World News

Northern Ireland

Staff praised for response to H1N1

By Gary Culliton

gary.culliton@imt.ie

The Chief Medical Officer in the North, Dr Michael McBride, has expressed sympathy for the relatives of the 19 people who died as a result of the H1N1 pandemic and praised staff for their response to the outbreak.

“I want to remember those people who contracted the H1N1 virus and were extremely ill or who died,” said Dr McBride. “Our sympathies go out to those bereaved families and relatives who today continue to live with the consequences of the H1N1 pandemic.”

Speaking as a report on the Northern Ireland response to swine flu was published, Dr McBride praised staff throughout the health service for the way they responded to last year’s pandemic.

He said: “The way in which all staff within and across organisations uni-ted against a common threat in the interest of the public was most impressive. People showed courage and leadership and were always ready to go the extra mile.”

Reflecting on how Northern Ireland may respond to any fut-ure pandemic, he added: “We have learnt a lot during this pandemic and those valuable lessons must be built into our future planning. However, it must be recognised that even the most comprehensive plans can only be generic and will need to be tailored to the new pandemic virus as its behaviour and characteristics become known.”

Earlier this month, the Pub-lic Health Agency (PHA) in Northern Ireland announced that a child with confirmed flu infection, who attended a school for children with special needs, died. “This death is a reminder that flu infection can cause serious complications, and indeed death, in those with certain underlying medical conditions,” the Agency stated.

Children who attend schools for those with severe learning difficulties should receive flu vaccine this year and the PHA has written to their parents and to all GPs, asking for them to be immunised as soon as possible.

While there is no evidence at present that flu is circulating widely in the community in the North, it is impossible to predict when it will, the HPA added.

“We would advise all those who are eligible for flu immunisation to make sure they get it as soon as possible.”

USA

Doctors urged to stop inaccurate insurance claims

By Gary Culliton

gary.culliton@imt.ie

The American Medical Association (AMA) has urged physicians to take action this autumn against inaccurate payments from private health insurers and has designated November as ‘Heal that Claim’ month.

The Association is now supplying physicians with tools to fight “flawed and inefficient claims processing” by various US health insurers.

One in five medical claims is processed inaccurately by commercial health insurers, according to the AMA’s National Health Insurer Report Card.

A 20 per cent error rate represents an “intolerable level” of inefficiency that wastes an estimated $15.5 billion annually, the AMA has claimed.

The administrative costs of ensuring proper insurance payments also places a heavy burden on doctors and can consume up to 14 per cent of their earned revenue, the Association added.

“The AMA’s goal is to significantly reduce the administrative costs of processing claims from 14 per cent to 1 per cent and allow doctors to focus on caring for patients instead of battling health insurers over delayed, denied or short-changed medical claims,” said AMA President Dr Cecil B Wilson.

November is an ideal time for physicians to bolster their efforts at appealing inappropriately-denied claims, the Association added, since health insurers often increase claim denials during the last quarter of the year.

The AMA is helping doctors overcome claims obstacles by offering easy-to-use online resources to help prepare, track and appeal claims. These resources include template appeal letters, printable checklists and logs that help them simplify their claims management systems.

Republic of Ireland

HSE is asked to endorse WHO recruitment ethics

By Lloyd Mudiwa

lloyd.mudiwa@imt.ie

The IMO has asked the HSE to endorse World Health Organization guidelines for the ethical recruitment of health workers, IMT has learned.

IMO President Prof Seán Tierney revealed that the IMO wrote to the HSE Human Resources Director Seán McGrath a fortnight ago, requesting that the HSE endorse the guidelines. “The key principle that we are seeking endorsement on is that doctors who are recruited from abroad to work in a health service in a higher-income country should, among other things, be assured that they get professional career development/structured training so that they can then eventually go and transfer something back to their countries,” he elaborated.

Arguably, as part of the WHO guidelines, Ireland would also commit to investing in training schemes in those countries, Prof Tierney added.

He commented: “In fairness, Irish Aid has already done that through a number of initiatives, including one that I am involved in through the RCSI and the recently-formed College of Surgeons of East, Central and Southern Africa [COSECSA] to try and develop surgical training and services in nine countries in the region.

“So I think Ireland can hold its head up in relation to some of those issues, though we do need a clear commitment that doctors recruited from abroad, either in the past or future, should have proper structured training posts, even though they may be outside those training schemes.”

Prof Tierney, who is Professor of Surgical Informatics at the RCSI, also runs the RCSI School for Surgeons, an online learning programme for surgical trainees currently being piloted in Africa.

UK

Rethink urged on immigration cap

By Gary Culliton

gary.culliton@imt.ie

The United Kingdom’s cap on immigration has been “rushed through” with “insufficient attention” to how it will work in practice, the British Medical Association (BMA) has warned.

The doctors’ union has urged the UK government to rethink its immigration cap in response to the recent Home Affairs Committee report on the topic.

Dr Terry John, Chairman of the BMA’s International Committee, said: “The government needs to rethink its plans to introduce an annual cap on immigration to take into account the impact these changes will have on the NHS. The BMA shares the Home Affairs Committee’s concern that the immigration cap has been rushed through.”

He stressed that the UK relied on doctors from outside the EU to fully staff the NHS. “We are particularly concerned that international graduates from UK medical schools may be unable to continue training. It is estimated that around 500 international medical students graduate from UK medical schools each year. These doctors are already factored into workforce planning and it would be a huge loss to the NHS if they were not able to work in the UK.”

Dr John added that the interim cap on skilled migration had already made it more difficult for employers to secure sufficient sponsorship certificates to meet their workforce needs. A sponsorship certificate is a ‘virtual document’, with a unique reference number, which an employer issues to a migrant so that they can apply for permission to enter the UK.

“The imposition of a permanent cap is likely to make the problem worse,” Dr John warned.

Doctors stand up for medical ethics

By Gary Culliton

gary.culliton@imt.ie

Physicians cannot be compelled to participate in any punitive or judicial action or to administer diagnostic treatment that is not medically justified, such as sedatives to facilitate easy deportation from a country, the annual General Assembly of the World Medical Association (WMA) in Vancouver, Canada, agreed last month.

National medical associations were urged to support and promote the right of all people to receive medical care on the basis of clinical need alone and to speak out against legislation and practices that are in opposition to this “fundamental right”, the WMA delegates agreed.

In a statement revising its policy, the WMA said that refugees, refused asylum seekers and undocumented migrants, as well as internally-displaced persons in all regions, were among the most vulnerable in society.

International codes of human rights and medical ethics declared that all people were entitled without discrimination to appropriate medical care, the Association added.

Canada

WMA elects its first Thai President

By Gary Culliton

gary.culliton@imt.ie

Dr Wonchat Subhachaturas, President Elect of the Medical Association of Thailand, has been elected President of the World Medical Association (WMA) for 2010/11 and becomes the first doctor from Thailand to hold the post.

A neurosurgeon who did his medical training in Bangkok and worked for many years at the city’s Central Hospital before moving to Charoenkrung Hospital, where he became Director, Dr Subhachaturas was deputy secretary of the Bangkok Metropolitan Administration and currently works at the Thai Health Professional Alliance Against Tobacco.

Dr José Liuz Gomes do Amaral, President of the Brazilian Medical Association, was elected President Elect of the Association. He will become the third Brazilian to become President when he takes up the post at the Association’s annual Assembly in Montevideo, Uruguay, next year.  Dr Amaral is an anaesthesiologist and specialist in critical care in São Paulo’s Santa Helena Hospital.

The annual General Assembly of the WMA was held in Vancouver, Canada, from October 13 to 16 and was attended by physician representatives from 50 national medical associations.

Haiti

Cholera strain traced back to South Asia

By Gary Culliton

gary.culliton@imt.ie

The Haitian Ministry of Public Health and Population has received the results of laboratory testing, showing that the cholera strain linked to the current outbreak in the Caribbean country is most similar to cholera strains found in South Asia.

The findings were reported as part of laboratory collaboration between the National Public Health Laboratory (NPHL) in Haiti and the US Centers for Disease Control and Prevention (CDC) in Atlanta. “This strain was transmitted by contaminated food or water or an infected person,” said Minister of Health Dr Alex Larsen.

In most instances, cholera does not spread widely within a country if drinking water and sewage treatment are adequate. When water and sewage treatment are inadequate, as in post-earthquake Haiti, cholera can spread rapidly. “Our primary focus here is to save lives and control the spread of disease,” said CDC medical epidemiologist Dr Jordan Tappero, who is leading the CDC cholera response team in Haiti.

The Haitian Ministry of Public Health and Population is prioritising measures to protect families at the community level, strengthen primary care centres and establish a network of special cholera treatment facilities.