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Fewer Falklands War suicides than feared, study suggestsThe claim that more Falklands veterans have killed themselves since the war ended than died in action is not borne out by statistics, a study says.Some 255 UK personnel died in action, but a veterans group has said the suicide toll since 1982 exceeds that.However, the Ministry of Defence has found 95 deaths were recorded as suicides or open verdicts.The MoD said every suicide was a tragedy and urged veterans of any conflict needing support to seek help.In 2002, The South Atlantic Medal Association, which represents veterans, said it was "almost certain" the number of suicides exceeded the conflict death toll.It placed the blame predominantly on a lack of care for those suffering post traumatic stress disorderBut the MoD has now investigated the circumstances of 21,432 Falklands veterans three decades after the end of the conflict, and found that as of 31 December 2012, some 1,335 had died.That compares with an estimated 2,079 deaths that would have been expected among men of a similar age and background who did not serve in the forces, according to the MoD.Of those Falklands veterans, 7% of deaths - or 95 individuals - were due to "intentional self-harm and events of undetermined intent (suicides and open verdict deaths)".That finding means that on average across the whole 30-year period, veterans were actually 35% less likely to kill themselves than the equivalent group of British men with no military background.An MoD spokesman said: "Every suicide is a tragedy and our thoughts remain with the families and relatives of all those lost who bravely served in the Falklands conflict."He said the government had committed £7.2m to improving mental health support for military personnel, including creating a 24-hour helpline in conjunction with charity Combat Stress.The spokesman added: "We would encourage any Falklands veterans or serving personnel who need help to come forward to access the wide range of support available."The study also found:78% of veterans' deaths (1,046) were the result of disease, while 19% (247 deaths) were the result of external causes of injuryCancer was the primary cause of disease-related deaths, with 455 cases recordedBut veterans were 30% less likely to die from cancer and 40% less likely to die from disease in general than men with no military background over the period since 1982Of the 1,335 Falklands deaths, 140 occurred while the individual was still in service - the rest died after leaving the Armed ForcesThe MoD said military personnel were likely to have higher levels of fitness and lower levels of ill health than the general UK population, which could account for the lower incidence of death from disease observed by the study.The death toll of 255 from the Falklands War includes 237 UK servicemen, along with four personnel from the Royal Fleet Auxiliary, six from the Merchant Navy and eight Hong Kong sailors.Falklands suicides 'overestimated'2008 - Veterans Assistance in the UKDr. Eduardo C. GERDINGBulletin of the Naval Center Year 126-Vol. CXXVI-Nº 822-Oct-Dec 2008PrefaceThe medical care of war veterans is inserted, like that of the ordinary British citizen, in the so-called National Health Service (NHS ) which is comparable in its structure to our National Institute of Social Services for Retirees and Pensioners ( INSSJP ). There are population differences, given that the United Kingdom has a significant immigrant group from India, Pakistan, Somalia and the Philippines to the point that 21.9 percent of children born in Great Britain are to foreign mothers. On the other hand, his retirement system has been in trouble for a long time. ( BBC News, Pensions in Crisis- December 10, 2002). In 2003 total health spending per capita in the UK was US $ 2,317.There are serious healthcare problems in military hospitals. In March 2007, Selly Oak Hospital was charged with mistreating British war veterans returning from Iraq. ( BBC, March 11, 2007 ) The British government, arguing that military hospitals cannot provide the same level of care as NHS hospitals has been closing them since 1990. In fact, the Royal Naval Hospital in Haslar, dating from 1753, It is the last military hospital to close its doors in 2009 and the remaining military personnel ( 200 people ) will be transferred to a Ministry of Defense hospital unit located at Queen Alexandra Hospital in Cosham, Portsmouth.The National Health Service ( NHS )The NHS is the UK's public health service, serving 57 million people. England, Scotland, Wales and Northern Ireland each have their own NHS. The NHS budget in 2007 was £ 90 billion and is to be increased by 4 per cent by 2010. ( HealthInsider-10 Oct 2007 ).The Scottish doctor Archibald Joseph Cronin, author of the famous novel The Citadel, was the one who established the innovative ideas that gave rise not only to the NHS but to the triumph of the Labor Party in 1945. In primary care or First Level of the NHS the pillars are GPs ( General Practitioners ) or family doctors and RN ( Registered Nurses ) or Registered Nurses .Note:The General Practitioner (GP) or family doctor is the professional who provides primary or first level assistance. GPs treat acute and chronic illnesses, provide preventive measures, and offer health education to patients of both genders. The English word physician is generally reserved for physicians specializing in internal medicine. In hospitals, GPs can perform minor surgery and / or obstetrics practices. In the UK to receive a GP, you must complete 4 years of postgraduate studies at a Faculty of Medicine. According to the OECD (Organization for Economic Cooperation and Development) of which Great Britain is a part, in 2007 the number of doctors increased by 35 percent in the last 15 years, reaching 2.8 million.Structure of the British National Health System (NHS)To get an idea of ​​the size of the NHS let's say that in March 2005 it had 1,300,000 employees making up the third largest workforce in the world after the Chinese Army and the Indian Railways. Despite this, the figure dropped by 17,000 from 2005 to 2006 (The Independent-Alarm at significant drop in number of NHS workers, April 27, 2007).Seventy percent of NHS costs are to pay salaries and two-thirds of health expenditures go to patients over 60 years of age who have a growing demand for care. As in our country, medical equipment is becoming more sophisticated every day and the public demands treatments with new and expensive drugs. (Adam Smith Institute-Three quarters of NHS cash is needed just to stay still says think tank).The National Service Frameworks (NSFs) constitute long-term health strategies (eg, prevention of coronary heart disease) and are developed by health professionals and associated agencies. Strategic Health Authorities (SHAs) are They are also part of the NHS and are the ones that direct and execute the fiscal policies dictated by the Department of Health at the regional level. On April 12, 2006, Patricia Hewitt, Secretary of State for Health announced that there was going to be a reorganization and the SHAs would be reduced to 10. Each SHAs in turn contains several Trusts The National Institute for Health and Clinical Excellence (NICE) is the health authority of the NHS that publishes evaluations made on specific treatments based on cost / benefit.The TrustsThe First Level Trusts (PCTs) number 152 and comprise 29,000 family doctors (GPs) and 18,000 dentists. PCTs control 80 percent of the NHS budget. Ambulance Services Trusts comprise 290 organizations covering 1600 NHS hospitals. NHS Care Trusts provide Medical and Social care but do not exist in Scotland. The Mental Health Services Trusts provide psychiatric care but are not linked to the Combat Stress organization. Such is the case with the Oxfordshire and Buckinghamshire Mental Health Service NHS Trust. Foundation Trusts are intended to decentralize the NHS so that communities decide based on their wants and needs.However, UNISON, which is the union that groups all public service workers, thinks that this undermines the principles of public health services and sees this as a trend towards the privatization of public services.Monitor is an autonomous entity, independent from the government, which monitors the NHS Foundation Trusts by ensuring that they are well managed and financially sound.Note:A Trust is a group of companies under the same management whose purpose is to control the market for a specific product or sector.You criticize the UK's National Health ServiceBasically the British complain about the following points:Lack of access to medical benefitsPatients who do not conform to the resolutions dictated by the NHS must seek and pay for medical care in the private sphere.2. PoliticizationFiona Godlee, editor of the British Medical Journal, said on April 1, 2006 that ¨the National Health System needs a scheme that replaces political dogma with decisions based on clinical criteria, that replaces confrontation with consensus, lack of reliability with democracy and short-term decisions with long-term stability schemes.The NHS is too complex and vital to our future prosperity to be governed by interests of its own or of any specific party.The continuous use of the NHS as a theater of experimentation of management constitutes a waste ”.(BMJ 2006; 332: 1518 June 24)3 . Double paySometimes patients choose the private setting to be treated more quickly. So they are paying twice: one is withholding tax for the NHS (which they don't use) and the other is private consultation.4 . Long Waiting ListsAccording to the Daily Telegraph, the UK Health Department admitted that approximately 500,000 people in England suffer from shift expectations of a year or more. The worst first-rate care centers are in London, on the east and south coasts of England. The government's goal for 2008 is that no patient has to wait more than 18 weeks to be seen. (Daily Mail-500,000 wait over a year for NHS treatment- 7th June, 2007)5 .SupergermsHigh concentrations of antibiotic resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile are considered to be the result of poor hygiene observed in NHS hospitals. Deaths linked to these two nosocomial infections have increased in one year by 59 percent. According to the Office of National Statistics, MRSA and Clostridium difficile caused more than 5,400 deaths in 2005. The highest peak in mortality (69 percent) according to death certificates were attributable to C. difficile. MRSA deaths increased 39 percent ( The Independent-Targets blamed as hospital infection deaths rised 59% -February 23, 2007 )6. ComputerizationIt is believed that an organization the size of the NHS should be able to meet the costs of developing and maintaining information systems.7. DentistryIn some areas there is reduced access to dental services and a tendency for these professionals to attend only private patients (BNN Online-March 1, 2006). In 2006 approximately 2000 dentists in England refused to sign a new type of contract introduced by the government according to which professionals would not charge from the NHS for treatment but would be assured an annual income of £ 80,000 for three years. The oral exam will be charged £ 15 and £ 40 will cover the repair of up to six cavities. (BNN Dentists ditch NHS, 8 April 2006 )8 . CoverageThe lack of accessibility to certain drugs in certain areas (due to the cost / benefit ratio) has led the British to jokingly nickname this "the postal code lottery"9 . DeficitsSome hospitals and trusts suffer from deficits and have incurred debt. A full report on this point and the allegations to the NHS can be found at BNN Online- NHS charges a complete mess, 18 July 200610 . Scandalsa) The scandal of the organs of Alder HeyIn December 1999 a team of researchers set about investigating the extraction of human organs that took place at the Royal Liverpool Children's Hospital NHS Trust.b) The Bristol Cardiac Surgery ScandalAn investigation was carried out on 290 children who died between 1984 and 1995 after having undergone cardiac surgery at the Bristol Royal Infirmary RegisteredNurses (RN)The history of nursing in the UK dates back to Florence Nightingale. On March 31, 2006 the number of nurses and midwives exceeded 682,000 making the Council of Nurses and Midwives or NMC the largest regulatory agent in the UK. There are approximately 400,000 nurses working for the NHS. The Royal College of Nursing (RCN), which has 395,000 members, was founded in 1916, in 1928 it received the Royal Charter and its patron was Queen Elizabeth II. The title of RN (Registered Nurse) is awarded only to those nurses endorsed by the Nurses, Midwives and Health Visitors Act of 1997. The bulk of them are dedicated to primary care. There are also Specialized Nurses, such as the Nurse Practitioner that complements the work of the GP,Registered Mental Health Nurses (RMN) are trained to care for the mentally ill, recognize symptoms, and even administer psychotropic drugs. In Trinidad Tobago, these nurses not only avoid unnecessary psychiatric hospitalizations but also provide prevention programs at the group level. (Health Sector Reform Program of Trinidad & Tobago)Registered nurses and their financial problemsNurses, policemen, teachers, ambulancemen and firefighters cannot afford housing in 65 per cent of British cities, whereas five years ago this was limited to only 24% of cities. (BNN Online-Key workers are priced out of homes-29 July 2006) During the course of the year, nurse Jusine Whitaker (37 years old) who, eight months ago was named Nurse of the Year, decided to resign from her job as nurse specialized in the treatment of lymphedema in protest at the permanent stress to which their peers are subjected by the constant health reforms. (The Independent, October 17, 2007). According to the RCN, during 2007 22,000 nursing positions were requested. (The Independent, April 5, 2007).The prescriptionsCancer drug prescriptions have placed a heavy burden on the NHS. Such has been the case with trastuzumab (Herceptin®). NICE recommends Herceptin® for women with early stages of breast cancer that are HER2 positive except when there are doubts about the patient's cardiac status. The NHS and NICE have approved the prescription in England and Wales of the so-called “smart drug” MabThera® (Rituximab). This drug is used for non-Hodgkin lymphomas. Rheumatoid arthritis affects 400,000 people in the UK (BBC News, 21 August 2007). However, the drug abatacept (Orencia®) was not approved. Orencia®, which costs £ 9,333 / year / patient could potentially benefit 12,000 patients in the UK alone (BBC News, 2 August 2007).The NHS offers financial assistance to those who cannot afford their treatments due to their low income. Patients who must receive chronic treatments can pay for their prescriptions through a prepaid certificate with considerable discounts. (Department of Health http: // www. Dh. Gov. Uk / en / Policyandguidance / Medicinespharmacyandindus try / Prescriptions /NHScosts/index.htm)Mental healthIt is estimated that 30 per cent of the world's population suffers from some type of mental disorder annually and at least two-thirds receive no care or receive inadequate treatment (The Independent-4 November 2007) .In the UK one in every six people suffer from chronic depression or anxiety and this affects one in three families. In most of Great Britain you have to wait nine months to receive sessions of Cognitive Therapy (CBT), (BNN-Therapy on NHS ¨must be increased¨, 18 June 2006).The impact on war veteransA study of 64 British Falklands war veterans revealed that half of them had some symptoms of post traumatic stress disorder (PTSD) and 22 percent had the full syndrome. (British Journal of Psychiatry (1991), 159, 135-141). 250 war veterans from the Malvinas, Northern Ireland, Bosnia, the Gulf War and other conflicts brought the Ministry of Defense to justice for not having been adequately treated by the PTSD upon their return, and another 1,600 were added to them. According to the South Atlantic Medal Association (SAMA) in the Malvinas Conflict 256 British combatants died but since then 264 have already committed suicide. (CMAJ-Suicide claiming more British Falkland veterans than fighting did-May 28, 2002). According to Roger Gabriel and Leigh A. Neal from the Gulf War Medical Assessment Program or MAP (a Veterans' Warfare Survey Program) at St. Thomas Hospital in London, any GP can diagnose a PTSD which will carry out the consultation with the psychiatrist as appropriate. (BMJ –Vol 324 -9 February 2002).Statue of the Abandoned SoldierThis statue, located in a Combat Stress, made by sculptor JamesNapier and modeled on Daniel Twiddy who wasseriously wounded in his face by splinters in Basra in 2003.The Combat Stress organization (Veterans Welfare Society)This society was founded in 1919 and is the only public welfare entity that provides assistance to war veterans who have suffered mental trauma as a result of combat. It has 13 regional centers and an experience based on 86 years of service. To date, more than 85,000 veterans and their families have been assisted and 8,000 veterans are currently registered. For hospitalizations (which cannot exceed six weeks a year) they have three centers: Hollybush House, Ayr (Scotland and Ireland) with 25 beds, Audley Court, Newport, Shropshire (England and North Wales) with 27 beds, and Tyrwitt House, Leatherhead, Surrey (England and South Wales) with 30 beds. They have a President, a Committee and an Executive Director on which report a Director of Clinical Services (a retired military psychiatrist), a Director of Finance and Administration (a civil accountant), a Director of Welfare and a Director in charge of collecting funds. The Director of Clinical Services controls Hollybush House, Tyrwitt House and Audley Court. There are no psychologists here but 15 registered nurses and two health assistants work. The clinical part is handled by the NHS GP. The patients have an average age of 44 years, have served 11 years, and on average it has been 13 years since they left active duty until they entered Combat Stress. 35 percent of applicants are rejected due to alcoholism or other severe addictions. According to the 2006 data, 80 percent belonged to the Army, 8, 7 percent to the Royal Air Force. 8 percent to the Royal Navy, 2.7 percent to the Royal Marines and 0.6 percent to the Merchant Navy. 10 percent of patients come from NHS referrals and 46 percent from friends or acquaintances.The so-called Comprehensive Care Plan (The Whole Person Care Plan) includes Cognitive Therapy (CBT), EMDR (Eye Movement Desensitization and Reprocessing). EMDR It is a method of desensitization and reprocessing of emotionally traumatic experiences through bilateral stimulation of the brain, education on Post Traumatic Stress, anxiety management, anger management, Creative Therapies, Relaxation Techniques , Sleep Hygiene, Occupational Therapy and Social Skills.Financial support for Combat Stress comes from the Ministry of Defense.The Robertson Truce, Seafarers UK, The Scottish Executive, The Officers´Association Scotland, The Corporation of Trinity House, The royal Army Chaplains Department, The Boughton Trust, Payroll Givers, Queen Mary´s Roehampton Trust, 51st Highland Division and Ross Bequest Trust , The Far East Prisoner-of-War Association, The Wates Foundation, and JP Getty Jr. Charitable Association. The day of admission to Combat Stress comes out £ 264 .. On March 31, 2007 they had received £ 2,732,000.The author at the Residential Treatment Center at Tyrwhitt House, Leatherhead, Surrey, England. The center provides the war veteran with a safe therapeutic environment in the company of their peers. Receive medical care that meets your needs with a team that seeks the most appropriate solutions.From right to left: Commodore Toby Elliott OBE RN (Executive Director ), Claire Evans (Head of Clinical Services) and Dr. Eduardo C.Gerding founder of the Nottingham-Malvinas Group. Photo taken atCombat Stress in Audley Court.The War Veteran's Personal FileEach War veteran has their own file which includes:a) The Medical History provided by their Family Physician (GP) and their Psychiatrist,b) A detailed report of their actual performance in combat made by an officer who was in charge andc) A final report made by a Welfare Officer.Files marked with a blue dot indicate new admissions.A neat bedroom in Audley Court. War veterans aregenerally reluctant to share the same. As theend of the year festivities approach many war veterans apply for admission due to amatter of loneliness.Veterans Recreation Activities at Audley Court. Thisincludes reflexology, relaxation techniques, Tai Chi, cookingclasses, computer classes, bowling, cycling, ping pong etc. On the rightMr. Jim Banks (Head Nurse).This painting was made by a Falklands War veteran interned at Audley Court. He himself had received a shot that destroyed his jaw. The image describes the intense pain suffered that he was not able to express in words. This constitutes part of the so-called Occupational Therapy. War veterans can also express their feelings through poetry, existing specialized therapists for them. (Arthur Lerner Ph.D ( Ed-Poetry in the Therapeutic Experience, 2nd edition )Special bathtub for disabled patientsThe War Pension SystemIn the UK, only war veterans who have been left with some degree of disability, widowers and orphans, receive a war pension. There are two systems: One for those affected before April 6, 2005 called the War Pensions Scheme and another for those who have suffered injuries after that date called the Armed Forces Compensation Scheme (AFCS). The latter does not prevent the veteran, if he wishes, from taking legal action against the Ministry of Defense .How War pensions are currently calculated according to the AFCSLevels from 1 to 15 are established depending on the severity of the injury.Level I correspWave to the most severe injuries and receive the largest amounts. Level 15 covers less severe injuries such as burns or knee dislocation. Those with Levels 1 to 11 receive a Guaranteed Income Payment GIP (Guaranteed Income for Life). This GIP is calculated by multiplying the pension payment by a factor that depends on the age on your last birthday. The younger the person, the greater the factor because the age that would normally be left to retire. The final GIP is a percentage of the rate that corresponds to you.The bands are as follows:Band A Levels 1 to 4 100%Band B Levels 5 to 6 75%Band C Levels 7 to 8 50%Band D Levels 9 to 11 30%Example:A 23-year-old soldier loses a foot as a result of a combat action. He is currently receiving a salary of £ 20,000. The corresponding factor is applied to a combatant of that age, which in this case is 0.878. The Guaranteed Income for Life (GIP) is calculated like this = Salary x Factor or £ 20,000 x 0.878 = £ 17,560. Since the injury is considered to correspond to Level 8, the person will receive 50% of their total GIP, meaning that they will receive £ 8,780 per year tax free.The case of the GurkhasLance Corporal Gyanendra Rai was seriously wounded by Argentine artillery at Bluff Cove during the Malvinas Conflict. Gyanendra Ray was discharged from the Army, receives no pension and was paid only £ 2,000 from the South Atlantic Fund. This Gurkha served 13 years in the British Army and not 15, which would have given him the right to collect a pension. ( Personal communication from Mike Seear )Apart from this, British immigration officials do not allow him to settle in Britain as they say that both Rai and other Gurkhas do not have "close ties to the United Kingdom". There is a provision stating that Gurkhas who retired before 1997 have no right to reside in the UK. An 84-year-old Gurkha named Tul Bahadur Pun who was awarded the Victoria Cross and was granted a visa called for justice for his peers. (BBC, 1 August 2007) http://www.cchero.co.ukLance Corporal Gyandendra RaiGyandendra Railost part of her backEl Grupo Malvinas-Nottingham

Fewer Falklands War suicides than feared, study suggestsThe claim that more Falklands veterans have killed themselves since the war ended than died in action is not borne out by statistics, a study says.Some 255 UK personnel died in action, but a veterans group has said the suicide toll since 1982 exceeds that.However, the Ministry of Defence has found 95 deaths were recorded as suicides or open verdicts.The MoD said every suicide was a tragedy and urged veterans of any conflict needing support to seek help.In 2002, The South Atlantic Medal Association, which represents veterans, said it was "almost certain" the number of suicides exceeded the conflict death toll.It placed the blame predominantly on a lack of care for those suffering post traumatic stress disorderBut the MoD has now investigated the circumstances of 21,432 Falklands veterans three decades after the end of the conflict, and found that as of 31 December 2012, some 1,335 had died.That compares with an estimated 2,079 deaths that would have been expected among men of a similar age and background who did not serve in the forces, according to the MoD.Of those Falklands veterans, 7% of deaths - or 95 individuals - were due to "intentional self-harm and events of undetermined intent (suicides and open verdict deaths)".That finding means that on average across the whole 30-year period, veterans were actually 35% less likely to kill themselves than the equivalent group of British men with no military background.An MoD spokesman said: "Every suicide is a tragedy and our thoughts remain with the families and relatives of all those lost who bravely served in the Falklands conflict."He said the government had committed £7.2m to improving mental health support for military personnel, including creating a 24-hour helpline in conjunction with charity Combat Stress.The spokesman added: "We would encourage any Falklands veterans or serving personnel who need help to come forward to access the wide range of support available."The study also found:78% of veterans' deaths (1,046) were the result of disease, while 19% (247 deaths) were the result of external causes of injuryCancer was the primary cause of disease-related deaths, with 455 cases recordedBut veterans were 30% less likely to die from cancer and 40% less likely to die from disease in general than men with no military background over the period since 1982Of the 1,335 Falklands deaths, 140 occurred while the individual was still in service - the rest died after leaving the Armed ForcesThe MoD said military personnel were likely to have higher levels of fitness and lower levels of ill health than the general UK population, which could account for the lower incidence of death from disease observed by the study.The death toll of 255 from the Falklands War includes 237 UK servicemen, along with four personnel from the Royal Fleet Auxiliary, six from the Merchant Navy and eight Hong Kong sailors.Falklands suicides 'overestimated'2008 - Veterans Assistance in the UKDr. Eduardo C. GERDINGBulletin of the Naval Center Year 126-Vol. CXXVI-Nº 822-Oct-Dec 2008PrefaceThe medical care of war veterans is inserted, like that of the ordinary British citizen, in the so-called National Health Service (NHS ) which is comparable in its structure to our National Institute of Social Services for Retirees and Pensioners ( INSSJP ). There are population differences, given that the United Kingdom has a significant immigrant group from India, Pakistan, Somalia and the Philippines to the point that 21.9 percent of children born in Great Britain are to foreign mothers. On the other hand, his retirement system has been in trouble for a long time. ( BBC News, Pensions in Crisis- December 10, 2002). In 2003 total health spending per capita in the UK was US $ 2,317.There are serious healthcare problems in military hospitals. In March 2007, Selly Oak Hospital was charged with mistreating British war veterans returning from Iraq. ( BBC, March 11, 2007 ) The British government, arguing that military hospitals cannot provide the same level of care as NHS hospitals has been closing them since 1990. In fact, the Royal Naval Hospital in Haslar, dating from 1753, It is the last military hospital to close its doors in 2009 and the remaining military personnel ( 200 people ) will be transferred to a Ministry of Defense hospital unit located at Queen Alexandra Hospital in Cosham, Portsmouth.The National Health Service ( NHS )The NHS is the UK's public health service, serving 57 million people. England, Scotland, Wales and Northern Ireland each have their own NHS. The NHS budget in 2007 was £ 90 billion and is to be increased by 4 per cent by 2010. ( HealthInsider-10 Oct 2007 ).The Scottish doctor Archibald Joseph Cronin, author of the famous novel The Citadel, was the one who established the innovative ideas that gave rise not only to the NHS but to the triumph of the Labor Party in 1945. In primary care or First Level of the NHS the pillars are GPs ( General Practitioners ) or family doctors and RN ( Registered Nurses ) or Registered Nurses .Note:The General Practitioner (GP) or family doctor is the professional who provides primary or first level assistance. GPs treat acute and chronic illnesses, provide preventive measures, and offer health education to patients of both genders. The English word physician is generally reserved for physicians specializing in internal medicine. In hospitals, GPs can perform minor surgery and / or obstetrics practices. In the UK to receive a GP, you must complete 4 years of postgraduate studies at a Faculty of Medicine. According to the OECD (Organization for Economic Cooperation and Development) of which Great Britain is a part, in 2007 the number of doctors increased by 35 percent in the last 15 years, reaching 2.8 million.Structure of the British National Health System (NHS)To get an idea of ​​the size of the NHS let's say that in March 2005 it had 1,300,000 employees making up the third largest workforce in the world after the Chinese Army and the Indian Railways. Despite this, the figure dropped by 17,000 from 2005 to 2006 (The Independent-Alarm at significant drop in number of NHS workers, April 27, 2007).Seventy percent of NHS costs are to pay salaries and two-thirds of health expenditures go to patients over 60 years of age who have a growing demand for care. As in our country, medical equipment is becoming more sophisticated every day and the public demands treatments with new and expensive drugs. (Adam Smith Institute-Three quarters of NHS cash is needed just to stay still says think tank).The National Service Frameworks (NSFs) constitute long-term health strategies (eg, prevention of coronary heart disease) and are developed by health professionals and associated agencies. Strategic Health Authorities (SHAs) are They are also part of the NHS and are the ones that direct and execute the fiscal policies dictated by the Department of Health at the regional level. On April 12, 2006, Patricia Hewitt, Secretary of State for Health announced that there was going to be a reorganization and the SHAs would be reduced to 10. Each SHAs in turn contains several Trusts The National Institute for Health and Clinical Excellence (NICE) is the health authority of the NHS that publishes evaluations made on specific treatments based on cost / benefit.The TrustsThe First Level Trusts (PCTs) number 152 and comprise 29,000 family doctors (GPs) and 18,000 dentists. PCTs control 80 percent of the NHS budget. Ambulance Services Trusts comprise 290 organizations covering 1600 NHS hospitals. NHS Care Trusts provide Medical and Social care but do not exist in Scotland. The Mental Health Services Trusts provide psychiatric care but are not linked to the Combat Stress organization. Such is the case with the Oxfordshire and Buckinghamshire Mental Health Service NHS Trust. Foundation Trusts are intended to decentralize the NHS so that communities decide based on their wants and needs.However, UNISON, which is the union that groups all public service workers, thinks that this undermines the principles of public health services and sees this as a trend towards the privatization of public services.Monitor is an autonomous entity, independent from the government, which monitors the NHS Foundation Trusts by ensuring that they are well managed and financially sound.Note:A Trust is a group of companies under the same management whose purpose is to control the market for a specific product or sector.You criticize the UK's National Health ServiceBasically the British complain about the following points:Lack of access to medical benefitsPatients who do not conform to the resolutions dictated by the NHS must seek and pay for medical care in the private sphere.2. PoliticizationFiona Godlee, editor of the British Medical Journal, said on April 1, 2006 that ¨the National Health System needs a scheme that replaces political dogma with decisions based on clinical criteria, that replaces confrontation with consensus, lack of reliability with democracy and short-term decisions with long-term stability schemes.The NHS is too complex and vital to our future prosperity to be governed by interests of its own or of any specific party.The continuous use of the NHS as a theater of experimentation of management constitutes a waste ”.(BMJ 2006; 332: 1518 June 24)3 . Double paySometimes patients choose the private setting to be treated more quickly. So they are paying twice: one is withholding tax for the NHS (which they don't use) and the other is private consultation.4 . Long Waiting ListsAccording to the Daily Telegraph, the UK Health Department admitted that approximately 500,000 people in England suffer from shift expectations of a year or more. The worst first-rate care centers are in London, on the east and south coasts of England. The government's goal for 2008 is that no patient has to wait more than 18 weeks to be seen. (Daily Mail-500,000 wait over a year for NHS treatment- 7th June, 2007)5 .SupergermsHigh concentrations of antibiotic resistant bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile are considered to be the result of poor hygiene observed in NHS hospitals. Deaths linked to these two nosocomial infections have increased in one year by 59 percent. According to the Office of National Statistics, MRSA and Clostridium difficile caused more than 5,400 deaths in 2005. The highest peak in mortality (69 percent) according to death certificates were attributable to C. difficile. MRSA deaths increased 39 percent ( The Independent-Targets blamed as hospital infection deaths rised 59% -February 23, 2007 )6. ComputerizationIt is believed that an organization the size of the NHS should be able to meet the costs of developing and maintaining information systems.7. DentistryIn some areas there is reduced access to dental services and a tendency for these professionals to attend only private patients (BNN Online-March 1, 2006). In 2006 approximately 2000 dentists in England refused to sign a new type of contract introduced by the government according to which professionals would not charge from the NHS for treatment but would be assured an annual income of £ 80,000 for three years. The oral exam will be charged £ 15 and £ 40 will cover the repair of up to six cavities. (BNN Dentists ditch NHS, 8 April 2006 )8 . CoverageThe lack of accessibility to certain drugs in certain areas (due to the cost / benefit ratio) has led the British to jokingly nickname this "the postal code lottery"9 . DeficitsSome hospitals and trusts suffer from deficits and have incurred debt. A full report on this point and the allegations to the NHS can be found at BNN Online- NHS charges a complete mess, 18 July 200610 . Scandalsa) The scandal of the organs of Alder HeyIn December 1999 a team of researchers set about investigating the extraction of human organs that took place at the Royal Liverpool Children's Hospital NHS Trust.b) The Bristol Cardiac Surgery ScandalAn investigation was carried out on 290 children who died between 1984 and 1995 after having undergone cardiac surgery at the Bristol Royal Infirmary RegisteredNurses (RN)The history of nursing in the UK dates back to Florence Nightingale. On March 31, 2006 the number of nurses and midwives exceeded 682,000 making the Council of Nurses and Midwives or NMC the largest regulatory agent in the UK. There are approximately 400,000 nurses working for the NHS. The Royal College of Nursing (RCN), which has 395,000 members, was founded in 1916, in 1928 it received the Royal Charter and its patron was Queen Elizabeth II. The title of RN (Registered Nurse) is awarded only to those nurses endorsed by the Nurses, Midwives and Health Visitors Act of 1997. The bulk of them are dedicated to primary care. There are also Specialized Nurses, such as the Nurse Practitioner that complements the work of the GP,Registered Mental Health Nurses (RMN) are trained to care for the mentally ill, recognize symptoms, and even administer psychotropic drugs. In Trinidad Tobago, these nurses not only avoid unnecessary psychiatric hospitalizations but also provide prevention programs at the group level. (Health Sector Reform Program of Trinidad & Tobago)Registered nurses and their financial problemsNurses, policemen, teachers, ambulancemen and firefighters cannot afford housing in 65 per cent of British cities, whereas five years ago this was limited to only 24% of cities. (BNN Online-Key workers are priced out of homes-29 July 2006) During the course of the year, nurse Jusine Whitaker (37 years old) who, eight months ago was named Nurse of the Year, decided to resign from her job as nurse specialized in the treatment of lymphedema in protest at the permanent stress to which their peers are subjected by the constant health reforms. (The Independent, October 17, 2007). According to the RCN, during 2007 22,000 nursing positions were requested. (The Independent, April 5, 2007).The prescriptionsCancer drug prescriptions have placed a heavy burden on the NHS. Such has been the case with trastuzumab (Herceptin®). NICE recommends Herceptin® for women with early stages of breast cancer that are HER2 positive except when there are doubts about the patient's cardiac status. The NHS and NICE have approved the prescription in England and Wales of the so-called “smart drug” MabThera® (Rituximab). This drug is used for non-Hodgkin lymphomas. Rheumatoid arthritis affects 400,000 people in the UK (BBC News, 21 August 2007). However, the drug abatacept (Orencia®) was not approved. Orencia®, which costs £ 9,333 / year / patient could potentially benefit 12,000 patients in the UK alone (BBC News, 2 August 2007).The NHS offers financial assistance to those who cannot afford their treatments due to their low income. Patients who must receive chronic treatments can pay for their prescriptions through a prepaid certificate with considerable discounts. (Department of Health http: // www. Dh. Gov. Uk / en / Policyandguidance / Medicinespharmacyandindus try / Prescriptions /NHScosts/index.htm)Mental healthIt is estimated that 30 per cent of the world's population suffers from some type of mental disorder annually and at least two-thirds receive no care or receive inadequate treatment (The Independent-4 November 2007) .In the UK one in every six people suffer from chronic depression or anxiety and this affects one in three families. In most of Great Britain you have to wait nine months to receive sessions of Cognitive Therapy (CBT), (BNN-Therapy on NHS ¨must be increased¨, 18 June 2006).The impact on war veteransA study of 64 British Falklands war veterans revealed that half of them had some symptoms of post traumatic stress disorder (PTSD) and 22 percent had the full syndrome. (British Journal of Psychiatry (1991), 159, 135-141). 250 war veterans from the Malvinas, Northern Ireland, Bosnia, the Gulf War and other conflicts brought the Ministry of Defense to justice for not having been adequately treated by the PTSD upon their return, and another 1,600 were added to them. According to the South Atlantic Medal Association (SAMA) in the Malvinas Conflict 256 British combatants died but since then 264 have already committed suicide. (CMAJ-Suicide claiming more British Falkland veterans than fighting did-May 28, 2002). According to Roger Gabriel and Leigh A. Neal from the Gulf War Medical Assessment Program or MAP (a Veterans' Warfare Survey Program) at St. Thomas Hospital in London, any GP can diagnose a PTSD which will carry out the consultation with the psychiatrist as appropriate. (BMJ –Vol 324 -9 February 2002).Statue of the Abandoned SoldierThis statue, located in a Combat Stress, made by sculptor JamesNapier and modeled on Daniel Twiddy who wasseriously wounded in his face by splinters in Basra in 2003.The Combat Stress organization (Veterans Welfare Society)This society was founded in 1919 and is the only public welfare entity that provides assistance to war veterans who have suffered mental trauma as a result of combat. It has 13 regional centers and an experience based on 86 years of service. To date, more than 85,000 veterans and their families have been assisted and 8,000 veterans are currently registered. For hospitalizations (which cannot exceed six weeks a year) they have three centers: Hollybush House, Ayr (Scotland and Ireland) with 25 beds, Audley Court, Newport, Shropshire (England and North Wales) with 27 beds, and Tyrwitt House, Leatherhead, Surrey (England and South Wales) with 30 beds. They have a President, a Committee and an Executive Director on which report a Director of Clinical Services (a retired military psychiatrist), a Director of Finance and Administration (a civil accountant), a Director of Welfare and a Director in charge of collecting funds. The Director of Clinical Services controls Hollybush House, Tyrwitt House and Audley Court. There are no psychologists here but 15 registered nurses and two health assistants work. The clinical part is handled by the NHS GP. The patients have an average age of 44 years, have served 11 years, and on average it has been 13 years since they left active duty until they entered Combat Stress. 35 percent of applicants are rejected due to alcoholism or other severe addictions. According to the 2006 data, 80 percent belonged to the Army, 8, 7 percent to the Royal Air Force. 8 percent to the Royal Navy, 2.7 percent to the Royal Marines and 0.6 percent to the Merchant Navy. 10 percent of patients come from NHS referrals and 46 percent from friends or acquaintances.The so-called Comprehensive Care Plan (The Whole Person Care Plan) includes Cognitive Therapy (CBT), EMDR (Eye Movement Desensitization and Reprocessing). EMDR It is a method of desensitization and reprocessing of emotionally traumatic experiences through bilateral stimulation of the brain, education on Post Traumatic Stress, anxiety management, anger management, Creative Therapies, Relaxation Techniques , Sleep Hygiene, Occupational Therapy and Social Skills.Financial support for Combat Stress comes from the Ministry of Defense.The Robertson Truce, Seafarers UK, The Scottish Executive, The Officers´Association Scotland, The Corporation of Trinity House, The royal Army Chaplains Department, The Boughton Trust, Payroll Givers, Queen Mary´s Roehampton Trust, 51st Highland Division and Ross Bequest Trust , The Far East Prisoner-of-War Association, The Wates Foundation, and JP Getty Jr. Charitable Association. The day of admission to Combat Stress comes out £ 264 .. On March 31, 2007 they had received £ 2,732,000.The author at the Residential Treatment Center at Tyrwhitt House, Leatherhead, Surrey, England. The center provides the war veteran with a safe therapeutic environment in the company of their peers. Receive medical care that meets your needs with a team that seeks the most appropriate solutions.From right to left: Commodore Toby Elliott OBE RN (Executive Director ), Claire Evans (Head of Clinical Services) and Dr. Eduardo C.Gerding founder of the Nottingham-Malvinas Group. Photo taken atCombat Stress in Audley Court.The War Veteran's Personal FileEach War veteran has their own file which includes:a) The Medical History provided by their Family Physician (GP) and their Psychiatrist,b) A detailed report of their actual performance in combat made by an officer who was in charge andc) A final report made by a Welfare Officer.Files marked with a blue dot indicate new admissions.A neat bedroom in Audley Court. War veterans aregenerally reluctant to share the same. As theend of the year festivities approach many war veterans apply for admission due to amatter of loneliness.Veterans Recreation Activities at Audley Court. Thisincludes reflexology, relaxation techniques, Tai Chi, cookingclasses, computer classes, bowling, cycling, ping pong etc. On the rightMr. Jim Banks (Head Nurse).This painting was made by a Falklands War veteran interned at Audley Court. He himself had received a shot that destroyed his jaw. The image describes the intense pain suffered that he was not able to express in words. This constitutes part of the so-called Occupational Therapy. War veterans can also express their feelings through poetry, existing specialized therapists for them. (Arthur Lerner Ph.D ( Ed-Poetry in the Therapeutic Experience, 2nd edition )Special bathtub for disabled patientsThe War Pension SystemIn the UK, only war veterans who have been left with some degree of disability, widowers and orphans, receive a war pension. There are two systems: One for those affected before April 6, 2005 called the War Pensions Scheme and another for those who have suffered injuries after that date called the Armed Forces Compensation Scheme (AFCS). The latter does not prevent the veteran, if he wishes, from taking legal action against the Ministry of Defense .How War pensions are currently calculated according to the AFCSLevels from 1 to 15 are established depending on the severity of the injury.Level I correspWave to the most severe injuries and receive the largest amounts. Level 15 covers less severe injuries such as burns or knee dislocation. Those with Levels 1 to 11 receive a Guaranteed Income Payment GIP (Guaranteed Income for Life). This GIP is calculated by multiplying the pension payment by a factor that depends on the age on your last birthday. The younger the person, the greater the factor because the age that would normally be left to retire. The final GIP is a percentage of the rate that corresponds to you.The bands are as follows:Band A Levels 1 to 4 100%Band B Levels 5 to 6 75%Band C Levels 7 to 8 50%Band D Levels 9 to 11 30%Example:A 23-year-old soldier loses a foot as a result of a combat action. He is currently receiving a salary of £ 20,000. The corresponding factor is applied to a combatant of that age, which in this case is 0.878. The Guaranteed Income for Life (GIP) is calculated like this = Salary x Factor or £ 20,000 x 0.878 = £ 17,560. Since the injury is considered to correspond to Level 8, the person will receive 50% of their total GIP, meaning that they will receive £ 8,780 per year tax free.The case of the GurkhasLance Corporal Gyanendra Rai was seriously wounded by Argentine artillery at Bluff Cove during the Malvinas Conflict. Gyanendra Ray was discharged from the Army, receives no pension and was paid only £ 2,000 from the South Atlantic Fund. This Gurkha served 13 years in the British Army and not 15, which would have given him the right to collect a pension. ( Personal communication from Mike Seear )Apart from this, British immigration officials do not allow him to settle in Britain as they say that both Rai and other Gurkhas do not have "close ties to the United Kingdom". There is a provision stating that Gurkhas who retired before 1997 have no right to reside in the UK. An 84-year-old Gurkha named Tul Bahadur Pun who was awarded the Victoria Cross and was granted a visa called for justice for his peers. (BBC, 1 August 2007) http://www.cchero.co.ukLance Corporal Gyandendra RaiGyandendra Railost part of her backEl Grupo Malvinas-Nottingham