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Buce

'I regularly see rickets' - Consultant Paedeatrician at LRI

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This would have normally gone in the politics thread, but Webbo seems to have unilaterally decided to lock it for Xmas.

 

Well, I'm not having this buried - it's a national disgrace and a damning indictment of austerity politics:

 

https://www.theguardian.com/society/2017/dec/23/poorer-children-disproportionately-need-hospital-treatment

 

It may be Christmas, but it is business as usual at Leicester Royal Infirmary children’s emergency department. Anxious families sit in the waiting room, receptionists deal with the stream of admissions and doctors continue on their never-ending rounds. The only concessions to the festive season are the murmur of a Christmas film on the television and some tinsel in the corridors.

Given the unrelenting pace of life in the NHS, Dr Damian Roland, a consultant in paediatric emergency medicine, says the social background of his patients is not on his mind when they arrive for treatment. But during a brief lull in another frantic day, he reflects on how child poverty is manifesting itself in the young people he treats.

4816.jpg?w=460&q=55&auto=format&usm=12&fit=max&s=39aaab886901ef630dc14005e64a5e06
Report shows ‘devastating impact’ of deprivation on child health with poorest teens 70% more likely to visit A&E than their wealthier counterparts
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“I don’t have time to sit with families for ages and discuss those particular social issues or have any chance of doing anything about it,” he says. “But clearly it’s important – and it’s affecting children. We need to recognise it as an issue, and there needs to be a debate about the public health responsibilities of frontline NHS services.”

It comes as no surprise to senior doctors such as Roland that deprivation is playing a part in poor children appearing at hospital more often than their richer counterparts. However, an eye-opening study for the Nuffield Trust, revealed in the Observer and based on hundreds of thousands of patient records over a decade, brings new and depressing evidence.

For condition after condition, the poorest fifth of young people are admitted in greater numbers than the richest fifth. In cases of tonsillitis, viral infections, abdominal pain, respiratory infections, convulsions, gastroenteritis, poisoning, chest pain – even head injuries – the poorest young people were admitted for emergency treatment at rates 40% or more higher than the richest.

In the case of some conditions such as epilepsy the gap has been closed, suggesting that education campaigns and a good strategy can help. But no medical professional believes that awareness campaigns designed to head off emergencies will on their own stop poor children needlessly turning up at hospital.

 

The worry is that with the NHS under pressure, a housing crisis and state spending squeezed, things will get worse before they get better – while stagnant wages are heaping pressure on families less able to cope with a medical issue that is allowed to become an emergency.

One of the report’s authors, Dr Ronny Cheung, a paediatric consultant at the Evelina children’s hospital, London, says he is seeing a growing evidence of conditions not only exacerbated by poverty, but caused by it. “I’m seeing kids with rickets on a fairly regular basis in my clinic,” he says. “That is related to nutrition at the very least. We are seeing more advanced cases. It should be a Victorian illness. It shouldn’t be around to this degree any more.

“What we see on a weekly basis is that poorer families who come in often take their children into hospital a bit later than they otherwise would. Maybe that’s partly down to health literacy, but – and I’ve spoke to parents about this – it is a struggle for them to bring children in. If your ability to make a living is on the line, your threshold for taking time off work to check a child’s health is going to be higher.”

 

Rates of admission for asthma are particularly alarming, having risen over the last decade – the poorest young people are now well over twice as likely to be admitted for the condition as the rich. Medical experts say that environment, and above all poor housing, is a prime cause.

According to the latest government data, there were 121,360 children in temporary accommodation in England in the third quarter of 2017 – with more than 88,000 of those in London. It is the highest number in a decade. The figure in London represents a 52% growth over the last five years. In the capital alone, more than 3,000 children are living in bed and breakfasts, or hostels.

“Housing problems can have a major impact on child health – whether that’s increased likelihood of respiratory problems because of poor housing conditions, or mental ill-health,” said Dr Dougal Hargreaves, of the UCL Institute of Child Health. “In a recent survey of paediatricians, over 40% had difficulty discharging a child in the last six months because of concerns about housing or food insecurity.”

 
The Nuffield study is published as years of progress in cutting child poverty is being reversed. Research by the Joseph Rowntree Foundation earlier this month found almost 400,000 more children in the UK were living in poverty last year compared with 2012-13. It warned that decades of progress were being erased due to stagnant wages and inflation. It has called on the government to unfreeze working-age benefits and build decent, affordable homes.

Meanwhile, the Institute for Fiscal Studies estimates the number of children living in poverty is likely to rise to a record 5.2 million over the next five years. The Nuffield report suggests that this also has serious consequences for an NHS already under strain.

The pressures of that poverty on families, Dr Cheung says, are becoming tragically clear. “A few months ago we had discussions with social services about whether a child was being cared for properly,” he recalls. “But it just turned out that the mother was working two jobs, she had two other children and was simply under pressure not to take more time off to go to an asthma appointment. In the end, we agreed to see the child at home because that was the only way we could make it work.

“This is about life chances. It’s about the fact that a quarter of the children in this country live in material poverty. It’s about a lack of social mobility. It’s a cycle.”

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Or how much is it a damning indictment of parents spending what little money they have on fags, booze and 60" 4K TVs?

 

I'm not excusing austerity politics, but it's not so simple as that.

Edited by Trav Le Bleu
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6 minutes ago, Trav Le Bleu said:

Or how much is it a damning indictment of parents spending what little money they have on tags, booze and 60" 4K TVs?

 

I'm not excusing austerity politics, but it's not so simple as that.

 

I'll let people who have more patience than me answer that.

 

I don't want banning for Xmas.

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1 minute ago, Buce said:

 

I'll let people who have more patience than me answer that.

 

I don't want banning for Xmas.

So you're telling me that there aren't a lot of irresponsible people who have no right to be parents? It's not as simple as your post, it's not as simple as mine.

 

Things were terrible in the 70s, surely you remember that. I wonder how many reports of rickets there were then (and before anyone says it, of course there were some). Social responsibility doesn't end with government.

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Both of you have a point, as something as horrid as this will not be down to one single thing. I do agree with the sentiment above and also think that it is down to the governments inability to realise that warnings and poster campaigns only go so far. These parents need help, they need proper supporting education. I see it first hand from the parents of my kids friends, they let their kids dictate their diets. They don’t do it because of neglect or lack of a caring nature (quite the opposite in fact), they do it because they have no real understanding of the damage they are doing. It’s frightening really.

Edited by Strokes
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One kid turned up to my sons class, with a bright blue tongue early last year, I said to him, why do you have a blue tongue charlie? He grinned and flashed a sweet packet at me. His mum, not even embarrassed said, he won’t have anything normal for breakfast so I took him to the shop this morning for a brain licker.

8553578D-C48E-4337-AA13-6C50ED1CAD0B.jpeg.54148fe154dcedb17297affda57b56bc.jpeg

Im not slightly exaggerating.

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8 hours ago, Trav Le Bleu said:

Read the above post.

 

Fresh fruit and veg isn't expensive. iPhones, large TVs, designer name clothes, drugs (both legal and illegal) are not essential. Tattoo parlours, nail bars and tanning shops are prolific in the poorer parts of town, yet none of these things are even vaguely important.

 

Try walking round the most impoverished parts of town some time without seeing any of these things. People have forgotten to look after the basics.

 

Also, like I said, I never claimed it was just as simple as that.

 

 

It’s an argument that gets made quite often but what I’d like to see is some evidence that poorer people do actually buy lots of large TV’s and iPhones because I doubt anyone who makes that sort of argument has been round a poor area knocking on doors with a tape measure ready to size up all the TV sets.

 

Nail bars etc being in the poorer parts of town is probably as much to do with the costs of running a business as anything else. Those are mostly quite low income businesses so you would expect to find them in areas where rent on commercial property is at the cheaper end.

 

I’m not saying all this doesn’t have some truth to it, maybe some people do need help prioritising their spending, but it seems harsh to dismiss every complaint, including ones which include kids getting sick, on the basis of what appears to be a stereotype backed up by no evidence being blanket applied to an entire group.

Edited by Rogstanley
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28 minutes ago, Rogstanley said:

It’s an argument that gets made quite often but what I’d like to see is some evidence that poorer people do actually buy lots of large TV’s and iPhones because I doubt anyone who makes that sort of argument has been round a poor area knocking on doors with a tape measure ready to size up all the TV sets.

 

Nail bars etc being in the poorer parts of town is probably as much to do with the costs of running a business as anything else. Those are mostly quite low income businesses so you would expect to find them in areas where rent on commercial property is at the cheaper end.

 

I’m not saying all this doesn’t have some truth to it, maybe some people do need help prioritising their spending, but it seems harsh to dismiss every complaint, including ones which include kids getting sick, on the basis of what appears to be a stereotype backed up by no evidence being blanket applied to an entire group.

I wasn't being dismissive, I was saying it's not just a political problem.

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There is overwhelming correlation between poverty and having kids out of wedlock without a job. 

 

If you obtain 5 gcse's, get a job and only have children when you are married, then there is overwhelming odds that you won't be impoverished. 

 

Far too many tweenagers get pregnant whilst working part time at tesco. 

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13 hours ago, Trav Le Bleu said:

I wasn't being dismissive, I was saying it's not just a political problem.

There will surely be some that need educating but to suggest that national level statistics can be explained away because Deontay spent a weeks benefits on four packets of B&H is ridiculous.

 

The fact you even think it's possible that people can't feed their kids because they once bought a TV and they have a few tattoos just shows how badly quality of life is suffering and how successful neoliberalists have been in convincing everybody that the vast majority of the poor deserve it.

 

We are seeing homelessness and food bank use rocket. Benefits have fallen. Wages are falling. Public services are being under funded. All independent analysis shows that the poor have taken the brunt of cuts. THIS is the reality. It's an absolute scandal.

 

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49 minutes ago, toddybad said:

There will surely be some that need educating but to suggest that national level statistics can be explained away because Deontay spent a weeks benefits on four packets of B&H is ridiculous.

 

The fact you even think it's possible that people can't feed their kids because they once bought a TV and they have a few tattoos just shows how badly quality of life is suffering and how successful neoliberalists have been in convincing everybody that the vast majority of the poor deserve it.

 

We are seeing homelessness and food bank use rocket. Benefits have fallen. Wages are falling. Public services are being under funded. An independent analysis shows that the poor have taken the brunt of cuts. THIS is the reality. It's an absolute scandal.

 

Yes and some  of this is down to bad decisions by people who live for the now, are easily influenced by thinking they need stuff they don't (advertising is surely one of the greatest evils that people swallow whole) and have probably give up trying.

 

I've highlighted the pertinent word to help you. For the last time, cos I've said it so many times, but everyone keeps missing the point...

 

IT'S NOT SO SIMPLE AS JUST ONE THING!

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14 minutes ago, Trav Le Bleu said:

Yes and some  of this is down to bad decisions by people who live for the now, are easily influenced by thinking they need stuff they don't (advertising is surely one of the greatest evils that people swallow whole) and have probably give up trying.

 

I've highlighted the pertinent word to help you. For the last time, cos I've said it so many times, but everyone keeps missing the point...

 

IT'S NOT SO SIMPLE AS JUST ONE THING!

Which is fair enough. So you'd think, let's educate people to make better decisions. It existed. It was called Sure Start. It's been cut. 

 

Individual decisions are of course an element, but the entire framework within which individuals make decisions has been worsened.

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3 hours ago, Trav Le Bleu said:

I wasn't being dismissive, I was saying it's not just a political problem.

The problem you're describing is people making bad decisions when prioritising their spending. Bad decisions are a product of poor education and the types of spending you're referring to, as you've pointed out are often a result of predatory practices from big business. Both education and regulation of business are functions of the state so like it or not, it is a political problem.

 

When you've got a government that cuts relevant support services at the same time as offering business free reign to do what they want in the name of free market capitalism then you get an increase in these sort of problems.

 

I'm a firm believer in freedom of choice, including the freedom to make bad decisions and I believe that people should take responsibility for the consequences of those decisions, but the role of the state for me is minimise the occurrence of those bad decisions primarily through education and also through regulation where business practices are obviously predatory. 

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12 hours ago, Strokes said:

One kid turned up to my sons class, with a bright blue tongue early last year, I said to him, why do you have a blue tongue charlie? He grinned and flashed a sweet packet at me. His mum, not even embarrassed said, he won’t have anything normal for breakfast so I took him to the shop this morning for a brain licker.

8553578D-C48E-4337-AA13-6C50ED1CAD0B.jpeg.54148fe154dcedb17297affda57b56bc.jpeg

Im not slightly exaggerating.

I have a similar story of my brother getting called into school to have a meeting with the headmistress. His daughter was constantly saying she was hungry in the morning so she could get the toast and jam they offer around. They warned him they would contact social services if he didn't start feeding her breakfast. He took a video on his phone of her eating a bowl of cereal and a yoghurt for breakfast. She still said she was hungry and asked for the jam and toast. When called in again he showed them the video and explained that she just loves jam and toast. 

 

Not really relevant to the topic at hand, but was quite amusing seeing this headmistress that was just laying into my brother for no reason ending up with egg on her face. 

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3 minutes ago, Realist Guy In The Room said:

If your life is absolute shit and you feel that it wont get better no matter what, spending £20 a week at Brighthouse is pretty understandable.

 

It doesnt make you neglectful.  For some it might be the only way they can think of to give themselves and their kids a greater sense of worth.

Yeah surviving is shit, it always has been and it probably always will be.

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1 hour ago, Dr The Singh said:

This country is still one of the richest and offers free education, health services etc, it's sad people struggle for food.  However due to the several generations of society continually happy being on benefits does make us working people show little sympathy.

Only 1.3% of welfare spend is on out of work benefits. Only a teeny tiny bit of this is on the long term unemployed. Having worked as a benefit fraud investigator, my opinion is it clearly exists but not to the level you'd think listening to people. In much the same way as health tourism exists but is nowhere near the level you'd imagine reading the daily mail.

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Just now, toddybad said:

Only 1.3% of welfare spend is on out of work benefits. Only a teeny tiny bit of this is on the long term unemployed. Having worked as a benefit fraud investigator, my opinion is it clearly exists but not to the level you'd think listening to people. In much the same way as health tourism exists but is nowhere near the level you'd imagine reading the daily mail.

That 1.3% does not include all the other welfare benefits such as child benefit, housing benefit and disability benefit for those on long term sick that these people struggling for food and not working get.  That actually equates for nearly 30%.  

 

Even still it's very shocking that we provide a wealth of services and still people cannot afford food.

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Either way an increase in rickets in a developed nation is a sign of a failing society, whether it is down to education, benefits culture, poverty, underfunded health service or a combination of other complex reasons is not the point. The point is everybody in the United Kingdom should be able to provide a healthy enough diet for their children that they don't get a disease that should have been eradicated decades ago.

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On 23/12/2017 at 23:43, Strokes said:

One kid turned up to my sons class, with a bright blue tongue early last year, I said to him, why do you have a blue tongue charlie? He grinned and flashed a sweet packet at me. His mum, not even embarrassed said, he won’t have anything normal for breakfast so I took him to the shop this morning for a brain licker.

8553578D-C48E-4337-AA13-6C50ED1CAD0B.jpeg.54148fe154dcedb17297affda57b56bc.jpeg

Im not slightly exaggerating.

My Mrs looks after the breakfast club at her school and the stuff I get told makes you feel sorry for some of these kids  and this is 14 15 year olds who go school early just to get some food down them, parents pissed up from the night before, no dinner money for the kids. There really are some shithead parents about.

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