Donie's Ireland news daily Blog

Ordinary people of Ireland are really struggling to survive

   

Parents are cutting back on food and delaying paying their bills in an effort to cover the costs of sending their children to school, a survey has revealed.

The Barnardos School Cost survey highlighted serious concerns among almost 1,000 parents questioned, some of whom said they were struggling to cover costs and were “embarrassed” at having to plead with school principals to help them out with items such as schoolbooks.

Reduced household income and cuts to the Back to School Clothing and Footwear Allowance has meant many parents are finding it more difficult to meet basic costs, even if in some cases those costs have fallen.

The survey will be published in full today and comes as figures show that around 1,700 families are applying every day for state help with the cost of sending their children back to school.

Almost 50,000 claims have been made over and above the 115,348 homes already issued with payments of €39.3m.

The department has received 47,000 claims for manual processing, equivalent to an average 1,700 a day. The payments have been cut since last year, from €305 to €250 for dependent children up to 22 years old and from €200 to €150 for younger children.

The survey found 80% said they were struggling to meet the costs involved in sending their child to school, with 10% claiming they were unable to pay bills and were forced to choose between getting a loan or getting into debt.

The Barnardos survey does not include transport costs, but parents said this is still disproportionately affecting children in rural areas.

Some schools have also demanded a higher voluntary contribution from parents, while other schools insist on greater use of tablets such as iPads, heaping further pressure on parents.

One parent told Barnardos: “We cut back on food and let other bills go unpaid to ensure children have what they need for school. The bus costs €350 for the year. We’re living on the edge all the time. So much for free education.”

Another said: “Our spiralling financial situation has meant seeking help from SVP [St Vincent de Paul] for the first time for an electricity account as a matter of emergency — a very undignified and depressing situation to find myself in but every balance I owe is now late, token part-payments being the only way I can keep the wolves from the door and I am struggling to see any light at the end of the tunnel.”

Barnardos CEO Fergus Finlay said parents and schools were now stuck in “a vicious circle”, where cash-strapped schools were seeking more money from parents, sometimes resorting to “emotional blackmail”.

“Schools are being put to the pin of their collar and they are trying to pass it on to parents,” said Mr Finlay. He said every child in Ireland had “one constitutional right”, that to an education, but the State needed to be prepared to help cover the cost of delivering on it. “Little by little, that right is being eroded by costs [parents] cannot afford, or they are doing without other basics to cover those costs,” he said.

Barnardos has advocated schools scrapping preferred suppliers of uniforms, allowing parents to incorporate school crests onto high-street uniform clothing, and the bulk buying of books over the next five years by schools using the school Book Grant Scheme, as well as wider use of book rental schemes.

‘131 Irish companies went bust’  

5 for each day of July 2012  

‘Vision-net claims’

 

Five Irish companies went out of business every day last month – and half of those stress-tested showed signs they were on the brink of failure – according to the latest figures from a leading credit and risk analyst.

Also half of those stress-tested by the credit and risk analyst also showed signs of being on the brink of failure.

Vision-net’s figures showed that between 1 – 25 July 131 companies were declared insolvent (down 15 per cent on the same month last year).
Of those, 97 were liquidated, 33 entered receivership, and one had an examiner appointed.

Some 9,428 Irish companies were also stress-tested and 49 per cent were found to be at high risk of failure. According to the analysis, businesses in the hospitality, construction, IT, motor, and wholesale and retail sectors were least likely to survive.

Start-ups

There was a drop in company and business start-ups in July (2,750) when compared with the same period in 2011 (2,871). While professional services accounted for almost one-quarter of these new businesses, the same sector recorded an equal number of business failures.

According to their latest filed accounts, 101 companies that held meetings of creditors last month owed their short-term creditors more than €37 million. In July 2010, 118 companies held meetings of creditors.

The figures show that 345 registered commercial and consumer judgements worth €27.5 million were awarded in the courts – with 241 of these being judgements awarded against consumers worth €25.3 million. Credit unions, Revenue Commissioners and banks topped the list of plaintiffs.

The Revenue Commissioners accounted for 19 of the 104 commercial judgements recorded in the courts this month, followed by professional services businesses and local authorities.

The average value of a judgement increased 76 per cent on last July to €79,610.

Christine Cullen, Managing Director of Vision-net, said the figures show that recovery in the domestic economy remains slow: ‘The trading conditions remain very challenging for companies, with many of them, particularly those in the hospitality and construction sectors, struggling to stay afloat as consumer demand remains weak and the property market continues to stagnate.”

“High levels of unpaid debt and cash flow problems are hampering the capacity of companies to stay in business or scale and this has a knock-on impact on jobs and growth,” she said.

Is Minister Reilly’s vision of our health really good enough for Ireland?

       

The Minister for Health, James Reilly, says the “new Directorate structure in the HSE will allow us to redesign the system to put the needs of the patient front and centre”.Photograph: Eric Luke

No major industry with a workforce of almost 100,000 would contemplate deep structural changes without a budget specifically earmarked for the process itself – apart from the HSE

Minister for Health James Reilly has brought forward another reforming Health Bill as he continues the road to achieving his overarching aim of “money follows the patient”. But with a projected health budget deficit of €500 million this year, will the latest reforms have any effect on imminent cuts to frontline services?

The stated aim of the Bill is to: make the Health Service Executive (HSE) more directly accountable to the Minister for Health; and to help prepare service delivery for the next phase of the health reform programme.

The biggest change is to create a directorate system with a Director General and directors of six specific areas. Significantly the legislation allows the Minister to increase the number of directors – a move that suggests some fluidity will be part of the imminent changes.

There is already a division of responsibilities at the head of the HSE. It’s not entirely clear from the Minister’s announcement how the existing structures will mesh with the new ones (see panel).

We know one national director, Dr Barry White, who heads up Clinical Strategy and Clinical Programmes, has already moved under the umbrella of the Department of Health. The National Cancer Control Programme is also heading in the same direction. Presumably, essential back-office divisions such as human resources, finance and communications will continue to function under their present heads. But what has yet to be spelled out is how the new and old will knit together.

There may be some clues hidden in the Minister’s statement which said “the Directorate will be accountable to the Minister for the performance of HSE functions – it will have to explain its decisions”.

Another indication of Dr Reilly’s wish to have more control of what is happening at the coalface comes further down the explanatory notes which observe that the new legislation “allows the Minister to issue directions to the HSE on the implementation of Ministerial and Government policies and objectives relating to HSE functions where the Minister believes that the HSE is not having sufficient regard to such objectives or policies in performing its functions”.

And there is a reference to establishing performance targets for the HSE in certain priority areas.

“For too long the treatment of patients in our health services has had to conform to the needs of the system,” said Dr Reilly at the announcement of the new legislation. “This new Directorate structure in the HSE will allow us to redesign the system to put the needs of the patient front and centre.”

Although a spokesman for the Minister has confirmed he had not based his new structure on any other health system, it shares some similarities with the National Health Service (NHS) in England. It too is in a major state of flux but has existing directorates in, among others, medicine, nursing, health improvement and protection and commissioning development.

It has the usual back-office directorates; the difference being that the NHS website makes it clear how the various boards and directorates relate to one another.

But as the NHS moves through a major change programme there is one glaring difference when compared with events here. It has set up a special transitional executive to manage the change process.

The NHS Transitional Executive Forum (NHS TEF) was established during the transition to “provide oversight of both NHS operational delivery and development of the NHS future system as part of the overall new governance arrangements for managing the total health and social care transition”. The plan is for the NHS TEF to cease to exist by the end of March 2013.

A lack of such defined planning for change has long been a weakness in the Irish health system. At no time since the new national strategy for health was published in 2001 have any of the many changes been visibly and accountably managed.

It’s a blind spot on the part of the Department of Health which has never seemed to appreciate the enormity or complexity of change management. No major industry with a workforce of almost 100,000 would ever contemplate changes of the magnitude the HSE has been through without a budget specifically earmarked for the process itself.

Ironically, the departing chief executive of the HSE, Cathal Magee, writing in the executive’s 2011 annual report, said it was notable that reform was costly and successful reform was best carried out in a stable environment to lead to sustainable platforms.

Structural change and managing the risk of such change in the current health services environment presented significant challenges, he said, adding that, “at a time of very considerable reductions in funding and resources, the risks associated with major structural change are multiplied”.

With insight like this, Mr Magee will be missed. Junior Minister for Health, Róisín Shortall, obviously appreciates his skills. The day he announced he was leaving the HSE, apart from acidly noting that the first she knew about it was from the media and not her senior minister, Ms Shortall said, “Cathal Magee’s departure is a significant blow to the health service and in this very challenging time of severe pressures, he will be badly missed.”

Another Magee observation from the annual report suggests that he “gets” the risks of so much change. “Governance needs to be at the heart of health sector reform. It is vitally important that as we move towards new operating models, that there is due diligence in the way we transition in order that patient safety is maintained,” he wrote. But he is out the door now, and as the HSE is dismantled, will not be replaced.

For patients, there is now a double jeopardy: the risk associated with structural change; and the risks inherent in trying to claw back in the region of €500 million between now and the end of December. Cuts made in a hurry inevitably hit frontline services for patients.

Earlier this month the Department of Health rejected HSE proposals to deal with the deficit by closing hospital beds and reducing elective treatments and operations.

Rather Secretary General Ambrose McLoughlin, in a letter to the HSE, noted elective activity was running ahead of that planned.

Pointing to management issues within the HSE’s primary care reimbursement service, he said, “We must seek to reduce the cost of each [medical] card, or at least control the cost of each card. The present rate of prescribing needs to be managed more cost-effectively.”

However much merit there is in refining prescribing practice, savings from this source will take a number of months to filter through. Unfortunately, in trying to cut a deficit of the magnitude it now faces, the department will eventually be forced to close beds and operating theatres. Secondary care costs much more than primary care per patient; high tech and expensive care will inevitably be cut in the absence of a supplementary health budget.

Sadly, the structural changes announced recently will have no effect on the immediate cuts in services patients can expect to see and feel. And cuts made in a hurry are potentially dangerous cuts that may threaten patient safety.

A visiting academic who is in Ireland on sabbatical offered the following view on structural change last week: “Structures are not the problem – you are tackling the wrong stuff. It’s your [health service] systems that need overhauling.” If he is right, then the reorganisation of the HSE, may, regrettably turn out to be “much ado about nothing”.

Paul Galvin GAA star gets his puck goat for the Killorglin fair

   

WITH a perfectly groomed goatee, a feisty personality and a real twinkle in his eye, there was only one choice when it came to naming the wild mountain goat that will lord it over this year’s Puck Fair.

King Paul — named in honour of Kerry GAA cult hero Paul Galvin– will be master of all he surveys from a lofty perch overlooking the town of Killorglin for three days and nights, starting on August 10.

Veteran goat-catcher Frank Joy led a seven-strong party into the rugged Kerry mountains in search of a worthy monarch at the weekend.

He was thrilled to find what he describes as a spectacular animal.

“It was very difficult terrain and we spent several hours chasing him before we finally succeeded on Saturday night,” said Frank.

“He is incredibly energetic and muscular. He’s really up for it and it’s clear he has got what it takes — just like Paul Galvin really.”

Mr Joy brought Paul to a field at his home where he will mix with two tamer goats to help him relax before he is transported to Killorglin town square.

There he will be crowned by the 12-year-old Queen of Puck, Claire O’Sullivan, in 10 days’ time.

Routine PSA Testing Cuts the worst cases of Prostate Cancers

’NEW AMERICAN STUDY STATES’

Threefold Fewer Metastatic Prostate Cancers Since Routine PSA Testing

  

If it weren’t for routine PSA prostate cancer screening, an extra 17,000 Americans each year would learn that they had the worst form of the disease, a new study suggests.

That kind of prostate cancer – metastatic prostate cancer, in which the cancer spreads to the bone or other parts of the body — is rapidly fatal, usually within two years or less.

The new study seems to make a powerful argument in favor of PSA testing. It finds that in the three years before widespread PSA testing (1983-1985), men getting their first diagnosis of prostate cancer were three times more likely to learn they had very late-stage cancer than men diagnosed in the most recent three years for which data is available (2006-2008).

“By not using PSA tests in the vast majority of men, you have to accept you are going to increase very serious metastatic disease threefold,” says study leader Edward Messing, MD, chief of urology at the University of Rochester Medical Center.

In 2008, about 8,000 U.S. men were diagnosed with metastatic prostate cancer. By projecting data from the pre-PSA era forward, Messing calculates that without routine PSA tests, 25,000 men would have been diagnosed in 2008 — an extra 17,000 cases of deadly disease.

But it’s not that simple, says Barnett Kramer, MD, MPH, associate director for disease prevention at the National Institutes of Health. Studies looking back at cancer trends in a population are very unreliable when it comes to showing what caused those trends.

For example, Kramer says, what if a man got a PSA test when his prostate cancer was in the very earliest stages of metastatic disease? Microscopic cancers already have seeded his body. But he would not yet have symptoms or detectable metastatic disease, so he’d be diagnosed with earlier-stage disease. He’s subtracted forever from the men whose first diagnosis was late-stage disease, even though screening could not save his life.

Messing says this misses the point of his study, which appears in the online July 30 issue of the journal Cancer.

“The reason our study has some meaning is that all a screening test can give you is a shift to lower-stage disease,” he says. “It can’t cure the disease and it can’t prevent the disease. All it can do is allow you to catch it earlier and give appropriate treatment for the stage of disease you have caught it at.”

Kramer notes that another study using National Cancer Institute data recently found that late-stage prostate cancers declined in men over age 75 after it was recommended that they stop getting PSA tests. It’s highly unlikely that not getting screened prevented these cancers. But it does show how easily false results creep into look-back studies.

Breast-fed babies less likely to die of malnutrition and infections

Breast milk is a basic right of human infants and young children and being a complete food for the first six months of a child’s life,

   

Health experts say that the prolonged breastfeeding for two years does protect an infant from early malnutrition and infections such as pneumonia and diarrhoea. It is believed that twenty-two per cent of neonatal deaths can be prevented if breastfeeding is initiated within first hour by all mothers.

Breast milk is a basic right of human infants and young children and being a complete food for first six months of life,

It can save more than one million lives. Breastfeeding has countless blessings for child, mother and society. Exclusively breastfed infants are two-and-half-time less likely to become ill and two times less likely to die than infants who are not breastfed.

Head of Community Medicine at CMH Lahore Medical College Professor Dr Muhammad Ashraf Chaudhry expressed this while talking to ‘The News’ on Tuesday in connection with World Breastfeeding Week, which is celebrated every year from August 1-7 to encourage breastfeeding and improve the health of babies around the world.

He added that breast milk is safe, clean, hygienic, and inexpensive and available to the infant at correct temperature. It contains disease fighting cells and proteins called antibodies that help protect infants from germs and illness such as diarrhoea and respiratory infections. Most babies find it easier to digest breast milk than formula milk. Suckling is good for development of teeth and jaws. Breastfed babies score higher on IQ (intelligence) tests. Breastfeeding reduces the risk of hypertension, high blood pressure, diabetes, asthma, and obesity in children in their future life, said Dr. Ashraf.

The theme of WBW 2012 is ‘Understanding the Past — Planning the Future — Celebrating 10 Years of WHO/Unicef’s Global Strategy for Infant and Young Child Feeding. It is Time to Act.’ Dr. Ashraf said that World Breastfeeding Week celebrates its twentieth anniversary in 2012. This time it focuses on the progress that has been made on the implementation of the global strategy for infant and young child feeding, which was adopted by the WHO and Unicef ten years ago. Implementing the global strategy effectively is essential to increase breastfeeding rates: especially exclusive breastfeeding for the first six months, and to reach Millennium Development Goal (MDG) 4 to reduce under five mortality by two-thirds, he said.

Dr. Ashraf opines that breastfeeding is the best way to provide newborns with nutrients they need. In infancy no gift is more precious than breastfeeding. Exclusive breastfeeding is recommended until a baby is six months old and continued breastfeeding with the addition of nutritious complementary foods for up to two years or beyond is recommended.

Dr. Ashraf said that statistics from around the world reveal that colostrum is discarded thus eliminating a potentially healthy tonic for the newborn. “In Pakistan, almost two-thirds of babies (65%) are given something other than breast milk such as ‘ghutti, fresh animal milk etc in the first three days of life (pre-lacteal feed) a practice that should be discouraged because it may inhibit breastfeeding or introduce contaminants.”

Talking of the benefits of breastfeeding for mothers, he said that it promotes bonding between mother and baby. Lactation prolongs postpartum amenorrhoea and provides protection against pregnancy (natural contraceptive). Using up extra calories, it makes easier for mothers to lose the pounds of pregnancy. It also helps the uterus to get back to its original size and lessens any bleeding a woman may have after giving birth. Breastfeeding mothers have protection from postpartum depression, obesity, breast cancer, ovarian cancer, risk of hip fracture, osteoporosis after menopause and diabetes. Breastfeeding makes life easier. It saves time and money, said Dr. Ashraf.

To a query, Dr. Ashraf said that in spite of numerous advantages of breastfeeding and risks of artificial feeding, breastfeeding appears a lost art and the feeding bottle usurped the breast. “Despite the marked advantages of breastfeeding, its popularity has declined in many parts of the world. Global data show that less than 40 per cent of infants below six months of age are exclusively breastfed. In Pakistan, there is 85 per cent exclusive breastfeeding at one month, with the figure plummeting to 55 per cent at two months and then to 37 per cent at six months. This proportion is very low with the recommended 100 per cent exclusive breastfeeding for children under six months.”

He added that the factors that cause discontinuation of breastfeeding include misconceptions of mothers, merely following the ‘fashion’ inadequate milk, exhaustion, lack of supporting environment, lack of counselling on the part of health care providers, and aggressive marketing of formula milk producers etc, placid role of the government in discouraging the so-called ‘substitutes’ of breast milk and non-implementation of breastfeeding ordinance 2002 and or relevant rules and regulations to encourage breastfeeding.

To a query, Dr. Ashraf explained that virtually all mothers can breastfeed, provided they have accurate information, and the support of their family, the health care system and society at large.

He added that it is observed that breastfeeding counselling helps improving breastfeeding practices. The awareness and behaviour of families and community need to be altered positively to promote breastfeeding through raising awareness among masses by using all channels of mass communication, suggested Dr. Ashraf.

He further suggests that lady health workers should be mobilised for promotion of breastfeeding as they are the delivery agents at the household level. “UNICEF and Ministry of Health (Nutrition Wing) should involve ‘Ulema’ to sensitise the people that breastfeeding for two years is also in accordance with Islamic teachings. Breastfeeding may be included as a subject in the medical, nursing and midwifery curricula,” concluded Dr. Ashraf.