I could spit i'm so mad!!!

[accymel]

Its terrible that nurse n doc have to have security these days, watched a prog that showed the violence that goes on in hospital A&E it was more that continuation of Fri nites town centre louts

[Acrylic-bob]

In October 2004 the Government’s Chief Medical Officer, Sir Liam Donaldson, offered the following facts on Tuberculosis.

• Tuberculosis (TB) is a serious, but treatable, infectious disease.
• TB in England increased by 25 per cent over the last ten years and is still rising;
over 1700 more cases occur each year than in 1987 when TB was at its lowest.
• 6638 people were newly diagnosed with TB in England in the year 2002. That is 13 for
every 100,000 people in our population – fewer than some, but more than several other
western European countries where TB rates in 2001 ranged from 5 to 44 per 100,000
population.
• About as many people in England develop TB each year as now become infected
with HIV.
• Every year around 350 people in England die from TB.
• Most TB in England occurs among people who live in inner cities. Two out of every
five cases are in London. The disease has doubled in London in the last ten years and a
few London boroughs now have TB rates comparable with some developing countries.
• People are at higher risk of TB if they have lived in parts of the world where TB is more
common. The disease follows patterns of migration and is therefore more common in
certain ethnic groups, especially if they were born abroad: in England, around seven out of every ten people with TB come from an ethnic minority population group
> nearly two thirds of our TB patients were born abroad
> about half of the TB patients who were born abroad are diagnosed with the disease
within five years of first entering our country
• HIV infection weakens a person’s immunity to TB. In England, this overlap is still
relatively small compared to other parts of the world, but at least three per cent of
people with TB are estimated to be HIV positive (higher in London).
• TB in cattle – bovine TB – is increasing in England. Very few human cases are due to
this bovine form, but continued vigilance is required.
• TB can be controlled by:
> promptly recognising and treating people with the disease
> ensuring that people with the disease complete their treatment. Lapsing on treatment
not only fails to cure the disease but contributes to the growth of drug resistance
> identifying and treating people with early infection, to Google Page Ranking event them later
developing the full disease
> prevention through BCG immunisation (BCG gives limited protection against
TB so cannot, on its own, control the disease)
• Drug resistant TB takes longer and is more difficult and expensive to treat. In England,
around six per cent of the TB bacteria from patients with TB are resistant to one or
more drug and one per cent show multidrug resistance. Higher rates in other parts
of the world threaten these low rates
• Left untreated, a person with infectious TB of the lungs infects on average 10-15
people every year. The risk of a contact acquiring infection depends on the nature and duration of their exposure:

[accymel]

Blamin 'eck Acrylic....... thats very worrying statistics

[lettie]

There are a few issues here. TB, HIV, Hep B etc and the migration to this country have been discussed in the alarming health stats thread in the Hints tips and advice section. Hospital cleanliness is a different ballgame.
There are a few issues with that one especially pertaining to MRSA. In the late 80's hospital cleaning services were privatised. Contracts went to the lowest bidders. To be the lowest bidders the company's cleaning staff were paid less and less was spent on equipment ie cleaning cloths. If you are being paid a pittance and made to make one cloth last a set amount of time, would you put your heart and soul into your job? Our cleaners used to be part of the ward team and under the supervision of the ward sister They were valued as a part of that team and therefore worked their asses off. Nowadays a cleaner may have to clean a few wards under the supervision of a domestic supervisor, who the wards will see once in a blue moon. The cleaner has limited time on each of those wards and no longer feels part of any team.
General hand hygiene. Nursing staff are pretty good at handwashing, you only have to look at my hands to see the damage that handwashing with these soaps and gels does. Medical staff are not that brilliant at handwashing and often need to be told to do it. Visitors are even worse. I have worked for the Maternity services for nearly 13 years and have yet to see a visitor wash their hands before handling a baby. When I worked on the surgical unit at BRI I never saw any visitor wash their hands before touching a patient. How many people have you visited in hospital? Did you wash your hands?
MRSA is a common bug. Many people who are not ill carry it and it causes no harm until it infects a wound for example. It is very similar in that way to Strep B (which a quarter of the world population carry) Patients, visitors and staff are not screened for MRSA prior to coming into hospital. If they had to screen all staff they would be short of a workforce in an already understaffed, overstretched system. A mate of mine at Preston was screened after an outbreak and was found to be a carrier. She had to have antibiotics which didn't work until she had had several courses. She ended up with a total of 3 months off work until she was clear. She was never at any time actually sick. If all staff were screened there would probably be a very large dent in the workforce. Screening patients prior to elective surgery would probably delay their surgery in a lot of cases and emergencies would have to be reverse barrier nursed in isolation. Hospitals are public places, therefore we have no control over who enters a hospital, so visitors would still bring the disease in with them.
There have been suggestions from the tories that Matron would be back in charge and would have to power to close ward areas in the event of an epidemic. I can tell you as a ward sister that Modern Matrons and Sisters already have that power. If I am not happy with the state of the ward I work on, I will not only say so, but make sure that something is done ie, heavy duty clean.....

[Acrylic-bob]

What is even more worrying is that the figures quoted are based on estimates for 2002. The situation will be even worse today?

Still, just think about it. if just 10% of the 6638 new cases remain untreated that is 663.8 people who will each infect at least 10 people in one year.

In year 1, 663.8 untreated infections.
in year 2, 1,327.6 untreated infections.
In year 3, 2,655.2 untreated infections

And so on, and so on and so on. This lethal disease is on the loose in this country again because successive governments refuse to take the steps necessary to protect the population for fear of being called "Racist". Something for parents to think about when their children's school is closed because of an outbreak of TB.

[accymel]

Shame it seeems we are going back to the dark ages when we have come so far in medical intervention, i really dont think the pc attitude helps at all with the situ pussy footing about when sometimes however un pc it is intervention needs must!

[accymel]

Dont think any one means to be at all critical to the medical proffession Lettie, they are doing the best they can within over stretched NHS, but the point of big holes in immigration in this country unlike others like the US, health issues aren't seen as top of list like the issue of benefits n yet the influx puts an enornmous stress on our medical services, i know they quarentine pets do they do same with humans with possible infectious diseases - do they even bother to check? Plus the vast increase of holidaying abroad to exoctic locations doesnt help either.

[lettie]

I didn't think anyone was being critical Accystanmac I have copied this bit from the health stats thread about pre immigration testing for diseases. This has been talked about before by the Government and is now being bandied around again..
Here's the copied bit......


"Done some digging on the pre immigration testing, and yes it has definately been discussed. At least 70 other countries do this, for people who are going to be there for any length of time. These countries include USA, Australia, Russia, China and most of the Arab States. At the discussion stage the WHO jumped in there, and said it was discriminatory, some British experts commented that it was a useless practice, as the rates in Russia and China are still rising rapidly despite the pre immigration testing. To cap it all the Institute for Public Policy Research said that screening immigrants would drive the problem underground and increase risk by stigmatising victims. The IPPR instead called for 'Welcome Health Checks' for immigrants instead of compulsory screening. These health checks would hopefully also be screening for Hepatitis B, and TB, as both of these diseases are rife in the Middle and Far East."

[accymel]

I dont think it should be regarded as stigmatising victims but part of the immigration process America are very strict with theirs ...suppose its a no win situ been seen to be pro active, tho interesting what u have copied for us Lettie puts another perspective on things i'suppose.

[lettie]

Countries like the USA and Russia won't let you in if you are HIV pos. New Zealand have started health checking now for immigrants. If you have a disease such as HIV, you are allowed to move there, but you have to be able to show that you can pay for all of your own treatment. It would not be discriminatory to test for certain diseases if having that disease didn't stop them from letting you in. If we screened here then HIV pos should be able to pay for their care and TB should be treated prior to moving here and retested to make sure that the treatment was successful. I think we are discriminatory for not testing when many of the other countries now test.

[accymel]

Very true Lettie i totally agree with u there.

[Alice]

Screening is vital but it is not the only thing we can do. I remember when everybody had a TB jab at school. I understand that this was stopped some years ago because it was considered that we had pretty much eradicated TB from our shores. Since then there has been a proliferation in unchecked immigration - hence the majority of current TB cases being in populations born abroad. I'd be willing to bet that the other third have mostly come into contact with these people too.
Until we get a government that is brave enough to face up to this issue maybe we should start a mass immunisation programme. at least that way we might control the spread.

[accymel]

Trouble is it'll get epidemic proportions b4 the Gov act notice not much mention of it as its nearing election. I think our Country should maintain the safety, monetry n health n stop being blaise with it, its not being discriminative its being protective for the benefit of everyone in this country n those on visitation.

[lettie]

All newborn babies of any descent other than European, North American and Antipodean are immunised for TB before leaving hospital, unless the parents refuse. My mates kids were still done at school the oldest now being 18. Unfortunately the majority of TB that I come across is in young asian women who come over here pregnant and their husband lives here. Basically arranged marriages abroad, get pregnant, bring husband/pregnant wife here then try to get the rest of the family in. Not being funny but that's how it is....

[pendy]

TB was virtually eradicated in this country due not only to the immunisation programme, but also to better housing and nutrition, vital components in the treatment of TB. We have seen an upsurge due to several factors, not least of which is allowing infected people into the country.

There is also the fact that a great many people from poor backgrounds (as many refugees are) are not well educated and do not realise that compliance with the full treatment is absolutely essential - they feel better, they stop treatment. The TB bug develops resistance - the drugs don't work any more. Also TB has become linked with HIV, and new and more virulent strains have developed.

The only way forward seems to be to resume screening of the population as a whole (which used to happen in the 50s) and heavily supervised treatment, all of which we can ill afford.

I agree with Lettie about hospital cleanliness, it used to be that each ward had a ward maid on duty at all times, and they took a pride in keeping their ward clean and hygienic. Perhaps a little more spent on that would save a fortune in treatment!