A Question Of Health
Is my GP paid a bonus for flu vaccinations?
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Your support makes all the difference.JAB SATISFACTION
Q. My GP's surgery phoned this week to remind me to have my annual flu vaccination. This is the first time this has happened. Is this to do with doctors being paid a fee for meeting targets?
A. This is an element in deciding what your GP earns. Since 2004, part of GPs' income is set by the points scored on the Quality and Outcomes Framework system.
A practice can score up to 1,050 points. Half the points come from clinical care of patients with 11 main diseases, such as heart disease, lung disease and asthma. If a practice keeps the blood pressure of most of its patients below 150/90, it can receive up to 56 points. If a practice provides flu jabs for patients who have heart disease, lung disease, asthma and diabetes, it can score 30 points.
I'm sure you were called because you are in one of the groups that qualify for points. But if flu vaccination is good for your health, why not give doctors an incentive to provide it?
HARD TO STOMACH
Q. I am being treated by my GP for irritable bowel syndrome (IBS). When I am in abdominal discomfort, I sweat profusely and the skin contracts around my scalp and eyes. I stopped taking mebeverine because it burns my mouth and my lips. Have I developed a psychological aversion to food? And if so, what should I do?
A. None of the symptoms are part of IBS, apart from the abdominal discomfort. They are likely to be psychosomatic. Symptoms of IBS include bloating and loose stools, which can be made worse by emotional events.
Medications such as mebeverine (for bowel spasm) will not help. See a psychologist interested in psychosomatic symptoms, or try cognitive behavioural therapy. Keep a strict diary of symptoms and your accompanying thoughts and feelings. If you ever notice blood in your stools, seek medical advice.
SOUR SWEETENERS?
Q. My husband has diabetes and I use artificial sweeteners in our cooking. Are we using too much aspartame? And are we at increased risk from cancer?
A. There have been cancer scares associated with artificial sweeteners. Cyclamates were banned in the US after a bladder-cancer scare. Saccharin was said to cause cancer in male rats, but in 2001 was given the all-clear.
The most popular sweetener now is aspartame. About 10 years ago there was a scare about brain tumours , but it was discounted.
The recommended maximum dose of aspartame is 40mg per day of aspartame per kilo of body weight. So a person who weighs 60 kilos is allowed 2.4g. There is no good evidence that aspartame is dangerous.
Have your say: Readers write
LS from London takes a dim view of people who feel they must drink to be sociable: How sad that your correspondent, who can't tolerate much alcohol, sees it as a social handicap. He seeks a solution whereby he can presumably drink more. He should be grateful that his body is giving him this message early in life, before irreparable damage is done. Plenty of people have a great social life without alcohol; maybe your correspondent could consider this.
Send your questions and suggestions to: A Question of Health, 'The Independent', 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk Dr Kavalier regrets that he is unable to respond personally to questions
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