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Nurses have reacted with dismay to the announcements by Jacqui Smith, the Home Secretary, that people caught carrying knives would be taken into A&E departments to see victims of stabbings and that hospital staff would be legally required to report knife wounds to the police.
So, on the first point, let's see: you've just been stabbed and taken to A&E, then who comes to visit? No, not Mum, but a load of criminals whose punishment is to look at you as exhibit A - person stabbed and now feeling rubbish.
“To allow people to view patients is a ludicrous idea - what about dignity and confidentiality,” says Rabina Tindale, chair of the Royal College of Nursing (RCN) emergency care association. Tindale is concerned that people with knife injuries will be put off coming for treatment.
And nurses don't have time to act as offenders' tour guides. Mike Hayward, acute nursing adviser at the RCN, says: “There are serious ethical and professional problems with bringing people into A&E. We would be concerned if people were brought in when we have a job to do.” He also says that “it would be worrying if everyone with a knife wound was reported to the police”. Clumsy cooks, beware.
But police interventions that target violence hotspots are particularly effective, says Professor Jonathan Shepherd, director of the Violence Research Group at Cardiff University, in the British Medical Journal (July 18). Emergency departments can help to identify hotspots by collecting anonymous data on the locations and times of violent events and the types of weapons, then sharing the data with crime-reduction agencies. He points out that crime reduction partnerships, made up of the NHS, local authorities and the police, lead to reduced violence compared with the latter two groups working alone.
Concern over Ritalin rates
We have bred a generation of pill poppers - but this time it's legal. Health Service Journal (July 17) reports that there is a 23-fold difference in the rate at which children in different parts of England are prescribed Ritalin to control their behaviour. Also called methylphenidate, the drug is an amphetamine used to treat children with attention deficit hyperactivity disorder (ADHD).
The highest rate was in the Wirral, where pharmacists dispensed one prescription for every seven children under 16 in 2007. Stoke-on-Trent had the lowest rate, on average one prescription for every 159 children. Across England the average is one prescription for every 23 children under the age of 16.
Primary care trust (PCT) figures for the number of prescriptions dispensed since 2003 placed in the House of Commons library show that 461,000 items of the drug were prescribed to children in 2007, up from 199,000 in 2003.
Wirral PCT acknowledged “the apparent high prescribing rates of ADHD drugs in comparison to other PCTs”.
Isle of Wight had the second highest rate (one for every 9.3 children). A spokesman for the PCT said he was not aware of any reason for this but that the island's small population could skew the figures.
A spokesman from the Department of Health says: “It is important to note these figures are dispensing levels, and not the number of children taking the drug [and] could include repeat prescriptions for the same child.” So - no need to worry then? Or are some kids taking bucketloads? Perhaps their parents are joining in, or maybe it's just keeping pharmacists busy and the pills are ending up in the bin.
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