Staunton-on-Wye School

With political interference and social engineering in state education and with my own children of primary school age, it was inevitable that I would be drawn into campaigning not only for the local district general hospital but also for the local village school.


The school at Staunton-on-Wye, a village close to the Welsh border in Herefordshire, was opened in 1860 and is in a Grade II listed building on three floors. It was originally built with money given to the region by George Jarvis, a local boy who made his fortune in London in the 18th century. The charity still owns the building although the school is now run by the local authority.
The historic buildings and generous surrounding land have served the local children well but are poorly suited to modern safety regulations and inclusion of adults and children with disabilities. Plans were made to move the school to a new building. Land was bought and funds for the new school were secured.
Late last year the local authority announced that it was reconsidering whether to allow the new school to be built because making this excellent school even more attractive to prospective pupils would threaten the viability of less popular schools. Furthermore the local authority argued that demand for school places was generally in decline and wanted to reduce school places by shutting schools.
The logic that a lower standard of state education was preferable to allowing the parents any choice struck me as typical Soviet-style government of the type which gave the lucky folk of East Germany the Trabant car (if they could bribe an official or were in the political ruling class, that is - otherwise they had to wait 15 years). The population trends were based on the 2001 census and have recently been shown to be highly inaccurate and underestimated immigration and the effect of increased birthrate in the indigenous population. We are currently seeing the chaos of this underestimate on midwifery services and we shall see the effect on schools in a few years just as school places are cut.
Deaf to our reasoned arguments the education department is due to announce school closures on the 10th January and we fear the worst.


On the radiology front things have been more positive.
On Monday Gordon Brown announced that the NHS was going to set up screening programs for stroke, heart disease, renal disease, diabetes and aortic aneurysm. Obviously the medical readers will recognise that this is basically meaningless waffle. Screening for stroke, diabetes, heart disease and renal disease presumably means having blood pressure and bloods taken, which I see from a flyer I got with my Clubcard statement this week, is being offered by Tesco for £10 (with a pedometer thrown in) and is already available for nothing from your friendly GP.
Aortic aneurysm screening is more interesting and Gordon was suitably vague. Very large studies published in the last few years have shown screening for AAA is both cost effective (by NHS criteria - less than £36000 per year of life saved) and offers benefit to men in the 65-75 age group. This is only true however if operative mortality is less than 5%. Ultrasound screening of the at risk group is relatively easy - even Mercury Health might be able to manage this with a few hundred imported Eastern European sonographers and it would go some way to compensating them for the loss of the MRI scanning contracts. The treatment of aneurysms however has to be done at a specialist centre with ITU facilities and the extra work would completely overwhelm the system. When I set up Aortascan, our private aortic aneurysm screening service in Hereford, I anticipated that NHS screening would be hyped up and publicised and then inevitably rationed, creating a demand for private scans. This is exactly what seems to be planned. The scans are going to be phased in for 65 year old men some time before 2011. What are the 66-75 year olds going to think about this; after all they are at even higher risk? What about women? The studies are in favour of screening for men but women die of aneurysms too. How is the government going to refuse screening for women without running foul of sex discrimination law and, more importantly for Nulabour, losing popularity?
The Conservative Party website called the announcement "chasing headlines" and allows reader comments on the issue. I am eternally grateful for someone who has posted the information that, instead of waiting for Gordon's largess, private scans are available for £50 at http://www.aortascan.co.uk/
I now have Gordon Brown pumping up demand for our aortic aneurysm screening service and David Cameron carrying an advert for our service on his website! You would have thought, with a team like this behind me, I would be inundated but the only call I had today was a Sun reporter who wanted to interview me. Our hospital corporate affairs director told me to steer clear and despite the lost publicity for our service I thought it was probably good advice. I really don't want any "Hospital Consultants Cash in on Patient Misery" headlines with my photo underneath.

Anyone know what Dr Grumble is up to? He has made his blog private and I don't have permission to view it. Was it something I said?

Scanning charlatans to be brought to order.

While the GMC has taken its eye off the ball in order to apologise on behalf of all doctors for the actions of a mass murderer it has forgotten its original role in protecting the public from quacks and charletans. This has allowed patient-for-profit companies such as Prescan to offer private screening scans with unfounded claims of the benefits and no regard to the risks.
It now looks like the Government may be stepping in to make up for the GMC and the Royal College of Radiologists inaction and are set to introduce legislation to curb the excesses of private screening. Here is an article I found on Medicexchange

Private medical screening faces regulation in UK
by Tim Castle

Companies selling private medical screening face government controls over concerns the tests make patients anxious and put pressure on the National Health Service, a senior medical advisor said on Thursday.

Muir Gray of the government's National Screening Committee (NSC) told medical magazine Pulse that the private health sector needed regulating over the tests.

Medical screening on offer from private firms ranges from cheap cholesterol checks to whole body scans costing thousands of pounds.

"We are thinking of how we control private testing because it's an example of low value activity which generates work for the health service, may cause harm and does not benefit the individual," said Gray, the NSC's programme director.

"Lots of GPs I know are very concerned about people who go to a private clinic for a blood test and then the people who run the private clinic say 'Oh your kidney results look a bit funny -- just go and see your GP'," he added.

Since 1996 the health service has had to submit all new screening programmes to the NSC to ensure they are effective and beneficial to patients.

Gray said private sector screening also needed to be controlled.

"We'll look at different forms of regulation -- some from the Healthcare Commission, some through the Advertising Standards Authority, some through the Office of Fair Trading. It will be an evidence-based regime," Gray said.

"I don't think we've got a proper system of regulation at all for the independent sector," he said.

The Royal College of GPs backed the concerns. "Screening is becoming increasingly popular and is not without hazard if done in an unprepared way," said RCGP chair Mayur Lakhani.

"Working to national standards would bring added peace of mind," he added.

But leading providers of private testing vigorously defended their services.

Private medical group BUPA said more than 80 per cent of its customers had health insurance and so any follow-up tests or treatments were usually covered with little or no impact on the NHS.

"BUPA health assessments provide early detection of many serious and life-threatening diseases from high blood pressure and diabetes to cancers and stroke," said BUPA Wellness Assistant Medical Director Peter Mace.

"They also save NHS resources by dealing with minor problems during the assessment or at subsequent follow-up appointments," he added.

Simply Health, which includes medical insurance company HSA and testing firm Your Health Screening, said it did not offer tests of "dubious value".

"Our screens are based around mainly heart and lung disease, which are widely recognised to have a significant impact on the health of the nation," said Simply Health Chief Medical Officer Malcolm Stone.

The Department of Health said it had yet to receive the NSC's advice on private medical screening, but would consider its recommendations carefully.

Source: Reuters

Dr Ray has dipped his toe into the screening business with private aortic aneurysm scanning. Increased regulation will be unwelcome but the case for screening for aortic aneurysm has already been accepted in the UK and USA and it's just a matter of the government deciding who should be doing it and how they can cope with the entire cohort of 65-75 year old men all arriving for a scan on day one. For £50 quid I would not hang around while they decide how to "manage demand".