The Nation's MOT - Chief Medical Officer's Report 2010

The Chief Medical Officer for Wales, Dr Tony Jewell, released his annual report for 2010 yesterday. As usual the gloomy Welsh media have decided to accentuate the negative – focusing on a dire warning that life expectancies might be lower in the future and on the state of children's teeth - heavily linked to deprivation in the report.  This is justifiable to a certain extent.

The most startling and depressing finding in the report in my opinion were the alcohol statistics - especially those for binge drinking and youth alcohol abuse.

However in the full report, which you can find here, there's quite a fair bit of good news. Here's a summary:

The Good News

• Life expectancies are increasing – 77.2 for men, 81.6 for women. Higher than both Scotland and Northern Ireland, lower than England.
• Neonatal deaths are levelling off at a low rate of around 4 per 1000 births, with improvements in the mother's health this may fall to Scandinavian levels in Wales.
• Premature mortality rates for those under 65 in Wales are roughly the Western European average and are similar to France, the north of England, northern Germany and Greece while better than Scotland, Finland and Eastern Europe.
• Wales is the first UK nation to have introduced an NHS service that helps identify people who have inherited a form of high cholesterol and can take action to reduce the risk of developing heart disease (Wales Familial Hypercholesterolaemia Project).
• Fewer younger people are taking up drinking or smoking in Wales, a pattern that largely follows the rest of the developed world.
• Participating in a community is shown to have health benefits and the majority of respondents in Wales trust most or many of the people in their communities. Less than 5% trusted nobody in their neighbourhood.
• Air and water quality in Wales is vastly improved compared to the industrial era, but with the need for vigilance.
• There's a much greater emphasis on prevention, intervention and collaboration in the Welsh NHS since the 2009 reorganisation instead of competition. There's a greater emphasis on quality of care and patient outcomes.
• The Welsh Government is committed to ensuring military personnel who lose limbs (up to 6 or 7 in Wales per year) will have any Defence Medical Service prosthetics matched by the Welsh NHS when they leave service.
• The Welsh Low Vision Service has dramatically improved waiting times, with those needing to attend now waiting no more than two weeks, compared to 50% waiting 6 months before the scheme was introduced. It has also been recognised internationally.
• The number of children aged 6-12 who have lost at least one adult tooth has fallen as have the rates of decay, but still lag behind the rest of the UK.
• The "1000 Lives" campaign, which seeks to prevent 1,000 avoidable deaths in the NHS has been a largely resounding success, with 1,199 lives "saved". A new 5-year programme is to be rolled out. Excellent progress has been made in reducing infection from respiratory equipment in critical care.
• A number of key components for better health monitoring and "health intelligence" are in place, but there are recommendations that there's greater use of evidence in policy, greater coordination of intelligence and greater investment in analysis and health literacy in the NHS workforce.
• A national "Institute of Public Health" is being developed by Public Health Wales, led by higher education partners and with collaboration across Wales.
• Public health law in Wales is to be consolidated by a Public Health (Wales) Act in 2012.
• Suicide rates for both men and women have fallen, only Neath Port Talbot had a rate significantly higher than any other Welsh local authority between 2007-2009. Bridgend's suicide rate, well publicised over this period, was only slightly higher than the Welsh average and lower than 9 other local authorities.
• The cancer mortality rate for men in Wales is below the EU average.
• The circulatory disease mortality rate for Welsh men is substantially lower than the EU average.
• Coronary heart disease, cancer and stroke deaths are on a downward trend with the lowest ever recorded number of cancer deaths for those under 75 in 2009.

The Bad News

• The principal causes of death in Wales are congenital abnormalities for the very young (under 1 y.o), accidents for all age groups between 1 and 39, cancer for women aged between 25-74 and men aged 40-74, circulatory diseases for those aged above 74. The causes are broadly similar for both males and females.
• Healthy life expectancy for both men and women in Wales are similar at around 62 years of age. Men enjoy a longer healthy life expectancy than those in Scotland and Northern Ireland (0.5 years below the UK average), but women have a shorter healthy life expectancy than those in Scotland and England (2.2 years below the UK average).
• High blood pressure, depression and asthma are the three most prevalent non-communicable diseases in Wales. Up to 1million adults in Wales (a third of the adult population) could be being treated for heart-related conditions by 2033.
• Smoking rates amongst adults are comparatively high (23%). The number of adults classified as obese is 22%, while the number of adults taking the recommended daily exercise is just 30%.
• Of 39 nations questioned Wales has the highest rate of those who have been drunk by aged 13. Binge drinking is "normal" behavior and evident in city and town centres. Alcohol related admissions to hospital are on an upward trend. Deaths from chronic liver disease are also on an upward trend albeit with a fall in 2009.
• The numbers of children with decayed, missing or filled teeth has risen and is linked to deprivation. In an average class of 30, 4 children will experience dental pain in the last 12 months. More than 5,000 general anaesthetics were given to children undergoing dental treatment in south east Wales, compared to just 2,700 in Birmingham. There are acute problems in Merthyr Tydfil and Blaenau Gwent.
• The cancer mortality rate for women is above the EU average, and significantly higher in Merthyr Tydfil compared to the rest of Wales.
• Pembrokeshire has a particularly high accidental death rate compared to the rest of Wales, blamed on reckless driving on rural roads.
• Hip fracture rates have slightly increased as have child pedestrian injuries (though they remain below targeted figures). There's no change either way in mental health figures.