Kensington Palace officials were forced to announce the pregnancy early because Kate is suffering from severe hyperemesis gravidarum . The country rejoiced when it was announced that the Duchess of Cambridge is pregnant again. But the spare is proving as troublesome for the Duchess as the heir – Kensington Palace officials were forced to announce the pregnancy early because Kate, right, is suffering from severe hyperemesis gravidarum. I was quite troubled to see this referred to by some commentators as morning sickness. It’s not. Morning sickness is a very common symptom of pregnancy, affecting about half of all expectant mothers, and it ranges from mild nausea to daily vomiting. It isn’t pleasant but it certainly isn’t serious. Hyperemesis gravidarum, on the other hand, is brutal. Affecting only two per cent of pregnant women, the sickness is so severe that sufferers end up dehydrated and weak. This often results in hospital admission – as it did when Kate was carrying her first child – for intravenous fluids and heavy-duty anti-sickness drugs. Thankfully, in most cases the health of the baby is unaffected. The Royal couple are also said to be hiring a maternity nurse, who will live with mother and baby round-the-clock. William and Kate did not do the same for Prince George – but I say if you can afford it, go for it. Managing with sleepless nights is one of the hardest things to get used to as a parent, and it is not necessarily easier the second time around. Sleep deprivation is a bit like being run over by a five-ton truck every day. It is a big strain on both parents, and I admire the couple for coming up with a sensible strategy and admitting that they need help. Their lives are under constant scrutiny, and I hope they will not be judged unfairly for this move. WHY I'M FORCED TO REVEAL YOUR SECRETS . My mother, who is in her 90s, recently had food poisoning. Shortly after she recovered, our local council wrote to her and then called asking all sorts of questions about what she’d eaten and where. My concern is that her medical information was passed on to the council without her consent. I thought what happened between patient and doctor was confidential? I can reassure you that the experience your mother has had is entirely correct and permissible. Patient confidentiality is a right of every patient, as you say, and doctors have a strict responsibility to uphold this. However, there are situations where confidentiality can be breached, such as in cases where protecting the health of the community overrides the individual right of a patient. Scroll down for video . Hyperemesis gravidarum often results in hospital admission as it did when Kate was carrying her first child . A doctor is required by law to report cases of any disease capable of starting an epidemic – such as serious food poisoning – immediately to the local public health team. This gives the authorities a much greater chance of preventing the spread. Some diseases are unlikely to cause an epidemic but reveal a breakdown in hygiene that needs investigation. Notifiable diseases are usually those that spread rapidly and are difficult to treat, or those that can be used to monitor the effectiveness of vaccine programmes. The list includes 30 infections, among them measles, scarlet fever, TB – and even plague. The full list can be found on the gov.uk website. As a GP, it is my statutory duty to report these diseases even when they are only suspected, rather than confirmed. The principle is to ensure that an outbreak is contained. Speed is of the essence and, in order to facilitate this, a GP is obliged to provide full personal details to officials in the patient’s local authority area. Those officials are then able to contact the patient directly so that appropriate action can be taken to control or prevent further infection. I have chronic bronchitis and although I’m not able to walk far, I do try in order to keep fit. My oxygen levels are normal but I still suffer from a lot of pain in my chest. I already use three different inhalers and my doctor says there’s nothing more he can do. Is there anything that you could suggest? Three million people in the UK are estimated to suffer from chronic obstructive pulmonary disease, or COPD, encompassing lung conditions including emphysema and chronic bronchitis. They all cause narrowing of the airways in the lung and a debilitating, progressive condition that interferes with normal breathing and exercise tolerance as you describe. Smoking is the main cause and if you are a smoker, quitting is the most important thing. Stopping smoking can prevent the disease from worsening. Your GP can offer you all forms of nicotine-replacement or tablets on prescription. Inhalers are not easy to use and many COPD sufferers have poor technique, which leads to them being less effective. A practice nurse will, if asked, check your technique and offer help. The next step of treatment once inhalers are at a maximum level could be tablet therapy. It is also crucial to discuss with your GP something called pulmonary rehabilitation, a type of physical and educational treatment specifically for COPD sufferers who feel disabled by their condition. Anyone in this situation who suffers chest pains should make sure their GP knows. The pain can be a symptom of COPD but also a sign of heart disease, and cardiology investigations may be needed alongside the respiratory treatments. HAS CANCER MOTHER LAURA PAID £80,000 FOR FALSE HOPE? Are NHS doctors keeping life-saving treatments from young mothers dying of cancer? The story of Laura Fischer-Beards, apparently saved last week by US surgeons after being refused NHS treatment for an ‘inoperable’ brain tumour, suggests they are. Mother-of-three Laura was given 12 months to live, but now has had an £80,000 ‘pioneering procedure’, reported to have extended her life by as much as 15 years. Of course I’m pleased for her. But the story is full of half-truths. Laura Fischer-Beards  was given 12 months to live, but now has had an £80,000 ‘pioneering procedure' She suffers from grade two glioma – a slow-growing, difficult and unpredictable cancer. Typically, patients live for between five and 15 years from diagnosis. Laura had already had radiotherapy, chemotherapy and surgery. And the procedure she paid for, awake mapping craniotomy, is offered on the NHS. But she’d suffered a stroke during the first surgery. Surgery would carry a huge risk of permanent disability and offer no guarantee she would live longer, as it’s almost impossible to remove all the cancerous cells, which don’t show up on scans. American doctors agreed to operate and say they removed ‘100 per cent of the enhanced tumour’. This sounds as if they’ve cured her, doesn’t it? Not so. This is medical terminology for: ‘We’ve got all we can see on the scans.’ Perhaps the operation has bought her more time. But she may well have lived as long or longer had they done nothing. It’s difficult to accept that watching and waiting can be as good as – or better than – ‘battling’ cancer. I recently read Do No Harm, by British neurosurgeon Henry Marsh. His more experienced self recognises that not operating often results in the same clinical outcome and life expectancy. Laura’s UK doctors would have operated if they thought it would benefit her. And beware false hope. The cruel part is not that she has spent £80,000 – it is what she seems to think she has been given for her money. I was furious when told about the case of a depressed patient forced by their boss to take time off for psychotherapy as paid holiday. The Chief Medical Officer’s latest report focuses on mental health, particularly the huge toll mental illness takes on our workforce. It states that 17 million working days are lost each year due to stress, depression and other mental health problems, costing Britain up to £100 billion annually. But that figure completely misses the huge and far more significant personal costs such issues cause to individuals and their families. Sadly, I see the problem workers face trying to access therapy – long waiting times and availability only during office hours. And although the example I’ve detailed is extreme, not to mention illegal, more options should be open to all patients that will keep them living as normal a life as possible. The Chief Medical Officer suggests fast-tracking workers ahead of others into therapy to improve the situation. But that would just create a two-tiered system, going against the principles of the NHS. It would far better to legislate to ensure that employers build mental health support into the core of their working practices. That would help improve the situation before individuals have even reached their GP’s surgery.
Kate Middleton is suffering from severe hyperemesis gravidarum .
Vomiting can be so relentless that sufferers end up dehydrated and weak .
This often results in hospital admission for intravenous fluids .
She received treatment in hospital before the birth of baby George .
Kensington Palace officials were forced to announce the pregnancy early because Kate is suffering from severe hyperemesis gravidarum . The country rejoiced when it was announced that the Duchess of Cambridge is pregnant again. But the spare is proving as troublesome for the Duchess as the heir – Kensington Palace officials were forced to announce the pregnancy early because Kate, right, is suffering from severe hyperemesis gravidarum. I was quite troubled to see this referred to by some commentators as morning sickness. It’s not. Morning sickness is a very common symptom of pregnancy, affecting about half of all expectant mothers, and it ranges from mild nausea to daily vomiting. It isn’t pleasant but it certainly isn’t serious. Hyperemesis gravidarum, on the other hand, is brutal. Affecting only two per cent of pregnant women, the sickness is so severe that sufferers end up dehydrated and weak. This often results in hospital admission – as it did when Kate was carrying her first child – for intravenous fluids and heavy-duty anti-sickness drugs. Thankfully, in most cases the health of the baby is unaffected. The Royal couple are also said to be hiring a maternity nurse, who will live with mother and baby round-the-clock. William and Kate did not do the same for Prince George – but I say if you can afford it, go for it. Managing with sleepless nights is one of the hardest things to get used to as a parent, and it is not necessarily easier the second time around. Sleep deprivation is a bit like being run over by a five-ton truck every day. It is a big strain on both parents, and I admire the couple for coming up with a sensible strategy and admitting that they need help. Their lives are under constant scrutiny, and I hope they will not be judged unfairly for this move. WHY I'M FORCED TO REVEAL YOUR SECRETS . My mother, who is in her 90s, recently had food poisoning. Shortly after she recovered, our local council wrote to her and then called asking all sorts of questions about what she’d eaten and where. My concern is that her medical information was passed on to the council without her consent. I thought what happened between patient and doctor was confidential? I can reassure you that the experience your mother has had is entirely correct and permissible. Patient confidentiality is a right of every patient, as you say, and doctors have a strict responsibility to uphold this. However, there are situations where confidentiality can be breached, such as in cases where protecting the health of the community overrides the individual right of a patient. Scroll down for video . Hyperemesis gravidarum often results in hospital admission as it did when Kate was carrying her first child . A doctor is required by law to report cases of any disease capable of starting an epidemic – such as serious food poisoning – immediately to the local public health team. This gives the authorities a much greater chance of preventing the spread. Some diseases are unlikely to cause an epidemic but reveal a breakdown in hygiene that needs investigation. Notifiable diseases are usually those that spread rapidly and are difficult to treat, or those that can be used to monitor the effectiveness of vaccine programmes. The list includes 30 infections, among them measles, scarlet fever, TB – and even plague. The full list can be found on the gov.uk website. As a GP, it is my statutory duty to report these diseases even when they are only suspected, rather than confirmed. The principle is to ensure that an outbreak is contained. Speed is of the essence and, in order to facilitate this, a GP is obliged to provide full personal details to officials in the patient’s local authority area. Those officials are then able to contact the patient directly so that appropriate action can be taken to control or prevent further infection. I have chronic bronchitis and although I’m not able to walk far, I do try in order to keep fit. My oxygen levels are normal but I still suffer from a lot of pain in my chest. I already use three different inhalers and my doctor says there’s nothing more he can do. Is there anything that you could suggest? Three million people in the UK are estimated to suffer from chronic obstructive pulmonary disease, or COPD, encompassing lung conditions including emphysema and chronic bronchitis. They all cause narrowing of the airways in the lung and a debilitating, progressive condition that interferes with normal breathing and exercise tolerance as you describe. Smoking is the main cause and if you are a smoker, quitting is the most important thing. Stopping smoking can prevent the disease from worsening. Your GP can offer you all forms of nicotine-replacement or tablets on prescription. Inhalers are not easy to use and many COPD sufferers have poor technique, which leads to them being less effective. A practice nurse will, if asked, check your technique and offer help. The next step of treatment once inhalers are at a maximum level could be tablet therapy. It is also crucial to discuss with your GP something called pulmonary rehabilitation, a type of physical and educational treatment specifically for COPD sufferers who feel disabled by their condition. Anyone in this situation who suffers chest pains should make sure their GP knows. The pain can be a symptom of COPD but also a sign of heart disease, and cardiology investigations may be needed alongside the respiratory treatments. HAS CANCER MOTHER LAURA PAID £80,000 FOR FALSE HOPE? Are NHS doctors keeping life-saving treatments from young mothers dying of cancer? The story of Laura Fischer-Beards, apparently saved last week by US surgeons after being refused NHS treatment for an ‘inoperable’ brain tumour, suggests they are. Mother-of-three Laura was given 12 months to live, but now has had an £80,000 ‘pioneering procedure’, reported to have extended her life by as much as 15 years. Of course I’m pleased for her. But the story is full of half-truths. Laura Fischer-Beards  was given 12 months to live, but now has had an £80,000 ‘pioneering procedure' She suffers from grade two glioma – a slow-growing, difficult and unpredictable cancer. Typically, patients live for between five and 15 years from diagnosis. Laura had already had radiotherapy, chemotherapy and surgery. And the procedure she paid for, awake mapping craniotomy, is offered on the NHS. But she’d suffered a stroke during the first surgery. Surgery would carry a huge risk of permanent disability and offer no guarantee she would live longer, as it’s almost impossible to remove all the cancerous cells, which don’t show up on scans. American doctors agreed to operate and say they removed ‘100 per cent of the enhanced tumour’. This sounds as if they’ve cured her, doesn’t it? Not so. This is medical terminology for: ‘We’ve got all we can see on the scans.’ Perhaps the operation has bought her more time. But she may well have lived as long or longer had they done nothing. It’s difficult to accept that watching and waiting can be as good as – or better than – ‘battling’ cancer. I recently read Do No Harm, by British neurosurgeon Henry Marsh. His more experienced self recognises that not operating often results in the same clinical outcome and life expectancy. Laura’s UK doctors would have operated if they thought it would benefit her. And beware false hope. The cruel part is not that she has spent £80,000 – it is what she seems to think she has been given for her money. I was furious when told about the case of a depressed patient forced by their boss to take time off for psychotherapy as paid holiday. The Chief Medical Officer’s latest report focuses on mental health, particularly the huge toll mental illness takes on our workforce. It states that 17 million working days are lost each year due to stress, depression and other mental health problems, costing Britain up to £100 billion annually. But that figure completely misses the huge and far more significant personal costs such issues cause to individuals and their families. Sadly, I see the problem workers face trying to access therapy – long waiting times and availability only during office hours. And although the example I’ve detailed is extreme, not to mention illegal, more options should be open to all patients that will keep them living as normal a life as possible. The Chief Medical Officer suggests fast-tracking workers ahead of others into therapy to improve the situation. But that would just create a two-tiered system, going against the principles of the NHS. It would far better to legislate to ensure that employers build mental health support into the core of their working practices. That would help improve the situation before individuals have even reached their GP’s surgery.
suffering from severe hyperemesis gravidarum . the sickness is so severe that sufferers end up dehydrated and weak. This often results in carrying her first child – for intravenous fluids often results in hospital admission as it did