Spare parts for sale

People should be allowed to sell their kidneys for £28,000 in an NHS-regulated organ market Dr Sue Rabbitt Roff, of Dundee University said in an article published online today by the British Medical Journal. She called on the health service to offer financial rewards to individuals willing to give up a kidney as a means of speeding up the rate of transplants and reducing the cost of treatments and dialysis to the NHS.

Dr Roff, a senior research fellow at Dundee’s department of medical sociology explained “We already allow strangers to donate kidneys out of the goodness of their hearts. They get their costs covered, they don’t know who the recipient is, there’s no publicity, no public acknowledgement of what they do. We’ve moved away from the notion it has to be a family member or a close associate who can give you a kidney. We’ve already moved into the zone of allowing the general public to make good-hearted donations. What I’m suggesting is, why don’t we add money to this equation in order to increase the amount of provision which is there...I came to this figure of £28,000 because that’s the average national income in Britain at the moment, so it seems a fair price across all the social strata..."

The British Medical Association said it would not support money being offered in exchange for kidneys.

Dr Calum McKellar, director of the Scottish Council on Human Bioethics said: “A legal, regulated market in human body parts would end up exploiting those who have very restrictive financial means, such as many students and foreigners.”

There are currently 725 people in Scotland waiting for a new kidney but the number coming up for transplant has plateaued at around 200 in recent years. How much smaller would be the number if those in various industries (chemicals, oil, tobacco, pharmaceuticals etc) had not poisoned and polluted our bodies for profit for decades?

Everything inside capitalism takes the form of a commodity, everything has its price, so it doesn't come as a surprise to Socialist Courier to read Dr. Roff's proposal.

Why Bother?

A senior consultant surgeon has spoken out against screening patients for bowel cancer in Scotland’s most deprived areas...because they are likely to suffer from other serious conditions which could kill them anyway.

Angus Macdonald, consultant colorectal surgeon at Monklands Hospital in Airdrie, said that in his experience in Lanarkshire, an area of high deprivation with one of the country’s lowest life expectancies, many patients with small tumours were more likely to die from other conditions before the cancer claims their life.

Health officials estimate that the NHS’s bowel cancer screening programme, for people between the ages of 50 and 74, could prevent 150 deaths annually. But Macdonald argues for some sections of the population it would not actually change the age at which a patient will die. “When you roll out a screening programme there is a very real possibility that you will identify cancers in the people who would normally have died from something else. We might operate on them and as a result we might actually shorten their lives.”

Research carried out by Macdonald, which is due to be published in the Journal of Colorectal Disease , adds weight to the principle of addressing the underlying determinants of ill-health such as socio-economic deprivation rather than of early detection and treatment of cancer as a principle health improvement strategy in such populations.

He said: “For the elderly time is precious. We’ll have some people coming up to their 50 years of marriage who have put together plans for over five or six years to save up for that once-in-a-lifetime holiday. When you tell them they have cancer they say they’ll cancel the cruise. I say, don’t. Go away and enjoy yourself if you can. It doesn’t matter if you have your operation just now or in two months, it is not going to make any difference at the end of the day.”

Dying Old

In The Herald Socialist Courier reads that 50% of the time that people spend in hospital over a lifetime occurs in the 12 months before they die. In a new book, Professor Phil Hanlon, a former adviser to the Scottish Executive, argues the elderly should be prescribed far fewer drugs and given fewer tests and procedures as they reach serious physical decline.

He said: “It is not that I would discard such people. I would simply give them a more human and humane approach, which would use less intensive NHS facilities. The big debating point is: would people die earlier? And the answer I would give to that is we do not know. You might actually live longer if you do not have all the stress associated with going to the hospital for treatment and healthcare-associated infections. We all get to that stage in life where your systems begin to shut down, albeit slowly, and medicine cannot reverse that. If you treat the person as if you are going to reverse that, you actually do them harm and that is what we do at the moment.”

Hanlon, who trained as a doctor, said: “The system is designed to deal rapidly with you, shunt you through and get you off the waiting list. All of that is not human and humane.”

Some estimates, he said, suggest one in five hospital admissions is at least in part caused by previous treatment. He envisages a more open conversation between health professionals, patients and their families about whether fewer tests and treatments would be desirable in what is likely to be their last 12 months of life. Decisions would be made on a case-by-case basis, however, he stressed.

Lindsay Scott, communications manager for charity Age Scotland, said: “As an organisation, we would look at this proposal from a discrimination point of view. It was the idea in the first place with the NHS that from cradle to grave everyone is treated equally.” However, he said some older people would support Mr Hanlon’s ideas. A survey of 300 pensioners in Scotland found 65% supported assisted suicide for people with a terminal illness and 54% would consider it as a means of ending their own lives.

Economic formulas not medical ones decide treatment

Previously reported here has been the inherent failure of the National Health Service due to the constraints of capitalism to offer full effective treatments . Another report confirms Socialist Courier's diagnosis .

Some of the UK's top cancer consultants warn that NHS drug 'rationing' is forcing patients to remortgage their homes to pay for treatment. The specialists accuse the government drugs advisory body of 'rationing' too severely and call for a "radical change" in the way decisions are made.

In their letter, the 26 cancer specialists say the decision shows how "poorly" NICE assesses new cancer treatments."Its economic formulas are simply not suitable for addressing cost-effectiveness in this area of medicine," they write. "We have seen distraught patients remortgaging their houses, giving up pensions and selling cars to buy drugs that are freely available to those using health services in countries of comparable wealth."

Defending its policy of restricting palliative medicines .

"There is a finite pot of money for the NHS, which is determined annually by parliament,"NICE's chairman said."If one group of patients is provided with cost-ineffective care, other groups - lacking powerful lobbyists - will be denied cost-effective care for miserable conditions like schizophrenia, Crohn's disease or cystic fibrosis."

Capitalism is at its terminal stage , time to apply euthanasia to such a heartless system .

nhs charges

A poll by Macmillan Cancer Support suggests nearly half of cancer patients in England are being forced to cut back on basic necessities in order to pay for their prescriptions.

Breast cancer survivor Amanda Whetstone says she regularly skips breakfast and lunch to save money to pay for her prescriptions.

"Although my cancer treatment - the surgery, chemotherapy and radiotherapy - has finished, I still need medication. As a result of my cancer I'm now on three different drugs. They cost me about £44 a month. That may not sound much to some, but I'm struggling financially. I'm now on statutory sick pay because I've been too unwell to work. My income is £360 per month and, quite frankly, I have barely enough money to live on.I budget for everything. I don't go out because I can't afford to socialise. I can't even invite friends over for a meal because I can't afford the food.I don't eat breakfast or lunch. The meals I do buy are ones that are on special offer.I can't afford fresh fruit or meat. I know that isn't healthy, but I simply can't afford to buy healthy food."

"Fighting cancer is hard enough without the terrible financial worry that comes with it.I feel penalised because I have a disease that the government doesn't consider should make me exempt from prescription charges."

health and wealth

We here at Socialist Courier have frequently posted stories that reveal the class link concerning health -- the wealthier you are , the better health you possess and the longer you live . Another report once again confirms this view .

The importance of money was illustrated by an ethnic breakdown of outcomes in the US. White Americans, who are on the whole wealthier and therefore more able to afford the insurance which underpins the US system, were up to 14% more likely than others to survive cancer.

Meanwhile the report states that the UK had 69.7% survival for breast cancer, just above 40% for colon and rectal cancer for both men and women and 51.1% for prostate cancer.

And "...there were also large regional variations within the UK, which were linked to differences in access to care and ability of patients to navigate the local health services. Both are directly linked to deprivation..."

The Blues

An article by the Guardian columnist Jacky Ashley makes interesting reading

According to official figures, up to 12% of people now experience depression in any one year. More telling is a deeper government study that shows that half of people with common mental health problems recover within 18 months but that "poorer people, the long-term sick and unemployed people are more likely to be still affected"

People get depressed because they don't have enough money to keep up in a materialistic and competitive society; because they are ill, or feel worthless without a job and role, or are struggling with caring responsibilities.

As we have grown richer, we have become less confident and optimistic about the future. Our increased material competitiveness has not made us happier.

What price a life ?

A cancer patient who was forced to pay out £3,400 per fortnight for the life-saving drug cetuximab has won his battle for funding , having previously been refused the treatment on the NHS , according to the BBC .

Originally ,the Scottish Medicines Consortium said it was not cost-effective because it could only prolong life, not cure him.

Preserving life for as long as possible should be the responsibility of the NHS , the patient is quoted as saying .

Maybe so , but under capitalism , there is always a price tag and a value placed upon a person's life . Not everyone is as fortunate as this patient was .

Malnutrition in the UK

A quarter of all adults admitted to hospital and care homes in the UK are at risk of malnutrition, a major survey has found.

The survey found that it was not just older patients who were at risk of malnutrition.
Patients under the age of 30 had a 27% risk of malnutrition, compared with a 34% for those over 80. Malnourished people stay in hospital longer, succumb to infection more often and visit their GP more frequently. They also require longer-term care and more intensive nursing care.

Professor Marinos Elia said: "This finding establishes - if there was any doubt - that malnutrition is a major public health issue in the community that must be addressed both at source and when individuals are admitted into care."

NHS - We are not all equal

The NHS is failing to deliver in poor areas, a study of general practices in the west of Scotland has found. Patients had a greater number of psychological problems, more long-term illnesses and a wider variety of chronic health problems. Consultations were shorter than in affluent areas and doctors reported being under greater stress.

The research compared consultations in typical practices, serving both affluent and poor populations.

"The NHS should be seen at its best in helping the neediest patients, but ... that is not the case... Despite a decade of political rhetoric about addressing inequalities in health care the NHS has still not squared up to this problem."

Health service rationing

According to the BBC , Doctor magazine asked readers about rationing.

16% - said patients had died early as a result.

Over 50% said patients had suffered as a result .

They reported not being allowed to prescribe drug treatments including smoking cessation drugs and anti-obesity treatment. They also reported that local NHS trusts had been placing restrictions on fertility treatments, obesity surgery and a host of minor operations, including those for varicose veins.

Many experts fear the situation will get worse with increasing demands on the health service made by the ageing population and expected advances in medicines.

Richard Vautrey, deputy chairman of the British Medical Association's GPs committee, said:
"The NHS could spend whatever you gave it, but it obviously works with a limited budget ...Rationing is the great unspoken reality. The only people who refuse to mention the 'r-word' are the media and the politicians, who continue to want to promise everything for everyone in order to win elections."

Malnourished old folk

A major survey is to try to establish how many people are malnourished when they enter hospitals and care homes. The three-day investigation by nutrition charity Bapen - assessing more than 500 institutions across the UK .

Based on studies carried out 10 years ago, an estimated 30% of patients in hospitals and care homes are clinically malnourished - a total of 3m people.

Charities such as Age Concern complain malnutrition remains prevalent .

As many as 10% of people aged over 65 are malnourished. That figure rises to 60% when it comes to elderly people in hospital.

"Weight loss and poor nutritional state is not a normal part of aging. And if it's happening we ought to address it and treat it." - The director of nutrition at King's College hospital , Rick Wilson said

Anyone for Tennis ?- The physical price of fame

A study of 33 young elite players aged between 16 and 23 at a national tennis centre, who represent Britain's best hope for a future Wimbledon winner, found 28 of them had damaged spines. Nine players had stress fractures. Some of the damage was irreparable.

Far from improving fitness, the game could leave them seriously damaged. The demands of modern tennis are so extreme and the competition so intense that young players in training face a high risk of fractures, slipped discs and damaged joints, researchers for the Lawn Tennis Association say. The increased speed and types of strokes used in tennis all boost wear and tear on the lower back.

"...These players have backs like 50-year-olds, not 16-year-olds." - David Connel, of the Royal National Orthopaedic Hospital

Drug Pushers

Which? surveyed 200 doctorsDrug companies are bombarding GPs with promotional materials and inducements . GPs received four visits per month on average from drug reps.
They also received five promotional mailings about new drugs a week, and inducements to attend conferences.

25% of the GPs questioned had been sponsored to attend a conference, seminar or training event in the UK in the last 12 months and 5% had been sponsored to attend an event abroad. In just one month, one GP was offered nine conference places and 13 meals, and received nine visits from drug reps, 10 letters, 21 leaflets, two patient information booklets and one training DVD. This amounted to 22 companies contacting her about 31 drugs.

Yet doctors still report a lack of information from independent sources and just only 7% trusted the information they received from drug firms.

Lets not make any bones about it - those in the pharmaceutical industry are in business to make profits and to compete with their commercial rivals .Drug companies will waste resources with duplication of effort for the marketing of their own particular product and leave doctors and other health workers no wiser when the information they receive proves so partisan .

What a world this is

Nearly a third of newly qualified nurses had not found a job six months after qualifying, figures show. And over half of physiotherapist graduates were unemployed, along with one in five midwives, according to a government census in March 2007.

9,000 nurses qualified between May and September 2006, but only 69% were employed six months later, meaning nearly 3,000 were unemployed.

Dr Peter Carter of the Royal College of Nursing, said: "I am hearing worrying stories from recently qualified nurses who are unable to get jobs because trusts are freezing entry level posts to save money...it is a waste of new and much needed nursing talent."

Meanwhile,

A group of stressed-out people in Spain have been given a chance to let off steam by demolishing a hotel in Madrid. The 30 winners of a contest were given sledgehammers to smash up the bedrooms and bathrooms of the 146-room hotel in the capital. The participants were selected by psychologists from more than 200 stressed applicants.

And our Fly the Flag Prime Minister

Elsewhere

Under the five-year plan, initiated by EU Agriculture Commissioner Mariann Fischer Boel, winemakers in EU countries will get cash rewards for producing less wine by abandoning some or all of their poorer quality vineyards.

The Poor - Poor Health Report

Socialist Courier has reported previously on the link between poverty and health and we make no apologies of continuing to highlight the problem that the poorer we are , the more we are at risk health-wise and that the establishment political parties have failed to resolve this state of affairs no matter how many reforms or campaigns . The politicians pay lip-service to change but nothing really changes .

The Sunday Herald reports that the gap in standards of health between people in the richest and most deprived areas of Scotland has grown rather than diminished in the past two decades. A new study has revealed how disparities in wellbeing among different sectors of society have improved little since the 1980s.

Although male life expectancy increased overall during the 20-year period, the gap between the richest and poorest widened from five years to seven and a half years during that time.

In addition, there was a doubling of the gap in heart disease hospitalisation rates between the most and least deprived areas.

In the early 1980s, the percentage of low-birthweight babies being born to mothers in poor areas was 6.7%, which was 2.9% more than those in the least deprived category. But by the late 1990s, the difference had grown to a 3.4% gap.

Professor Phil Hanlon, public health expert at Glasgow University, pointed out that differences in the health of the rich and the poor had existed for hundreds of years. But he added it was disappointing that government efforts in the past 15 years in Scotland had not succeeded in closing the gap.

Peter Kelly, director of the Poverty Alliance said "These poorer health outcomes are not solely the responsibility of individual action and behaviours, but are the outcome of larger social processes,"

The Dumbing Down of Doctors

In a previous post Socialist Courier high-lighted how the Romanian health service was reducing costs by dispensing with cancer specialists . Couldn't possibly happen here many readers may have said .

But we now read a government plan to cut senior staff in paediatric wards and neonatal units and replace them with trainee doctors will put infants at risk, doctors and patient groups have warned.

At the moment most paediatric wards have up to seven specialist paediatric senior house officers (SHOs) - doctors with up to four years' experience. Most could be replaced under Modernising Medical Careers. In future, trainee doctors with one or two years' experience will spend four months in paediatrics before moving on to another specialism, and would not necessarily have any interest in that area of medicine.
45,000 babies are born prematurely each year. Babies born at 23 weeks have a 17 per cent chance of survival and require expert medical support, while half of all babies born before 30 weeks suffer from apnea, which causes them to stop breathing.

Senior medical staff warned yesterday that inexperienced trainees are unsuited to difficult procedures such as putting an intravenous drip line into a baby's arm or treating vulnerable premature babies.

A senior London doctor said the impact on the care of vulnerable young children and premature babies could be disastrous. "Paediatrics is a specialism and, to be safe, people must be trained," the doctor said. "If things go wrong during pregnancy, you would call to the delivery an Senior House Officer who would deal with any complications. There is a big difference in a critical situation between an SHO and a trainee. These changes could result in the death of a baby or brain damage... "

Remedy UK , a 13,000-strong doctors' campaign group , accused the Department of Health of "dumbing down" doctors with MMC. "It used to take 21,000 hours of training to become a consultant but this has been reduced to 6,000. There is a move towards dumbing down the system rather than aiming for excellence," said a spokesman.

And here we read what it now feels like to be a doctor .
"...professionalism is being reduced to being a bit like just being on a production line."

First , capitalism made medicine and health into a business , run by accountants , now capitalism turns it all into a factory .

It's Sick , isn't it ?

Around 10,000 people in the UK, mainly of black, Asian and Mediterranean origin, have sickle cell anaemia. Another 800 have the most dangerous form of thalassaemia, a similar disease. Sufferers of the two conditions must undergo regular blood transfusions.

Part of the treatment can either be 2 pills a day that cleanses their blood of life-threatening excess iron - a side effect of the frequent blood transfusions needed to treat the disease -- or alternatively , insert a needle into their stomach for eight to 12 hours a night at least five nights a week .

While the drug is available in Scotland, most patients in England are not able to get it because local NHS organisations are refusing to pay for a drug that costs £10,000-£15,000 for a year's supply for a young person. So now it's back to these injections which many families find highly stressful and do only infrequently, thus endangering the child's life.

Dr Farrukh Shah, a consultant haematologist at the Whittington Hospital in London, said: 'All patients who would benefit from Exjade should get it without arguments about who's going to fund it. They are being made victims of NHS internal politics. It's all down to people passing the buck financially between hospitals and Primary Care Trusts.... It's distressing for patients and their parents. Patients are struggling to maintain the needle treatment and desperately want to get Exjade, but many can't. When I tell them that their PCT has refused to pay for something that would make their life a whole lot easier in many ways, many end up crying.'


Vanessa Bourne of the Patients' Association said :"..you can't expect a parent to put a needle in their child's stomach every night because that treatment is so horrible to administer. Would PCT bosses, as parents, wish to do this to their child every night?..."

And while we are constantly admonished to care for our young , Capitalism simply counts up the pounds and the pence .

Capitalism is a Cancer

Bucharest will witness a protest demonstration of a grisly kind today. The streets of the Romanian capital will be filled with cancer patients pleading with a government that they say has turned its back on them.

More than 370,000 patients have been diagnosed with cancer in Romania but only 76,000 are in treatment, according to official estimates. This year's budget for cancer treatment has been set at 336 million lei (£65 million), a fraction of the amount spent in other EU member states. The UK, with a population less than three times as big as Romania's, spent £4.3 billion on cancer in 2005-06. Many women with breast and gynaecological cancers who had had surgery and radiotherapy are unable to get chemotherapy.

In September, the government ordered a ban on newly trained doctors joining two-year oncology [ the study and treatment of tumors ] courses to qualify as specialists - the first EU member state to obliterate the specialty of oncology - replacing it with a 4 month course instead .

The government also introduced a new system for distributing drugs to cancer patients on 1 April. Previously, it had been handled by hospital pharmacies, but now patients can take a scrip from their doctor to a city pharmacy, and take the drugs at home. But the pharmacies are reluctant to supply the drugs because of bad experiences in the past with underfunded government schemes. The Ministry of Health has big debts from past years and they are sceptical that the government will pay this time . "Cancer drugs are expensive and no one wants to invest a lot of money in buying them and then find re-payments are blocked." . Thousands of patients were left without treatment.

Organisers of the protest in front of the Ministry of Public Health accuse the government of neglecting the suffering of cancer patients. They say ministers are withholding investment because they view cancer patients as economically unproductive.

Referring to the Minister of Health, Eugen Nicolaescu, a Federation of Cancer Patient Associations spokeswoman said :-

"He is an economist, not a doctor. He sees just figures and money, not human lives..."

And what do we read in The Herald .

A spokeswoman for the BMA in Scotland said:"It is no longer financially feasible to deliver everything to all people..."We need to have a sensible debate about rationing in Scotland in context of the Scottish health service."

While Dr Andrew Walker, health economist at Glasgow University, said:-

"...the Scottish Medicines Consortium, which guides the NHS on new drugs, already performed a cost benefit analysis to determine what should be made available to patients...As an economist I would like to see the same sort of model for the other 85% of the health service"