far too quiet - right, time for a debate

[relliott]

okay, seeing as there has been nobody in this forum for a while lets get you all well practised in the art of medical debating! Exciting prospect i know:p but I'm sure we can make it fun!

Okay, consider this.... is it fair that some health authorities offer certain treatments on the NHS that others do not? This was raised in one of our vocational studies classes lately. In the Arran and Ayrshire health board infertile couples can be eligible for IVF treatment fairly readily, but in Greater Glasgow Health board only certain couples will be considered and will have to wait around 2 years.

Should regional variations in treament be allowed? How would you change it? Why do you think variations occur?

This should start a fairly interesting conversation with a bit of luck

[elliottsimpson]

I certainly wouldn't want to be the one making the bigger decisions, but Lanarkshire in general, and Monklands in particular has done quite well out of the funding announced yesterday for cancer services in Scotland. And I'd like to assure the readers that the six figure sum allocated to be spent in Pathology and Haematology will be well used and that we are worth every penny!

Not in the slightest bit biased.

Elliott

:) :)

[crumpet]

lol
[thinks:hmmmmmmm wonder how much coffee that would buy elliott if the money was his- probably a lot buuuuuuut would it last long lol]

[andrewbaillie]

Looks like Mr McLeish took the hint! Or did he??

[relliott]

hey elliott, any chance of a donation to the Lost Hippo Retrieval Company? We're short on hippos given that they all migrated to africa for the winter

[elliottsimpson]

Tracy has finished her 3 month attachment in Lanarkshire (2 in Wishaw and one in Monklands) and has gone back to Johannesburg - maybe she could get you one - the postal charges (like the elephant charges) might be a bit on the large size, though.

:lol

[andrewbaillie]

No excuses for losing it in the post though!
You know what the Royal Mail are like!

Lets just hope they manage to lose any special 'white powder' letters that come this way

[elliottsimpson]

We were in Canterbury last week. Heard a really sick / sad tale.

There was to be a special Even Song Service to mark the end of the Canterbury Festival. Allegedly, a few hours before it, a tourist in the crypt noticed someone acting furtively - they might have been of Eastern origin and the appeared to be sprinkling a powder. When the person realised (s)he had been oberserved, (s)he had walked off fairly rapidly.

So, the security forces were all alerted. The Special Service was re-located and the Fire Brigade came clothed in appropriate bio-hazard gear and swept out everything on the floor of the crypt All powder, dust, etc. was chemically treated to eliminate any threat.

It later was found that the poor person had been scattering the ashes of some deceased relative - knew (s)he wouldn't get permission, so had done it unofficially.

Sad, really.

[Real D]

Dear oh dear were getting a bit serious here dad, mind you it is a sad tale - I hope they didn't get too upset about their loved one being classed as a biohazard!

Anyway - back to Ruths debate, unfortunatly 'postcode prescribing' happens all over but it seems to be very prevelent in the south east with people 'borrowing' an address from someone to get treatment and other such things. The problem is that some health authorities go ahead with inovative and new treatments before they have been shown to be effective, nevermind worth the money - take that Multiple Sclorosis treatment, it still ahs no proof of efficacy as far as I know yet patients ar incensed when they cant get something that costs thousands of pounds and does nothing!


ANyway I'm supposed to be off duty!!!!!!


Bye 4 now

[andrewbaillie]

I think its too easy to forget what it must be like for pateints suffering from MS. It really is a crippling, disabling disease for a lot of the sufferers (as I'm sure you know already!).

I think what we should all remember is that the reason they become 'incensed' when they cant get the treatment is that they are willing to try anything that may even have the smallest chance of restoring (or preventing further degradation of) some of their mobility, easing the painful muscle spasms and generally offering a slightly better quality of life.

After all, in the absence of a cure arent things like quality of life etc. most important?

[DScollon]

Absolutely. But when you start working, you'll realise how much is deducted from your salary every month in National Insurance contributions. Is it right that money coming off my own salary be spent on a treatment which is very expensive and has not been shown to help?

Personally, in that particular case, I'd prefer the money to be spent on research to establish if it does actually work. That way, there's a case for having it available across the country rather than in a few postcode areas.

There's no easy answer to this, is there?

[andrewbaillie]

I suppose thats why we can have debates about things like this, cos theres no easy answer, and everyone has a different opinion on the subject depending on their circumstances.

I think it would probably help to get as many point of views on the subject as possible.

[jojo]

I agree with Andrew the sufferers from MS are just trying to find anything to cure or even relieve their symptons.If i were in their shoes i'd probably do the same.
However i think Derek is right a certain amount of money should be used for research to see how effective it actually is, as after we have found out for sure we can either begin to prescribe it or use the money for further research and find something that actually helps to relieve their symptons.

My mum just shouted in that we've to make cannabis legal and give them it free on prescription!!(i have to live with this woman!!:lol )

[andrewbaillie]

That sounds like a really good answer if the issure was brought up in an interview. Seeing both sides of the coin so to speak!

[Real D]

Sorry to make you think I'm cruel and heartless Andrew!

I didn't mean the drugs shouldn't be available, but why not research them more and give them when they KNOW they will do something rather that giving false hope.

On your Mums point Nic, Canabis can be shown to be one of the few things that will deal with the pain, paralysis and humiliation of MS, BUT I would rather the Government had put money into researching an extract that could become a pill that is prescribable rather than keeping people who are in pain going through dodgy and illegal routes to get some much needed relief. Or in the most part not getting it at all as they don't want to do something criminal

Anyway - far to deep!!

[andrewbaillie]

I'll reserve judgement on the cruel and heartless thing for now...hehe...just kidding. No, you are right about the research needing to be done. There is no point in spending a huge chunk of your budget to provide patients with a drug that may not work. Rather than continuously pouring the money into its production, why not an investment into research to see if it works?
I would say that more public awareness about this would help.

How about complementary therapies in the meantime? I think that complementary therapies have a role to play, and not just with MS, but in general too! . What do you all think?

[DScollon]

Note to Elliott: Maybe Tricia, the complimentary therapist in ward 15 would take the odd NextGen student.

[jojo]

That would be interesting i actually applied for wrok experience at two homeopathic hospitals but none of them got back to me!!

[nicolacurrie]

yeah, would be, i read all those info sheets on complimentary therapy that the MS centre gave me, looks so useful. My bio teacher is always going on about how they really help too

nic xx :p

[elliottsimpson]

OK. I'll copy this thread to Tricia and see if she's willing / able to help. Watch this space.

Elliott

[Real D]

Complementary therapies are a very valable resource - although I would be happier if they would submit them to more research and testing, or at least stop places like Holland and Barrett selling them to anyone and everyone without checking suitability.

The problem is that a large number of herbal remedies are metabolic stimulants (or whatever the phrase is) and can affect other medication to a varying degree. For example I'm sure you all know St Johns Wart and it's effects on medication but did you know that it is almost as good an anti-coagulant as warfarin or aspirin. A lady who works at a local private cosmetic treatment clinic that does face lifts etc. was telling me that they had to add herbal remedies to their list of things to stop prior to operation as one lady bled profusley during a minor proceedure as she didn't consider her St Johns Wart to be medication!

Anyway - I would be interested to know if there are any homoeopathic remedies for pain that work as most homoeopathic substances have little or no effect on other medicsation and are safe in most stages of pregnancy

Any of you willing to do some leg work for me and we can share what - if anything we find?

Bye 4 now
Les

[andrewbaillie]

Depends what you mean by 'leg-work'!

[jojo]

My local library has lots of books on homeopathy so i can look them up and find out for you!I Like a challenge i do !!!

[jojo]

Hi theres a website for pain support using complementary medicine. It tels you aobut lots of different therapies and you can contact a qualified homeopathist for advice.

Its http://www.painsupport.co.uk

Hope this helps!

[Real D]

Thanks for that Jojo.

All I mean by 'leg work' is a quick can can - no seriously!
My only real resource is the internet as our local library doesn't even have a medical dictionary! so I was wondering if any interested people would want to look at books, journals etc and then share what they find!


Bye 4 now
past my bed time!