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The Ukip leader told reporters last week that, like many smokers, he had started using them as a way of cutting down the number of real cigarettes he smoked. Nick Clegg has said that he made the switch entirely and now only
Yet there is increasing pressure from doctors groups for the government to crackdown even further on the industry marketing e-cigarettes (including the existing tobacco industry), despite there being only some theoretical, unproven risks associated with them, compared to the very real risks of smoking.
I hope that after the election Farage and Clegg use whatever power they have to ensure that the e-cigarette industry is not regulated out of existence. The evidence is clear: tobacco kills, nicotine doesn
Believe it or not, doctors WANT a 7-day NHS, too
David Cameron would like the NHS to run 7 days a week, with consultant-led care available to all when they need it. So would voters and so would I.
Because, despite the prospect of disrupted weekends, this is an ambition that is surprisingly popular with my colleagues and other clinical staff. We are all too aware of the evidence that shows patients are more likely to die if they are admitted to hospital at a weekend [url=www.cheapusacigs.com]Newport Cigarettes[/url]. This is a shameful and shaming. If the solution requires us to work ina different way then so be it.
Many of us also recall our time as junior doctors and of being acutely aware that we were not equipped to deal with some of what we faced at weekends when input from senior doctors was minimal [url=www.cigarettesno1.com]Newport Cigarettes Website[/url]. Certainly we tried our best, but it never made up for a few decades of experience that our superiors had [url=www.wholesaleusacigs.com]Newport Cigarettes Carton Price[/url]. The limited service available at weekends - such as imaging and scans - is also incredibely frustrating.
Doctors have sympathy for the general public because we, like them, sometimes need to see a GP or attend a hospital outpatient appointment. On the few occasions I needed to see a doctor myself, I had to take a half-day off work. It is ridiculous.
And there is no doubt that a consultant-led service improves the quality of patient care. A 2012 report by the Academy of Medical Royal Colleges cited dozens of studies which pointed to this as well as supporting evidence from other professional organisations. Everyone is in agreement that is the gold standard but there something about Mr Cameron pledge that rings hollow. He made the same promise 5 years ago and it has failed to materialise. The problems of logistics and economics that have prevented it happening then are still in place now.
David Cameron's first election poster of the 2010 general election campaign focused on the NHS
Where the money, and perhaps most importantly the doctors is an issue on which ministers are alarmingly quiet. In order to roll out a 7-day service, we need more doctors. Since 1995 the number of consultants has increased from 18 [url=www.ctdonut.com/marlboro]Cheap Cigarettes Free Shipping[/url],000 to over 36,000 while the number of trainee doctors has similarly doubled [url=www.usacigscoupons.com]Tobacco Store[/url]. But if the number of doctors continues to increase to meet demand, this will place extraordinary pressure on the NHS in the form of salaries. Indeed, a study by the Centre for Workforce Intelligence has warned that NHS England consultant salary bill would rise by 60 per cent just to cover the cost of these new doctors becoming consultants. This has prompted a suggestion that newer consultants could be asked to accept lower salaries.
I would think that consultants support for a 7-day would evaporate if this was the case. The real problem, though, lies in general practice. Older GPs are already feeling the strain and retiring, while, on average, 20 per cent of training places remain unfilled.
We need to be pragmatic. The statistics on increased mortality in hospitals at weekend has led to a panicked insistence on a 7-day-a-week NHS across the board. What started as a patient safety issue has morphed into a healthcare wish list of luxuries we don have the money for, and it is being used for pie-in-the-sky electioneering. In the process, we lost sight of the patient safety angle.
Labour's 2015 general election poster
We therefore need to make the distinction between opening for safety and opening for convenience, with us prioritising the former and accepting the latter is a luxury. I propose looking at the areas where the mortality rates are high and focusing on ensuring that they have 7-day cover through existing consultant rotas and increasing other staffing levels if needed. Some disciplines, such as paediatrics, have already accepted the need for 7 day a week consultant input and have structured their services accordingly without recruiting more consultants.
And let acknowledge that specialities such as dermatology do not need to provide 7-day cover. Rather than promising the same old service, just on more days, we should be prioritising better use of consultant time and exploring other things, such as telemedicine for use at weekends for those with minor ailments who might want to see a GP about? It might not be as headline grabbing but it better than issuing yet more hollow promises.
After 12 wonderful years, farewell and thank you to Telegraph readers
After almost 12 wonderful years of writing this weekly column, I decided to explore other journalistic projects and so, sadly, I am leaving the Telegraph. It been an incredible privilege to write for this newspaper and to have a platform from which to share my thoughts and views.
Over the years I have had thousands of letters, cards and more recently, emails, from readers. Many have been deeply personal. People have told me things they have never shared with anyone else and I have been humbled that they felt able to confide in me. Others have been rather rude, some very funny, but all have confirmed for me that Telegraph readers are engaged and passionately concerned about healthcare and wellbeing - their own and that of of others - and how it is delivered. While I might not always agree with the politics, you have so often made me think again and question my position. This reciprocity of ideas has had a profound impact on me.
I am especially grateful to Charles Moore, who took an enormous gamble on an inexperienced 23 year old medic when, as editor, he hired me - and to all the Telegraph staff I have worked with.
But above all I want to say a heartfelt thank you to all the readers, especially those of you who have been with me from the beginning when I was writing about my life as a junior doctor. Sharing my thoughts and experiences with such an engaged [url=www.cigarettesss.com]Tobacco Shop[/url], intelligent and thoughtful group of readers has been a privilege. Goodbye, take care of yourselves, and thank you.
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