One Response to “Use of prophylactic Tamiflu in nursing homes”

  1. William Boyd January 28, 2015 at 10:29 pm #

    Dear Dr. McCartney,
    Briefly I found a link to your blog via Inside Health, a prog which I like because of the rational discussion free from guff.

    Re Tamiflu being prescribed for everyone in nursing homes, I too have the greatest misgivings about this. I used to have, during the previous decade, two elderly relatives in a nursing home. (The joke I had with the staff was that as my relatives were ‘self funders’, I was looking for quantity discount on the fees).

    I saw this blanket treatment of the elderly as a pointless waste of money and as I am a 67 y.o. asthmatic I too have been gently prodded in the direction of flu injections. Based on hard experience, (I was an engineer so I like to seek sound evidence), I found that those winters when I did have a flu injection resulted in pretty terrible winters for me. Where I was left to my own devices, i.e. the inhalers plus strategems like keeping a slightly further physical distance from other people (sounds a bit anti-social!), I discovered that I could get through winters with much less trouble.

    It is now 10 years since a practice nurse suggested that I try a winter without flu injections. That proved a consistently better way for me, however I would ask some penetrating questions of the drugs industry.

    1 How many strains of flu are there?
    2 And how many strains in the ‘cocktail’ does your anti-viral combat? (Ah, that’s asking the tough one!).
    3 Where is the real statistical evidence that the winter death rate has dropped due to this blanket flu injection policy, esp. measured against its total cost. (Another killer question).

    I should at this point declare some more background. My late father was a GP, but as he retired in 1972 and died in 1998 that is of less relevance than the fact that I was married for 23 years to an Edinburgh University immunologist who was head hunted by the University of Adelaide back in 1996. Her PhD (1973) was into anti-viral compounds to the common cold so this would be one of the first occasions where there was proper research into anti-virals. This has therefore placed me in a much more privileged position than the average patient. My late father was always highly critical of the deceptive ways of the drugs industry so from an early age I was well warned. He would have approved of your stance today as I do too.

    What is also very worrying is that the Dept of Health is stuffed with senior civil servants who have, or had close links to the drugs industry so these people are, in my view, wholly compromised when it comes to making a stand. It is not helped by the general media which is seeking to report upon the latest ‘wonder drug’, thus breeding a society which believes in ‘a pill for every ill’. It seems to me that only the doctors are in the position of being able to push back against big pharma. You are getting no support from Government Depts, hospital managements et al. Clearly the letter from Thames Valley area NHS proves that they are implicitly on the side of the drugs companies.

    The public too has some culpability here because they won’t make enough effort themselves to benefit their health by taking some simple non-drugs mediated precautions. Don’t over-eat, don’t drink very much booze, don’t drive too fast, don’t smoke, just don’t do stupid things. This would save the NHS a fortune, but people do not appreciate that they have to use its services carefully. Free prescriptions – great idea. Now comes the bombshell, my father’s killer question. If bread was free what would the dustbins be like? Ouch!

    I think that a small charge might just sort some of the nonsense out. A small charge for prescriptions, a small charge for an appointment, a small charge for a visit to A&E, etc etc. When I say a small charge I do mean a small charge, but it could help save the NHS. And if the public had to pay for their Tamiflu injections they might start to ask, is this really worthwhile? Here’s one who thinks it is something of a con trick.