newsbites

WHO

Target medical errors

Millions of patients would benefit if healthcare workers could be made to wash their hands more often, identify their patients better, and not reuse old needles, the World Health Organization said as it launched a drive to cut down medical errors. The United Nations' agency said that medical mistakes affect one in 10 patients worldwide. In sub-Saharan Africa as many as 18% of injections are given with reused syringes or unsterilised needles, WHO said.

The British chief medical officer, Dr Liam Donaldson, who is heading the agency's campaign, blamed the problem on complacency and announced nine recommendations, drafted by using feedback from experts from more than 100 countries. The agency recommended better hand hygiene for medical workers; proper patient identification, to guard against one person getting medicine intended for someone else or newborn babies being given to the wrong parents; and a ban on the reuse of needles.

WHO also said that healthcare providers should ensure operations are carried out on the right body parts, double check drug names that sound similar, and ensure that medical workers communicate properly when handing patients' care over to colleagues (www.reuters.com).

Fashion

Dangerous ties

Malaysian doctors have declared ties a health hazard and called on the health ministry to stop insisting that they wear them. Citing studies that show ties are unhygienic and can spread infection, the Malaysian Medical Association said that often ties were not washed and carried germs that can cause pneumonia and blood infections, the Star newspaper reported. "And when doctors are doing their clinical rounds, they dangle all over the place," the paper quoted association president Teoh Siang Chin as saying.

L Woods

The Star also quoted a ministry official as saying that it needed more proof that neckties were a danger before it relaxed the dress code for doctors in hospitals (www.reuters.com).

China

Hospitals need police protection

China's Ministry of Health has asked police to patrol local hospitals to protect medical workers from violent attacks by angry patients and their relatives. The ministry's spokesman Mao Qu'nan appealed to police and hospitals to cooperate to halt the violent trend, the state owned China Daily newspaper said. "Bringing about a harmonious medical service environment is not just down to hospitals," it quoted him as saying. "The police should be more involved in safeguarding hospital staff and the facility itself."

Patients commonly take out their anger about treatment quality or costs on hospital staff or property in China. Lax supervision has lead to overcharging, bogus treatments, and corruption since 1980s market reforms ended lifelong state provided health care. In December, doctors and nurses at Shanxia hospital in Shenzhen, Guangdong province, donned hard hats for their rounds after being jostled and spat at for days by relatives seeking compensation for a patient's death (www.reuters.com).

Doctors' free lunches

Drug companies at work

Almost all US doctors take freebies from drug companies, and a third take money for lecturing, signing patients up for trials, or going to meetings, according to a survey published in the New England Journal of Medicine (2007;356:1742-50). The study of 1662 doctors found that 94% "reported some type of relationship with the pharmaceutical industry," with more than 83% receiving food in the workplace and 78% receiving free samples.

More than a third said they received money from drug firms for giving lectures, signing up patients for drug testing, or going to medical meetings. And the more influential a doctor was, the more likely he or she would benefit from gifts or payments from drug companies, the researchers analysing the survey found (www.reuters.com).

US healthcare

Under criticism

Patients in the United States get the poorest health care and yet pay the most compared with five other rich countries, according to a report by the non-profit making Commonwealth Fund group, which studies health care. Germany, Great Britain, Australia, and Canada all provide better care for less money, the report found. Canada rated second worst out of the five overall. Germany scored highest, followed by Great Britain, Australia, and New Zealand.

"The United States is not getting value for the money that is spent on health care," Commonwealth Fund president Karen Davis told Reuters. "We focus primarily on measures that are sensitive to medical care making a difference—infant mortality and healthy lives at age 60," Dr Davis said. "Those are pretty key measures, like how long you live and whether you are going to die before age 75."

The group has consistently found that the United States, the only one of the six countries that does not provide universal health care and where almost one sixth of the population has no health insurance, scores more poorly than the others on many measures of health care. Per capita health spending in the United States in 2004 was $6102 (£3070; €4540), twice that of Germany, which spent $3005 per person. Canada spent $3165, New Zealand $2083, Australia $2876, and Britain $2546 per person (www.reuters.com).

Medical innovations

"No scar" surgery

Doctors in eastern France say that they have carried out the world's first "no scar" surgery, removing the gallbladder of a 30 year old patient through her vagina. The team used an endoscope and minute instruments for snipping tissue and clipping blood vessels. The only abdominal approach was with a 2 mm needle, which gave a second view of the operation and was also used to inflate the abdominal cavity to create a space in which the surgical team could work.

The patient, who had gallstones, reported no pain after the surgery but was kept in hospital for two days as a precaution. The lead doctor, Jacques Marescaux, told Agence France-Presse that the operation at Strasbourg University Hospitals broke new ground in minimally invasive surgery. The operation was the culmination of a three year research project, he said (www.afp.com).

UK MTAS

The row continues

UK junior doctors failed in their court case that asked for judicial review to stop a discredited job selection process. They say the system is unfair and will not allocate posts in the NHS to the best candidates. Remedy UK, an organisation representing 10000 young doctors, wanted the court to rule that training posts granted by the medical training application service (MTAS) should last for only one year, allowing for a fairer system to be introduced in six months.

Mr Justice Goldring called MTAS a "flawed system." The health secretary, Patricia Hewitt, concedes that the deeply unpopular system "has simply not worked." A review by doctors' leaders binned the system and proposed a rescue package, whereby applicants would each get one guaranteed interview for their first preference job. But Remedy UK says that this means doctors who could have expected four interviews will have been penalised.

Separately, junior doctors whose confidential details were made available on the MTAS website in April have called on the police to mount a criminal investigation against those responsible (www.guardian.co.uk).