Tuesday, 6 January 2009
Ageing with Grace - The Nun Study
One of the main health stories today, was an appeal for people to donate their brains to science to help with the study of diseases like Alzheimers and Parkinsons. Brain donation is relatively rare and there are various theories as to why this is the case. Some think that because it is so tied up with personality that there is a reluctance to do so; others that it is because people get donation of organs and donation to medical science mixed up. But maybe it's the simplest reason of all; that the scientists didn't think to ask. This story reminded me of a scientist who did ask, and who now conducts one of the most comprehensive longitudinal studies of ageing; the nun study.
In 1986, Dr David Snowdon, an assistant professor in epidemiology at the University of Minnesota, was looking for a research project to consolidate his position at the university. He happened to get into a conversation with a graduate who was also a nun, and she suggested that he do a research project involving the nuns at her convent in Munkato, Minn. He was reluctant at first, but was persuaded and the project that he chose was to study Alzheimers and the effects of ageing on the brain. There was only one problem; studying Alzheimers meant studying brains, which meant the participants would have to agree to donate their brains after death to the project. On the day that he went up to the convent he was very nervous, but he explained what he was doing and the possible benefits it could have. The ice was broken when one nun piped up, 'Well, he can have my brain! I won't need it when I'm six feet under!' In total, 678 nuns from seven Notre Dame convents signed up for the project. Information about keeping your brain active, the risk factor involving head injury and stroke in precipitating Alzheimers, the function of folic acid and spotting a risk before the disease starts, all come from this study.
Research into disease requires money, but it also requires the good will and generosity of research volunteers. If there is ever a cure for this wretched disease, it will be because of the goodwill of people like the Notre Dame nuns. Maybe it's time we followed their example. After all, are you going to need your brain when you're six feet under?
Friday, 2 January 2009
It's the Bed Numbers, Stupid
At the moment, I am enjoying a quiet holiday somewhere in the north of Norway. Wine is plentiful, there is snow on the ground and I have just sampled smoked lamb ribs, which is a traditional dish here at New Year. I did not intend to begin blogging again until I got back to Scotland. Then I saw this article in the Herald about an exchange between Labour and the SNP about people getting turned away from Hairmyres and Wishaw A&E. It's all the fault of the Scottish Government apparently for not putting in a £100m investment package that was planned for them under Labour's brillant plans to downgrade Monklands.
I know I shouldn't reply to this. I know I should sit back, have an extra sip of the 10 year Rioja that we're drinking just now, and let it roll over me. But it's a bit like a car crash. You know that you shouldn't slow down to look at it..but you ..just do. And this kind of blatant politicing is like an itch I can't scratch. So let's start off with an unbiased considered statment.
Labour, you are talking absolute tosh on health. You have been talking absolute tosh for the past few years on health and you have not stopped, even when everyone from Allyson Pollock to John Lister have told you so. You have been found wanting and put out of government, but like a whining child, you have always got to be right, you have always got to have the last word and the last word has always got to be abusive. You should be ashamed of yourself and you should grow up.
Now to this issue. I find it very hard to believe that Labour do not already know the answer to the question that they put to Nicola Sturgeon over A&E refusals but let me sum it up; it's the bed numbers, stupid.
When Hairmyres was rebuilt on its original site and Wishaw General was built as a new hospital, they were built under PFI. PFI is prohibitively expensive, so one of the ways of saving money is to build the hospitals smaller. This means physically less space to put beds in. Which means a reduction in beds. NHS Lanarkshire lost 300 acute beds in total across the authority. Hairmyres has been running at 99% capacity since day one (85% occupancy is considered the safe rate for turnaround to control infection) and Wishaw has had similar problems. Now, where do they send these patients when they can't admit them? Guess what, they send them to Monklands. Yes, the hospital whose A&E Labour wanted to shut. Just as well that didn't go ahead, isn't it?
We are not the only people plagued with this problem. Reduced bed numbers are a common feature of PFI hospitals, as detailed in the excellent report, 'The PFI Experience' and bednumbers have been reduced across Scotland as a whole. This makes keeping a rein on infection very difficult and it means longer waiting lists for non emergency surgery. That is the problem.
Now to this £100 million nonsense. This was money that was promised for the upgrading of primary services in Lanarkshire, for health centres, the non-existent cancer centre at Monklands and the provision of 'community casualty units in rural areas to make up for an A&E being shut. This amount went up to £300 million at one point, as protests about Monklands grew more vociferous. The trouble with the money was that it was a promise, not a reality. And long before the SNP came to power, the plans for the new mental health services and the cancer centre at Monklands were being kicked into the long grass. I doubt that there was any real intention to enact the initial plans and as the money was not ring-fenced, it would probably all have gone to the rack renting racket that is PFI. It's swallowed everything else here.
I am someone who is political. I am not usually party political; I judge policies on their merits and statements on their truthfullness. But as it is New Year I have a suggestion for a New Year resolution for Labour.
You have lost the argument on health. You have been proved wrong by the chaos that has resulted, whether that is the white elephant of Stracathro, the crippling debt of PFI, the medical training applications shambles or the IT project which has cost a fortune and doesn't work. Stop opening your mouth to let your belly rumble. Use your period in the wilderness to reflect on what you have done and show some humility. Maybe, maybe just then, you will have a useful part to play with the rest of us in picking up the pieces of the NHS, and maybe we might still have a public health service in ten years time. Indulge in the kind of sour grapes politics that this argument represents and you will stay exactly where you are and what you are; a party full of sound and fury, signifying nothing.
Right, where's the Laphroig? I need a double..`
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