Is it now time for more stomach reduction surgery to deal with the growth in Type 2 Diabetes?

The Northern Ireland Audit Office Report “Type 2 diabetes; prevention and care” published on Tuesday 6th March is critical of DoH’s failures in both creating and implementing policy for Type 2 Diabetes.  Type 2 Diabetes is an important disease because; it is common (6% of the population and rising), is generally progressive (the speed of which is inversely proportional to how well it is controlled), is very costly to manage (£400 million a year or 10% of health budget), and … Read more

Professional Arrogance in Health Care: is it a systemic cultural problem?

“Shock”, “disappointment”, “disbelief”, “embarrassment” are just some of the many comments that accompanied the findings of Sir John O’Hara’s report;  The Inquiry into Hyponatraemia-related Deaths. The public, not only here but across the British Isles and beyond, have been made aware of unacceptable failings in the care of four (probably five) children and the cover ups to their avoidable deaths.  People are genuinely concerned and wondering how safe health care is overall.  This is a reasonable and rational reaction but … Read more

It’s time to bring back prescription charges for all – no exceptions…

  In a briefing document published on December 18th the Department of Finance outlined three proposed approaches to “balancing the budget” over the next two years.  For me, it was unsurprising that as part of the proposals to “raise additional revenue” for 2018-20, the department suggested reintroducing a charge for “each health service prescription item dispensed”. Prescriptions have been free here since 2010.  Reintroducing prescription charges could generate “up to £20 million” annually, the department estimated which I feel is … Read more

Sleep; wake up to the benefits…

Sleep is finally revealing its secrets and they are proving more sensational than we ever dreamt. Sleep, that part of human functioning we treat with such contempt and distain, might be a means of improving many aspects of our lives particularly our health. Sleep, of sufficient quality and quantity, is offering a panacea for a range of medical conditions plaguing modern life. But will we listen? We; fail to take enough exercise, eat too much poor quality foods; sustain bodies … Read more

Bonfires and Traffic congestion; are we seeing the medical consequences?


DoH’s Health Inequalities; Regional Report, 2016, just published, tells us positively that in general as a population we are in great shape. In spite of our national moaning about our poor health – and interminable complaining about the inadequacies of our health service – we are as a fact, on average, healthier than we ever have been with access to the most amazing services and procedures. We now live to 80; 100 year ago the average age of death in … Read more

Homeopathy and the NHS…

So the NHS may finally be clearing its shelves of homeopathic practice and remedies.  To address the current funding crisis, the NHS has announced that a number of remedies which are either ineffective, frankly dangerous or both will no longer be available.  Homeopathy is one of them and rightly so.   No doubt some, perhaps Prince Charles a strong advocate for homeopathy, will protest that this move will adversely affect the health of the nation but they will be in the … Read more

Berlin and the ghosts of history…

  The other weekend, along with Angela Merkel, I was in Berlin.   Not together of course; she was there to work on forming a new government, I in pursuit of pleasure.  Berlin is a great city both for business and pleasure with its unique culture and complex history; magnetic and absorbing it just keeps pulling me back. We stayed near Potsdamer Strasse in the old Siemens building; the company’s HQ before it was destroyed by Allied bombs in the 1940s.  … Read more

ITV has gone to pot…

Imagine a producer at Al Jazeera, the Qatari TV channel, pitching a program idea to his managers which goes something like this.   We select a group of overweight elderly Doha Residents, people with a certain celebrity in our beloved Kingdom – we want the audience to like them but they need to be men of the people – and we take them off to Britain where we take them on a road trip around; public houses, distilleries, micro-breweries and vineyards … Read more

Prescription Medicines in the Dock – Who is to blame for the increasing drug deaths in our society?

Ireland bucks the UK trend in drug overdose deaths; here they are more likely to result from “prescription medicines” than “illegal drugs”. Coroners locally implicate; tramadol, oxycodone or fentanyl in overdose more frequently than in England, Scotland or Wales where deaths are mainly linked to; heroin or cocaine. One implication is that prescription medicines are more readily available and, extending this logic, doctors and pharmacists are in some way involved; if we did our jobs better drug deaths would be … Read more

The Camino; the origins of the EU idea?

It seems far-fetched, risible even, yet some experts claim the Camino de Santiago de Compostella is the origin of the European Union project. The argument goes that the pilgrims of the Middle-Ages who tramped across the many Pilgrim Ways that coalesce in the City of Santiago, north-west Spain, brought tolerance of differences and a focus on a common goal; a road that eventually led to the idea of a united Europe. Pilgrim’s objectives were spiritual, religious and off course selfish. … Read more

Drug Addiction Services: what is the policy?

We are currently in Belfast experiencing a significant increase in the number of people with drug addictions and I’m informed that similar rises in prevalence are occurring elsewhere.  In addiction things are never simple.  A 24-year-old patient who died back in the spring died of an overdose of opioids – he frequently had a number of fentanyl patches adhered to his body – but he also was a heavy smoker of marijuana and regularly took a range of prescription medicines … Read more

Don’t get bogged down trying to stay active, just go for a good walk…

Following a heart stent insertion and a chance meeting with an old friend I hadn’t seen for years – we were each at our GP surgery picking up heart medicines – we decided “walking for old men” would be our thing for 2017.  The medical evidence is clear; exercise is better medicine than our prescribed pills; we just needed the commitment. Sufficient exercise is more effective in reducing the risk of heart disease than taking blood pressure and cholesterol medicines; … Read more

Misogyny bullying and brutal violence; what is there to worry about in the Middle East?  

My eldest daughter, a primary school teacher, returns to Qatar this weekend as do hundreds of young people from these shores supporting the education systems across the Middle East.  With developments over the summer I felt anxious as we said our farewells; she was sanguine as young people are.  Having left the Emirate in June just after the borders and airspace were closed, and sanctions imposed by a coalition cobbled together by Saudi Arabia, no fresh chicken or milk were … Read more

What role do consultants play in health service waiting lists?

Seanin Graham’s exclusive in the Irish News “Desperate Patients Pay for Eastern Europe Ops” highlights a persistent problem in our Health Service; lengthening waiting lists.  She focuses on the use by local patients of surgical services in other European states and identifies the lengths some will go to improve their situation.   She has identified the problem and, for very few patients,  an expensive solution, and where this is a useful reminder that as a population we deserve better, she fails … Read more

Boys and young men who would once be proud builders of World-class Ocean liners are now relegated to building bonfires…

We all felt sorry for the articulate young man whose apartment near Sandyrow was damaged by an 11th Night bonfire.   He, sensibly, didn’t want to be recognised so the interview was done off camera.   He wanted to live in safety, he wanted compensation for the damage but above all he didn’t want to annoy anyone or interfere with “cultural expression”.   These seem reasonable middle-class values and who could argue with them?  His neighbour, a thirty-something woman, equally articulate, praised the … Read more

Antibiotics are such a fragile resource why do we continue to abuse them?

It’s now OK, according to a paper in BMJ not to finish a course of antibiotics.  It is merely a myth according to researchers who can find no evidence that stopping your antibiotics when you feel well, does not lead to bug-resistance as we have always believed.   Doctors, however, in spite of this finding are still suggesting that you should continue to take antibiotics as instructed and that means completing the course.  It’s all a bit confusing and what’s the … Read more

Charlie Gard: a life worth a legacy…

Charlie Gard will probably die in the next few days. His death I hope will be private, peaceful and dignified and my sincere sympathy to his parents Connie Yates and Chris Gard and I truly hope they can move on with their lives after the torture of the last few months. Charlie’s short, tragic life has been lived too much in the glare of publicity, and as a result many will know of his case and the legal wranglings surrounding … Read more

The expansion of the Ulster waist-line is threatening to bankrupt the Health Service in 20 years, obesity should be weighing heavily on the Health Minister’s mind; if only we had one…

Good grief Northern Ireland you’re getting bigger!  One-in-four of us has now moved up the scales to possess a “Over-30-BMI-Body”.  Given that the expansion of the Ulster waist-line is threatening to bankrupt the Health Service in 20 years, obesity should be weighing heavily on the Health Minister’s mind; if only we had one.   If we had, he or she should recognise the seriousness of the issue and scrap our Obesity Strategy (Fitter Futures for All: Framework for Preventing and Addressing … Read more

A tribute to Patrick Johnston – Vice-Chancellor of Queens University

There was palpable shock and genuine grief among the staff of Queens on Sunday evening following announcement of the death of the Vice-Chancellor, Paddy Johnston. A top flight academic and brilliant administrator had died suddenly in his prime when he had so much more to give. We were in the same year at St Columb’s College, Derry during the first half of the 1970s. He being a day boy and I being a boarder, and being in different classes of … Read more

The dead are rising from their graves in West Belfast…

  It’s all in a day’s work.  Every day is different in community pharmacy and the stories we hear could not be made up.  Terry Maguire relates an unfortunate, frightening and bizarre night one of his patients had. Wet clay patches dappled his oversized anorak, his reddened face was muddied and his greying, thinning hair; wet and woolly.  He was smiling manically and exuded a strong stench of stale urine and strong alcohol.   Had it been closing-time I might have … Read more