Wednesday, May 23, 2012

Health concerns


According to the database maintained by the Department of Health, Dr. Abrams serves the most deprived population in England, the Everton district in Liverpool. His surgery – a grim, squat, brick structure topped with barbed wire and with bars on the windows. Men in Everton die about eight years earlier than the average in England.

Abrams, who gave up hospital medicine more than 15 years ago because he thought health was "more about people than diseases", says the issues in Liverpool are more about the "social side of life".
 "We have intergenerational problems here about the lack of work. We have a depopulating area. You cannot treat these problems in the conventional way." He says cutbacks in central funding have seen cash earmarked for poor populations "diminish" – which spells trouble for the patients in Liverpool. "I would love to have a hepatitis C nurse at the practice because it's a big problem with drug misuse. But there's no money available."

40% of residents in this part of Liverpool are officially "workless" – three times the national average.
only 29% of school-leavers have five GCSEs graded between A* to C including maths and English – the lowest rate in England.

In Liverpool, cash can be a matter of life and death. Poorer people are at greater risk of diseases related to inadequate diets, lack of exercise, smoking, poor pay and job insecurity. The thinking is that if you are unemployed you don't necessarily fall ill because of a lack of cash, but because you get depressed and fall into drink or fail to look after yourself.
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Ministers are planning to switch billions of pounds of NHS spending from the north to the south of England in a move that will hit poorer areas that already have the highest rates of ill health, new research shows.

"Severing the link with deprivation will skew resources disproportionately towards with high utilisation and high concentrations of the elderly. This will lead to a considerable shift of health care funding away from the neediest, poorer areas of the north and the inner cities and towards the least needy, most affluent and most elderly areas of the south," wrote the author of the research, Clare Bambra, a professor of public health policy at Durham University.
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The the National Audit Office, the government spending watchdog says just half of the 3.1 million people with diabetes receive the regular checks they need . Widespread failings in NHS care for the growing number of diabetics lead to 24,000 unnecessary deaths each year and many others suffering complications such as blindness and amputation. Every diabetic is meant to undergo nine care processes each year, such as having blood pressure, blood glucose and cholesterol levels measured, eyes examined for damage to the retina, and the skin, circulation and nerve supply of feet checked, to reduce the risk of complications.

Barely one in seven diabetics was achieving recommended treatment standards that also reduce their risk of complications. Just 16% of patients received adequate treatment to control their blood glucose, blood pressure and cholesterol levels. And 69% failed to reach at least one of the standards while 15% had no testing at all, leaving both groups with a greater risk of developing problems. Mid Essex NHS primary care trust only managed to give 6% of its diabetic patients all nine checks in 2009-10, while the best performer, Gateshead, still only did so for 69% of its patients.
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A survey carried out  in England last October and November shows what unhealthy places hospitals are.  One in sixteen of the 14.9 million patients admitted in 2011 was found to have an infection such as MRSA or C Difficile which they contracted while in hospital. That is about one million patients.
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