Health inequalities in Wales are widening

Wales' Chief Medical Officer's annual report contains some very positive plus points, not least the fact that people here are living longer and that deaths from heart disease and strokes are continuing to fall.

A main reason for this is undoubtedly the investment in general practice, starting to bear fruit. With GPs focusing on cardio-vascular prevention as part of their QOF targets, that is then being passed onto the patients, and they hopefully have a better understanding of how to manage conditions such as high blood pressure and diabetes. So we can see the clear link here between investment in primary care and positive health outcomes.

On the other hand, it is rather disappointing to see in this same report, how the gap is widening in the rate of deaths from cancer, between the rich and the poor. Which begs the question are we focusing enough on those in deprived areas? And the answer seems to be a resounding “no”. There has been a lot of rhetoric and SOME investment, but to drive down these inequalities, it isn’t happening quickly enough. Without greater strategic enhancement in primary care services and Public Health to tackle people’s lifestyle choices, the situation will remain the same. And these strategies need to start at school, so children understand as they grow up, what a healthy lifestyle is.

I can’t stress enough the importance of Public Health to improving the nation’s health and therefore, we mustn’t lose sight of that in the restructuring of the Welsh NHS, currently taking place. It is of the upmost importance to ALL of us, but particularly the less well-off, that the right doctor workforce is put in place, for generations to come.

Study highlights the need for greater awareness surrounding obesity

Nearly three quarters of Welsh children don’t realise a eating mainly junk food, could lead to potentially fatal conditions like diabetes and heart disease.

This is the startling finding of study by the British Heart Foundation. Apparently, children think the worst health effects of eating junk food are merely putting on weight and rotten teeth.

This highlights just how little youngsters know about and understand the relationship between the old saying "You are what you eat". So I think the BHF has come up with a brilliant and innovative way to try and get this message through to kids.

The charity's developed an online computer game, the Yoobot, hopefully helping them understand the long term consequences of a poor diet. It allows them to create a mini version of themselves, showing how the choices they make for their Yoobot (about food and exercise) have a direct impact upon their health and wellbeing. Perhaps after children have finished this, they'll be encouraged to move away from the computer screen and go and kick a ball around or ride a bike!

Strong action, not just words is needed to tackle violence in the NHS

Strong action, not just words is needed to tackle violence in the NHS
I'm glad to see violence against NHS staff is on the agenda for discussion in the Assemby today. However, I would rather it wasn't even a problem that needed discussing in the first place. I find it quite incredible that anyone would want to attack the very people trying to help them and make them better.

Violence towards doctors and other health professionals sadly isn't a new phenomenon either. It's certainly getting worse. More than a year ago, BMA Cymru called for all ALL frontline healthcare workers to be given a free personal attack alarm to help protect them.

In Wales, there are some 22 cases of violence or aggression reported by NHS workers each day and estimates suggest that it costs the NHS more than £6 million a year. This would also seem to suggest that the Welsh Assembly Government isn't getting to grips with the problem.

Let's stop and think about the victims here too, many of which are BMA members. I know from speaking to some, just how terrifying it can be to face someone aiming a punch at you, when you're just trying to locate the cause of that person's chest pains. It's pretty much taken as a given in some professions, such the police, that at some point during the course of your work, you will encounter violence. It certainly shouldn't start becoming "acceptable" if you work in the Welsh NHS.

The Welsh Assembly Government and NHS Wales are already committed to a zero tolerance approach towards violence and abuse of staff, with a working group making the following recommendations;

1. Police should be patrolling NHS premises to deter perpetrators of violence and reassure patients and staff

2. Extend the use of CCTV and one work alert sysem

3. The existing all-Wales violence and aggression training passport scheme should be incorporated into all NHS staff training

4. Trusts must ensure they work with the CPS to ensure the effective prosecution of perpetrators of violence

5. Employers must encourage and support victims to act as witnesses in any prosecutions

6. Staff should have free access to solicitors to pursue prosecutions and the recovery of additional costs incurred resulting from violent and aggressive acts at work

BMA Cymru fully supports these and hopefully this afternoon’s debate takes into account the recommendations too. We would welcome the practical implementation of them NOW to protect staff and send out the right messages to the violent and aggressive few. We need to reverse the current trend of increasing violence, or else we face a situation where people will be put off entering health care roles and those health professionals already in them, leave - at a time when NHS Wales cannot afford to lose employees. BMA Cymru urges WAG to get tough on this, sooner, rather than later.

Overhaul of the sick note system is long overdue in Wales

The package of measures announced today to get people in England back to work and to help them stay in work, looks like being a step in the right direction. Perhaps it's something Wales should consider adopting.

The BMA has been calling for the sick note system to be reviewed for many years and we believe a Fit for Work service to help people back into employment may be the right way forward. The new ‘fit note’ has potential, particularly were it to be introduced to Wales, where we have some have the highest rates of incapacity benefit in the UK.

Whatever the change to the system though, it's crucial GPs are able to continue to act as the patient’s advocate and don’t end up policing the system for the Department for Work and Pensions. GPs are required to provide facts (not opinions) and do not take decisions on who gets benefits. That is the way is should stay.

It would also have been good to have seen a commitment to making sure every worker has access to basic occupational health services. Employers do need to take more responsibility, particularly in difficult economic times like now, as work-related ill health problems may well become more common.

Hidden and human cost of the credit crunch

A top Welsh police chief says there could be more victims of domestic abuse, as the credit crunch takes hold. If that's the case it's a sad, and very disturbing consequence of economic hardship.

Gwent Police chief constable Mick Giannasi says there is evidence of more tensions behind closed doors, as families worry about money.

Of course, the stress of finding enough cash to pay the bills and feed the family all adds up to more pressure on the breadwinner(usually male). But there can never be a valid "excuse" for violence in the home.

The BMA is aware its members can play a part in getting this hidden issue more out into the open, previously calling on doctors and all health professionals to be increasingly aware of domestic abuse. Doctors need to ask their patients the right kind of questions about attacks in the home and respond appropriately. They need also to be given training in dealing with domestic abuse, to "spot" the signs.

Today, on White Ribbon Day, here are just two alarming statistics, highlighting the depth of the problem.

Domestic abuse is THE number one cause of death for women across the world, aged between 19 and 44.

Domestic abuse accounts for 50% of women who are murdered.

View the YouTube video detailing our success over junior doctors accommodation in Wales

Barriers in hospital car parks inevitable consequence of abuse of system

So, Swansea's Singleton hospital has finally had to bite the bullet and invest in car park barriers to stop people who aren't actually going to the hospital, from parking their cars there.

Since free parking at Welsh hospitals was introduced earlier this year, it's been noted in the press, just how many people are taking advantage of the changes. I even blogged on it to try and highight the issue and stop drivers from abusing the system.

Now, bosses at Singleton say it's so bad there, they've had patients missing appointments because they can't find a parking space. I find it incredible that those of us who just want to spend a few hours wandering around Swansea City centre for a few bargains, are actually preventing patients from getting the help and treatment they need. But I guess it is inevitable, given human nature, that people will try and take advantage of free parking for patients. So we clearly have to send these same people the message that it's inappropriate and they are simply disadvantaging the very individuals that everyone wants to help with this initiative - patients and their relatives.

Hopefully, installing barriers will nip this growing problem in the bud, before it gets any worse. And it is right and proper that hospitals police parking arrangements to ensure that the right people have access to the facility. Free parking is the right policy for Wales and it shouldn't be spoilt by a selfish few.

Lower alcohol limit needed to reduce deaths on our roads

The Road Safety Compliance consultation has just been released and I have to say there are several sensible ideas in it, which, if adopted, could really help improve road safety.

It’s also good to see that the Government intends to investigate the impact of drugs on driving, as well as starting a major awareness campaign on the issue. Research does suggest that illicit drugs contribute significantly to road accidents in the UK. So it’s vital we fully understand the dangers of drug driving and that police forces are given more support, to tackle the issue.

BMA Cymru Wales also supports the REMOVAL of a drunk driver’s ability to request a second alcohol test by a doctor, if they are just over the limit. Modern technology means such a requirement is now unnecessary. And, some drivers may be exploiting this, in the hope that their alcohol levels will drop as they wait for a doctor to arrive.

The BMA will continue to lobby the UK Government to reduce the current drink drive limit. The science is clear: a 50mg limit would lower the number of road crashes, deaths and serious injuries on our roads.

The introduction of the current limit, backed by police enforcement and hard-hitting media campaigns, led to a dramatic fall in the number of deaths on our roads. But it’s been stagnant since 1993. We need a new impetus, with a lower limit, to reduce the 2,946 deaths and around 30,000 injuries on Britain’s roads last year.

Let's ALL pledge to call time on binge drinking

It's great to see Welsh police forces and Church leaders in Wales coming together for the first time, to try and tackle perhaps the biggest social problem at the moment - binge drinking.

Police chiefs and the Archbishop of Wales want us to start carrying cards or sign up online, to pledge to cut down on the amount we drink.

Critics may regard it as a bit "gimmicky", but we have to really start addressing the issue and any new and novel ways of doing this, should be welcomed.

I know doctors in Wales will certainly view this as a good idea, as it's us who often see first hand the very devastating effects excessive drinking can have. It's no coincidence that Friday and Saturday nights, when the vast majority of the Welsh public go out and "have a few", are also the busiest for hospital A&E departments.

I'm not trying to preach here and be a complete killjoy, most people like to have the "odd" drink now and again, which is fine. What this campaign is focussing on, is those who don't know when enough is enough, when their behaviour starts to deteriorate and they become violent and aggressive. And that can cause all manner of problems.

Let's also not forget the financial cost here too. Surely the £70-85 million spent by the Welsh NHS on alcohol-related incidents and diseases every year would be put to better use by actually trying to save people's lives.

So before the next "big night out", maybe stop and think and sign the pledge just as I have.

Welsh Junior Doctors Committee video

Watch the Vice Chair of the BMA's Welsh Junior Doctors Committee talking about the reformation of the committee and what issues it's working on, for doctors in Wales.

Time to support some of Wales’ most vulnerable people

It’s time to address what seem to be completely inadequate mental health facilities for young offenders in Wales. Bridgend MP Madeline Moon has highlighted the issue. The lack of provision for some of society’s most vulnerable young men is so bad, they have to travel to England to get appropriate help.

One of the reasons for opening Parc Prison in Bridgend was to allow young people in Wales to carry out their sentences, as near to their families as possible, at a time when they need them most. And if the exact opposite of that is happening, then something needs to be done to remedy the situation. That’s why I back Madeline Moon’s call to set up a dedicated community mental health service at Parc. Otherwise, chances are these youngsters will go on to re-offend and will be returning to Parc prison to serve time as adults.

Wales now needs to go it alone on presumed consent organ donation

I'm really saddened to read the UK Organ Donation Taskforce's report on presumed consent for organ donation.

It also gives me a bit of a sense of deja vu, it not being so long ago since the Assembly's Health, Wellbeing and Local Government Committee rejected the idea too.

If you're a regular reader of this blog, you'll no doubt be very familiar with the BMA's stance on presumed consent, which is in favour of a soft version of it (ie anyone who does not want to donate their organs, can register their objection. Families would also be consulted to identify any unregistered objection).

This perhaps gives more weight to the argument that Wales should also go it alone, being left to decide for ourselves what organ donation system we think is best. It's all well and good different committees and organisations submitting recommendations, but ultimately it should be down to the general public to decide. Which is why we fully support the Welsh Assembly Government's series of public consultations on the issue taking place at the moment.

Let's hope it leads to an informed debate and informed decisions being made. Afterall, it is hundreds of people's lives on the organ donor register in Wales, potentially being put at stake.

Major breakthrough in fight against LCOitis

Wales is suffering from a major new epidemic - LCOitis.

The symptoms? Confusion, yawning and, in the most extreme cases, an inability to stay conscious. The source of this new and worrying epidemic - colleagues point to the appearance of the Government of Wales Act 2006 as the most possible source.

Let me explain...

Yesterday, I attended a major conference organised by the Bevan Foundation and Positif Politics. It brought together a whole host of speakers to explain how Wales is governed and how organisations like BMA Cymru Wales can make use of the Assembly's new powers. Under the Act, the Welsh Assembly Government and Assembly Members can now ask for Legislative Competence Orders (LCOs) from the UK Government -which basically means the power for the Assembly to change the law in the areas that are devolved.

Until yesterday, I was an extreme sufferer of LCOitis. Everytime an AM, MP, journalist or Welsh academic started talking about 'LCOs' my condition deteriorated.

Thankfully, I am happy to report - I'm getting better. The cure? Well, anyone who thinks they may be suffering should consult Daran Hill and Huw Edwards' excellent guide to the Government of Wales Act, available by contacting the Bevan Foundation.

So far, it's the only known cure.

Action speaks louder than words

BMA Cymru Wales’ Policy and Public Affairs team took part in a Healthy Living event at the Assembly today.

As part of the Assembly’s Healthy Living Week, key health organisations and charities from around Wales had a stand in the Senedd, all with varying themes, focusing on improving health and well-being. It was an excellent opportunity to network and to forge new alliances. BMA Cymru Wales will be meeting with a variety of other organisations over the next few weeks to talk about collaborative working on a number of important health issues.

Assembly Members including, Jeff Cuthbert, Jonathon Morgan, Jenny Randerson, Jane Hutt, Gwenda Thomas and Bethan Jenkins all spoke about the importance of becoming a healthier nation.

Such events are extremely useful, if only to put the issue in the spotlight for a few days. But that’s also where we need to start making a big difference. To stop the ever-growing obesity epidemic here, now’s the time for more than just highlighting the matter for a week. It needs to be continuous, throughout the year. And it needs to be about more than just words. A good point was made by one politician who said it will take years before we start seeing an effect on burgeoning waistlines. But by getting moving NOW, hopefully the tide will turn sooner rather later.