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Written by Dr Madsen Pirie
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Tuesday, 23 October 2007 |
The 'safe' alcohol levels recommended by the Royal College of
Physicians in 1987 turn out to have had "no basis in science," but to
have been "plucked from the air." As Andrew Norfolk reports
, they felt they had to say something, so "it was a sort of intelligent
guess by a committee." The levels for 'hazardous drinking' were 21
units a week for men and 14 for women. Health Minister Stephen Dorrell
subsequently raised them to 28 and 21 respectively, their present
levels. They do not seem to be supported by international scientific
opinion.
The WHO’s International Guide for Monitoring Alcohol
Consumption and Related Harm set out drinking ranges that qualified
people as being at low, medium or high-risk of chronic alcohol-related
harm. For men, less than 35 weekly units was low-risk, 36-52.5 was
medium-risk and above 53 was high-risk. Women were low-risk below 17.5
units, medium between 18 and 35 and high above 36.
Intriguingly, moderate drinkers have lower mortality than total
abstainers or heavy drinkers, and someone has to drink 63 units a week
to reach the mortality level of a teetotaler.
There's a tweak at the end of the Times report supplied by a
commentator. Apparently, since alcohol liver disease is overwhelmingly
down to vitamin B (specifically B12) deficiency, the BMA considered
recommending that it be added to alcohol to combat cirrhosis. It is
reported that they decided not to make the recommendation "as this
would encourage alcoholism". If true it is remarkable that they would
regard the death of patients as preferable.
Compulsory medication like this is unnecessary. Ideally there
should be beers and whiskies which have B12 added, and which drinkers
would be able to choose if they wish. Indeed, it's rather surprising
that there aren't.
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Written by Alex Williams
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Friday, 05 October 2007 |
Only a fortnight after British Education received a withering indictment from the OECD, British Healthcare has been condemned
as among the worst in Europe by an EU-wide research poll – coming 17th
out of 29 countries. The NHS scored poorly in several key areas of the
poll, such as waiting lists, MRSA infection rates, access to cancer
care and cancer survival rates.
The Euro Health Consumer Index – compiled by a top Swedish think-tank –
has injected an unpleasant new reality into Gordon Brown's "Do I or
Don't I”" dilemma over whether or not to call an autumn election.
Despite the government pumping huge sums of money into the NHS and
embarking on a series of reorganizations, the quality of UK healthcare
remains very poor. As a result, the government has consistently polled
behind the Conservative opposition on the NHS, even though health is
traditionally Labour territory. Strategists are said to be nervous
about the Prime Minister's ability to withstand the opposition
onslaught that an election campaign would invite.
Of course, most dispassionate observers agree on what is wrong with the
NHS: government monopoly, centralization, targets, bureaucracy and
political interference. The Conservatives' proposals
to inject choice and competition into the system are therefore welcome
– politicians need to move beyond thinking that all problems can be
solved by throwing money at them. The Tory proposals don't go as far as
the ASI would like, of course, but allowing market forces to interact
between patients and doctors in the same way that they do in other
industries could be just the shot in the arm UK healthcare needs.
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Written by Dr Eamonn Butler
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Wednesday, 03 October 2007 |
Gordon Brown has been UK prime minister for 100 days. I'm not sure that
his tenure (awaited so long) has thus far changed anything, though
there have been a lot of fine words. One batch of the latter forms the
proposal to make the National Health Service more 'personal'. And to
this end, doctor-turned-politician Lord Darzi will today publish an
interim report from his review on the subject.
Sadly, this is a forlorn hope. The NHS is roughly where the Sovet
Union was under Stalin. No, I don't mean firmly and ruthlessly
controlled from the centre – although that is obviously true. I mean
it's engaged in a kind of market socialism. Its stalinesque top-down
control structure cannot possibly deliver the fine nuances of service
that are appropriate to 60m potential patients. So what it does is to
look at what customer-driven market systems deliver and try to copy it.
This means, of course, that it is always behind the times. Our
scientists may still come up with ground-breaking medical innovations,
but our healthcare delivery system is lagging. The telephone service
NHS Direct came years after insurers had been running their own call
centres. Only now is the NHS beginning to use the internet to talk to
its customers.
But you still can't book an appointment online. Indeed, you're
hard pushed to see a family doctor out of hours at all. (If a National
Food Service controlled all our restaurants, you'd be queuing up to get
in, and they'd be closed after 5pm and at weekends.) Public services
can certainly improve by aping the market economy. But, as the Soviet
Union showed, isn't it better to have the real thing?
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