Your comments: 7 February 2018

I am disturbed to read that a CSP director has backed a call from senior health figures for a debate on mandatory flu vaccine for all NHS staff (see page 10 of this issue). I believe a mandatory system would go against freedom of choice in the NHS and making an informed consent.

 

Is a 10 per cent effectiveness rate enough to justify it? Will each staff member receive the actual flu vac insert with the list of horrific side-effects, including Guillain-Barré syndrome, before forcing them to take the vaccine or nasal spray? And how can you prove that staff are responsible of speeding the flu? Apparently, they carry flu virus without knowing it! How did they prove that? Why not take swabs to check? 

 

The main reason why people get flu in the first place is lack of sleep and good nutrition. NHS staff are chronically overworked, wards are understaffed and hygiene in some hospitals is still below standard.

 

Further, hospital food is far from nutritious. I understand there is a debate on this topic on CSP Facebook page. I really hope that people’s freedom of choice will be taken into consideration.

 

I read with interest the recent article on bowel disorders.  I congratulate the team for the positive outcomes experienced by patients who feared they would never get their bowels (and lives) back on track. Both my research on using abdominal massage to treat chronic constipation and my work with people with long-term disability convinced me of the necessity for a holistic bowel assessment. 

 

Sadly, the usual response to chronic constipation is laxative polypharmacy, with varying degrees of success. In fact, it is helpful to review not just bowel history, but also diet, fluid intake, toileting position, lifestyle factors, medications and activity levels. Alternative treatment options may include abdominal massage, biofeedback and rectal irrigation. 

 

A clinical guideline, developed at Bradford University and titled Management of Chronic Constipation of Adults within the Community, is available.

 

Alexandra Hejazi’s column called for an end to sending assistive substandard devices overseas. Those of us who work overseas are aware that the skills in using and maintaining equipment are nothing like UK standard. I too have witnessed equipment with missing parts or that is poorly maintained. But to imply that all, or most, shipments overseas are ‘substandard’ after one visit to one country is unfair. I am involved with a charity called PhysioNet.   

 

Its volunteer therapists ensure that items leaving the UK are safe and serviceable. Consignments are often followed up with visits from UK therapists who train local staff in assessing, fitting, adjusting and maintaining equipment. 

 

Rather than criticise this service to developing countries, physiotherapists are ideally placed to improve it.