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International Primary Care Association

Clinical Focus Volume 7 N3

Volume 7 Issue 3 - 2013


Palpitations and fluttering are extremely common. A clinician faced with a patient presenting with such symptoms needs to be able to rapidly differentiate between normality, benign arrhythmias and pathological arrhythmias that may be associated with substantial risk, including that of stroke or sudden cardiac death.

The chill of winter will have reached all of us with the publication of this issue, made worse by the government’s belligerent stance on public sector pay freeze, including NHS workers, despite the talk of an economic recovery. The comfort of improving economic statistics and numbers are not the same as the experience of rising food, transport and fuel bills, little prospect in acquiring a decent job and a reduction in public services.

Poor planning in medical manpower, and a lack of focused investment has produced the spectre of massive strain on emergency services this winter. The UK simply does not produce enough of home-grown medical or nursing personnel which leads to a clinical brain drain from other countries such as the Philippines, India, Pakistan, Nigeria, Ghana….This problem is coupled with the disruption of frequent NHS re-organisations and a management heavy structure, despite the reforms, culminating in poor or absent decision making, which results in further deterioration of services.We have heard the low rumbling of political stances commence during the party political conference season and this will crescendo to the next election. I am not optimistic that the NHS will fare well but am having a bet on a further restructure within the lifetime of the next government.

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