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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…

The Unpaid Over-worked "Angels"

The NHS in Scotland is close to breaking point, with most nurses claiming they are forced to work overtime to meet patient needs, a new report has found. A majority of nurses say patient care is suffering because of the pressure they are under, according to a staff survey by the Royal College of Nursing (RCN). Nurses are going unpaid for the extra hours they work because this was not agreed in advance, the report reveals, and time back in lieu cannot be taken because this would leave colleagues even more short staffed.

Nearly 2,000 nursing posts have been axed in Scotland in recent years. The survey finds that 54 per cent of nurses are working beyond their contracted hours each week in order to meet demands, with 58 per cent saying they are under too much pressure. More than half (55 per cent) say they are not providing the level of care they want to as the pressure builds. Only 38.1 per cent in Scotland say they would choose nursing as a career if they had to do it all again.

Norman…

The welcomed immigrants

With training numbers cut, budgets frozen – it costs on average £70,000 to educate and train a qualified nurse in England – and the winter coming, foreign nurses represent a quick fix. Public spending cuts combined with nursing training places falling from almost 21,000 in 2009 to fewer than 18,000 this academic year means there is a significant shortfall in hospitals.

 One NHS employee said: “If you need a lot of nurses quickly, then the best thing to do is jump on a plane and bring them back from an EU country. They’re happy and the hospitals are happy.”

Howard Catton, RCN director of policy, said: “When employers are getting on planes to recruit nurses, you know you have a crisis in workforce supply. That is happening right here, right now.”

Forty trusts have already recruited from overseas in recent months, resulting in more than 1,360 nurses coming to work in England. A further 41 hospital trusts will follow suit. Spain and Portugal are the most popular sources. As more than 10,…

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…

Not so confidential

A leading Scots GP claims the NHS is profiting from allowing pregnant women's details to be sold to commercial companies, often without their full knowledge or consent. Glasgow GP Dr Margaret McCartney also warns that the NHS and professional bodies such as the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of General Practitioners (RCGP) are guilty of a conflict of interest by collaborating in the advertising of thousands of products to pregnant women and new mothers.

She also criticises Bounty, a promotions company which supplies 2.6 million Bounty bags a year to new mothers, including 812,000 newborn packs distributed through NHS maternity wards. Many of the mothers who sign up to receive Bounty Bags while in hospital are not aware they are agreeing to their email address and telephone number being used by commercial companies, she argues. In some cases they do not even realise the person collecting the information is not an NHS employee, while …

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…

Nursing the figures

It’s estimated 5000 NHS workers, including around 2500 nurses, have lost their jobs in the last three years. NHS chiefs spent £94million on temporary nursing staff last year – to fill the gaps left after they axed the 2500 nurses. The cost of using supply and agency nurses in Scottish hospitals soared by £4million compared to 2010, a report has revealed. And the number of staff hours taken up by temporary nurses rose by 1.5million to 6.3million.

Ellen Hudson, of the Royal College of Nursing Scotland, said: “It is vital that bank nursing is available to cover shortages when staff are off sick.However, the bank should not be used to cover long-term vacancies caused by recruitment freezes as it would be much better for patients if they’re filled with permanent staff.”

The RCN said the small increase in the number of nursing and midwifery staff was largely accounted for by the inclusion of nursing and midwifery “interns” in the workforce figures. The internship scheme is available to newl…

Drugging our old folk

Elderly patients in care homes across Scotland are being prescribed powerful drugs for long periods of time without proper checks on whether the medication is needed. In some cases, frail patients are being kept on multiple and potentially harmful doses for up to two decades without doctors or staff questioning whether they are necessary. Patients are often kept on a mix of drugs for health problems that may have resolved over time.

The Royal Pharmaceutical Society in Scotland (RPSS) in a report calls for more powers for pharmacists to review patients’ medical records. Pharmacists say they are becoming “increasingly concerned” about patients’ safety.

 Drugs regularly handed out to elderly patients include anti-psychotic medicines for dementia. These are classed as high-risk because of their links to heart problems and strokes, yet some patients remain on these far longer than is required. Other drugs could be causing …

A sharing, caring Scotland

A total of 2,025,400 people had put their names forward for the NHS Organ Donor Register as of 31 March - almost 40% of the population. Across the UK, the number of people on the organ donation register stands at 30%.

Three people in the UK die every day because of a lack of access to organs. The Scottish government also said the number of people who died while waiting for organs fell from 38 in 2010-11 to 36 in 2011-12. The tragic fact is that more than 600 people in Scotland are still waiting for a life-saving transplant.

Docs Get Ready to Fight

The British Medical Association is poised to ballot its members on industrial action for the first time in 40 years. Under the Dept. of Health plans, doctors' pension contributions would increase immediately by up to 2.4%, with continued increases over the next two years. It also wants to raise the retirement age to 68 and end the final salary scheme for hospital doctors. Although the DoH proposals are intended to apply to NHS workers throughout the UK, Scotland has its own devolved NHS pension scheme which is overseen by the Scottish Public Pensions Authority. However, if the Scottish Government decided to break with the reforms it is likely Holyrood would have to pick up the tab for any shortfall.

Dr Dean Marshall, outgoing chairman of the BMA's Scottish General Practitioners Committee, said doctors north of the Border had been let down by Holyrood's inaction and the Scottish Government's "complicity" with Westminster on the issue.

Dr Marshall said: "Is …

The old neglected again

Older patients are “not safe” on hospital wards in Scotland because of a lack of qualified nurses to care for them according to Royal College of Nursing (RCN) findings. The report suggests there is just one nurse caring for nearly ten patients on old people’s wards. A survey of almost 1,700 nurses found that 78 per cent said comforting and talking to patients was not done or done inadequately on their last shift because of low staff numbers. Some 59 per cent said promoting mobility and self-care was left undone or unfinished, with 34 per cent saying they could not provide patients with food and drink, and 33 per cent claiming they were unable to fully help patients to the toilet or manage incontinence.

The RCN warned there was a danger that “care becomes compromised” and said that many nurses say “they are too busy to provide the standard of care they would like”. The report said: “Older people in Scotland are being let down by a lack of professionally qualified nurses in hospitals, de…

NHS rationing

What is the value of a few precious extra months of life? It's a very difficult question to answer, but if Scottish Medicines Consortium's is to be believed then, it is not worth £2.5 million.

Prostate cancer is the most common cancer in men in Scotland, with 2700 cases diagnosed every year. It kills two men every day. There are 19,000 Scottish men currently living with the disease.

Last October, Alex Salmond, the First Minister, signed up to a charter calling for better treatment for patients.

The Scottish Medicines Consortium has denied Scottish men a drug that prolongs life. It said the cost of abiraterone at £3000 a month did not justify the health benefits – even though it can extend lives by more that three months .

In a letter to the Scottish government, sufferer John Thomson writes "It is a disgraceful decision, cruel and unjust, that abiraterone is not available simply because of cost. How do you evaluate the cost of drugs against someone’s life?...This drug not onl…

Another union ready to fight

Doctors are threatening their first wave of industrial action in nearly 40 years, after they overwhelmingly rejected proposed changes to their pension plans. Under the final offer proposed by the UK government, some doctors will see their pension contributions rise from 8.5 per cent to 14.5 per cent of their salary. They will also have to work longer before they can retire. Existing methods of pension accrual will be replaced by a career average revalued earnings scheme for all doctors and there will be no automatic lump sum, currently enjoyed by some doctors upon retirement. According to the BMA, the proposed changes would see doctors working until 68, an age beyond which many feel “competent and safe”.

A UK-wide survey by the organisation of 130,000 doctors and medical students – including 6,638 in Scotland – found an overwhelming majority opposed to the pension reforms, with almost two-thirds prepared to take some form of industrial action. More than a third (36 per cen…

health and safety??

Hospital chiefs are discouraging “whistleblowing” nurses from reporting their concerns about patient safety and staffing levels, nursing leaders have warned. More than one-third of nurses in Scotland (37%) said they had been discouraged, or told directly, not to report their concerns to their NHS health board or employer.

The Royal College of Nursing (RCN) revealed more than 80% of nurses in Scotland said they had highlighted problems. But, in more than half of cases, no action was ever taken. The overwhelming majority (84%) of nurses in Scotland fear they will be victimised if they speak out about the problems.

Theresa Fyffe, RCN Scotland director, said: “It is extremely worrying that nurses are being explicitly told not to raise concerns, particularly after all we have learned about the consequences of ignoring issues around patient safety. The survey clearly shows nurses are committed to improving care for patients, but more than half, 55%, say no action was ever taken when they rais…

making cancer victims suffer

New research by a leading charity reveals that hundreds of cancer patients are living close to the breadline due to their illness, with 73% experiencing a loss of income and increased costs such as hospital travel and higher utility bills. Cancer patients in Scotland are skipping meals and worrying about losing their homes because of a drop in income and higher living costs.

Around 30,000 people in Scotland are diagnosed with cancer each year, costing many of them thousands of pounds.

Elspeth Atkinson, director of Macmillan Scotland said: “Cancer is an expensive disease to live with, but this research shows just how close to the breadline many cancer patients really are."

Research has shown that more than half of all terminally ill cancer patients do not claim benefits they are entitled to. Complicated benefits forms, a lack of awareness of entitlements, embarrassment or simply feeling too ill or emotionally drained, prevents many people accessing welfare benefits.

http://www.heralds…

Cancer of Capitalism

Professor David Cameron, an expert in breast cancer from Edinburgh University, said new treatments were increasingly being developed which targeted specific subtypes of cancer, helping make them more effective.

"These drugs are expensive. Some of that is the real cost of developing them and some of that is if you are only going for a subset of cancer then your total predicted sales will be less," Prof Cameron told The Scotsman. "The business model of the company will be that in order to develop the money to develop the drug your subsequent sales in the patent lifetime have to be sufficient to cover all your costs. So actually, the cost for rarer cancer is likely to be higher and not lower."

The caring unpaid over-worked angels

Nurses are "propping up" the health service by consistently working over their contracted hours and providing last-minute shift cover.

The Royal College of Nursing (RCN) Scotlandfound just one in 10 nurses feel they have good staffing levels where they work. 96% of nurses reported working in excess of their contracted hours, with a quarter saying they did so every shift. One in six said they rarely or never took the breaks to which they were entitled. 29% said they missed their meal time at work at least three times a week. One in five nurses said that in the last six months they had spent a week or more at work despite feeling too ill to be there. Another 29% said they provided last-minute cover for absentee staff at least on a fortnightly basis.

The Royal College of Nursing (RCN) Scotland said there were "serious concerns" for patient care in the NHS

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 mi…

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.&q…

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 s…