Gary Culliton brings you a round-up of the healthcare-related news making the headlines around the world.
Regional patterns in Europe’s drinking revealed
People in Europe consume more alcohol — 12.5 litres of pure alcohol equivalent per year on average — than in any other part of the world, new data reveal, and how frequently, where and in what context it is consumed influences the effect it has on health.
‘Alcohol in the European Union’, a report by the World Health Organization (WHO) co-sponsored by the European Commission, reveals significant subregional patterns of consumption and health effects across the European Union (EU).
“Europe’s dubious honour of having double the global average alcohol consumption has clear, recognised health consequences for drinkers, those around them and society,” said Zsuzsanna Jakab, WHO Regional Director for Europe.
Although high in all cases compared to the global average, the breakdown of alcohol consumption by subregion reveals the highest consumption in central-eastern and eastern Europe (14.5 litres of pure alcohol per adult, per year), compared to 12.4 litres in central-western and western Europe, 11.2 litres in southern Europe and 10.4 litres in the Nordic countries.
However, when these figures are weighted against the indicators of hazardous drinking, the proportion of drinking outside mealtimes, drinking in public places and irregular, heavy (binge) drinking, they reveal a different picture.
The Nordic countries have a hazardous drinking score of 2.8 (from a range where 1 is least detrimental and 5 is most detrimental), compared to an only slightly higher score of 2.9 for central-eastern and eastern Europe, and significantly above central-western and western Europe (1.5) and southern Europe (1.1).
The standardised alcohol mortality rate per 100,000 population across the EU was 57 for men and 15 for women in 2004.
Yet subregional mortality rates varied widely, from 129 (men) and 27 (women) per 100,000 in central-eastern and eastern Europe, to the lowest rate of 30 (men) and 10 (women) in southern Europe.
In addition to these general differences, specific drinking tendencies in the subregions influence the causes of death. Deaths from cardiovascular diseases (excluding ischaemic heart disease) and injuries are proportionally higher in central-eastern and eastern Europe, owing to the high overall volume consumed in these countries, together with irregular, heavy drinking sessions.
In the Nordic countries, deaths from mental and neurological disorders are proportionally higher, owing to the high prevalence of alcohol dependence and alcohol-use disorders.
Cancer is proportionally higher in southern Europe, as consumption levels were considerably higher two decades ago and cancer often takes a long time to develop.
The New Zealand Medical Association (NZMA) said it strongly supported a policy announced by the government that would enable women on social welfare benefit and their female dependents to access financial assistance, should they choose to use long-acting reversible contraception. The policy will apply to women aged between 16 and 19 years old.
NZMA Chair Dr Paul Ockelford said financial support that improved access to effective contraception would provide women with real choice in managing their fertility.
“The government could look at extending financial assistance to those on a low income, in addition to social welfare beneficiaries, but this is an excellent start,” Dr Ockelford said.
“There are a number of initiatives already in place, some national and others at a District Health Board or Primary Health Organisation level, that improve access to contraception. Some are targeted at specific groups such as young people, for whom poorly-managed fertility has detrimental outcomes. However, this announcement builds on these existing initiatives and will greatly improve access.”
Dr Ockelford added that while there were a number of long-acting methods of contraception on the market, not all were fully funded, which makes them costly and restricts a woman’s options in choosing contraception. Dr Ockelford said that contraception should be provided by the woman’s usual doctor to ensure continuity of care.
The NZ government is investing NZD$1 million (€607,500) over the next four years in special needs grants assistance that will cover the cost of attending medical appointments for women on benefit who chose long-acting reversible contraception. The grant will take effect from July 30 and then more widely from October.
SAS welcomes funding allocation for training
The leader of staff, associate specialist and specialty (SAS) doctors in Scotland, Dr Sue Robertson, has welcomed confirmation that Stg£1.4 million (€1.74m) of funding for training and development opportunities for SAS doctors has been awarded by the Scottish government.
The funding, which was awarded by Scottish Government Health Directorates, will be allocated by NHS Education Scotland and be awarded in stages: £400,000 from April 2012, £500,000 from April 2013 and £500,000 from April 2014.
The spending will be allocated over three years and will allow SAS doctors the opportunity for personal and professional development. This comes three years after similar funding was made available in England.
Dr Robertson said: “I am delighted that this funding has been awarded for the training and development of SAS doctors in Scotland. The contribution of SAS doctors is often overlooked in the health service, despite the growing numbers of our group. We make up a significant proportion of the NHS workforce and the NHS benefits from the service we provide.
“It is therefore imperative that the NHS demonstrates its commitment to the support and development of this important group of doctors and this funding is a positive step in the right direction. It is vital that Scottish Health Boards improve the attractiveness of the specialty doctor grade. By offering the opportunity for career development and progression, they will attract and retain good-quality doctors in these roles and continue to provide a high-quality service for patients in Scotland.”
Call for end to Turkey’s action against medics
Doctors meeting in the Czech Republic as part of the World Medical Association have urged the Turkish government to restore to the Turkish Medical Association the responsibilities for professional autonomy and self-regulation that it recently took from it.
WMA Council members, meeting in Prague, said they were extremely concerned by the Turkish government’s action to reduce drastically the self-governing powers of the medical association given to it by the Turkish parliament in 1953.
The Council called on all physician members of the Turkish parliament to remember their duties as physician leaders and to support the right of the medical profession to autonomy and self-regulation. And it commended the Turkish Medical Association and those members of the Turkish parliament who had challenged their Government. The meeting in Prague heard a plea for help from Turkish physician delegates to the WMA.
They said that as a result of their Government’s decree, their medical association no longer had the authority to establish and issue ethical guidelines for physicians, conduct investigations about alleged malpractice, determine disciplinary sanctions against doctors or develop core curricula for undergraduate or postgraduate medical education.
They were particularly concerned that the government had removed from the medical association’s mandate the words to ensure “that the medical profession is practiced and promoted in line with public and individual well-being and benefit”. As a result of this, the Association could no longer challenge actions that adversely affected the right to health, the provision of healthcare, public health, and individual patient well-being. This diminished the independence of physicians, as well as the health of their patients, the WMA doctors said.
The Australian government did the right thing by sparing health from broad funding cuts to provide a budget for tough economic times and to fund a budget surplus, doctors in Australia have stated.
Australian Medical Association President Dr Steven Hambleton welcomed new funding for aged care, bowel cancer screening, dental services, health infrastructure and electronic health initiatives.
“The changes to the Extended Medicare Safety Net (EMSN) appear to have been based on clinical and economic evidence and do not involve services or procedures that are regularly required by families,” said Dr Hambleton.
However he added: “We have strong objections to changes to Practice Incentive Payments (PIP). PIP cuts to GPs will have a doubly-negative impact on the health system by penalising GPs for not meeting new higher targets for cervical cancer screening and specialised diabetes care and also by removing incentives for immunisation.”
The Centers for Medicare and Medicaid Services (CMS) in the US has proposed delaying the ICD-10 diagnosis code implementation date until October 1, 2014.
The postponement is the first of many steps that regulators need to take to reduce the number of costly, time-consuming regulatory burdens that doctors are shouldering, the American Medical Association (AMA) has said.
“The AMA is reviewing the proposed rule and will issue formal comments to CMS on the delayed ICD-10 deadline, as well as the standard unique health plan identifier proposed in the same rule,” said Dr Peter W Carmel, AMA President.
“A robust, unique health plan identifier is an administrative simplification solution that has the potential to bring about significant cost-savings by eliminating the ambiguity that makes healthcare transactions so costly today.”