Crimes sem castigo, por cá e por lá

A medicine stockpiled by the Department of Health to hand out to millions of Britons during a flu pandemic may not even work, MPs warn. Some £424million has been spent on supplies of Tamiflu since 2006, yet there is no clear evidence available that it is effective. A flu pandemic, which relates to an epidemic crossing a large geographical area, is considered by the Government to be a far deadlier risk to Britons than a terrorism attack or weather catastrophe. However, we may have little protection against it.

A report by MPs on the Public Accounts Committee accuses NHS watchdogs of not demanding enough evidence from drugs firms on the safety of their products before allowing them to be used by British patients. NICE decides which drugs are used on the NHS and the Medicines and Healthcare Regulatory Agency (MHRA) approves them for public and private use. The MPs' report accuses both of just 'taking manufacturers' word for it' that drugs work. If that is the case, millions of patients could be taking medicines which are ineffective and may have potentially dangerous side-effects.

Esperança média de vida: Grã Bretanha

These maps show the life expectancy for men (up) and women (down) across the regions of the UK - the darker the area, the longer the life expectancy.

Obesity: again and again and again

The growing threat of obesity to the nation's health has been revealed in an astonishing survey which shows four areas in England where at least 30 per cent of adults are defined as such. This is the average level predicted across Britain but only by 2025 or 2030. The four local authority areas named in the Department of Health report are Gateshead; Tamworth, in the West Midlands, and Swale and Medway, both in north Kent.

NHS: cultural revolution II

Fonte: aqui.

Andrew Lansley's recent announcement that the government is embarking on a two-month "period of listening" about its NHS reform plans has been seen by some as a U-turn over a deeply flawed policy.

There are, however, some areas where the government is not prepared to listen: the commitment to abolish primary care trusts, to transfer major powers to commission services to GPs, and the ambition to vastly increase the participation of the private and, in theory, voluntary sectors in providing health services. In future, the NHS will continue to be funded from taxation and (for the time being) will be free at the point of delivery, but the government will step back from running the service.

Private sector involvement in the NHS is not new. Dentistry, worth £2.1bn, opticians and pharmacies are already in the private sector. GPs themselves are effectively private contractors, accounting for £8bn, or almost 10% of the entire NHS budget. Under Labour, private involvement was extended via independent sector treatment centres (ISTCs), handling mainly non-emergency elective treatments, as a way to bring down waiting lists.

But the current proposals are much more bold. Plans are under way to further outsource central services, such as workforce development (total budget £5bn) and procurement management. Even NHS Direct (worth £146m) is in the firing line.

But what about core and non-core clinical services provided by NHS trusts and community health organisations? These could be harder to outsource. This is especially true of the most complex, unplanned hospital admissions that are costly and inherently difficult to plan for. The Department of Health's (DH) own statistics show these account for approximately £12.5bn of a total budget for "hospital and community services" of £51.5bn. But that still leaves £39bn that could potentially be subject to private sector competition.

Drogas

Drug use may be going down but more people than ever are being treated for drug problems in England's hospitals. The NHS Information Centre's annual drug misuse report shows the number of admissions to hospital in England due to a drug-related mental health or behavioural disorder rose by 5.7% to 44,585. Similarly, the number of hospital admissions due to drug poisoning also rose by 4.8%, to 11,618, with those aged 16-24 the most likely to be treated. In 2009-10 a total of 206,889 people received help from drug services, with men almost three times more likely than women to get that support. However, 23,680 (38%) of the 62,685 people who were treated for drug dependency ended up no longer addicted to the substance that had led to their treatment.

Obesity: again

A man who once weighed nearly 70 stone is to launch legal action against the NHS, claiming they failed to help him as his size soared. Former postman Paul Mason received life-saving gastric surgery last year binge-eating his way to gargantuan size. But the 50-year-old, who now weighs in at a comparatively small 37 stone, said he should have been helped years ago. Mr Mason, who was eating 20,000 calories a day at his heaviest, claims he sought help from his GP after ballooning to 30 stone. Instead of receiving a treatment programme to manage his weight, he has complained he was told in 1996: 'Ride your bike more.'

NHS: service by numbers

Hospital bosses are advertising for an adviser to help decide which jobs to axe to save money - and will pay £1,000 a day for their services. The so-called 'turnaround' director will earn twice as much as the Prime Minister to oversee 'efficiency and cost-saving measures'. Details of the lucrative salary came as the NHS is being forced to make spending cutbacks, with frontline staff at risk.

NHS (UK): rolling

Hospitals will have up to 10 per cent of their income based on patient satisfaction, the Health Secretary has announced. Andy Burnham set out his vision of the NHS until 2015 and said some payments would be withdrawn if unsafe care was found. Under his plans, hospitals could face tough financial conditions in the next few years, with the amount they are paid to treat patients frozen until 2015.

Mr Burnham denied this would result in hospital closures but said they would have to find ways of working more efficiently. He wants to see more patients treated in the community, which is cheaper than providing hospital care, as the NHS strives to save billions in the next few years. As a result, patients with long-term conditions, including cancer, could be given dedicated one-on-one carers to help oversee their health. Also today, Mr Burnham suggested NHS staff could be given a guarantee of employment in return for flexibility at work and accepting a pay cap. He stressed patients should be at the forefront of what the NHS does.

Reforma da reforma oral

NHS dentistry has been left behind in the drive to improve the health service.

The British Dental Association said while hospitals and GPs had largely solved access problems, the issue was still dogging dentistry in England. A report by the union said there was so little information available on local people that they did not know who they needed to focus their efforts on.

NHS dentistry has been a long-running problem for the government. Ministers sought to improve access by introducing a new contract in 2006 to entice more dentists into NHS work - unlike GPs they have significant portfolios of private patients.

But it made little impact. In fact, in the two years immediately following the start of the new system 1m fewer patients saw an NHS dentist. The government has already agreed to another reform of the system after commissioning a review of dentistry by independent experts.

Tratamentos do Principe Carlos

Fonte: aqui.

Promoted and sold under ‘Duchy Originals’ brand, these medicines have been made from plant extracts and are said to be effective in curing ailments such as colds, low disposition, fretfulness and dyspepsia. Andrew Baker, Duchy Originals's chief executive said, "The decision to launch these products reflects the Prince of Wales's passion for integrated healthcare. We hope that the Duchy Herbals range of herbal remedies will encourage more people to adopt this integrated approach to their health."

NHS: nurse

Fonte: aqui.

An NHS nurse has broken the £100,000 pay barrier for the first time as the drive to cut waiting lists brings lucrative rewards for senior staff. The nurse consultant, who is based in Rotherham, earns double the basic salary of around £50,000 by working overtime under a generous Health Service initiative.

Fumar ou morrer de susto?

Fonte: aqui.

Starting Wednesday, smokers in Britain will be greeted with a startling new warning when they pick up their regular pack of cigarettes. A graphic new ad campaign aims to show smokers, in no uncertain terms, the fate that might await them if they continue their habit.

A defesa dos doentes

A saúde custa caro. Todos sabemos disso. A saúde trata pessoas e não cadeiras ou malas. Também sabemos que cada vida humana não pode ter um custo ilimitado, sob pena de não termos recursos para mais nada do que para os gastos com a saúde.

O equilíbrio é difícil. Este doente na Grã-Bretanha, decidiu recorrer aos Tribunais porque o hospital que o tratava lhe recusou o financiamento para aquisição do medicamento que os médicos lhe prescreviam:

• Colin Ross, 55, from Horsham, West Sussex, who has the bone marrow cancer multiple myeloma, launched his legal battle to obtain the drug Revlimid
• Mr Ross was challenging a decision by West Sussex Primary Care Trust (PCT) last March to refuse funding.
• Judge Simon Grenfell overturned the PCT's decision that the new drug would not be cost-effective, and said Mr Ross's case should be treated as "exceptional".

Mas o pior, é que cada hospital tem o seu critério para pagamento dos medicamentos: He found out about the discrepancy by talking to a fellow patient at the Royal Marsden Hospital who lives 12 miles away from him and was receiving the drug.

Pois é, os critérios são diferentes, mas os doentes é que sofrem: "The mental anguish that we have been through has at times been unbearable, and wholly unacceptable in this day and age,"

Os doentes devem estar preparados para mais lutas idênticas. Mas, é preciso que se ganhe a luta, antes de morrer!

Exames

Fonte: aqui.

A mistificação dos dentes!

Gostamos de verdade. Não gostamos de aparências. Não gostamos de mistificações. Gostamos ainda menos de mistificadores!

Tudo isto a propósito desta "pérola": o relatório do OE2008 limita-se a adiantar a saúde oral como "domínio prioritário, especialmente focalizado na prevenção da doença de modo a que alguns segmentos da população, em particular crianças, grávidas e idosos com baixos rendimentos, possam ter dentes saudáveis".

Vamos ao portal do Ministério da Saúde e vemos com mais detalhe a tal "pérola": Pela primeira vez, o Serviço Nacional de Saúde (SNS) vai integrar um Programa Nacional de Saúde Oral, que vai alargar ao conjunto das crianças de 6 a 12 anos a intervenção de prevenção da cárie dentária realizada nas escolas, assegurar a cobertura de 65 mil grávidas e aumentar os apoios aos idosos beneficiários do complemento solidário na aplicação de próteses.

Senhor Professor Correia de Campos, perguntamos-lhe: quantos portugueses vão ser abrangidos pelo novo Programa Nacional de Saúde Oral? 150.000? 200.000? Estamos ou não a fingir que o Serviço Nacional de Saúde presta serviços na área oral? Estamos definitivamente a fingir, Senhor Ministro!

Mais valia dizer aos portugueses, a ladaínha habitual, "não há dinheiro, não há higiene oral"!

É que com medidas destas, estamos a contribuir para a imagem do Serviçozinho Nacional de Saúde para pobrezinhos! Ou dito de outra forma, só recebem o cheque-dentista os pobres.....indigentes e grávidas! Por amor de Deus.

Vejamos o que se passa em alguns países Europeus:

• Em Inglaterra, diz, toda a gente tem acesso à saúde oral, com diferentes níveis de co-pagamento em função do rendimento.
• em Espanha, todas as crianças têm cuidados gratuitos até aos 18 anos, idade a partir da qual se entende que a prevenção é responsabilidade individual.

New watchdog

Nós chamamos-lhe "Entidade Reguladora", os Britânicos chamam-lhe "Watchdog".

Seja como for, o Primeiro Minitro Gordon Brown, face a uma imensa teia de instituições que andam à volta da saúde, decide impôr ordem em multiplas casas, com mão de ferro, senão vejamos a notícia: A new regulator with powers to fine hospitals and shut down wards will be created under legislation set out today in Gordon Brown's first Queen's Speech.

Vejamos mais detalhes:

• The Care Quality Commission will bring together the functions of the existing Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission.
• It will also be equipped with a stronger remit to "inspect, investigate and intervene" where hospitals are failing to meet hygiene standards.
• The integrated regulator, to be set up under a forthcoming Health and Social Care Bill, will cover adult social care as well as health services.

É importante, que os Governos, que vão estando perante desafios maiores e mais complexos, consigam ter controlo sobre alguns desvarios que vão existindo. E a Grã - Bretanha está a fazê-lo.

Por cá, ainda recentemente, tivemos o escandalo do encerramento de várias cantinas de hospitais, e não tivemos conhecimento de qualquer penalização para a Administração das respectivas instituições. Se não há penalização, o crime compensa.....

Parece que os dentes não fazem parte da saúde

Em Portugal, há já muitos anos, que o SNS se esquece dos dentes! Isto é, quem quer ir ao Dentista, paga. Pensamos que o SNS nem tem lista de espera de Dentista. Simplesmente, parece que não tem Dentistas....

Também desde há longos anos, que o SNS tenta ser um decalque do NHS, Britânico. Até no serviço que presta quanto aos dentes, o SNS se quer parecer com o NHS, se não vejamos esta notícia:

• Falling numbers of state dentists in England has led to some people taking extreme measures, including extracting their own teeth, according to a new study released Monday.
• Others have used superglue to stick crowns back on, rather than stumping up for private treatment, said the study. One person spoke of carrying out 14 separate extractions on himself with pliers.
• More typically, a lack of publicly-funded dentists means that growing numbers go private: 78 percent of private patients said they were there because they could not find a National Health Service (NHS) dentist, and only 15 percent because of better treatment.
• "This is an uncomfortable read for all of us, and poses serious questions to politicians from patients," said Sharon Grant of the Commission for Patient and Public Involvement in Health.

Os portugueses sempre admiraram França, e sempre gostaram menos dos Britânicos. Seria bom, que na saúde, a tendência também fosse França. O Professor Correia de Campos até foi em França que desempenhou funções de Administrador Hospitalar.....

A indumentária do Pessoal da Saúde na Grã - Bretanha

O novo Ministro da Saúde Britânico, Alan Johnson, impõe novas regras quanto às roupas que o pessoal da saúde deve usar: Long-sleeved white coats, favoured by physicians for decades, are set to be banned under an NHS shake-up aimed at tackling hospital superbugs.

Mais, toda aquela série de parafernália que o comum dos mortais usa, tem que ser banida, tais como: relógios, brincos, jóias e até unhas grandes....

É que as infecções nos hospitais britânicos só tem paralelo em alguns hospitais do leste da Europa: The moves come after a report found British hospitals were among the worst in Europe for superbugs, behind countries such as Slovakia, Hungary, Poland and the Czech Republic.

E parece que a higiene é tão problemática na Grã-Bretanha, como em Portugal: Experts have said that up to two-thirds of doctors do not wash their hands properly.

A prevenção na saúde: o consumo de sal e as crianças

Infelizmente, nas sociedades ocidentais, combate-se sobretudo o tabagismo. Foi preciso falecerem milhões de pessoas, por razões relacionadas com doenças associadas com o consumo do tabaco, para que hoje em dia, se chegue a um autentico fundamentalismo anti-tabaco.

Quase se questiona porquê que se o tabaco é assim tão mau, porquê que não se proíbe a sua comercialização, como se faz com a cannabis ou com os opiáceos? Mas, o financiamento dos orçamentos estatais é bem mais importante!

Para além do tabaco, esquece-se a sociedade ocidental (aquela em que nos inserimos), da gordura (dos hamburgueres, das batatas fritas, dos bolos, etc.), do sal (das batatas fritas, dos aperitivos, dos guisados ou dos molhos), do excesso de consumo de medicamentos, etc.

Mas, como a sociedade ocidental adora manter a sua relação cínica com alguns dos seus males, há sempre males mais apetitosos do que outros!

Vejamos esta notícia, proveniente do Reino Unido:

• Children as young as four are eating so much salt it is putting their health at risk by raising their blood pressure, a study suggests.
• The average four-year-old ate 4.7g a day, which is way above the 2-3g recommended for this age group, the Journal of Human Hypertension reports.
• In the study, which involved 2,127 4-18-year-olds in Britain as part of an official audit for the Department of Health called the National Diet and Nutrition Survey, salt intake did not include salt added in cooking or at the table, although this often occurred.
• Every extra gram of salt consumed by the children was related to a rise in systolic (peak) blood pressure of 0.44mmHg - which the researchers say tallies with past studies linking high salt intake with high blood pressure.
• Jo Butten of Consensus Action on Salt and Health said: "The message for parents is to check labels, especially on foods such as breakfast cereals and snack products, which they may not expect to contain high levels of salt, and choose the lower salt options.

Por cá, não vemos nem estudos semelhantes a estes, nem activismo que tente impor regras mais estreitas junto dos fabricantes de alimentação!

Sem prevenção, há pior qualidade de vida e mais custos de saúde! De certeza.

Lições do NHS

Nem sempre temos que seguir modelos alheios. Mas, não faz mal nenhum, olhar para outros exemplos, para além do nosso. Tudo isto a propósito do número de horas de trabalho dos Médicos na Grã-Bretanha, no National Health System (NHS).

Vejamos esta notícia: GPs in England spend almost 40% longer on each patient consultation than they did in 1992/93, research shows.

Óptimo, para os doentes, pois assim os seus Médicos podem ouvi-los mais e melhor. Mas, atenção aos detalhes: Data released by the Information Centre for Health and Social Care show the average consultation time in 2006/07 was 11.7 minutes, up from 8.4 minutes.

Contudo, However, most are not working outside "normal" hours as they once did. In 1992/93 the average GP worked around seven hours a week outside surgery hours.

Sempre a baralhar e dar de novo: A new contract was introduced for GPs in 2004. The deal allowed them to opt out of evening and weekend work, in return for around a £6,000 a year drop in pay.

É sempre bom poder optar por trabalhar menos, abdicando de alguma parte do salário.

Mas, parece que os Médicos Britânicos não se podem queixar dos contratos elaborados com o NHS, da era Blair: But performance-related components to the contract have led to their pay rising by over a fifth in the first year of the contract, with average GP pay now above the £100,000 barrier.

Convenhamos, que 1 libra = 1,5 euros, pelo que cada Médico de Clínica Geral aufere na Grã - Bretanha cerca de 150.000 euros por ano. Não está mau!