Dealing with diabetes inside of and outdoors the NHS | @guardianletters

A breakfast of bacon, egg, sausage and fries was a regular function of Sir David Nicholson’s past diet program. Photograph: Scott Barbour/Getty Photos

It truly is truly great information that Sir David Nicholson is successfully tackling his sort two diabetes by way of diet regime and workout (I lost management of my overall health. And I was chief executive of the NHS, 17 Might). But it was not “ironic’” at all that he created the situation while head of the NHS, it was inevitable, for numerous causes:
• The NHS is in reality a National Medical Service – it fixes us when factors go wrong rather than striving to preserve us healthy to start off with.
• A minuscule part of the £95bn NHS budget is devoted to encouraging us to do the healthy issues that Nicholson has now been prompted to do. It’s a drop in the ocean in contrast with the massive marketing devote of the junk food business.
• NHS dietary guidance – to base meals on starchy meals – is a main culprit in the diabetes epidemic.
• The long hours and sedentary way of life demanded of individuals at all levels of the NHS place them at risk of diabetes. And there is no need to have for Nicholson’s GP to be so fatalistic. There is plenty of evidence that diabetes can not only be nicely managed, but reversed – it’s a life style condition and can be cured with life style modifications.
Loren Grant (ex-NHS manager)
Manchester

• The Improving Accessibility to Psychological Therapies NHS support in Swindon and Wiltshire has been working a programme for two many years, copying the perform carried out in Newcastle, on reversal of variety two diabetes. It is depressing that neither David Nicholson nor his GP seems to have been mindful of the developments taking location in such a essential field.

The programme involves following a rigid calorie-managed diet (800 calories a day) for two months. This crash diet plan has been demonstrated to reverse the diabetes in some circumstances, and this reversal can be maintained with a healthier lifestyle. The programme in Swindon offers a substantial sum of psychological help to assist motivate and keep the stringent diet.
Dr Liz Howells
Clinical director, Lift Psychology

• So David Nicholson felt that his regular day-to-day hotel breakfast of bacon, egg, sausage, tomato and fries, and his regular Friday-night consuming of eight pints of beer, was regarded as to be acceptable. He now has diabetes. As a nation we are consistently getting reminded of the significance of a healthful diet and standard exercise. We, the hoi polloi, are also getting advised that failure to heed this suggestions can lead to avoidable sick-wellness and consequently the necessity of medical treatment which is a drain on our NHS assets. Bearing this in mind, was David Nicholson really the right selection to hold the privileged place of being the head of the NHS?
Michael Gatoff
Bowdon, Cheshire

• David Nicholson did not use any of the preventive companies he is recommending the NHS invest in. He waited until he had signs and symptoms prior to going to the medical doctor, took fright on account of his family background, refused treatment, and then altered his very own way of life. Judging by this it would be better to invest in school health training, particularly offered the epidemic in childhood weight problems, but responsibility for this has been devolved to difficult-pressed neighborhood councils and totally free colleges are currently being permitted to opt out of serving wholesome lunches to pupils (Prime medical doctor slams colleges policy for fuelling epidemic of little one obesity, 26 April).
Dr Richard Turner
Harrogate, North Yorkshire

• David Nicholson’s public confession of the shortcomings in his taking care of his very own overall health whilst working the NHS makes use of a diagnostic rarely encountered in physical overall health care: the unconscious. Referring to his father and grandfather’s deaths in their 60s Nicholson asserts: “Unconsciously I was not seeking soon after my health because I considered that is what would occur [to me].” Carl Jung as soon as wrote that “we think we are the masters of our very own property but we deceive ourselves”, and he invested much of his daily life exploring and documenting how unconscious forces encourage our behaviours and so-known as selections of action.

Nicholson’s confrontation with a diagnosis of type 2 diabetes also displays the declare of the late Jungian analyst James Hillman that physical signs can be seen as a way the psyche employs to impact on the frequently heavily defended ego. Confronted with the signs and the urgency of the scenario, Nicholson describes the way of life modifications he has created. Even so, he slips back into his own role by giving us the really alarming stats on the prevalence of diabetes and says “it’s some thing we can and must do a lot more to prevent”. If his very own confession is something to go by, then prevention may require to begin with a recognition of the place of the unconscious in physical wellness care as effectively as psychological well being care.
Stephen Bushell
Buckingham

• It is incredible that David Nichloson did not realise that the troubles he lists are some of the traditional and well-identified signs of diabetes. This man is aware of the burden that diabetes is putting on the NHS however is possibly contributing to that strain himself.

Hotel meals and station snacks are no excuse: the kind of hotels David Nicholson has employed will serve fresh fruit, yoghurt, grilled tomatoes and so on for breakfast, and all station cafes now provide fruit, salads and low-excess fat sandwiches. Fries, muffins and crisps are not obligatory, they are “a life-style choice”. This phrase is considerably utilized by the existing government when denouncing these who supposedly “pick” unemployment and a life on meagre advantages, nevertheless diabetes is frequently the consequence of an unhealthy life style, which is also usually a deliberate selection.

Several men and women have an unhealthy diet via ignorance, poverty or emotional troubles but David Nicholson does not suffer from any of these, so I feel angry that a person who has been paid a very substantial salary from taxpayers’ cash has so disregarded what his own common sense and NHS understanding must have informed him.

I wish David Nicholson nicely in his new far more healthier way of life and hope that his report will be a salutary warning to several other people. However, I still resent the fact that my contribution to his salary enabled him to indulge in the beer and chips for so extended.
Anne Anderton
Newcastle

• Like David Nicholson, I also was advised by my GP several years ago that I had kind two diabetes “for existence”. Two many years ago (and a few thousand Metformin tablets later), my son, not medically educated, convinced me to try a raw meals diet program for thirty days. Nervously, I did so. My blood sugar ranges dropped to standard and they have not returned to their pre-diet level. I nevertheless eat the occasional piece of cake, chocolate or pudding, and a couple of cooked meals, but my system can plainly take care of that. There are about 4,000 sufferers registered as diabetic in the Selby spot alone – that’s a good deal of tablets. I’d detest to consider that it might be in the interest of pharmaceutical businesses to have that mantra continue: “You have acquired it for daily life.”
Mick Haining
Selby, North Yorkshire

• I am delighted to read through that David Nicholson has grow to be a convert to the concept that self-management courses can assist men and women live with long-phrase problems. What a shame that right after being successfully piloted more than 10 many years ago and run from inside of the NHS the professional patients programme went from currently being nationally obtainable to a programme delivered by a personal firm in just a handful of locations. Maybe he will now add his fat to the argument that self-management should after again be accessible to everybody and delivered within the NHS.
John Gessler
Barnsley, South Yorkshire

Dealing with diabetes inside of and outdoors the NHS | @guardianletters

Outdoors the box: rethinking how museums existing disability

The Cabinet of Curiosities staff had been amazed by the volume and variety of objects they found in museum collections. Photograph: Richard Sandell

Richard Sandell and Jocelyn Dodd, from the Study Centre for Museums and Galleries (RCMG) have been functioning closely with artist and performer Mat Fraser for the past two years. The research-led collaboration, supported by the Wellcome Believe in, just lately culminated in a series of cabaret-meets-lecture museum performances called The Cabinet of Curiosities: How Disability Was Stored in a Box.

A heady mix of research, visual culture, songs and an inspired rap, the performances check out the function that health care contemplating and practice has played in shaping attitudes towards differences, and aim to challenge the way we believe about disability.

Richard Sandell

Jocelyn and I 1st noticed Mat reside in 2005 when his demonstrate – Thalidomide! A musical – was on tour. Sitting in the audience, we seasoned a potent mix of emotions. We realized a good deal about the story of thalidomide and along the way we have been discomfited, shocked and angered. We also laughed.

We laughed a great deal. Following the display we sat in the bar listening to other members of the audience talk animatedly about the performance and we reflected on the marked differences amongst Mat’s therapy of the subject matter and the way that a museum might normally tell the story of thalidomide.

In which museums have tended to be measured and cautious – anxious to present materials in a balanced, frequently dispassionate way – Mat’s approach was imbued with emotion, flagrantly personalized and extremely political. Nevertheless, like museum presentations, it was also grounded in rigorous study. It was compelling, provocative and utterly memorable.

At that time our research was very strongly rooted in museum practice and even though our subject was novel, our method was largely tried and tested. We had grow to be interested in comprehending why disabled folks – occasionally referred to as the greatest minority – have been largely absent from museum narratives. Why, at a time when museums were increasingly making an attempt to represent much more inclusive histories, was engagement with the background and culture of disability hardly ever tackled?

We set about investigating museum collections and were surprised by the volume and selection of objects and artworks we identified – materials that was strongly linked to disability but really seldom presented in a way that manufactured these links visible.

Over time our analysis practice has turn out to be more and more concerned not merely with comprehending this phenomenon, but with effecting modify – both in how museums present disability and in unlocking museums’ prospective for modifying the way audiences (and society much more broadly) consider about disability. It was this ambition that led us to approach Mat in 2011 to check out the prospects for collaboration.

Mat Fraser

When I 1st met Richard and Jocelyn, I was not even remotely acquainted with the way museums technique their exhibitions. I did have a familiar sense of not belonging – feeling as if my standpoint of getting a disabled man or woman was absolutely absent whenever an artefact to do with disability was presented in collections and exhibiting presentations. Museums, like a lot of mainstream environments, do not demonstrate us as we actually are, or had been.

When they asked me to think about undertaking a show about the re-presenting of disability in museums, even though it was extremely much outdoors of my knowledge, I jumped at the chance.

Each Richard and Jocelyn have been and are obviously quite at ease with all of the politicised and socially concerned elements of disability, and have a comfort about the entire subject that is rare to discover, definitely in such professions. So of course, when I started out to do the real research in the archives of the project’s partner museums, I expected to encounter a a lot more reticent, conservative and fearful ignorance, from each artefacts and workers.

Rather what I typically identified was a rigorous enthusiasm for uncovering the previous, redressing the medicalised past methods of disability representation, and an virtually relieved pleasure that their museum was taking component in this task. That they had been health care and scientific museums made this all the a lot more surprising, and welcome.

The biggest shock in my discoveries was how a lot of artefacts there are in the archives that never just talk about disability they veritably shout about them. Hunting at all of these occasionally incredibly illuminating objects from the previous stored focusing me on the general job at hand. I increasingly came tosee this as helping folks – the public, disabled individuals, museum curators, managers, medical college students, medical professionals, scientists, everybody – to understand why things require to change, and to illustrate approaches in which that may be feasible (in a hopefully non-threatening way).

Thankfully, there was considerably proof from earlier museum experiments in this spot to bolster and inspire what I was saying. My total occupation was the two brilliantly supported by the prior analysis and writing, and enormously aided by the enthusiasm from the curators and museums staff I was operating with.

I still found it a challenge, and it truly did assist me produce as an artist, expanding my practice and reconnecting me with levels of academia I would virtually forgotten I could do. It also significantly expanded my demographic for audiences, but when all the dust settles on it all, what remains is the real reality in society that these improvements are painfully overdue and that we require to preserve operating in this discipline to get the work completed. It really is one thing I hope, inside the capacities of what I do and past them, I can be a component of.

Follow Richard on Twitter @RSMuseumStudies and Mat @mat_fraser

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Outdoors the box: rethinking how museums existing disability

Scandal of elderly forced into A&E as faith lost in care outdoors hospitals

The numbers vastly outstrip the eight per cent rise in the population in excess of the age of 80 for the duration of the period.

Final 12 months, more than 362,800 individuals above the age of 90 arrived at A&ampEs — a rise of 93 per cent given that 2007-08.

The figures cover the last two years of the Labour government, when the steepest rises took place, as nicely as the 3 years because the final election.

Dr Mann, an A&ampE consultant, stated: “Increasingly, what we are seeing is a default circumstance where older people finish up in A&ampE, without even phoning GP out-of-hours services, simply because they, or these caring for them, have provided up on them.

“Staff in nursing residences will contact for an ambulance simply because they know one particular will be there swiftly — whereas they have learnt from experience that it is far more hard for them to consider to get a medical doctor out.”

Labour on Tuesday evening blamed the increases on cuts to social care and decreased council budgets for solutions such as home assists.

Even so, Jeremy Hunt, the Well being Secretary, explained that too a lot of elderly individuals had been ending up in hospital simply because of the flawed GP contract that allowed household medical doctors to abandon responsibility for out-of-hours care.

From April, GPs will have to get all around-the-clock duty for the care of all patients aged 75 and above.

Mr Hunt said: “Labour’s disastrous 2004 GP contract left a lot of vulnerable elderly patients without excellent out-of-hrs care, so it is rank hypocrisy for them now to complain about the consequences of their historic mistake. We have ripped up that contract and are bringing back appropriate family doctoring, with named GPs for older folks to assist alleviate A&ampE pressures.”

The figures also demonstrate a 65 per cent rise in A&ampE attendances among people in their 50s and 60s above the five many years, and a 56 per cent rise amongst people in their 70s. Across all age groups, the increase in sufferers attending A&ampE was 51 per cent.

Given that the 2010 election, there has been a 25 per cent rise in folks in their 80s attending A&ampE units in England, and numbers rose by 44 per cent for between people in their nineties.

Final 12 months, the head of the Care High quality Commission mentioned emergency providers were “out of control” in large parts of the country since of rising numbers of frail elderly sufferers getting admitted instead of being provided care to maintain them out of hospital.

In spite of mild weather in most places and unusually lower levels of flu in latest weeks, most NHS trusts with large A&ampE units have missed targets to deal with 95 per cent of individuals inside 4 hrs.

Caroline Abrahams, the charity director of Age Uk, explained: “It is important that older people get the treatment and care they need, and occasionally this indicates going to hospital. However, we know that in some situations getting admitted to hospital is the consequence of not acquiring excellent quality care at house.”

Andy Burnham, the shadow wellness secretary, mentioned: “The Government’s severe cuts to social care have left 1000′s of older people without having the assistance they need to have — at risk of going into hospital and acquiring trapped there. It is a single of the root causes of David Cameron’s A&ampE crisis.

“It is appalling to consider that, each and every week, there are thousands of frail and frightened people speeding through our towns and cities in the backs of ambulances to be left in a active A&ampE. This is frequently the worst place for them to be and a disorientating knowledge that can trigger real distress. With correct help in the home, this could all be averted.”

Scandal of elderly forced into A&E as faith lost in care outdoors hospitals