Content editor, Joanna Lowy, comments on all things health-related, and gives you a sneaky peek into her news-based medical musings of the week. Sometimes controversial, other times humorous, always straight from the heart; here you get to know the girl behind the facts! Enjoy! Comments welcome and invited!
Like many, I am sure, I was rather intrigued by reports out yesterday which claimed that breast cancer screening does not actually reduce mortality rates. Although the number of women who die from breast cancer is steadily decreasing, the study from Oxford University suggests, there is no evidence it is because of the mammograms that every woman between the ages of 50 and 70 are invited to attend.
In fact, the research reveals, the largest drop in mortality is actually in women under 40 who are not routinely screened, factors such a better treatment are likely to improve survival and screening is dangerous anyway because it raises the risk of unnecessary surgery and treatment.
Yet I am intrigued by these claims, and not only because of the limitations to the study which many have pointed to.
I am intrigued because I do not generally understand how, in this day and age, screening could be anything but positive.
And I am not alone. The other side of the coin – namely via the NHS – paints a strikingly different picture. According to an analysis by the Department of Health last year, breast screening led to a 20% reduction in deaths. The statistic residing proudly on NHS Choices estimates that screening saves around 1,300 lives a year and that a third of breast cancers are diagnosed as a result.
Yet it is here that I stumble. You see, when breast cancer screening was introduced in the 80s – as in Pacman, Michael Jackson and dodgy perms – health chiefs then predicted it would cut deaths by a third. And an article on the BBC website from 1998 cites the same number of lives saved as the NHS does today. So why has this not progressed in any way?
It is not that I believe screening to be unworthy, but I would have expected it to have progressed over the last 40-odd years.
Maybe then, the reality that screening leads to three times as many deaths as it saves would no longer be a reality.
Maybe then false positives would be a thing of a past; unnecessary treatments an unthinkable reality.
And why are doctors operating on or treating a woman who they deem to have breast cancer when there is a chance that they might not, anyway? Surely screening is a first step, a mere indication of the need for further testing. I struggle to believe that in this day and age, the results of a mammogram are taken as gospel without any further investigation.
And if they are, then perhaps it is time we start questioning that, instead.
You might be mistaken for thinking they are, seeing as any time a well-known member of society becomes disgraced, the media jumps on the gluttonous pot of gold that still sits at the end of their rainbow. Which, invariably, is suddenly a lot shorter following their forced resignation.
But we need only look at recent events, such as ex-Halifax Bank of Scotland chief, Sir James Crosby - said to hold a central role in its demise - giving up his knighthood and 30% of his pension, as of last month. Denis McShane, former Labour party politician and one of the worst culprits of the MPs’ expenses scandal, had his pay and pensions suspended for a year, and a disgraced police officer, who was found to have sold seized guns, had his pension reduced by 25%. Initially, reports claim, he was due to have it stripped by 65%, but a judge ruled this as unfair, following an argument by his lawyer that his actions, whilst unlawful, did not put anyone at risk.
So what about good old David Nicholson, who last week announced he would retire next year to the tune of a £1.9 million pension? Nice work, if you can get it.
Being in charge of the scandal-hit Mid Staffordshire Hospital Trust for two years, during which countless numbers of avoidable deaths took place as a result of shocking levels of care, his actions certainly did put many people at risk.
So what of his pension pot, I hear you ask?
Mr Nicholson served the NHS for 35 years. And, for all the furore surrounding his involvement in Mid Staffs at the time of its demise, and, indeed, the bitter legacy he leaves behind, “the man with no shame” is said to have done a lot of good for the health service, too. The fall in NHS waiting times, the reduction of infection rates and mixed sex accommodation being at an all-time low are the accolades Jeremy Hunt has chosen to bestow on the outgoing chief executive.
Yet whilst no one, I am sure, feels as though he shouldn’t get a penny of his hard-earned retirement, I’d be shocked if anyone actually supports the likely reality that he should pocket the lot.
But he will, and the reason behind it is a lot worse than the stomach-churning image of the ex-chief executive of the NHS sunning himself in the Maldives, draped in gold and diamonds. Of course he does not deserve £1.9m – especially the taxpayer funded part of it - but he also should not be choosing the terms of his resignation in the first place. In fact, he should not be resigning at all. He should have been fired. Months ago.
And it’s because of this that that pension pot is probably going to remain untouchable. After all, how can the NHS take away from a man they maintain, through their inaction, has done nothing wrong?
I’m going to do something that I have never done before. You may, therefore, want to sit down for this.
I am going to write a blog even though I don’t really know how I feel about the subject.
Don’t get me wrong, I have plenty to say about the latest media controversy surrounding pregnant women and the so-called test they are to undergo to determine whether or not they are smokers. And if they are smokers, referred to smoking cessation services in order to quit.
But do I know what side of the argument I’m really on? Not really.
You see, part of the whole uproar, which has got many – including members of the RCM – up in arms, is the ‘how dare midwives police pregnant women?’ aspect of the test which checks carbon monoxide levels in the body.
Yet it becomes kind of irrelevant when we trawl beneath the media-frenzied headlines and see the real hard facts of the tests which, dear reader, is optional. Yes, you read that right – pregnant women will not be forced to take the test.
I don’t mean to put a downer on the collective sigh of relief, but if it’s not compulsory what, exactly, is the point?
Let’s be honest, the only person who is going to choose to take an optional test into whether or not they are a smoker is a non-smoker.
I would timidly suggest making the test compulsory, but away from an ideal world this is simply impossible. After all, where to draw the line? Testing alcohol levels? The consumption of chocolate mousse?
I am not blind to the stark differences between protecting a foetus and a child. After all, if a child was being abused by his mother we would think nothing of reporting this mother to social services.
Yet somehow, until a baby leaves its mother’s womb, it’s hands off. I suppose it’s an unspoken rule that any external interference is simply inappropriate. As a general non-believer in abortion, I’m not quite sure why this is, but it seems to be the reality nonetheless.
And so although my normal reasoning would lead me to support a compulsory test such as this, for some reason it just doesn’t sit quite right with what is, and is not, considered appropriate.
Until that changes, a test like this is simply redundant.
The Advertising Standards Agency (ASA) is failing to protect our children, if reports this week are to be believed.
According to the report launched by the Children’s Food Campaign, children are still being targeted online by junk food manufacturers, despite rules against it similar to those hinged on other types of advertising.
The report singles out both online advertising and social media as a perpetrator of childhood obesity.
It seems that one of the greatest sources of this online advertising lies in the so-called advergames, which large manufacturers, such as Haribo, Chewits and Cadbury, place on their websites to entice young children into their calorie-fuelled worlds.
This is significant because although children, as defined by the letter of the law, include all those under 16, I cannot imagine anyone under the age of nine playing an advergame.
Which means that we are looking, specifically, at the younger age of the spectrum.
The report highlights evidence that young brains process advergames differently from digital advertising, and that they may be influenced without being consciously aware of it. I am absolutely in no doubt of this and I commend the campaign for highlighting the importance of protecting children.
But let’s be honest, when we think about it properly, significantly more serious concerns arise.
First and foremost: What are children, specifically under the age of nine, doing on the internet unsupervised, anyway? I’m pretty sure if parents truly knew what their children were being exposed to, they wouldn’t be so bothered about a game involving Haribo.
And as research yesterday revealed, parents - 98% of them, in fact - really don’t know the full extent of what their little ones, as young as three, are falling prey to.
A quarter of children interviewed as part of the Netmums study admitted to accessing eating disorder sites and one in five looked at self harming websites. More than 10% admitted visiting suicide sites and viewing child abuse images, and 6% admitted to seeing violent pornography. Others have also been victim to viewing gambling or terrorism related content.
Most chillingly, perhaps, one in five said they had “thought about” doing what they had seen online.
If it’s ludicrous of manufacturers to think they can rely on the honesty of a 6-year-old when faced with a permission pop-up, verifying their age, it is equally ludicrous of parents to think they can trust any online media in the hands of their young children.
Another report in December warned parents to check what their youngsters are playing on their phones and computers. But again, I ask: Why do they have phones and computers?
The second, somewhat pressing issue, lies in the – to my mind – extremely obvious reality: If young children are eating junk food, it’s because their parents are buying it for them. Young ‘uns can nag all they like for an unhealthy takeaway, but if their parents ‘say no, it’s no’. At least, that’s the answer that was given to me as a child, anyway. You can bemoan a child for being exposed to junk food adverts but the actual danger is only going to be realised if parents decide to stock their cupboards with the stuff.
The emphasis, once again, is wrong.
And so, while I applaud the campaign and agree that the ASA has a long way to go, the belief that this is anything more than just a piece in the larger puzzle of childhood obesity is just deluded; an overly simplistic understanding of the very real dangers facing our children today.
New guidance published by the GMC yesterday tells patients that they should always expect doctors to admit when they’ve done something wrong and apologise.
Patients’ safety, dignity and comfort must come first, the guide says, somewhat redundantly. I mean, is it me, or does this ‘guidance’ scream irony? Sixty-five years of a National Health Service, and only now must doctors admit their mistakes and prescribe themselves a dose of humble pie while they’re at it? What, are we supposed to be grateful, or something?
There is so much more I could say about this – and would – if there wasn’t a more pressing thing to discuss.
You see, if I can’t understand why or how a doctor could be so reluctant to put the safety of their patients first – evidenced too clearly by the shambolic care at Mid Staffordshire Hospital, among others now crawling out of the woodwork – I am simply baffled as to how patients themselves are willing to do the same.
The continual barrage of desperate media pleas urging parents in Wales to get their children vaccinated against the measles epidemic which has so far hit 886 people – and counting – is frightening. Every day another expert speaks out, repeating the facts and figures which anyone who reads the news could probably recite by heart by now. But for whatever reason, the message, whilst certainly helping, is just not getting through adequately enough.
Even the fears that the epidemic is to make its way across the whole of the UK seems not to be enough in the fight against the potentially fatal disease. Engaging in just one discussion with the father of an 18-month-year-old, who has not yet been vaccinated and seems in no rush to do so, illustrated quite clearly the faux-confidence of natural immunity that afflicts so many – the ‘surely it would never happen to me’ syndrome.
Except, in this case it is even worse because it is not ‘me’ we are talking about, but a son or daughter. A vulnerable being that relies on their parent to make the necessary decision for them. Because if they don’t, then who will?
Just what, exactly, is it going to take?
And how on earth can we expect doctors to respect us and put our health first if we refuse to do the same?