Thursday 17th October 2013
Budget farce as James Reilly doubts medical card €113m HSE savings
Plans for massive cuts to the medical card scheme have descended into farce after the health minister cast doubt over the target figure outlined in the budget and the HSE said it will have to be independently verified.
The target of €113m through medical card “probity” was foisted on Health Minister James Reilly on Sunday, without any verification or assessment of how it could be achieved.
The embattled minister told the Oireachtas health committee yesterday the figure was “allocated” by Public Expenditure Minister Brendan Howlin.
“I am speaking frankly and I am concerned about what can be achieved here,” said Dr Reilly.
He said the figure was based on Mr Howlin’s “deliberations” of a consultancy report by Price Waterhouse Cooper that said €60m to €200m could be achieved through identifying waste from ineligible cards.
“That report is from 18 months ago and obviously a lot of action has been taken since then,” said Dr Reilly.
He has asked the departments of the Taoiseach and public expenditure to carry out a validation of the figure and the impact it would have on the health service.
Tony O’Brien, head of the HSE, said the executive is carrying out an “independent verification process” before the figures are included in its service plan for 2014.
He said if the savings could not be made through probity — or flushing out dud cases — then cuts will hit other health services.
Fianna Fáil has estimated that about 100,000 medical cards would have to be withdrawn in order to reach the €113m figure.
Mr. O’Brien insisted there would be no change to people’s entitlement or the way medical cards are assessed, as a result of the target.
“Therefore, if that €113m cannot reasonably be achieved through probity measures, then an alternative way of meeting that shortfall will have to be found.”
Sources close to Dr James Reilly said €113m was imposed “from the top down” rather than than from the “bottom up” approach of identifying the waste, and then determining what could be saved from its elimination.
They said that James Reilly was given the figure and told to find the savings within it.
The Irish Examiner can also reveal that the HSE raised concerns 18 months ago about the accuracy of the potential savings in the PWC report. A disclaimer by the report’s authors said the savings were “indicative only and cannot be relied on for any purpose other than providing a broad understanding” of the issue.
A further €25m in health savings will be reached by removing medical cards from 35,000 over-70s. The Irish Senior Citizens Parliament who are organising a protest march next Tuesday against the budget “attacks” on Irish elderly people.
Mr O’Brien also raised concerns about changes to tax reliefs for private health insurance in the budget.
The HSE depends on income provided by private patients in public hospital beds, he said. “If there were to be a significant impact on the number of insured patients, that would have a knock-on impact on the funding of the health servicesnext year,” he said.
HSE West group meets over HIQA report on death of Savita Halappanavar
A special board meeting of the HSE West/North West Hospital Group has ended after four hours of talks at Galway University Hospital.
The 12-member board considered the findings and recommendations from three reports following the death of Savita Halappanavar last October.
The findings from the inquest into her death and the recommendations that emerged from the Coroner’s Court were discussed, along with the HSE Clinical Review into the treatment she received and last week’s HIQA report into issues relating to her care at GUH.
The board is not releasing details about decisions made at the meeting until it has communicated with the staff involved tomorrow morning.
It is expected the measures to be taken will then be made public.
Mrs Halappanavar died from an infection caused by sepsis almost a week after she was admitted to hospital on 21 October 2012.
The special board meeting was called following the publication of third report into her care last week.
The master storyteller that was the great cyclist Lance Armstrong
To his millions of fans, American cyclist and cancer survivor Lance Armstrong was more than just a great sportsman, he was an inspiration. To the film-maker who documented his spectacular fall from grace, he was a master storyteller. But were his supporters too ready to believe the fairytale?
The story of the charismatic Texan cyclist who recovered from life-threatening cancer and went on to win the Tour de France a record seven successive times was one of the greatest tales in sporting history.
In 2009, Lance Armstrong attempted to write another chapter into the legend by coming out of professional retirement to compete in the Tour again at the age of 37. He granted Oscar-winning filmmaker Alex Gibney rare access to his inner circle to chronicle the comeback.
For Gibney, the experience was akin to being embedded with the military in a warzone.
“When you’re with a group of soldiers in Iraq or Afghanistan you’re going to end up feeling part of their unit,” he told me.
“I don’t think that’s necessarily wrong. The trick is how to come out of that with some broader perspective – but it’s intoxicating while you’re in the middle of it.”
Gibney admits the “them and us” mentality inside Lance Armstrong’s Astana cycling team encouraged a kind of Stockholm syndrome. Anyone who questioned his repeated denials that he had used performance-enhancing drugs came to be viewed as the enemy.
“I did begin to feel that some people on the outside were a bit fanatical about the subject of whether Lance had doped,” he says. “You can’thelp but take on the vibe of the team.”
Through the media and in the courts, Armstrong aggressively pursued critics who continued to question whether he was riding clean. Alex Gibney watched as his subject attempted to maintain control over the powerful and lucrative myth he had constructed.
“I think the truth in the mind of someone who is a master storyteller does become elastic,” he suggests.
“There’s a moment in the film when Lance loses in Verbier to Alberto Contador (on stage 15 of the 2009 Tour de France) and he says to me ‘I’m sorry I screwed up your documentary.’
“I don’t think that was just banter. I think that was Lance’s way of saying ‘you came to me to deliver the fairytale that everyone’s come to believe that I can deliver and I failed. I’m not going to win. I’m not going to be first and I’m sorry.'”
Armstrong behind eventual 2009 Tour winner Alberto Contador
After Armstrong’s 2009 comeback, in which he finished third, the myth began to disintegrate.
- Tour de France victories: 1999, 2000, 2001, 2002, 2003, 2004, 2005 (22 individual stage wins)
- Battle with cancer: Diagnosed with testicular cancer in 1996. The disease spreads through his body. Launches Lance Armstrong Foundation for Cancer. Declared cancer-free in 1997 after brain surgery and chemotherapy
- Retirement: Announces he will retire after the 2005 Tour de France. Angered by drug allegations against him, he returns to professional cycling in 2009. He finishes third. His accident-filled 2010 Tour is his last
Former teammates went public with allegations of drug use. The US Anti-Doping Agency accused Armstrong of running the most sophisticated and extensive doping scheme in professional sports history.
He finally came clean in an interview with talk show host Oprah Winfrey last January, in which he admitted taking banned substances and undergoing prohibited blood transfusions during all of his victorious Tour de France campaigns.
In earlier films such as Enron: The Smartest Guys in the Room, Taxi to the Dark Side and Mea Maxima Culpa, Alex Gibney has explored the abuse of power by big businesses, the military and the Catholic Church.
In his latest film, it’s Armstrong’s rewriting of his own personal life story, a story that inspired and gave hope to cancer patients around the world, that Gibney finds particularly difficult to accept.
“It’s an abuse of storytelling power,” he says. “He told a story that everyone wanted to believe in too much. He knew how much everybody wanted to believe in it.
“He made the lie so enormous, so all-encompassing, that he couldn’t dial it back. His only choice was to go forward and make it even bigger.” So he carried on cheating, winning Tour after Tour.
Armstrong was engaged to musician Sheryl Crow and travelled by private jet
Stripped of those seven titles, pursued by lawyers seeking to reclaim prize and sponsorship money, Lance Armstrong’s reputation as a sportsman is now in ruins. He has been banned from competitive cycling for life.
Alex Gibney, director of The Armstrong Lie
For Alex Gibney, Lance Armstrong’s epic downfall should serve as a cautionary tale. Even heroes, he argues, need to accept their flaws. “There can be inspirational stories that are messy,” he says.
“Spiderman to me is a more intriguing tale than Superman because you reckon with Peter Parker’s dark past and to some extent his deep-seated anger rather than the pure hero that Superman is.
“When we’re told stories that seem too good to be true we should say to ourselves, ‘Hey, maybe this is too good to be true.'”
Life style changes for humans can save millions from diabetes
MILLIONS of people at risk of developing diabetes could avoid the disease with simple lifestyle changes, say researchers diabetes is preventable with simple lifestyle changes.
A major review of scientific evidence concluded that diet and exercise are vital for staving off the illness, which affects 3.8 million people in Britain.
Combined with stopping smoking and regular checks on blood pressure and glucose levels, Type 2 diabetes can be prevented altogether, the team from the University of Alberta, Canada, said.
Last month, Diabetes UK said losing weight, eating more fruit and vegetables and taking regular exercise is all people need to do to significantly slash their chance of developing Type 2.
It’s particularly important for people who are already at high risk to talk to their GP to make the diet and lifestyle changes that can help
Dr Matthew Hobbs, Diabetes UK’s head of research
But chief executive Barbara Young said people were not taking the risks seriously and that the country was “sleepwalking towards a public health disaster”.
Dr Matthew Hobbs, the charity’s head of research, said of the findings: “This shows again that it’s particularly important for people who are already at high risk to talk to their GP to make the diet and lifestyle changes that can help.”
Children are drawn to our colourful cigarette packets, A study shows
Children find colourful cigarette packets appealing but are repelled by products that have plain packaging.
The Irish Cancer Society studied pupils from third class in Scoil Aonghusa primary school in Tallaght, Dublin, who were shown branded cigarette packs and asked what they thought of them.
“The children found the packs appealing and were particularly positive about the bright colours and rainbow-coloured effects used on some packs,” it found.
“They felt that the pink slimline packs would appeal to young girls. They also liked the ‘fancy writing’ used on the packs.”
“Young people are a key target market for the tobacco industry, which needs to recruit 50 new smokers a day to replace those who have either died or quit, in order to keep making profits. Most of these new smokers are children.
“Around 80pc of smokers start before the age of 18 and children in Ireland began smoking at an earlier age than in any other country in Europe,” said a spokeswoman.
The children who were shown examples of what plain packaging may look like responded negatively and called them “disgusting and gross”.
“One of the boys remarked that he did not know how people could buy the cigarettes in plain packs. They felt that plain packs show what it (smoking) does to you and were shocked by the images of the health effects of smoking used on the plain packs.”
Health Minister James Reilly has secured the agreement of the Cabinet to introduce standardised packaging for tobacco products in Ireland, and he welcomed the video.
Drought in East Africa dictated how the brain changed the evolution of human intelligence
Scientists show shifts from dry to wet and back in East Africa’s Rift Valley caused the development of the human brain
Humans evolved their very large brains in response to the dramatic shifts in the climate of East Africa, the cradle of humanity where man’s ancestors are thought to have originated about two million years ago, a study has suggested.
Scientists have matched exceptionally wet periods and very dry periods in the East African Rift Valley to sudden spurts in the evolution of the hominid ancestors of Homo sapiens, which resulted in the evolution of the modern human brain.
Academics have long argued about what led to the unusually large brain of humans with its capacity for language, abstract thought and consciousness. The latest theory suggests it was triggered by the need to adapt to dramatic changes in the local environment of early man.
“It seems modern humans were born from climate change, as they had to deal with rapid switching from famine to feast – and back again – which drove the appearance of new species with bigger brains and also pushed them out of East Africa into Eurasia and South Africa,” said Professor Mark Maslin of University College London, the co-author of the study published in the on-line journal Plos-One.
The Rift Valley is an extensive geological fault marked by mountains, lakes and fertile valleys. Many of the most important fossil remains of early humans have been unearthed in the region, leading to suggestions that it was the most important place for the early origins of man.
The study looked at climate change over the past 5 million years, where there have been large fluctuations between wet periods where lakes were far higher than they are today and dry periods where sand dunes formed in former lake beds.
The scientists found that there were relatively short periods lasting about 200,000 years when East Africa became very sensitive to the cyclical changes in the Earth’s orbit around the Sun – known as Milankovitch cycles – which lead to global-scale changes to the climate, such as ice ages.
In East Africa, these orbital changes to the Earth led to rapid shifts between very dry and very wet periods of about 20,000 years, when typically the lake valleys repeatedly filled up with freshwater and then dried out several times, forcing the human inhabitants to move north or south.
“Due to these changes in orbit, the climate of East Africa seems to go through extreme oscillations from having huge deep freshwater lakes surrounded by rich, lush vegetation to extremely arid conditions, like today, with sand dunes in the floor of the Rift Valley,” Professor Maslin said.
“These changes resulted in the evolution of a new species with bigger brains, and also forced early humans to disperse out of East Africa,” he said.
The study found that there were three time periods in particular when this kind of climate change corresponded to important stages in human evolution.
The first occurred about 2.6 million years ago when the Rift Valley dwellers were pushed into southern Africa and a new species called Homo habilis emerged. The second happened about 1.9 million years ago when an important species called Homo erectus emerged from Africa to colonise much of Asia, while the third occurred about 1 million years ago when Homo heidelbergensis emerged.
Professor Maslin said that the technique is not accurate enough to deal with the past 150,000 years, when Homo sapiens first evolved, but that it nevertheless could explain the earlier evolutionary transition leading to Homo erectus, which is the first large-brained hominid with truly human-like skeleton showing a distinctive adolescent growth-spurt.
Susanne Shultz of Manchester University, the co-author of the study, said that climate change can be linked directly to the evolution of this important human species at a time when there were several species occupying the same geographic region at about the same time.
“We found that around 1.9 million years ago a number of new species appeared, which we believe is directly related to new ecological conditions in the East African Rift Valley, in particular the appearance of deep freshwater lakes,” Professor Shultz said.
“Among these species was early Homo erectus with a brain 80 per cent bigger than its predecessor,” she added.
The present-day lakes of the Rift Valley are much smaller than they would have been at the height of a wet period. Lake Logipi at the northern end of the Kenyan rift valley, for instance, once occupied the entire Suguta Valley, which is presently littered in sand dunes, and was about 300 metres deeper than it is today.