call for a democratic health service

1
1345 In line with the recommendations of the ad-hoc committee, the number of participants whom the Director-General is inviting to the conference is restricted to 100. They are being drawn from Governments and national drug regulatory authorities, industry, consumers’ and patients’ organisations, health-care providers, teachers, economists, health educators, and political and social scientists, as well as other UN Agencies and non-governmental organisations. Former and new members of the ad-hoc committee on drug policies will also be invited, as will members of the peer review group and authors of working papers. Invitations will, it is hoped, be issued early this month. The Director-General has expressed his thanks to those Governments (Denmark, Finland, Italy, Malta, Norway, Sweden, and UK) which have responded to his appeal for funds to support this enterprise. So far about US$200 000 has been pledged; but there is a considerable shortfall, and negotiations are continuing with WHO member states who are unable to provide funds during 1985 to see whether they might pledge contributions in 1986. Because of the undertaking to hold the conference in 1985, the Director-General has made it possible to use funds from uncommitted voluntary sources to enable preparations to go ahead. No funds will be diverted to the conference from the WHO regular budget. The above report is based on a statement by Dr Leo Kaprio, formerly director of the European region of WHO, to the 38th World Health Assembly held in Geneva last month. Dr Kaprio is executive secretary ofthe forthcoming conference. International Diary 1985 4th world congress on Emergency and Disaster Medicine: Brighton, UK, June 4-7 (Dr Peter Baskett, Honorary Secretary/Treasurer, Club of Mainz, Frenchay Hospital, Bristol BS16 1LE, UK). World symposium on Occlusion and the Temporo-mandibular Joint: London, UK, June 20-23 (Jane Tillson, Symposium Secretariat, Conference Clearway Limited, Conference House, 9 Pavilion Parade, Brighton, Sussex BN2 IRA, UK). International symposium on Hazards of Light: Manchester, UK, July 10-13 (Dr Richard Gregory, Department of Biochemistry, Medical School, University of Manchester, Oxford Road, Manchester M13 9PT). WHO advanced course on Quantitative Methods in Cancer Epidemiology: Lyon, France, Aug 26-Sept 6 (Research Training and Liaison Unit, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 08). International conference on Economics of Medical Technology: Valkenburgh, Netherlands, Sept 2-4 (Conference Secretariat, Economics of Medical Technology, University of Limburg, PO Box 616., 62000 Maastricht, Netherlands). International congress on Cardiac Doppler: Pisa, Italy, Oct 14-18 (Scientific Secretariat, Instituto di Fisiologia Clinic, CNR, Universta di Pisa, Via Savi 8, 56100 Pisa). International meeting on Human Population Genetics: Toulouse, France, Oct 21-23 (Institut National de la Sante de la Recherche Médicale UlOO, Meetings Secretary, CHU Purpan, 31052 Toulouse). 1st international congress on Neo-adjuvant Chemotherapy: Paris, France, Nov 7-9 (Hopital de la Salpetnere, 47 boulevarde de 1’Hopital, 75651 Paris, Cedex 13). 27th annual meeting on the Long Term Patient: Ontario, Canada, Nov 22-24 (Dr M. V. Seeman, Programme Committee, Group-Without-A-Name 1985, Clarke Institute of Psychiatry, 250 College Street, Toronto, Ontario M5T 2R8). 1986 3rd congress of the international society for Biomedical Research on Alcoholism: Helsinki, Finland, June 8-13 (Organizing Secretariat, Ms Sari Salo, 3rd ISBRA Congress, Alko Ltd, POB 350, SF-00101 Helsinki). National Health Service Call for a Democratic Health Service A charter has been drawn up by the London Health Democratisation Campaign seeking to promote public discussion of NHS organisation and policy. The charter complains that in one central respect-that of democratic organisation-the NHS remains "deeply flawed". Central Government controls NHS organisation from the Secretary of State for Social Services through the Department of Health and Social Security to regional health authorities and district health authorities. Family practitioner committees are independent but directly accountable to the Secretary. of State. Community health councils represent the interests of NHS users, but they have very limited power and resources. The charter seeks democratic representation of NHS users and workers; the accountability of planning decisions to local users; and defined rights of access to information on local needs and resources. It is hoped that these three demands would foster discussion of the NHS’s overall policy objectives (incorporating policies on environment, employment, food, transport, and housing) with the aim of reducing inequalities in health. The charter is available from LHDC (Healthrights), Room 318a Waterloo Road, London SE1 8XF (01-633 9377 ext 55). Trends in Sexually Transmitted Diseases 547 000 new cases were seen in NHS genitourinary clinics in 1983, an increase of 6% over 1982 and 200 000 more than in 1973. The Department of Health and Social Security, in a bulletin of information about trends in sexually transmitted diseases, records an annual average increase in the number of cases of 5% over the period 1973-83. The classical venereal diseases, syphilis and gonorrhoea, are becoming less prevalent and accounted for only 9% of all cases in 1983, compared with 18% in 1973. The most common condition in 1983 was non-specific genital infection in men and candidiasis in women. Many patients seen in clinics did not have a sexually transmitted disease: in 1983 cases not requiring treatment accounted for 22% of all cases. DHSS statistical bulletin no 3/85, New Cases of Sexually Transmitted Diseases (ISBN 0 946539 68 5) may be obtamed (£1) from DHSS Information Division, Canons Park, Government Buildings, Honeypot Lane, Stanmore, Middlesex HA7 1AY. Regulations on List of Approved Drugs Amended Revised regulations intended to clarify the circumstances under which a drug on the "black" list (not prescribable under the NHS) may be dispensed, have been drawn up by the DHSS. The amendments, effective from June 1, make it clear that a pharmacist or dispensing doctor may not supply a Schedule 3a drug (on the black list) in response to an order by name, formula, or other description on an NHS prescription form, unless the drug has an appropriate non-proprietary name, as defined by the regulations, and is ordered by that name or by its formula. In that case only, may a blacklisted drug with the same specification be supplied. If a drug has more than one active ingredient there must be an appropriate non-proprietary name for the combination. This amendment will permit restricted drugs to be dispensed where necessary (that is, when generic products on the approved list are not generally available) but prevent such drugs from being dispensed simply by listing their ingredients. Substitution was intended to be allowed in circumstances where there is no generic version at present available, as, for example, ’Distalgesic’ (paracetamol and dextro- propoxyphene). Competitive Tendering in the NHS Mr John Patten, Parliamentary Under-Secretary for Health, has declared that the policy of competitive tendering in the NHS has been a great success, producing savings of L13 186 million on 119 tendering exercises. Health authorities are using the money saved

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Page 1: Call for a Democratic Health Service

1345

In line with the recommendations of the ad-hoc committee, thenumber of participants whom the Director-General is inviting tothe conference is restricted to 100. They are being drawn fromGovernments and national drug regulatory authorities, industry,consumers’ and patients’ organisations, health-care providers,teachers, economists, health educators, and political and socialscientists, as well as other UN Agencies and non-governmentalorganisations. Former and new members of the ad-hoc committeeon drug policies will also be invited, as will members of the peerreview group and authors of working papers. Invitations will, it ishoped, be issued early this month.The Director-General has expressed his thanks to those

Governments (Denmark, Finland, Italy, Malta, Norway, Sweden,and UK) which have responded to his appeal for funds to supportthis enterprise. So far about US$200 000 has been pledged; butthere is a considerable shortfall, and negotiations are continuingwith WHO member states who are unable to provide funds during1985 to see whether they might pledge contributions in 1986.Because of the undertaking to hold the conference in 1985, theDirector-General has made it possible to use funds fromuncommitted voluntary sources to enable preparations to go ahead.No funds will be diverted to the conference from the WHO regularbudget.The above report is based on a statement by Dr Leo Kaprio, formerly

director of the European region of WHO, to the 38th World Health Assemblyheld in Geneva last month. Dr Kaprio is executive secretary ofthe forthcomingconference.

International Diary

1985

4th world congress on Emergency and Disaster Medicine: Brighton,UK, June 4-7 (Dr Peter Baskett, Honorary Secretary/Treasurer, Club ofMainz, Frenchay Hospital, Bristol BS16 1LE, UK).

World symposium on Occlusion and the Temporo-mandibular Joint:London, UK, June 20-23 (Jane Tillson, Symposium Secretariat, ConferenceClearway Limited, Conference House, 9 Pavilion Parade, Brighton, SussexBN2 IRA, UK).

International symposium on Hazards of Light: Manchester, UK, July10-13 (Dr Richard Gregory, Department of Biochemistry, Medical School,University of Manchester, Oxford Road, Manchester M13 9PT).

WHO advanced course on Quantitative Methods in Cancer

Epidemiology: Lyon, France, Aug 26-Sept 6 (Research Training andLiaison Unit, International Agency for Research on Cancer, 150 cours AlbertThomas, 69372 Lyon, Cedex 08).

International conference on Economics of Medical Technology:Valkenburgh, Netherlands, Sept 2-4 (Conference Secretariat, Economics ofMedical Technology, University of Limburg, PO Box 616., 62000 Maastricht,Netherlands).

International congress on Cardiac Doppler: Pisa, Italy, Oct 14-18(Scientific Secretariat, Instituto di Fisiologia Clinic, CNR, Universta di Pisa,Via Savi 8, 56100 Pisa).

International meeting on Human Population Genetics: Toulouse,France, Oct 21-23 (Institut National de la Sante de la Recherche MédicaleUlOO, Meetings Secretary, CHU Purpan, 31052 Toulouse).

1st international congress on Neo-adjuvant Chemotherapy: Paris,France, Nov 7-9 (Hopital de la Salpetnere, 47 boulevarde de 1’Hopital, 75651Paris, Cedex 13).

27th annual meeting on the Long Term Patient: Ontario, Canada, Nov22-24 (Dr M. V. Seeman, Programme Committee, Group-Without-A-Name1985, Clarke Institute of Psychiatry, 250 College Street, Toronto, OntarioM5T 2R8).

1986

3rd congress of the international society for Biomedical Research onAlcoholism: Helsinki, Finland, June 8-13 (Organizing Secretariat, Ms SariSalo, 3rd ISBRA Congress, Alko Ltd, POB 350, SF-00101 Helsinki).

National Health Service

Call for a Democratic Health Service

A charter has been drawn up by the London HealthDemocratisation Campaign seeking to promote public discussion ofNHS organisation and policy. The charter complains that in onecentral respect-that of democratic organisation-the NHS remains"deeply flawed". Central Government controls NHS organisationfrom the Secretary of State for Social Services through theDepartment of Health and Social Security to regional healthauthorities and district health authorities. Family practitionercommittees are independent but directly accountable to the

Secretary. of State. Community health councils represent theinterests of NHS users, but they have very limited power andresources. The charter seeks democratic representation of NHSusers and workers; the accountability of planning decisions to localusers; and defined rights of access to information on local needs andresources. It is hoped that these three demands would fosterdiscussion of the NHS’s overall policy objectives (incorporatingpolicies on environment, employment, food, transport, and

housing) with the aim of reducing inequalities in health.The charter is available from LHDC (Healthrights), Room 318a Waterloo

Road, London SE1 8XF (01-633 9377 ext 55).

Trends in Sexually Transmitted Diseases

547 000 new cases were seen in NHS genitourinary clinics in1983, an increase of 6% over 1982 and 200 000 more than in 1973.The Department of Health and Social Security, in a bulletin ofinformation about trends in sexually transmitted diseases, recordsan annual average increase in the number of cases of 5% over the

period 1973-83. The classical venereal diseases, syphilis andgonorrhoea, are becoming less prevalent and accounted for only 9%of all cases in 1983, compared with 18% in 1973. The most commoncondition in 1983 was non-specific genital infection in men andcandidiasis in women. Many patients seen in clinics did not have asexually transmitted disease: in 1983 cases not requiring treatmentaccounted for 22% of all cases.DHSS statistical bulletin no 3/85, New Cases of Sexually Transmitted

Diseases (ISBN 0 946539 68 5) may be obtamed (£1) from DHSS InformationDivision, Canons Park, Government Buildings, Honeypot Lane, Stanmore,Middlesex HA7 1AY.

Regulations on List of Approved Drugs Amended

Revised regulations intended to clarify the circumstances underwhich a drug on the "black" list (not prescribable under the NHS)may be dispensed, have been drawn up by the DHSS. Theamendments, effective from June 1, make it clear that a pharmacistor dispensing doctor may not supply a Schedule 3a drug (on theblack list) in response to an order by name, formula, or otherdescription on an NHS prescription form, unless the drug has anappropriate non-proprietary name, as defined by the regulations,and is ordered by that name or by its formula. In that case only, maya blacklisted drug with the same specification be supplied. If a drughas more than one active ingredient there must be an appropriatenon-proprietary name for the combination. This amendment willpermit restricted drugs to be dispensed where necessary (that is,when generic products on the approved list are not generallyavailable) but prevent such drugs from being dispensed simply bylisting their ingredients. Substitution was intended to be allowed incircumstances where there is no generic version at present available,as, for example, ’Distalgesic’ (paracetamol and dextro-

propoxyphene).

Competitive Tendering in the NHS

Mr John Patten, Parliamentary Under-Secretary for Health, hasdeclared that the policy of competitive tendering in the NHS hasbeen a great success, producing savings of L13 186 million on 119tendering exercises. Health authorities are using the money saved