The “obesity crisis” is a recurring theme in the news and is something I have written about before. I plan to write briefly on it again this week having read an article by a Cardiologist on the BBC news health page.
“A report by the Academy of Medical Royal Colleges called for a range of measures...including improving food in hospitals” to try and tackle the so called obesity crisis. Another “report by the group Sustain has also called for hospital food to meet mandatory nutritional standards.”
After all, shouldn’t hospitals be leading by example?
The clinician speaks of their own experiences and feels it is unacceptable to have “fast food franchises on site and corridors littered with vending machines selling junk food.” I can draw parallels with this as the cardiology ward I volunteer on has a ‘fizzy drinks’ vending machine down the corridor, but by contrast the meals on the ward itself appear to be balanced and the menu follows a fortnightly cycle.
Chief executives and senior managers defend such practices by arguing that the revenue from the sale of these products is used to save lives. But is such practice acceptable? These items may well have contributed to the patients admission in the first place! Most would agree that selling cigarettes to produce revenue to treat patients would be unacceptable. So, how different is selling fast food products to produce revenue?
Hospital staff are also suffering from serious weight problems as well as patients. A recent report from the Royal College of Physicians revealed that “half of the 1.4 million people who work for the NHS are obese”
Shouldn’t NHS staff be leading by example?
The article suggests that education alone will not tackle the obesity crisis and that the food industry (for example advertisements,) has a much greater impact on our eating habits than we realise.
In summary the NHS and health campaigners need to try and capture the attention of the public above the food corporations who are driven by profit rather than good health. However perhaps patients will only listen once the message has reached the NHS staff surrounding them. To achieve this the food industry needs to be regulated more strictly and a good place to start would be hospitals. Finally obesity is an ongoing problem and not one which can be fixed quickly and simply.
Tuesday 26 February 2013
Tuesday 12 February 2013
Stafford Hospital Scandal
Data shows there were between 400 and 1,200 more deaths than would have been expected at Stafford Hospital from 2005 to 2008. However it is impossible to say all of these patients would have survived if they had received better treatment.
But one thing that it is clear is that many were let down by a culture that put cost-cutting and meeting targets ahead of the quality of patient care.
Examples include patients being so thirsty that they had to drink dirty water from vases and at times receptionists were left to decide which patients to treat in A&E.
You may have read about investigations into the scandal before because there have actually been five major investigations into care at Stafford Hospital.
The first investigation began in May 2008 and was prompted by complaints and statistics showing unusually high death rates at the hospital. The March 2009 report following this investigation brought the scandal to national prominence for the first time.
The most recent investigation, the public inquiry, was looking at how the lapses could have been allowed to take place and why they were not picked up sooner. The commissioning and regulation of the trust at the time was also being looked at as this is something campaigners felt had not been looked at properly before.
The resultant report argued for "fundamental change" in the culture of the NHS to make sure patients were put first.
The report made a total of 290 recommendations, including making it a criminal offence to hide information about poor care, introducing laws to oblige doctors to be open with patients about their mistakes, a code of conduct for senior managers and an increased focus on compassion in the recruitment, training and education of nurses.
It was also announced that a new post of ‘chief inspector of hospitals’ will be created in the autumn.
However the fundamental change needed does not mean more reorganisation of the NHS. In fact, the report suggests that one of the factors behind the problems at Stafford Hospital was the constant upheaval the NHS is under.
Despite calls from relatives for the individuals involved in the scandal to face sanctions the report states that the board is ultimately responsible. ‘It was the board which took the decision to pursue a cost-cutting drive to achieve foundation trust status and it was the board which refused to listen to the complaints of patients and at times staff.’
But one thing that it is clear is that many were let down by a culture that put cost-cutting and meeting targets ahead of the quality of patient care.
Examples include patients being so thirsty that they had to drink dirty water from vases and at times receptionists were left to decide which patients to treat in A&E.
You may have read about investigations into the scandal before because there have actually been five major investigations into care at Stafford Hospital.
The first investigation began in May 2008 and was prompted by complaints and statistics showing unusually high death rates at the hospital. The March 2009 report following this investigation brought the scandal to national prominence for the first time.
The most recent investigation, the public inquiry, was looking at how the lapses could have been allowed to take place and why they were not picked up sooner. The commissioning and regulation of the trust at the time was also being looked at as this is something campaigners felt had not been looked at properly before.
The resultant report argued for "fundamental change" in the culture of the NHS to make sure patients were put first.
The report made a total of 290 recommendations, including making it a criminal offence to hide information about poor care, introducing laws to oblige doctors to be open with patients about their mistakes, a code of conduct for senior managers and an increased focus on compassion in the recruitment, training and education of nurses.
It was also announced that a new post of ‘chief inspector of hospitals’ will be created in the autumn.
However the fundamental change needed does not mean more reorganisation of the NHS. In fact, the report suggests that one of the factors behind the problems at Stafford Hospital was the constant upheaval the NHS is under.
Despite calls from relatives for the individuals involved in the scandal to face sanctions the report states that the board is ultimately responsible. ‘It was the board which took the decision to pursue a cost-cutting drive to achieve foundation trust status and it was the board which refused to listen to the complaints of patients and at times staff.’
Finally there are still certain questions which remain unanswered for me, for example; Why wasn't the alarm raised earlier? Could an incident like this happen again? Perhaps some of these questions will be answered in the full response to the inquiry due to released next month.
Tuesday 5 February 2013
The Great Abortion Divide
A short post this week on a programme I watched on BBC1 last night, ‘Panorama: The Great Abortion Divide’
The Abortion Act was passed in 1967. Technically the law did not legalise abortions, but rather provided legal defence for those carrying them out. Under the act abortions can be performed legally (in England, Scotland and Wales) under certain conditions. For example if continuing with the pregnancy involves a greater risk to the physical/mental health of the woman than having a termination.
In the UK each year about 200,000 abortions are carried out - as a result some people question whether the legislation passed in 1967 is being abused, did it intended to sanction so many procedures?
When discussing or thinking about medical ethics I try to think back to the four main ethical principles; autonomy, beneficence, non-maleficence and justice - how can these be applied to abortion?
As i’m sure you are aware there are two main groups in the ‘abortion divide’, pro-life and pro-choice and both are mentioned and represented in the programme. Something I found interesting was that there was very little talk of the foetus itself in the programme, what about the rights of the ‘child’? However this relates to the most complex issue in the debate - when does life begin, when does the foetus become a human being?
Another interesting aspect of the programme was just how different things are in Northern Ireland. Despite being in the UK a woman cannot get an abortion, even in cases of rape.
The legislation dates from 1861 and a woman can only access abortion services if her life is at risk.
The programme describes two options available to women in Northern Ireland with an unwanted pregnancy, a trip to England for a private procedure or breaking the law by taking abortion pills with the knowledge they could be charged with murder.
So, currently there are two very different laws governing abortion within the UK but perhaps this will change in the future? What about a reduction in the number of weeks after which you can have an abortion? (Something the Health Secretary Jeremy Hunt revealed he would favour last year.)
If you can watch the programme on BBC iPlayer!
The Abortion Act was passed in 1967. Technically the law did not legalise abortions, but rather provided legal defence for those carrying them out. Under the act abortions can be performed legally (in England, Scotland and Wales) under certain conditions. For example if continuing with the pregnancy involves a greater risk to the physical/mental health of the woman than having a termination.
In the UK each year about 200,000 abortions are carried out - as a result some people question whether the legislation passed in 1967 is being abused, did it intended to sanction so many procedures?
When discussing or thinking about medical ethics I try to think back to the four main ethical principles; autonomy, beneficence, non-maleficence and justice - how can these be applied to abortion?
As i’m sure you are aware there are two main groups in the ‘abortion divide’, pro-life and pro-choice and both are mentioned and represented in the programme. Something I found interesting was that there was very little talk of the foetus itself in the programme, what about the rights of the ‘child’? However this relates to the most complex issue in the debate - when does life begin, when does the foetus become a human being?
Another interesting aspect of the programme was just how different things are in Northern Ireland. Despite being in the UK a woman cannot get an abortion, even in cases of rape.
The legislation dates from 1861 and a woman can only access abortion services if her life is at risk.
The programme describes two options available to women in Northern Ireland with an unwanted pregnancy, a trip to England for a private procedure or breaking the law by taking abortion pills with the knowledge they could be charged with murder.
So, currently there are two very different laws governing abortion within the UK but perhaps this will change in the future? What about a reduction in the number of weeks after which you can have an abortion? (Something the Health Secretary Jeremy Hunt revealed he would favour last year.)
If you can watch the programme on BBC iPlayer!
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