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 .

Poor health

Women from deprived backgrounds are treated differently and have a lower breast cancer survival rate than more affluent women , says a study

The charity Cancer Research UK studied nearly 13,000 patients from England's Northern and Yorkshire health regions. It found deprived women were less likely to be diagnosed in the early stages of disease, when treatment is most likely to be effective. They were also less likely to have surgery or radiotherapy.

The British Journal of Cancer study found that among the most affluent group, 40% had lumpectomies, which allow breast conservation, rather than full mastectomies to remove the breast. However, the figure among the most deprived group was just 31%.

They said that more women from deprived areas were likely to favour a mastectomy because it is a one-off treatment, whereas lumpectomy requires a course of radiotherapy, and therefore regular trips to a clinic, which can be difficult and costly.

The study also found that more than 22% of women from deprived backgrounds did not receive surgery, compared with just over 13% of more affluent women. Part of the reason for this disparity was due to late presentation, but the researchers also found women from deprived backgrounds were also more likely to have other health problems which made them unfit for surgery, or to turn down the option.

A slightly higher proportion of affluent women were seen within 14 days of referral by their doctor than women from more deprived areas. Women in deprived areas were less likely to be given radiotherapy and, on average, had a lower rate of five-year survival.

Dr Rosemary Gillespie, of the charity Breast Cancer Care, said: "The persistence of inequalities in treatment and outcomes highlights that key messages about breast health and screening are still not reaching those in deprived communities who need them."

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."

The price of a life

Certain capitalist economists accuse the National Institute for Health and Clinical Excellence of valueing the quality of human life too high . NICE judged "value for money" at a cost far higher than the NHS could afford.

The effectiveness of the drug, and its side-effects, are balanced with its cost to give a price per extra year of good health - called a Quality Adjusted Life Year (QALY).
In approximate terms, if the new treatment can deliver one QALY for £20,000 or less, then it is deemed cost-effective and heading for NHS approval. If the QALY costs up to £30,000, it may still be approved for NHS use by NICE.

The think tank The Kings Fund and City University, suggested that this £30,000 threshold was far too high when compared with how the rest of the NHS worked out which treatments to fund.
Some primary care trusts simply just pay £12000 in key areas such as circulatory disease per QALY .

Professor Nancy Devlin, from City University said "It's all about value for money... in the current NHS, where there is far less money to spend..."

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 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"