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Reading the thoughts of an NHS doctor who wrote about his disappointment that none of his medical students protested about a rise in student fees, I wasn’t at all surprised.

Medical students are too scared to protest out of fear they will be discriminated against.

With a fire extinguisher being hurled at policemen, a young man with cerebral palsy being pushed from his wheelchair and dragged across a street and kettles leaving young people trapped in freezing conditions for hours, is it any shock that medical students who are CRB checked and need to have a clean criminal record stay away?

Being a final year medical student from the pre-top up fee era, my education has cost around £1,200 a year in tuition fees, add that to: accommodation, books, food, smart ward clothes, petrol and car running costs to get to placements and general living costs and I’ll be starting my first job in around £42,000 of debt.

During my first job I will earn a basic salary of £24,000 a year, being in this much debt on a very average salary absolutely terrifies me, however future medical students look set to be a whooping £54,600 higher in debt than me (£63,000 in tuition fees based on seven years at university).

£63,000 debt only to work for the NHS for the rest of your life

Medical students don’t deserve that sort of debt when they will spend the rest of their lives working for the NHS.

This fee rise won’t affect me as I’ll be graduating soon but as someone who struggled through education as I’m the first person in the family to make it to university, I dread to consider, that had I been born a few years later, I may simply have had to give up my dream.

I wish that I could show my support at the protests but I can’t due to a combination of timetabled hospital duties and being absolutely petrified that my face would appear on the news amongst a small number of troublemakers and could affect me for the rest of my life.

“Professional suicide me thinks”

We live in a time when too much emphasis is put on doctors being perfect both outside of their job as well as inside, to the extent that I felt I had to get permission from my medical school and anonymously from the GMC just to go on a reality television show during my summer holiday.  But that didn’t stop certain acquaintances coming out with comments such as:

“Can u believe sunshine’s in it. omg! professional suicide me thinks”

“I don’t think I’ve ever met anyone whose actually made a decision they’ll regret for the rest of their life”.

It doesn’t matter that I have passed my exams, that I have glowing reports from consultants I have worked under and that I really care about my patients.  Because we live in an age where proving you are an actual human being on television in your own time or marching in a protest which turns nasty through no fault of your own, could harm your career despite having all the qualities that patients want in a doctor.

When I asked my medical school for permission, the doctor I spoke to said it was a sad thing that students felt they couldn’t do what they wanted in their own time for fear of fitness to practice issues.  And in his words: “We’ve had a Miss Wales, we’ve had sporting achievements and now we’ll have you.”

I will always believe in the notion that if I get brought before a panel to discuss something as trivial as peacefully protesting or an appearance on tv, then I would insist that every single doctor in the country with any form of a criminal record is stuck off before me.  I hope other medical students take the same viewpoint and are brave enough to attend the protests.

Burger chain McDonalds is to join forces with health experts to help write new policies on UK health as part of a plan to tackle obesity, alcohol and diet related diseases.

McDonalds are to help write UK health policy

Other companies are also in on the action such as: KFC (the makers of fried chicken), PepsiCo (who manufacture sugary drinks) and Unilever (who amongst other brands are responsible for pot noodle and Ben and Jerry).

Also getting involved are Mars (who make those chocolate covered caramel bars) and Diageo who are responsible for wines, spirits and beers such as Guinness.

So how are they getting involved in health policy, well five  “responsibility deal” networks have been set up whose members will include employees of the companies.  They have been invited to suggest measures to address public health.

Working alongside them will be consumer groups like CancerResearch UK and Which? (probably more the kind of people who you would expect to be involved in polices to tackle preventable health problems).

Wide range of people involved

So what do the Department of Health say about this decision? Well they told the Guardian that they’ll be engaging a wide range of people for the next white paper such as businesses and local government.

The problem people have is that white papers have the nation’s health as their best interest whilst industry had profit as their best interest.  I mean what could a company famous for selling fries and burgers have to say about tackling obesity?

There would be outrage if we asked Benson & Hedges and Marlboro to comment on smoking related diseases so why is this not being nationally condemned?

In my opinion the public have yet to see the effect problems such as obesity will be causing in the future because they have only seen the consequences on a small scale to date.

GPs will be providing fit notes instead of sick notes to get staff back into work from April 6th.

GPs will soon be providing fit notes, that state what duties a patient can do.

The new notes will state the duties a worker can carry out. It is then up to employers to accommodate the staff member so they can perform those parts of their job.

The principal is that work aids a person’s recovery and prevents isolation and social exclusion.

The fit notes will apply to people who are off work for seven days where a doctor believes extra support would help them return to work quicker.

I wonder how this will apply to psychiatric conditions like stress and depression.

Image: Suat Eman / FreeDigitalPhotos.net

For every two lives saved through breast cancer screening one woman has unnecessary treatment according to new research.

Breast cancer screening saves two lives for each unnecessary treatment. Photograph: Yongjiet

This would come as a shock to people who believe that screening is faultless. Screening programmes do save lives but they also have disadvantages.

Screening detects the onset of a disease which gains an advantage from early treatment. In the case of breast cancer, if detected early it can be treated successfully with less aggressive management.

But to successfully diagnose the early stages of a disease there needs to be an agreed cut off for those who do have the disease and who do not. The people that test positive can then go on to have further investigations and treatment.

The problem is that having an agreed cut off means that there are people either side of the fence. People who test positive that don’t have the disease (false positives) and people who test negative that actually do have the disease (false negatives). Falling into either category can cause problems:

False positives lead to invasive tests, treatment and the associated anxiety of a cancer diagnosis.

False negatives lead to false reassurance, which can cause late presentation of a condition which may have become untreatable.

Obviously given the choice someone would rather have a false positive than a false negative, and so cut offs tend to be waited towards providing more false positives than false negatives.

So what do today’s results mean? Well although it sounds as if the new research is highlighting the disadvantage of breast screening it is actually a welcomed result.

This is because critics had claimed that for every one woman saved, ten underwent unnecessary treatment. Now women can be reassured that the screening is doing more good than harm.

Image: Youngjiet

A new report outlines flaws in the hospital care of dementia patients

A report has been published from the Alzheimer’s Society, pointing out a number of flaws in the hospital care of those with dementia.

It comes just a week after the news broke that patients with dementia are being prescribed antipsychotics inappropriately and the subsequent side effects lead to 1,800 deaths a year.

Dementia, is the global impairment of mental functioning, this occurs in a clear consciousness and is usually progressive.

The condition is usually caused by cerebrovascular disease (a problem with the blood vessels in the brain e.g. a stroke) or Alzheimer’s, the cause of Alzheimer’s is unknown but it is likely to be due to genetic factors.

Dementia affects a person’s memory and causes them to become disorientated, the person’s awareness is lost and the disease also changes a person’s personality and behaviour.

The combination of symptoms places pressure on the staff responsible for the care of dementia patients.

The report form the Alzheimer’s Society outlines failures in the care of dementia patients and was determined by questionnaires from over 2,000 carers and nurses.

It stated that people with dementia occupy 1 in 4 hospital beds and they stay longer in hospital than patients without dementia. Not only does this cost the NHS but it has a negative effect on the patients symptoms and physical health.

More than 1 in 3 dementia patients are discharged to a care home despite living at home prior to admission.

1 in 4 nurse managers and nursing staff felt antipsychotic drugs were inappropriately prescribed.

Carer’s determined the main problems were, a lack of:

  • Understanding of dementia by staff
  • Individual care
  • Help with eating and drinking
  • Social interaction
  • Involvement in decision making
  • Dignity and respect

Nursing staff felt the main concerns were:

  • Managing difficult behaviour
  • Communicating
  • A lack of time to spend with patients

The report suggests that the number of people with dementia being cared for in hospitals should be reduced. This means funding should shift into community care.

It also suggests carers, friends and family should be involved in the care and decision making process. And a individual care plan should exist for each patient, which focuses on the patients likes and dislikes.

Image: Simon Howden / FreeDigitalPhotos.net