Podcast Episode 3 - TTIP, lung cancer and dementia screening, killer spiders...

In our third podcast, Dave and I discuss appearing on Question Time, TTIP, lung cancer screening, dementia and killer spiders.  Enjoy! Share! Feed back!

www.medicave.co.uk
@mdmedicave

If you want to download it to your computer, you can click this link directly.

Or you can point your RSS reader or podcast app to the following feed:
http://feeds.feedburner.com/PodcastMediCave

BBC Question Time

A previous Liverpool episode

A quick note to say that I'm going to be in the audience for BBC Question Time on Thursday 23/10/2014 at 22.35 on BBC 1 from Liverpool.

On the panel are Scotland's first minister Alex Salmond MSP, Labour's shadow energy secretary Caroline Flint MP, Conservative minister for disabled people Mark Harper MP, UKIP's Louise Bours MEP and the leader of the Unite trade union Len McCluskey.

We all have to submit one question by email today. Max thirty words.

I wanted to give people the opportunity to criticize the government's funding of the NHS and the pay-freeze imposed on its staff. I didn't just want to rant leftily, as I doubted that that would make the cut.

It also has to be based on current news events.

I went for:

How do we save our NHS from the ‘perfect storm’ of austerity, increasingly expensive treatments and an ageing population, whilst paying staff the wages they deserve?

This was based on the idea of the 'perfect storm' discussed by Monitor's Dr David Bennett.

It would also give the opportunity to discuss staff pay and the recent strike action.

I need to submit a second question on the day when I arrive at the venue.

What would you ask?

I hope I get to ask it. Keep an eye out for me.

What does UKIP really stand for? And what the hell is TTIP?

UKIP

UKIP have an MP. The Conservatives, Labour, Liberal Democrats, Greens, Respect, a couple of independents and several parties representing Welsh, Scottish and Northern Ireland parties already did. Are they on the news as much? Doesn't seem that way. Many agree - that's why thousands of people have signed this petition to get the Greens on to the televised pre-election debates if UKIP are.

UKIP are big news though, because they speak for us, for ordinary people and will make Britain fairer for all, right? They're different to the 'Westminster Elite'. Nigel Farage drinks beer! He's like me!

Farage went from private education to a job in the City as a banker. He was a member of the Conservative Party before helping form UKIP. From that, he sounds more like others in politics than like me, but you can't help your background. Better to look at what UKIP stand for.

If you're thinking of voting UKIP to get a fairer society and get away from the current rule by a wealthy elite, first read some of their policies:

– We will introduce a 35p income tax rate between £42,285 and £55,000, whereupon the 40p rate becomes payable. (Cutting taxes for those earning over £42k)

– Inheritance tax will be abolished. (Inheritance tax only kicks in on estates over £325k or £650k for couples - most estates aren't affected. Abolishing inheritance tax would only increase the accumulation of wealth by already wealthy families)

– UKIP opposes ‘plain paper packaging’ for tobacco products and minimum pricing of alcohol. (Measures backed by doctors and evidence that would make people healthier, but might affect some company profits)

– UKIP will withdraw from the jurisdiction of the European Court of Human Rights. (As a human, I'd like some rights)

– UKIP will require foreign vehicles to purchase a Britdisc, before entry to the UK, in order to contribute to the upkeep of UK roads and any lost fuel duty. (Yeah! Foreigners should pay for our roads if they drive on them. That would stop them coming over here, staying in our hotels, eating in our restaurants and spending their foreign money. And I assume they should charge us for using their roads as well?)

– UKIP will abolish green taxes and charges in order to reduce fuel bills.

– UKIP supports a diverse energy market including coal, nuclear, shale gas, geo-thermal, tidal, solar, conventional gas and oil.

– UKIP will repeal the Climate Change Act 2008 which costs the economy £18bn a year.

– UKIP will abolish the Department of Energy and Climate Change and scrap green subsidies.

(Yes, energy is too pricey but the energy companies still manage to make excessive profits. Global warming is coming and will be very, very expensive.)

– UKIP will abolish the Department for Culture Media and Sport. (Well, we've already had the Olympics, I suppose.)

– UKIP will cut the foreign aid budget by £9bn pa, prioritising disaster relief and schemes which provide water and inoculation against preventable diseases. (Foreign aid is good. It makes us slightly less unpopular abroad. With ebola, we've seen what happens if poor countries are kept poor and unable to manage crises such as deadly epidemics. Maybe it's just a nice thing for us to do.

The truth is that UKIP are misleading the electorate and are happy to allow people to think that voting for them will help them get a better life. A UKIP vote is one for the wealthy, not for ordinary people.

If you like, you can look at the Green Party's ideas. If you want to protest against the government or the Westminster Elite, there are choices other than UKIP. Yes, they like the environment, but they tie this in with the well-being of all people, not just the wealthy few. It's a far more positive message than that of UKIP. I wouldn't tell you who to vote for, but please check what the party you choose actually stands for before you make up your mind.

UKIP has been hit by scandal after scandal, but most of these stories seem to be quickly forgotten. Many members have some very backwards views on race and gender. They certainly care a lot about immigration. Immigration certainly bothers people, but it does have benefits. One of these is to low-pay employers, who can exploit them to make cheap goods. If they had to pay a living wage and treat workers fairly, they could no longer bring in cheap foreign labour to live in poor conditions. UK workers would be competitive and migrant workers wouldn't be 'stealing our jobs'.

Also remember that if we send all immigrants home, they might send all ours back.

UKIP want us to leave Europe and be free of all their pesky regulations. Regulations that affect our beloved corporations.

Only sometimes regulations are good. Corporations are robots. They are built to make money. They might be briefly not evil if that will result in them making money. If customers will only buy their stuff if they are good then they will respond to that. However, most of the time, people aren’t aware of the bad stuff they do, or there isn’t a choice, or they can’t afford to make the choice, so corporations will do whatever bad stuff they can get away with so long as it makes them money.

Often, the only thing stopping them doing this is regulation from national and supra-national bodies. The EU isn’t just about straightening bananas, it does all sorts of stuff for us including cheap flights, cheaper international phone calls, consumer protection, food safety and human rights. Yes, the European Convention on Human Rights is a good thing. Unless you like being a slave, discriminated against, or killed, or being told what to believe or being tortured etc. It just has some unintended consequences, as all regulations do.

It’s bodies like the EU that will be instrumental if we want people and companies to pay the tax they owe without stashing their cash in tax havens.

But one thing going on in Europe now might be about to make things a whole lot worse. Apparently that thing is called TTIP.

TTIP

A sticker on a bus

I’d love to say I know what TTIP is, but, to be honest, I don’t. So what's the concern? Boris Johnson says I'm a 'numskull' for worrying about it. Thanks Boris. I'm not the only worrying, though. Here are some angry protesters.

When I say I don’t ‘know’ what TTIP is, I mean that I only know these brief details that have been leaked. The negotiations are actually happening in secret.

It’s supposed to be a free-trade agreement between the EU and the US.

The pitch:

To remove restrictions between the two areas to make it easier to invest.

To decrease bureaucracy and duplication of regulations, so companies only have to meet one set of rules when creating products and services.

To increase growth and create bazillions of jobs.

Brilliant.

So what’s everyone’s beef? Well, beef for one. If we harmonize food production rules, we might find Europe’s current safety standards lowered to those of America. Have you seen the state of an American chicken farm? Sardines in a can don’t know how lucky they are. The example often cited is the use of growth hormones to make cows bigger. Europe doesn’t allow this, America does. What’s wrong with grass and grain?

Ok, what else? Companies investing sounds good, right? Not necessarily if they are investing in our healthcare system. TTIP will make it easier for US companies to take over NHS contracts. Worse than that, they could sue governments if they are prevented from doing so. The corporations tout fair competition but they want to remove the NHS’s protection from predatory PLCs. Cameron has been asked to keep the NHS out of these discussions.

If you need reasons to be concerned about TTIP, try:

These ten

and

These (similar) six.

And if you agree that it sounds bad in it's current form, that we should be told more about it and that we should make sure that our safety standards and public services are corrected, then look at these petitions:

https://secure.38degrees.org.uk/page/s/vince-cable-fix-ttip#petition

http://www.change.org/p/to-the-eu-and-uk-governments-do-not-sign-up-to-ttip

So, in summary...

Is it a contradiction to criticise UKIP's anti-Europe stance and the TTIP negotiations going on in Europe in the same post? Maybe. But maybe it's just that the world's a bit more complicated than 'Europe is bad for Britain' or 'immigration is too high'. It's the nuances of these debates that are more important than the headlines.

Think long and hard before you vote UKIP. It is unlikely that all your problems are because of immigration, it's just a simple and visible thing to make you scared about. If you care about the rest of UKIP's policies, then please read them and decide if they would benefit you and really make Britain the kind of country you want it to be.

The world has changed and Britain isn't in charge any more. Our own well-being is tied up with that of the rest of the world. Maybe there's more to life than being the most powerful country and reducing inequality within our own country would make us all happier. If we do want a say on the world stage, then it's hard to do it alone and being part of Europe has many more benefits than drawbacks.

We need to engage with Europe and hold it to account. Sometimes it is too expensive. When things are going wrong, such as with TTIP, we need to know about it and do something about it. The alternative could be disastrous.

Podcast Episode 2 - Anaesthetic awareness, sporting head injuries, ebola.

In our second podcast, Dave and I answer the question 'Will I wake up during my operation?' and discuss sporting head injuries, ebola, green cola and dogs.  Enjoy! Share! Feed back!

www.medicave.co.uk
@mdmedicave

If you want to download it to your computer, you can click this link directly.

Or you can point your RSS reader or podcast app to the following feed:
http://feeds.feedburner.com/PodcastMediCave

Ban Boxing (and every other sport)!

Image: Andrzej Krauze - taken from New Scientist article

I have to say that I don't like professional boxing. Not to say I've never watched it, but it does make me uncomfortable. I've watched amateur boxing at the Olympics. They wear headgear and it seems more of a sport to me. It may be no safer than the pro side but at least it has the sheen of a points-based contest. As argued in this New Scientist article, head injuries are the aim of pro-boxing. I don't see how we can still justify it as entertainment. I'd get rid of it if I was in charge. You may be glad I'm not.

That leads to the question: What level of risk is acceptable in a sport, either to the competitor or others? I don't have the answer to that, but all sports should be trying to get the balance right between preserving the game and protecting those playing. No, 'they make loads of money' isn't justification for putting them at unnecessary risk.

Dave and I talked about this on the pod, but we came across some interesting articles and stories that you might want to read.

I'm obsessed with NFL (American Football) at the moment and we mentioned in Podcast 1 that we wanted to talk more about it so we got to it in Podcast 2. Head injuries have been big news in the NFL for some time. Over 3000 former NFL players sued the league in 2012 and a settlement was agreed in 2013 for $765m to provide medical care for those affected.

NFL involves HUGE guys tackling each other. All players must wear a helmet, but this can only help so much. There is now an initiative starting in schools called Heads Up Football that aims to teach kids proper tackling technique and reduce head and spinal injuries. When concussions do occur, the NFL has guidelines in place for the assessment of players and when to let them play again. This involves pre-season baseline testing and the presence of neurologists at every game. When players sustain a concussion, they should not play until they have fully recovered as the risk from second injuries is great.

The lawsuit above covered a few different types of head injury, but it seems that the main issue was CTE or chronic traumatic encephalopathy - a degenerative disorder related to repeated concussions. It's linked with movement disorders, personality changes, substance misuse and suicide. Clearly, even minor head injuries need to be taken seriously. As a vast money-making machine, the NFL is finally starting to take responsibility for reducing these injuries and protecting its employees.

Football (our football) is much earlier in this journey. It's a non-contact sport though, right? Well that's fine until a keeper wants to get a ball with his hands or body and an attacker wants to score with his legs. Petr Čech (Chelsea) suffered a depressed skull fracture in 2006 and has been wearing protective headgear since. Last year, Tottenham were criticized for letting their keeper Hugo Lloris play on after being rendered unconscious in a similar collision.

Partially in response to this incident, the Premier League introduced new guidelines prior to the start of the 2014-2015 season. These included giving doctors (who are employed by the team...) the power to remove players from the game, rather than leaving the decision to the team or player. Surely the Premier League can afford an independent doctor at a game to assess these things - armed with a rule that says, "If a player is knocked out, they are getting subbed off. I don't care if you've used all your subs, it's great when a defender has to get his gloves on."

Last week, the inadequacy of the current set-up was displayed again when another Chelsea keeper was knocked out. He was assessed by the club doctor and allowed to carry on but was subbed later when he felt unwell, with blood coming out of his ear. FIFA have supported the decision to keep on playing (caution - Daily Mail link) but I can't see how unconscious players should be allowed to wake up and carry on. It's not bravery or commitment, it's reckless and stupid.

I don't watch much rugby, but the RFU puts out this info sheet, which looks pretty good. it talks about the 4 R's when concussion is suspected (such as when a player has been knocked out):

Recognise

Remove

Recover

Return

If any one knows whether this works in practice, I'd be keen to hear.

The conflict between safety and spectacle is rarely more apparent than in motorsport. Fans want speed (and many will freely admit, crashes) but no-one wants to see drivers hurt. As the pinnacle of motorsport, Formula 1 has improved greatly from earlier decades, where death was an accepted and inevitable part of the season. There's not been a driver death in F1 since I was ten. Circuit design, improvements in protective equipment, car safety and rule changes have all helped reduce the risk. The lessons learnt in F1 have filtered down to lower formulae and to our road cars.

But any thoughts that F1 was now "safe" were shattered last weekend, when Jules Bianchi crashed into a recovery vehicle that was by the side of the track to move another stricken car. I had read that he had undergone surgery for a subdural haematoma (bleed on the brain) but I can't actually find confirmation of this now so sorry if that isn't the case. What has been said is that he's suffered a diffuse axonal injury, where rapid acceleration and deceleration causes damage to nerve cells due to shearing. This is a common but devastating consequence of severe head injury.

We'll be thinking of him and his family.

At this point I'd like to say that motor sport, at all levels, can only run because of the dedication of a legion of unpaid marshalls, who stand out in all weather to keep the racers safe. They are backed up by knowledgeable and passionate officials and an enthusiastic community of doctors and paramedics who are constantly trying to improve medical provision at these events. Here's some concussion guidelines for F1 and for loads of information about Medicine in Motor Sport, read that.

A HANS device and helmet

Will any good come from this? This accident occurred following a previous incident and the organizers have come under fire for not putting out a safety car to slow everyone down in wet conditions whilst the first car was recovered. There is a debate about closed cockpits in F1 (like a fighter-jet canopy to protect drivers' heads) but worry that fans won't like the look of it. Some fans will moan about every change in F1 but ultimately get used to it. We'll have to wait to see what lessons can be learned.

Ultimately, organizers should take all reasonable steps to protect their athletes. We, as fans and consumers, should accept changes to improve the safety of the sports we love.