Healthcare bodies want to scrap the term ‘patients’. As a GP, I have a better idea | Ann Robinson

Many healthcare organisations want to dump the term “patients”, according to participants at a major event in London yesterday called the Future of People Powered Health. “Patient” is widely disliked – with its connotations of having to wait patiently, quietly and uncomplainingly to be the passive recipient of a doctor’s largesse. “Customer” isn’t much better; “client” or “service user” have some takers, and “partner” may be the best of a bad lot. But do we need a term at all?

Halima Khan, executive director of Nesta Health Lab who organised the event in partnership with Guy’s and St Thomas’ Charity , says the debate about whether to ditch the term “patients” has been bubbling up for some time. Many feel that the word, derived from the Latin “patiens” (one who suffers) is now obsolete. There’s support from patient and professional groups to consider changing the language in the hope that some entrenched attitudes will change too. “The Royal College of General Practitioners, for instance is teaching trainee GPs to talk to and about patients in a different way.”

But mental health campaigner Gillian Lamb (not her real name), who has been treated for serious mental health problems, sectioned and admitted to psychiatric units, says she couldn’t care less what she’s called so long as she’s treated with dignity and respect. “I’ve never minded being called a patient because I don’t feel inadequate, secretive or ashamed of having a mental illness. But I know others who are very sensitive about the medicalisation of their condition, and they do object to the term.”

Opponents of ditching the word “patient” say the original meaning of the word doesn’t matter, there’s no suitable alternative, it doesn’t carry connotations of passivity any more, attitudinal change can occur without ditching the name, and changing the name may not lead to meaningful change.

One suggestion is to borrow the language of intentional and therapeutic communities, set up like house-shares in which people are called members and are all expected to muck in and have equal status even if they have different roles. Lamb says that on her ward, “patient meetings” were called “community meetings” – or a “coalition of the unwilling” as an off-message staff member called it.

But the language that organisations use can reflect their philosophy and intended style of delivery. So an upmarket care home wanting to sell itself as being like a hotel may call residents “guests”. The term “service users” has become popular in the NHS though it’s (unintentionally) ironic given that accessing services is often a key problem for people suffering from chronic conditions – “service hopefuls” might be more accurate. “Stakeholders” crops up a lot; I have no idea what it means; don’t we all have a stake in our health and social care?

As a GP and occasional “patient”, I don’t see the need for any term at all. We have 4500 people registered at our surgery. Every person who comes into see me is, just that, a person. When I was in hospital recently for an operation, I didn’t morph into a patient when I entered the ward. I was the same person that I am in the street, but requiring a particular service. After a particularly dehumanising experience with a night nurse, I felt like screaming “I am not a patient, I am a free person”, in a parody of the The Prisoner. Needless to say, I didn’t do that but instead behaved nice and patiently. I say, let’s ditch the term patient altogether and replace it with … person.

Healthcare bodies want to scrap the term ‘patients’. As a GP, I have a better idea | Ann Robinson

6 Reasons Why Dragon Fruit is a Good Idea for Your Dessert

6 Reasons Why Dragon Fruit is a Good Idea for Your Dessert

A proof of idea for an HIV cure exists. Now even our setbacks are beneficial | Françoise Barré-Sinoussi and Sharon Lewin

It was a sad and disappointing turn of events: the kid known as the Mississippi child, in remission of HIV infection for much more than two many years right after discontinuation of antiretroviral treatment (Art), now has clear evidence of HIV rebound. The announcement will undoubtedly be viewed by some as a setback in the renewed quest for an HIV cure.

It doesn’t want to be. We require to take the highs and lows in our stride. We have a proof of idea that a cure for HIV is attainable in the Berlin Patient, Timothy Brown, who acquired a bone marrow transplant and remains virus free off therapy for more than six years.

We also have the situation of the French Visconti cohort, now comprising twenty HIV-positive men and women who have been taken care of very early with HIV medication, but then stopped treatment. Right after virtually ten many years off therapy, they are keeping the virus under tight manage.

Only one person, who is now in remission for a non Aids-connected cancer, reinitiated Artwork despite his HIV infection even now currently being controlled at the time that he obtained anti-cancer therapy.

The lows – if the Mississippi infant case can be called a reduced – provide main insights into the scientific problems that lie ahead for the researchers, scientists and others gathering at the Aids 2014 symposium in Melbourne this week.

Comparable to the Mississippi infant, the Boston patients – two guys who received bone marrow transplants that appeared to rid them fully of HIV – also relapsed, and are now back on antiretroviral treatment.

What has been most encouraging for all three sufferers was that the time the virus stayed beneath management off remedy, or in remission, was drastically longer than what we have ever witnessed before. The Boston patients were virus-free of charge for 12 and 32 weeks, and the Mississippi infant virus-totally free for a impressive 27 months.

Nevertheless, as we have discovered above the past 3 decades, HIV has many tricks up its sleeve.

An minute sum of virus – which none of our present exams are even shut to detecting – was capable to persist in these 3 patients and reappear at any time, with absolutely no warning.

The Mississippi baby, and the Boston sufferers, tell us that to attain extended phrase HIV remission we will likely need to have to tackle the difficulty on multiple fronts – lowering as much as attainable the quantity of extended-lived, latently contaminated cells existing in the entire body, as effectively as bolstering the host defence. 1 can not be carried out without the other.

We have usually known that the search for an HIV remedy wasn’t going to be easy. We have to be optimistic, and hope that situations like the Mississippi infant will demonstrate to be one more piece in the jigsaw puzzle that is an HIV remedy.

To attain this objective will need substantial academic collaboration as nicely as public-private partnerships that can drive innovative and effectively-funded strategic research over the prolonged term.

We have to proceed the search for an HIV remedy. We owe it to the 35m men and women living with HIV.

A proof of idea for an HIV cure exists. Now even our setbacks are beneficial | Françoise Barré-Sinoussi and Sharon Lewin

The New HWTrek Guides Hardware Projects From Idea to Production in Asia

Given that its inception in November final yr, Taiwan based HWTrek began out as a cross among a crowd-funding and a manufacturing advisory platform for hardware companies. But now, HWTrek is placing more focus on the manufacturing advisory side and has newly produced a platform referred to as the HWTrek Undertaking Advancement Hub.

Several fresh hardware entrepreneurs have brilliant suggestions. But creating those ideas a genuine merchandise is exactly where most fail. To resolve this problem, the Hub guides inventors by means of a quite thorough phase-by-stage approach from idea to style to advancement and ultimately manufacturing, all the while retaining them on track with a strong project management instrument. It also gives a extensive database of vetted makers and suppliers. This is astute timing, offered the explosion of hardware startups all around the planet.

It all starts with a questionnaire that asks specifics about your venture. This data then informs the seasoned HWTrek group and device how very best to manage the venture with a custom-made manufacturing schedule and workflow. The platform also makes it possible for inventors to invite task collaborators to talk progress or any troubles that need to have to be resolved. When the time comes, the HWTrek crew has skills across vetting factories, discovering the appropriate manufacturing partners, good quality assurance, understanding rules and managing logistics to assist overcome any major hurdles.

The impetus to produce the Improvement Hub came from seeing most startups fail prior to obtaining to total production.  “Startups are shy about asking dumb questions and they usually do not know how to deal with Asian companies.” Says Lucas Wang, CEO of HWTrek.

In dealing with Asian makers, it is important to determine partners who are the two interested in your solution and 1 that is reliable. To demonstrate your item is very good, building a functional prototype is a single way to improve your credibility and get companies interest and signal that you are serious.

For most inventors, obtaining goods made in Shenzhen is the most evident decision, where the manufacturing ecosystem is firmly established.  It’s more affordable, more rapidly and much more scalable than anyplace else. In contrast, due to the higher charges of manufacturing, many companies in the U.S. only function with substantial value merchandise like auto elements or health care products. Besides Shenzhen in the south of China, Dongguan is the area to get components and Hong Kong is a great location for discovering designers.

Chinese hardware entrepreneurs of course have a core advantage in getting shut to the manufacturing hubs. Even though most are nevertheless not very revolutionary or are straight copies of Western ideas, there are some who are breaking into the scene with impressive outcomes. ANTVR, is China’s try at the new era of virtual actuality gaming. It successfully raised over $ 260,000 on Kickstarter. A much more progressive Chinese solution is Darma, the world’s 1st intelligent cushion that helps to relieve back pain. Fitted with sensors that push notifications to your smartphone, it reminds you when to stand up, correct your posture and even provides you a personalized relief workout routines. But do not fail to remember how lucrative the Chinese consumer marketplace is. China is California based wearable tech organization, Misfit’s second largest market place.

With years of experience, skills and fortified relationships in the hardware area, HWTrek is definitely poised to consider benefit of the world’s normal shift in the direction of web linked hardware. The Venture Improvement Hub is a great leap forward in assisting to propel this generation of hardware entrepreneurs.

The New HWTrek Guides Hardware Projects From Idea to Production in Asia

The NHS needs a lifestyle-conserving idea how about a well being tax?| Peter Wilby

The NHS: time is operating out for ‘a credible idea for preserving Labour’s most enduring achievement’. Photograph: Ian Waldie/Getty Pictures

The NHS is a monster. Its capacity to eat public resources is with no restrict. That is not just due to the fact of an ageing population or developments in expensive healthcare engineering. It is also simply because of growing expectations. Nobody ever considers themselves to be in ideal overall health: there is constantly a wart to be removed, an irritable bowel to be explored, a cough to be relieved, a intercourse drive to be restored.

Proposals to charge for visits to GPs or for hospital stays are in no way met with something less than public outrage. Failure to supply high-priced medication that give, at very best, an further few months of existence to the terminally sick are denounced by newspapers that otherwise rail towards high taxes. Any proof that a hospital fails to strain each and every sinew to keep alive an ailing 95-year-previous is branded as unacceptable “age discrimination”.

The insatiable growth of the NHS’s demands for money have in no way been far more graphically illustrated than beneath the existing government. Though “ringfenced” from the coalition’s spending cuts, the NHS is extensively believed to be deteriorating to the level of collapse because it needs an yearly budget boost of at least 4% (in genuine terms) to meet rising expectations. It almost certainly requirements more, as cuts in care providers put additional burdens on GPs and hospitals.

Though Tory leaders insist they can be trusted with the NHS, the right’s reply is clear: accept the support is unsustainable and replace it with an insurance-based mostly technique in which, even though fundamental remedy remains free of charge, individuals otherwise get what they pay for in premiums. What is Labour’s response? Other than hoping for some type of financial alchemy from the shadow chancellor Ed Balls, it seems to have none. Proposals for a 1% national insurance coverage surcharge devoted to the NHS – emanating from former minister Frank Area and Nick Pearce, director of the IPPR thinktank and ex-head of the Downing Street policy unit – were floated, only to be disowned instantly by Labour leaders. Final month, calls from Lord Warner, a former wellness minister, for a £10 NHS “membership” charge were dismissed as the ravings of a discredited Blairite.

But a credible notion for preserving Labour’s most enduring achievement in government is desperately required. An earmarked wellness tax may be a single whose time has come, and probably a model for financing other strained public companies and modifying voters’ resistance to taxation.

Gordon Brown introduced a one% national insurance health surcharge in his 2002 spending budget. The trickier question is how far the notion can be extended. Should all health spending come from distinct revenue sources – the total proceeds of NI, say, or a general revenue tax? Need to some thing comparable be completed for schooling? Ought to older people’s care bills be financed from an enhanced inheritance tax? Need to corporation tax go to in-work rewards – which, in impact, subsidise inadequate wages?

Hypothecated taxes, as economists get in touch with them (deriving from the Greek hypotithenai, which means “to give as pledge”), are typically opposed by finance ministries due to the fact they minimize central manage. But they are not new. The Television licence charge to support the BBC is a hypothecated tax so was the “ship cash” raised to finance the Navy, which received Charles I into difficulties. Originally, the proceeds of automobile duty went to a fund for the creating and upkeep of roads (people even now refer to the “road fund licence”). Several American states use petrol tax for a comparable function.

Labour took office in 1997 with a manifesto pledge to finance welfare-to-work from a “windfall levy” on privatised utilities. NI itself started out as a hypothecated tax or “contribution” to fund social safety including pensions (however not the NHS). Numerous countries dedicate “sin taxes” on tobacco and alcohol to well being promotion.

This kind of earmarking can reconnect voters to the functions of taxation. Even Labour politicians now refer routinely to the “tax burden”. Tax is portrayed as a disincentive to enterprise, investment and tough operate. In the public thoughts, tax is one thing “they” invest, almost certainly on ministerial limousines and other “wasteful” luxuries. Nearly no person connects the amount of tax they shell out with the quality of their children’s education or how extended they wait to see a GP.

Nor is taxation connected to, say, transport infrastructure or the abilities of the workforce, which might make Britain a greater place to do company. We require a a lot more adult conversation which tends to make voters inquire if what they achieve in reduced taxes will be outweighed by what they drop in inferior companies – although also comprehending that if they demand, say, costly medicines or shorter hospital waiting lists, they need to shell out higher taxes.

British curiosity in hypothecated taxation peaked in the early 1990s soon after the Thatcher government’s well-known tax cuts the Demos thinktank and the Fabian Society have been amongst the supporters.

Many objections emerged. First, governments tend to raid earmarked money and use them for other purposes, as they did with NI and the road fund. They are also apt, if the earmarked tax is meant to meet only component of a service’s charges, to reduce basic expenditure on that service leaving it no much better off.

2nd, tying investing on vital companies to the yields of certain taxes may make individuals providers dependent on the company cycle. Third, sections of the public – the childless or individuals who use personal training or overall health insurance coverage, for instance – would clamour to opt out of certain taxes. Fourth, the opposition to general taxation may turn into even much more intense, and the strain to minimize unpopular spending items this kind of as advantages or overseas help irresistible. The temptation in an election campaign would be to guarantee 1% greater wellness tax and a two% lower in common taxes.

These objections are not insuperable – the very first and second, for illustration, could be conquer if revenues for overall health or training had been paid into a separately managed fund with its personal borrowing powers. And if hypothecated taxes have disadvantages, basic taxes – which are opaque to a lot of voters – have more.

Like each other centre-left get together in Europe and America, Labour battles towards its opponents’ propaganda good results in casting taxation in a wholly unfavorable light. New Labour experimented with to apply its guarantees without the taxes to shell out for them. It failed. It is time for anything new, and the bolder the better.

The NHS needs a lifestyle-conserving idea how about a well being tax?| Peter Wilby