Sensible rationing of dementia drugs – a lead from France

The first country in Europe to act on concerns over limited effectiveness In May 2018 the French minister of health announced the delisting of drug treatments for dementia; payments for memantine and the acetylcholinesterase inhibitors donepezil, rivastigmine, and galantamine would no longer be reimbursed by the state. What a sensible approach. Without the expensive drugs […]

Dont ration hearing aids if you want to reduce early dementia (as well as falls and depression), and avoid Regional Disparities

Some health trusts have been reducing the number, access, and quality of hearing aids. This is particularly prevalent in Wales. The message from a large study in Michigan is that this is an important population measure: keep access to the best hearing aids available to all and avoid post code and regional discrimination. England currently […]

Closure of many more surgeries…. And there’s an epidemic of dementia coming….

Popular cities like Bristol do not expect to be without GP cover. There have been many more since I last posted on GP closures. The Headline generated by Amanda Cameron in Bristol Live 2nd August reads:  Health chiefs explain decision to close two GP surgeries in Bristol – The decision left 15,000 patients needing to sign […]

The dementia care system is neither healthy nor caring

The cradle to grave system of health care breaks down if you are severely demented. The caring that the different dispensations (England, Scotland, Ireland and Wales) give for mental handicap in children is not repeated in adults. My mother is incontinent, cannot speak, walk or feed herself, and is an empty shell of the teacher […]

Covert and post coded randomised rationing of dementia care..

The daily mail claims there is a deliberate bureaucratic block on spending money on dementia. The implication is that these citizens, at the end of their lives, don’t matter. After all they often don’t have the mental capacity to vote, and they don’t have the life expectancy, so the combination means their votes don’t matter. […]

Should dementia from sports injuries and concusion be subject to “deserts based rationing”?

If the dementia risk rises by 17% when the risk of dementia is 10%, the absolute risk only rises to 11.7%. The article by Kat Lay in the Times chooses to use relative risk calculation, but it is important just the same. NHSreality has been saying since inception that certain sports persons, especially those that […]

Here is an idea to fix the NHS: let’s get rid of GPs. Lets see how Scotland’s GPs vote…Dementia is going to overwhelm all our services, including our GPs unless we address reality…

Well, he might not realise it but we are already doing just what Philip Johnson advocates. What with waste and duplication, the inability to live with any uncertainty, and the patients expectation of excellence for minimum contribution, we are ensuring that GPs either retire, leave or get ill. Litigation, complaints, bullying, threats, denial and disengagement […]

Hearing loss and dementia: more research is needed. Patients with hearing aids in hospital need special consideration, and for over 70s, that’s over 60% of us …

More research is needed into the relationship between hearing loss and dementia. Patients with hearing aids in hospital need special consideration, and for over 70s, that’s over 60% of us … The rationing of hearing aids is patently perverse, and the outcome could be more long term dementia care demand on the state. And of […]

Families asked to feed dementia patients…. How do we design a system that is fair to both the well spread, and the very locally based families?

The quality of care that demented and dementing patients are receiving is inadequate. There is not enough funding, in any system, and especially one without rationing, to provide the quality of care needed. ( National Dementia Audit: Important improvements in dementia care, but more support needed report finds) If you have a stroke, or have […]

Will the state expand whoever wins? Why is dementia excluded from state care, but all other conditions are not? A mutual fund for elderly care can only work if it is universal….

It feels from the party manifestos that there is an agreement that the state needs to do more, especially to reduce inequalities. The conservatives wish to use capital assets for domestic/home based care in the same way as assets are used for Nursing Homes now. ( Down to £23,000 ) NHSreality sees nothing wrong with […]