Health Inventions Save Lives
How the ‘Life Tube’ and ‘Health Passport’ can save your life
By Jim Webber
Seen one of these puppies?
The Life Tube is one of three new health inventions which could save lives – and will certainly improve health outcomes. All the new measures help to improve access to health services.
- the Health Passport, a 16-pager designed by the Health and Disability Commissioner and based on a UK version;
- the Disability Icon which attaches to the medical files of people with impairments or disabilities.
All three are very different. Life Tube is an Age Concern initiative – a compact home for your emergency details (doctor, prescriptions, allergies, next of kin). It’s kept in the fridge and comes with a LIFE TUBE sticker for the fridge door. Not mentioned, but worth keeping in mind, is that there’s space in it for a few emergency pills. Some of us have to have a few pills each day to stay alive. The Life Tube costs $5 from Kapiti Age Concern. It’s an easy thing to grab if you have to leave home in a hurry – earthquake, fire, ambulance.• Health Passport is an A5 diary-size file, chatty and helpful, but not that easy to find and carry. It doesn’t have a specific medications list and is bigger than a real passport. Promoted by the three regional District Health Boards and available free from hospitals and some medical centres. • The Disability Icon is an alert than can be attached to your medical files on request. Everyone with a disability should seek its inclusion: Phone the DHBs’ Service Integration Development Unit at 04 8062434 and ask for a Disability Alert application form. The international “wheelchair” icon reminds hospital staff that you have a disability and might need special responses if your impairment is not obvious. Example: If you go to hospital by ambulance and can’t use public transport to return home, you may have a problem – particularly if you live in Kapiti. Transport options It’s wise to think about both the transport options and also the possible problems of going into hospital without vital information with you or in your medical file. Post-polios, for instance, generally need less anaesthetic than others: When I went in for a hernia repair my last thought, before the fentanyl turned the operating lights into tadpoles, was that I should have mentioned it to the anaesthetist. The lingering effects kept me off cryptic crosswords for two weeks. Transport home to Kapiti can be difficult unless you have an arrangement in place, particularly if you’re visually or mentally impaired or use a wheelchair. No other centre with Kapiti’s population is as far from a regional hospital. The Kapiti-based Red Cross shuttle can carry a folding wheelchair, as can some of the Kapiti Carers vehicles. Both volunteer-staffed services carry more than 2000 patients a year to and from hospital.
Surgery From SH1
An amazing ‘fold-out’ operating theatre has arrived in Kapiti on the back of a bus chassis; and is parked next to Paraparaumu Hospital.
Soon after arriving, doctors started operating on local people with a range of health problems.
The Mobile Surgical Unit, as it’s called, travels the country on a five-week loop, stopping off for the day at 23 regular sites.
The surgery the patients receive at each site is booked well in advance — with the patients’ GPs, specialists, and MHS staff liaising to ensure efficiency of service.
Running on an ongoing circuit of the country, MHS employs two aptly-named “steerologists” who between the two of them maintain the Bus’ demanding punctuality and, upon arrival at each location, effectively prop up an entire operating theatre with their own hands.
Handling a 20m-long, 39-tonne truck day after day without incident is a feat in its own right, yet as the steerologists will attest to their role involves much more than mere driving.
Upon arriving at each site, the driver has task of parking the Bus with enough precision to maintain ease-of-access to the Bus itself, to not obscure traffic or accessways to surrounding buildings, and to be within reach of the cables required to provide crucial power to the Bus to power it during surgery.
‘Pop out’ walls
Once parked up accurately, the Bus deploys its self-levelling hydraulic ram stabilisers and at the touch of a button the sides of the trailer unit expand outwards, doubling its width.
While power is sourced from a nearby building (usually the local hospital or medical centre), the steerologists are conscious of the dire consequences a power outage mid-surgery could have.
They thereby ensure that the power takeoff generator is set to fire up should power be lost, with the onboard UPS providing energy until the truck’s engine starts and the PTO generator kicks into action.
With the Bus prepped for use, the surgical team board to prepare for the day’s first patient.
Much like the patients themselves, the surgeons, anaesthetists and nurses have their dates booked well in advance to ensure their availability for the day.
As the medical staff are usually from out of town (often practising at a main city hospital), transport to and from the Bus location is also arranged in advance, as is accommodation if required.
The sole purpose of the Bus is to provide surgery at locations lacking permanent surgical facilities. In doing so, individuals who need an operation are able to have a surgery date booked for them without the burden of having to arrange transport to, and possibly accommodation in, larger centres.
As most people express some degree of anxiety leading up to an operation, it is important that the procedure is made as stress-free and comfortable as possible for them.
Having the Bus visit them in their own town, close to their home, friends and family, goes a long way towards this. The patient can get a good night’s sleep, wander down to the Bus site in the morning and make their way back home in time for the 6 o’clock news.
Truck (prime mover) model: 2001 Freighliner Argosy 110” Hi Top sleeper cab
Truck engine: Cummins Signature Series 500 hp
Truck gearbox: Roadranger 18-speed
Generator (PTO): 60 KVA
Trailer unit: Custom built by Mills Tui (Rotorua)
Trailer unladen value: $5,200,000 NZD
Trailer width: 2.5 m (on road); 5 m (expanded)
Bus total length: 20 m
Bus total weight: 42 tonne
Steering assistance: 30° rear tri-axle; exterior camera system
Daily Mail attacks the policy of ‘sharing excellence’
between health systems
By Tom Aitken in London
While British and NZ experts recently discussed medical co-operation, the right wing Daily Mail ‘hysterically’ bemoaned the cost to Britain of doctors emigrating ‘for a life in the sun.’
It all came about because, as a NZ doctor pointed out, half of the doctors who emigrate are bound for New Zealand or Australia.
The discussion came at a seminar organised by the NZ-UK Link Foundation which debated the interchange of medical workers.
It covered the migration of health and social care workforce members between the two countries and was held at King’s College, London.
The Foundation was set up originally in 1990 as the Waitangi Foundation — and its latest seminar looked at patterns of medical migration, and the policies of the two countries.
Gauld noted that media coverage in the UK of the 2014 State of Medical Education and Practice report by the General Medical Council had focused on indications that around half of all migrating doctors were bound for Australia and New Zealand.
Mail’s ‘self-induced hysteria’
But the Daily Mail – surprise, surprise – responded (with its usual outrage and indignation): ‘…They cost us £610,000 to train… but 3,000 a year are leaving us for a life in the sun…’
Despite the Mail’s usual self-induced hysteria, not all who migrate from Britain do so permanently. A frequent pattern is a working holiday of one or two years’ duration, followed by a return home to family and friends.
This return, however, is not always permanent. A majority of British doctors who leave the country are seeking to escape the NHS, which they find increasingly bureaucratic and inefficient.
Doctors like the NZ ‘can do’ ethic
Opinion polls show that they find New Zealand’s public health care system a better environment than the NHS to work in. They also like the less bureaucratic ‘can do’ ethos of New Zealand.
Professor Gauld says New Zealand still relies heavily on the arrivals from Britain and elsewhere.
As Gauld remarks, there has always been a two-way flow of migrants — temporary and permanent — between ‘down under’ and the UK.
However, when it comes to doctors, the market is increasingly global and competitive; many nowadays can choose where they want to live and how long they want to live there.
Some go to New Zealand in search of work opportunities, especially younger doctors seeking training places.
Some want to see where Frodo trekked. Some are escaping to what they hope will be a more relaxed life and a better environment for their families.
Change in all the countries affected
Until recently New Zealand relied heavily on foreign inflow, but feels increasingly able, at least in some of the relevant areas, to grow its own practitioners, Professor Gauld says.It has progressively increased its local intake of medical students and a larger pool of graduates is now seeking employment.
Another factor is that Australia has become a tighter market for house surgeons and registrars, which means that New Zealand’s young doctors are more likely to stay at home. And, usefully and persuasively, the New Zealand dollar has strengthened noticeably.
But New Zealand is still some way from total self-reliance in staffing of it medical and welfare system. There is a vague aim to reduce the number of foreign doctors to 15% of New Zealand’s medical workforce by 2020 or so, he says.
However, general practice and psychiatry are still listed among areas in which skilled immigrants are welcomed with open arms — and the beach and the mountains are never far away.
What Professor Gauld had to say brought responses from Professor Jill Manthorpe, Director of the Social Care Workforce Research Unit at King’s, and Professor Stephen Bach, of the College’s Department of Management.
Professors Manthorpe and Bach added interesting British commentary on what Robin Gauld had said — and the debate ended in broad agreement about the principal points under discussion.
More informal discussions, which followed afterwards in a neighbour room, were encouraged and aided by an excellent New Zealand Sauvignon Blanc––but to my shame I cannot remember which of the many varieties it was!
BBC Health News says obesity carries huge costs to the economy
By BBC reporter Hugh Pym
The worldwide cost of obesity is about the same as smoking or armed conflict and greater than both alcoholism and climate change, research has suggested.
The McKinsey Global Institute said it cost £1.3tn, or 2.8% of annual economic activity – it cost the UK £47bn.
Some 2.1bn people – about 30% of the world’s population – were overweight or obese, the researchers added.
They said measures that relied less on individual responsibility should be used to tackle the problem.
Lost outputThe report said there was a “steep economic toll”, and the proportion could rise to almost half of the world’s population by 2030.
The financial costs of obesity are growing – for health care and more widely in the economy. By causing illness, obesity results in working days and output lost.
The researchers argued that a range of ambitious policies needed to be considered and a systemic rather than piecemeal response was essential.
What is obesity?
A person is considered obese if they are very overweight with a high degree of body fat.
The most common way to assess if a person is obese is to check their body mass index (BMI), which divides your weight in kilograms by your height in metres squared.
If your BMI is above 25 you are overweight. A BMI of 30-40 is considered obese, while above 40 is very obese. A BMI of less than 18.5 is underweight.
“These initiatives would need to draw on interventions that rely less on individual responsibility and more on changes to the environment,” the report said.
If the right measures were taken there could be long-term savings of £760m a year for the UK’s National Health Service, it added.
The initiatives assessed in the report include portion control for some packaged food and the reformulation of fast and processed food.
‘Crisis proportions’It said these were more effective than taxes on high-fat and high-sugar products or public health campaigns. Weight management programmes and workplace fitness schemes were also considered.
The report concluded that “a strategy of sufficient scale is needed as obesity is now reaching crisis proportions”.
The rising prevalence of obesity was driving the increase in heart and lung disease, diabetes and lifestyle-related cancers, it said.
Dr Alison Tedstone, chief nutritionist at Public Health England (PHE), said: “The report is a useful contribution to the obesity debate. PHE has consistently said that simple education messages alone are not enough to tackle obesity.”
Dr Tedstone said obesity required action across national and local government, industry and society as a whole, and there was “no single silver bullet solution”.
The report was produced by McKinsey Global Institute, the business and economics research arm of consultancy firm McKinsey & Company.