Monthly Archives: February 2012

Madonna says she doesn’t need much sleep

Are Eight Hours too much?

 

Madonna says she doesn’t need much sleep, and Margaret Thatcher is famously said to have only slept for 4 – 5 hours a night as Prime Minister.

Leonardo da Vinci slept little, as did Napoleon, Edison, Jefferson, etc.

Madonna at her 'Confessions' Tour at Wembley A...

Madonna

We often worry about lying awake in the middle of the night, frightened we aren’t getting enough sleep.

But has anyone thought why we think eight hours could be the norm?  Maybe less could be good for you?

 

A growing body of evidence from both science and history suggests that the eight-hour sleep may be unnatural for some people. Continue reading

How to understand Andrew Lansley's Health Bill

Explaining Coalition’s

Health and Social Services Bill

 

Anyone who doesn’t understand politics will wonder why the Coalition isn’t employing the tribal wisdom of the Dakota Indians, passed on  from generation to  generation:

Horses for Courses

When you discover that you are riding a dead  horse, best strategy is to dismount ” .  

 

However, in today’s  Government, more advanced strategies are often  employed, such as:

1. Buying a stronger whip.

2. Changing  riders.

3. Appointing a committee to study the horse.

4.  Arranging to visit other countries to see how other cultures ride dead  horses.

5. Lowering the standards so that dead horses can be  included.

6. Reclassifying the dead horse as  living-impaired.

7. Hiring outside contractors to ride the dead  horse.

8. Harnessing several dead horses together to increase  speed.

9. Providing additional funding and/or training to  increase the dead horse’s performance.

10. Doing a productivity  study to see if lighter riders would improve the dead horse’s  performance.

11. Declaring that as the dead horse does not have to  be fed, it is less  costly, carries lower overhead and therefore contributes substantially  more to the bottom line of the economy than do some other  horses.

12. Rewriting the expected performance requirements for  all horses.

And of course….

13 Promoting the dead  horse to a supervisory position.

If you don’t understand this  theory, you haven’t lived long enough. 

Any similarity to any Bills currently going through Parliament is entirely intentional.

 

Being serious:

If you want a brilliant, even-handed analysis of the Bill, go to

http://www.telegraph.co.uk/health/9106880/Read-this-and-prepare-to-fight-for-your-NHS.html

Written by Dr. Max Pemberton,  a doctor working in the NHS who believes health care should be affordable for all.

 

Latest from Dr. Grumpy

Latest from Dr. Grumpy

 

He writes to say

I’ve got a junkie over in the ICU, who overdosed on a bunch of stuff yesterday.

 She was on a this morning, but they were going to see if she improved enough today to get her off it.

So I called over there a minute ago to talk to her nurse:

Dr. Grumpy: “How’d she do this morning?”

Nurse Icu: “She’s more awake, and we got her off the ventilator, but may have to put her back on again.”

Dr. Grumpy: “Why? Is she still having trouble breathing?”

Nurse Icu: “No, she’s just a bitch.

 

One of Dr. Grumpy’s patients came in for an appointment.

Doctor Tenma in the 2003 remake of the TV series

His sleeves are too long!

Mrs. Carehome: “A friend of mine is a doctor, and he wrote down some questions for you about my condition.”

(hands over a folded piece of paper)

Dr. Grumpy: “Ma’am, this makes no sense. It’s just a random jumble of words and letters, and they don’t relate to anything. Are you sure your friend is a doctor?”

Mrs. Carehome: “The nurse said he used to be. We both live over at Shady Hills, though he’s in the Alzheimer’s unit.

Dogs get cancer too – but help humans with research

English Cocker Spaniel 9 May 2004 C

Cocker Spaniel

Dogs May Hold Clues

to Cancer Cures

 

 

The American National Cancer Instituteis now studying canine cancers alongside human cancers, to try and find cures for both.

The reason?

  • Dogs have strong genetic similarities to people.
  • They also get naturally occurring cancers.
  • There are similarities in the types of cancers that develop.
  • Dogs respond to chemotherapy much like people do.
  • The canine genome has been sequenced, allowing scientists to study what gene mutations are linked to specific cancers.
  • Faster disease progression in dogs means researchers can see more quickly what drugs work.

Researchers hoping to develop a promising new approach to treating cancer in people are trying it in another group: pet dogs.

The aim of personalized medicine is to design an optimum cancer therapy after analyzing genes in a patient’s tumor. Dogs, which have strong genetic similarities with humans, get many of the same types of cancers as people and have similar responses to cancer-fighting drugs. When diagnosed, dogs often have a shorter survival time than humans, allowing researchers to see if a drug is making a difference in a shorter period.

In people, it can take three to five years from the time they are diagnosed until the disease reaches an advanced stage. But in dogs, trials testing whether novel drug therapies extend survival can be finished in six to 18 months, says Melissa Paoloni, director of the Comparative Oncology Trials Consortium at the National Cancer Institute.

Canine patients also are easier to enroll in clinical trials.

Last year, when cancer researchers wanted to do a genetic study of Cocker Spaniels, a breed at relatively high risk of getting melanoma, and Great Pyrenean Sheepdogs, who are at risk for osteosarcoma, a bone cancer, they contacted PetSmart Inc., the Phoenix-based national chain of pet stores.

Making use of its big database, PetSmart sent out 117,000 emails to Cocker Spaniel and Great Pyrenean owners, who had entered contact information after bringing in their pets for grooming. The request: Has your dog been diagnosed with cancer and would you be willing to have your dog’s genetic information analyzed?  Within a week, nearly 300 pet owners responded with an offer to send saliva samples to be analyzed.

That kind of large and speedy response in a human study is very difficult to achieve, says Jeffrey Trent, who organized the pet study. Dr. Trent is president and research director at Translational Genomics Research Institute in Phoenix, which is participating in a privately funded effort to develop personalized treatments for people with certain types of melanoma. If the personalized medicine approach “makes a difference in treating the canines,” Dr. Trent says, “it can readily be moved into trial in humans.”

Genetic Failures

All cancers are believed to have genetic features, though what particular mutation or other aberration is involved with each type of tumor often isn’t known. When this information is discovered, through genetic sequencing, for example, tests can be done to see if the tumor responds to any of various drugs or combinations of drugs.
Here are some of the cancers and genetic diseases humans and dogs share:

•Osteosarcoma, a bone cancer

•Non-Hodgkin’s lymphoma, a blood cancer

•Prostate carcinoma

•Glioma, a brain cancer

•Melanoma, a skin cancer

•Mammary carcinoma

•Lung carcinoma

•Head and neck carcinoma

•Soft tissue sarcoma, a cancer of tissues such as muscles

•Bladder carcinoma

Source: National Cancer Institute

Although the cost of sequencing a genome has plummeted, it is still expensive and therefore not readily available to the vast majority of patients. And, in line with accepted standards of care, new agents are traditionally tried only in people who have advanced disease or have failed to respond to traditional therapies. With dogs, drugs and different drug combinations can be tried in newly diagnosed animals.

One question researchers face is whether a patient’s tumor can be analyzed, and a treatment recommendation formulated, quickly enough to allow doctors to make clinical decisions. Working with dogs, Dr. Paoloni and colleagues conducted a pilot study last year to see if they could accomplish this in less than a week. The researchers enrolled 31 dogs with different types of cancer, including lymphoma and melanoma. The result: A genetic analysis of each dog’s cancer and a report listing which chemotherapy agents might best treat it, was generated for each dog in under five days, a “feasible” time frame for treatment, says Dr. Paoloni.

Researchers, including those at the National Cancer Institute, plan to launch three clinical trials later this year in dogs with osteosarcoma, a bone cancer, angiosarcoma, a blood-vessel cancer, and melanoma, the deadly skin cancer. The trials will test combinations of medicines based on the genetics of the dogs’ tumors. They also will try to analyze whether drug regimens based on personalized tumor data can prevent cancer from spreading to other organs and lead to longer survival.

The researchers say they believe that trying to understand how to stop metastasis in dogs’ cancer will offer insights into the process in human cancers as well.

So it can really be true that a dog is man’s best friend, if together cures for cancers can be developed more quickly and efficiently.

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Cameron and the 'F' word

Cameron talks about F-F-F-F

British Mark III tank in ditch, 1917.

G M F U

 

Cameron has been stuttering away trying to make up a sound bite for the cameras (he should realise that after past master Tony Blair, no-one else comes near), and all he could come up with was ‘The Four Fs’.

Whitehall Wags’ emails were red hot with suggestions as to what the ‘Fs’ stood for (most printable was ‘feeble’).

But all he did was to remind me of an old Army saying;  when anything goes wrong it is described as a ‘Grand Military F-Up’.

Apart from laughing at the ditches he and LaLa are digging, what about US?  To use another military phrase, who cares about the PBI (poor bxxxxy infantry) i.e. Patients?

Around the Country patients are gleefully or morosely sending in the latest from the health front line.  Some of the ways of getting NHS treatment are inventive and deserve a wider audience – so I am going to put up the best ideas on this page.  Watch this space!

Idea No 1

Cancer patient was taken ill in middle of Chelsea (as one is).  Kindly shopkeepers called an Ambulance, which parked up in quiet street whilst two very competent Ambulance Crew got on with doing their jobs -superbly as usual.  They installed patient in a comfortable position, and got on with ECGs, evaluations, monitoring, BP, etc. etc.

As things went on, her Blood pressure dropped, she began to feel more alive, and found herself the centre of a very caring team effort.  After about an hour or so, one of the Ambulance crew said they were going to take her to A & E.

This was not such welcome news.  She had been there before;  it isn’t exactly known for TLC, and she had glanced at the Junior Doctors TV programme filmed there, which had filled her with dread.  Pleading with the Ambulance crew, she asked to be taken home.  They asked her searching questions about her home circumstances – then decided that provided she would accept a visit from her local GP, they would take her there.

They accompanied her into her flat;  made sure she was warm and had everything to hand, then departed.

Shortly after they phoned to say they had contacted her GP, and the GP would be coming round to see her.

Only thing wrong with this scenario – the GP is already well entrenched in the new Health Reforms, so phoned to say she was too busy to come.

 

 

 

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Cameron hosts Mad Hatters Tea Party

Were you invited to

English: The Mad Hatter, illustration by John ...

Did Downing Street host these madmen?

Cameron and LaLa’s Tea Party?

 

No?

Well, it wasn’t for the likes of those who disagree with LaLa and Cameron.  Those invited had been cowed by the Dept. Health’s political roller coaster.  Or perhaps might make money under the NHS reforms.

Sore you didn’t get an invite?

Vent your anger by adding your name to the government e-petition here:

http://epetitions.direct.gov.uk/petitions/22670

If there is a problem clicking through, please cut and paste.

 

This  petition set up by a doctor  has now gathered 150,000 signatures (strange – Cameron says doctors are the ones keen on LaLa’s NHS reforms).

It only needed 100,000 signatures to force a debate – so one wonders how many more will be needed to make Downing Street take notice? The more names on it, the more pressure on the government and MPs to rein in Andrew Lansley’s plans.  And hopefully 38 Degrees will be able to take this forward.

 

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What was in the Goody Bag at Cancer Wellbeing Event

 

Every visitor to the Cancer Wellbeing Event

got a Goody Bag !

 

 

Visitors crowding into Kensington Town Hall for the Cancer Wellbeing Day found companies had been incredibly generous with samples.  Ijeoma, Simmone and Paula in the LINk organisers’ office nearly ended up in the street, as their office filled up with the goodies that poured in for the Event.

As a patient, I had been horrified by some of the products I was given to supposedly help my peeling skin, painful eyes, splitting feet etc.  I remember the Pharmacist at the Royal Marsden shaking his head as he handed over yet another ‘approved’ but useless product, saying “I am afraid this won’t do you any good”.  And he was right.

So I was determined that at this event visitors were going to take away with them samples of all the many products that companies make for us, but we are never told about.  Some of them were developed abroad especially for cancer survivors – all of them have been used by me and my friends – and had helped us.

As a cancer survivor, I wanted nurses, doctors, carers etc. to know

  • What WE liked
  • What helped us
  • What products were really helpful, etc.

so I asked those companies that had helped me if they could let us have a few samples.  The response was overwhelming !

So here’s what was in the Goody Bag – and I hope that you find something useful that might help you handle side effects from cancer drugs.

However – please ask your CNS or doctor before you start using anything mentioned here – and then enjoy!

The bags contained a selection of the following, and if anyone wants to try something but it wasn’t in their bag – contact me at at verite@greenbee.net and I will ask the company if they can send samples.   Looking for more information?  Just key in the name into the Search window above the right hand column;  I have written more about these products in various articles when I tried them out.

DEEP FREEZE PATCHES  You can buy these patches at any good chemist, they are made by Mentholatum, and are used by just about ever major football and rugby club to treat their players when they have an injury.  They can work for us when we get pains – but if pain persists then use the Deep Heat sister product.

EQ8 is a refreshing and fruity new energy drink with a virtuous difference – it’s made from natural ingredients and is designed to give a natural energy lift. With just a nip of natural caffeine, EQ8 is the ideal way to revive and re-energise naturally and makes a great alternative to tea and coffee. Plus, EQ8 Cranberry & Apple is filled with anti-oxidants and counts as one of your five-a-day.

www.eq8energy.com  or follow EQ8 at http://www.facebook.com/eq8energy or twitter@eq8energy.

FLEXITOL

These are my unsung heroes when it comes to products!  This is an Australian company, and many of us know that cancer patients are really well looked after in Oz, particularly when it comes to products that help with drug side effects.  Their Heel Balm saved my feet when they looked like horses’  hooves,  and I even discovered that I can get this on prescription – why doesn’t anyone ever tell us?  They make a range of different skin care products, such as Lip Balm and Dry Skin cream, and other products are also available on on prescription.  Your doctor can look this up in the BNF book on their desk.

LILLIPOPS  

 

Keep a supply in your freezer for those days when drugs act up and you feel nauseous. Developed for pregnant women, someone had the bright idea that they might help cancer patients too – and now some hospitals are trialling them in their chemo wards.

 

 

LIVING NATURE

Living Nature is endorsed by Breast Cancer Network New Zealand as ‘above reproach’ for products, practices and committment to helping women’.

The company’s Philosophy is that they believe that when it comes to beauty solutions, nature has the best answers.  When developing their skin care and cosmetic products, they look at how nature does it and are inspired by the remarkable healing properties of New Zealand’s native plants. 85% of New Zealand’s native plants are not found anywhere else in the world and the bio-activity of some of these ancient species is amazing. Active Manuka Honey is nature’s miracle skin healer, Manuka Oil is a powerful skin protector – just a few of their unique New Zealand ‘Hero ingredients’.

 

 

 

 

 

ORGANIC PHARMACY

Started just ten years ago, the Organic Pharmacy has spread across London, and now has an outlet in Los Angeles.   One reason why the company is growing so rapidly is because they aim to give you as much information as possible. Whether you suffer from breast cancer, skin allergies and sensitivities or you want to optimise your skin and health, they say “an informed, honest choice is your right, we encourage all our customers to ask as many questions as they need to and we are there to support you every step of the way”.  Their website has a list of carcinogens and toxins to watch out for.  And as they say, “We hope that we have shown the world it is possible to choose an organic product that is beautiful to look at, luxurious to use and more effective than its synthetic counterparts without compromising your health or beauty.   Not only did this company supply us with lots of blister packs of their soothing day creams, but they also gave a fascinating talk about products that could help us.  www.theorganicpharmacy.com


PEACHYKEEN ORGANICS

Peachykeen Organics gave us Vouchers for 25% off any products you order online.

Their range is organic, and if  you have ‘Brillo Pad’ skin I find their Body Butter is brilliant;  although it is very oily, it sinks into your skin fast, leaving you with smooth skin.  www.peachykeenorganics.co.uk

ROHTO DRY EYE RELIEF  

Another Mentholatum product, which is incredibly soothing for when we get those nasty red eyes as side effects from some drugs.  Ask advice of your medical team before you start using this – or better still, your pharmacist – as they know all about this product.

SYNERGY

Carers looking after bed-bound people found either a Synergy  If Bed Bath pack or a Dry Shampoo pack in their bag.  There has been a lot of comment recently in the press that elderly patients are no longer given bed baths whilst in hospital (Ugggh!), but now there is no excuse – these packs don’t need bowls of water – but are used straight from the packet.  I have used the Dry Shampoo when in a hurry and my hair is really in need of TLC!  If visiting an elderly person in hospital and you suspect they aren’t being looked after – take some packs in with you!

TINTS OF NATURE

So often anyone who has coloured their hair finds that they can’t get help when undergoing  treatment.  But Tints of Nature Shampoo and Conditioner has studied what we need, and formulated products with natural and certified organic extracts for gentle but effective cleansing. Natural proteins and conditioners care for the hair, leaving it healthy and manageable. The range is free from Sodium Chloride (salt) and harsh sulphates, such as Sodium Lauryl Sulfate.  Sample packs of  Tints of Nature Shampoo and Conditioner were included in the bags, and they have lots of fashionable  colours which can be mixed with a natural colour to cover grey hair.  www.herbuk.com

 

 

 

 

WAHANDA

Some lucky bags contained Wahanda spa gift vouchers.  Even if your bag didn’t have one, this is an incredible service that is very cancer survivor friendly.  We should all have a monthly massage during the years when we are on hormone therapy, and every week Wahanda comes up with incredible ‘money off’ offers where a full 12 hour massage can be around £20.  They also offer reflexcology, facials and other beauty treatments – and even Pilates.  http://www.wahanda.com/the-wahanda-gift-voucher/

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Yukon Quest

Cancer survivors love to prove themselves in this race

 

and mouth cancer survivor Lance Mackey ended up on the podium in third place – not bad after 1,000 miles of gruelling racing.

Winner was veteran musher Hugh Neff, who produced the closest finish ever;  just 26 seconds separated him and Allen Moore, who must have thought he had the race in the bag as he had led almost the whole way.

Lance was a four-times winner of this race, but this time he settled for third place;  still proving that cancer survivors are a pretty tough bunch.

(Scroll down for latest video)

I took these photos on 8 March 2009 at the cer...

Lance Mackey

Some people survive cancer – then celebrate by doing something extraordinary:

like enter one of the world’s toughest dog sled races.

Next to the Iditarod Dog Sled Race, the Yukon Quest is THE biggie everyone wants to win.  Run every February, it is a forerunner for the Iditarod, and pointer to which teams to watch.

Head and neck cancer survivor Lance Mackey has won this 1,000 mile race four times.

In the video (below) of the start of the Quest, you catch a glimpse of sled dogs ‘booted up’ in bright pink bootees:  they belong to double mastectomy survivor DeeDee Jonrowe, who always dresses her team in this neon pink colour (the dogs wear bootees – much to their disgust – to protect their paws from the icy cold trail that could cut them to ribbons).

Watching this video might give you a tiny idea of just what these mad mushers go for; and how easy it is to get hooked.

 

Britain is latest country to fall for the exhilerating sport of dog sledding, and Penny Evans, stalwart of sledding in UK, has sent me this report – which tells of an epic race for one British musher when he and his wife emigrated to Canada, and ends up with him competing in qualifying race for the Yukon Quest.

What Penny is too modest to mention is that her Penkhala kennel huskies form the backbone of Rob’s team.  Talk about taking coals to Newcastle ……

To live the dream?

Photos of Rob and Louise :  Tracey Ackerson and Tracy Green

Competitor Rob Cooke certainly is living his dream. And for thousands of British dog lovers, he is the one they watch.

Given the opportunity of secondment to the Canadian Forces on an exchange with Britain’s Royal Navy, Rob and his wife Louise jumped at the chance and took their British bred Siberian Huskies back to their roots. It didn’t take either of them long to realise this was their dream, and soon with very careful selection their Shaytaan kennels had swelled ranks with US and Canadian stock and Rob was competing in middle distance races with his pedigree dogs – many of whom had been shown at the world’s most famous dog show, Crufts.

 

Then came the life-changing decision when Rob’s leisure sport became his vocation. On retirement from the UK Services, Rob and Louise moved from their house in downtown Halifax Nova Scotia to a dis-used zoo in New Brunswick.  “So handy said Louise, all those cages are perfect for the dogs, though perhaps taking on the remaining incumbent llamas came as a slight shock!

With trails spreading for miles from the backyard, Rob and Louise started training in earnest.  Whatever the weather they soon began to learn the needs and techniques of long-distance mushing and Rob never does things by halves, his research is never-ending and his knowledge is put into practice with his beloved dogs.  Typical Brit … and indeed for most mushers, “dogs-come-first” is the motto of their lifestyle.

But there was a bigger horizon … last Autumn Rob packed his best dogs into their van and travelled West across the American continent all the way to Alaska to train and compete with the big names in the sport. Staying with Lev Shvarts in his kennels Rob and his team quietly took on the Alaskans at their national sport.  Training was slow to start, snow was scarce, but then the White-Stuff arrived and races began.  Despite jibes about Slow-berians (most competitive teams run Alaskan cross-breed dogs rather than pedigree dogs) with a couple of finishes under his sled Rob was beginning to get noticed and he and his homebred pups, were making their mark.

As much as The Iditarod (the 1,000 mile race held every March to commemorate the famous Anchorage to Nome serum run in 1925) is known worldwide, the Yukon Quest is “the professionals’ choice” – a gruelling sled race between White Horse and Fairbanks taking in some of the most difficult terrain and weather conditions in the world.  The Quest 300 is the “starter-kit” run over the same trails but making a 300 ml loop rather than the full distance trail.  This race was to be Rob’s best shot at qualifying for the full Quest, hopefully next year.  Seven teams of Alaskan Huskies and Rob’s one pedigree Siberian team (somehow indiscernibly the “slow” had over past months been dropped from quotes) set out last Saturday.  The rest is history …. Rob’s faithful UK and worldwide fan-base watched results from each checkpoint.  Fourth position as he left Two Rivers – could he hold on to that slot for the remainder of the race?  Everything crossed…  unbelievably by Mile 101 he had gained a place and was up to third.  Snow was falling over the Southern Counties of GB and Rob’s dogs’ relations were enjoying a rare opportunity to run on sleds round Rendlesham Forest in Suffolk, but four miles of running requires nothing like the endurance and stamina the Shaytaan Gang were needing for their task in paw.  They held position through Central Checkpoint, this was beginning to get serious now for the arm-chair followers.  Then the unbelievable happened … Rob arrived at Circle City in second position … which he held to the finish amidst huge accolade from both sides of The Pond …. by now the word SLOWberians was only heard in whispers.  Here is the quote from the Fairbanks Daily News-Miner

“Rob Cooke of Edmundston, New Brunswick, was looking for experience and a qualifier for the 1,000 mile Quest.  ‘I just came here to finish. To finish in second place is just amazing,’ Cooke, 45, said. ‘Everybody has said to me you’re absolutely mad trying to do this as a qualifier, but it was everything I expected it to be. I just had such a fantastic time. I’ve been dragged across glare ice, I smacked my hip and rolled my sled going down Eagle Summit.’

Cooke was awarded the Vet’s Choice Award for exemplary dog care of his team of Siberian huskies.”

Louise from their home in New Brunswick where she continues to care for and train the second teams had a slightly different view sent to me by e-mail:

“Thank you! Still can’t believe what they did! … His idea of a fantastic time isn’t the same as mine lol!”

Oh and Facebook lit up like a Christmas tree with congratulations.  Rob may never be BBC Sportsman of the year, but he is living his dream which if you ask him he is not even halfway through yet ….

Yes, Brits have competed abroad and run the Iditarod and even The Quest, but never with anything other than local teams and certainly not pedigree dogs.  To all us Siberian Husky enthusiasts worldwide, he and Louise are certainly our Local Heroes (Penny doesn’t mention some of stock were bred by her – Ed).  And you know what ?  more importantly than his second place finish, beating teams from hugely famous Alaskan Kennels such as Lance Mackey and Sonny Lindner and running his own bred pedigree dogs, the most important award to us all will always be the Vet’s Choice Award.  Respect is never achieved at the cost of co-members of a team and never more true when they have four feet not two.   Long may Rob, Louise and their dogs continue to carry the flags of the UK and Siberian Huskies ….

This is latest interview on the trail.  Notice Lance is drinking water to keep his throat moistened because of cancer.

For more information: http://www.yukonquest.com/site/yq300main

 

 

 

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Last gasp for ideas to reform the NHS

WITCH DOCTOR #3 (of 4) Cover

WITCH DOCTOR #3 (of 4) Cover (Photo credit: BrandonSeifert)

Why doesn’t Lansley take his own advice

and listen?

 

That invaluable blog, www.nhsManagers.net  says:

Politicians are complaining about bureaucracy in the NHS. They confuse bureaucracy with management and management with administration. They don’t realise that in UK PLC 16% of staff are managers. In the NHS the figure is 13% and the cost, just 5% of the budget. Elsewhere in the economy management costs might be as high as 11%.

Baroness Warsi, Nick de Bois  and others claim the reforms will cut bureaucracy. We all know and have rehearsed ad-nauseam, that the plan to cut the SHAs and PCTs and replace them with (so far) the DH, NHSCB, Four Strategic Health Authorities, 50 Commissioning Support Units, 250 CCGS, 15 Clinical Senates, 165 Health+Wellbeing boards and 165 HealthWatchers is the sleight of hand of a clumsy magician. We realise sacking 45% of managers and rehiring them to do the same work at different desk is cost shifting, not cost saving.  They just don’t seem to get it.

What started out as a simple, perhaps naive, idea; to give power and money to GPs, because they know the patients, know the hospitals and know what’s-what, is the same as asking … a traffic-cop to make the cars runs smoothly through the town centre because he knows his manor. It is beyond them both.

Latest cost-saving idea is to stop syringing out years in GP’s surgeries.

Probably why Lansley can’t hear the chorus from all the Royal Colleges complaining about his Health and Social Services Bill?

Me?  I am looking around for alternatives.

Last week I threatened my doctor that if he didn’t find out what was wrong with me, my next option was to look for a Witch Doctor.

Reckon this one looks a likely candidate.

And his potions might not be any worse than the drugs that I’ve been on – whose side effects no-one seems to be able to sort out.

My doctor laughed.

But I was serious.

Because we are reaching  a point where the NHS is throwing in the towel, and in my case I strongly suspect it’s because the next steps in my care are going to be expensive.

My GP tried to tell me that the NHS is running out of money – and came out with the fact that I was getting on (he nearly said ‘OLD’, but saw my face in time).

I said the NHS hierachy should have thought of that before;  they had had 40 years of my taxes, which they should have saved for the future instead of spending.  During this time I had used the service so little that I had been removed from this doctor’s list, “because we never see you”.

So I reminded him they had had the use of MY money all this time, and felt they owed me something.  He sharply said this had no bearing on the matter – but I think it does.

Then friends in the NHS send me this doeful little ditty, which says it all:

www.abetternhs.wordpress.com

Now the Witch Doctor option seems to get more interesting.  Until I remember Steve Jobs, who decided he was going to go for Alternative Medicine first – but sadly that didn’t work out.

But I am sorely tempted – the Witch Doctor looks a lot more interesting than those Junior Doctors in the TV series, filmed in my local hospital.  These scaring the living daylights out of patients needing ‘procedures’, as they tried out their non-existent skills using human guinea pigs as pin cushions.

Decisions – decisions.  But interesting possibilities! At least a Witch Doctor is a sole trader, and if things go wrong, the village knows where to find him.  Now, that’s a great incentive for patient power!

 

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Why cheaper drugs may not be good news for patients

English: Methylphenidate packages from several...

Wikipedia

 

Major  drug companies

facing  job losses

and closures

 

For years it has been known that drug companies have a very, very close relationship with Doctors and the NHS.

Some would have said too close, especially those cancer patients who suffered from drug side effects and found doctors surprisingly unhelpful.

  •  But there were advantages.  Drug companies needed help from NHS to run clinical trials.
  • Patients who took part in clinical trials were told that they had much better chances.
  • And the end result was cancer survival rates generally improved.

In the ’80s and ’90s, people and politicians began to talk openly about cancer.  Drug companies realised there were billions to be made in producing drugs that helped prolong the life of cancer patients, and started to invest heavily in research and trials, searching for the holy grail of cancer treatment.

Drug companies became the darlings of the stock market.  Yes, the initial outlay was stupendous. But, if a pharmaceutical manufacturer came up with a drug that could be prescribed to treat cancer and prolong life, this was almost a licence to print money.  Don’t knock it though – if you have a company pension it was probably a big investor in drug company shares, seen as ‘blue chip’ investments.

But now there is a new problem looming:  cheap Generic Drugs.

Rise of Generic Drugs

A generic drug is a drug defined as “a drug product that is comparable to brand/reference listed drug product in dosage form, strength, route of administration, quality and performance characteristics, and intended use.

A generic drug must contain the same active ingredients as the original formulation. According to the U.S. Food and Drug Administration (FDA), generic drugs are identical or within an acceptable bioequivalent range to the brand-name counterpart with respect to pharmacokinetic and pharmacodynamic properties.   The FDA’s use of the word “identical” is very much a legal interpretation, and is not literal.

This has meant that generic drugs can have cheaper ingredients, which can sometimes react badly on patients.  But because they are cheaper, NHS doctors will always prescribe a generic drug if one is available;  and where patients have to buy their own drugs, they will tend to buy the cheaper version.  And many insurance companies will only pay for the cheaper version.  Hence drug companies will lose out.

Most drugs are patented to ensure that the company that develops them doesn’t lose their commercial advantage by others copying the drug.  Copying would be fairly easy to do;  any company developing a drug has to let the health watchdogs know what the drug was made of – making it easy to copy a successful drug – if it weren’t for patents which make this almost impossible, due to strict legal controls.

But drugs developed during the heydays of research are now coming to the end of their 20- year patent protection, enabling other companies to copy the formula.

So who is going to be first to suffer?

This problem has been growing, and drug maker AstraZeneca has just announced that it will cut another 7,300 jobs in Britain.

This comes a year after Pfizer announced it would close its UK research site.

There are still large profits being made, but there are pressures on the whole industry.

Jonathan de Pass, chief executive of the company EvaluatePharma, says  “It’s just an immensely challenging time for big pharmaceutical companies. Their whole business model is under huge strain – the whole research model is under pressure.”

What about new drugs?

Not so easy.   As Prof.  David Phillips of the Royal Society of Chemistry told the BBC, “It’s a fact that the easy targets, in the body, for the production of drugs have, essentially, all been used up.

“The cost of producing new pharmaceuticals, new drugs, is so astronomical now that it only takes one failure of a drug which doesn’t perform as well as was expected or has side effects – one withdrawn from the market that way can really cripple a company.”

A year ago AstraZeneca wrote down £281m when it discontinued research on Motavizumab , a respiratory medicine. In February 2011, late-stage clinical trials were halted on the prostate cancer drug zibotentan.

Patents usually last 20 years, during which market exclusivity allows companies to recover the research and development costs and make a profit. However, once the patent expires any company can make a “generic” version of the drug and sell it for a tiny fraction of the price.

In the USA the biggest-selling drug in the world – Lipitor (the cholesterol-lowering statin) earned Pfizer £8bn two years ago.  The patent expired in November last year and cheaper alternatives are now on offer.

This could cause a problem for AstraZeneca, as it makes a statin called Crestor. Although its patent does not run out until 2016, it has been suggested that cheap Lipitor could damage sales.

“It’s still early days, but people are going to be prescribed generic Lipitor – that is bound to have an effect,” said Mr De Pass.

So what can be done to ensure continued research into drugs of benefit to patients?

Prof.  Phillips said the key would be research on the fundamental science: “We need to get a stimulus to get that research done in the small companies and in universities so the bigger companies, later down the line, can pick up the promising leads and develop them from there.”

Co-payments

Case Study:  when a cancer patient at Chelsea and Westminster Hospital asked for Monofer (an iron-infusion for aneamia) instead of the one prescribed, which the drug makers said was more suitable for cancer patients.  The patient offered to pay the difference in price;  the hospital refused.  So the patient had the less-suitable drug infused, and six months down the line it has cost the hospital well over £1,000 to pay for consequences of giving wrong infustion – and they have now had to administer Monofer.

When Alan Johnson was Labour Minister of Health, he was made to agree that patients could co-pay for difference in drug costs.  However, this climb-down seems to have been forgotten, so it is up to patients to point out the law to the NHS, and if they would rather have a more expensive drug – they should be allowed to pay the difference.

Pension plans

Almost all pension plans will be investors in drug companies.  They are some of the largest and most profitable in the world, so it makes sense for pension plans to invest in them.  However, if they start losing money, not only will patients lose out, but their pension plan payouts will too.

So what of the future?

Drug companies are beginning to realise that they will have to become more open when talking to patients.  In Britain, we have one of worst compliance records (taking drugs) in world;  oncologists don’t have time to deal with drug side effects, so patients give up and don’t take their drugs.

This is not only bad for patients (according to World Health Organisation French cancer patients on average live over four years longer than Britons), but as we die earlier and don’t take drugs, this affects the drug companies’ profits.

Eventually drug companies will realise that to keep up their profits, so shareholders will authorise reasearch costs for new drugs, they will have to consult more with patients.  When this happens, it will be a win-win situation for both parties – but don’t hold your breath!

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