Recently in Health Category

by Hackney GP Michael Fitzpatrick

The old medical adage "prevention is better than cure" has been extended from infectious diseases to diverse social problems, such as obesity, teenage pregnancy, substance abuse and antisocial behaviour, all supposedly raging at epidemic proportions.

Although the conviction that early intervention yields better outcomes has a common sense appeal, it is only true if the diagnosis is correct and the preventive measures used produce the desired effects (without producing adverse consequences).

But consider obesity and teenage pregnancy. It is by no means clear that the scale of these problems is as great or the consequences as serious as the scaremongers and moralisers who have taken up crusades around these issues seem to believe. Panics about alcohol and drugs, crime and delinquency have come and gone over the years, whether or not there has been a significant recent increase in these problems. The causes are complex and simple solutions are in short supply.

Early intervention is driven by the power of wishful thinking. The notion that there is a window of opportunity before the age of three within which adults can decisively influence infantile development is an old dogma of psychoanalysis now dubiously reinforced by speculative neuroscience. Massive research into Sure Start has confirmed that the evidence for its efficacy is very weak - yet it is stronger than that for any other form of early intervention.
The downside of early intervention is that it pathologises whole communities, inevitably communities that already suffer poverty and neglect.

By replacing family and social links with therapeutic relationships between targeted individuals and professionals, early intervention further undermines personal resilience. Rather than strengthening individuals and communities, it renders them more atomised and more dependent on state support.

by Dr Mike Fitzpatrick

The history of medicine reveals that doctors resort to recommending diets when they have no effective treatments - a state of affairs that prevailed from antiquity until the 1930s. Dietary protocols for numerous conditions, from insulin-dependent diabetes to pernicious anaemia, have disappeared with the development of new drugs or other forms of therapy.

The food issue: why food is at the heart of social care

by Dr Michael Fitzpatrick

Early commentary on the fifth edition of the Diagnostic and Statistical Manual (DSM V) of the American Psychiatric Association - due for publication in 2013 - has focused on the new range of sexual disorders. These include "absexuality" (the Mary Whitehouse syndrome of excitement at being appalled at displays of pornography), "hypersexuality" (the affliction of Tiger Woods, film stars and premiership footballers), and, so that nobody feels left out, "sexual arousal disorder" (experienced by people who are just not interested).

by Kaarina Elisabeth
 
Harriet Harman believes that unless women are guaranteed positions in government, we won't get good government. She advocates positive discrimination, already employed for race and gender by various bodies. And it can be a good thing. It makes groups feel their views are represented.

writes Nigel Leaney

Social care staff need to address poor hygiene of service users: it can be a sign of a lack of self-care or an expression of eccentricity

One of the difficult areas that social care workers often have to deal with is that associated with self-care and personal hygiene. In mental health care this is often medicalised into diagnostic issues either to do with "negative symptoms" of schizophrenia or depression.

by Peter Beresford


Although many have welcomed plans for NHS personal budgets, they raise some wider questions about universal entitlement.

The extension of personal budgets to the NHS has been welcomed as good news by many. Bureaucratic divisions between health and social care have created serious difficulties for long term service users. Their needs don't divide neatly between the two sets of services and systems of support. They have also often been restricted to a limited menu of NHS services.

  by Andrew Holman

At last night's meeting of the All Party Parliamentary Group on learning disability, I got the chance to ask Sir Jonathan Michael a question about his report on the health of people with learning disabilities.

His report, the Independent Inquiry into access to healthcare for people with learning disabilities had been prompted by a Mencap campaign, spearheaded by the publication of Death by Indifference, detailing a shocking and unnecessary loss of life. Deaths that bring a greater pain to any of us who have known people die unnecessarily when you add the guilt about whether you could have done anything more to prevent it.

by Joe Levenson

While there is wide acknowledgement that preventive services are the way forward, health and youth justice are lagging behind

 by Peter Beresford
 
It's a long way from old British motorbikes to social care and the National Health Service - or is it? This is the sixtieth anniversary of the founding of the NHS, the organisation that proved there is an alternative to people only doing things or looking after each other for profit. There's also another anniversary this year which warrants similar celebration and I have just discovered a key connection between the two.