Calls to Mental Health Charity reveal human cost of recession.

By Nina Lakhani The Independant 21.05.12

High unemployment rates and rising living costs have led to a surge in calls to leading mental health charity which is struggling to cope with demand.

Mind’s info line dealt with more than 40,000 calls in the past 12 months, but an unprecedented high volume meant two in every five calls went unanswered. The number of people seeking advice about personal finances doubled since the start of the financial slump in mid 2008. The casual link between economic depression and mental health problems is well established, though Britain has thus far been spared from the rise in suicide seen in Greece and Ireland, where the financial collapse has been felt most acutely. The suicide of Dimitris Christoulas in Athens last month led to much soul searching due to his note said he could no longer live with dignity on a pension cut to the bone.

Mind’s info line, which provides advice ranging from how to access treatment to managing debts, dealt with 18% more calls between October 2011 and April 2012 compared to the same period a year earlier. Calls to its legal line increased by 28%. There are signs the impact of the ongoing crisis is spreading to previously unaffected families, with more and more employed people reliant on food handouts. Mind’s figures come as the country prepares for a double dip recession and at least another year of pay freeze, and precarious employment. Yet many mental health groups face an uncertain future due to cuts. Paul Farmer executive of Mind said: “Dealing with this is a job for everyone, government, employers and charities, as getting Britain out of recession is as much about the mental health of the work force as it is about economics.” Stress, depression and anxiety already cost the economy £30bn every year. This could be cut by a third if employers improved the way they dealt with workplace stress and mental ill health. Francoise, 49, a customer services co-ordinator at a blue chip company became depressed about 18 months ago due to mounting work pressures. Poor concentration and anxiety made coping with work difficult until she reached breaking point last June. But with support from Mind, A Therapist, medication and a psychiatric nurse, she will soon return to work. Health Minister Simon Burns said: “We are boosting funding for talking therapies by £400m over four years from April 2011. This will ensure that evidence- based therapies are available to all who need them.”

Gerry Gajadharsingh writes

NICE has approved mindfullness therapy as a recongnised treatment for anxiety and drepession, what is mindfullness? Breathing and Meditation.

I’m not taking a daily pill if I’m not sick.

Terrence Blacker Health The Independent Friday 18^th May

 The doctors have found something new to nag us about. Having thundered against smokers (inside, outside, active, passive), sermonised weightily around the perils of drink, and warned us that, unless we stop getting fat, these islands will soon sink under our weight, they have now turned their attention to the over 50’s.

A study published in the latest edition of The Lancet suggests that everyone in that age category should now be taking some drugs called statins everyday. By reducing cholesterol in the blood, the argument goes; the pills cut by 15% the chance of someone in the low- risk category suffering a fatal heart attack or stroke. Fewer people would die, and the cost to the NHS of screening and healthcare would be reduced. Here is the new double- whammy of generalised medical advice: not only is this good for you, it is great for the country and the economy.

The role of doctors in our world has changed in the past 5 years. Not so long ago, their work was with individual patients: now they are on hand everyday to provide the latest bossy prescription as to how we should all live our lives, like secular priests scolding us from the pulpit of science. It is not difficult to see how this happened. We live in an anxious, self analysing culture. Government, fretting about the rising healthcare cost of an ageing population, has become increasingly interested in the idea of prevention reducing the need for cure. Together individuals and politicians have turned to the medical profession for advice. Doctors, few of whom are over burdened with problems of self esteem at the best of times, have allowed the attention to turn their heads. It should go without saying that the idea of millions of healthy people taking a daily pill is distinctly creepy. Common sense, even if it is not to be found in the pages of The Lancet, suggests that messing around with the metabolism of a healthy human is unnecessarily risky.

The new report claims, unconvincingly, that taking a cholesterol reducing pill would offer , “a benefit that greatly exceeds any known hazards of statin therapy”. That little qualifier “Known” gives one pause, as does the list of potential side effects: muscle wastage, liver damage, stomach upsets, sleeplessness, memory loss, “bleeding strokes”, and diabetes. The human spirit would also be infected. When a larger part of the population is told that it needs to be medicated by the state in order to stay alive and do its bit for the economy, it is not just cholesterol that is being reduced.

Doctors do wonderful work in the surgeries, But it is time for them to stop self importantly prescribing to society as a whole, particularly when their advice involves shovelling an unnecessary drug into their bodies of the healthy. They are giving us a headache.

 Gerry Gajadharsingh writes

Hmmm, difficult one. The evidence that statins can help reduce cardio0vascular risk in men of a certain age is strong, perhaps more to do with lowering inflammation than just reducing cholesterol. However there are ways of reducing cardiovascular risk by lifestyle factors including the right nutritional advice. There is increasing evidence that reducing cholesterol is not just about reducing saturated fats but also reducing high glycaemic load carbohrdrates, this message has not yet filtered out to the person in the street! However I agree that managing risk is a personal choice, we all sometimes choose to do things that we know may not be good for us but it is our choice.

A doctor’s strike would betray their patients

by Sarah Wollaston Conservative MP for Totnes and a former GP

The Daily Telegraph 16-05-2012

The BMA is being unrealistic in opposing reasonable increases in pension contributions.

This week the British Medical Association is trying to persuade doctors to vote in favour of a strike action- the first such action since 1975.In doing so, the BMA proves yet again how out of touch it has become with the interests of patients and doctors alike.  When I joined the BMA in 1986, I was unaware that it was a union. I had assumed that it was a professional organisation supporting standards and education. And like most doctors, I joined mainly for a free copy of the weekly British Medical Journal, which at that time was the only way to find out what jobs were available. Now in a “Pension Ballot Special” a BMA newsletter tells members that the association has no choice but to vote on industrial action for a “fairer” approach. It splashes on the 14.5% that, crucially, only the highest paid doctors will have to contribute towards their pensions. It claims, misleadingly, that no patients would be harmed by industrial action.

The BMA tries to persuade doctors that they could open for their usual hours during industrial action but not carry out any pre- booked or routine appointments, or issue any repeat prescriptions. Likewise, hospital colleagues are invited to turn up and make decisions about what is or is not an emergency. The results would not only be farcical but dangerous: doctors would find themselves facing an exasperated and irritated public. If that sounds unreasonable the BMA industrial relations officer will be on hand to give guidance. He or she can expect to be very busy. The public is unlikely to have much sympathy.

Thirty years ago things were very different, doctors were relatively underpaid but their vocation and professionalism commanded public respect. Labour changed all this in the 1990’s. GPs ditched out of hours work and Saturday surgeries and the European Working Time directive was also waived by Labour, which undermined continuity of care and worsened working conditions for junior doctors.  Assuming that all consultants were on the golf course or seeing private patients, the government insisted that they should be paid only for the time that they spent on NHS work. It should have come to no surprise that it ended up paying even more because of unpaid time that consultants were previously giving to the service for free. A decade later, doctors are well paid and few GPs work Saturdays or nights. The public are simply not going to feel sorry for striking doctors who earn more than £100,000 per year, sometimes for a four day week. To put the issue into perspective, doctors earning more than £120,000 pay 8.4% of that into their pension pot. This would eventually rise to 14.4 % after tax relief. To get an equivalent pension in the private sector would require about a 3^rd of the same salaries- and doctors are living about 10 years longer than they did in the 1970’s. The rest of the country has woken up to the reality of pension costs- and we are soon to witness what happens to a country like Greece, which has failed to do so. No government wants to pick a fight over public sectors pensions, but to ignore demographic and financial realities would dump the burden on the next generation. I hope that doctors will follow at least one aspect of the BMAs advice, “whatever your views, it’s vital you vote.”

 As an MP, I now pay 13.75% towards my pension, and work evenings and many Saturdays. Of course one of the main differences between an MP and a GP is the way people feel about you. I hadn’t realised how much people respected doctors until I entered parliament. That support matters and a vote for strike action over pensions is a sure way to lose it. Perhaps every doctor should ask a friend in the private sector how much pension they will receive, and how much they must contribute. They might be in for a shock. The BMA have made the wrong call: this is unnecessary strike would not be victimless. I sincerely hope that doctors will vote to put their patients first.

Gerry Gajadharsingh writes

Its great to see a former GP speaking out. Anybody running a business wil know how hard it is out there in the real world. Most people I know in the private sector have minimal pension provision, we simply cannot afford it. For those  luckily enough to have state pensions, should realise what a good deal they are getting, are we all in this together perhaps the BMA thinks not?

Sickness rates worse for public sector staff.

Although UK absenteeism is declining reports Louisa Peacock. The Daily Telegraph 16-05-2012

Public sector workers are 63% more likely to pull a “sickie” than their private sector counter parts official figures show, as overall absence rates fall to a record low.

The date from the Office for National Statistics (ONS), shows public sector absence hit 2.6% last year, compared with 1.6% in the private sector. This means state workers are 63% more likely to take time off than their industry counterparts. The ONS said that private sector workers were less likely to get paid for their sick day which may have been what could have driven the “sickness gap”. However some occupations- such as police and nursing- had likelihoods of absence which could also explain the gap, while the public sector employed more women, who generally have higher sickness rates than men. Overall the UK Sickness absence rate fell to 1.8% last year, down from 1.9% in 2010 and the lowest since comparable records began in 1993 when it was 2.8% .Women have consistently higher absence rates than men, but both sexes have seen a fall over the past 19 years. Older people generally took more sick days than other ages echoing a long term trend. The most common reasons for sickness last year included back problems and minor illnesses such as coughs, colds and flu.” However there has been a 10% increase over the past year of people taking time off due to stress, depression and anxiety. London workers had the lowest sickness rates at 1.3% last year, potentially because of the volume of young and private sector staff. The North East and Wales suffered the worst rates at 2.5% because they gad more public sector staff. Business groups repeated calls for the government to adopt a new approach to help firms manage sickness absence, which is costing the UK economy £15bn a year.

Gerry Gajadharsingh writes

I was first invited to a parlimentary working group on work sickness about 20 years ago at the time back pain was the most significant cause of taking time away from work. Fast forward 20 years and stress is now up there. Actually stress/anxiety has always been there its just that clinicians and patients are now more accepting that anxiety can play a part in many work related illnesses.

It’s true, Injections hurt less if you look away.   

The Daily Telegraph 16-05-2012

 Looking away whilst being given an injection makes it less painful, just like the nurse says, according to researchers. It is age old advice handed down by nurses to generations of children receiving jabs against measles mumps and other diseases. But they are more than just reassuring words. The evidence is that looking away genuinely takes some of the sting out of injections. It is all to do with the expectation of pain, according to research from the universities o in Hamburg and Berlin for the medical journal Pain.

A group of people were made to watch a video of a hand being pricked by a needle, a hand being touched by a cotton bud and a hand on its own. The screen was positioned in such a way it looked as it may have been the volunteers own hand they were watching. While they viewed the clips, small electrical stimuli were passed through their own hand, some painful and others less painless. The volunteers reported that they felt the most pain during the clips of a needle pricking a hand compared with the other two clips. This was backed up by the results of monitoring their eyes and watching for pupil dilation- a sign of enhanded activity in the nervous system, stimulated by pain. The leader of the research, Marion Hofle said: “Throughout our lives we repeatedly experience that needles cause pain when pricking our skin…. But expectations- like information given by a clinician prior to injection- may also influence how viewing needle pricks affects pain.” The simple advice from a nurse works because it reduces patient’s expectations about the “strength of forthcoming pain prior to injection.”

She added: “Viewing a needle prick leads to enhanced pain perception as well as to enhanced autonomic nervous system activity. We’ve provided empirical evidence in favour of the common advice not to look at the needle prick when receiving an injection.”

Gerry Gajadharsingh writes

When I do venesection (taking blood from a patient) I do this with the patient lying down, as a consequence it is minimally painful, this research suggests a mechanism why?