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					                      The Diabetic
The Newsletter of                                                                                            All monies
the Friends of the                                                                                           collected is
 Manx Diabetes                                                                                             spent on the Isle
      Centre.                                                                                                 of Man no
    We are the
support Group of
                                                                                                           monies are sent
    the Centre                                                                                                off Island


   The Best and most Informative Diabetic Newsletter on the Isle of Man
                     Issue number 14.                                                         Date: September 2006



                                                        i
                                    LEADING FROM THE FRONT
                               Caaryjn Laare Chingys-Shugyr Vannin
                            A Charity registered in the Isle of Man. Charity number 894.
 All monies collected from whatever source will be used exclusively on the Isle of Man for the benefit of diabetics and
                                                 their medical carers
   Web: www.diabetes.org.im             e-mail: editor@diabetes.org.im            e-mail: secretary@diabetes.org.im
 The Friends of the Manx Diabetes Centre presents comprehensive document to the DHSS for the retention
                         of the Manx Diabetes Centre but with Enhanced Facilities
        Mr Leonard Singer will stand for the Keys to get a mandate for 24 hour services in Ramsey.
          823 people don‟t turn up for appointments to their surgeries during July. Disgraceful.
         Ten years ago the youngest was six now thereare36 Diabetic Children on the Isle of Man .
                                   6 are now under five years of age
In this issue                                                    The Diabetes Clinical Audit
* The Diabetes Clinical Audit
* The Cost to a Charity of the New Pricing in
                                                                 The Diabetes Clinical Audit
Proportion                                                        As pointed out at the AGM, the Isle of
* Mr Singer asks the Question „Who does the                      Man DHSS had already started its
Heath Service Serve‟?
* The No Shows
                                                                 Diabetes Clinical Audit on 1st April 2006
* 36 Diabetic Children on the Isle of Man and                    which will end on the 31st October 2006.
rising
* The Prosthetic and Orthotic Audit.
* Donations
* DHSS in efforts to “prioritise” finds allies
* The Audiology Department
* Diabetes Management in primary care
* The Hospital Chapel
* Updates
* Falls Prevention Project Worker.
* The Last Laugh




  Food to eat in
          Food to take away
                  Food for thought

             Are all available at
                                                                           Cover of report submitted
          Feegan’s Internet Lounge
              8 Victoria Street
                  Douglas
   The Friends of the Manx Diabetes         the Manx Diabetes Centre and
Centre once again leading from the front    demolishing any concept of just
and with the Interest of the Manx           reverting into “Care in the Community”
Diabetic patient paramount, attended a      that had not worked before without a
meeting at Crookall House on the 17th       proper specialist Diabetes Centre in
July to protest at the concept of any       place.
contemplated diminution of the facilities      Consequently the Chairman tabled a
at the Manx Diabetes Centre, and            68 page report in support for the
reverting to the old system of “Care in     retention of the Manx Diabetes Centre in
the Community” when we did not have a       its present specialist form with a full
specialist Manx Diabetes Centre.            multi-disciplinary team, but with
   The Meeting was attend by Mr John        enhanced facilities.
Houghton MHK, a Trustee of the                 The report spelled out why we needed
Friends of the Manx Diabetes Centre,        a Manx Diabetes Centre, what was
The Chairman of the Friends of the          diabetes, diabetes complications, the
Manx Diabetes Centre Mr Henry J             direct and indirect cost of diabetes to the
Ramagge, and the representatives of the     DHSS, the Diabetes Clinical agenda,
DHSS conducting the Audit, Ms Marie         “Care in the Community”, and the
Berry, Clinical Governance Facilitator      response of the Friends of the Manx
and Mr R Louden Brown, Public Health        Diabetes Centre to any proposed
Specialist.                                 possible “Care in the Community”
   The Audit has been commissioned by       without a full multi-disciplinary
Mr Norman McGregor Edwards, the             specialist Manx Diabetes Centre in
new Director of Health, Strategy and        place.
Performance, of the Health Services            The report contained testimonials on
Division of the Department of Health        why we should not take the “Care in the
and Social Security.                        Community” route without a Specialist
   The Meeting was conducted in a very      Manx Diabetes Centre from leading
friendly and cordial atmosphere with        Diabetologists, Dr Geoff Gill from the
each side putting forward its point of      University Hospital Liverpool; Dr Niaz
view with the 28 year old perennial         Khan from the Bangor Hospital North
arguments.                                  Wales; Dr Stefan Slater, from the
   It was mooted on the DHSS side, that     Victoria Infirmary South Glasgow
there was no need to have produced the      University Teaching Hospitals Trust
report as there was no question of any      now retired in Edinburgh; and Dr
diminution of the facilities at the Manx    Stephen Judd from Flinders University,
Diabetes Centre.                            in South Australia.
   However Mr Houghton and the                 In    conclusion,     the    Chairman
Chairman were adamant that it had to be     enumerated the extra facilities offered at
tabled as Mr Edwards had written to the     the Centre and stressed that we cannot
Chairman on the 16th May saying “I did      allow any deterioration of the facilities at
not say that we would not go down the       the Manx Diabetes Centre.
„Care in the Community‟ route as you           In fact we have to build, he said, on
described it”.                              what we have, as without it, what the
   The Chairman had therefore felt it       DHSS would be doing with the
necessary to write a report supporting      introduction     of    “Care     in     the
Community” with a diminished Manx            i)       We needed the dedicated
Diabetes Centre, is taking away from the     midwife that is sometimes not available
Manx people the preventative specialist      during the diabetic ante-natal clinic at
care, that we at present have at the         the Manx Diabetes Centre, to be released
Diabetes Centre, for no valid medical        to the Centre when needed so they can
reason.                                      attend the anti-natal sessions.
   In fact he said, what was required was    j)       We need whatever personnel Dr
extra personnel at the Centre.               Khan requires for the development of his
a)       The Centre needed an extra          endocrine service, as some patients need
Doctor. The Group wanted the re-             to go to the mainland for some routine
appointment of Dr Blackman on a three        treatment at DHSS expense.
day weekly basis.                            k)       We require the Manx Diabetes
b)       We needed at least one full time    Centre to remain under the one roof as a
receptionist to be able to deal with the     dedicated space for the diabetes care of
telephone, with drop-in patients, with the   the Manx Diabetes patient, with its
many daily calls that patients make for      specialist multi-disciplinary team to
help, and assist with the patients on        cater for diabetic clinics, podiatry,
arrival.                                     dietary clinics, retinal photography, ante-
c)       We needed extra nurses to deal      natal care, patient education, drop in
with the higher incidence of diabetes that   facilities etc.
is now prevalent on the Island.                 The report emphasises that the Manx
d)       We needed extra secretaries as      Diabetes Centre because of its location is
the present compliment cannot now cope       acting as a Community Diabetes Centre,
with the work load.                          therefore the Friends of the Manx
e)       We needed extra equipment and       Diabetes Centre recommended to the
facilities.                                  DHSS that their slogan “Care in the
f)       We needed extra podiatrists as      Community” should be reclassified to
they are now swamped.                        “Shared care in the Community” with
g)       We needed extra dieticians, as      the Manx Diabetes Centre and its team
diet is a major part of Type 2 diabetes      of specialist at its very centre, as we
treatment and is an important adjunct to     have now but with enhanced facilities.
insulin treatment. Dietetic advice and          The Friends of the Manx Diabetes
education on an individual basis is the      Centre recommend this was the proper
true prime management for most patients      way to go as do our eminent
with diabetes.                               diabetologists
h)       We needed the Prosthetic and           With diabetics and its complications
Orthotic personnel full time on the Isle     on the increase, as evident by the
of Man so that the consultant Physicians     number of diabetic patients now on
and all staff at the Manx Diabetes Centre    dialysis that cannot be accommodated at
who deal with patients with problem feet     the Unit which is now overflowing into
and amputees have access to these            the Intensive care unit, we cannot in
people on instant call, and not have to      anyway tamper with our Manx Diabetes
wait for consultations at a minimum of       Centre.
three weekly intervals, or more, to the         The Chairman‟s report brough to the
detriment of the patient.                    notice of the audit, that Diabetic care
                                             must be equal to all, and should be the
same for all, whether they lived in             As you are all aware from the 21st
Douglas, Onchan, Ramsey, Castletown,         August our Post Office followed in the
Peel, Port St Mary, Port Erin, Morown,       footsteps of the UK post office and
Kirk Michael or Andreas.                     introduced a new way of working out
 This cannot happen, he claimed with         our postage.
just “Care in the Community” as all             We appear to have to conform in
surgeries have different levels of           everything that is introduced in the UK
expertise in the many facets of medicine     whether it is workable on the Island or
including diabetes.                          not.
   Standardised care for the Manx               Whilst normal letters remain the same,
diabetic patient, he pointed out, can only   large letters now cost 10p extra locally
happen in a specialised Manx Diabetes        and an extra 10p for the UK.
Centre, as otherwise we risk care.              This means that charities are unable to
   A questionnaire entitled Diabetic         process the number of newsletters or
Services Audit, which the Audit              large letters sent out to members, as the
Members claimed they had agreed with         postage cost for a charity that depends
Dr Khan and Mrs Anne Birttles, was           on donations, becomes prohibitive.
then completed by Mr Houghton and the           Again leading from the front, the
Chairman.                                    Friends of the Manx Diabetes Centre
   We shall now await the results of the     have approached Mrs Pamela Crowe
outcome of the audit which they said         MLC, the Chairman of the Isle of Man
would be in the nature of a report, and      Post Office.
would be made available to the Group            This with a view of the possibility of
on completion of the Audit. But we shall     the Friends of the Manx Diabetes
not go away.                                 Centre, accorded Charity status by the
   The meeting lasted two hours fifteen      Charity Commissioners of the Isle of
minutes.                                     Man, and other registered Charities on
   The report presented by The Friends       the Island, be granted free postage on the
of the Manx Diabetes Centre is available     payment of one lump annual sum. This
in full, to any member, on loan, from the    sum to be agreed and we look forward to
Chairman, by ringing Tel (01624)             constructive discussions with Mrs Crowe
613702, and making arrangements for          on the issue.
collection from 39 Cronk Drean,                 We ask all other Charities that find
Douglas.                                     themselves in a similar predicament, to
                                             join us and write to Mrs Crowe with this
                                             or any other suggestions that they may
„Contrary to Popular belief, it is           wish to put forward, her address is:
     not hotter than Hell‟                      Mrs Pamela M Crowe MLC,
   Sign seen outside a North Carolina        Chairman, Isle of Man Post Office, Post
   Church during the heatwave there          Office Headquarters, Spring Valley
                                             Industrial Estate, Douglas, IM2 1AA.
                                                In the meantime we have been
                                             forced to reduce this quarter the pages
The Cost to a Charity of the New             of The Diabetic, our newsletter, in
Postage Pricing in Proportion,               order to keep postage within normal
                                             parameters because of the demands in
the numbers of our Newsletters now
being sent through the post.
   If you are on the net and do not receive
it that way, please give us the
information so that we can save on
postage. We shall then e-mail you and
let you know how to get it off our
website.
    Your thoughts on the matter would be               Mr Leonard Singer MLC.
most gratefully received.                         When asked what this was all about,
    Please ring the Chairman on (01624)        he said that he had asked the Question of
613702.        or    e-mail     him      at    “Who does the Health Service serve,
chairman@diabetes.org.im .                     because of the constant apparent lack of
    Any recommendations would be               common sense and understanding of
appreciated so that we can get back to         some of the problems faced by those in
printing as normal.                            need of medical services by those
  I wonder who in the Isle of Man              supposedly in charge”.
thought up the catchy phrase “pricing in          He continued “whether it is the
Proportion”.                                   Minister in charge or the civil servants is
    So sad. Once again we blindly follow       often questionable, when decisions
the UK.                                        appear to be made that ensure that „No
    When will we think for ourselves?          Boat is Rocked‟”.
                                                  He was of the opinion that “In recent
   Require old fashioned unwanted              years it has not been the weight of the
 Mangle in working order so that we            argument that has won the day, but
   can squash the newsletters into a           straight opposition to change.
  smaller envelope to enable it to go             There is an apparent failure to tackle
 through the slit and avoid the extra          problems when placed before the
               postage                         Department, or an inability or wish to re-
   Please reply to The Chairman on telephone   assess a situation, even when the facts
                  (01624) 613702               clearly demonstrate the need for change
                                               to the advantage of the patient”.
                                                 Mr Singer pointed out that “during
Who does the Health Services                   these last 5 years, not only in the DHSS ,
Serve?                                         but other departments too, any ideas that
   The Diabetic spoke with Mr Leonard          have come from outside of the
Singer MLC, who has already indicated          department or from outside the Council
that he will stand for election once again     of Ministers have been assumed to have
for the Keys, with a mandate if elected        been without merit”.
to fight for the restoration of the 24 hour       He highlighted the effort of the
service at the Ramsey Cottage Hospital.        Friends of the Manx Diabetes Centre in
                                               trying to get a better deal for diabetics,
                                               assuring better and quicker treatment by
                                               efficiency, and also ensuring healthier
                                               living for those in need, often results in
                                               those calling for sensible dialogue being
labelled as troublemakers undermining        We shall notify you of the event on Press
the service.                                     and Radio and in our December
   Similarly as Mr Singer put it “the                       Newsletter.
recent parallel of the resolution by two
public meetings in Ramsey called by the
Hospital League of Friends to restore the    The No Shows
24 hour cover at the Hospital because of        When you go to your surgery to visit
the failure of the Minister and Members      your doctor, you have probably seen on
to carry out a supportive Tynwald            their electronic board a notice that says
resolution, is labelled by some as           how many people have not attended for
“undermining the system” which is far        their appointments during the previous
from the truth, but that is typical of the   month, with a request saying, “Please
reaction one receives nowadays”.             ring if you can‟t make your appointment
   Mr Singer strongly feels that “at the     so that your appointment can be given to
top, the DHSS needs a dramatic change        someone else”.
of direction”.                                  The Friends of the Manx Diabetes
   “The People” he emphasised, “come         Centre have conducted a survey of
first and waste must be recognised and       eleven Practices on the Isle of Man, and
eliminated, and every penny possible         the collective “No Shows” at these
must be available to provide Medical         Practices during the month of July has
Services, not more „Administration‟.         been a total of 823 people.
   In conclusion, he explained that he          These are people that have been given
had been asked by the League of Friends      appointments by their surgeries, but that
to stand once again for the House of         don‟t bother to turn up, and just leave
Keys in November, with his priority          their doctors waiting with no possibility
mandate being the restoration of the 24      of giving the appointment to another
hour cover for the 15,000 people living      more worthy patient. A complete and
in the north of the Island.                  utter disgrace.
   In accepting the invitation, he assured      The surgeries told us that this was a
the people of Ramsey, that of course if      relative easy month because of the
elected, he would fully represent the        holidays.
people, in all matters, as he had done          However it was intimated that on non
before when elected to the House.            holiday periods this figure can rise by as
   The Diabetic thanks, and is very          much as 33%.
grateful to Mr Singer for agreeing to put       This is a deplorable state of affairs, it
his points of view on the matter to The      is not fair on our doctors, it is not fair on
Diabetic.                                    the Patients, and it is not fair on the
   The Diabetic also extends sincere         DHSS. One can only presumes that these
condolences to Mr Singer and his family      people do not need to see a doctor, so
on the loss of his son.                      why make the appointment in the first
                                             place and waste everyone‟s time
                                                Were we to take this 823 no shows
  The Friends of the Manx Diabetes           figure for the month of July, then at an
Centre will be holding a Coffee Morning      appointment allocation rate of 10
    during the month of December.            minutes per appointment per patient,
                                             this would represent a total of 8,230
                                             minutes of consultations time lost just
for the month of July, or to put it           Doctors time for these “No Shows”, the
another way the equivalent of 137 hours       DHSS?
of consultation time lost for July,               It is certainly not the “No Shows” and
conservatively 12.5 daylight days             it is about time that we hit their pockets,
between all our surgeries.                    and not let them think that the DHSS
   This is really atrocious.                  owes them something and they can
   If we don‟t take the increase in figures   trample over everybody else.
of 33% but just extrapolate July we are
                                                Entitlement cards will not be
looking at a minimum of 1,644 hours
per year (137 daylight days lost               compulsory, but everyone will
between all our surgeries), which could               have to have one.
be used by other patients from all over         Deputy Prime Minister Mr John Prescott
the Island who are in real need to see        36 Diabetic Children on the Isle
their Doctor, but that there are no           of Man and rising. Over six are
immediate appointments available for          under 5 years old
them.                                            36 Children between the ages of 2 and
   The Friends of the Manx Diabetes           17 are now being cared for with
Centre believe that it is incumbent on the    diabetes at the Children‟s Ward on the
DHSS to do something to circumvent            Isle of Man, and more are being
this disgraceful and selfish state of         diagnosed. . Over six newly diagnosed
affairs to help our GP Practices and the      each year, with 3 so far this year.
real patients they have to look after.           Of these 36 children over 6 are under
   In the private sector, if you go to a      5 years of age.
dental surgery, make an appointment and          Once they reach the age of seventeen
don‟t turn up, they may charge anything       they are then taken over full time by the
up to £20 per half hour penalty for not       Manx Diabetes Centre.
attending without notice.                         The Diabetic spoke with Mrs Pam
   Similarly in the private medical           Unsworth the part time paediatric
profession if you don‟t turn up they          diabetes nurse at the Manx Diabetes
charge you a penalty.                         Centre.
   Is it not about time that these people
(that don‟t turn up without notice being
given), are fined? If they were fined,
there would be no more “No Shows”,
they would make sure that when an
appointment was made they attend, or
gave notice that they cannot make it.
   The DHSS under the Act is there to
provide free medical treatment, but it is
certainly not there for these people to
take the mickey of the free facilities                   Mrs Pam Unsworth
provided. All of us have a responsibility
to get behind this and stamp it out.            Pam was a staff nurse at the
   Let us wake up and confront this           Children‟s Ward a post she held since
disgrace. We wonder who pays for the          1990.
   From 1994 diabetic children have           Teaching the family what they require
been looked after at Noble‟s Children‟s     to know about insulin etc and getting
Ward, and since the advent of the Manx      them involved with dieticians, as diet is
Diabetic Centre, the Centre has been        an     essential     part    of    diabetes
used for consultation when appropriate.     management.
   Although Pam‟s office. is in the            Pam also does school visits to get the
Diabetes Centre there is no input from      children back to school almost
the centre as the children are looked       immediately, or as early as possible after
after by Dr Kurien the Paediatrician at     diagnosis. This she aims to try to do
the Children‟s Ward, and clinics are held   within two days of diagnosis so that
there only with the older young people      means she also needs to do school visits.
14yrs +, but still seen by the paediatric      She praised the teachers for their
team until transfer to Dr Khan.             wonderful help and understanding of the
   However in 2003, because the             problems of young diabetics attending
numbers of children suffering from          schools.
diabetes had been increasing, Pam was          “We want the children back to school
seconded to the Centre and is now a part    as soon as possible after diagnosis”, she
time Paediatric diabetic nurse based at     said, “and we again visit whenever they
the Manx Diabetes Centre, for 19 hours      change teachers, and when they are
per week, she holds clinics and generally   starting at a different school.”
operates from there She also is over and       Pam also provides telephone support
above these times at the Children‟s         that involves parents ringing for advice,
Ward.                                       also she needs to be kept up to date on
   This was created by the need for the     the situation, not only at home but also
children and their families to be           at school. What she calls. “trouble
supported in a specialist environment       shooting” to try to find what is really
which the Manx Diabetes Centre is           going on.
capable of providing, with its multi-          This telephone support is to help
disciplinary team of specialists.           families when the children are ill, to try
   Pam sees her job as taking the child     to circumvent their problems and keep
from when newly diagnosed, supporting       them out of hospital.
the family, education, and trying to keep      In this connection they might ring
their admission into hospital to a          three or four times in a day, and she
minimum but if admitted, trying to get      works closely with Dr Kurien at the
them back home within 24 hours.             Children‟s Ward, so that she is aware
   This however means said Pam, that        when a child is not well, and she
she is having to make herself available     organises admissions if she thinks it is
for home support. Having to support         necessary for an overnight stay, but a lot
them at home at injection times, and        of the children they keep out of hospital.
taking the parents through the education       Whereas years ago they would ring to
process of what living with a child with    say that a child that had diabetes was not
diabetes entails.                           well and would automatically bring them
   This involves from six to ten home       in for a couple of days.
visits per child, to get them through the      As regards education, Pam said, that
essential information they would need to    she did a couple of visits a year, and that
safely look after their child.              is for ongoing education and to check
that that they have not got into bad             We also thank Dr Kurien and all the
habits.                                       Staff at the Children‟s Ward for their
   She pointed out that she probably has      wonderful support in looking after our
six or seven at a time or maybe up to ten,    diabetic children.
that are having some problems for a little       We appreciate Pam giving us a little
while and she may have to put extra           of her precious and valuable time to talk
efforts on the little ones, and then things   to The Diabetic.
settle down and drop off, and they get           Our Children are in good hands and
back to normal.                               we wish Pam and all the staff at the
   Most of the children are on multiple       Children‟s Ward all the best in trying to
daily     injections     which     requires   keep one step ahead of the problems of
additional support.                           all our diabetic children.
   She also provides travel support
especially when they are going to             The Prosthetic and Orthotic
Disneyland in Florida and of course           Audit
other destinations.                              The long awaited report on the
   The children also use the Glucose          Prosthesis and Orthotic Departments has
monitor which for the children is a good      just been published.
educational tool.                                Its outcome is no surprise to the
   Pam would not attribute the high           Friends of the Manx Diabetes Centre
incidence in diabetes to the Isle of Man,        The report has not as yet been
as she felt that this was now a global        dissected by us, but at first glance it
problem, and sometimes none of the            leaves much to be desired and we are
parents of those children diagnosed with      pressing the DHSS for answers before
Diabetes were themselves diabetic.            we write to them formally with our
   She was of the opinion that in the old     views.
days, ten years ago there were some              The authors of the report claim that
twenty thousand less people living on         they sent out 64 questionnaires and
the Island than they do today, and then       received back 34, on which the report is
there were only about ten kids with           based.
diabetes compared to 36 today. .                 We have therefore written to Mr
   Nonetheless she pointed out “we now        Norman McGregor Edwards The
seem to be getting a lot of young ones in     Director of Health Strategy and
the past few years”.                          .Performance Health Services Division
   Ten years ago she sadly said, the          of the Department of Health and Social
youngest she had was six, but that now,       Services and asked him for information
she had about half a dozen under fives.       on the following: -
   She praised the team system in                1) We cannot understand why the
dealing with the children which she said      report is based on 34 questionnaires
was invaluable.                               being returned from the 64 sent out.
   We are most grateful to Pam                How is this possible when there are
Unsworth our paediatric diabetic nurse        some 90 amputees on the Island using
based at the Manx Diabetes Centre, for        the Service, and hundreds use the
her comprehensive work with diabetic          Orthotic Clinic.
children of all ages.                            a) Why only 64 sent out when The
                                              Chairman has spoken with other patients
and members of the Group using the              DO   YOU   WANT     THE
Prosthetic and Orthotic Clinics that did      PROSTHETIC AND ORTHOTIC
not receive questionnaires. They have         PERSONNEL TO HOLD CLINICS
been completely ignored, not only are         EVERY WEEK ON THE ISLAND?
they aggrieved at not being consulted but     …………..YES……………NO
they feel most strongly, that having
experienced the problems first hand, that        DO YOU WANT THESE CLINIC
there should be an Othortic and               PERSONNEL TO BE ON THE
Prosthetic Clinics on the Island full time.   ISLAND                               FULL
   2)    What was the input of the            TIME………YES……..NO.
Podiatrists professional personnel that          We believe that the DHSS didn‟t want
met with the Audit people, no mention         these 34 patients answering these direct
appears to be made of them in the report.     questions, that is why they have been
Why was their input ignored?                  omitted.
   3) What was the input of Dr Khan              It must be realised that with any
who has been fighting for the Prosthetic      statistic, or referenda it is all dependant
and Orthotic clinics to be held on the        as to how the questions are couched and
Island on a weekly basis, and who has         how crucial questions are omitted, in
had more than one meeting, and                order to arrive at a desired result. You
corresponded      with     the    hospital    can make statistics stand up and beg.
management on this issue. Why were his           6) We also asked for the report on
views ignored in the Audit.                   the audit of the Orthotic service which is
   4) What has been the input of the          conspicuous by it absence from the
Chronically Sick and Disabled Persons         report that the DHSS has sent us
Committee who have been fighting for             So apart from the Questionnaire that
this to came about over the past year         they did send out to a select few, as not
with many written interventions. Why          even all the hundreds of users of the
were they ignored,                            Prosthetic and Orthotic services have
   5) What was the input of the Friends       been consulted, who else has been
of the Manx Diabetes Centre, who have         consulted and what was their input?
been fighting for this for the past three        The whole audit is taken from 34
years, with our members who have lived        people answering the DHSS preset UK
with these complications and have             based questions, which in reality dealt
knowledge of the Orthotic and Prosthetic      with semantics and not the glaring
problems. Why were we all ignored?            issues. Again an internal audit does not
   a) In fact how can the DHSS ignore         live up to expectations.
all these people and produce a report              At this rate let us hope that our own
from just 34 patients that answered the       Diabetes Audit will not follow the same
questions. Questions set by the DHSS          path.
modelled from UK sources, not                      We shall deal in detail with this audit
orientated to the Isle of Man problems,       report in our December Newsletter.
and which the most important straight            In the meantime we await with avid
questions are not even set down in the        interest the replies to our questions.
UK based questionnaire, Which should           Once again the report is based on
have been geared to the Isle of Man.          UK practices when we are a
Namely: -
Nation and an Island and need our            carers and that not one penny would be
own facilities not those of the UK.          sent off Island.


Donations
  On the evening of the 7th August the
Friends of the Manx Diabetes Centre
were presented by the Isle of Man
Karate Club with the sum of £1,000.
  This money was raised by them
during a sponsored 1 hour Karate
Techniques at their Glencrutchery            The Treasurer Mr Jerry Ludford-Brooks
Gymnasium during normal training             presents certificate to Mr John Kennish
sessions.
                                                The Treasurer Mr Jerry Ludford-
                                             Brooks then presented the Karate Club
                                             with a framed receipt Certificate in
                                             appreciation of their Donation. He
                                             explained that the Group made a
                                             presentation of these certificates to
                                             groups, offices, shops and private
                                             individuals that make donations to the
                                             Friends of the Manx Diabetes Centre in
                                             the sum of £50 pounds or over.

The Presentation by Mr John Kennish to       *********************************
             the Chairman
                                                Miss Linda Rooney who had with
   Prior to the presentation Mr John         children and friends collected the sum of
Houghton MHK explained to all those          £325.10p approached the Chairman with
present what diabetes was, what it did to    a view of donating the Collected Monies
people, the complications that arise if      for exclusive use on the Isle of Man.
not properly cared for, and why the Isle        She was most insistent that she
of Man diabetic patient needed a multi-      wanted the monies to be used for the
disciplinary team of specialists at our      Manx Diabetes Centre, hence her
Manx Diabetes Centre. He emphasised          approach.
that; “Diabetes was a Chronic incurable         The Chairman was most grateful for
condition which requires complex and         the donation and once again assured her
specialist management”.                      that no monies would be sent off Island.
   After the presentation was made to the
Chairman by Mr John Kennish, the
Chairman thanked those present for their
wonderful effort and assured them that
the money would be spent, as was their
wish, on the Island for the benefit of the
Isle of Man Diabetic and their medical
                                             sufficient and not fall into the U.K.
                                             trap. WE ARE NOT IN THE UK.
                                                 Just to show how U.K. orientated this
                                             report is they have it available in,
                                             GUJARATI;
                                             PUNJABI;
                                             HINDI;
                                             SOMALI;
                                             GREEK;
  Miss Linda Rooney with her Mother          ARABIC;
        making the presentation              URDU;
                                             CHINESE-SIMPLIFIED;
  We are once again talking to the           CHINESE-TRADITIONAL;
Manx Diabetes Centre with a view to          BENGALI;
seeing what they might need this             TURKISH;
                                             VIETNAMESE;
                                             ITALIAN;
                                             POLISH;
DHSS in efforts to “prioritise”
                                             And of course ENGLISH
finds allies                                 BUT NOT IN THE                       MANX
   The DHSS in its quest to “prioritize”     LANGUAGE, for after all the report
its services at Noble‟s Hospital finds       is supposed to be geared to the Isle of
allies in the Healthcare Commission of       Man not UK.
the United Kingdom, whom the DHSS               This just shows us that the report is
got to write a report on our Noble‟s         more orientated to UK. practices where
Hospital services.                           they need all these languages, than to the
   At the time of going to press, the        requirements of the Isle of Man.
Friends of the Manx Diabetes Centre             The civil servants at the DHSS may
have as yet not seen a report even though    be delighted with all the languages that it
they have asked for one, but have heard      is available in for our Island, but we are
comments from members.                       not.
   The report as the DHSS once again            So at the suggestion of the Chairman,
required is written with a UK mindset.       and in his presence, a member of the
   It is not really directed to the Manx     Group rang the Healthcare Commission
requirements but rather to an                in the UK and asked for a report in
assimilation of what is going on in the      Manx, (trouble making once again).
UK.                                             We were told they did not have one,
   Consequently it appears to fall in line   However we were adamant and insisted
with the “prioritising” agenda of the        that if the report was supposed to be for
DHSS, We appear to have to many              the Isle of Man, we wanted one in
facilities as compared to a similar size     Manx.
population in the UK..                          To cut a long story short and after
    For the record, once again we must       considerable arguments, they said they
make it abundantly clear to the DHSS         would look into it and if possible have
that the Isle of Man is a Nation and         one for us in a couple of weeks.
also an Island, and we have to be self
   If and when we receive it, we shall       Friends of the Manx Diabetes Centre to
send a copy to Mr Norman McGregor            ask the pertinent and awkward questions.
Edwards the Director of Health Strategy        We shall however comment in detail
and Performance. Health Services             on the report in our December
Division of the Department of Health         newsletter.
and Social Services, for his perusal. And
to remind those at the DHSS from the         The Audiology Department
Minister down, that the Manx people              A member of the Group informs us
are proud of their hospital facilities and   that on 2nd February 2006, they attended
that they don‟t want them in any way         the Audiology Department at Noble‟s
diminished to follow U.K. practices for      Hospital.
our Manx people.                                 Tests and a casts were made for a
   The above shows how ridiculous and        hearing aid and they were told it would
expensive the whole matter is as it          take 20 weeks for it to be supplied.
appears to have been done without the            They have just been asked to attend
depth of knowledge required for the Isle     on 22nd August 2006 (six months and
of Man services, its topography and the      some twenty days later), for it to be
Manx people, but with a UK slant.            fitted.
   The report has been done in all the           If this is the waiting time for hearing
languages required for the UK market         aids to be supplied at our top of the art
but not for us, even though we still         Hospital, then all The Diabetic can say
firmly believe we are not yet part of the    is:
UK.                                              “There must be a lot of deaf or
   However as things are going, we           partially deaf people walking about on
might as well throw in the towel as we       the Isle of Man”.
shall eventual be taken over by the UK,
as everything the UK does we
automatically adopt.                         Diabetes Management in
    Let us buck up our ideas, we are a       Primary Care.
Nation let us keep it that way.                 The Diabetic spoke with Julie
   We cannot loose any of the services at    Maddrell following the successful course
Noble‟s that we have today in order that     undertaken by members of the Manx
the DHSS “prioritizes”. It does not          Diabetes Centre.
matter who says so. It does not compute.        Those taking the course were Mrs
   The Elections are round the corner,       Julie Maddrell (podiatrist), Amy–Louise
make sure you insist on this issue, and if   Harris     (Podiatrist),  Josie   Baxter
your prospective MHK cannot give you         (Dietician), and Dr Amutha Krishnan.
a pledge that he or she will resign if          The Course was a Post graduate
there is any tampering or sacrificing any    training course over a duration of 6
of any of our hospital services to           months combining long distance
“prioritize” then don‟t vote for them.       learning and study days, it was
   You have a vote, use it.                  accredited by the University of
Incidentally we were not asked for our       Huddersfield.
views or invited to participate in any of       The diploma was aimed at health
these events, or workshops, probably         professionals who hold a relevant
because the DHSS did not want the            qualification in healthcare eg. GP,
                                             Nurse, Podiatrist, Dietician, Pharmacist
and is related to clinical practice and         and a networking of meetings. Other
those working with patients who have            professional dealings with diabetic
diabetes.                                       patients is an excellent way of improving
   The course progresses through                patient care.
Diabetes in a logical manner from                  Each module cumulates in 1/2 pieces
diagnosis       through     to     treatment    of reflective coursework which as a
(including       insulin     and      insulin   participant they say they all found very
conversion) to monitoring for and               useful.
management of complications.                       For example:
   The course work enhances this at each           They had to pretend to be diabetic for
section of the course and is aimed at           3 days and their medication was
improving patient care.                         “smarties” and they had to keep a blood
  The course enables the student to work        glucose monitoring diary at various
at their own pace.                              times of the day.
   The course was divided into modules,            They also had to try and exercise 30
      Setting the scene – discusses            minutes per day, look at their food diary
         glucose metabolism and the             and take all the other medication used
         effects that occur when this           for prevention e.g.. lipid control, aspirins
         process is dysfunctional.              etc.
      Type 1 and 2 diabetes and                   They found the whole module a
         impaired glucose tolerance is          nightmare as not really being diabetic,
         also covered as is tests               for the first 2 days some forgot to check
         undertaken and levels for              their blood sugars before breakfast and
         diagnosis identified.                  take their medication 20 minutes before
      Healthy Living – discusses all           they ate, and they felt like they had
         aspects including diet, exercise,      failed miserably but found the
         smoking cessation, BP control,         experience of finger pricking that it is an
         and lipid control.                     art – one that they just about mastered
      Treatment – all aspects covered          after the 3rd day (much to the dismay of
         in     depth     including      oral   their sore fingers) The fact that this
         medication, short and long acting      module was also at Christmas/New year
         insulin and blood glucose              made it very difficult to comply – it has
         monitoring.                            certainly given them strength to maintain
      Future developments also briefly         the encouragement that patients require
         looked at e.g. inhaled insulin.        to keep on track.
      Complications – shows the                   After the “finger pricking” difficulties
         relationship between risk factors      they dreaded having to inject themselves
         and the complications of               in the tummy, but surprisingly, they
         diabetes.      Prevention       and    claim that this was painless. Incidentally
         treatment discussed in detail.         it was nothing lethal that they gave them.
                                                   Some of the modules encouraged the
      Specialist Section – this will be
                                                participant to reflect on their own
         for the candidate and their
                                                patients that perhaps they had difficulties
         profession e.g. Podiatry, GP,
                                                with, and how they could look at
         Nurse, Dietician etc.
   All      the     modules       encourage     challenging ways to improve their
                                                patient management.
participants to “shadow” local services
   This finally led to an exam which was
probably the most daunting part of the
course, as there was a lot to do in a short
time.
   They say that the whole experience
has improved their knowledge in the
management of a diabetic patient, and in
particular the reasoning behind why
certain medications are used for different
patients, or why medications are stopped
due to increasing risk factors.                 Cannon Brendon Alger, Rev. Phillip
   Julie    and      Amy-Louise      being          Frear, Rev. Leslie Cuthrie.
podiatrists say they tend to focus on the
complications of the feet, but this course       The Hospital Chapel is situated
has increased their knowledge of overall      through the hospital main entrance,
risk of complications that diabetic           turning left on to the main corridor, a
                                              few yards on left hand side.
patients face.
                                                 Although furnished as a Christian
   This enables them to support other
                                              place of worship, the chapel is open
professionals in ensuring that they are
                                              around the clock for the use of staff,
giving the same advice that is levels of
                                              patients and visitors of all faiths and
exercise, and blood pressure control.
                                              those of none. Please feel welcome to
   Clinically they feel more confident
                                              use it as a place of prayer, reflection or
when patients discuss their blood
                                              simply somewhere to be quiet.
glucose tests to encourage them to seek
                                                 There are three hospital chaplains who
advice if it is apparent that they need
                                              can be contacted at any time, either
“better control”.
                                              through the hospital switchboard or on
   The course has also raised the
                                              the following numbers:
importance of Podiatry and the role that
                                                 Cannon Brendon Alger (Roman
they play within the multi-disciplinary
                                              Catholic)      675509
team and clinically it has raised the
                                                 Rev Phillip Frear (Church of England)
importance of recognising and knowing
                                                             675523
where to seek and access specialist
                                                 Rev Leslie Guthrie (Free Churches)
services with regards to feet.
                                              626494
   Direct referrals from staff who were
                                                 On the bookshelf in the Chapel
on the course have ensured those
                                              entrance is a selection of pastoral cards
patients with “At Risk” feet or active
                                              and other helpful literature. Please help
problems access the podiatry services as
                                              yourself to anything which may assist
soon as possible.
                                              you.
   This certainly has improved the
                                                 There is a short inter–denominational
management of these patients.
                                              service in the chapel every Wednesday
   Our thanks go to Julie for talking to us
                                              afternoon at 2.30pm taken by one of the
about this all important course
                                              chaplains. All are welcome to come
undertaken by four members of the
                                              along and join us.
Manx Diabetes Centre.
                                                 The above article was supplied by
                                              courtesy of “In touch” Magazine a
The Hospital Chapel                           DHSS newsletter publication.
                                             17%             Rise in the Number of
Updates                                      nurses since 1997
Stockings for Leg Ulcers                     33%             Proportion     of     extra
   A technology has been developed by        spending used for higher pay next year.
researchers at Manchester University‟s          Incidentally our DHSS budget for
William Lee Innovation Centre which          Administration charges only, for the
could represent a major advance on           period 2004-2005 was £2,711,046,. but
existing ulcer treatments for patients       the Estimate under the same heading for
with conditions such as diabetes and         2006-2007 is now £ 4,401,400.
vascular disease.                               I leave you to work out the differences
   The have invented a scanner that          in this and the other heads of
produces made to measure compression         expenditure in the budget for yourselves,
stockings that could transform the           so that we can really learn how to
treatment of leg ulcers for thousand of      “prioritise”.
patients.
   The 3D scanner maps the outline of        Teardrop Test for Diabetics.
the patient‟s leg and sends the data to a       Test that uses teardrops to measure
computer knitting machine.                   blood glucose could herald the end of
   Within 24 hours the machine produces      finger pricking for diabetic patients.
high-tech stockings that fit perfectly.         These tests are being developed in the
   Doctors can even tell the machine         University of Central Florida in
exactly how much pressure they want          America. This type of tests could even
applied and to what part of the leg, in      be used to screen patients for diabetes
order to speed up healing.                   well before they may contract the
                                             disease.
UK NHS Waste by Numbers,                        The prototype that has been created by
£2.8bn         Pay bill for army of          the scientist working in Florida needs
managers and bureaucrats.                    just one teardrop to analyse blood sugar
£1.75bn        Cost of three layers of       levels.
unnecessary bureaucracy, according to           If they are normal a solution in the
public review last year.                     device turns pink. If they are too high
£600m          Deficit built up over last    then it turns dark red.
year.                                           We hope that this device will come to
£578m          Increase in managers‟ pay     fruition and be widely used in the not too
in two years                                 distant future
£300m          Extra cost in new GP          .
contract.                                               “There is no list,
£9m ``         The total budget for „art‟             and Syria isn‟t on it”
spent by the NHS                                 Mr Jack Straw British Foreign Minister
72%           Increase in cost of building
hospitals in first three years of the        Falls Prevention Project Worker
Private Finance Initiative.
45%            Rise in the number of
burocrats since Labour came to power in
1997
                                                after-effects of even the most minor fall
                                                can be devastating for an older person‟s
                                                physical and mental health.
                                                   Data for the Island shows that more
                                                than 1,000 people over the age of 65
                                                attend Noble‟s Accident and Emergency
                                                Department each year following a fall,
                                                these being only a small percentage of
Sandra Pressley, Elaine Hayes and Chris
                                                those whose fall goes unreported.
  Jackson at last years falls prevention
                                                   Developments are currently underway
             awareness day.
                                                to look at: Community assessments to
                                                identify those at risk of falls including a
   Elaine Hayes says: “I have been
                                                falls    user     information     pathway,
involved in the National Service
                                                incorporating a series of information
Framework falls group since its outset in
                                                leaflets on reducing risk factors for falls
2002 during which time we have,
                                                and     appropriate     referral    system.
amongst other things devised the
                                                Addressing the problem of in-patient
hospital falls risk assessment tool,
                                                falls through auditing use of the „falls
corporate falls prevention guide book,
                                                risk assessment tool‟ to then identify
collated data on local falls and have
                                                training and educational needs and, in
undertaken several health promotion
                                                conjunction with the health promotion
activities.
                                                team, expanding exercise provision in
   To further facilitate initiatives, six
                                                the community for the older age group
months ago I was able to develop hours
                                                starting with training key people in the
within my current role as part of a two
                                                provision of chair exercises for the more
year project, aims and objectives
                                                frail elderly and then cascading this
including:
                                                training.
STRATEGIC AIM:
                                                   The Help the Aged second National
   To devise an Island wide policy for
                                                Falls Awareness Day takes place this
the prevention and management of falls.
                                                year on June 27th.
OBJECTIVES:
                                                   The aim of this year‟s event is to raise
     To improve the collection and
                                                awareness of: the risk of falling as we
         analysis of falls data/information.
                                                age, the conditions that increase the
     Ensure          a    safer     hospital   chances of falling and the practical
         environment.                           changes that can be made to reduce the
     Identification of older people            risk.
         who have fallen or are at risk of         It is hoped that some of these
         falling.                               developments will form the basis of a
     All over 65‟s at risk of falling are      local media promotion on this day.
         offered appropriate interventions         For more information regarding the
         to reduce risk.                        project or to discuss issues within your
          Encouraging active healthy           area please feel free to contact me.
         lifestyles in older people.                    Elaine Hayes Tel: 650912
   Falls represent the most frequent and              Falls Prevention Project worker
serious type of accident in the over 65‟s,        Newlands Building, Noble‟s Hospital”
they destroy confidence, increase                      E mail: elaine.hayes@gov.im
isolation and reduce independence. The
  The above article was supplied by        “Because of the hot weather, I am
courtesy of “In touch” Magazine a       trying to get rid of these pests” says his
DHSS newsletter publication.            friend.
                                           “Have you had any success?”
                                           “Yes, I have killed five, three males
The Last Laugh
                                        and two females”.
  A man walks into his friend‟s house
                                           “My, you must be getting proficient,
and finds him swatting flies.
                                        how can you sex them?”
  “What on earth are you doing?” he
                                           “No problem, three were on the beer
asks.
                                        and two were on the phone”.

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