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    <title>Wikio Blogs - health</title>
    <link>http://www.wikio.co.uk/blogs/health</link>
    <description>Wikio Blogs - health</description>
    <copyright>wikio</copyright>
    <dc:rights>wikio</dc:rights>
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      <title>[Health] Abortion on demand as birth control in the UK (&lt;B&gt;Patrick Joubert Conlon&lt;/B&gt;)</title>
      <link>http://www.wikio.co.uk/discussion/666408</link>
      <description>I blanked out the emotions after each of my SEVEN abortions : As new figures reveal the massive increase in multiple abortions, a mother tells of their devastating legacy. Statistics show that last year 1,300 women had at least their fifth abortion. Almost 950 of those having a termination had already had four previously. Almost 200 had already had five, 110 had had six before and 54, like Angela, seven or more. Ain't socialism great? Everyone's equal and everyone can be as depraved as he/she wishes. O, Brave New Airstrip One !&lt;br/&gt;&lt;br/&gt;Daily Mail : I blanked out the emotions after each of my SEVEN abortions ...&lt;br/&gt;JivinJehoshaphat : Life Links 7/15/08 ...&lt;br/&gt;&lt;br/&gt;blogs : JivinJehoshaphat,jillstanek.com,&lt;B&gt;Patrick Joubert Conlon&lt;/B&gt;,Daily Mail...&lt;br/&gt;(5 posts, last update: 15/07/2008 16:36)</description>
      <pubDate>Tue, 15 Jul 2008 14:36:00 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/666408</guid>
      <dc:creator>&lt;B&gt;Patrick Joubert Conlon&lt;/B&gt;</dc:creator>
      <dc:date>2008-07-15T14:36:00Z</dc:date>
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      <title>[Health] Seven Stabbed To Death In Crazy 32-Hour Day (Anorak News)</title>
      <link>http://www.wikio.co.uk/discussion/664029</link>
      <description>“SEVEN MORE STAB DEATHS IN A DAY.” So says the Daily Express. The Mail chimes in with: “SIX stabbed to death in just 24 hours as Blade Britain’s knife epidemic spirals out of control.” But not as out-of-control as in the Express, which sees seven killed in “just 32 hours”. The Independent does the maths: “Seven killed in a [...]&lt;br/&gt;&lt;br/&gt;Daily Mail : SIX stabbed to death in just 24 hours as Blade Britain's knife epidemic spirals out of control ...&lt;br/&gt;Irons in the Fire : I don't think that 'gun-free paradise' thing ...&lt;br/&gt;&lt;br/&gt;blogs : Daily Mail on Sunday,Daily Mail,Evening Standard,Irons in the Fire,Anorak News...&lt;br/&gt;(5 posts, last update: 13/07/2008 00:56)</description>
      <pubDate>Sat, 12 Jul 2008 22:56:00 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/664029</guid>
      <dc:creator>Anorak News</dc:creator>
      <dc:date>2008-07-12T22:56:00Z</dc:date>
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      <title>[Health] Abortion by Internet (The F-Word Blog)</title>
      <link>http://www.wikio.co.uk/discussion/662668</link>
      <description>The Indpendent are reporting on an internet site, Women on Web, who are selling abortion pills online to women in countries with heavily restricted access to abortion. The drugs cost £55. This originates from a British Journal of Obstetrics and...&lt;br/&gt;&lt;br/&gt;BBC News : Women 'using web for abortions' ...&lt;br/&gt;Slugger O'Toole : Abortion at home ...&lt;br/&gt;&lt;br/&gt;blogs : The Guardian,The Telegraph,The F-Word Blog,BBC News,The Independent...&lt;br/&gt;(8 posts, last update: 11/07/2008 13:38)</description>
      <pubDate>Fri, 11 Jul 2008 11:38:32 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/662668</guid>
      <dc:creator>The F-Word Blog</dc:creator>
      <dc:date>2008-07-11T11:38:32Z</dc:date>
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      <title>[Health] The case against co-payments in the NHS (NHS Blog Doctor)</title>
      <link>http://www.wikio.co.uk/discussion/657476</link>
      <description>From the home of two-tier medicine There is a particularly unpleasant piece of mischief in today’s Times from the normally reliable Stephen Pollard. It’s the usual doctor bashing stuff which is now sadly de rigueur from journalists who have swallowed all the government propaganda. I expect this sort of stuff from Polly , but not from Pollard. Hamish Meldrum, the BMA chairman, has just expressed his concerns at the idea of allowing co-payment within the NHS. “My gut instinct is that this goes against the sort of NHS I believe in, which is free at the point of use, fair and equitable to all.” ( Hamish Meldrum ) Stephen Pollard does not like this at all and finishes Meldrum’s statement thus: And which, [Meldrum] didn't add, would let patients die rather than use a drug their health authority will not supply. Equity it may be; but it can be the equity of death. But no one should be surprised at the sheer callousness of Dr Meldrum's position. The notion that an organisation which represents doctors ought somehow to have the patient's interest in mind is attractive. But it is also naive. When it comes to the public, the BMA sees us as little more than a cash cow. ( Stephen Pollard ) Does the general public really think that doctors see patients only as a cash cow? God, I hope not. I find that truly upsetting. But, whether or not Pollard is right in making that statement, the article as a whole is both credulous and naïve. The recent cases of patients being banned from the NHS for buying drugs only normally available to private patients caused a furore, and understandably so. The decisions were outrageous. But hard cases make bad law. Let me try to explain what Hamish Meldrum and many other doctors, including Dr Crippen, are worried about. If the right of NHS patients to make co-payments, in other words their right to “top up” their NHS treatment with some form of treatment deemed to be superior, becomes a routinely acceptable option, how long will it be before it becomes compulsory? For a co-payment of £1000 you may have your hernia repaired now rather than in nine months For a co-payment of £500 you may have your MRI scan now rather than in six months For a co-payment of £500 you can be guaranteed an appointment with the consultant rather than with the nurse-practitioner For a co-payment of £100 you can have the branded drug rather than the generic version imported from the third world Co-payment structuring in the USA The potential is endless and would be a real cash-cow for an over-borrowed government. It would be a short cut to a two-tier or even a three-tier system. To some extent it goes on already. As any GP in the country will tell you, many patients already pay for a quick private consultation with a specialist, or for a private MRI scan. In my area, the waiting list for a “routine” MRI scan is currently sixteen weeks. A long distance lorry driver off work with lumbago may well choose to pay for a private scan. It goes on all the time on the quiet. It should not have to, but it does. Best not talked about in company for, let it become formalised, it will become the rule rather than the exception. That is what doctors are worried about. I am surprised that Stephen Pollard cannot see that. &lt;br/&gt;&lt;br/&gt;Times Online - Guest contributors : Bloody-minded unions? Yes, the BMA is deadly ...&lt;br/&gt;Fora : The NHS: It is supposed to be about healing the sick first and foremost, isn't it? ...&lt;br/&gt;&lt;br/&gt;blogs : NHS Blog Doctor,Stephen Pollard,Times Online - Guest contributors,Fora...&lt;br/&gt;(4 posts, last update: 07/07/2008 15:45)</description>
      <pubDate>Mon, 07 Jul 2008 13:45:00 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/657476</guid>
      <dc:creator>NHS Blog Doctor</dc:creator>
      <dc:date>2008-07-07T13:45:00Z</dc:date>
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      <title>[Health] Wot - no better quality Health Service for NI? (Slugger O'Toole)</title>
      <link>http://www.wikio.co.uk/discussion/652617</link>
      <description>As far as I can make out, not a cheep from the Northern Ireland Health and Social Services Dept, ( see recent press releases), in response to the big new drive for a higher quality health service in England unveiled yesterday. For instance, one big aim is to speed the validation of new drugs and end the post code lottery for approving their use by NICE, the National Institute for Clinical Excellence. Nice has applied to NI since 2006. What’s happening about this, guys? Have you a cunning plan up your sleeves you haven’t told us about yet? Or is this another example of Executive inertia? Are NI patients too to get the right to chose their own GP, consultant and hospital; benefit from the end of the post code lottery and be prescribed new drugs with less regard to cost ; and receive detailed reports on their medical condition - all as promised to the English? Wake up Michael McGimpsey and the scores of staff in Dundonald House. Or can I have missed some well-buried report?&lt;br/&gt;&lt;br/&gt;The Independent : Pick your own surgeon – a new future for the NHS ...&lt;br/&gt;Isn't She Talking Yet? : Hospital league tables ...&lt;br/&gt;&lt;br/&gt;blogs : Isn't She Talking Yet?,The Independent,Slugger O'Toole...&lt;br/&gt;(3 posts, last update: 02/07/2008 03:12)</description>
      <pubDate>Wed, 02 Jul 2008 01:12:35 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/652617</guid>
      <dc:creator>Slugger O'Toole</dc:creator>
      <dc:date>2008-07-02T01:12:35Z</dc:date>
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      <title>[Health] Monday, 30 June, 2008 (Talk about Newsnight)</title>
      <link>http://www.wikio.co.uk/discussion/651107</link>
      <description>The Future of the NHS Thanks for your thoughts earlier in the day on our plans for tonight and for your views on the future of the NHS and whether it really can last another 60 years . Do keep them coming - we'll be sending comments over to the production team before the programme. So - at the risk of repeating myself - tonight, as the government unveils Lord Darzi's prescription for the National Health Service , we'll be examining his and other visions for the future of the NHS in a special edition of Newsnight. Gavin will be presenting live from a brand new super-surgery in Leicester where he'll be debating the prospects for the NHS with politicians, professionals and practitioners. NHS at 60 And don't forget to keep the contributions coming in for our 'picture of health' interactive map of NHS concerns . Liz MacKean will present a round up of your views on Wednesday's Newsnight as she travels the country in an antique ambulance. Liz explains how the map works here . Before that on Tuesday's Newsnight Economics Editor Paul Mason will doing some number crunching: how big is the NHS funding gap and what can be done to bridge it? And on Thursday's programme Newsnight Review regular Kwame Kwei-Armah will be charting the changes of the NHS in the last 60 years as portrayed on TV and cinema - from Dr Finlay to Charlie in Casualty . &lt;br/&gt;&lt;br/&gt;BBC News : Quality ranking key to NHS funds ...&lt;br/&gt;Olly's Onions : NHS Headline mix-up ...&lt;br/&gt;&lt;br/&gt;blogs : BBC News,Olly's Onions,Talk about Newsnight...&lt;br/&gt;(3 posts, last update: 30/06/2008 23:18)</description>
      <pubDate>Mon, 30 Jun 2008 21:18:00 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/651107</guid>
      <dc:creator>Talk about Newsnight</dc:creator>
      <dc:date>2008-06-30T21:18:00Z</dc:date>
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      <title>[Health] We have to the technology; we can rebuild the race! (Gene Expression)</title>
      <link>http://www.wikio.co.uk/discussion/650255</link>
      <description>Baby to be born free of breast cancer after embryo screening : The couple produced 11 embryos, of which five were found to be free from the gene. Two of these were implanted in the woman's womb and she is now 14 weeks pregnant. By screening out embryos carrying the gene, called BRCA-1, the couple, from London, will eliminate the hereditary disease from their lineage. Obviously the headline is hyperbolic in this specific case. Changing probabilities is not necessarily a guarantee. But I think the bigger picture here warrants serious notice. Armand Leroi has outlined the major issues, so I won't review them again.... Read the comments on this post... &lt;br/&gt;&lt;br/&gt;Times Online : Baby to be born free of breast cancer after embryo screening ...&lt;br/&gt;Dr. Melissa Clouthier : Picking Perfect Babies ...&lt;br/&gt;&lt;br/&gt;blogs : The Telegraph,Gene Expression,Dr. Melissa Clouthier,Times Online,News Scotsman...&lt;br/&gt;(7 posts, last update: 30/06/2008 17:19)</description>
      <pubDate>Mon, 30 Jun 2008 15:19:00 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/650255</guid>
      <dc:creator>Gene Expression</dc:creator>
      <dc:date>2008-06-30T15:19:00Z</dc:date>
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      <title>[Health] Choice (Nick Robinson's Newslog)</title>
      <link>http://www.wikio.co.uk/discussion/650517</link>
      <description>That is the word which, I'm told, lies at the heart of today's NHS Plan . Don't be surprised, however, if other more politically appealing words such as "quality" (as against "quantity") and bottom-up (as against "top down") take pride of place in the presentation of what we're being told is the most important day for the health service since it was formed 60 years ago . The surgeon-come-minister Lord Darzi believes that patients need to be given greater clout in the health service and that the information revolution will allow this to happen. He's planning to give us all absolute freedom of choice about where we're treated and to supply us with the data to allow us to make informed choices. Surgical teams will be forced to publish annual quality reports which record their performance in terms of safety, medical outcomes and patient satisfaction. So, in theory at least, we'll all be armed with the equivalent of "Whichdoctor" and able to travel anywhere from Lands End to John O'Groats to get the best possible healthcare. What's striking about this is how similar it appears to be to the recently released proposals from the Tories. Ministers say that Team Cameron can't mean what they say since they resist the introduction of increased capacity to the NHS - in the form of controversial new GP-led health centres or polyclinics - and hospital reconfigurations. Whoever's right, it leaves me wondering how much choice there really is between the government and the opposition in this the NHS's 60th year. &lt;br/&gt;&lt;br/&gt;BBC News : NHS overhaul plans to be laid out ...&lt;br/&gt;Talk about Newsnight : Can the NHS last another 60 years? ...&lt;br/&gt;&lt;br/&gt;blogs : Nick Robinson's Newslog,BBC News,Talk about Newsnight,ICMCC Newspage...&lt;br/&gt;(4 posts, last update: 30/06/2008 14:43)</description>
      <pubDate>Mon, 30 Jun 2008 12:43:36 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/650517</guid>
      <dc:creator>Nick Robinson's Newslog</dc:creator>
      <dc:date>2008-06-30T12:43:36Z</dc:date>
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      <title>[Health] 11-year-old Romanian rape survivor permitted abortion (Feministe)</title>
      <link>http://www.wikio.co.uk/discussion/649484</link>
      <description>Good news: Despite threats from anti-choice groups, the 11-year-old Romanian girl who was raped by her uncle has been allowed to terminate the pregnancy. In a letter to the government committee, the girl said she wanted to be able “to go to school and to play”. “If I can’t do this my life will be a [...]&lt;br/&gt;&lt;br/&gt;BBC News : Romanian girl, 11, permitted abortion ...&lt;br/&gt;appletree : ‘Pro-Life’ Romanians try to force 11-year-old girl to carry child ...&lt;br/&gt;&lt;br/&gt;blogs : The Liberal Avenger,The Guardian,Boston Globe,Red Orbit ,Seattle Post-Intelligencer...&lt;br/&gt;(19 posts, last update: 29/06/2008 12:35)</description>
      <pubDate>Sun, 29 Jun 2008 10:35:36 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/649484</guid>
      <dc:creator>Feministe</dc:creator>
      <dc:date>2008-06-29T10:35:36Z</dc:date>
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      <title>[Health] The fMRI smackdown cometh (Mind Hacks)</title>
      <link>http://www.wikio.co.uk/discussion/646889</link>
      <description>Over the last few months, the soul searching over the shortcomings of fMRI brain scanning has escaped the backrooms of imaging labs and has hit the mainstream. Numerous articles in hard hitting publications have questioned some common assumptions behind the technology, suggesting a backlash against the bright lights of brain scanning is in full swing. There's two strands to this debate, and both stem from the fact that the technology and conceptual issues of brain imaging are incredibly complex. To fully understand what happens during a brain imaging experiment you need to be able to grasp quantum physics at one end, to philosophy of mind at the other, while travelling through a sea of statistics and neurophysiology. Needless to say, very few, if any scientists can do this on their own. So the first strand involves how brain imaging experiments are reported in the media. Under the sheer weight of conceptual strain, journalists panic, and do this : "Brain's adventure centre located". It's a story published this morning on the BBC News website based on an interesting fMRI study looking at which brain are associated with participants choosing a novel option in a simple gambling task. But out of the four words of the headline, only the first is accurate. And this leads to the second strand of the debate, which, until recently, has been largely conducted away from the media's gaze, amongst the people doing cognitive science themselves. It starts with this simple question: what is fMRI measuring? When we talk about imaging experiments, we usually say it measures 'brain activity', but you may be surprised to know that no-one's actually sure what this actually means. Neuroscientist Nikos Logothetis published an important paper Nature a couple of weeks ago aiming to explain exactly what we know so far about the link between what brain scans measure and what the brain is actually doing. It's very wide-ranging and includes lots of grit-your-teeth hardcore neurophysiology, but is, I think, essential reading if you're neuroscientifically inclined. It focuses on BOLD , the signal that reflects the ratio of oxygenated and deoxygenated blood measured by fMRI, and the fact that it can be altered by a huge range of different biological process and neural firing patterns. One of the main points of the paper is that the brain is not simply an array of tiny localised processors, but it is more like an an ecosystem of communication. Activity can result from sending more signals, trying to send less, or, from what seems to be particularly important - maintaining a balance of excitation and inhibition. Furthermore, it seems that a great deal of neural activity is not from neurons that might be directly involved in a task, but from 'neuromodulation' - general processes of management and coordination, often linked to attention. This can wax and wane, can spread like ripples and can occur in all sorts of non-linear ways that makes interpretation difficult. What this means is that brain imaging experiments need to be carefully designed to control for these effects, but this entirely depends on our understanding of the effects themselves. In other words, our understanding of what brain scanning data tells us evolves over time. A study conducted ten years ago might mean something different now. An article in Science , published in the same week as Logothetis' paper, reports on new statistical methods for interpreting imaging data, a different issue again. The latest edition of The New Atlantis has an article that attempts to come to grips with some of the philosophical aspects of brain imaging experiments, in terms of the conceptual limits in inferring mental states from biological changes. I have to say, it's a bit miscued in places, assuming that brain imaging relies on ideas about brain modularity (which it doesn't) and suggesting some rather strange notions about mental causation , but it has many good points and is worth a read. It's important that these sorts of issues come to light, because it hopefully heralds a time of increased caution in our interpretation of brain scans - and that goes for scientists, the media and the general public. This is essential, because this data is starting to be be used, literally, in life or death decisions. The same issue of The New Atlantis has an article on neuroimaging and capital punishment that discusses the ethical dilemmas in applying this imperfect technology to legal decisions. Link to Logothetis on 'What we can do and what we cannot do with fMRI'. Link to Science article 'Growing pains for fMRI'. Link to New Atlantis on 'The Limits of Neuro-Talk'. Link to New Atlantis on Neuroimaging and Capital Punishment. &lt;br/&gt;&lt;br/&gt;BBC News : Brain's adventure centre located ...&lt;br/&gt;Pure Pedantry : Must Read Paper on fMRI -and- The Worst fMRI Science Journalism Ever ...&lt;br/&gt;&lt;br/&gt;blogs : Seed Magazine,Physorg,BBC News,Tick Tock Talk: The IQ brain clock,YubaNet.com...&lt;br/&gt;(9 posts, last update: 28/06/2008 08:54)</description>
      <pubDate>Sat, 28 Jun 2008 06:54:00 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/646889</guid>
      <dc:creator>Mind Hacks</dc:creator>
      <dc:date>2008-06-28T06:54:00Z</dc:date>
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      <title>[Health] DISABILITY DOLLS? (Tangled Blog)</title>
      <link>http://www.wikio.co.uk/discussion/646646</link>
      <description>Wonder what YOUR reaction to "disability dolls" is? The latest one on the market is "Down's Syndrome" doll. This is not the only “disability dolls” available on the market. You can buy dolls with prosthetic limbs, walking frames, hearing aids, “blind” dolls complete with guide dogs. It's a tricky one this but I listened to a teenage girl with Down's Syndrome being interviewed on the issue and SHE did not care for the Down's Syndrome doll. I would take her opinion seriously. My own reaction is to think these are a sick rip-off.&lt;br/&gt;&lt;br/&gt;Times Online : Disability dolls become more popular ...&lt;br/&gt;Mommy Life : Down syndrome dolls - what do you think? ...&lt;br/&gt;&lt;br/&gt;blogs : Isn't She Talking Yet?,Times Online,Mommy Life,Tangled Blog...&lt;br/&gt;(4 posts, last update: 26/06/2008 16:55)</description>
      <pubDate>Thu, 26 Jun 2008 14:55:08 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/646646</guid>
      <dc:creator>Tangled Blog</dc:creator>
      <dc:date>2008-06-26T14:55:08Z</dc:date>
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      <title>[Health] Cancer Patient Commits Suicide When Told NHS Will Not Cover Chemo (Secondhand Smoke)</title>
      <link>http://www.wikio.co.uk/discussion/645594</link>
      <description>This is a crucial issue involving the assisted suicide debate. We have already seen in Oregon a woman denied coverage for chemotherapy to extend her life, but told that Medicaid will pay for her assisted suicide . Now, that scenario played out in the UK. The melting down NHS denied a chemotherapy treatment and the man, in despair, killed himself. From the story : A cancer patient killed himself a day after being told he had been refused a wonder drug by his local primary care trust.Terminally-ill Albert Baxter, 75, committed suicide hours after learning he had been turned down for a drug which could have prolonged his life and shrunk his tumour. In desperation, the cancer sufferer offered to pay for the drug, only to be told that he would have to foot the bill for his entire treatment which he could not afford. The pensioner, who was diagnosed with renal cancer in January 2007, had been told by his oncologist, Dr Fiona McKinna that the drug Sutent was his only hope... But when he learned that his appeal had been rejected he returned to his home in Eastbourne, East Sussex. He was found dead the next day by his partner with a bin liner over his head in June last year. His partner of 30 years, Barrie Curryer, 70, a retired nurse, hit out at the postcode lottery for cancer treatment.He said: "What really upset him was that he worked all his life and paid into the health system and was refused treatment." What is amazing to me is that assisted suicide advocates would probably respond, "He should have had a doctor available to do it!" More to the point, this story again shows the money nexus between treatment denials and euthanasia, in which treatments needed by those with a low "quality" of life in order to stretch limited resources are denied--even if it would extend life--supposedly in order to allow greater access to the more deserving of care. Look at the total picture that is emerging! Extending life is being redefined as medical inappropriate or not worth paying for. Killing is being redefined into palliative care. This is abandonment: If we legalize assisted suicide, one consequence would be to make treatment denials more palatable--since we will always offer abandoned patients "death with dignity." Caveat emptor! P.S. It is also worth noting that plastic bags used in conjunction with either drugs or helium are a favored method of "self deliverance" taught by fanatics such as Derek Humphry in books and on web sites. I wouldn't be surprised if such suicide counseling was involved in this case.&lt;br/&gt;&lt;br/&gt;Daily Mail : Cancer patient kills himself day after he is told NHS Trust would not fund £25,000 drug ...&lt;br/&gt;bioethics.com : Cancer Patient Commits Suicide When Told NHS Will Not Cover Chemo ...&lt;br/&gt;&lt;br/&gt;blogs : bioethics.com,Secondhand Smoke,Daily Mail on Sunday,Daily Mail...&lt;br/&gt;(4 posts, last update: 24/06/2008 20:09)</description>
      <pubDate>Tue, 24 Jun 2008 18:09:41 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/645594</guid>
      <dc:creator>Secondhand Smoke</dc:creator>
      <dc:date>2008-06-24T18:09:41Z</dc:date>
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      <title>[Health] The illusion of choice - they are at it again (NHS Blog Doctor)</title>
      <link>http://www.wikio.co.uk/discussion/645399</link>
      <description>It is time to re-visit “choice” again. “Choice” within the NHS or, as most doctors would say, the illusion of choice. First, some simple facts. In 1997, until New Labour took over, I could refer my patients to any NHS hospital in the country. At that time, theoretically, I could refer them to any hospital within the EC, although I never tested the hypothesis. Over 90% of my patients went to local hospital by choice. They were not interested in going elsewhere. Occasionally, one would give a gentle steer to a hospital further afield. For example, there was one consultant who we knew was not performing well, who had matrimonial and alcohol problems, and who has now taken early retirement. His normally high standards were slipping. Nothing that would show in a league table, but we knew what was going on. One of the first “improvements” New Labour made to healthcare was to remove this choice and restrict our patients to the local hospital. If I wanted to refer “out of area” I had to convince a committee of over-promoted, non-medically qualified pilonidal typists that the service my patient needed was not available locally. And it was no good me saying that Mr Jones, the local urologist (or whatever), was the worst and most dangerous surgeon in the country. A service is service. We are not talking quality here. This new restriction bothered the family doctors but, let’s be honest, it did not bother the patients. Most of them did not notice. They continued to go locally as they had always done. Now, “choice” has been restored. We have “choose and book”. Most patients are not interested and are exasperated by the bureaucracy. They still want to go locally but preferably without the new paperwork. Sadly, a number of them, particularly the elderly, are unable to get though the Choose and Book bureaucracy (currently 25% of our patients fail to make an appointment). Of those that do make an appointment, over 95% choose one of the two local hospitals. As they always did. It saddens me to see that the new Tory policy is jumping on the bandwagon of the illusion of choice. Hospital league tables are close to meaningless. OK, well, the unfortunate hospital right at the bottom is best avoided, but most hospitals are clumped together in the middle, and the difference between, say, 78% and 82% means nothing. This does not mean that I am against choice. Far from it. Choice is essential. But the exercise of choice must have consequences for the hospital. We need a system where the money follows the patient. Real choice and real consequencies. The government is as detached from reality as ever. It its last desperate dying days, it is going to introduce a NHS Constitution which will embody the illusion of choice. Details are awaited but it seems that: It will not, however, determine what services, drugs, operations and treatments the NHS will provide. Many had hoped the constitution would free the health service from political control so that it can be run by an independent board in the same way as the BBC, but it is understood that this has been discounted. Along with the rights will come a list of patient responsibilities such as keeping appointments, treating minor ailments at home and not being abusive or violent towards NHS staff. There will be a new focus on preventive care and emphasising what patients can do to keep themselves healthy by directing them to websites such as NHS Direct and NHS Choices. Source Read the final part of the last sentence again: …emphasising what patients can do to keep themselves healthy by directing them to websites such as NHS Direct and NHS Choices. Most of my patients who need medical care are over the age of sixty. Many are frail and vulnerable. They do not use computers. They do not understand websites. Take a look at the NHS Choices front page. I cannot be bothered with it, and I know how to use websites. How many £millions did this site cost? How many cataract operations or hip replacements would those £millions have bought? Ask yourself this. How many elderly women with poor eyesight and painful hips are going to be able to use this site to exercise their right to make an informed choice? They won't bother. They will ask me for advice and usually they will prefer to go to one of the two local hospitals. It is time to move on from this obsession with process, and this endless promulgation of the illusion of choice.&lt;br/&gt;&lt;br/&gt;The Telegraph : NHS constitution to guarantee minimum standards of care ...&lt;br/&gt;Burning our money : Citizens To Be Guaranteed Excellence! ...&lt;br/&gt;&lt;br/&gt;blogs : The Telegraph,NHS Blog Doctor,Burning our money...&lt;br/&gt;(3 posts, last update: 25/06/2008 13:36)</description>
      <pubDate>Wed, 25 Jun 2008 11:36:00 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/645399</guid>
      <dc:creator>NHS Blog Doctor</dc:creator>
      <dc:date>2008-06-25T11:36:00Z</dc:date>
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      <title>[Health] I create gods all the time - now I think one might exist, says fantasy author Terry Pratchett (A Gonzo Journal)</title>
      <link>http://www.wikio.co.uk/discussion/642198</link>
      <description>I create gods all the time - now I think one might exist, says fantasy author Terry Pratchett Copyright © 2008 Cowboy Caleb - http://cowboycaleb.liquidblade.com - .&lt;br/&gt;&lt;br/&gt;Daily Mail : I create gods all the time - now I think one might exist ...&lt;br/&gt;Why Dont You Blog? : Mail tries to make Pratchett look a prat ...&lt;br/&gt;&lt;br/&gt;blogs : Technoccult,A Gonzo Journal,Why Dont You Blog?,Daily Mail...&lt;br/&gt;(4 posts, last update: 22/06/2008 22:55)</description>
      <pubDate>Sun, 22 Jun 2008 20:55:23 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/642198</guid>
      <dc:creator>A Gonzo Journal</dc:creator>
      <dc:date>2008-06-22T20:55:23Z</dc:date>
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      <title>[Health] Have you got a reward card? (Mr Eugenides)</title>
      <link>http://www.wikio.co.uk/discussion/641623</link>
      <description>Smokers in the poorest areas of Dundee are being offered £150 worth of groceries by the health service if they are able to give up cigarettes. Participants in a 12-week scheme will be given £12.50 a week by NHS Tayside if a carbon monoxide breath test proves they have not been smoking. The money will be credited onto an electronic card which cannot be used for cigarettes or alcohol. I've said this so many times that it's lost all meaning, but this may be the most depressing news story I've read this year. Is there any further for us to fall, I wonder? Are we at the bottom of the chum bucket yet? Because this is the public policy equivalent of dangling a fish in front of a seal; go on, citizen, jump through the hoop! Jump through the hoop for NHS Tayside! Smoking is mighty bad for you, no doubt about that. But the pervasive, systematic infantilisation of an entire society is surely worse. It's notable that these rewards will not be in the form of cash. That, of course, would leave these poor fuckers with a scrap of autonomy; worse, they might make bad life choices with the money, and we can't have that, eh? No, giving them a smart card that only allows them to purchase approved items is infinitely more patronising; an exquisitely degrading detail. We're giving you this money, Hamish, but we control what you use it for. No lager for you, Hamish, it's bad for you. Bad Hamish. Anyway, giving up the weed will save you a lot more than £12.50 a week; you can buy plenty of Stella with that. (As long as you're 21 .) It's a shame that this pilot currently only serves the impoverished consumptives of the NHS Tayside catchment area, but with any luck it will be rolled out across the nation before long. One wonders how many luckless proles will be tempted to take up smoking in order to qualify for the weekly handouts, but these people are doctors, and frightfully smart, so no doubt someone has already thought of that. And there's no need to restrict the scheme to smokers, either. Just think of the possibilities! Here's a suggestion for starters; pregnant mothers should have their child benefit payments credited to the smartcard, not paid into their bank accounts. Doing it that way would ensure that they used the money to buy fresh fruit and veg; any attempt to buy vodka with the card would trip an alarm and send security staff running, as well as flagging the unborn child's record on the National Children's Database so that social workers can be on hand at the delivery to whisk the child away to a place of safety. You may snort at my flight of fancy, reader, but somewhere in an office in Whitehall, some pea-brained wonder is reading this and nodding sagely to themselves. Mark my words; one day, all benefits and tax credits will be paid out this way, and obesity, public drunkenness and hacking coughs will all be a thing of the past. A complex system of rewards and state-administered incentives will set us free. Remember, you heard it here first.&lt;br/&gt;&lt;br/&gt;BBC News : Smokers are offered money to quit ...&lt;br/&gt;Boatang &amp; Demetriou : Next they’ll be bribing criminals to stop mugging, thieving and raping ...&lt;br/&gt;&lt;br/&gt;blogs : Red Orbit ,BBC News,Mr Eugenides,Tangled Blog,Sky News...&lt;br/&gt;(10 posts, last update: 23/06/2008 14:39)</description>
      <pubDate>Mon, 23 Jun 2008 12:39:25 GMT</pubDate>
      <guid>http://www.wikio.co.uk/discussion/641623</guid>
      <dc:creator>Mr Eugenides</dc:creator>
      <dc:date>2008-06-23T12:39:25Z</dc:date>
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