Hip Surgery and Prescriptions

Odd combination but I haven't done a post for a while, so I thought I would do a couple of topics together.

Earlier in the year it was reported that thousands of pounds were lost to the NHS due to prescriptions every year i.e. in Wales where prescriptions are free (as in Scotland and Northern Ireland) it was reported that "people in Wales received an average of 22 items on prescription last year, costing the NHS £594m" (http://www.bbc.co.uk/news/uk-wales-politics-14738797).

But the news is that the cost of the prescriptions have risen in England (while the other UK nations stay free). I'm not going to list figures because that would be boring and that's not what matters here really, it's still a fairly low price to pay; but yes, the price has has gone up and that may be an issue for some people i.e. those who have long term conditions who need constant prescriptions. Maybe there should be funding schemes set up to help these people, but then again there is so much funding being lost these days it would be hard to see that happen.

The question is, why can't England have free prescriptions like the rest of the United Kingdom? Well; "The government says abolishing prescription charges in England would leave the NHS £450m short each year" (http://www.bbc.co.uk/news/health-17576096), which is a fair argument but they aren't dealing with the losses they are making in Wales (as illustrated earlier). There were a number of opinions expressed in the comments on the BBC website. Some were for the rises but others were unhappy with the rises and thought that it was 'unfair' (a very common term used in the report). What I suggest is that we be thankful for the NHS and what they do for us for free and we just accept these extra payments. If you are in a critical condition and on the brink of death they will perform life saving surgery without asking any questions, how about that for healthcare. I've been to other countries and seen their standards of healthcare where they can barely put up all the people in a hospital who need treatment. What are people suggesting? That we go private? Then things will be ten times more expensive because healthcare will no longer be good practice, it will be a business, charging people to live because they know that people want one thing; and they will pay anything to keep their lives. Honestly, what do people think is the alternative to what services we have?!

In terms of the hip surgery story, it is much like the PIP breast implant story; "surgeons have been warned to stop using a particular type of metal-on-metal hip implant because it has an 'unacceptably' high failure rate" (http://www.bbc.co.uk/news/health-17590832). The BBC reported that over a 4 year period "10.7%" had to be replaced which is almost 29 out of the "270" who have been given the "Mitch TRC and Accolade" hip replacements. There is a lot of investment and research put into things like hip replacements and other structures that are put into the body. This is because it has to be accepted by the body and also try to act as if it is natural/meant to be there; for example making sure the bones can move with it in place or making sure the metal doesn't rust in the body.

One way of performing hip replacement surgery is to do 'anterior approach' which is said to be better because "rehabilitation is simplified and accelerated, dislocation risk is reduced, leg length is more accurately controlled, and the incision is small" (http://www.hipandpelvis.com/patient_education/totalhip/intro.html). It was interesting to find that (written in a report in 2007) it wasn't the preferable choice of hip surgery in the USA because apparently "there are several reasons: lack of familiarity, traditional teaching, and lack of the necessary instrumentation and equipment" (as above). However the techniques may have improved since the report was written.

Although this is a very long surgical video (almost 2 hours) detailing the whole procedure, if you flick through it you can see the basic outline of how the anterior approach surgery is carried out with a small incision.

To finish, back to the H5N1 story which is raging on in America at the moment; news is out that a "US panel has approved the publication of two controversial H5N1 bird flu studies, after they were revised" (http://www.bbc.co.uk/news/world-us-canada-17569494). There was controversy over whether to release the publications in case bioterrorists got hold of them. But the "panel said the publications no longer revealed details that could lead to abuse by terrorists" (link as above).

News Round Up

A couple of stories, "PIP Breast Implants" and "Worldwide Flu Pandemic?", that I have covered in the last two months have come up again in the news recently with new developments.

Firstly in the "PIP Breast Implant" story, the BBC reported that "Lloyds TSB refunds cost of woman's faulty breast implants" (http://www.bbc.co.uk/news/business-17361122). Lloyds paid out £3,700 to the lady "on the grounds she was sold faulty goods" (http://www.bbc.co.uk/news/business-17361122). This is the first story I can find of someone being refunded the money that they paid for the faulty PIP breasts but the private clinics that fitted them are still refusing to pay out to the patients.

Secondly when I wrote the "Worldwide Flu Pandemic?" story there was a lot of talk at the time of closing/suspending research over risks of the H5N1 escaping and causing a flu pandemic. I then recently read in New Scientist (28th January 2012 (page 6)) that the "controversial flu research is on hold" on the basis that some "experiments could cause the H5N1 bird flu virus to spread more easily." It then went on to say "US bio-security experts say some details must be withheld, in case bioterrorists get hold of them." I'm not so sure about how big the risk of bioterrorism is though.

However, in the Telegraph it was reported "Scientists clone cashmere goats in bid to increase wool production" (http://tinyurl.com/7cztex2). This is a goat that was cloned in India to increase the production of "pashmina wool, or cashmere" (http://tinyurl.com/7cztex2). "Noori was cloned by Dr Riaz Ahmad Shah, a veterinarian in the animal biotechnology centre of Sher-i-Kashmir University and took two years to clone Noori, using the relatively new 'handmade' cloning technique involving only a microscope and a steady hand" (http://tinyurl.com/7cztex2). This is only one in a list of animals that have been cloned, but what about the ethics of cloning?

PIP Breast Implants

I didn't really know a lot about the recent breast implant story but I decided to find out about it...this is what I came up with.

Recently there has been a lot of coverage in the news about PIP (Poly Implant Prothese) breast implants due to "a health scare, after French authorities found a rupture rate of 5% and recommended implants were removed" (http://www.bbc.co.uk/news/health-16395244). Poly Implant Prothese was a French firm that "were banned in 2010, after their implants were found to contain industrial grade silicone gel, rather than medical grade" (http://www.bbc.co.uk/news/health-16395244). This supposedly led to a higher risk of the implants rupturing.

Andrew Lansley, the Health Secretary for England, launched a review, at the beginning of the week, due to the conflicting evidence for the rupture rates of the PIP implants. Some sources claimed that there was only a "1% (rupture rate) - in line with other implants" (statistics from the Medicines and Healthcare products Regulatory Agency (MHRA) (http://www.bbc.co.uk/news/health-16395244). Fergus Walsh, the medical correspondent for the BBC, has written an article at http://www.bbc.co.uk/news/health-16401016 about warnings of the statistics that have been produced and how some of it can be misleading due to the way that the data has been set out and collected.

In essence, this story is about the peoples reaction to the story. "40,000 British women have been fitted with the implants" (http://www.bbc.co.uk/news/health-16395244). Essentially, the data that Andrew Lansley is trying to get is the data that these women want to know; how many British women have had ruptured implants?

The options aren't very good at the moment for the women who have had the PIP implants. "Private clinics are refusing to replace the implants free of charge" (http://tinyurl.com/7w9o556). Looking at Attwood Solicitors website I found that those with the PIP implants can put a claim in for compensation but it's  not guaranteed. They also directed me to other websites for 'patient advice'.

I looked at three of the five websites that they advised the patients to look at;
- Harley Medical Group quoted The Chief Medical Officer (Dame Sally Davies), she said, "there is not enough evidence to recommend routine explantation (removal) of these breast implants". HMG have decided to find out which of their patients were given PIP implants and deal with those people, but have decided not to give free removals. (http://tinyurl.com/6prsrpq).
-Surgicare Medical Group have said that they have not been recommended to remove these implants and say they have been monitoring their rupture rates over several years and have not found any data that is a cause for concern. (http://tinyurl.com/6p7c9x9).
-Transform Cosmetic Surgery Group commented saying that they do not have sufficient data of ruptures in the PIP implants to remove them free of charge for their patients. (http://www.transforminglives.co.uk/latest-news.html).

Andrew Lansley said today that "private clinics that fitted implants have a "moral duty" to remove them" and that "the NHS would pay to remove, but not replace, implants if a private clinic refused" the issue with this is for the taxpayer who will then have to foot the bill; but he then said that "if the NHS was forced to remove an implant "the government would pursue private clinics to seek recovery of our costs" (http://www.bbc.co.uk/news/uk-16523464).