Our booze culture

The Western Mail has reported today that the number of people admitted to hospital with alcohol-related conditions has risen by 30% in five years.

These figures are unsettling. The population is drinking more and our society is awash with pro-alcohol messaging, marketing and behaviour.

Over the festive period, the admissions to A&E for alcohol misuse will put a huge strain on NHS resources. Intoxicated patients are dealt with by a variety of medical staff and even security guards if they are violent and abusive. Added to this are the costs of tests and treatment, and if the patient is then sent to a hospital bed on a ward, the costs mount up even further.

Supermarkets offering cut price deals and drinks promotions in pubs and clubs exacerbate the problem as people indulge over this period. All these promotional activities serve to normalise alcohol as an essential part of every day life. It is no surprise that young people are drawn to alcohol - when it is cheaper than bottled water, we have to worry about what message we are sending our children.

Alcohol misuse causes family breakdowns, is a major factor in domestic violence, is often related to crime and disorderly behaviour and it kills. It is related to over 60 medical conditions including heart and liver disease, diabetes, strokes and mental health problems. The public should be made aware of the serious risks associated with drinking, so that they can make informed decisions about how much alcohol they are consuming.

Alcohol can be an enjoyable part of social and cultural life especially over Christmas. But the growing booze culture is creating serious problems for the future. Sometimes people may not even be aware that they are drinking too much – it is easy to do. It is important to keep track of how much you are drinking. We would like to see people enjoying alcohol sensibly without over doing it.

Are you a healthcare professional who has dealt with patients who have been admitted due to alcohol misuse? Share your experiences with us.

Action on aggressive behaviour in A&E

I am pleased that the pilot to install CCTV in 4 A&E departments in Wales is being rolled out today and if successful, will be extended across Wales.

The Minister is clearly taking action on the violence and aggressive behaviour agenda.

BMA Cymru have repeatedly stated that there should be zero tolerance to violence of any sort in the NHS and the mechanisms must be there to minimise the likelihood of attacks, to support staff who experience them, and to ensure that anyone who commits an act of violence is dealt with appropriately.

Hopefully these cameras will make people think twice before attacking hospital staff who are trying to ensure the good health and well-being of patients.

Progress still needs to be made however, on protecting those working in primary and community care – especially the lone workers who are particularly vulnerable. I blogged earlier in the year on what BMA Cymru believe would be the most effective mechanisms to eradicate the problem.

I hope that this pilot will prove successful and demonstrate that violence against healthcare workers will not be tolerated.

Have you been subjected to violence and aggression in the workplace? Tell us about your experiences.

Room for improvement

Auditor General Jeremy Colman, has today published a report entitled "Unscheduled care: developing a whole systems approach", which concludes that despite the strengths of the current system, there is work needed to improve the way which services work together.

The BMA has been calling for better service integration within the Welsh NHS for a long time - unscheduled care plays a key part in that agenda.

The report says that too many people who have urgent reasons to access the NHS or social services are encountering inefficiency, uncertainty and delays. Jeremy Colman says that a solution to this would be to show people how their needs can be met more effectively elsewhere.

It may sound obvious, but ensuring that patients are seen or treated in the right place at the right time will make a big difference to the efficiency of NHS services and so it is essential that we get that right.

The report recommends that the new LHB’s should take the lead in redesigning the structure of unscheduled care. I hope the Minister considers this and will take the appropriate action to address the issue. Of course, any changes must be backed by an effective channel of communication and better working practices.

In addition, universal targets for seeing patients in A & E Departments are skewing priorities – patients in more need should be prioritized and treated accordingly. That is just not happening at the moment. The use of smarter targets is a real solution to that and something we have been encouraging the Assembly Government to look into.

We must be careful not to undermine what we already have in Wales both in general practice and in secondary care. We need services that support and compliment each other – the danger which has become apparent is that unscheduled care has become a separate and isolated part of an already disjointed service.

At a time where NHS reorganisation is taking shape, it is crucial that the Minister acts now, so that the future benefits of the NHS in Wales can be fully realised. We would very much welcome the opportunity to work with the Assembly Government and the new LHBs on improving the service.

If you have any thoughts on the report, let me know.

Chief Medical Officer for Wales publishes Annual Report

Wales’ Chief Medical Officer Dr Tony Jewell, has today published his annual report which looks at different methods of prevention to ensure the long-term health of the nation, including immunisation, screening and education.

He warns that preventing disease and illness is the key to a healthy future generation. I welcome this report and agree with the recommendations Dr Jewell sets out for improving the health of the nation. It is vital to focus on health promotion and illness prevention as well as illness itself.

Dr Jewell says that overall health in Wales is continuing to improve, but continued action is still needed to address issues like obesity, binge-drinking and smoking. These three issues are important for BMA Cymru members, and for years we have been trying to improve the health of the nation by campaigning for smoking bans, minimum pricing for alcohol and preventing childhood obesity.

The effect of the smoking ban is noted by Dr Jewell in the report. Findings from research commissioned by the Welsh Assembly Government show clear evidence of reduced exposure to environmental tobacco smoke, particularly in pubs, clubs, bars and at work. This means that the legislation has achieved its main objective to reduce environmental tobacco smoke. It is encouraging that the studies found no evidence of any shift of smoking to the home, or of increased exposure to children.

BMA Cymru would like to see further action taken by the Government in the long run, including banning advertising and displaying cigarettes at point of sale; as well as banning cigarette vending machines and scrapping the sale of ten packs.

Childhood obesity is a growing epidemic, and the soaring rates have lead to an increase in childhood type II diabetes and will lead to more future cases of heart disease, osteoarthritis and some cancers. Teaching children at an early age about the advantages of a healthy lifestyle and introducing exercise into a daily routine may prevent them from chronic health conditions later on in life.

A sensible approach to alcohol is always important, but it is particularly pertinent at this time of the year. We want the public to be aware of the risks associated with drinking, and would like to see advertising for alcohol banned as well as minimum price levels for the sale of alcohol.

Health Minister Edwina Hart has welcomed the report and the recommendation that more focus should be placed on preventative measures. I look forward to seeing what action the Welsh Assembly Government takes. Let me know what you make of the report.

You say goodbye and I say hello…..

Rhodri Morgan will formally step down as First Minister of Wales today, and I would like to wish him well for the future.

After 10 years as the Leader of Wales, Rhodri leaves a great legacy behind him. Under his leadership we have seen devolution take shape and flourish, and his commitment to Wales is admirable. Over the last 10 years Wales has remained loyal to the true values at the heart of the NHS. We have gained free prescriptions and free hospital parking, and maintained a clear rejection to the introduction of competition, choice and greater use of the private sector.

The approach to healthcare in Wales has been compared to England by Morgan, as “clear red water”. This rejection of the internal market has become part of Welsh identity. Instead of targets and choice, we invest in community and preventative measures, and in promoting public health.

During the rest of this Assembly I look forward to BMA Cymru working with Wales’ new leader Carwyn Jones, to ensure that Wales is the premier place for doctors to come and train and work.

The recruitment and retention of junior doctors must be high on the Government agenda moving forward. If we don’t have the quality and quantity of doctors, the health service will fail to function. This is a great concern to us and our members.

I hope that he and the Health Minister will work with us to build a health system that delivers better health for the people of Wales. We realise that we are in the middle of a recession, and difficult decisions will have to be made, but it is vital that health is properly funded.

So fare-well Rhodri, and welcome Carwyn, we look forward to working with you.