Hi dear reader, Welcome to your spring in full bloom edition of your favourite health news round-up! Always so nice to witness the colder darker days of winter morph into the brighter sunnier days of spring, with daffs and crocuses having sprung from the parks and grass verges. On the sporting front, the men’s Irish rugby team having won the 6-Nations tournament, with England being the only team to beat them, whilst the men’s football Premier League now being in the homestretch of the season with just a handful of games to go, there’s a couple of exciting months ahead before a summer of international football with the four yearly Euro 2024 Championships taking place in Germany – Will Gareth finally claim some glory? Trusting as always that you enjoy these four carefully selected articles from the past month :-

7^th The Guardian – Aviva’s profits rise as demand for UK private health insurance booms

Booming demand in the UK for private health insurance, as NHS waiting lists remain at near-record levels, has boosted annual profits at Aviva, with more frequent claims and higher medical costs driving up premiums. Britain’s biggest general insurer said sales of health insurance had risen 41% in 2023 compared with the previous year, with strong demand from from businesses and individual customers, who were taking out policies as the crisis in the state health service continues.

The step up in Aviva’s health insurance business contributed to a 9% rise in annual operating profits to £1.5bn last year, better than analysts had forecast. Aviva’s chief executive, Amanda Blanc, said: “We’ve seen individuals looking at the NHS and saying: ‘I can afford to buy health cover, so I will do that.’ So, we’ve definitely seen a take-up of individual policies. We’ve also seen small businesses  take advantage of the opportunity to protect their employees.”

More small employers are offering health cover to their staff and some big companies are expanding their cover, with add-on provisions such  as a digital GP service, she said, which offers customers access to an NHS-qualified primary care doctor through video consultation and text. About 1.2 million people are covered by Aviva health policies, making it the third biggest player in the UK market after Bupa and Axa.

Charlotte Jones, Aviva’s chief financial officer, added that more people were signing up for health cover through their company than before. “Where it’s always been there, but they haven’t prioritised it – through salary sacrifice or something like that – there’s more of a push, and more people are prioritising it.” Blanc said premiums had gone up partly due to higher medical costs, which are rising by 8% to 10%, although Aviva had been able to limit price rises through long-term contracts with hospitals. Customers were also making more frequent claims, she said – both for low-cost items such as physiotherapy, which they traditionally would have got through the NHS, and more expensive procedures such as surgery.

Hospital admissions paid for through private medical insurance remained at near record levels between January and September of 2023, up 7% on a year earlier, according to data released by the Private Healthcare Information Network this week. “That doesn’t surprise me at all,” Blanc said. “There are some schemes where you have a waiting time but if you can’t get an NHS appointment within six weeks, your private health cover kicks in.” NHS waiting lists for routine operations in England hit record highs last year but fell back in January. The waiting list is expected to “start to fall consistently but slowly from the middle of 2024”, the Institute for Fiscal Studies has predicted – though it will remain larger than it was before the Covid pandemic until 2030.

18^th The Independent – Secret NHS report reveals failure to protect trainee paramedics from sexual harassment and racism

A confidential NHS England report, uncovered by this publication, has found that “extremely alarming” conduct and undermining behaviour are rife in ambulance trusts across the country, with trainees subjected to derogatory comments about their age, ethnicity, and appearance in front of patients.

There is a “worrying acceptance” that this is “part of the job”, with students hesitant to raise complaints about sexual behaviour by male colleagues in case it gives them a reputation as “annoying snowflakes”, the report says. The revelations come after a recent NHS staff survey revealed that thousands of ambulance staff had reported unwanted sexual behaviour from colleagues and patients last year.

One healthcare leader described the findings as “harrowing”, warning that much more needs to be done to protect junior staff. Examples of racist and sexist behaviour between colleagues , uncovered by The Independent, include:

• One male paramedic touching a student inappropriately on multiple occasions – including her breast and groin – and making sexually inappropriate comments such as: “That has got me going”
• Incidents reported at one trust that included an employee blackfaced at a works fancy-dress party, making monkey sounds, and even laughing at colleagues unable to eat during Ramadan
• A male paramedic asking a student to go to a hotel room and saying: “Women don’t have gag reflexes.”
• One racism complaint not being taken forward because the staff member was deemed to be simply “set in their ways”
• A student who complained about bullying and a “toxic environment” being moved to another station, while the mentor was given a new student straight away
• One professor telling a  trainee: “We’re not going to change the culture … so we try to protect our students from the worst”

The national report, which is understood to have gone through several edited versions and is marked commercially sensitive, was not due to be released until The Independent obtained it  through a freedom of information request. It found an “undercurrent” of bullying in some areas, with examples of students leaving their job, with one apparently told: “Your concerns don’t matter – we have to meet patient demands.”

Ambulance handover delays have also led to student paramedics having less experience and training on the job, prompting fears that newly qualified paramedics do not have sufficient levels of experience in life-critical situations. Saffron Cordery, the deputy chief of NHS Providers, said: “Trust leaders have zero tolerance of sexual harassment and racism in the NHS. But these harrowing findings make clear that more can and must be done to ensure the wellbeing and safety of staff.”

NHS England triggered the review following “extreme challenges” faced by ambulance services in 2021 and 2022. An independent review into ambulance services in February warned the NHS that “serious allegations of sexual assault, harassment or inappropriate behaviours” had been made within ambulance services across the country, which employ nearly 17,000 paramedics.

Anna Parry, managing director of the Association of Ambulance Chief Executives (AACE), said rooting out “inappropriate and outdated elements of toxic workplace” is one of the ambulance service’s top priorities to ensure staff are able to do their job “free of harassment of any kind.”

A Department of Health and Social Care spokesman said: “Discrimination, sexual harassment or misconduct of any kind is unacceptable, and NHS organisations have a responsibility to protect both staff and patients. They said the NHS has launched it’s “equality, diversity and inclusion improvement plan to tackle racism, prejudice and discrimination and has set out its sexual safety charter.”

19^th The Times – Vaping ‘linked to cancer and damages the body like smoking’

People who vape suffer similar changes to their DNA as smokers who develop cancer, researchers have revealed. Scientists at University College London analysed samples of cheek cells from vape users and compared these with those from cigarette smokers. Both groups had similar changes to the DNA of cells in their mouth.

These changes were, in turn, linked to the future development of lung cancer in smokers. The authors of the study, published in the journal Cancer Research, said the findings did not prove e-cigarettes cause cancer but show that “the devices might not be as harmless as originally thought.” It is the first major study to draw a link between e-cigarettes and an increased risk of cancer.

Little is known about the long-term effects of e-cigarettes, and debates over their harm have so far mainly focused on concerns about nicotine addiction among the young. On Wednesday MPs will be presented with world-leading legislation restricting the flavours and promotions of vapes, as well as banning smoking for younger generations altogether. Rishi Sunak said that the bill would “save thousands of lives and billions of pounds for our NHS” and that he was confident of staving off a party rebellion. Some MPs on the Tory right, led by Liz Truss, have criticised the smoking ban for those born after January 1, 2009, as curtailing individual freedom, but all of the UK’s present and former chief medical officers, including Professor Sir Chris Whitty, have taken issue with this argument.

Writing for The Times, they said: “To be pro-individual choice should mean being against the deliberate addiction of children, young people and young adults to something that will harm, potentially fatally.” They urged MPs to back the legislation to help end the “flagrant marketing of vapes to children using colours, flavours and packaging.” They added: “Vapes can help smokers quit. But if you don’t smoke, our advice is don’t vape.”

A recent investigation by The Times revealed how the promotion of e-cigarettes by the government and NHS as a tool to stop smoking led to an epidemic of youth vaping, as organisations linked to the tobacco industry played down e-cigarettes’ health risks. Because vaping is relatively new, little is known about long-term side effects. UCL’s study is the first to examine how smoking and vaping can modify the DNA in cells, in a process known as epigenetics. These changes are thought to allow cells to divide more quickly, potentially growing into tumours.

The study involved data from 4,000 people, with co-author, Professor Martin Widschwendter, said: “Changes that are observed in lung cancer tissue can also be measured in cheek cells from smokers who have not yet developed a cancer. Importantly, our research points to the fact that e-cigarette users exhibit the same changes, and these devices might not be as harmless as originally thought. Long-term studies of e-cigarettes are needed.”

Dr. Ian Walker, executive director of policy at Cancer Research UK, said: “This study contributes to our understanding of e-cigarettes, but it does not show that e-cigarettes cause cancer. “Decades of research has proven the link between smoking and cancer, and studies have shown that e-cigarettes are far less harmful than smoking and can help people quit. Smoking tobacco causes 150 cases of cancer every single day in the UK, which is why we look forward to seeing the government’s age of sale legislation being presented in parliament. Nothing would have a bigger impact on reducing the number of preventable deaths in the UK than ending smoking, and this policy will take us one step closer to a smoke-free future.”

An academic article published in 2018 accused Public Health England of “complacency” as “thousands of children become nicotine addicted through vaping” amid the rising popularity of cheap, brightly coloured vapes pioneered in the United States by Juul. It warned of the unknown health consequences of e-cigarettes and the possibility of an “epidemic of devastating lung disease for today’s children.” Meanwhile, international organisations such as the World Health Organization continued to question the scientific evidence around e-cigarettes and warned that they were harmful to health.

By 2023, more than one in five children under 18 in the UK have tried an e-cigarette, a 30 per cent increase in a year. The UK’s pro-vaping approach made it a target for those wishing to promote the use of e-cigarettes around the world. A Times investigation in December exposed ties between tobacco companies and a secretive lobbying campaign to boost e-cigarette sales and block health measures aimed at protecting children.

Cigarette manufacturers have funded scientific papers which have played down the risks of children vaping and helping to run a supposedly ‘grassroots’ campaign which presented itself as the voice of ordinary vapers and tried to influence policy decisions. Hundreds of British doctors attended smoking cessation training sessions which included advice on the use of e-cigarettes and nicotine replacement therapies by smokers looking to quit. They were run by an NHS doctor who has received millions in funding from a foundation which was solely-funded by a tobacco giant.  

Smoking remains Britain’s biggest preventable killer, resulting in about 80,000 deaths a year, and is a major driver of socioeconomic and geographic inequalities. Passive smoking of second-hand smoke, including by children, damages health for life. The NHS carries the burden of trying to undo some  of the damage smoking causes.

27^th The Times – Satisfaction with the NHS falls to record low

Satisfaction with the NHS has fallen to a historic low, with only a quarter of the British public believing that the health service is working. Experts said people felt in a “toxic relationship” with the NHS, supporting the institution on principle but increasingly fed up, sick and anxious because of its failures.

The annual report by the King’s Fund and Nuffield Trust think tanks found that public confidence in the health service was at its lowest since polling began in 1983. The difficulty of seeing a GP was the biggest source of frustration. Just 24 per cent of people said they were satisfied with the NHS in 2023, a year of “strikes, scandals and sustained long waits for care”. This had fallen from 29 per cent the previous year and a peak of 70 per cent in 2010. Before that, the lowest satisfaction level had been 34 per cent in 1997.

The overwhelming majority of those surveyed still supported the principles of the NHS, with nine in ten saying it should be free at the point of use. Dan Wellings, senior fellow at the King’s Fund and the report’s author said the national sentiment was encapsulated by one patient who remarked that they “love our NHS” but “it’s a bit of toxic relationship.” Wellings added: “People don’t want to criticise it. They don’t want to be negative about something which has been there for them, for their families, from cradle to grave, for a long time. There’s still a huge belief in the institution.”   

A separate report published on Wednesday shows that the economic and social costs of mental health problems in England have more than doubled in the past 20 years. The report, by the Centre for Mental Health and the NHS Confederation, estimates that poor mental health cost £300 billion in 2022 – twice the NHS’s entire budget in England. Wes Streeting, the shadow health secretary, said: “After 14 years of Conservative neglect, the NHS has never been in a worse state.” The Department of Health said NHS funding would be a record £165 billion a year by the end of this parliament, adding: “We are fully committed to a faster, simpler and fairer NHS, free at the point of need.”

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So there you have it good people, another round up which I trust that you found as interesting as ever, this month covering some serious subjects including sexual & racism harassment proven to be very much prevalent within the NHS, as well as the ever increasing appreciation that vaping is not as harmless as many people had originally thought and were indeed led to believe – as reported upon by some of the broadsheet newspapers. Of course, with the lighter & longer days now in the Spring season, outside activity including running & cycling becomes much more appealing and easier to get oneself motivated to achieve, thereby helping to ‘repair’ the immune system from the bugs and viruses of winter.

Until May,

Please stay well and healthy,

Kind regards,

Daniel Donoghue

MD, Surrey Circle Health

Specialist ‘Whole Market’ Medical Insurance Brokers