MacDoctor

It’s official – we have the worst access to heart surgery in the first world, according to this article! $6 billion dollars in extra health funding and we still don’t have first world access to life-saving operations. And why is this?

“Staff shortages in the health sector, especially in intensive care unit nursing, were fingered as a major factor in the country’s poor performance.”

We don’t have enough doctors and nurses! What a sad indictment on the minister and ministry of health. Tony Ryall comments thus:

“Mr Ryall told the Herald the findings were “virtually the same” as those in another report received by the Government in 2003.”

And, in fairness to the current government, there wouldn’t have been much difference prior to 1999 either.

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It is now 20 years since the Metro magazine article blew the lid off unethical experiments on cervical cancer at National Women’s Hospital in Auckland. The study failed to inform the women involved of their risks, or even that they were involved in a clinical trial at all. Consequently a number of women died of cervical cancer who could have been saved.

The Cartwright inquiry was formed to investigate the trial and directly resulted in:

“* A national cervical screening programme.
* An overhaul of the medical disciplinary system.
* The creation of the Health and Disability Commissioner system.
* State-appointed ethics committees to oversee research.
* Reinforcing of the concept of doctors having to fully inform patients.”

That’s a fair achievement for a single inquiry, although only the ethics committee was a direct result of the unethical trial. I have mixed feelings about the HDC and the drive to “fully inform” patients.

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The prize for the most eye-watering double entendre of the year goes to Rodney Hide, who commenting on Winston Peters and Helen Clark last night said:

““She’s stood him down but she hasn’t cut off his baubles””

Nasty. And without anaesthetic, too!

Rodney, I know you and Peters don’t get on, but surely a simple tarring and feathering would suffice?

In Douglas Adams’ Hitchhiker’s Guide to the Galaxy, Adams describes the ultimate bureaucrat, the Vogon thus:

“A Vogon would not lift a finger to save his own grandmother from the Ravenous Bug-blatter Beast of Traal without orders signed in triplicate, sent in, sent back, lost, found, queried, subjected to public inquiry, lost again, and finally buried in soft peat for three months and recycled as firelighter.”

This is a splendid description of the kind of machinations that parents have to go through when trying to access any state help for disabled children as told in today in the Herald article “The red tape run-around“. Somebody once said that a bureaucrat is someone who can cut red tape, lengthways. And that is certainly what it feels like, trying to access health services.

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I am on-call tonight and it has been really busy, so no meaningful blogging from me today. Do not despair! Here is an old post I wrote some time ago which might interest you:

“The HOS of 25th March contains an article entitled “Strange but True”. It is a re-write of a daily Mirror article “Can dogs give you breast cancer? Bizarre medical theories that experts claim may actually be true” .  I like the original title – It does not suggest that the information in the article is an established fact.

For those of you who read the Sunday Herald article and and maybe are considering getting rid of your dogs, let me put your mind at rest. The original medical article is from the journal Med Hypotheses (2006;67:21-26 if you really want the reference). 

Note to journalists: The word Hypotheses is a clue. It tells you that this journal consists of wild and woolly theories that require a LOT more study before we call them true.

I won’t go into details but the study was of only 69 women with breast cancer (and 135 without). These are very small numbers. Applying statistics to small numbers like these is virtually meaningless and the results are “problematic” (this is medical statistician speak for “sucked out of my thumb”). At worst we can say that there might be a link, but the only way to find out is to get BIG numbers of people (like 10 000 or so) and study them. Then we might know something approaching the truth.

Dog ownership has been relatively stable for many years but breast cancer rates increased by about 40% between 1975 and 1998 and then dropped sharply as soon as hormone replacement therapy for menopause was abandoned. This tells us that dog ownership is not a very likely candidate for causing breast cancer. There have also been several good studies that show that owning a dog actually prolongs your life and reduces your chances of heart disease.

So give Fido a break, there is no evidence that he’s some sort of canine leper.”

Hat-tip once again to Homepaddock who has made me aware of this article on waiting lists for drug addicts (I am always amazed she manages to blog about so much stuff – does she not sleep?). She rightly points out how this once again illustrates how little difference Labour has made to the health system, despite the increased funding. Thinking about it, I can see that this example represents many of the faults in the current health system. I can also see that fixing the problem will require much more than simply throwing money at it. And this is one problem we really want to fix:-

“A report from the National Addiction Centre, obtained exclusively by The Press, estimates that crime by opiate addicts awaiting treatment costs the country $286 million a year.”

And that doesn’t even touch the untold misery that drug addiction causes in addicts and their families.

Apparently, the Greens seem very happy that they have managed to extract a $1 billion fund to insulate every house in New Zealand from the government (i.e. You, the taxpayer), in exchange for their agreement on the ETS. The Greens think this may help in the fight against global warming. I think it might help in the fight against people freezing. Let me explain.

Every winter, I see an endless stream of little people with bad chests wandering through my emergency department. Children with respiratory ailments make up a fair chunk of my day. Nearly all of these children come from homes that are cold, damp and drafty. Although I have grave doubts that insulating New Zealand homes will make any appreciable difference to our planet, I am certain that it will help these kids. So though I think the ETS is going to cost me a pile of money for very little gain, at least I have the satisfaction of knowing that I will have helped some kids keep cosy and warm.

This thought is keeping me sane. Don’t knock it.

BTW, I was wondering if this $1 billion is the same $1 billion that the Nats are planning on spending on broadband? You, know, the $1 billion that Labour said the Nats would have to mortgage your granny to afford…

I see National has accused Labour of having a hidden agenda – wanting to force the amalgamations of district health boards.

““Behind closed doors,” says National’s health spokesman Tony Ryall, “Labour appears to be working on a plan to forcibly amalgamate some DHBs, and proposals are already at the point that they’re making their way through Cabinet.””

I find this amusing on two levels. Firstly, it is highly likely that National would dearly love to amalgamate DHBs themselves. So that makes Ryall’s comments rather tongue-in-cheek. It takes you a few seconds to register that this is National commenting on Labour. Pot; meet kettle – have carbon.

The second reason this is amusing, is that amalgamating DHBs is probably not a bad thing.

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Homepaddock pointed out this little gem on her blog. 

“The Canterbury District Health Board said police were investigating several incidents where pain medication has been diluted or replaced with water at Christchurch Hospital.”

I am assuming that the pain medication was a narcotic such as morphine. It is also very likely that the perpetrator of this travesty is a medical professional – probably a nurse or a doctor. They may or may not be an addict – some people steal narcotics to sell. The person involved makes Winston Peters seems a saint…

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Just a quick update to the famous Herceptin saga. The Herald today mentions that Roche has offered a further $2 million off the 12 month course. Not hugely interesting (unless Pharmac change their minds), but buried in the article are the latest costings.

“The July paper lists the 2009 cost of the nine-week regimen at $5.9 million, plus $3 million for the 12-month arm of the trial, $7 million to extend usual treatment to 12 months, $1.4 million in extra DHB costs delivering the 12-month regimen, and $1.1 million for an unnamed other drug – a total of $18.4 million.”

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