Hospitals fail to check for potentially fatal conditions
Millions of people could miss out on health checks for potentially fatal conditions, an investigation has revealed, because cash-strapped hospitals deem them to be a low priority.
As many as nine million patients may miss out on checks designed to spot potentially fatal conditions such as heart disease and diabetes, unless current provision and uptake improve, according to the GP magazine investigation.
The health checks look for risk factors such as high cholesterol and blood pressure.
One senior GP criticised the “ad hoc” programme, saying more central guidance is needed, while one health trust said carrying out the checks is not a priority due to “other pressures” and a charity leader warns of a “postcode lottery”.
In April a mandatory target to check 20% of those aged 40-74 each year was introduced, having been an informal target since 2009.
GP magazine sent Freedom of Information requests to all 151 primary care trusts (PCTs) in England, of which 118 responded.
The figures obtained show that, in 2011-12, 1.7 million checks were offered to patients: 14% of all those eligible for the programme. Around 920,000 checks were actually carried out. This is an increase on 2010-11 when 1.1 million checks were offered and 645,000 were carried out.
Around two-thirds (64%) of PCTs did not provide enough NHS health checks to meet the Government’s 20% aspirational target in 2011-12, GP magazine said.
One-fifth (21%) of PCTs admitted they will fail to meet the compulsory target in 2012-13, despite being given three years to prepare, the figures show.
Three PCTs did not provide a single check in 2011-12 and another provided just four checks.
A spokeswoman for NHS Cornwall and Isles of Scilly, which did not provide any checks in 2011-12, told GP magazine that the programme is not prioritised, “owing to other pressures”.
Nationally, patient uptake is falling, with only 54% attending a check in 2011-12, down from 60% in 2010-11. Just 11% of patients in NHS Portsmouth turned up for their check.
Despite government funding, six PCTs spent nothing on their programmes in 2011-12.
The figures also reveal a geographical disparity in funding for checks. In 2012-13, funding from PCTs varies from £1.3m in NHS West Sussex to just £28,452 in NHS Southampton City, GP magazine said.
Dr Richard Vautrey, deputy chairman of the British Medical Association’s GP committee, said: “The programme is done in such an ad hoc way, without central guidance. That’s why it is so patchy in uptake and, probably, effectiveness.
“It would have been far better to have greater national standards for the scheme, and national rates of payment for the scheme. This would have led to better cost and clinical effectiveness.”
Jules Payne, chief executive of the Heart UK charity, said: “It’s encouraging that the number of health checks conducted has increased on the previous year. However, these findings aren’t all good news. Some PCTs have indicated that they will deliver far fewer health checks than they should be, and there is enormous variance in PCT spending on health checks.
“This has all the classic ingredients of health inequalities and a postcode lottery for accessing services.”
Baroness Barbara Young, chief executive of the Diabetes UK charity, said public awareness needs to be raised.
“Something like this (the health checks) is pretty fundamental to tackling the rising tide of diabetes,” she said.
“I think the problem with the geographical disparity is that it has not actually been mandatory, it has been optional. Some PCTs have taken it very seriously, some haven’t.
“The other missing link in this is public awareness. It is hugely patchy.”
Natasha Stewart, senior cardiac nurse at the British Heart Foundation, said the lack of provision or uptake means many people are unaware that they have cardiovascular disease.
“The results of this survey reflect concerns that people aren’t being offered the check, or they are not taking the NHS up on their offer,” she said.
“This means there are a lot of people who are unaware they are living with cardiovascular diseases, or the risk factors which lead to them. Local authorities need to take health checks out into the community, rather than expecting the community to come to them.”
A Department of Health spokesman said: “The NHS health check is one of the best ways to identify those at risk of diabetes, strokes and heart and kidney disease. Preventing long-term illnesses saves lives and saves the NHS millions of pounds.
“The check is being rolled out nationwide and PCTs should offer them to qualifying patients. PCTs are monitored to ensure they deliver the programme.”
Dr Andrew Mortimore, director of public health for NHS Southampton City, said: “We’re in the process of reviewing our NHS health checks programme, and this will include a review of the levels of investment in future years. Current levels of investment were set some time back and we’re aware that they are lower than our fellow cluster PCTs.”
British universities accused of social engineering after drawing up plans to favour pupils from poorer backgrounds
Universities have been accused of social engineering after drawing up admissions schemes that favour applicants from poorer backgrounds. Instead of selecting students solely on merit, four institutions – Edinburgh, Leeds, Bristol and Birmingham – have devised systems which boost the grades of children from low-income homes.
In some cases, this can see a disadvantaged child with three Bs at A-level winning a place over a privately-educated child with three A*s.
Critics said the system could discriminate against middle class children whose parents have sacrificed a lot to give them a good education.
Ministers have previously urged universities to consider backgrounds – or ‘the contextual data’ – when deciding whether to offer a place, and most do this on a case-by-case basis. But the latest plans are different – and more controversial – because they give each applicant a numerical score based partly on social background.
Freedom of Information requests reveal the points awarded by Edinburgh for going to a very low-performing school boost the score of a child with three Bs beyond that of one with three A*s from a better school.
At Leeds, the system allowed medicine applicants to be given so many points for coming from a poor area that three B grades effectively became three A*s. It was suspended earlier this year.
Bristol is implementing a points system where pupils from poor schools ‘will be given an automatic weighting to their total academic score’, while Birmingham has drawn up a similar policy but is not yet using it.
Tim Hands, headmaster of the independent Magdalen College School in Oxford, said admissions which scored contextual data could be ‘bordering on generic discrimination’. ‘Students deserve transparency and accuracy, not hasty measures which risk appearing subservient demonstrations of political correctness.’
But Rebecca Gaukroger, head of admissions at Edinburgh, said: ‘We don’t accept that the scoring of academic grades or contextual data undermines the holistic assessment of applications.’
How a potato juice supplement could help cure stomach ulcers
Early days yet
Stomach ulcers could have handed in their chips – thanks to the humble potato. Scientists at Manchester University have discovered spuds contain unique antibacterial molecules that can treat the condition.
Members of the university’s microbiology team now hope the substance, dubbed ‘potato juice’ could go into production as a daily diet supplement.
Inspiration came as one of the department’s scientists tucked into a spud for Sunday lunch. It led to the discovery of a key molecule which could both cure and prevent the bacteria that lives in the stomach and causes stomach ulcers and heartburn.
The discovery is one of many being made by scientists at the university as they try to develop the products and medicines of tomorrow.
Uniquely, unlike with antibiotics, the stomach bacteria cannot develop resistance to the ‘potato juice’ which also does not cause any side-effects.
Scientists at the university even carried out the test on different types of potatoes – discovering Maris Piper and King Edward varieties worked the best.
The process to extract the as yet unnamed molecule has now been patented, with hopes it could one day be sold as a supplement similar to probiotic yoghurt drinks.
Ian Roberts, professor of microbiology at the Faculty of Life Sciences, who worked on the discovery, said: ‘One of our scientists was having Sunday lunch when her boyfriend’s grandma said they used to use potatoes to cure stomach ulcers.
‘Afterwards she went and bought a bag of King Edwards from a shop on Curry Mile and started testing them in the lab.
‘When I first heard about the idea of using potatoes to treat stomach ulcers I have to admit I was a bit sceptical. But on another level I wasn’t surprised – a lot of botanical products have very interesting compounds and we just have to find them.
‘We see this ‘potato juice’ as a preventative measure to stop stomach ulcers developing that people would take as part of a healthy lifestyle. It could be a huge market if we can get it developed.’
The discovery of ‘potato juice’ is just one of a number of new medicines and treatments being developed by staff at the University of Manchester’s intellectual property department.
Staff there seek out companies from across the world to develop the university’s inventions.
Business manager Dr Sunita Jones said: ‘It is really exciting to see these new discoveries – they cover all areas of science so it really keeps us on our toes.
‘As a scientist, the end goal of any work is to put something into the public arena which will benefit people.
‘We work to develop all the new technology that comes out of the university, by getting licensing agreements or forming spin-out companies. It’s great to see years of research pay off with a new drug or product at the end.’
In praise of packaging
The proposal to require ‘plain’ packaging for tobacco products has now completed its consultations. The ASI submitted evidence against plain packaging, and we published Chris Snowdon’s report on the subject.
The case for plain packaging is weak since it has not been tried anywhere. Proponents claim that glitzy packaging leads people to take up smoking, whereas the tobacco companies say it is about promoting their brands over others. Supporters cite tests in which subjects said they felt ‘negative’ about cigarettes in plain packs. I myself would feel pretty negative about having to look at other people’s packs showing tumours and corpses.
Counterfeiting and smuggling would be easier with plain packaging, reducing tax revenues. Already one cigarette in nine is smuggled or fake. The civil liberties issue makes a strong case against plain packaging. Although proponents tell us that it will only apply to tobacco products, activists in Australia, which took the lead in plain packaging laws, are now campaigning for graphic warnings on alcohol and for what they deem to be ‘junk’ food to be sold in generic packaging.
Packaging can influence choice of brand by projecting an image that users want to identify with. The feelings that go with a product are part of the intangible value that it adds. Malt whisky in India is seen as an ‘aspirational’ product associated with success and ambition. Young Indians enjoy feeling part of that world, in addition to enjoying the whisky itself. Similarly tobacco companies like to project an image for their brands. Friends of mine who started Regius Cigars wanted to convey an image of top quality, and designed distinctive packaging in black and gold. Plain packaging would require them to forego the distinctive imagery that marks out their brand and gives it class.
I applaud the New World vintners for the innovative and bold wine labels they have adopted. They brighten up the table, and I doubt they make people drink more wine. I do think that putting disgusting pictures on them would make people ‘negative’ toward them, however.
It would be a duller world if everything activists thought bad for us had to be sold in plain packaging. It would be less informative, and would deny us the intangible pleasures of associating with images and lifestyles we aspire to be part of. It would be a drabber world and one considerably less free.
Hey, young people: stop your sobbing
The British left’s championing of the underdog has morphed into promoting that most unpleasant of traits: self-pity
Last week, a High Court judge, Mr Justice Foskett, dismissed a claim by a 23-year-old unemployed geology graduate from Birmingham, Cait Reilly, that working at Poundland for nothing – or rather for benefits [work for the dole]– was a breach of her human rights. Instead the judge sensibly declared that it was mad to compare being made to work in the shop to ‘slavery or forced labour’.
It’s hard to believe that such indulgences reached the High Court in the first place. How could anyone seriously compare a workfare scheme to enforced, back-breaking toil on a cotton plantation? Even more bizarre is that such embarrassing self-pity is often considered to be a raised middle finger to The Man or, at the very least, Tory chancellor George Osborne. Far from Reilly’s actions flowing from leftist radicalism, it’s the outcome of a statist culture that encourages blubbering self-pity in the young.
As Brendan O’Neill recently argued, such a narrative of self-pity has been provided by an education system that obsessively protects young people’s self-esteem. It’s fair to say that the children of the New Labour era have been more flattered, mollycoddled and shielded from adult responsibilities than any other generation. They have grown up to believe that having illegible handwriting, the attention span of a gnat or ending up with disappointing exam grades is never their fault. Almost anything can be excused away by medical or therapeutic sick notes; these young people are encouraged to blame parents, peers and teachers for any difficulties. The cultivation of vulnerability among the young, to see any pressure they may face as potentially ‘damaging’, has amplified that most unappealing aspect of being a teenager: self-pity.
Whereas in the past adults would encourage teenagers to toughen up, they are now socialised into a culture that endorses this woe-is-me outlook. Protecting a young person’s self-esteem is considered a top priority these days. This is why the type of work young people may be required to do, such as working in shops alongside plebs, is considered far more troubling than youth unemployment. For liberal leftists, it would be far better to provide young people with the material resources through which they can survive free from any nasty pressures from the outside world. In fact, much of the discussion on ‘vulnerable young people’ – always vulnerable, never ambitious – is about devising ways that their fragile self-esteem can be protected from parents, peers, teachers, relationships, internet trolls, ‘slave based’ work experience or ‘exploitative’ paid employment. The emphasis is always on protection, not on encouraging freedom or independence.
Traditionally, the youthful drive to escape, from claustrophobic family life and mind-numbing small towns, meant that young people would be prepared to rough it, to take risks and to make opportunities for themselves. It would also mean that such youngsters were more likely to be open to the politics of change and transformation. Now they are likelier to demand state protection from life itself. As increasing numbers of twentysomethings and thirtysomethings live at home with their folks, that burning desire to escape and make a mark on the outside world is mostly absent. Instead, self-respecting ambition, drive and chutzpah have been replaced by the politicisation of pity. Alongside weeping buckets for yourself, leftist radicalism now consists of seeing others as objects of pity in need of government munificence or state protection from individual prejudices or nasty comments on Twitter.
Obsessive pity for the underdog has long been an ignoble feature of British radicalism and in recent years that retrograde tendency has intensified. In the late Eighties, the less that welfare socialism could relate to working-class aspirations, the more that radicalism became an arena for the well-off to showboat their concern for the poor. Left-wing politics simply spoke less and less to working people with aspirations. And increasingly, such free, aspiring individuals were viewed with suspicion; being free, it seems, simply means being free to harm others, yourself and your children. The state became an arbiter to limit the mental ‘damage’ caused by unchecked individuals. Such psychologising of everyday life means that some people have internalised a sense of helplessness. In turn, these people view others, not as active agents capable of making their own lives, but as other diminished souls in need of constant support. The politics of pity has therefore become a powerful way to legitimise the therapeutic state. To question it now runs the risk of being labelled callous and uncaring.
The original vision of social democracy at least recognised that individuals were capable of making their way in the world. The goal of social democracy was to alleviate objective barriers and enable people to be judged on their talents and abilities. Now social democrats view individuals as generally incapable without financial support and extensive state monitoring. This isn’t the same as a safety-net in times of hardship, but rather an instinctive awareness that, in the absence of civic society or cohering political beliefs, the state must hold individuals together.
Pitying concern for the poor, young people on work schemes or victims of harassment sounds very benign. In reality it’s an authoritarian impulse to ensure that individuals remain accounted for and that a political relationship between citizens and the state exists. For all their Big Society rhetoric of freeing up the individual, even the Conservative Party cannot let go of initiatives designed to tighten state control over individual autonomy. In the absence of beliefs and ideas, what else is there to bind people together?
And this is ultimately what pity politics justifies: high levels of state intrusion and snooping throughout society. Pity for ‘vulnerable youth’ involved with the riots only paves the way for yet more state meddling and autonomy-sapping ‘support’. Grandstanding pity for supposedly vulnerable minorities in society often leads to restrictions on free speech, free assembly and free thought. The effect is also the encouragement of self-pity and the demand for protection from psychological harm and dented self-esteem. It leads to grievance-struck individuals who demand that the state recognises their particular identity, censor opinions that hurt their feelings or, in the case of Reilly, protects them from doing work experience. To be radical these days means to demonstrate screeching self-pity (‘you don’t understand me, how dare you say that’) or patronising pity for those ‘less fortunate than ourselves’.
All of this isn’t the same as expressing social solidarity or having compassion towards somebody else’s suffering. Solidarity and compassion seek active agency in alleviating problems, a cornerstone of a humanistic outlook, whereas pity frees an individual of guilt and flatters their ego. The writer Faisal Devji pointed out that pity is one of the worst emotions because the fact that it is vicarious and detached means that anything can be justified in its name. Pity is not grounded in real situations so it can become shrill and hyperbolic. This is why pity lends itself to narcissism; it’s an emotion designed to encourage individuals to help themselves rather than others. Consequently, it inflames an infantile, often nihilistic and destructive, reaction to a person’s surroundings. This is why the politics of pity is the script that radical Islamists, lumpenised rioters and the Occupy protesters have all rehearsed from.
The new politics of pity is the unfortunate but logical outcome of both identity politics and therapy culture. It is where self esteem and recognition for ‘hurts’ are paramount and personal responsibility is an offensive imposition. On either side of the pity coin, the conclusion is always the same: a complete rejection of autonomy and demands for the state to play an enlarged role in diminishing our lives. It’s surely time young people stopped being so enslaved to the therapeutic state.