The ConDems NHS (What Do We Make Of It So Far).

Well er... not a lot!

Six months down the line from the lack of any decisive victory over, well anyone, lets look at what has been achieved and what is planned.

GP Commissioning has been lauded, as the only way forward for the majority of Healthcare within the NHS. It is the Lansley answer, to all the previous 'top down', centralised decision process, that hallmarked the reign of NuLabour, but is largely the path that had already been ordained by Andy Burnham, before his demise as Health Secretary (and what a piss poor one he was). There is some 'spin' to this. GP's are the front line of all Medicine and Healthcare. The first point of contact (except for A&E), where the public becomes patient. Thus, it is posited that they should control the purse strings and commission any services, or treatments that, spring from that Primary Care role. In the process, we largely rid ourselves of the cumbersome and expensive, Primary Care Trusts (PCT). Except of course, that for all their faults the PCT's did most of the Admin, the Commissioning and Governance. And of course they provided the 'out of hours' cover the GP's wriggled out of for 6% of salary.

If then, the GP's are to cover all of this, they will have to undergo a step change in roles. One that they have little or no experience of, and, judging by the lack of enthusiasm displayed by many, one they have very little desire to fulfill. They will likely have to engage some of the Managers they have expressed considerable disdain for, or another organisation to undertake all the 'back office' work. Step forward the Private Sector, be it in the form of the 'Big Four' accountant/management bodies, or one of the many Private providers (Welcome to the Boots - Price,Waterhouse,Coopers, Healthcare Consortia, operated on behalf of NHS UK plc). I do not wish to be a merchant of neither doom nor gloom, but a void tends to be filled by the one who is quickest on their feet, and these people are pretty damn quick. When you ( a GP) are floundering in a mire of bureaucracy and red tape; have no real idea of the ramifications of what your new role needs, to give it credibility, with the National body that approves your Consortia; if someone offers you a 'model' that removes the doubt, many will grasp it.

Maybe some will gravitate toward the 'not for profit' social enterprise model, which could be a good thing, but the pitfalls and dangers, not the least of which is the very real possibility of 'inheriting' the debt and forward contracts of the existing PCT's, which Lansley has said he will not cancel or guarantee, may well put you off. Put you off, without the sort of financial 'clout' and dubious, but successful creative accounting capability of a well known Accounting LLP (remember the inspired auditing of the Banks that got us here in the first place).

And what about assuming the role of procurer of the drugs and supplies, now that NICE is to be emasculated? How do you evaluate the claims of 'Big Pharmas' products and devices, in a world of pitfalls and dubious trials, all proclaiming much, but generally delivering very little, except possible death in a bubble pack? How do you evaluate and procure an out of hours service for your patients? Do it yourself? There is a singular lack of enthusiasm to go back to that, I'm sure. Certainly from the sigh of relief that emanated from BMA Towers, when the Government gave it to the PCT's to provide, would lead one to that view. And, I'm pretty sure that giving GP's their 6% back will be met with howls of derision as an inappropriate value for such an onerous task.Will you spend your hard won budget at the local trust Hospital or contract with the ISTC or even BMI for routine operations?

I am not certain that such decisions should, or even could be made effectively by GP's. I am certain that many will not even want to. This is the largest change in Healthcare since the birth of the NHS. Whilst consultation is taking place, it is largely with those organisations, that most feel have failed to deliver a just and fair NHS that addresses inequalities; the GP bodies (see last post). I do have hope; not a lot, because I have little faith in any breed of Politician, especially those that are trying to make me happy, whilst removing hope of any prosperity in the next, how ever many years. I'm not at a time in my life, like many others, where there are years available to me, to observe these policies through to any conclusion.

I despair of the much that is happening. The complete madness of a 'responsibility deal' with the major fast food retailers (McDonald's, Pepsico etc) is akin to placing regulation of game keeping with the poachers. As is enjoining with the major food and drink suppliers, to promote 'health'. That any of these, will actively pursue a policy based upon any motive, other than self interest and profit, is somewhere between naivety and lunacy. They already produce products laced with the toxic, man made, chemicals that have likely caused much of the ailments that modern flesh is heir to. To devolve even more power of damage to these architects of high carbohydrate diets, infiltrated with High Fructose Corn Syrup, Soy fed meats, Hydrolysed Vegetable Protein and other injurious additives is madness of a scale only to be found in the USA. Do we wish to emulate a society where the food lobby guides Government Policy and the Drugs Industry then feeds off the damage? Because that is where we are going. If Lansley and Cameron have their way, that is where we will arrive.

PS This is one view. That from the Black Tower. If nothing else it is amusing.

The Dept. of Health in the Dock (again).

The Editorial in the Lancet this week upbraids both Politicians and Doctors (mainly GP's) for failing to address Healthcare inequalities. It's is not very kind to Health Officials, and targets the Permanent Secretary particularly. In less than edifying language Margaret Hodge, was scathing about the failure to deliver the promise of NuLabour to remove these inequalities, despite the vast increase in the NHS budget and thirteen years of power.


The editorial was particularly strong in it's condemnation of the Profession and GP's in particular, for the vast rewards they have reaped, since 2005, when they took on the new contract. This saw income rise to an average of £105k, with some making £250k, by virtue of the bonuses paid for the achievement of goals within the Quality Outcomes Framework (QOF). These were mainly politically motivated objectives, that saw routine Healthcare reduced to a target culture, whereby GP's could derive payments for taking and recording things like blood pressure, or BMI, for certain patient cohorts. Worst of course, was the need to attain certain levels within QOF to reap a reward, which heralded the 'lipid' testing of perfectly healthy people, and the subsequent dosing of them with statins, or antihypertensives (whether they needed it or not).

Substantively, I agree with the sentiment of the Lancet article, although some of the detail is a bit 'overblown'. After all, some the GP's, who stand accused of indifference to their patients plight, may just have been exercising some scientific 'triage' of the goals set by various QOF's, and found them wanting of evidence of efficacy, and simply ignored them. Well more power to them, but why don't they stand up and be counted? As for Hodge, well she has an appalling record, in voting for all the Blair reforms in Healthcare, including the setting up of Foundation Trusts, yet she has obviously now 'seen the light' and wishes to align with the patient. The report is here.

When the 'blessed' Tony came to power in 1997, he was in a unique position. The majority of the country saw him as a reformer, with an evangelistic zeal, to drag Healthcare and Education into a new dawn, with reforms that were purported to be  based on scientific agenda, not the thinly disguised and hugely expensive, 'privatisation' of these core needs of the populace. Instead, he failed to carry through his promises but gave us the 'spin' of his continuation of the previous lot's desire to sell off the assets we all owned, for a handful of beads and a sack of corn.  Neo-Thatcherite to the core, he embraced private sector solutions to the urgency of improving Health (and Education) that were hugely expensive, and with it spawned legions of highly paid management cadres, who sucked up most of the money, building 'empires' to justify their ludicrous elevation within Healthcare.

He fostered many of the 'Quangos' that the ConDems are now pulling apart, on the premise that Governance was all about measuring process, at the expense of outcomes. The disenchanted Doctors, many of whom hated the rhetoric, failed to champion their patients and saw the chance to better their position by negotiating a new deal that placed them as financial equals to the Consultant cohort. Some at the time (2005) could not believe that they escaped from out of hours cover, for a paltry 6%. One of the senior negotiators for the BMA, even said he thought they were "having a a laugh". And, of course they were, all the way to the Bank! This single act alone hugely increased costs, but more; the outcome of QOF was to elevate costs even more, as the tests to prove it's effect spiralled.

So, money was spent that achieved little of any substance, other than the enrichment of most within the NHS, except the 'coal face' workers, who found themselves more and more, isolated from the patients they were there to serve. Management found ways to cut costs, that deprived patients of standards of care enshrined in that contract we all have with those we pay to help us when we need it. Emerging from this, large numbers of complaints began to arise, that then gave birth to a whole new Bureaucracy, given the task of 'managing' these. Not, I must add resolving them, because that does not seem to have been the objective. Obfuscation, delay, and even lies, were then employed, to prevent the delivery of truth, justice or candour. 

Well, that was then, and this is now. The Coalition has suggested, even promised to change, all that has gone before. But Neo-Thatcherism is not dead, and now lives on in all politicians, with little to separate any from all. Practice Based Commissioning was already being rolled out by Brown's lot, before he lost the election. Calling it GP Commissioning does not change it, although at least it was not wholesale, it was a slow 'rollout'. Wholesale change, may be a good thing, although trying to cut a ludicrous 20% in the process is both unrealistic and unattainable. It will be just the same as before; figures will be produced to prove it's happening, that some Select Committee in five or ten years time, will tell us were untrue. Some very good people will lose their jobs and evidence based Healthcare will continue as before, without any evidence to back it's ludicrous policies. We'll all get fatter, get Diabetes, Heart Disease and Cancer and interventions to allegedly reduce the incidence will fail, just as they have for the last thirty years. The good Doctors will retire early, the bad one's will become leading lights in GP commissioning. Everything will be different, but stay the same.

Oh, and patients; you thought you had been screwed already, now you're really going to be f****d.

Is This How To Run A Railway?

 

No, this post is not about the appalling Railway system of the UK. It is an analogy for the NHS.

As the ConDems savour their power, with increasing confidence, imbued with the enthusiasm of born again Christians, maybe we should compare it to that which occurred, when the major transportation system of the UK was sold off to the highest bidders, ( the lowest, in truth)  for each region, or service. The end result of the Tory plan was a disjointed 'mish mash', of competing companies, supported by ever increasing volumes of Taxpayer Gold, that made millionaires of some, bankrupt  a few, and produced a worse service than we ever saw under the old British Rail. We also saw the rise and demise of Railtrack and its substitution with Network Rail, the governing body of the Industry and owner of the Infrastructure. It is a Company Limited by Guarantee and thus has no Shareholders. The DfT is a member, but does not own it. It pretty much does what it likes because Blair, who set it up, did not want the sort of Governance that had plagued him with other bodies. The result has been a huge increase in accidents, poor or even absent maintenance, overcharging, overcrowding, lack of any real democratic input or control.

So what has this to do with the NHS, one might ask. Well we are going down the same road. NICE is to lose its role of cost benefit analysis and negotiation with 'Big Pharma' the (piss poor) Care Quality Commission will be replaced by Monitor, because all Trusts will become Foundation Trusts. PCT's will become no more, being  replaced with GP Consortia in the role of the Commissioning bodies; poacher and gamekeeper under the same hat. ISTC's, the 'Big Four' accounting and management bodies (PwC, KPMG etc), will be handed roles on a plate, to organise or even provide services,despite their complicity in the debacle of Banking Audit, and the Private Healthcare companies, are 'to be encouraged' (bribed), to bid for contracts, to provide and commission services, for Healthcare. And the useless Complaints System will become a battleground of even more complexity and futility, being hamstrung by the lack of any Public Scrutiny brought about by the constitution of the changes.


Just as in the Railways, there will be a bewildering array of bodies, organisations, some spawned from 'Big Pharma' themselves, all trying to make a profit out of misery and accident. The rigid safety mechanisms overseen by the military precision of the engineers who ruled British Rail (nearly all ex REME engineers) was supplanted by companies who lost lives due to lack of safeguards and planned maintenance. The result has been escalating costs, obscene profits, lack of forward planning and danger to the passenger.


For passenger, substitute patient and you will see what I am getting at.

The Things 'They' Do To Women.

As many who read this blog will know, I am a critic of the current and highly flawed practises perpetrated upon women by Medicine. It is my belief, that many interventions, alleged to be for their good, are in fact counterproductive, and include in these, breast cancer screening, with mammography and the use of HRT  (hormone replacement therapy). I'm also pretty convinced that most of the treatments persued in 'curing' cancer, especially breast (and prostrate cancer), are ineffectual to a large extent, but I'll save that last bit for another day.


Postmenopausal HRT, was hailed as a breakthrough in assisting women adapt to life after child bearing years were over, both in maintaining their femininity and easing, or eliminating the symptomatic 'hot flushes' (flashes for the yanks). This is obviously something many women prized as an outcome, because it seemed like an 'elixer for youth'. Well, it turned out to be something completely different, and for some it was a death sentence. In JAMA yesterday, the results of  an 11 year study of a very large cohort of women was published that concludes, that combined HRT increases breast cancer significantly; well, in the cohort study, it was nearly doubled. Worst still was the fact that the type of cancer was node-positive, not the 'benign' type that 'Big Pharma' had already acknowledged was more likely when on HRT. How any breast cancer can be viewed as such boggles my mind but hey-ho, drug companies often use such terms as their stock in trade. Highly regarded (by me anyway) Paul D. Maher also highlghts this study in his blog today, which may mean great minds think alike, (would that I was as credentialed or clever as he) but maybe not. 

Well, it was already known in 2002, that the Women's Health Initiative Trial (WHI) was halted due to evidence of harm, and that many advocates ('Big Pharma'), refuted this as being purely observational and as such inconclusive. Whilst I still hold to the view, that observation does not prove causation, at the same time, observed harm, is a serious problem.worthy of urgent and serious investigation. After all whilst the use of 'extract of pregnant horse piss' may have afforded women comfort in menopause, it was hardly something worthy of risking one's life to eliminate. Amongst the many charges leveled at HRT in both the 'combined' form and Oestrogen only types are;-

• Heart Disease
• Stroke
• Lung Cancer
• Blood Clots

Insulin Resistence is also attributed as being a highly possible side effect, which may throw some light on the high incidence of Type 2 Diabetes amongst post menopausal females. That's a hypothsesis only, but there does seem to be some anecdotal evidence for this. Once more the drugs industry stands charged with producing dangerous products that do much more harm than good. Well, no change there then!

Acedemic Arrogance in the Matter of CAM.

In the matter of Complimentary and Alternative Medicines (CAM), much has been said by both medical bloggers, Doctors and Clinicians. Such words as 'wibble', 'mumbo-jumbo' and other derogatories, have been usefully employed to deride CAM. And, sections of the protocols employed within CAM, have been highlighted to prove the point. Homeopathy and Acupuncture particularly, have been held up to the light of day, and pronounced as worthless, and without any scientific proof of efficacy. I heartily agree with this view, and would apply it to quite a few other aspects of CAM. But, I do think, that to classify everything outside of mainstream drug protocols and the medical 'mainstream' as useless, is nonsensical, counter productive and further, it is arrogant in the extreme.In many ways, it also flies in the face of a number of treatments already adopted by many Clinicians.

Physiotherapy has become an essential part of recovery protocols, or even primary interventions for many, both in Hospital and in the Community. Yet, it is, in strict terms 'complimentary', to Medicine and Surgery. So get your terms right Doc'. If the use of specific vitamin supplements by Medics is invoked, again you are venturing down this road again. Some will recommend or even prescribe fish oil concentrates, to certain patients (Amcor). This is of course despite the fact, that the NHS will be paying through the nose for an expensive version, of that which can be obtained, 'over the counter' from quality sources. But that's the problem we have with NICE; they often recommend (or don't) the use of particular products based upon flawed or skewed evidence, or simply price.

In the matter of evidence, a lot outside of the 'mainstream', is viewed as being without any evidence of efficacy or safety, when the truth is that there is wealth of well constructed trials, just as good, if not better than those conducted by, or paid for by 'Big Pharma'. It's just that Clinicians pronounce judgement without even bothering to look for them. It used to be a widely used protocol in coronary heart disease, to utilise magnesium both in IV form as well as orally. It is also viewed as a major deficiency, especially in the elderly, and with the concentration in the diet, of 'industrial foods', is also becoming a deficiency in the wider populace. Supplementation, is now the only way to ensure an adequate intake due to it's depletion in the soil and consequently the food grown, and animals who live on it. It is essential for human metabolism and a deficiency, is linked to many diseases as well as CHD. But prescribing it, and taking it is CAM. Yet it is embraced by many, both within and without Medicine. It is also the subject of much research as shown here and and here too.

Moving onto drugs; there are number currently in use that owe their existence to CAM, which of course embraces herbs, vitamins and supplements. Metformin, the drug almost of first use, for Diabetics, is the synthetic form of French Lilac. Statin's, for what use they are, are the result of a poison found in China called Red Yeast Rice, and of course many, if not most of the older drugs in use, especially analgesics, are all based on, or made from natural sources (Opiates). In fact in the early days of medicine there was nothing else, as anyone who has studied its history can attest. In many ways, some herbs can afford results to patients, that are better, or as good as drugs, and usually (but not always) with fewer or no side effects. The problem arises, that treatments, based on this type of medicine, yields little or no benefit to the Drugs Industry.' They' love to 'patent' everything, so as to make money; lots of money. It seems in fact that 'Big Pharma' and some Doctors view disease as an income stream, rather than something to cure, and patients as a means to a handsome livelihood.

Doctors also advocate diets. Diets are part of CAM. Most of that, which they tell the patient, is counterproductive, because they do not keep up to date with research, or slavishly follow the advice of vested interests of the Drugs Industry, which requires dietary input to legitimise its drug protocols. This often flies in the face of common sense (high carb diets for Diabetics) or legitimises heavily flawed, or unproven hypotheses such as 'fat causes heart disease' (see last post), but diets however, are part of CAM, so curb the hypocrisy, Doc' you recommend diet all the time! Just because it's the wrong one does not change this.

There is much within CAM that is wrong, so wrong it boggles the mind. It is full of 'snake oil salesmen', some legitimised (they think) by being actual Doctors, MD's that is, not simply graduates of some obscure institute on the 'net. Some will flog you a pendant, that will change your life, or a bracelet to cure your arthritis. Others will promise you explosive sex if you take their herbal concoction. But beneath it all are some good and honest practitioners, who utilise the best of both schools of thought and will resort to drugs when needed. One particular area dear to my heart, as a Diabetic carer, is the reckless use of antibiotics for Urinary Tract Infections.

A simple treatment with a sugar derivative, called D-Mannose, cures the bulk of UTI's that stem from E-Coli, but by a different mechanism. It simply attaches to the bacteria preventing it adhering to the bladder wall and is flushed out. It cures about 80% of common UTI's

Closed minds. Hubris. They all contribute to the arrogance displayed by many in Medicine. The dismissing of everything outwith drug protocols peddled by 'Big Pharma', or the politicised advocacy of useless or even harmful diets, displays the lack of any real pragmatism in Healthcare. There is some light; some are now looking to supplements such as Vitamin D3 and CoQ10 as a means of supporting patients immune systems. Some will even advocate lifestyle changes as a means of curing rather than simply treating symptoms with spurious drugs that prove to be more dangerous to the patient than the ailment with which they present. More power to them.

There is a place in Medicine for all that is science based, but sometimes a gamble has to made. You can't do a double blind placebo trial in humans for UTI's with D-Mannose. It would be unethical. But I can attest to it working. And I became very seriously ill with it, and had three courses of antibiotics and was diagnosed with possible cancer. It wasn't I'm pleased to say, but I and many others (not all) could be spared that and the NHS much cost if this simple protocol was invoked. There are many others; most inherently benign. Is it not time at least to try a middle road?

Andrew Lansley, Evidence Based Nutrition and the NHS.

Chis Kresser aka the healthy sceptic highlights the fact, that the new 'Dietry Guidelines for Americans' is not an evidence based document in any way. Considering it is the first complete update since 1977, with the intervening years being significant, in that despite the uptake of low fat, high carbohydrate diet, both CVD, CHD and Diabetes have increased dramatically. The Committee, seems to have conveniently ignored this fact in its deliberations and closed it's mind to any view, outwith conventional one's peddled by the moron's that govern Healthcare in the US and of course, in the UK as well. Because it is certain, that these guidelines will form the basis for those recommended for UK citizens be they Diabetic, Obese or suffering from heart disease

 Some scientists, so affronted by the lack of science displayed by the report and its lack of evidence in its conclusions, have seen fit to write a critique. You can read this here.  It is important to do so, to realise the depth of stupidity that is often displayed in advice handed down to the populace by this or indeed almost any Government.


In the UK, we will soon see, the closure of the Food Standards Agency (hurray) with the role being assumed by the Dept. of Health (boo). And we are told by the Secretary of Health, one Mr Lansley that;  “I am committed to improving the public’s health by providing evidence-based advice to support people in making healthier choices. The transfer of nutrition policy in England to the Department of Health means we can give the general public more consistent information". 

I do not know, whether to be pleased to hear this or not. It depends greatly, which evidence he will base this policy upon, and whether there is any real desire by the current coalition, to make a sea change in policy that will effect real improvements in Health, for the populace and at the same time save money, because there is little doubt in my mind that basing criteria for nutrition upon  real evidence based guidelines, will indeed achieve significant cost savings and real improvements in health.

If we are to view some policy decisions already made, such as the 'scrapping' of the piss poor Private Finance Initiative for Schools, which would have seen huge, but 'off balance sheet' costs being borne by council tax payers to fund schools, planned by  'NuLabour', then there is hope. So far this model, for Hospital building has created worse constructs, than would otherwise have been the case, together with huge costs to the Taxpayer. For instance, the new Birmingham 'super' Hospital, as reported in Private Eye, will cost some £2.6bn over 35 years for a build cost of £627m. However in that same journal we learn that despite the criticism leveled at 'NuLabour' for their "flawed PFI model"  by a Mr. Osborne, that there are now "no plans to review the use of the private finance initiative, as a procurement vehicle in the National Health Service".

The future looks even bleaker for justice and candour too. With the emphasis on GP commissioning and Foundation Trusts as the future of Healthcare, we will no longer have any sort of public scrutiny of , well just about everything. Public access, to what will be Private Consortia, in the case of GP's and closed meetings, as is the case with Foundation Trusts, will make the public even less informed than now. Which is little hard to contemplate. As 'social enterprises' they will also be immune to Freedom of Information requests. If the LibCons, really want enjoin with people in discussing our futures, this decidedly seems the wrong way to go about it. Nothing new there then!
  
......     

More Drugs for Diabete's - Back to the Future?

Way back in the mists of time, chemists discovered a glycoside compound from the bark of apple trees that had a profound effect on glucose disposal in Diabetics. This extract, called Phlorizin, brought about glucosuria, which is the excretion of glucose in the urine. It also to some extent also caused polyuria (excessive urination). As these are often symptoms of  Diabetes itself, and as it was only 1835, it took a while for it to be viewed as anything that could be useful. As time went by experiments were undertaken to find a use but it was not until the 1970's that the mechanism of the compound was discovered and named. Sodium-Glucose Co Transporter-2  inhibitor (SGLT2)  is what it became and is the current theme of most research, for yet another drug for Diabetes.

I say yet another, because rather than using the original compound, which was in fact poorly absorbed in the gastro-intestinal tract, 'Big Pharma' needed to come up with a better 'mousetrap' in the form of a synthetic compound that could be patented, so that money could be made. Frankly, I find it a little alarming as the way it works is to inhibit the capability of the kidneys to 'save' glucose from being excreted in the urine. This a process discovered, that the kidneys perform, to conserve vital energy in the body and functions at a certain level. In Diabetics with high circulating glucose in the blood, the kidneys filter out the excess and do not conserve it all, as with normal humans, hence both glucosuria and polyuria are symptomatic in the Diabetic with low level control of hyperglycemia. What these new experimental drugs aim to achieve, is to enhance this phenomena, outwith the normal kidney function, so that the process 'kicks in' at lower levels of concentration. It does this by inhibiting SGLT2 in the kidneys.

 Astra-Zenica are conducting trials of their contribution to this wonderful idea at present; it is called  Dapaglifozin and is being developed in conjunction with Bristol-Myers Squib.What is important is the unintended consequences that may ensue from this, and the effect it may have on kidney function in the longer term. These may be obvious to many Diabetics with a grasp of their problems and the primary one is the enhancement of urinary glucose. All Diabetics are prone to urinary tract infections and genital fungal infections. This is largely because of the high glucose content of their urine, as bacteria and fungi feed on this. Low levels of glucose and acid urine inhibit this but Diabetics struggle to maintain this and, as a consequence get this type of infection and use antibiotics regularly as a result. This of course adds to the problems most already have and exposes them to long term or repeated incidents of UTI's for which ever more drugs are prescribed adding to the polypharma to which they are all subjected. To expose them to even more risk in this area seems somewhat counter productive.

In addition these drugs thus far have not displayed a great deal of success and are viewed very much as an 'add-on' protocol, for use with other hypoglycemic agents, such as metformin. They do enhance the performance of of these agents and lower HbA1c a little, but nothing startling. They also do enhance weight loss to a small extent, which is usually a good thing for a Diabetic, but, is it not about time, that science stopped its constant search, for a fix for something that is easy to stop. Reduce the glucose level at source, by stopping eating carbohydrates to any extent and Diabetics ease the burden on their already overburdened pancreas, and both the need or at least the volume of drugs needed is reduced or even eliminated.Of course that presents a problem for healthcare and especially 'Big Pharma'. So much money is at stake, both for them and for the NHS, which spends in excess of 10% of it's entire budget on Diabetics. The gravy train would halt and quite a few employees would no longer be needed. Turkeys voting for Christmas, I think not!

It also goes to show the panic in the Industry at the moment to come up with new ideas for drugs because patents are fast expiring and little is in the pipeline. There has been nothing of any significance, discovered  in Medicine in nearly twenty years, except more 'me too' drugs or new strains of the old one's. So they are turning once again to the old favourites such as cancer or diabetes. They've peddled useless or near useless and dangerous drugs to these cohorts for years, without any glimmer of a cure and it's costing them billions in compensation for some, such as Avandia, the cost of which has virtually wiped out GlaxoSmithKlines profits for the whole of the last year. Makes your heart bleed does it not?

It would be nice for a change to see research being directed at a cure, for some of these ailments or at least some acknowledgement that lifestyle changes can be just as effective as taking a store cupboard full of dangerous and often self-defeating drugs. Perhaps that is asking for the impossible.