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Why is the UK a swine flu hotspot?

By Jeremy Laurance, Health Editor

This 2009 file microscope image originally  provided by the Centers for Disease Control and Prevention, shows a negative-stained image of the swine flu virus

AP Photo/Centers for Disease Control and Prevention, C. S. Goldsmith and A. Balish

This 2009 file microscope image originally provided by the Centers for Disease Control and Prevention, shows a negative-stained image of the swine flu virus

As the global swine flu pandemic gathers pace, one question is puzzling scientists. Why is a small country on the eastern seaboard of the north Atlantic so badly affected?

Britain is among the top half dozen global hot spots for swine flu. Along with Mexico, where the disease orginated, the US, Canada, Chile, Argentina and Australia, we are leading the way in the battle against the bug. We have more cases, and more deaths, than any other country in Europe and the pandemic is growing exponentially here, with 55,000 new cases last week, while it is subsiding elsewhere, notably in Mexico. And because we are in the front line, we are having to learn as we go.

This is not what was expected. Britain is an island nation, accustomed to the security that living within sea borders brings. But when it comes to highly pathogenic viruses, even the English channel cannot protect us.

When the pandemic emerged in Mexico last April, spreading first to the US and then across the Atlantic to Britain and Europe, it was thought that, as we were entering our summer, the virus might spread only slowly, giving us a few months grace to prepare for a winter surge.

It has not turned out that way. The expected winter surge, which may still occur, has been preceded by a summer one. In the early weeks of the pandemic, last May, Britain and Spain had roughly equivalent numbers of cases. But as the weeks have passed, Britain has been much harder hit. By 16 July, we had 9,718 confirmed cases and 14 deaths, nine times more than Spain with 1099 cases and two deaths. In Germany, France and Italy, the number of cases is still in the hundreds and there have been no recorded deaths.

Confronted with these puzzles, experts respond with a single phrase: the behaviour of the flu virus is very difficult to predict. Flu repeatedly confounds efforts to understand, and forecast, its course - it behaves in mysterious ways. Nevertheless, Sir Liam Donaldson, the Government’s chief medical officer, offered two possible explanations for Britain’s high rate of swine flu sickness this week.

Our close links with the US, with large numbers of visitors coming and going, made Britain an ideal staging post for the virus to break out from north America. Heathrow is one of the world’s busiest international transport hubs and as such is one of the key routes for global viral transmission.

In addition, Sir Liam said, disease surveillance in the UK is exceptionally good. It may be that we are picking up more cases which in other countries are going undetected.

A further reason, cited by some experts, is that schools close earlier for the summer holidays on the continent and this may have slowed the spread.

The upshot is that the pandemic in Britain may simply be more advanced than in other countries, and they will eventually catch up.

The unpredictability of the virus is re-inforced by its behaviour in the southern hemisphere, which was expected to face the first wave of the pandemic. But while there are significant epidemics in Australia, Chile and Argentina, there is little evidence of swine flu in South Africa, with just 18 confirmed cases at 6 July.

At the same date, Chile had 7,376 cases and 14 deaths while Argentina had 2,485 cases and 60 deaths.

Some parts of Australia have experienced significant outbreaks, but the overall total (5,298 cases at 6 July and 10 deaths) is still below that in the UK. And it is mid-winter there.

What will happen next? "It is very difficult to predict," said Allan Hay, the man in the best position to do so - were it possible - as director of the World Health Organisation’s Influenza Monitoring Centre in mill Hill, north London.

"In Mexico it peaked in late April, and it is supposedly turning down in the US. It certainly hasn’t been escalating in those countries, but nor has it disappeared."

"In the UK, we anticipate it might peak in a week or two - the closure of schools for the summer holidays may have an impact. Then we will expect to have a normal flu season in the winter and all the indications are that it will be caused by the pandemic H1N1 virus."

"We don’t know if it will replace the seasonal flu virus [or circulate in parallel with it]. In Australia, we have seen most infections caused by the pandemic virus. That is the usual experience - one virus tends to dominate. But we are monitoring the situation closely. Other seasonal viruses may return in the coming years."

It may be Britain’s misfortune to be hit first and hit hardest by the world’s first flu pandemic for 40 years. On the other hand, if it causes only mild illness this winter, we may be counting our blessings by the following one should the virus mutate to something nastier. What doesn’t kill us, makes us stronger.

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Filthy Country
[info]tommore wrote:
Friday, 17 July 2009 at 04:25 pm (UTC)
I tell you why the UK is "a swine flu hotspot": it is a filthy country inhabited by filthy people. Go to a pub and see if there is any soap in the toilets.
Re: Filthy Country
[info]adam_london wrote:
Friday, 17 July 2009 at 04:38 pm (UTC)
Wow. I suggest you get on the phone to Sir Liam and make your findings public.
Re: Filthy Country - [info]tommore - Friday, 17 July 2009 at 05:00 pm (UTC) Expand
Re: Filthy Country - [info]fulkehunke - Friday, 17 July 2009 at 05:42 pm (UTC) Expand
Re: Filthy Country - [info]tommore - Friday, 17 July 2009 at 05:56 pm (UTC) Expand
Re: Filthy Country - [info]fulkehunke - Friday, 17 July 2009 at 06:07 pm (UTC) Expand
Re: Filthy Country - [info]tommore - Friday, 17 July 2009 at 07:49 pm (UTC) Expand
Re: Filthy Country - [info]fulkehunke - Friday, 17 July 2009 at 08:43 pm (UTC) Expand
Filthy Country - irrelevant - [info]cronyblatcher - Friday, 17 July 2009 at 07:39 pm (UTC) Expand
Re: Filthy Country - irrelevant - [info]tommore - Friday, 17 July 2009 at 07:54 pm (UTC) Expand
Re: Filthy Country - irrelevant - [info]cronyblatcher - Friday, 17 July 2009 at 08:23 pm (UTC) Expand
Re: Filthy Country - [info]tatcawh - Saturday, 18 July 2009 at 04:11 pm (UTC) Expand
what flu?
[info]jimliverpool wrote:
Friday, 17 July 2009 at 05:33 pm (UTC)
Every person who has a sniffle now thinks they have swine flu. As the signs and symptoms are EXACTLY the same as 'ordinary flu' i.e. winter flu, or a 'summer cold', according to any so-called informed info site, be it NHS Inept or otherwise (and i say this as a nurse myself), then anyone who rings them or their GP and says they have a cold with a bit of a cough, is now not even tested but becomes automatically a 'suspected case of swine flu' stat, and so it goes on. I had a meal with a friend around in mid June just after it 'broke' and her chest had been bad with flu symptoms for 2 weeks , she blithely announced, as we ate in a small restaurant and sure enough within a few days i had the symptoms myself. People laughed when i said i thought it was the swine flu, but now it would be assumed that it was. Possibly wrongly.

At the end of the day, the only thing to fear is fear itself.

Re: what flu?
[info]fulkehunke wrote:
Friday, 17 July 2009 at 05:55 pm (UTC)
That's because the stocks of Tamiflu have been purchased and it makes more sense to give it as a precaution than waste time and money getting an exact diagnosis. If all of these suspect cases turned up at A and E you would be the first to complain.I suspect Tamiflu has a shelf life, better to use it than lose it. It's a strategy all be it untested, It's also a learning curve for the next, maybe more deadly infection.
Re: what flu? - [info]jimliverpool - Friday, 17 July 2009 at 06:02 pm (UTC) Expand
Re: what flu? - [info]fulkehunke - Friday, 17 July 2009 at 07:00 pm (UTC) Expand
Re: what flu? - [info]jimliverpool - Friday, 17 July 2009 at 07:23 pm (UTC) Expand
Re: what flu? - [info]dnmurphy - Friday, 17 July 2009 at 06:05 pm (UTC) Expand
Re: what flu? - [info]tommytcg - Saturday, 18 July 2009 at 01:18 am (UTC) Expand
Disease prevention UK style
[info]joeny wrote:
Friday, 17 July 2009 at 05:42 pm (UTC)
From personal experience, nurses don't even wash their hands or wear gloves when they take blood. If you dare mention it, you get a hard time. And yet the NHS code is emphatically that hands must be washed and gloves worn, every time.

And NHS wards are filthy, based on my father's stay 2 years ago, and from several reports from friends and relatives.

I can't say whether this is causing higher levels of swine flu, but it can't help !
Re: Disease prevention UK style
[info]dnmurphy wrote:
Friday, 17 July 2009 at 06:08 pm (UTC)
At my local hospital (Cromer) where I have blood tests they do wash hands and wear gloves.

Standards of Hygiene in some NHS hospitals are appalling though. My partner had a hysterectomy a few years ago and had a private room with shower. she had to clean the shower when she went in as it was filthy, had the previous user's hairs in it.

She said the Nurses and doctors were great, but the nurses said cleaning rooms was contracted out and there was a lack of overall accountability.
Why is the UK a swine flu hotspot?
[info]inchman wrote:
Friday, 17 July 2009 at 05:48 pm (UTC)
Perhaps we are piggy-in-the-middle?
Britain swine flu capital of Europe
[info]rickraider wrote:
Friday, 17 July 2009 at 05:49 pm (UTC)
I posted the other day that Britain had more cases than the rest of Europe put together. Clearly the precautions taken in large countries like Germany, France and Spain are working as usual our useless government sits on its hands and does no checking of immigrants and people coming from hotspots. We are now the Swine Flu centre of the world and many people will die because of the lack of attention from Brown and co
Wired up society
[info]living_fossil wrote:
Friday, 17 July 2009 at 05:56 pm (UTC)
In somecountries that still have small communities these things will burn out but the UK is wired up as a society so when the lightning hits it strikes everywhere at once. Eventually the killer virus will emerge that will destroy the social aberation that is the UK today.
Its called retribution
[info]mike_spain wrote:
Friday, 17 July 2009 at 06:43 pm (UTC)
12 years of an amoral and corrupt government with liars such as Blair & Brown may well have brought the wrath of GOD down upon the UK. This question about the UK being a hot spot has puzzled many of us especially ex-pats living abroad who cant understand why the UK seems to have been singled out amongst all western nations for this swine flu epidemic. Spain where I would expect some cross contamination from Mexico is largely immune to this plague and even the US states bordering Mexico seem untouched. Maybe its the massive influx of immigrants from asia without any health checks that has made the UK vulnerable as its a proven fact that Tuberculosis has escalated in the UK from zero because of Labours unfettered immigration. Is this just Labour propoganda or is it reality, its hard to tell with a bunch of lying s**** in charge of the country who wouldn't know the truth if it hit them in the face !!!
Re: Its called retribution
[info]fulkehunke wrote:
Friday, 17 July 2009 at 07:19 pm (UTC)
So you live abroad, but you're not an immigrant.You can go wherever you wish because of an accident of birth you are British. What a hypocrite you are. I presume you have to drink bottled water abroad. I presume you are cloistered among other ex-pats(immigrants) creating your own version of little Britain. I also presume you will hightail it back for free medical care. As for your loving God, if he singles out a mother and unborn child to kill in the name of retribution then you can keep him, he sounds as hypocritical as you. It's a very new,very unknown virus that is as unpredictable as the GREAT BRITISH weather, don't count your chickens just yet my friend.
Re: Its called retribution - [info]mike_spain - Friday, 17 July 2009 at 08:18 pm (UTC) Expand
Re: Its called retribution - [info]fulkehunke - Friday, 17 July 2009 at 09:16 pm (UTC) Expand
Re: Its called retribution - [info]colinru - Saturday, 18 July 2009 at 12:16 pm (UTC) Expand
Re: Its called retribution - [info]mike_spain - Saturday, 18 July 2009 at 07:24 pm (UTC) Expand
Re: Its called retribution - [info]fulkehunke - Sunday, 19 July 2009 at 10:22 am (UTC) Expand
Re: Its called retribution - [info]mike_spain - Sunday, 19 July 2009 at 12:18 pm (UTC) Expand
Re: Its called retribution - [info]fulkehunke - Sunday, 19 July 2009 at 05:05 pm (UTC) Expand
Re: Its called retribution - [info]fulkehunke - Sunday, 19 July 2009 at 11:14 am (UTC) Expand
Re: Its called retribution - [info]mike_spain - Sunday, 19 July 2009 at 04:41 pm (UTC) Expand
Re: Its called retribution - [info]cronyblatcher - Friday, 17 July 2009 at 07:19 pm (UTC) Expand
A good day to bury bad news
[info]mike_spain wrote:
Friday, 17 July 2009 at 06:48 pm (UTC)
Is this another of Labours deflection attempts at burying bad news by panicking the population over an unquantified threat !!! I suggest the reporters out there dig carefully to see what Brown and his bunch of criminals have slipped out on the quiet !
As usual the blindingly obvious answer is not apparent to what pass for 'experts' in
[info]cronyblatcher wrote:
Friday, 17 July 2009 at 07:17 pm (UTC)
bananarepublicanised Blatcherist Britain http://www.newstatesman.com/200407260019
Re: As usual the blindingly obvious answer is not apparent to what pass for 'experts' in
[info]fulkehunke wrote:
Friday, 17 July 2009 at 09:29 pm (UTC)
are you Andy Coulson?
Sluts and drunks
[info]tim_bee wrote:
Friday, 17 July 2009 at 08:26 pm (UTC)
Need I say more?
mike_spain...further investigation?
[info]kodak321 wrote:
Friday, 17 July 2009 at 08:35 pm (UTC)
mike_spain has a good point. What percentage of deaths has occurred in ethnic minority groups? London and Birmingham are hotspots (both with high ethnic concentrations), large numbers of illegals, and no doubt, over crowded housing conditions. Are we being told the truth?....I doubt it....
Re: mike_spain...further investigation?
[info]fulkehunke wrote:
Friday, 17 July 2009 at 09:37 pm (UTC)
Manchester,Coventry,Bradford,Preston you name it, all have high ethnic populations> This is a virus, it has NO prejudice it infects all human kind, blaming ethnic groups is not going to give you immunity. I assure you Nick Griffin is as susceptible as you.
Re: mike_spain...further investigation? - [info]mike_spain - Saturday, 18 July 2009 at 07:59 pm (UTC) Expand
Re: mike_spain...further investigation? - [info]mike_spain - Sunday, 19 July 2009 at 04:45 pm (UTC) Expand
Re: Sluts and drunks
[info]kodak321 wrote:
Friday, 17 July 2009 at 08:43 pm (UTC)
No Timmy...now off to bed...take teddy with you...now go...
[info]edwren wrote:
Friday, 17 July 2009 at 09:32 pm (UTC)
We have universal access to healthcare and diagnosis here which most of the other countries listed do not so the figures may not be very reliable
[info]fulkehunke wrote:
Friday, 17 July 2009 at 09:40 pm (UTC)
Thank you, a voice of reason. And very concisely put.
Re: flukehunk
[info]kodak321 wrote:
Friday, 17 July 2009 at 09:52 pm (UTC)
flukehunk, stop being so juvenile...the link is there with TB and AIDS...and this one needs to be investigated....and your typical lefty response is pathetic....
Re: flukehunk
[info]fulkehunke wrote:
Friday, 17 July 2009 at 10:22 pm (UTC)
Is the link there with, Yersinia pestis, or multiple sclerosis, or the common cold. I take Juvenile to be a compliment as to be so naive, and simplistic, renders you so narrow minded that you presume you are immune to a disease because of your ethnicity or cleanliness. It makes you more dangerous than the disease.
Fluke
[info]kodak321 wrote:
Friday, 17 July 2009 at 10:36 pm (UTC)
Fluke, the link is there with many infections...different ethnic groups have immunity/or otherwise to infections....please read up on the subject....now stop being a juvenile tosser...
Re: Fluke
[info]fulkehunke wrote:
Saturday, 18 July 2009 at 06:37 am (UTC)
I would take you seriously if you could spell my name properly. Thinking you can win an argument by being abusive and aggressive is the epitome of juvenile. I presume Kodak321 is a pseudonym for Liam Donaldson given you are the resident expert. The only people with immunity to swine flu are those who have had it. Now you shew away and play with your toy guns.
Blame Labour incompetence
[info]timonsays wrote:
Friday, 17 July 2009 at 11:00 pm (UTC)
I have been saying for ages that the problem is that Labour were too stupid, too incompetent and too complacent to impose a travel ban between Britain and Mexico.

As for travellers from other hotspots, such as the US, we should have done what Japan, for instance, did, and used remote temperature sensing. This involves checking the temperature of every passenger arriving using remote sensing equipment, and anyone who has an eleveted temperature could either have been sent back (if foreign) or given suitable medication and advice (if British).

Foreigners have no right to enter Britain. It is a privilege, and one which can be denied to anyone who is infected and likely to spread disease.
fallacious argument
[info]cronyblatcher wrote:
Saturday, 18 July 2009 at 04:58 am (UTC)
the cause is clearly explained here : http://www.newstatesman.com/200407260019 and it is a consequence of 32 years of government as an enemy of the State and of the peoiple
Typical
[info]thisanthat wrote:
Saturday, 18 July 2009 at 05:23 am (UTC)
A myriad of reasons and excuses (Nu Labour spin) and nothing concrete on how to resolve the matter.
The Mexicans virtually shut down thir country and had a good deal of success. This simple yet effective response has proved invaluable to the Mexican nation. A pity our so called experts didnt have the same fore thought!
deport these morons
[info]orwells_army wrote:
Saturday, 18 July 2009 at 07:06 am (UTC)
We have a pandemic. I know, let's blame immigrants! Black and Asian of course.

I see the BNP are out in force again.

If anyone has carried this disease into Britain it is likely to be white American visitors or wealthy white Britains on yet another holiday. And we don't impose on them do we?

We really would be a better country if we deport the BNP and their supporters.
The moron is YOU
[info]timonsays wrote:
Saturday, 18 July 2009 at 07:50 am (UTC)
So how do you explain the Tower Hamlets hotspot?

This is hardly an area famous for its wealthy white population!! There is obviously an issue here worth investigating.

I do agree that wealthy whites who travelled to Mexico on holiday were partly responsible, and there were early outbreaks of swine flu in wealthy private schools. On the other hand, we need to be open minded about ALL the aggravating factors. I did not myself suggest that immigrants are a problem, but I am open-minded when others suggest this.

You are obviously one of those extreme left-wing cretins who believes that immigrants must never be criticised, that immigrants are all wonderful, that immigration is an unalloyed benefit and that there should be no ceiling on the number of immigrants in Britain.

If anyone should be deported - along with all those here illegally - it is people like you. You don't really love this country or its history or its native people. Why don't you have the honesty and integrity to go and live in Africa or Asia where you would obviously feel so much more at home.

The rest of us can then look at this problem with an open mind. Maybe immigration is an aggravating factor, or maybe its not. The hotspots in immigrant areas are certainly a valid issue which need explaining. So let's talk about this rationally and honestly.
Re: The moron is YOU - [info]fulkehunke - Saturday, 18 July 2009 at 09:34 am (UTC) Expand
Re: The moron is YOU - [info]orwells_army - Saturday, 18 July 2009 at 02:43 pm (UTC) Expand
Re: deport these morons - [info]0pi0 - Saturday, 18 July 2009 at 08:04 am (UTC) Expand
Re: deport these morons - [info]mike_spain - Saturday, 18 July 2009 at 07:31 pm (UTC) Expand
prevention
[info]patrea wrote:
Saturday, 18 July 2009 at 07:43 am (UTC)
The spread of the virus is preventable. Government has ignored the evidence for 2 years
http://www.medicalnewstoday.com/articles/154192.php tri-air
Testing policy back in May
[info]0pi0 wrote:
Saturday, 18 July 2009 at 08:27 am (UTC)
Back in May, even if displaying possible symptoms, people who didn't fit the demographic of `just returned from Mexico/USA' / `attendee or member of staff at school with a confirmed AH1N1 outbreak' (or relative of these) were not routinely tested. My daughter and some school mates came down with sore throaty flu and were told that as they didn't go to the independent school a mile away where there was a confirmed outbreak of AH1N1 they wouldn't be tested. It didn't seem to matter that outside school they have contact with, and in any case live in close proximity to, teenagers from a variety of schools, including the one where there were confirmed cases. Seemed at the time a somewhat short-sighted, `tick-box' kind of policy, given that the virus would appear to be rather virulent, if only certain words - USA, Mexico, attendance at (whichever private school) triggered a response from the health service.
Recognise the role of airborne transmission
[info]sirhillary wrote:
Saturday, 18 July 2009 at 09:25 am (UTC)
Part of the reason is the authorities lack of understanding about how influenza is spread. There's plenty of evidence of airborne transmission and the little recognised role that re-circulating 90% of the air in modern sealed buildings acts in spreading viruses and bacteria with no filtration in place
Statistics are inaccurate
[info]fuchsiaperfect wrote:
Saturday, 18 July 2009 at 10:10 am (UTC)
Now that people aren't being swabbed for swine flu, the statistics must be based on guestimates. I suspect it's being over-reported in the UK and under-reported in other countries. After what happened to Mexico's tourist industry when swine flu was reported there, I wouldn't be surprised if some countries are under-reporting suspected swine flu cases. After all, deaths are thankfully rare in healthy people.

Although I resent being called "filthy" (see first comment) I agree that the state of public loos leaves an awful lot to be desired. I've known for some years now that frequent hand washing reduces the number of viruses I catch so I've resorted to carrying one of those waterless hand sanitisers around with me (but hope I'm not going to end up as an OCD sufferer).

I'll be one of the last in the queue for vaccination because I'm middle-aged and healthy, and I'd rather put my trust in good nutrition and frequent hand washing.
Re: Statistics are inaccurate
[info]tommore wrote:
Sunday, 19 July 2009 at 10:34 am (UTC)
I am sorry for having offended you, fuchsiaperfect, I am only reporting a fact: I have just returned to London from a trip to Milan and the contrast between the two cities' hygiene standards is dramatic: in Milan's public toilets, I never needed to touch anything - toilets and sinks are operated by pedals on the floor; in London, I cannot even wash my hands: the toilets are filthy and the soap dispensers always empty. How can the UK not be a swine flu hotspot? it is an intercontinental metropolis with the hygiene standards of a third world country (immigrants are not to blame: most bars and pubs owners are greedy British too stingy to buy soap). Our duty is to point these things out.
I too carry an anti-bacterial gel, I greatly recommended it and it has nothing to do with OCD. This is what I mean: what on the continent is standard hygiene (bidet, soap, etc.) in the UK is considered OCD.
Dinner is served.
Re: Statistics are inaccurate - [info]fulkehunke - Sunday, 19 July 2009 at 08:55 pm (UTC) Expand
Swine Flu
[info]jack_smith77 wrote:
Saturday, 18 July 2009 at 11:56 am (UTC)
What doesn't kill us makes us stronger??!! Incorrect. What doesn' kill us may indeed leave us weakened; permamently weakened.
Immigrants...illegal?
[info]kodak321 wrote:
Saturday, 18 July 2009 at 01:18 pm (UTC)
There's not the slightest chance there will be an investigation into why immigrant areas have a a much higher incidence of infection. We have over 1 million (some estimates, 2 million), illegals living with family/friends in overcrowded conditions.

The Government (Alan Johnsons last pronouncement "Immigration doesn't keep me awake at night"), may have encouraged conditions that led to the current crisis. This strain isn't particularly dangerous, but if it mutates (as many in the scientific community expect), then the UK is in a particularly perilous position.

timonsays is entirely correct to question why the hotspots are predominately in immigrant areas. Absurd posturing as practicised by fluke (the immigrant love-in junkie), are pathetic.
Re: Immigrants...illegal?
[info]quietzapple wrote:
Saturday, 18 July 2009 at 04:22 pm (UTC)
Tosh.

New immigrants tend to live in areas of high population density because they are poorer on average than the indigenous population.

Higher density of population/housing correlates with poorer health.

If there was a UK Mexican expatriate housing block you would be likely to find a much higher incidence of swine flu there.

I wonder what the Mexican for "there's nowt sa queer as racists" is?
Re: Immigrants...illegal? - [info]fulkehunke - Sunday, 19 July 2009 at 07:45 am (UTC) Expand
box ticking culture passed down to schools
[info]suffbeach wrote:
Saturday, 18 July 2009 at 05:43 pm (UTC)
Where I reside in Suffolk, unfortunately there is an active bypass pattern around a substandard GP practice due to bullying, lack of diagnosis and referaals - what are those?????????!!!!!! and a full blind eye turned to complaint handling, despite a warning letter from the HCC in 2007 drawing attention to this. The council have cut all our public transport so that nobody can reach the hospital 17 miles away unless they have a car. Many people have cut down from two cars to one, due to economic climate.

So a number of points here. Infections such as flu, scarlet fever and other nasties which should be dealt with in our community - end up being taken into out of hours, or the walk in or reluctantly into overused casualty.

Also due to nobody being allowed to sign on anywhere else - the PCT allow a situation to run where nobody can approach another GP surgery - this leaves patients with no diagnosis forced to take infections into work - as no sick note, and jobs very vulnerable out here and scarce. Also the local primary school is run by a highly unprofessional individual who has hounded some families over genuine absence, preferring to have a section 2 disease sitting in school putting other children at risk, in order for the correct box to be ticked. So nasty infections sit in school, as there is no medical diagnosis for some. The culture is dreadful, writing to the PCT or the Education Department triggers carefully worded sanitized responses putting the blame at the door of the parent - in other words whole families being caught between two institutions both behaving badly whilst drawing their public wages.

The last letter my family had, in response to our very legitimate worries, ie our child not being believed to have had pneumonia, despite the correct paperwork provided, we felt for a small child to be interviewed by a punative head on his first day back after a long illness as if he had been naughty was wrong.

The result a letter stating that all illness must be taken to the GP whatever it is or it will be recorded as unauthorised absence - I am led to believe from successful NHS public announcements that vomiting bugs and swine flu are not supposed to be taken into a GP surgery.

I fully blame my PCT and the council for aiding and abetting the uncessary spread of nasty germs. The government really needs to scrutinize our area, however most of us would prefer a hard hitting article in the newspaper or a document made
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