)