Hundreds of thousands more schoolchildren should be treated for attention deficit hyperactivity disorder (ADHD), say leading experts.
A major study led by University of Oxford academics suggests ADHD is seriously underdiagnosed and says more children should be given medication such as Ritalin, which it found is highly effective.
Concerns have been raised about the number of youngsters overmedicated for the disorder – but the evidence suggests just 10 per cent of those with ADHD are on any form of medication.
“We have strong evidence that in the UK, and many countries outside the US, ADHD is underrecognised and underdiagnosed,” said Professor David Coghill, a child and adolescent psychiatry expert from the University of Melbourne and a co-author of the study.
Disabled activists have attacked the Royal Society of Medicine (RSM) for hosting a conference on “choice at the end of life” that was little more than a “love fest for euthanasia”.
RSM said before the event that the conference would “question whether or not assisted dying is complementary or contradictory to the notion of person-centred care”.
But speakers in favour of legalising assisted suicide far outnumbered those who opposed a change in the law.
One of those behind the conference, Professor Roger Kirby, who chairs RSM’s academic board, told the audience that the idea for organising it came to him after reading an article written by the husband of a terminally-ill woman who travelled to the Dignitas clinic in Switzerland to take her own life.
The other senior medical figure who helped organise the event, he said, was Professor Gillian Leng, deputy chief executive of the National Institute for Health and Care Excellence (NICE), whose terminally-ill husband, Professor Paul Cosford, told the conference that he was in favour of a change in the law.
Professor Cosford, who has incurable cancer, and is patient and medical director for Public Health England, suggested that having choice at the end of life should include the option of an assisted suicide.
He told the conference: “I cannot predict how I will die but I can focus on living well now if I know that I would have some kind of control at the time if I need it.”
He added: “To enable choice at the end of life, taking account of individual care needs, may well need a change in approach.
“I do think that might include [the option of] assisted dying.”
He was followed by two further speakers who were in favour of legalisation: Tony Wicks, whose wife ended her life at Dignitas; and Julie Smith, whose husband had been prevented from travelling to Switzerland to end his life at the clinic.
The first three speakers were all supportive of legalising assisted suicide, while the fourth, an assistant coroner, expressed no opinion.
The next speaker was Dr Catherine Sonquist Forest, a strong advocate of legalisation, who takes part in the practice of assisted suicide in California – where it is called “medical aid-in-dying” – where it was legalised in June 2016.
The conference did not hear from an opponent of legalisation until the sixth speaker, Juliet Marlow, from Not Dead Yet UK (NDY UK), who had only been added to the list of speakers after NDY UK raised concerns at not being invited to speak at the event.
GPs in England are being encouraged to keep a register of patients with autism in order to improve the care they receive. Health chiefs say a register would alert GPs to the specific needs of adults and children with autism and help tailor services for them. The National Autistic Society said it would “help improve the health and wellbeing of autistic people”. But getting a quick diagnosis was still an issue, a child autism charity said. Autism is a lifelong, developmental disability that affects how a person communicates with and relates to other people, and how they experience the world around them. GPs in England already keep a register of patients with learning disabilities, and the National Institute for Health and Care Excellence thinks patients with autism should be easily identified by healthcare professionals too. NICE says a register – which would be anonymous outside a patient’s surgery – would help staff to adapt their approach to suit patients’ needs. For example, doctors
Is there an hidden agenda, for do not all requests for information have a cost cutting implication especially when these are directed from politically motivated bodies who are solely looking to reduce costs and not your well-being.
‘…………By Catherine Foot director of evidence at the Centre for Ageing Better
Solutions that transcend traditional boundaries could be key to providing the most effective services for the money available
If we are to achieve excellent care for everyone in later life, then creating, understanding and applying evidence needs to become routine. Photograph: Jens Kalaene/dpa/Corbis
What do you think is most needed to improve the quality of later life in this country?
You might say money – to reverse the chronic under-resourcing of publicly funded social care, for instance, or to invest much more widely in the housing adaptations that we know can help older people to remain independent.
You might say leadership – a form that brings together planning, housing, care and health, and the private, statutory and voluntary sectors, to work meaningfully together, sharing goals and delivering services that meet people’s needs and priorities in later life.
You might say we need to focus on attitudes and empowerment – to build a society that fully values and includes older people, families and carers and creates services for them that are designed with them.
Or you might say that we need to help more people in mid-life get skills and information to think about and prepare for their financial, social, housing and care needs in the future.
At the Centre for Ageing Better we believe we urgently need better information and evidence about what actually works to improve our later lives.
As with many areas in social policy, high-quality evaluations remain too few. We know much more about the nature of the problems than we do about the essential, transferable and sustainable ingredients of the solutions. We also particularly lack extensive evidence for interventions that cross traditional sector boundaries – that combine elements of social care and mental health interventions, say, or housing.
We need this evidence for a number of reasons. Fuelled by the pressure of continued public services spending cuts, we need more than ever to understand how we can deliver the most effective services for the money available. Services must have increasingly robust proof of their impact or else risk losing their funding. We also need evidence because it is through the cycle of innovating, learning and improving that we can achieve excellent services. And we need evidence because services should be transparent and accountable, clearly able to say what they do, why it works and what impact it has.
Good evidence comes in all shapes and sizes. Randomised controlled trials are unlikely to be realistic or feasible in much of social care practice, but proportionate, insightful and above all useful evidence can be generated at much lower cost. The insights that good evidence can bring should not be a line-by-line manual for exactly how every provider must work for every person, without a role for professional judgment and personalisation. Nor should the insights be so inextricable from the context in which they have been generated as to be dismissed as unworkable anywhere else. Good evidence shows what outcomes can be achieved, for which people, how, and at what cost.
Social care is of course far from an evidence-free zone. There is an active and growing research community; the National Institute for Health and Care Excellence is developing evidence-based social care guidelines, and organisations like the Social Care Institute for Excellence do important work to promote an evidence-based approach and encourage providers to foster work cultures that value reflection, learning and innovation.
But if we are to achieve excellent care for everyone in later life, then creating, understanding and applying evidence needs to become routine. ……..’
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