Sunday, 25 March 2007

Smoking kills

It has long been known that smoking causes lung cancer and lung cancer can cause death (death normally being classed as a bad thing). Apart from premature death, there are a number of other things that happen as a result of smoking (the following information available on the website for ASH - Action on Smoking & Health):

Increased risk for smokers
  • Cataract
  • Hearing loss
  • Impotence
  • Depression
  • Tooth loss
  • Rheumatoid arthritis
Symptoms made worse by smoking
  • Asthma
  • Multiple Sclerosis
  • Optic Neuritis
Diseases more severe or persistent
  • Pneumonia
  • Tuberculosis
  • Crohn's disease
Do you want any of that list or have it made worse? I don't. Well, that's the sort of thing smokers look forward to.

A guy who goes by the name of fibrodenial has this to say:
"It has finally happened… smoking cigarettes now threatens your livelihood, making smokers an officially oppressed people. Wikipedia describes oppression as "the negative outcome experienced by people targeted by the cruel exercise of power in a society or social group." A government at war with tobacco companies over the right to obtain revenue through product regulation and taxation has created enough propaganda to convince society that anyone using the uncooperative industry’s nasty little products must be erradicated."
I like the bit about "smoking cigarettes now threatens your livelihood". I would have thought the obvious health problems it causes meant it threatened your livelihood already. Apparently, banning smoking is a "cruel exercise of power". How is it cruel if it will improve your health and the health of people around you (remember the effects of passive smoking)?

The ban of smoking in public places starts on July 1st. Note the word 'public'. It means you can still smoke in private places if you want to and that means it doesn't affect your human rights.

What about the hospitals in the UK? I found this quote in an article in the British Medical Journal:
"Each year in the United Kingdom smoking causes more than 120,000 deaths. It remains the largest single preventable cause of death and disability in the country and costs the NHS in England about £1500m a year."
Think about that figure - £1500m. If everyone was to stop smoking, just think of the other areas in healthcare that could benefit.

Anyway, I've mentioned the benefits of the smoking ban, but what about the negatives? To have a balanced argument I have to mention that the sale of cigarettes and tobacco generates millions for the UK economy and if the country never smoked, we wouldn't have the revenue from the sale of nicotine patches et al either.

That is a fairly weak argument though - when the smoking ban happens there will be a short term increase in the sales of patches generating revenue. Also, the money that would have been spent on cigarettes and tobacco would either spent on other things or saved - the latter reducing the ridiculous average personal debt level in this country.

Ok, so I've stated my opinion about the benefits of the smoking ban. What do you think?

Technorati tags: Smoking Ban, Health

Saturday, 3 March 2007

The ambulance IT system

I read this article and was shocked.
"Urgent talks are underway to save a computerised capacity and activity monitoring system (CAMS) used to direct ambulances to hospitals best placed to deal with patients after PCTs in the East of England SHA withdrew their funding.

The East Anglian Ambulance Trust and acute trusts across Norfolk, Suffolk and Cambridgeshire are in last minute talks with East of England (EoE) SHA to prevent the screens going blank on 7 March 2007."
Instead of just withdrawing the funding (£175,000 per year), why can't the PCTs actively find ways to make it financially worthwhile. There are clear technical and productivity benefits - so it would definitely be worth saving.

Apparently there has been a massive overspend of £175m. What happened to proper financial planning and project management? I learned that sort of thing at A-Level and this is a government project - so they should know this stuff. It's just plain ridiculous.

Nurses update the system's information on a two-hourly basis and it contains details of the number of empty beds and waiting times. That sort of thing can be essential as there are many cases where patients need to get to hospitals as soon as possible and if they arrive at one that's full, they could die.

Recent evaluations of the system show that it can save a lot of money and it tends to divert around 5% of patients. That might not seem much, but when you consider the number of busy A&Es across the country, it can add up to quite a few people.

The reporter for E-Health Insider mentioned:
"Losing CAMS is unlikely to endanger patients, sources told EHI, as hospitals have a duty to treat patients in an emergency. But it will mean the ambulances and trusts revert to pen and paper."
Considering that the NHS is implementing the National Programme for IT, which supposedly revolutionises the way hospitals work, this goes against the objectives of the government project.

In the FrontPoint Systems blog, they call it "short-termism" in this entry. It's certainly that. There have been many cases where businesses have initially made losses, but then gone on to make a profit. Why can't the PCTs see that the savings will eventually cancel out the epxense (ok, it might be a long time given the overspend, but it will happen eventually).

The key objectives in the strategic action plan for the Welsh version of this system are:
  • Provide and coordinate an increasing range of mobile healthcare for patients who need urgent or unscheduled care
  • Provide an increasing range of other services and alternative care pathways, e.g. in primary care, diagnostics and health promotion
  • Improve the speed and quality of service provided to patients with emergency care needs
  • Improve the speed and quality of call handling, provide significantly more clinical advice to callers, and work in a more integrated way with partner organisations to ensure consistent telephone services for patients who need urgent care
  • Improve overall efficiency, effectiveness, consistency and quality of care provision
  • Ensure Trust compliance with the Civil Contingencies Act 2004
  • Provide strong leadership, both clinical and managerial, so that organisation structure, culture and style match new models of care
Those objectives will be the same as the English version, and they are worthwhile objectives. Why not do something to keep the system going?

So, what do you think?

Technorati tags: Ambulances, IT, Healthcare