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The Failure of Reformism Admitted

The NHS cannot tackle the health gap between rich and poor by itself and can only provide a "sticking plaster" for such inequalities, according to the convener of Holyrood's Health Committee. MSPs on the Scottish Parliament's Health and Sport Committee found that while there had been "many well-intended initiatives" aimed at reducing the differences in health between affluent communities and those in deprived areas "none has made any significant difference". The committee concluded most causes of health inequalities are "rooted in wider social and income inequalities"
Committee convener Duncan McNeil said: "That your income, your education and where you live contribute to how healthy you are is an issue that as a society should bring us significant shame. Since devolution, successive governments have made this a political priority and invested significant amounts of public money in tackling this complex issue. But sadly none have m…

The poorer - the sicker

A Scottish government report covering a 15-year-period from 1997 to 2012 revealed that hospital admissions for heart attacks were three times higher in poorer areas than in the least deprived areas. The report said the admission rate for heart attacks in the most deprived areas had increased by 45% since 2007 and by 15% in the last year. Deaths from heart disease are about five times more likely in Scotland's worst-off areas, compared with its most affluent communities.

 Cancer is more common in deprived parts of the country. Those aged 45-74 who are diagnosed with the disease in deprived areas are also more than twice as likely to die.

The rate of  alcohol-related admissions in the most deprived areas is around eight times higher than in areas of low deprivation.

Deaths in the poorest areas of the country were more than three times as common as in the most affluent in 2012.

Public Health Minister Michael Matheson said "At the root this is an issue of income inequality - we n…

The Cancer Industry

The international tobacco industry makes about £30 billion in profits each year – a profit of approximately £6,000 per death from smoking.
Tripling tobacco taxes around the world could cut smoking by a third and prevent 200 million premature deaths by the end of this century, researchers claim. In the European Union, a doubling of cigarette prices would prevent 100,000 deaths a year in the under-70s. 
The new tax would encourage people to quit smoking rather than switch from more expensive to cheaper brands, and help to stop young people taking up the habit, say the scientists. They came to the conclusion after conducting a systematic review of 63 studies on the causes and consequences of tobacco use in different countries. In high-income countries, 50 to 60 per cent of the price of a pack of cigarettes is tax. But in low- and middle-income countries, tax makes up only 30 to 40 per cent of the cost. Tripling tobacco taxes would also increase global government revenues from tobacco by…

The Burnt-out NHS

Doctors in Scotland are suffering “stress and burnout” as growing NHS workloads take their toll, medical leaders today warned.  BMA Scotland chairman, Dr Keighley has warned that the fall in hospital bed numbers over a number of years has led to rising waiting lists and more pressure on Accident and Emergency.

Health boards and the Scottish Government are struggling to deal with the pressures of an ageing population, Westminster-led funding cuts and rising expectations from patients which include a shift towards a seven day working week in hospitals. New contracts are now being proposed for doctors, along with “radical” changes to training and greater weekend working. Dr Keighley insisted doctors are ready to look at new ways of working.

The crucial contact between doctors and patients has particularly suffered, according to Dr Keighley.

The “inexorable rise of managerialism” in the NHS has been a “major cause of dysfunction”, he added, and there is a need to return to clinical prior…

Poverty to blame for bad health

Poverty and not Scotland's lack of sun is mainly to blame for a catalogue of illnesses associated with low levels of vitamin D, a new scientific study suggests.

Previous findings identified links between Scotland's lack of sunlight and conditions such as multiple sclerosis and depression. However, a study commissioned by the Food Standards Agency (FSA) in Scotland and the Scottish Government claims the country's inhabitants do get healthy levels of sunlight.

According to the researchers, the study gives added credence to other documented links between vitamin D levels and wealth, with those from deprived areas and with the lowest incomes exhibiting lower levels of the vitamin. The researchers said that "There is a link between vitamin D levels and socioeconomic status, with those deprived areas and with the lowest incomes exhibiting lower levels of vitamin D,"


Capitalism isn't fit for purpose

In the most deprived communities, men and women can expect to spend 22.7 years and 26.1 years respectively in "not good" health. That compares to just 11.9 years and 12 years for men and women in most affluent parts of Scotland.  Cancer and heart attack rates remain higher among those living in deprived areas. Since 2008 "the admissions rate in the most deprived areas has increased at a faster rate than in the least deprived areas", leading to an increase in both relative and absolute inequality. Dr Brian Keighley, chairman of the BMA in Scotland explained "... "for those people living in the most deprived communities the inequalities in health have never been more apparent. We cannot simply continue to argue that public health policies are working to improve the lives of Scots when the differences between rich and poor are so apparent...whilst doctors can do all they can to treat these illnesses, they will not reduce the drivers of inequality in society.…

The poor health of the poor

The gap between rich and poor is leading to thousands of unnecessary deaths in Scotland, health experts say. NHS Health Scotland examined 30 years of health trends and found large differences in preventable causes of death across social groups. It revealed that there was little difference in death rates from non-preventable diseases such as brain and ovarian cancer, but large differences in more preventable causes like alcohol-related deaths and heart disease. The common factor suggested for the persistence of health inequalities was social inequalities.

Dr Gerry McCartney, head of the public health observatory at NHS Health Scotland, said: "Health inequalities represent thousands of unnecessary and unjust deaths per year across almost all social groups in Scotland.”

Director of Public Health Science Andrew Fraser said these patterns of death were not inevitable. "The answers lie in tackling the causes of inequalities, and not just the recognised causes of disease. Patterns…

Crazy Capitalism

Few visitors to the Socialist Courierblog will need to be told of the great frequency and seriousness of mental and emotional disturbances which afflict large masses of the working population, including not only those who receive psychiatric treatment but also the members of the families living in the same household.

Marxists approach the topic of illness as a whole in society, rather than dividing it along the traditional line between body and soul. It means recognising the unity of the physical and mental sides of a person, and talking about whole ranges of different types of ‘illness’ which may be neither particularly physical nor psychological. This approach would reveals how mental and physical health stems more from the economic demands of the system of production. Mental illness is always a sign that basic human needs are not being satisfied; that there is a lack of love, a lack of reason for being, a lack of justice; that something important is missing and, because of this, p…

Your Choice - Mending or Ending Capitalism

In America Obamacare, reforms to the health system of that coutry has been called “creeping socialism” by the free-marketeers and the American public has been barraged by propaganda against any form of “socialized medicine”. The problem of medical costs for people in the United States is a severe and often tragic one. In the UK we possess the much acclaimed National Health Service. The NHS is very far from perfect, but it works far better than the health system in the US, where almost all care is bought and sold in the market place. The NHS is the centrepiece of the welfare state. For over 90 percent of the population it provides their only access to health care. It is immensely popular, despite its inadequacies. The well being of workers concerns the ruling class and, for sure,  this is reflected in the priorities of the NHS. Acute medicine for the able bodied of working age is better funded and includes the most prestigious areas of medicine. Those caring for the elderly and the ph…

Alienated Lives

Why are Scots sicker than the rest of the UK?

Dr Phil Hanlon and researchers at the Centre for Population Health have compared life, incomes and health outcomes in Glasgow, Liverpool and Manchester. They found “deprivation profiles” were almost identical, but premature deaths in Glasgow were 30 per cent higher.

This excess mortality ran across almost all ages, males and females and deprived and non-deprived neighbourhoods. It was not, surprisingly, lung cancer, heart and liver disease were not the factors tipping Glaswegians over the UK average.  It was higher levels of drug and alcohol misuse, suicide and death through violence.

Why are some Glaswegians so prone to self-harming and life-shortening behaviours?

Chief Medical Officer Harry Burns cites the work of Aaron Antonovsky, who maintained that a sense of coherence (SOC) is necessary for adult health. The  medical sociologist defined the SOC as “the extent to which one has a feeling of confidence that the stimuli deriving from on…

Patients are not Widgets

Dr Brian Keighley, chairman of the British Medical Association (BMA) in Scotland, hit at the NHS Trusts.

 "We now see health boards talking about 'their' patients, almost implying that the doctors it employs or contracts with are mere technicians in the pursuit of their corporate aim. What an insult to those of us who came into medicine to treat patients to the best of their ability." He said: "Bean counting and clinical direction by managers with top-down politically-inspired targets are not compatible with relationships founded on trust between physician and patient. Patients are not widgets and I get upset when they are treated as such, and when I am considered a mere tool within a corporate design. This slavish addiction to an ethos of corporatism and managerialism has led to doctors, nurses and other clinicians becoming progressively disempowered." He added: "What I want to see for my successors in the NHS is a return to what is at the heart of l…

Good health, but at what price?

A woman awaiting a transplant for a rare condition, atypical haemolytic uraemic syndrome (aHUS), an inherited condition that has destroyed her kidneys had her operation cancelled at the 11th hour because the Government refused to pay for the drug she needs to prevent the organ being rejected. Up to 70 patients are in the same position. They have been forced to put their lives on hold, and risk their condition deteriorating, while ministers and officials argue over whether the NHS can afford the drug, Eculizumab, which costs more than £300,000 per patient per year. The health minister, Earl Howe, rejected a recommendation from an expert committee that the drug be "routinely provided nationally".


Instead, Earl Howe referred the drug for further investigation by the National Institute for Health and Care Excellence (Nice), which took over responsibility for treatments for rare diseases. Nice has yet to explain how it is going to assess drugs for rare diseases. Nice's verdi…

The cost of cancer

Allan Cowie, general manager for Macmillan Cancer Support in Scotland, has revealed that after fear of pain, money worry is patients’ greatest cause of stress. And demeaning work assessments ruling people are fit to work are also causing unnecessary suffering.


Many Scots, according to the charity boss, have been left with the fear of being labelled scroungers, meaning vital benefits go unclaimed. Cowie said:

“ We worry the stigmatisation of those on benefits may mean patients with cancer are too ashamed to claim. We have encountered cases of terrible poverty. We have heard of instances where people only worry about benefits when they face losing their home. Up until that point, they are more concerned with the dreadful worry of if they will live or die. We have also heard of cases where people have no food in their homes because they have channelled all their money into keeping a roof over their heads. This is not acceptable in this day and age.”

Cancer sufferers face additional cost…

Patents or Patients

When HIV/Aids took hold around the world and antiretroviral (ARV) drugs became available from 1987, the  drug treatments required then cost $15,000 a year, which very clearly limited their use to well-insured or relatively rich western patients. Prices for AZT3 officially started at $25 per pill in South Africa. Although HIV/Aids was the scourge of Africa in the 1980s, its management ad treatment was initially completely out of reach of  those hit by "slim" disease as it was then known as locallywho were just expected to go away and die. And millions, denied medication, did die. An estimated 10 million people perished between 1996 and 2003 thanks to denial of drugs by Big Pharma. And all the while the medicines were just sitting there ... out of the financial reach of the inflicted. Big Pharma was quite happy to see millions of deaths in order to keep patent law - and its profits.

 Thanks to India's 1970 patent law, drugs could be made to the highest technical standard…

We need a need-based health service

The NHS is failing to provide needs-based care in areas of blanket deprivation, GPs working in Scotland's poorest areas will tell MSPs. The GPs from The Deep End group, which represents 100 practices in the poorest parts of the country are expected to warn that the health service's approach is a "recipe for widening health inequality" when they appear before the Public Audit Committee.

The report warned that the distribution of GPs in Scotland does not reflect the higher levels of poor health and greater need in poorer areas and that "deep-seated inequalities remain between the least and most deprived communities" despite research showing higher rates of multimorbidity (more than one chronic medical condition) in patients from the most deprived areas.

This, combined with "dysfunctional links between general practice and other parts of the NHS", is "a partial explanation of 20 years of failure in addressing inequalities in health. The GPs calle…

The Tyranny of Work

The mental health of Scottish workers is being put at risk thanks to the "relentless pressure" of management systems meant to increase their productivity. Unions and researchers claim workers have suffered extreme stress, depression and in a few cases threatened suicide.  Austerity has allowed some firms to use management techniques to make their staff's lives a misery.

The impact on the mental health of employees was highlighted in the report Performance Management And The New Workplace Tyranny. Phil Taylor, professor of work and employment studies at the university in Glasgow, carried out the research.  He said performance management had evolved into a "continuous, all-encompassing" process of "tight monitoring and strict target compliance".

Taylor said: "Many who have been in the workplace for 10, 15, 20 years, talk with great pain about how the workplace they joined has been transformed beyond all recognition over those decades and the asp…

Depressed Scotland

The number of people in Scotland prescribed antidepressants has reached record levels, with more than one in seven people taking the drugs. There has been a steady rise in usage. There were 1.26 million drugs dispensed in 1993/94, increasing to 5.01 million in 2011/12.

The diagnostic criteria for depression as two weeks of low mood, irrespective of any change in the circumstances of the patient which might have left them feeling down. It even proposes that being low two weeks after bereavement should be considered depression.

Glasgow GP Des Spence argues treating depression like a medical condition is distracting attention from what really makes patients unhappy. "I think we use antidepressants too easily, for too long and that they are effective for few people (if at all)." Dr Spence's  concern about the widespread use of antidepressants is they leave the real reason for someone's poor mood unexplained. He said: "Improving society's wellbeing is not in the …

Deprived Scotland

A boy born in the most deprived 10 per cent of Scotland would have a life expectancy of just 68. That is eight years younger than the national average, and 14 years below boys born in the least deprived parts of the country.

 Rates of mortality for heart disease are twice as high in deprived areas, at 100 per 100,000 under-75s, compared with the national average. Cancer mortality rates are 50 per cent higher in poorer areas, at 200 per 100,000.

The number of Scots aged under 25 who are out of work has doubled to 90,000 since 2008, the Joseph Rowntree Foundation said.

The report also highlighted the rise in part-time employment, from 70,000 in 2008, when the economic crisis hit, to 120,000 now.

The Scottish Government insisted Westminster benefit cuts were the biggest threat when it came to poverty and inequality. Julia Unwin, chief executive of the Joseph Rowntree Foundation, said: “The Scottish Government has powers to do a lot now. They don’t need to wait for constitutional change.&quo…

Scottish health apartheid

New figures revealed men in the wealthiest areas live 11 years longer than those in the most deprived parts of the country. For women, the gap is 7.5 years between the poorest areas and the most affluent. Deprived area residents have higher rates of heart disease, obesity, diabetes and drug and alcohol abuse as well as poorer mental health.