Wheelchairs have come a long way – shame the NHS hasn’t | Lucy Webster

Gone are the days of clunky wheelchairs seemingly designed to hinder as much as to help – at least for some. The latest promising development in the disability world comes from ex-Royal Marine Phillip Eaglesham, who was almost paralysed after contracting Q-fever on his last day in Afghanistan. When he began to lose strength, he used a Segway to get around and realised how helpful its versatility was. Now that he cannot use one, he has designed a new chair that copies some of the Segway’s features to allow wheelchair users to manoeuvre easily and, most importantly, raise themselves up to eye-level and have a decent conversation.

My electric wheelchair is nowhere near as cool, but I can raise myself to just below standard eye-height. It’s hard to express how much this helps me have a normal life. Yes, of course it means that I can reach things on shelves and whatnot. But it also means I can do typical twentysomething activities such as introduce myself in a noisy environment or even, God forbid, sit at a bar.

Without it, crowded places such as clubs become a nightmare, as does meeting new people. People are conditioned to notice others of a standard height and to patronise those whose heads are more at the level of a child’s. My cerebral palsy makes it hard to project my voice, so being able to raise myself up allows me to engage with others as an equal.

Yet the relevant authorities do not believe that features such as this are important. The NHS wheelchair service will only provide wheelchairs that meet medical needs; independence and social needs are ignored. The result is that decent wheelchairs, and by extension a decent quality of life, are reserved for those who can afford them – and they can be prohibitively expensive. The new design is projected to cost a tidy £10,000.

My friend Anna has spinal muscular atrophy, and relies on a highly specialised chair that can transform into a standing frame to help retain her muscle strength. Last year her old chair malfunctioned – throwing her to the ground, leaving her with sprained ankles. Since then, while she fundraises for a replacement, she has been given a manual chair that she cannot move at all, and a borrowed powerchair that does not meet her needs. The model she needs, that will allow her to go about her daily life, costs £24,000. The NHS provided a voucher for £1,295, the cost of its standard chair. This barely makes a dent in the total sum needed. Over a year later, Anna is finally ready to order the right chair. Others may not be able to work so hard to raise money.

For some disabled people, our wheelchairs are the substitute for our legs. Yet the way we treat disabled people is like asking someone who has broken both legs to pay for the operation to fix the second break – and this from a government that aims to get more of us in work, while remaining indifferent to helping us do so.

Inventions like Eaglesham’s have the potential to make disabled people’s lives much better. But with so many people unable to access a chair that is even remotely suited to their lives and needs, progress seems far off. As technology improves, the possibility of better equipment grows, but so does the gap between those who can and cannot afford it. Only the state can level this cruel inequality.

Wheelchairs have come a long way – shame the NHS hasn’t | Lucy Webster

World Bank to name and shame countries that fail their stunted children

The president of the World Bank has warned he will name and shame countries that fail to tackle the malnourishment and poor growth of their children, as part of a mission to rid the world of stunting.

Jim Yong Kim, the former physician who heads the Bank, told the Guardian he would take to the podium at the World Economic Forum in Davos every year to point the finger at governments who failed to live up to promises to tackle a scourge affecting tens of millions of children.

Kim said stunting – which refers to children with a height considerably below the average for their age – was a humanitarian disaster but also an economic issue that held back nations. Malnutrition, the lack of stimulation and toxic environments take their toll on children’s brain development, modern neuroscience shows.

For the sake of their children but also their countries’ future prosperity in a world that increasingly needs an educated workforce with technological skills, governments must take action, said Kim, adding that equality of opportunity was meaningless when children started with such disadvantage. The problem is huge. In India 38.7% of children are stunted, in Pakistan 45% and in the Democratic Republic of the Congo 70%.

“Everyone puts all their eggs in the equality of opportunity basket,” said Kim. “But we’re essentially lying when 25% of children in the world are stunted. Inequality is baked into the brains of 25% of all children before the age of five. So the only way that we can realistically say there is equality of opportunity is if we bring stunting down to zero.”

Stunting around the world

There were certainly other issues, he added, such as the competence of schools. But there was little point complaining that children in the DRC could not read a single letter after going through three or four years of schooling. “It might not be because the education’s bad,” he said.

“It’s a stain on our collective conscience. I think we can start a global movement. My goal is to cut stunting in half. We have 14 years until 2030. We can cut stunting in half in seven years and then end stunting in the world by 2030. That is the only way we can look ourselves in the mirror and say there is equality of opportunity in the world,” he said.

Kim pointed to a World Bank-supported programme in Peru as an example of what is possible. It gave conditional cash transfers to the mothers of stunted children, enabling and educating them to give their children nutritious food and stimulation through play. Similar incentives were given to health clinics to support them. If the children did well, monthly payments continued. “It was the first time we tried this aggressive, what we called a demand-side intervention. They went from 28% in the mid-2000s to 14% in seven years,” he said.

“We’re going to say to every country in the world that has a problem with stunting, we’re ready to bring you the Peru formula. We’re willing to provide financing for these conditional cash transfers. Conditional cash transfers are great anyway. They help poor people. They stimulate the economy, they are a great thing to do.

Jim Yong Kim says equality of opportunity is meaningless when children start with disadvantages as a result of poor growth. Photograph: Altaf Qadri/AP

“But you have to start making an effort at reducing stunting. Or else every year I’m going to stand up in front of all the potential investors in your country and say – you’re not making any progress on stunting. This has very serious implications for the quality of your workforce into the future,” he said.

Scientists have found that all children, regardless of race, should grow 25cm in their first year of life and 12cm in the second.

Only recently has the impact on the brain been explored. Imaging shows fewer neural connections in the brains of stunted children than in those of children who have grown well. That does not necessarily mean they are damaged for life, but their ability to learn can be impaired.

“This is probably the root of intergenerational poverty,” said Kim. “Stunted women who are malnourished become pregnant. Just because they were stunted and malnourished doesn’t mean that their children have to be, but they probably end up not having sufficient nutrition when they are pregnant and they give birth and their children are stunted and it just goes on.”

Technological change means that countries will have ever fewer low-skilled jobs in agriculture and manufacturing. “In that case, the most important infrastructure we can invest in is grey matter infrastructure,” he said.

Many people, including the Nobel economic sciences laureate Amartya Sen, have been arguing for years that investing in people is the way to growth. “I think that with the new science of stunting we have now the direct link. If you don’t have light manufacturing and you don’t have low-skilled work in agriculture, you’re left with mostly services. If you are going to compete in the service economy you’re almost certainly going to have to be digitally competent. And you’re almost certainly going to have to be able to learn throughout your lifetime.

“What I’m arguing is you need to make first and foremost an investment in your people and specifically you need to make an investment in the grey matter of your children.”

Kim believes governments will respond. In 2002, when he was head of the HIV department of the World Health Organisation, he launched a campaign to get 3 million people on antiretroviral treatmentby 2005 and let it be known which countries were lagging behind. Known as 3 by 5, it was controversial, but the initiative resulted in a rapid increase in access to the drugs. There are now 17 million people taking them.

What is stunting?

Childhood stunting is a huge problem worldwide, affecting an estimated 162 million children under five in 2012. These are children whose height is considerably below the average for their age. They are below the 5th centile on the child growth charts of the World Health Organisation – which means that fewer than 5% of healthy children would be expected to be their size.

Undenutrition is the prime cause of stunting. Children can be born to a malnourished mother, so they have not grown properly in the womb, or they can have too little nutrition in the first years of life. Stunting can also be the result of recurrent infections such as diarrhoea in places where sanitation is poor. If children are stunted at the age of two, it is unlikely that their growth will catch up with the norm. They are likely to be small and underweight.

Stunted children tend to have poor cognitive development, with underdeveloped brains. Malnourished children also have little energy, resulting in apathy and a lack of curiosity, which means they are unable to learn and are unlikely to be able to escape poverty.

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World Bank to name and shame countries that fail their stunted children

Edward Lear’s shame about his epilepsy | Letters

It has been assumed, as Colin Grant says, that no one outside Edward Lear’s family “knew of his epilepsy or the shame he felt about it” (After the fall, 13 August). But Lear noted in a late diary entry that he had “almost always” managed to keep his sometimes “heartstopping and braintwisting” seizures secret. The forms of Lear’s grand mal seizures seem to have varied and there are indications that he sometimes had absence seizures (petit mal).

It was not only in the culture of Emily Dickinson’s polite America that epilepsy was associated with syphilis, insanity and masturbation, both in the popular imagination and among influential medics. The many editions of the pamphlet Onania, first published in England circa 1715, established masturbation as a cause of epilepsy, and for a while one of Lear’s sisters slept in his bedroom to make sure he did not give way to “impurity”. Lear would have been in accord with Graham Greene’s doctor who prescribed “good walks”, but did not live long enough to enjoy the benefits of Kepler’s malt extract.
Charles Lewsen
Bristol

• Join the debate – email guardian.letters@theguardian.com

Edward Lear’s shame about his epilepsy | Letters

Shame: Barrier to Drug Addiction Treatment

Drug addiction is difficult to overcome, even in the best of circumstances. The choices an addict must make to fight through both physical and emotional barriers can require unforeseen strength and willpower and must include a goal that is both challenging and achievable. Most people can’t easily take this path to drug addiction treatment and wellness alone, and they require the support of friends, family and care providers. However, breaking through the barrier of asking for help, admitting the addiction problem and allowing oneself to consider opioid detox are some of the most difficult parts of the recovery process.

An Opioid Addiction Crisis

Our society is experiencing an opioid addiction crisis, with many individuals and families battling the reality of this frightening addition. Opiate addicts are not typically heroin junkies on the streets. They can be high-functioning professionals with families, obligations and friends, and in many ways, they can even seem to have an ideal life. This illusion is difficult to maintain for a long period of time, however, as the guilt and shame of addiction can cause addicts to become withdrawn and isolated.

With more than 200,000 new cases of opioid addictions each year in the United States alone, the likelihood of each of us knowing someone who is an addict is likely. Many addicts become dependent on opiates due to injuries or pain, and the impact of addiction is just one more obstacle to add to what is already a difficult situation. It is a trap that many addicts fall into before they are fully aware of what is happening.

A Long History of Addiction

Addition can also be the result of genetics, with some people being naturally predisposed to the rewards of addiction. This is why addiction can happen to anyone, and it can be especially prevalent in families, with several generations affected by the difficulties of addiction. The first documentation of opiate use was 5,000 years ago, and it has a long history of attracting users in a variety of forms and turning them into addicts.

Opioid Use: Shame and Isolation

The embarrassment of admitting an addiction to friends and family can be nearly unbearable for many sufferers. The shame of acknowledging that a drug is controlling their lives is often enough to prevent addicts from telling friends or seeking drug addiction treatment. Wishing to try to control the situation on their own, addicts may attempt dangerous solo withdrawal or may continue to use opioids long-term while carefully hiding the evidence. The danger is real, as on an average day in the United States, 78 people die of an opiate overdose.

The Vulnerability and Difficulties of Shame

Those who struggle to admit addiction issues may have lived a life of success, and admitting failure is a difficult thing to do. Just the thought of telling someone – a friend, counselor family member or doctor – the truth about hiding an addition may bring on the symptoms of fear or even a panic attack. Why is shame one of the most difficult barriers to admitting a problem? It is hard-wired into our brains to never let others know that we are weak, and this makes admitting a problem of weakness and dependency a very difficult thing to do.

Guilt and Motivation: Overpowered by Shame

Guilt also plays a huge role in the overwhelming feelings of shame When addicts feel guilty about their own behavior, they will develop a strong feeling of shame and humiliation. Although guilt can be motivating and make the addict want to improve and change, shame causes feelings of weakness or incompetence that can overcome any sense of motivation. The idea of allowing others to know about the terrible secret, and the possibility of being judged makes the idea of admitting the problem overwhelming.

Secrets and Separation

Hiding a secret brings a feeling of isolation, and addicts may also create separation from friends and family in an effort to preserve their secret and perceived inadequacy. Even a simple conversation with a friend or family member becomes difficult, as the fear of being discovered is constant. As isolation grows, the addict’s ability to seek opioid detox treatment becomes even more daunting due to a lack of emotional support. Disconnection from social ties is known to be problematic for humans, and increasing isolation is just the beginning of a downward spiral of continued addiction.

The Purpose of Shame

Shame is an emotion that does have a purpose; as a function of the conscience, it allows people to adapt to relationships and remember to behave in a responsible and morally acceptable way. It can also serve as a way to self-evaluate one’s behavior while also identifying how others may respond to expressions of shame. Self-awareness and shame are emotions that develop when children are very young, and it continues to develop into a healthy or debilitating emotion based on individual life experiences.

Chronic Shame

Unaddressed chronic shame can lead to a dramatic change in lifestyle. Shame is typically a fleeting emotion, but for an addict, it can become a way of life. As it festers, it can be the cause of many other painful emotions that overwhelm the addict, further crippling the ability to function and live in a meaningful way. A numb, paralyzed reality is the end result, and the addict may begin to spiral into a place of deep despair from which it is difficult to recover.

A Shift in Priorities

Shame can lead to many anxieties and fears, and they will become difficult for the addict to continue to hide from friends, coworkers and family members. The addict may end relationships or sabotage them to prevent his or her shameful secret from being revealed. Apologies and canceling plans can become the new normal, and an addict’s shame will increase by continually letting down friends and family members who were once his or her priorities.

Anger and Frustration

Shame can also present itself as anger. Emotional pain and frustration can cause the addict to lash out at friends and family members in new and unusual ways. Anger can come across in a variety of expressions, including obnoxious comments, judgmental attitudes or mean actions. Bullies are a prime example of the type of anger that is likely caused by emotional pain, shame or frustration. No one likes a bully, and acting like one can create distance and further isolation from social connections.

Conquering Shame in a Safe Environment

Breaking through shame and developing the confidence and motivation to address addiction is a healing process that starts in a vulnerable place. Addicts who are able to break through their shame to confide in others can enjoy support and a safe environment to begin that healing process. When loved ones and friends accept and support an addict, letting go of shame and engaging in positive life changes becomes possible.

The ability to cling to hope and be surrounded by support and love is often the push opiate addicts need to be successful with making healthy life changes. The opportunity to talk about struggles with addiction and willingly accept drug addiction treatment while being comfortable with vulnerability and trust in others are key to a successful recovery.

Going Public, Avoiding Stigmas

Publicly acknowledging the addiction is the next step to leaving shame behind. Honesty and a willingness to speak openly about addiction will help friends and acquaintances be more comfortable with the reality of the support the addict may need. However, there is a strong stigma associated with opiate addiction, and the addict must be strong and socially supported to not fall back into a pattern of shame, especially if he or she retains a fear of being judged by others. During the recovery period, addicts are very vulnerable to feeling shame and retreating back into an isolated lifestyle.

Social Connections and Support: The Antidote to Shame

Whether you are an addict who is experiencing a sense of isolation and helplessness, or you have a friend or family member in the depths of addiction, breaking through shame is a strong first step towards getting help. The support of family members and friends can be a candle in the dark, and these social connections provide a sense of hope in the quest to conquer addiction through opioid detox.

Shame: Barrier to Drug Addiction Treatment

Spanking, caning and consent play: how feminist porn frees women from shame

Can a feminist have rape fantasies?

According to feminist pornography producer Pandora Blake, who runs the fetish porn site Dreams of Spanking and frequently portrays fantasies of “non-consent”, the answer is a no-brainer. “Absolutely.”

The general consensus in the feminist porn movement is that no fantasy, no matter how anti-feminist the subject matter appears to be, is off limits. To tell a woman what she is and is not allowed to be turned on by is just about as anti-feminist as it gets.

Related: What should you tell your kids about porn?

“Removing shame from hardcore BDSM desire and rape play and age play and all of the kinky taboos that women just have not been allowed to like ever, that’s the kind of stuff that really draws me into the feminist porn movement,” says Courtney Trouble, the producer behind Trouble Productions and a past Feminist Porn Conference keynote speaker.

“If we come out and say ‘I have a rape fantasy,’ it’s like, ‘Whoa, you are broken,’” Trouble says. “That’s the conversation, and it just needs to change.”

Feminists routinely fight for sexual agency – a woman’s right to make decisions about her own sexuality, including when and with whom to have sex, and when, if ever, to get pregnant. Feminists traditionally rebel against the forces that would hem in these rights: the puritanical voices that say that a woman who enjoys sex is a slut, that would restrict access to contraceptives, that claim that dressing provocatively is inviting rape.

Following that logic, feminists argue they shouldn’t invoke shame around the sexual fantasies of others – even if those fantasies include images of kink and domination, or even rape.

“There’s a clear distinction between fantasizing about being coerced, and actually being coerced,” Blake says, explaining that just because she has (and depicts) dark fantasies doesn’t in any way mean that she’s endorsing real-life nonconsensual sex acts.

“In some cases, people’s porn preferences contradict who they are in the world – as responsible people who are committed to justice and equality,” says Tristan Taormino, a feminist porn producer, sex educator, and organizer of the annual Feminist Porn Conference in Toronto. “And I’m OK with that.”

Taormino’s own porn focuses on female enjoyment, on diversity of bodies, and on the comfort and authentic expression of her performers. She often subverts the tropes viewers might expect to find in porn.

“Certainly there are things in mainstream porn that I think are stereotypical, or repetitive, boring, or even offensive,” Taormino told me, “but the answer is not to shut down porn. The answer is to make more porn.

“Most mainstream porn revolves around the ever-present erection,” she says, “which speaks volumes about how it really revolves around male pleasure, male desire, male fantasy. So I’ve shot scenes where a male partner will make a woman come with his hands, mouth or a toy without ever taking his pants off.”

She also includes scenes where women initiate sexual encounters, or where actors direct each other, rather than everyone seeming to know what they’re doing at all times. No pizza boys show up at the door only to mobbed by a gaggle of waiting co-eds. She makes a point to emphasize consent and mutual enjoyment.

Trouble’s porn also frequently focuses on subverting expectations set by mainstream porn. As a plus-sized performer who has been asked by mainstream producers to appear in porn with phrases like “chubby chaser” in the title, or asked to eat cake in porn scenes, Trouble delights in making porn where fat people are depicted as desirable. And while mainstream “lesbian porn” usually consists of scenes where stereotypical, feminine, straight female actors perform sex acts on each other for the enjoyment of straight male viewers, Trouble shoots girl-on-girl scenes with lesbian viewers in mind, and with butch actors as well as femme.

The feminism of Trouble and Taormino’s porn isn’t limited to the content – they are also strongly committed to a safe and comfortable work environment, fair pay, and a creative voice for their actors. This behind-the-scenes work is especially important for porn like Blake’s. While Blake doesn’t believe that the content of her work is at odds with her feminism, where it gets complicated, she says, is in portraying and sharing those fantasies without promoting actual violence toward women. In a world where porn is the de facto sex education for any teenager with an internet connection, socially responsible producers have to think not only about what will get people off, but what people will learn.

Blake says that making a big disclaimer about consent in the beginning of a film would break the spell of the fantasy, but the negotiation of boundaries that’s part of any healthy BDSM still needs to happen.

The Dreams of Spanking site includes tons of behind-the-scenes footage that shows what happens when someone calls cut (which she encourages her performers to do if they need or want to), or how the scene really does stop when someone uses a safe word. Rather than to-camera interviews where performers can feel like they’re on the spot to say the right thing (“I’ve lied in that situation,” she says), the Dreams of Spanking behind-the-scenes footage shows what really happens on her sets, so that viewers can see that everyone involved is a willing and enjoying participant.

Blake says she only casts people who are kinky in their real lives, whom she meets through the BDSM scene, to make sure that they know what they’re signing up for and that they’ll genuinely enjoy it.

“In a way,” she says, “I’m filming a live BDSM scene,” as opposed to actors depicting BDSM. “It’s about taking your authentic experience and turning it into a performance.”

Blake says that she’s always been kinky, since long before she knew what that meant. She remembers reading the descriptions of canings in Roald Dahl’s autobiography and being simultaneously fascinated and ashamed of her response.

“Even then I knew that it was not accepted to be fascinated by descriptions of other people’s pain,” she said. “All of us have to unlearn that received shame before we can enjoy ourselves and our sexuality, even if it’s the most pleasure-based sexuality, let alone when it’s anything outside of the norm.”

Related: Feminist pornographer wins right to reinstate sadomasochism website

She first discovered spanking as an erotic activity when she was a teen reading erotic fiction, but it wasn’t until she started exploring the world of online porn that she realized she wasn’t the only one who was turned on by the idea of spankings or canings more severe than playful smacks.

“What’s hot about spanking is the fear of it, the anxiety and anticipation of what’s coming,” Blake says. She likes to create scenes not where spanking just comes out of nowhere, but where a character anticipates it, “like a schoolgirl who knows she’s going to get a caning after school and can’t think about anything else and she’s asking her friends how bad it’s going to be, if it’s going to hurt.”

It’s not unfeminist to be a female submissive, Blake says, but it’s unfeminist to assume that someone in the BDSM scene is a submissive just because they’re a woman. She says that people in the BDSM scene, like people everywhere, have internalized ideas of gender norms, and that that’s part of what she’s trying to fight with Dreams of Spanking.

“The way to have sex in a feminist way is with consent, communication, and respect,” Blake says. “So if it’s possible to have sex that way, it’s possible to BDSM in that way, because they’re the same, really.”

Spanking, caning and consent play: how feminist porn frees women from shame

Jeremy Hunt"s plan to shame GPs with minimal cancer referrals is not the solution | Zara Aziz

A GP in consultation with a patient. Referral rates for cancer diagnosis will fluctuate in accordance to a variety of factors. Photograph: David Sillitoe for the Guardian

The well being secretary, Jeremy Hunt, desires to name and shame GP practices with lower cancer referral costs. The NHS Selections website will mark reduced-referral GP practices as “red”, or “green” if they refer far more. This is in response to significant variations in cancer diagnoses across England, which is becoming attributed to GPs not referring individuals early sufficient. According to figures from the Royal College of Basic Practitioners , three-quarters of individuals with cancer are referred right after one particular or two GP consultations. There is definitely room for improvement.

Several higher-danger symptoms are less difficult to refer, such as a persistent cough, a adjust in bowel routines or excess weight loss. It is the non-certain symptoms this kind of as tiredness that are typically the most demanding. Pancreatic cancer is a notoriously challenging diagnosis and can present with just malaise, reduction of appetite, new onset diabetes or back ache, all of which we see on a day-to-day basis in basic practice. Pancreatic cancer is the ninth most typical cancer in the Uk but the fifth most typical cause of cancer death.

GPs have clear tips on “two-week wait” referrals for all cancers, whereby any person who presents with specific high chance indicators or signs, known as “red flag”, ought to be referred straight away and seen in hospital within two weeks. The criteria for referral is really specific and does not consider into account a GP’s intuition or non-particular symptoms. In our practice we audit our two-week wait referrals, to guarantee first of all that the patient has been witnessed by a specialist and hasn’t been misplaced in the method and secondly, to see if a cancer diagnosis was produced. The vast bulk of our referrals are, reassuringly, not diagnosed with cancer.

Demographics also perform a large element when it comes to looking at cancer diagnosis and mortality costs. I educated as a GP in an affluent semi-rural practice and often noticed the anxious nicely. The appointments were longer, much less pressured and a lot of sufferers attended for an “MOT”. It was then that I saw my 1st malignant melanoma when a “well” patient came to have all their moles looked at. It was a quite early presentation and they made a full recovery with no spread or recurrence of the disease.

I now function in a massive urban practice with varied health beliefs. There is more deprivation and healthcare complexity and a lot of sufferers, specifically guys, will present right after weeks or months of worrying signs and symptoms. For some of our sufferers, their proximity to hospitals or cultural beliefs indicate that they will bypass GPs altogether and attend A&ampE departments for initial presentation of signs and symptoms.

Most GPs do not see plenty of new cancer diagnoses each year, however most of us will make one or two cancer referrals a day. Nationally, only 10% of two-week referrals turn out to be cancer, which is comparable to individuals referred from our practice. But we do see lots of coughs, colds, malaise, aches and pains. The danger with this “kneejerk” name and shame policy would be that we would see a sharp rise in anyone with a cough or cold getting referred. As a end result, this will rapidly saturate the capacity of cancer clinics and delay investigations. The last point that we would want is the two-week wait to improve to a four-week wait or even longer.

Statistics for every practice are presently offered on the internet for GPs and the public to appear at. GP practices are conscious if they are substantial or reduced referrers it would seem that the new proposals would include absolutely nothing but be tantamount to “naming and shaming” medical professionals. Any analysis of cancer referral prices need to seem at the patient demographics of a practice, its cancer prevalence and other parameters such as no matter whether it is an outlier in other respects. There will indeed be some GP practices that are a result in for concern, but this is normally currently apparent to commissioning groups and NHS England, and it would make much more sense to performance manage these locally rather than adopt a damaging culture of blame and dread.

Jeremy Hunt"s plan to shame GPs with minimal cancer referrals is not the solution | Zara Aziz

"National shame" of cancer late diagnosis

1 in 4 individuals was only diagnosed following they had been admitted to hospital as an emergency, the report identified.

It warns that this kind of circumstances were twice as most likely to die inside of a 12 months compared with those provided an urgent referral by their GP.

Ciarán Devane, the charity’s chief executive, explained the findings ought to be handled as “a wake-up call” to the Government about the way sufferers have been getting taken care of and warned of a “looming crisis” in cancer care.

He explained: “It is a national shame that our cancer survival rates are amongst the worst in Europe, that patients are getting treated with a lack of dignity, or being denied a ‘good’ death.”

By 2020 virtually half of the population can assume to be diagnosed with cancer for the duration of their lifetimes, forecasts show.

The charity stated urgent improvements have been needed in diagnosis and treatment of sufferers, given the inability of the NHS to cope with today’s demands.

Mr Devane stated: “With the quantity of folks living with cancer set to increase, political parties should inquire themselves – how will we cope with these growing numbers when we can’t even meet the demands of numerous folks these days?”

The report identified that 1000′s of individuals had been denied “a good death” with ample soreness relief, and in a location of their selecting.

Whilst 73 per cent of sufferers expressed a need to die at property fewer than a third had been ready to do so, the study located, and much more than half did not have complete discomfort relief in the final 3 months of their lives.

Main strides have been created in the therapy of cancer in latest decades.

Earlier this week, researchers explained 50 per cent of individuals who are diagnosed today can anticipate to reside for at least 10 many years.

But progress diagnosing cancer has been far slower. Most current figures show that 68.2 per cent of people diagnosed with six of the most frequent cancers are alive 1 yr later, in contrast with 59.two per cent 15 years ago.

Authorities said survival rates in the United kingdom are lagging far behind individuals in a lot of countries in Europe simply because so several cases are not picked up right up until a patient arrives at Accident &amp Emergency departments, suffering acute signs.

Study demonstrates the Uk has the lowest 1-year survival prices for 4 cancer varieties (colorectal, lung, breast and ovarian) compared with five countries – Australia, Canada, Sweden, Denmark and Norway – with comparable well being programs and ranges of wealth to the United kingdom.

In December a review of 29 countries which compared five-12 months survival located that the UK’s charges were worse than the EU typical for nine out of ten typical cancers, which includes breast, bowel, prostate and lung cancer.

"National shame" of cancer late diagnosis

Uk cancer care a national shame, says Macmillan charity

Cancer patients receive chemotherapy at Harrogate district hospital. Photograph: Christopher Thomond for the Guardian

Cancer care in Britain has been dubbed a national shame, and despite a lot of people with the ailment living longer, sufferers are currently being denied a dignified death, according to a top charity.

As well numerous individuals are diagnosed as well late, are proven a lack of compassion throughout their care and truly feel abandoned after remedy, stated Ciarán Devane, chief executive of Macmillan Cancer Assistance.

His damning verdict accompanied the charity’s first state of the nation report which condemns United kingdom governments for lagging behind western European countries and other people on cancer survival prices.

“Any notions that cancer care in the United kingdom is ‘fixed’ are rubbished by our findings,” explained Devane. “While the NHS does amazing things every single day, it is a national shame that our cancer survival charges are among the worst in Europe, that sufferers are becoming treated with a lack of dignity, or being denied a ‘good’ death.

“Cancer sufferers no longer either basically get cured or die. Many reside a extended time but struggle with severe wellness problems,” mentioned Devane.

“With the quantity of folks residing with cancer set to increase, political parties need to ask themselves – how will we cope with these growing numbers when we are not able to even meet the needs of numerous individuals nowadays? … With a Uk cancer crisis looming, we have to consider action now.”

Macmillan’s report says 1 in three (32%) individuals with cancer die inside of a year of diagnosis, suggesting for numerous diagnosis is too late, and lambasts lack of data and support for individuals and shortages of specialist cancer nurses. It says there is lack of compassion towards some individuals when they are at their most vulnerable. Substantial numbers of people with cancer “knowledge extended-phrase bodily, emotional, monetary and perform troubles”.

Calling for a shift in funds from hospitals to local community care, the charity calls for government concentrate on minimizing late diagnosis, priority for patients’ experiences alongside clinical matters and to allow individuals commit their final days in the location of their picking and with free of charge social care.

Macmillan factors to the disparity in patients’ wishes on in which they want to die, shown in its own on the internet survey in 2010, and the place they do die, as recorded for England and Wales in 2012 by the Office for Nationwide Statistics. Therefore although 73% of people with cancer want to die at property, much more than a quarter elsewhere, and much less than one% in hospital, in actuality only thirty% die at residence, 32% elsewhere and 38% in hospital, the report says.

It cites evidence from the British Journal of Cancer that 1 in four cancers in England are diagnosed by means of emergency admission to hospital, rather than through screening or GP referral, rising to half all instances of pancreatic and virtually two-thirds of brain or central nervous system cancers.

It also says that there is “a shocking postcode lottery” inside of the Uk more than survival charges, treatment method and care for those with cancer.

The report also points to investigation on cancer survival published in the Lancet health care journal 3 years ago, for colorectal, lung, breast and ovarian cancer in Australia, Canada, Denmark, Norway, Sweden and Britain.

It was persistently reduce in Denmark, England, Northern Ireland, and Wales, particularly in the initial 12 months after diagnosis and for sufferers aged 65 many years and older.

The proportion of folks with lung cancer dying inside a 12 months of diagnosis in the United kingdom was 70%, compared with 65% in Denmark, 61% in Norway and 56% in Sweden.

The Division of Health in England said: “We want the Uk to be the best place in the world to survive cancer. We have invested £750m over 4 many years to support early diagnosis and boost accessibility to screening and have previously observed considerable enhancements in some cancer survival prices.

“The current cancer knowledge survey has shown higher amounts of satisfaction with the care and compassion shown to patients. Even so, the NHS always operates to improve specifications. We are starting up a evaluation looking at the situation of option in finish-of-existence care.”

Uk cancer care a national shame, says Macmillan charity