Leading doctors urge BMA to reconsider strikes amid concerns over public trust
Lord Ara Darzi, a former health minister and surgeon, followed calls made by Professor Robert Winston, a Labour peer, who told the Times the 'highly dangerous' walkout could damage the public's trust in doctors.
Earlier this week, the BMA announced that resident doctors, formerly junior doctors, in England would walk out for five consecutive days from 7am on July 25, in a dispute over pay.
Lord Darzi, 65, told the Times: 'Doctors have a special place in society. The public's trust in doctors is earned, not guaranteed.
'I fear it will never recover if the BMA go ahead with strikes that are plainly unjustifiable.'
Meanwhile, Professor Sir Stephen Powis, who is set to leave his post as NHS England national medical director imminently, warned the BMA to 'think really hard' about whether the industrial action is justified.
In his final interview before retiring, Sir Stephen, 64, told the newspaper the walkout would cause 'tens of thousands of appointments and procedures' to be cancelled.
The pair's calls echoed those made by Prof Winston, 84, who said he resigned from the BMA on Thursday.
In a statement on Friday, a BMA spokesman said it is 'disappointing' when any of its 195,000 members resign, but said resident doctors are beginning their careers 'more than 20% worse off in real terms than their counterparts in 2008'.
The spokesman added: 'We're sure that doctors who dedicated their lives to the health of the nation want to safeguard the profession and the NHS for the future. This means improving pay and conditions so that resident doctors stay in the health service and the UK to become expert clinical leaders, running entire services and innovating treatments.
'Doctors take their professional obligations incredibly seriously, and the decision to strike is not made lightly.
'But with nine out of 10 of our resident doctor members who voted backing industrial, it's clear that there is support for doing what is necessary to fight to restore pay.
'Of course, no strikes have to happen, and no care needs to be disrupted, if the Health Secretary meets with us to discuss the 'journey' to pay restoration as he so often called it in opposition.'
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You may need an ileostomy if certain parts of your digestive tract become damaged and can no longer function to digest food and eliminate waste from your body. Health conditions that may require an ileostomy include: Crohn's disease, a type of IBD that can involve inflammation and scarring along any part of the digestive tract ulcerative colitis, a type of IBD that causes inflammation, sores, and scarring in the large intestine and rectum a tumor in the lower digestive tract, such as from rectal or colon cancer, but it can also result from cancer that has spread from another location in the body an inherited condition called familial adenomatous polyposis, in which polyps form in the colon and can lead to cancer congenital structural issues with the intestines, such as Hirschsprung's disease injuries or accidents with internal damage that involve the intestines Surgeons recommend an ileostomy if damage to the digestive tract occurs in: the top part of the large intestine the end part of the small intestine the entire large intestine Otherwise, if the intestinal damage affects only a portion of the large intestine, they may recommend a colostomy instead. 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They may also help the surgeon decide where to place the stoma for your comfort as well as ease in managing it yourself. What happens during an ileostomy procedure? An ileostomy is performed in a hospital under general anesthesia. The surgery can be open or laparoscopic, using smaller cuts and lighted instruments. You will know before the surgery which method is recommended for your condition. If needed, your surgeon may also remove damaged portions of your digestive tract or your entire rectum and colon. This is known as a proctocostomy with an ileostomy. For a standard ileostomy, the surgeon makes a small incision that will be the site of your ileostomy. They'll pull a loop of your ileum through the incision. This part of your intestine is turned inside out, exposing the inner surface. It's soft and pink, like the inside of a cheek. The part that sticks out is called a stoma. It may protrude up to 2 inches. If you are having K-pouch surgery, your surgeon will use some of your small intestine to form a pouch for your output to collect. What to expect during recovery from ileostomy surgery Ileostomy surgery is a major surgery. You may be hospitalized for a few days, a week, or longer. This exact time can depend on how long it takes your digestive tract to begin digesting food again. On average, it takes about 6 to 8 weeks to recover fully from the surgery. During this time, you may have restrictions on lifting and physical activity, but depending on your specific work and the amount of physical activity it requires, you may be able to go back to work with accommodations. Right after surgery When you wake up from surgery, you may have a tube extending down your nose and into your stomach, known as a nasogastric tube (NG). It can help drain the contents of your stomach and stimulate digestion. Your surgical team typically restricts food and liquid right after surgery to allow your digestive tract to heal. During this time, you may receive pain medications and any other medications you typically take through an intravenous (IV) line. In the days after surgery After surgery, your team may recommend a slow transition to an adjusted diet: When you are cleared to eat clear liquids, you can usually begin to take medications by mouth. Slowly, you'll be able to eat a full liquid diet. If you tolerate a liquid diet, they may clear you for eating solid, low fiber foods as your bowels adjust to the changes. Your care team may recommend smaller, more frequent meals as your body adjusts, and you may also still receive IV fluids during your hospital stay. You may also notice excessive intestinal gas, especially if you had laparoscopic surgery. Depending on the type of bag you are wearing, it may build up inside. You can usually release gas by opening the bag slightly. You may also have gas pain in your abdomen, particularly if your digestive tract isn't yet passing gas into the bag. Your care team typically monitors and measures your ileostomy output. Once your output (of both liquid and gas) is normal, you may be able to leave the hospital. However, it can sometimes take a few days for your bowels to adjust to passing gas and output after surgery. Some practices that may help stimulate your digestive tract include: Walking: Moving around after surgery can help stimulate your digestive tract, help move gas and output through your body, and support your recovery. Chewing gum: Chewing gum stimulates the gastrointestinal reflex, which promotes the muscle contractions that move food through the digestive tract. Wound care and ostomy management You typically receive education on caring for your stoma and the skin around it. Digestive enzymes in your ileostomy output can irritate your skin, so you must keep the area clean and dry. Beginning while you're in the hospital, an ET nurse can help you learn to take care of your stoma. This may include: changing your ostomy bag with or without help every few days using specific medical supplies to clean the skin around your stoma learning to check the skin around your stoma for irritation or sores using specific medical supplies to help heal any sores that may develop on your skin learning who to contact if you experience any issues, once discharged from the hospital wearing clothing that doesn't constrict your stoma, such as loose, high-waisted bottoms Depending on your insurance plan, you may have continued appointments with an ostomy nurse or receive limited home care services as you learn to take care of your stoma. Ileus after ileostomy surgery Some people develop post-operative ileus in the days after abdominal surgery. An ileus occurs when the movement of your digestive tract is interrupted, even though no physical blockage is present. It can have symptoms that may include: nausea vomiting not passing gas abdominal bloating, pain, or tenderness If you develop ileus, your care team may: stop food and water give you anti-emetic medication to reduce nausea put in an NG tube to drain your stomach contents address electrolyte imbalances, which may contribute to ileus reduce opiate pain medications, which may contribute to ileus treat any infection, if applicable There isn't a cure for ileus, but research suggests that chewing gum may help stimulate the digestive tract. Ileostomy-specific complications For many people, an ileostomy can be lifesaving or give remission from IBD symptoms. However, there are some ileostomy-specific health complications that it's important to be aware of: Irritated skin around the stoma If your output comes into too much contact with the skin around your stoma, it can cause irritation. This can happen if you cut the opening on your bag too wide or if there isn't a good seal. Your doctor or ostomy nurse can recommend a medicated topical spray or powder to heal this irritated skin. You can also try different types of wafers, as well as ostomy pastes or rings, to help strengthen the seal and prevent irritation. Leaks Skin irritation can also make getting a good seal around your bag more difficult. If this happens, some of the contents of your bag may leak, especially if it is very full. If you often have leaks, it may mean you need to change your bag earlier. It's best to talk with your ostomy nurse about frequent leaks. To prevent leaks, it's also usually recommended to avoid eating before bed to limit output and to empty your bag right before you go to sleep. Sometimes, trying a different ostomy paste or bag may help you find one that works better for your body. You can usually contact ostomy product manufacturers for free product samples. Your ostomy nurse may also request these for you. Pressure ulcers If you use an ostomy belt to hold your bag in place and wear it too tightly, you can develop pressure ulcers. If this happens, it's best to talk with your ostomy nurse. In addition to treating ulcers, they may recommend alternatives to an ostomy belt, such as an ostomy wrap. However, wraps are usually sold by third-party retailers and are not covered by insurance. Dehydration and electrolyte imbalances Because your large intestine is not working to reabsorb liquid from your waste, you may lose water more quickly and need to drink more fluids to compensate. It's best to drink 8 to 10 (8-ounce) glasses (about 2 liters) of fluids every day. The risk of dehydration increases if you lose additional fluids through vomiting, sweating, or diarrhea. With an ileostomy, diarrhea typically involves having much more output than usual. You'll need to replenish lost water, potassium, and sodium and seek medical attention for severe dehydration or electrolyte imbalances. You may need to receive these electrolytes through an IV line. Blockage It's possible to develop a full or partial blockage of your stoma. Symptoms can include: only passing small amounts of output and gas into your ostomy bag not passing any output or gas into your ostomy bag nausea and vomiting abdominal pain A complete blockage usually requires urgent medical attention to clear the blockage. It's best to contact your stoma nurse for advice. If the protruding part of your small intestine is swollen, try cutting a bigger opening in the seal around it to give extra space. If you think you may have a partial blockage from something you've eaten and you don't have nausea or vomiting, you could try: switching to a liquid diet walking applying a heating pad or sitting in a warm bath massaging the area around your stoma While there isn't any scientific research to support it, some people report that drinking a small amount of carbonated cola may help pass a partial blockage. However, carbonated beverages may increase gas, and it's usually recommended to avoid them with an ileostomy. Extended-release medications Extended-release medications may not fully absorb if you have an ileostomy. This is because your digestive tract is shorter than it was before. If you take an extended-release medication, talk with a doctor about an alternate formulation. Odor Some people may experience odor with their ostomy bag or output. Some things that may help include: using bag deodorizer products (which are usually covered by insurance), including drops or tablets you place in the bag to neutralize odor avoiding foods with a strong odor, like eggs, fish, garlic, and onions eating foods that help reduce odor, such as yogurt, buttermilk, and cranberry juice not chewing gum or using a straw, which can both increase gas avoiding alcohol and tobacco, which can increase odor eating slowly and not skipping meals Lifestyle changes with an ileostomy You may need to adjust your lifestyle and diet if you have an ileostomy. Lifestyle changes Getting used to living with an ileostomy can be an adjustment both physically and mentally. Still, it's important to note that you can do most things with an ileostomy that you could do before you had one. This includes: dating having sex going swimming taking baths playing sports eating in restaurants traveling Some people seek help from an ostomy support group. Meeting other people who've returned to regular activities after surgery can help ease any anxieties. Others may talk with a mental health specialist about their concerns. While not essential, you might consider adaptive clothing or products designed for people with ostomies. These may minimize the appearance of your ostomy bag through your clothing or provide additional support for certain activities, like swimming. Options can include: an ostomy wrap or belt that you can wear under your clothing to hold the bag securely to your body ostomy adaptive clothing with pockets for the ostomy bag undergarments with pockets to hold your ostomy bag swimwear designed for people with ostomy bags Your ostomy nurse is also a good resource. Diet Your care team may recommend avoiding or limiting high fiber foods that can contribute to a blockage. These may include: nuts and seeds corn beans and legumes berries fibrous skin from fruits and vegetables (for example, grape, apple, zucchini, and cucumber skin) Some people may develop blockages from these foods, while others may be able to eat them safely in small amounts if they chew them well or blend them. If you're trying a fibrous food, it's best to eat a small amount, chew it well, and see how you tolerate it. Frequently asked questions Are there alternatives to an ileostomy? The J-pouch procedure is an alternative to an ileostomy that may be performed if you've had your entire colon and rectum removed. In this procedure, the doctor creates an internal pouch from the ileum that is then connected to the anal canal, allowing you to expel your waste through the usual route with no need for a stoma. The J-pouch procedure is an alternative to an ileostomy that may be performed if you've had your entire colon and rectum removed. In this procedure, the doctor creates an internal pouch from the ileum that is then connected to the anal canal, allowing you to expel your waste through the usual route with no need for a stoma. How will an ileostomy change how I urinate or have bowel movements? An ileostomy will not change how you urinate. Your urinary system is separate. However, with an ileostomy, you will not have bowel movements. Instead, ostomy output collects in an external or internal pouch, which you must empty a few times a day. An ileostomy will not change how you urinate. Your urinary system is separate. However, with an ileostomy, you will not have bowel movements. Instead, ostomy output collects in an external or internal pouch, which you must empty a few times a day. What is the life expectancy with an ileostomy? Having an ileostomy does not affect your life expectancy. However, the underlying health condition that required an ileostomy may affect your life expectancy. Having an ileostomy does not affect your life expectancy. However, the underlying health condition that required an ileostomy may affect your life expectancy. Will I have to have more surgeries after an ileostomy? After a permanent ileostomy, you usually do not need additional surgeries. However, this may vary depending on the reason for your ileostomy. However, people with a temporary ileostomy may choose to have their ileostomy surgically reversed at a later date, usually 6 to 8 months after their initial ileostomy surgery. After a permanent ileostomy, you usually do not need additional surgeries. However, this may vary depending on the reason for your ileostomy. However, people with a temporary ileostomy may choose to have their ileostomy surgically reversed at a later date, usually 6 to 8 months after their initial ileostomy surgery.
Yahoo
an hour ago
- Yahoo
Britons smoke an estimated 28.6 billion cigarettes every year, study finds
An estimated 28.6 billion cigarettes are smoked in Britain each year, the equivalent of 78 million a day, according to new analysis. There are particularly high levels of consumption in more disadvantaged areas, with researchers calling for targeted public health efforts to tackle smoking rates. Charities warned the 'staggering figure' is a 'stark reminder of the deadly toll of inaction', and urged the Government to prioritise the Tobacco and Vapes Bill after Parliament's summer recess. The Cancer Research UK study, carried out by experts at University College London (UCL), used monthly Smoking Toolkit Study data from between 2022 and 2024. The analysis estimates adults who smoked consumed an average of 10.4 cigarettes per day, with 5.5% of those smoking more than 20 a day. Average consumption per smoker per year was 528 cigarettes, equating to 28.6 billion per year. Office for National Statistics (ONS) data suggests 11.9% adults in the UK – the equivalent of six million people – smoked in 2023, the lowest proportion since current records began in 2011. However, England could struggle to meet its smokefree target of 5% by 2030 if current trends continue, according to Cancer Research UK, with projections suggesting it may not be met until 2039. The study also highlighted inequalities in cigarette consumption in Britain. People from more deprived backgrounds smoked 11 cigarettes a day on average, compared to those in wealthier areas, who smoked 9.4 per day. Researchers also found people in the North East and Scotland smoked the most – 11.7 each – while people in London and the South West smoked the least, with 8.4 and 9.5 cigarettes respectively. Dr Sarah Jackson, research fellow at UCL's Institute of Epidemiology and Health Care, said bringing down consumption rates can improve public health and also help the environment. 'Tackling smoking is not just about preventing uptake among future generations,' she said. 'Supporting the six million people in the UK who currently smoke cigarettes to quit will have major benefits for public health and for the environment. 'Despite declining smoking rates, over 28 billion cigarettes are still consumed in Great Britain each year, generating up to 140,000 metric tons of toxic, non-biodegradable waste annually. 'Reducing cigarette consumption, particularly in the most affected regions and communities, is critical not only to save lives and narrow health inequalities, but also to protect our environment from one of the most pervasive forms of plastic pollution.' Dr Ian Walker, executive director of policy at Cancer Research UK, said: 'While great strides have been made to bring down smoking rates, we can't afford to be complacent. 'Every week, around 550 million cigarettes are still smoked in Britain – that's enough to fill an Olympic sized swimming pool. It's vital that everyone, wherever they live, can access the support they need to quit smoking for good.' Dr Walker described the Tobacco and Vapes Bill as 'a historic opportunity to help stub out the harms of smoking' but said it is frustrating the the legislation 'isn't progressing through Parliament as quickly as it should be'. The legislation – which cleared the House of Commons in March – will prevent anyone born on or after January 1 2009 from legally smoking if it becomes law. It is set to undergo further scrutiny in the House of Lords. However, around 20 billion cigarettes have been smoked in Britain since the bill was reintroduced in Commons in November last year, according to the analysis. Dr Walker added: 'Tobacco is a toxic product that should have no place in our future, and I urge all parliamentarians to back a smokefree UK and prioritise this Bill when it returns to the House of Lords. 'This world-leading legislation has strong political and public support that can't be ignored.' Reacting to the study, Hazel Cheeseman, chief executive of Action on Smoking and Health (Ash), said: 'Since Parliament last debated the Tobacco and Vapes Bill, an estimated 6.7 billion cigarettes have been smoked in the UK. 'That staggering figure is a stark reminder of the deadly toll of inaction. Every day that passes without this legislation is a day lost in protecting our children from addiction and improving public health. 'We urge the Government to make this Bill a priority immediately after summer recess. The country cannot afford further delay – this is a once-in-a-generation opportunity to create a smokefree future, and it must not be squandered.'
