World News

A round-up of the latest medically-related news from around the globe by Gary Culliton.

Doctors reject NHS pay freeze proposal

The British Medical Association (BMA) has rejected a proposal to suspend pay increments for all NHS staff in England.

Health service workers in Britain are already subject to a two-year pay freeze, but under proposals from NHS employers, are being asked to agree a further cut and forego their incremental pay increases.

In its formal response to NHS employers, the BMA said: “After consultation with our members, the overwhelming response was that the BMA should not sign up to the proposed national framework to allow local freezing of incremental pay progression.”

Dr Hamish Meldrum, Chairman of Council at the BMA, said: “Obviously these are difficult times and NHS staff are already working extremely hard to provide services as efficiently as possible. At a time of rising inflation, their pay has been frozen for two years, and this latest proposal would amount to a further, severe real-terms cut.

“While bankers are to be allowed to continue to receive massive bonuses, it is absolutely perverse to penalise the dedicated and hard-working staff who keep the NHS running.

“The service is about to undergo an expensive restructuring, and there are many other areas where savings could be made in the NHS, such as the costly Private Finance Initiative,” said Dr Meldrum.

In December, NHS employers wrote to the trade unions on the NHS Staff Council and the BMA proposing that local NHS organisations would be allowed to freeze incremental pay progression for all groups of staff in return for a commitment to a guarantee of no compulsory redundancies, where possible.

Lawlessness preventing care

The World Medical Association (WMA) has appealed to the Mexican government to restore order in the north Mexican city of Ciudad Juarez where physicians are reportedly being “blackmailed, kidnapped and killed” in drug-related violence.

Three medical workers have been killed and 11 were kidnapped last year.

Dr Federico Marin, the President of the Mexican Medical Association, has urged the WMA to intervene to help the physicians in Juarez.

He told the WMA: “Due to the escalating violence and now the kidnapping of physicians, it has become impossible for the physicians in Juarez to provide medical care without threat to themselves. They have had to organise a work stoppage to bring attention to this issue.”

Dr Wonchat Subhachaturas, President of the WMA, strongly condemned the violence facing doctors. “Physicians have an ethical duty to care for their patients and governments have a duty to ensure that appropriate conditions exist to allow physicians to care for their patients. The situation in Juarez appears to be out of control, threatening physicians and preventing them from carrying out their clinical work. The government’s inability to curtail drug-cartel violence is unacceptable.”

Health reforms ‘make sense’ for the US economy

With congressional Republicans expected to push for the repeal of healthcare reform, major American business and healthcare leaders have said that reform is forging ahead because it “makes sense for the nation’s economy”.

The President of the American Medical Association (AMA), Dr Cecil Wilson, said at a conference in Miami that the AMA continues to support the Affordable Care Act, and has urged “improvements where improvements are needed”, such as changes in malpractice laws and larger payments from Medicare.

The Association is urging the nation’s doctors to get involved in forming regulations that will provide details of the reforms.

The President of the American Hospital Association (AHA), Richard Umbdenstock, said US hospitals continued to firmly support the need for reform because their emergency rooms (ERs) were now providing more than $35 billion a year in uncompensated care, mostly to the 50 million Americans who don’t have coverage and often use ERs as their sole source of healthcare.

He said the AHA had submitted a brief supporting the US government in the court case filed by almost two dozen states challenging the new healthcare law on constitutional grounds because the law required virtually everyone to have health insurance.

Plans to monitor health workers’ EU movement

There is a clear need to monitor the movement of health professionals across Europe, Hungary’s Minister of State for Health has said.

The proposed health priorities of the Hungarian Presidency of the EU — which runs from January to June this year — include mobility of health professionals. The country wants its Presidency to “balance free movement with equity in access to high-quality healthcare”, and will stress “need-driven training” and improving the personnel retention capacities of national health services.

“There is a need for enhanced co-operation at EU level to address health workforce shortages across the EU,” said Dr Miklós Szócska. Hungary’s Minister of State for Health. “There is a clear need to monitor the movement of health professionals.”

The Hungarian Presidency’s over-arching theme in health will be ‘Patient and Professional Pathways in Europe’. The main legislative proposals in the pipeline include a draft directive on patients’ rights to cross-border healthcare. Hungary will seek to promote enhanced co-operation among Member States in this area.

There is also to be a pharmaceuticals package to tackle falsified medicines, while Dr Szócska has also highlighted a definite need for new models of efficient healthcare and for scarce investment resources to be used efficiently.

Throughout the Presidency, meetings will be held and evaluated on mental health, childhood vaccination, health promotion and disease prevention, IT-supported evidence-based health policy, telemedicine and data.

The WHO is supporting a conference on childhood immunisation, ‘Healthier Future for our Children’, on March 3 and 4, and will be providing expertise on the mobility of health professionals for the conference ‘Patient and Professional Pathways in Europe’ on April 4 and 5.

A ministerial conference on e-health will take place on May 10-12.

Doctors ‘satisfied’ with their jobs

Most doctors in Australia are moderately or very satisfied with their jobs, according to new research published in the Medical Journal of Australia.

The study was funded by the National Health and Medical Research Council (NHMRC) and carried out by Dr Catherine Joyce, Senior Lecturer for the Department of Epidemiology and Preventative Medicine at Monash University, Melbourne, who along with her co-authors from Monash and the University of Melbourne, investigated whether levels of job satisfaction and determinants of satisfaction differed bet-ween Australian GPs, specialists, specialists-in-training and hospital non-specialists.

Dr Joyce said that most doctors were moderately or very satisfied with their jobs and there was no significant difference in job satisfaction between GPs, specialists and specialists-in-training. However, hospital non-specialists appeared to be less satisfied than GPs.

Specialists were most likely to be very satisfied (37.5 per cent), followed by GPs (32.7 per cent), specialists-in-training (21.4 per cent) and hospital non-specialists (16.9 per cent).

Fewer than 2 per cent of doctors in each group were very dissatisfied, but 12 per cent of hospital non-specialists were moderately dissatisfied compared with 7 to 8 per cent for other doctors. Dr Joyce said that having a professional support network was strongly associated with job satisfaction.

Outbreak of ‘mad cow disease’ claims its second victim

The human variant of the brain-wasting ‘mad cow’ disease claimed a second victim in Italy after a middle-aged woman died in hospital in the northwestern port city of Livorno, it has been confirmed.

The local health authority said the 44-year-old Livorno woman was admitted to a city hospice in July in the final stages of her battle against variant Creutzfeldt-Jakob disease (vCJD). Italy’s first case, a Sicilian woman, died in 2002, a year after she contracted the disease. vCJD is the human form of the fatal brain-wasting illness first identified in cattle — BSE, or bovine spongiform encephalopathy. A total of 275 people have been infected with the disease over the past decade: 170 in Britain, the worst-affected country; 25 in France; and four in Ireland.

Meanwhile, German and Swiss researchers have discovered that prions, the infectious agents that trigger CJD and BSE, are transmissible by air. Presented in the journal PLoS Pathogens, the findings could lead to the development of new defensive measures to be implemented by scientists and animal experts.

Researchers have known for some time that prions are transmissible via contaminated surgical instruments, food, milk, saliva, faeces, urine, and blood transfusions, although the latter is a rare occurrence. However, information about whether prions can be transmitted through the air was lacking.

Scientists from the University of Zurich in Switzerland and the Institute of Immunology, Friedrich-Loeffler-Institut, Tübingen in Germany, found that just one minute of exposure to prion-containing aerosols was enough to trigger disease in each mouse subject. Furthermore, the longer they were exposed to the aerosols, the faster the first symptoms of disease emerged.