Lloyd Mudiwa, Aoife Connors and Gary Culliton bring you a round-up of the latest healthcare-related news from around the globe.
The British Medical Association (BMA) has said laws allowing doctors to work anywhere in Europe must be speedily updated to protect patients.
Doctors’ leaders have told the European Commission (EC) that existing rules covering the free movement of medical professionals were no longer fit for purpose. They want changes, including improvements to fitness to practise procedures.
The Commission is considering revisions to its directive on the mutual recognition of professional qualifications, under which European Economic Area (EEA) medical qualifications are valid across Europe, enabling EEA doctors to seek work in any country in the area.
In a submission on the proposals, the BMA insists it is vital any simplification of the directive “does not dilute checks and balances that enable competent authorities such as the General Medical Council to regulate doctors effectively and ensure patient safety”.
The BMA also wants the Commission to introduce a legal duty on medical regulators to share registration and fitness-to-practise information proactively with each other.
According to the BMA, data protection regulations preventing EU member states from sharing information must be addressed as a matter of urgency.
They further sought clarification around testing of language proficiency of EEA doctors. “It is essential that doctors are able to communicate appropriately with their patients and colleagues, and that the regulatory authorities are able to assess the fitness to practise of each doctor in their jurisdiction.”
Responsibility for language testing currently rests with employers.
The BMA also wants better regulation of services provided online, and a strengthened code of conduct for regulators allowing them to demand original and officially translated copies of documents to prevent fraudulent applications or the identity theft of verified doctors.
The EC is expected to produce a green paper on the issue this autumn, with legislation likely to follow in 2012.
The Australian Medical Association (AMA) has said its government’s spend in the previous four years on public hospitals has delivered “a small return on a huge investment”, with the hospitals effectively stuck in a holding pattern.
AMA president Dr Andrew Pesce said the latest hospitals report from the Australian Institute of Health and Welfare (AIHW) showed that on all the basic measures, there has been no real change in the capacity of public hospitals to meet demand.
“There has not been much bang for the extra bucks spent on our hospitals,” Dr Pesce said, adding that doctors working in public hospitals across Australia knew there had been little marked improvement in the capacity of public hospitals to meet growing demand, and this had been confirmed by the AIHW report.
“The 378 new public hospital beds opened in 2009-10 is a big improvement on the 11 new beds opened in the previous year, but this is a long way short of providing the 85 per cent bed occupancy that allows for the safest and most efficient treatment. The number of beds per 1,000 population is still on a steady decline, so the capacity of public hospitals is not keeping pace with the population.”
Dr Pesce said there was no change in the proportion of patients seen in emergency departments within the recommended times for their triage category.
While US policymakers hope the initial ‘Welcome to Medicare’ examination will help physicians get new and returning beneficiaries hooked on preventative care, most doctors are not taking the bait, the American Medical Association has stated.
The vast majority of Medicare patients will be eligible for free wellness exams in 2011. But unless there is a remarkable turnaround, tens of millions of eligible patients will not get one.
The initial wellness visit for new programme beneficiaries, known as the ‘Welcome to Medicare’ exam, has been available since 2005, while the annual wellness visit, which started in 2011, is designed to serve as a regular checkup for established Medicare patients.
Even though more than 2 million seniors become eligible for Medicare every year, only about 100,000 of the initial exams are billed to the US Federal government each year.
The Centers for Medicare and Medicaid Services reported that 298,000 beneficiaries received the annual checkup service between January 1 and March 23.
Unless the uptake rate increases significantly this year, that puts Medicare on track to cover the visits for only about 1.3 million people — well shy of the more than 46 million who are eligible to receive one.
A lack of physician awareness might be one reason the exams are not more popular. However, many doctors who know about the services also do not offer them.
Some point to the time and resources they must expend to offer exams they consider to be of limited value, according to the AMA, which says the concept of the new wellness exam feels counter-intuitive to some doctors who are already providing annual checkups that involve more diagnosis and less record-keeping.
The United Nations Commission on Information and Accountability for Women’s and Children’s Health has agreed on new recommendations to improve health accountability, in a bid to save the lives of more women and children in developing countries.
The 10 recommendations are designed to ensure that resources are spent more effectively to save lives.
They include specific approaches to help countries develop better ways of getting key health data to improve their understanding of health needs and where resources should be focused.
Other recommendations include developing a co-ordinated system for tracking health spending on women and children. An oversight mechanism will be created as a national and global feedback mechanism to support the continuous improvement and delivery of health services for women and children.
The Commission has recommended monitoring progress based on specific indicators such as the number of women who have access to skilled care during childbirth and the number of children treated for pneumonia.
UN Secretary General Ban Ki-moon has tasked the Commission with developing a mechanism for holding donors accountable for their pledges and holding countries responsible for how money is spent.
The main aim is to improve transparency, ensure consistency in reporting and more effectively track resources.
Non-communicable diseases are the leading cause of death and are on the increase, according to the Global Status Report on Non-communicable Diseases (NCDs) launched on April 27 in Moscow.
The report was released during the WHO Global Forum on NCDs and provided direct feedback to the First Global Ministerial Conference on Healthy Lifestyles and NCD Control, organised by the Russian Federation and the WHO.
In 2008, 36.1 million people died from conditions such as heart disease, strokes, chronic lung disease, cancers and diabetes. Almost 80 per cent of these deaths occurred in low and middle-income countries.
However, the report states that millions of such deaths can be prevented by stronger implementation of new measures that exist, including policies that promote government-wide action against NCDs such as: stronger anti-tobacco controls, promoting healthier diets, physical activity, reducing harmful use of alcohol, along with improving people’s access to essential healthcare.
The Global Status Report on NCDs provides global, regional and country-specific statistics and evidence that’s needed to launch a more forceful response to the growing threat posed by such chronic NCDs.
It also provides a baseline to chart future NCD trends and responses in countries, including the socio-economic impacts.
Cardiovascular diseases account for most NCD deaths, or 1.7 million people annually, followed by cancer, 7.6 million; respiratory disease, 4.2 million; and diabetes, 1.3 million, the report shows. These four groups of disease account for around 80 per cent of all NCD deaths, and four common risk factors: tobacco use; inadequate physical inactivity; the harmful use of alcohol; and poor diets.
This new report is a key part of the 2008-2013 Action Plan for the implementation of the WHO Global Strategy on the Prevention and Control of Non-communicable Diseases.
By Gary Culliton
The World Medical Association (WMA) has urged other countries to follow Australia’s lead in introducing plain packaging for cigarettes.
Dr Mukesh Haikerwal, Chair of the WMA Council, said he and his colleagues were delighted with Australia’s announcement. “The WMA welcomes the stringent measures of the Australian Government to progress tobacco control and we hope this will be followed by other nations,” said Dr Haikerwal.
At a three-day Council meeting in Sydney (April 7-9), WMA delegates agreed to recommend to their annual Assembly in October plans designed to strengthen the Association’s anti-tobacco policy to combat moves by the tobacco industry to make its products more appealing to young people.
The WMA said it would step up its fight against smoking with proposals to ban the production, distribution and sale of candy products that depict or resemble tobacco products.
The Council delegates argued that the WMA should extend its policy to include restrictions on smokeless tobacco and tobacco-derived products, which would include prohibiting all government subsidies for tobacco-derived products.
Dr Ardis Hoven, chair of the Board of the American Medical Association, said the tobacco industry was now involved in aggressively promoting new forms of cigarette products, such as smokeless tobacco and electronic cigarettes, in shops and on the internet, in a move designed to attract young people.
He said the WMA needed to respond strongly.