At any rate, he certainly startled the reporter from the Carlisle News & Star who made a splendid splash with the story, giving just a paragraph to the counter-argument from Detective Superintendent Paul Carter of Cumbria Police. “Class A drugs destroy the fabric of people’s lives,” he responded.

“We have to do everything we can to get people away from drugs like heroin and cocaine.” Well, “Cop Backs Drug Laws” hardly sounds like news, does it? But actually it is Carter who seems increasingly out of step.

For decades many academics and professionals have regarded the current blanket prohibition on recreational drugs (though not alcohol or tobacco) as absurd, counter-productive and destructive. But there has never been any political imperative for change, and a thousand reasons to do nothing.

For nearly 40 years, since the habits established in the 1960s took root in society, there has been a stand-off. Across the free world, and most of the unfree, anyone ­seriously interested in smoking, snorting, swallowing or injecting illegal substances can acquire the wherewithal with a little effort, and proceed without much fear of retribution, particularly if they are wealthy enough.

Police and politicians say they are ­interested in punishing the suppliers and not the users. This is an intellectual nonsense, but it has suited everyone who matters. The drug users don’t care; governments have felt no ­pressure to attempt a politically dangerous reform; and above all it suits the international gangsters who control the drug business, which offers massive rewards and – for them – minimal risks.

But 2009 has seen a change: among the academics and professionals who study this issue, from Carlisle Racecourse to the think-tanks of ­Washington, there is growing sense that reform is possible and increasingly urgent.

The argument is not that drug use is A Good Thing. It is that the collateral damage caused by the so-called war on drugs has now reached catastrophic proportions. And even some politicians have started to think this might be worth discussing.

The biggest single reason (as with so much else this year) is the Obama Effect. In one way, this may be short-lived since the president’s reputation will eventually be tarnished by ­reality. But the chief barrier to reform has been that the international agreements barring the drugs trade have been enforced primarily by threats of retaliation from the White House.

Obama is the third successive president believed to have used illegal drugs: Bill Clinton famously did not inhale; in a conversation that was secretly taped when he was governor of Texas, George W. Bush didn’t deny that he had smoked marijuana or used cocaine; Obama has admitted using both dope and “a little blow”.

Unlike the other two, he is also on record as favouring decriminalisation of cannabis and more generally addressing the problem. The president having other preoccupations, there is no sign of him proposing the Do What The Hell You Like Bill to Congress any time soon. There is every sign that the blanket ban on other people’s initiatives has been partially lifted.

Obama has also come to power amid a growing sense of alarm about the US prison population. Nearly four million Americans are either physically in jail (including almost 5 per cent of all black males) or under some form of state or federal jurisdiction. About 20 per cent of these are listed as having committed drug offences.

But this must be a gross underestimate of reality. I recently asked a British judge what percentage of the defendants in his court were there for drugs-related crimes: not just direct breaches of the drug laws, but also crimes committed by those whose behaviour was affected by drug use or who were trying to obtain money to buy them.

He thought for a moment then said: “Sixty per cent. And most of the rest involve alcohol.” We may assume that, in the more drug-pervasive ­American culture, the figure would be higher than this.

At the same time, Americans have seen on the nightly news the brutal wars between ­Mexican drug gangs reach their border. And afterwards they have watched The Wire, which has given them a serious dose of daily inner city reality. Some observers see the collective shrug that greeted the admission of dope-smoking by the ­Olympic swimming hero Michael Phelps as a sign that ­attitudes are changing in middle America.

What would be less clear to TV watchers is the extent to which, under harsh and prescriptive sentencing guidelines, the wrong criminals are locked up. According to Sanho Tree of the Institute for Policy Studies in Washington: “There have been judges who’ve been literally in tears because they have been forced to sentence girlfriends of low-level dealers to 20 years. Perhaps they fielded a call for their boyfriends. And then the kingpin walks out in six months depending on how much ­information they’ve given.”

Attitudes are certainly changing elsewhere. Several countries, especially in South America, are starting to flirt with liberalisation – Portugal decriminalised all drug use in 2001 and the policy is said to have widespread acceptance. Now the former president of Brazil, Fernando Henrique Cardoso, has called for the decriminalisation of cocaine and says that many serving politicians quietly agree with him.

The South American shift ties in with a growing belief that the US-backed policy of coca eradication has been useless – if the crop disappears from one remote valley, it pops up in another. Meanwhile, the once trumpeted poppy-eradication mission in Afghanistan is increasingly perceived as a strategy that could strengthen the Taliban by curbing overproduction.

“We’re fighting over minimally processed agricultural commodities,” says Tree. “Heroin, cocaine and marijuana are incredibly cheap to produce. There is an inexhaustible resource of poor farmers to grow these crops and an undiminished supply of consumers. The more we increase law enforcement the greater the risk-reward for the traffickers. It’s an exercise in futility.”

Tree is by no means a lone voice in the Washington policy nexus. Jim Webb, ­the Democratic senator for Virginia, said in April that the issue of marijuana legalisation should be “on the table”. There is interest too from rightwing libertarians such as the Texas congressman and sometime presidential candidate Ron Paul. Indeed a leading pro-reform voice in Washington is the Cato Institute, usually associated with the Republicans. And the campaign is backed by well-organised pressure groups.

It is hard to find coherent advocates on the other side of the argument. On the web, I came across Drug Watch International, based in Omaha, promising “current information … to counter drug ­advocacy propaganda”.

The lead item on its site dates from 2002. I did track down its president, Dr John Coleman, formerly an undercover agent at what is now the Drug Enforcement Administration. He proved an ­amiable interviewee who offered me an intriguingly contrarian defence of the American alcohol prohibition years: unpopular though the law was, ­­­drink-related diseases fell. The drug prohibition, he felt, also worked.

“In the US, the levels of drug use in most categories are lower than in the 1960s, ’70s and ’80s. There’s a lot of social change, a lot of ageing out,” he said. “We have a more intelligent law enforcement system. The confiscation laws are very effective. I don’t think we should be surprised if public policies work. We do have drug problems, I’m not minimising them. But if we ignore the progress we’ve made, we’re short-changing ourselves.”

It is the practical men who seem most disposed to support the status quo. The most eloquent I discovered was back in Carlisle – Paul Carter, the cop at the racecourse conference. “I joined the police 28 years ago and I went to the deaths of many young people who had overdosed on heroin, particularly, and each one is an utter tragedy. I think there are fewer now and that we are beginning to make a difference.

“There’s a cycle of life when you’re on heroin when you’re either asleep or not aware of what’s going on around you. If society sanctioned that effect on another generation, what does that say about us all?”

The policy wonks arguing for change have not, as a rule, attended a dead body in a dingy flat, but the macro-argument tends to lead in another direction even among senior police officers like Norm Stamper, the former police chief of Seattle, who told The New York Times: “We’ve spent a ­trillion dollars prosecuting the war on drugs. What do we have to show for it? Drugs are more readily available, at lower prices and higher levels of potency. It’s a dismal failure.”

The drug laws were dingy from the start: Congress made marijuana illegal in 1937 after a farcical debate, due to pressure from ­western farmers who wanted their Mexican labourers to work harder. The user community keeps discovering “legal highs”, governments promptly ban them whereupon their popularity increases.

In Britain, there is something close to despair among academics about the political process. Drugs are classified A, B and C, allegedly according to the degree of harm. But the theory ignores the immutable constitutional provision that laws are subject to the approval of the editor of the Daily Mail. Cannabis was downgraded from B to C and then back again, to meet the government’s political needs; this had no effect on either ­suppliers or users.

Ecstasy (which alarms the Mail) is deemed a class A drug, the most dangerous rating, although – according to a major study published by The Lancet in 2007 – it ranks 18th in degree of harm among 20 well-known substances, ahead only of poppers and khat (both legal) and well behind alcohol and tobacco (ditto).

“We’re supposed to have evidence-led policy formulation,” says Mike Levi, professor of criminology at Cardiff University, “but it often doesn’t happen in the drugs area.”

At the conferences Levi attends, the argument has shifted. “The question of a more rational drug policy is certainly being debated. There aren’t many old-fashioned zealots for the old methods of drug control even in the police, who are more open to change than recent home secretaries. But however good an idea it might be in the abstract it would take a more mature political and media conversation about it before it is likely to ­happen. Always keep ahold of nurse, for fear of finding something worse, that’s where we are now.”

In Britain, with its top-down system of government, a notionally left-of-centre but illiberal administration and a hysterical press, reform is improbable, although Gordon Brown recently had a brief meeting with Danny Kushlick, from the pro-legalisation group Transform. But there is a new atmosphere in the US, where the change in emphasis in ­Washington is enough to allow initiatives to come from below.

Already, dope-­smoking is de facto legal in California thanks to the lifting of the ban on medical marijuana. Purchase requires a prescription – but anyone who wants a joint but can’t find a Californian medic who thinks it will help backache just isn’t trying. This system may well spread.

Strangely, all this is happening just as Holland, the country that has been out on a limb for years with its coffee-shop culture, is beginning to row backwards. Once again, though, it may well be an anomaly. The Dutch are starting to tire of their exceptionalism and the drugs tourism that has resulted, just as they have tired of their liberal immigration policies. And the coffee shops have fallen foul of the indoor-smoking taboo.

Drug use generally in Holland seems to be low. But then you can prove almost anything with selective use of drug statistics: it is also low in ­Sweden, which is surprisingly stern. The main source for these stats is the UN Office on Drugs and Crime, which maintains a huge bureaucracy to fight the drug problem, or at least to collect astonishingly detailed statistics: 3.8 per cent of Scots aged 15-64 use cocaine every year; 21.5 per cent of the same cohort of Ghanaians use cannabis; opium prices in the ­Phongsaly and Huaphanh provinces of Laos range between $556 and $744 per kilo … You might think that, knowing all this, they might be able to do something.

The UNODC’s executive director, Antonio Maria Costa, has been the chief proponent of continued prohibitionism. But, even as he introduced his 2009 report which, as ever, trumpeted evidence of success, he seemed a little rattled, repeating the new White House line about treatment rather than enforcement while warning that legalisation would be “a historic ­mistake”. He went on: “Proponents of legalisation can’t have it both ways. A free market for drugs would unleash a drug epidemic, while a regulated one would create a parallel criminal market. Illicit drugs pose a danger to health. That’s why drugs are, and must remain, controlled.”

Of course drugs need to be controlled, just as alcohol, tobacco, firearms, prescription drugs, food additives and indeed UN bureaucrats with massive budgets need to be controlled. But the whole point is that illicit drugs are not controlled.

The international ­pretence of ­prohibition sees to that. One of the major arguments advanced for continuing the ban on ­cannabis is that the currently available strains of the drug do not offer the gentle highs of the hippie years but are ­intensively cultivated and far more potent, with potentially serious ­psychological effects. The analysis is correct, according to my stoner friends. But the logic is 180 degrees wrong. Imagine a total ban on tobacco, which is no longer so unthinkable.

Among the consequences would be an immediate return to the unfiltered full-strength gaspers of the 1950s, just as American alcohol prohibition produced moonshine. One benign ­consequence of drug legalisation would be that users would have a ­guarantee of quality and strength/mildness: an end to heroin flavoured with brick dust (many believe adulteration is the real killer), and the type of ­marijuana they actually want.

But the case for legalisation is not about allowing baby-boom couples to enjoy a joint after a dinner party without drawing the curtains or being obliged to visit a dodgy bloke called Dave. Decriminalisation or even legalising cannabis on its own would achieve little. Something more radical is required.

The crucial issue concerns the supply chain: the way prohibition has enriched and empowered gangsters, corrupt officials and indeed wholly corrupt narco-states across the planet. It was a point made ­eloquently by the Russian economist Lev Timofeev, when interviewed by Misha Glenny for his book about global organised crime, McMafia. ­

“Prohibiting a market does not mean destroying it,” ­Timofeev said. What it means is placing a “dynamically developing market under the total control of criminal corporations”. He called the present situation a threat to world civilisation, which international public opinion had failed to grasp.

Proper reform means legitimising production and supply, precisely so it can be controlled. Would it unleash a drug epidemic worse than the one we now have? Well, it would be an unusual child of the 1960s who did not mark the moment with a celebratory joint. But the novelty would soon wear off. And from then on, the places where it is easiest to obtain drugs would no longer be the inside of jails and inner-city school playgrounds.

Imagine a situation – as John Ashton started to do at Carlisle ­Racecourse – where all drugs were sold in pharmacies licensed for the purpose. ­Taxation could be set at a level that brought in revenue but still made ­illegal dealing uncompetitive. For the more dangerous and addictive drugs there would be compulsory medical supervision. Identity checks and strict record-keeping would be required. There would be laws (which could ­actually be enforced) against advertising, adulteration, use in public, ­driving under the influence and supply to minors.

In what way would that be worse than the present situation?

Matthew Engel is a regular contributor to FT Weekend Magazine

We should abandon the fantasy of a drug free world and start taking responsibility for regulation. If you really want to control who grows coca, who produces cocaine, who sells it and for how much, who can take it, and how much they pay for it, create a framework that is logical, accountable and adjustable.

Still not convinced? Consider the declining popularity of tobacco smoking. High taxation, credible education programmes and effective treatment programmes work – a legal ban on smoking would not. Why should cocaine be treated any differently?

From:
http://www.ft.com/cms/s/2/486fb0d8-7ca3-11de-a7bf-00144feabdc0.html

Since Health Direct posted on Feb 24, 2009 High Stakes- Spice legal highs from the lab
we have consistently recieved high levels of readership.

Indeed Labour’s incompetent hypocracy has been frequently highlighted by Health Direct.

On Aug 02, 2006 we posted: Risks of taking drugs compared- Scientific review of dangers of drugtaking- we reproduced the first ranking based upon scientific evidence of harm to both individuals and society. It was devised by government advisers – then ignored by labour ministers because of its controversial findings.

As opponents turn their fire on to President Obama’s health plan, a gross mischaracterisation of Britain’s tax funded National Health Service has become the weapon of choice to attack it.

In response British politicians from Gordon Brown, the prime minister, downward have resorted to all of the 140 characters available on Twitter to defend it – implying that all is beautiful in the British NHS, and the US system with its 47m uninsured, its monumental costs, and its ability to bankrupt individuals is the approach that is “evil” – to use Sarah Palin’s description of the UK’s NHS.

This is a debate being driven by blind prejudice on both sides. For a start, what Mr Obama is proposing is not a British NHS. There is no proposal that a government backed insurer would run hospitals, as is still largely the case in the UK.

Second, half of the mighty 17 per cent of gross doemstic product that the US spends on health care – roughly double the level in the UK – is already funded by tax dollars through Medicare, Medicaid and the Veterans Health Administration, which incidentally does run medical facilities and provides some of the best health care in the US.

Third some of the charges levelled against the NHS are plumb wrong. That Teddy Kennedy would not get treatment for his brain tumour in the UK. That the NHS indulges in forced euthanasia. That people over the age of 59 do not get coronary artery by-passes.

The fractious British political classes have united in defence of the UK’s healthcare system after it has become a byword for the failings of universal, state-funded provision among the US Republican right.

Gordon Brown, prime minister, and David Cameron, leader of the Conservative opposition party, have both declared their commitment to the National Health Service.

The US right has used the NHS as an example of the potential pitfalls facing President Barack Obama as he tries to push through a healthcare reform bill.

Some Republicans have ridiculed it as a bureaucratic and “Orwellian” system that often denies care to the elderly – with Sarah Palin, the former Republican presidential candidate, decrying it as “evil”.

But in Britain, where since 1948 all citizens have enjoyed free healthcare from birth to death, the attacks are widely seen as wrong and insulting.

Some are true. The UK does have a lower dialysis rate for kidney disease than the US. Some of its cancer survival figures look appreciably worse and quite probably are worse: “probably” for a bunch of reasons, which include comparability of the data and the fact that five-year survival figures are by definition what was happening then, not what is happening now.

The NHS does indeed have waiting lists for non-emergency surgery, although after a doubling in spending in real terms over the past decade they are much shorter than they were. And, in contrast to the impression of “socialised medicine” held by some in the US, people can by-pass those queues by going private.

About 10 per cent of the population has some sort of private insurance, paid for indivdually or by their employers. The proportion has barely shifted over a decade, implying at least some sort of satisfaction among Brits at what they get.

In response to the worst of the UK performance, Brits can also pluck selective statistics from the US showing it has much poorer overall results for diabetes and a bunch of other chronic conditions where Britain’s primary care physicians treat patients well in the community, reducing complications and avoding costly hospital care.

A balanced view of the two systems might go like this. The US has some of the very best medicine in the world, particularly hi-tech medicine, notably in its leading academic health centres, and it has more of it than in the UK.

But study after study shows that overall the highest level of health spending in the world does not deliver anything like the best results.

A recent study, for example, looked at deaths in those aged under 75 that are amenable to treatment – for example, infections, cancers, diabetes, heart and vascular disease.

Overall, the US had the worst record among 19 industrialised countries, and the rate at which those deaths had been declining had slowed over the previous five years against the declines seen in other countries.

The US record was worse than that not just of the UK, but for example Portugal and Ireland. Martin McKee, of the London School of Hygiene and Tropical Medicine, one of the study’s authors, says: “If the US performed as well as the top three countries in the study” – France, Japan and Australia – “there would have been 101,000 fewer deaths per year.” There would also have been tens of thousands fewer in the UK if it had done the same.

Both systems have their strengths and weaknesses. But rather than presenting a caricature of the NHS, US opponents of reform might ask why. The US spends half as much again as almost any other country on healthcare, yet it still gets overall results that are nowhere near the best. One contributory reason, although only one, is the quality of care received by the uninsured. And that should be the real focus of the debate.

From:
http://www.ft.com/cms/s/0/4cecb8e4-88d9-11de-b50f-00144feabdc0.html?nclick_check=1

Huge variations in funding mean that cancer sufferers’ chances of being given life-extending drugs, surgery, and specialist care vary wildly from one part of the country to another.

While the average amount spent on a cancer sufferer in some parts of London is almost £15,000 a year, in Leicestershire it is less than £5,000.

Cancer experts said the research, carried out by The Sunday Telegraph, exposed a “grotesque lottery” in which life-and-death decisions were routinely being made by bureaucrats who were “unelected, unaccountable and unqualified” to make the rulings.

The figures obtained by the paper give the most detailed picture so far of the postcode lottery in cancer care.

Data from 150 Primary Care Trusts for 2007/2008 detailing cancer funding was divided by separate NHS records showing the number of cancer sufferers in each area.

Average spending was highest in Tower Hamlets, in East London, where cancer patients were allotted £14,697 for the year.

Those living in the cities of Birmingham, Leeds and Manchester all received average funding of at least £12,500.

Spending was lowest in Leicestershire and Rutland, with just £4,989 allotted to the average patient; about £500 more was spent in Harrow, North London, Hampshire, Northumberland and North Yorkshire.

Last year a study of patients with advanced cancer showed a tripling in the life-expectancy of those given drugs which many PCTs refuse to pay for.

Research on patients treated by University Hospitals Birmingham Foundation Trust compared the fate of 40 given the drugs Sutent and Nexavar for kidney cancer with 40 whose requests for funding were denied.

Those given the drugs survived 22 months, while those denied them lived just seven months, the study found.

Prof Nick James, director of research and development at University Hospital Birmingham, said: “A lot of PCTs are severely restricting access to drugs which can make a substantial difference to survival”.

While PCTs across Birmingham had agreed to fund many drugs for cancer patients living within their borders, those living further afield could only secure the same treatment if they won lengthy battles with bureaucracy, Dr James said.

The oncologist and professor of oncology at the University of Birmingham added: “Clinicians and patients in some areas are forced to battle continuously with bodies which are unelected, unaccountable and unqualified”.

He said that patients and doctors wasted “hundreds of hours” drafting appeals, writing to MPs and campaigning in the local media in an attempt to be heard by PCTs who often failed to even reply to correspondence.

The research found that PCTs across the country spent an average of £7,807 on cancer patients per year.

Jonathan Waxman, professor of oncology at Imperial College London, accused the labour Government of devising a “grotesque lottery” of local decision-making by PCTs in order to duck the blame for difficult decisions.

He said: “It is an absolutely absurd system, which is exposed by this excellent investigation. These discrepancies in funding are the reason people die.

“Why should how you are treated depend on where you live, and on decisions made by 150 different organisations who don’t have specialist knowledge of the patient?”

The study found the gulf between funding allocated in different parts of the country was growing.

Figures analysing spending per head of population showed the highest spending in Leeds, at £157 per head, compared with just £48 per head in the London boroughs of Camden and Newham.

The gap between the PCTs spending the most and those spending the least per head of population (weighted to take account of the health of the local population) increased from £70 to £109 between 2006/2007 and 2007/2008.

Cancer charities expressed alarm at the extent of the differences revealed by the research.

Sarah Woolnough, head of policy at Cancer Research UK, which raises funds to find treatments for cancer, said: “These huge variations in how much PCTs spend are worrying. We urge the Government to ensure that all PCTs deliver an efficient and high quality service for cancer patients in the face of predicted NHS cutbacks”.

Mike Hobday, from Macmillan Cancer Support, said: ” We know there are some PCTs which say yes to everything, and others which almost always say no, and that is something that we are concerned about.

“Some variation is to be expected, and in fact is necessary to meet the needs of particular populations, but it is really important that those commissioning services examine these findings closely”.

Dr Peter Marks, director of public health at NHS Leicestershire County and Rutland, said its local death rates for cancer were significantly lower than in the rest of England, while survival rates for specific cancers were similar, and in some cases better, to those elsewhere.

Shadow Health Secretary Andrew Lansley described the findings as “extremely concerning”.

He said: “Britain languishes near the bottom of the table in Europe when it comes to five year cancer survival rates. It’s clear that ministers’ promises to improve access to cancer drugs and treatments are ringing hollow for many vulnerable patients.”

From:
Cancer-lottery-London-patients-get-three-times-more-funding-than-those-in-Leicester

The NHS Information Centre found that the number of job vacancies for hospital doctors, dentists, nurses and midwives rose for the first time in five years.

Staff retiring or leaving the sector and the impact of cuts to doctors’ hours are likely to have contributed to shortages across England. London is especially badly hit.

Doctors’ leaders have been heavily critical about the impact of preparing for the European Working Time Directive, which came into force on August 1st.

The directive, which has reduced the maximum working week for junior doctors and other staff by the equivalent of one working day — from 56 hours to 48 — means that a significant number of hospitals are relying on agency staff to plug gaps in their rotas.

As The Times reported last week, the College of Emergency Medicine said that pressure was greatest on “middle-grade” doctors with at least four years training, who would be typically asked to cover shifts in Accident and Emergency (A&E;) wards at evenings and weekends.

Trusts are spending tens of thousands of pounds to fill vacant posts with agencies charging between £90 to £95 an hour to provide a middle-grade doctor to staff units when a senior consultant is not present.

The health service spent more than £584 million on employing agency staff in 2007-08, the latest year for which full data is available.

The British Medical Association, the Royal College of Surgeons and the Royal College of Paediatrics and Child Health have been heavily critical of the changes.

Doctors can opt out of the directive on a voluntary basis, but only individually, throwing rota planning into “chaos”, according to senior doctors. They want whole departments or specialities to be allowed to suspend the rules.

John Black, the president of the Royal College of Surgeons, called last week for the 48-hour limit to be postponed or suspended if during the swine flu pandemic, if the NHS has to cope with an expected surge of illness this winter.

The staff vacancy figures, compiled in March, showed that total vacancy rates are also up across most staff groups, rising to 5.2 per cent compared to 3.6 per cent in the same month last year. Three month vacancy rates jumped two thirds from 0.9 per cent to 1.5 per cent.

Of the total number of vacant posts, one in five had been left unfilled for three months or more.

Unions have already warned that a large number of nurses and midwives are due to retire in the next decade and among qualified nursing staff total vacancies rose from 2.5 per cent in 2008 to 3.1 per cent. Long-term vacancies also increased from 0.5 per cent to 0.7 per cent at the end of March.

Among midwives, vacancies increased from 2.1 per cent in 2008 to 3.4 per cent, with long term vacancies accounting for about one in four of all midwife vacancies.

The Royal College of Midwives has called for 5,000 extra staff to be recruited in order to improve care for mothers and babies, but it says the Government has only promised funding for the equivalent of 3,400 posts.

The figures show that London has the highest long-term vacancy rate among qualified nursing staff with the 3 month vacancy rate increasing from 1.2 per cent in 2008 to 1.6 per cent this year.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6741241.ece

Data from the Office for National Statistics covering 2004 to 2008 shows record numbers of deaths linked to the superbugs in England and Wales.

Opposition politicians said the labour Government had allowed “a horrifying death toll” because of its “slow and sloppy” response to spiralling levels of infection in NHS hospitals.

Official data shows a doubling in the death toll linked to MRSA during the period 2004 to 2007, compared with the previous four years, and a quadrupling in deaths linked to C. diff, when two sets of three-year figures are compared.

Norman Lamb, the Liberal Democrat health spokesman, said: “These figures describe an absolutely horrifying death toll, and many of these people have lost their lives because of infections which could have been avoided if firm action on infection had been taken a long time ago”.

Annual deaths linked to MRSA quadrupled between 1997 and 2007, while those associated with C. diff quadrupled between 2004 and 2007, figures show.

Katherine Murphy, from the Patients Association, said the statistics showed the gulf between “flowery” Government rhetoric about a war on infection, and poor hygiene which had been allowed to continue unchecked.

“The NHS has been told to put other targets ahead of safety, and this is the inevitable outcome,” she added.

Infection experts have repeatedly warned that assessments based on the number of death certificates which record the presence of MRSA and C. diff are likely to underestimate the scale of the problem, because doctors are reluctant to admit that basic infections have caused fatalities.

Earlier figures published by the ONS have shown that the worst hospital for C. diff deaths in England or Wales was the Royal United Hospital in Bath, which had 268 deaths from the infection between 2002 and 2006.

The George Eliot hospital in Nuneaton, Warwickshire, the Walsgrave Hospital in Coventry and the Royal Infirmary in Leicester all had more than 200 deaths caused by the infection over the same period.

The worst-ever outbreak of C. diff in this country occurred between 2004 and 2006 at Maidstone and Tunbridge Wells NHS Trust, where the bug was linked to the deaths of 331 patients.

More than 5,000 people have backed The Sunday Telegraph’s Heal Our Hospitals campaign, which is calling for a review of hospital targets to make sure they work to improve quality of care.

From:
http://www.telegraph.co.uk/Death-toll-from-hospital-bugs-hits-new-high

In total almost 1,200, or one in every 20 dentists, earned more than £200,000 between 2007 and 2008, three times as many as the previous year.

The rising number of dentists earning what were described as “staggering” sums was revealed just a day after it was disclosed that some GPs now make up to £380,000 a year.

The payments come despite the fact that 3 million fewer patients are seeing an NHS dentist since a new contract was introduced in 2006.

Official figures show that dentists are carrying out greater numbers of treatments per patient than in the past, as well as more complicated procedures.

Those in the highest earning brackets also put in longer hours, with the majority working more than 45 hours a week, the figures, released by the NHS Information Centre, show.

The income is before tax but after expenses, which typically include the costs of renting surgeries and paying staff, have been taken into account.

The figures, based on dentists’ tax returns, include those who work solely for the health service as well as dentists who have a mix of NHS and private work.

They show that 382 of the 20,000 dentists in England and Wales earned more than £300,000 last year, while 1,172 earned more than £200,000. The average income was £89,062.

The new contract was deeply controversial among dentists and around 1,000 left the NHS before it was even implemented.

Problems included quotas to carry out a certain amount of treatments every year.

Dentists who reached their target too soon were effectively asked to work for free, while those who failed to reach the quota faced demands from their local healthcare trust to pay back tens of thousands of pounds of their salary, so-called “clawbacks”.

The new contracts also abolished a number of pay bands, meaning dentists now get paid the same to fit a patient with 10 fillings as just one.

The British Dental Association said that the figures reflected the hard work of dentists attempting to make a success of the new contract.

John Milne, Chair of the BDA’s General Dental Practice Committee, said: “These statistics reflect the second year of operation of the 2006 dental contract in England and Wales, a time when dentists were working hard to overcome problems with the new arrangements and make them work for their patients.

“Many practitioners were contending with the uncertainty of potential clawback of their contract values,” he added.

But Norman Lamb, the Liberal Democrat health spokesman, said that the amounts involved were “staggering”.

“These figures will astonish people who are struggling to find an NHS dentist. The amount of money some dentists are earning is staggering. It is vital that the NHS can compete with the private sector to secure the best staff. However, we need to know that we are getting value for money.”

Earlier this year ministers announced plans to pilot a change in how dentists are paid, linking part of their income to how many dentists they have on their books, in a bid to improve access.

Earlier this year a survey for Which? magazine suggested that three million people in England had been unable to get an appointment with an NHS dentist in the last two years.

From:
http://www.telegraph.co.uk/Nearly-400-NHS-dentists-earn-more-than-300000

Thousands of healthy workers are thought to have taken advantage of official guidelines on the pandemic to extend their summer holidays.

By simply phoning the NHS swine flu hot line or visiting its website, unscrupulous workers can get themselves a course of antiviral medicine and do not need a sick note from their GP for the first seven days’ absence.

The labour Government is considering doubling this period to a fortnight, which companies fear could make the situation worse and cost them millions of pounds in lost productivity at a time when they are struggling with the effects of the recession.

There are predictions that more healthy workers will be tempted to call in sick as the weather improves over the next week, after the wettest July on record.

The Employment Law Advisory Service, which provides legal advice to companies on personnel problems, disclosed yesterday that it had begun receiving calls from concerned managers as soon as the self-diagnosis website was set up last month.

It has since heard from more than 1,000 companies that believe staff have exploited concern about the spread of the H1N1 virus to take an extra week off. It believes that the Department of Health’s guidance risks creating a “skiver’s charter”.

Peter Mooney, the service’s head of consultancy, said: “Managers feel that some staff are simply taking advantage of concerns about the transmission of swine flu to take an extra few days off work. Because the emphasis has been on not going to your local GP but using websites to assess the infection and the risk to others, those who stay at home are not going to need a doctor’s note or have too many people calling on them to see how they feel.

“Based on the volume, and the nature, of calls we have been taking, the number of deliberate false cases of the condition is having a significant impact on workplaces across the country — something bosses are keen to tackle.”

The Department of Health’s own planning assumptions state that nine per cent of the workforce could be absent at any one time during August, rising to 12 per cent in the winter. Ministers set up emergency measures to reduce the pressure on the NHS and slow the transmission of the virus amid predictions of a worst-case scenario in which one in three of the population falls ill and 65,000 people die.

Those who believe they have symptoms are advised to contact the National Pandemic Flu Service over the phone or online, rather than visit a family doctor.

If they are diagnosed with swine flu, they are given a number to allow them to collect a course of antiviral drugs and told to stay at home for a minimum of seven days in order to prevent further spread of the virus.

The flu service website and phone line handed out over 150,000 doses of Tamiflu in its first week. However, there is evidence that only about one in four recipients actually has the H1N1 virus.

GPs have said that they are being inundated with calls from patients claiming to have swine flu and requesting a note to sign them off work for longer than a week. Many are concerned that they are being asked to certify that people are ill without having seen them, meaning shirkers could take advantage.

Recent figures suggest the average worker takes 7.4 days off sick a year at a total cost of £17.3?billion to the economy, so the impact of staff taking another fortnight off for self-diagnosed swine flu could cripple some small businesses.

Ben Willmott, a senior public policy adviser at the Chartered Institute of Personnel and Development, said: “Obviously some employers are concerned that employees could take advantage of that.”

He urged managers to make sure they have contingency plans in place so they can cope if staff are genuinely ill with swine flu, and also to ensure that workers know that absence levels are monitored in order to catch those “swinging the lead”.

Meanwhile, GPs have been warned that a Tamiflu solution designed for babies will run out if it continues to be given to people who do not like to swallow capsules.

The Royal College of General Practitioners has told doctors not to prescribe the antiviral liquid to older children or adults. In a bulletin to members, the college said this was happening “across the country” and was “causing an unprecedented demand for the solution”.

Those who cannot swallow capsules should instead open the capsule and dissolve the powder in a sweet drink, it recommended.

http://www.telegraph.co.uk/Swine-flu-skivers-cost-firms-more-than-virus-say-employers

A poll for GP magazine found nearly 90% of family doctors fear conditions such as tonsilitis, bronchitis and meningitis may be overlooked.

The symptoms are so vague and wide ranging, swine flu can masquerade as a vast array of other diseases

Since the National Pandemic Flu Service was launched last month, it has prescribed the anti-viral drug tamiflu to 150,000 people.

But concerns have been raised that the phone lines are staffed by people with no medical training, working from a check list.

In the survey of 251 GPs, 87% said it was possible that diagnosing swine flu over the phone could mean that other diseases may be missed.

Just 3% were confident that this would not happen.

The poll comes after it was revealed that a 13-year-old boy from Yate, south Gloucestershire became seriously ill with a kidney infection after being misdiagnosed with swine flu.

Responding to the poll, one GP said: “The symptoms are so vague and wide ranging, swine flu can masquerade as a vast array of other diseases.”

Another doctor said it was “blindingly obvious that a telephone diagnosis will very rarely, but very significantly, miss an alternative diagnosis which could lead to severe morbidity or mortality”.

Professor Steve Field, chairman of the Royal College of GPs, accepted that the poll was an accurate reflection of doctors’ concerns.

He admitted there would be a few patients who should be going straight to their GP, rather than contacting the flu service.

But he said patient safety had been the top priority when the checklists for the new service were being drawn up.

He also stressed that the service was not designed to give a diagnosis, but to enable patients suspected of having swine flu to get speedy access to anti-viral drugs.

Professor Field said: “The National Pandemic Flu Service has taken a lot of pressure off GPs previously swamped by calls from worried patients.

“This has freed up a lot more of GPs’ time to concentrate on patients whose conditions are worsening or have developed complications as well as those people continuing to access their GP for advice and treatment for other conditions.”

http://news.bbc.co.uk/1/hi/health/8184877.stm

The contracts begin to expire between January and May next year. But the department is proposing that where a primary care trust decides it wants to keep a service on, the tendering process will take as long as six months.

The first to be renewed is the Eccleshill treatment centre in Bradford, whose contract formally expires in January. However, the department of health said a new contract would not be awarded until February.

The Bradford and Aire-dale primary care trust declined to say whether Circle, its operator, would be given a contract extension to keep the service running as it was put out to tender – although it did say it was “planning to ensure service continuity”.

With no timetable set for re-tendering another 12 contracts that expire next year, their operators fear they too will face renewals that run up to or beyond the contract end.

Jill Watts, chief executive of Ramsay Health Care, which has four treatment centres whose contracts expire in the first part of next year, said: “The timetable is quite ludicrous. The message we were originally given was that there would be a much quicker process.”

Ken Anderson, former commercial director at the department of health and the original negotiator of the contracts, said going through a full tendering process for centres that had performed well was “a waste of taxpayers’ money”.

Now a banker with UBS, Mr Anderson said the department had known for five years that the contracts would need to be renewed.

The providers have already agreed that the services will be provided at NHS prices, he said, and all that was needed was a re-negotiation.

The process the department has proposed was “farcical”, he said. “It leaves staff and the companies hanging on the wire, not knowing if they are going to be providing healthcare.”

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The health secretary wants powers formally to ask Monitor, which regulates foundation trusts, to intervene when one of the hospitals hits the headlines for the wrong reasons. NHS bodies said that would threaten the regulator’s independence.

The move follows the discovery that mistakes in emergency care at Mid-Staffordshire Hospital had caused hundreds of unnecessary deaths.

Mr Burnham is proposing that the health secretary should be able legally to ask the regulator to act where there is “demonstrable poor quality, demonstrable poor governance or a failure of leadership”.

But Sue Slipman, director of the Foundation Trust Network, said the issues on which ministers could intervene were far too widely drawn. They threatened an important settlement of the NHS reforms, she said – that foundation trusts would be free-standing organisations, regulated independently, and no longer subject to direction by the secretary of state.

The proposals were “second guessing Monitor”, she said, and could mean the health secretary intervening “every time there was a negative story in the newspapers”.

Yesterday, the NHS Confederation, which represents all health authorities and trusts, reinforced her argument, saying the proposals were “unnecessary” and threatened a repeat of the 1990s, when similar freedoms given to ordinary NHS trusts were steadily clawed back by the Department of Health.

Nigel Edwards, the confederation’s director of policy, said: “It is not clear that this is necessary.” If the quality of care were at issue, the new healthcare inspector, the Care Quality Commission, had the power to close services, which would trigger action by Monitor, he said. He also pointed out that Mid-Staffordshire had been dealt with effectively by Monitor, which replaced the trust’s leadership.

“This can be seen as a symbolic first step to reclaiming the freedoms and independence that were bestowed on foundation trusts,” he said. It was “against the whole spirit of the existing legislation”.

The health department insisted the new powers would be used “rarely” and in “exceptional circumstances”. But Mr Edwards said having them would put ministers under pressure to act “and the definition of exceptional will become looser and broader”.

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The labour Government’s drug rationing watchdog says “therapeutic” injections of steroids, such as cortisone, which are used to reduce inflammation, should no longer be offered to patients suffering from persistent lower back pain when the cause is not known.

Instead the National Institute of Health and Clinical Excellence (NICE) is ordering doctors to offer patients remedies like acupuncture and osteopathy.

Specialists fear tens of thousands of people, mainly the elderly and frail, will be left to suffer excruciating levels of pain or pay as much as £500 each for private treatment.

The NHS currently issues more than 60,000 treatments of steroid injections every year. NICE said in its guidance it wants to cut this to just 3,000 treatments a year, a move which would save the NHS £33 million.

But the British Pain Society, which represents specialists in the field, has written to NICE calling for the guidelines to be withdrawn after its members warned that they would lead to many patients having to undergo unnecessary and high-risk spinal surgery.

Dr Christopher Wells, a leading specialist in pain relief medicine and the founder of the NHS’ first specialist pain clinic, said it was “entirely unacceptable” that conventional treatments used by thousands of patients would be stopped.

“I don’t mind whether some people want to try acupuncture, or osteopathy. What concerns me is that to pay for these treatments, specialist clinics which offer vital services are going to be forced to close, leaving patients in significant pain, with nowhere to go,”

The NICE guidelines admit that evidence was limited for many back pain treatments, including those it recommended. Where scientific proof was lacking, advice was instead taken from its expert group. But specialists are furious that while the group included practitioners of alternative therapies, there was no one with expertise in conventional pain relief medicine to argue against a decision to significantly restrict its use.

Dr Jonathan Richardson, a consultant pain specialist from Bradford Hospitals Trust, is among more than 50 medics who have written to NICE urging the body to reconsider its decision, which was taken in May.

He said: “The consequences of the NICE decision will be devastating for thousands of patients. It will mean more people on opiates, which are addictive, and kill 2,000 a year. It will mean more people having spinal surgery, which is incredibly risky, and has a 50 per cent failure rate.”

One in three people are estimated to suffer from lower back pain every year, while one in 15 consult their GP about it. Specialists say therapeutic injections using steroids to reduce inflammation and other injections which can deaden nerve endings, can provide months or even years of respite from pain.

Experts said that if funding was stopped for the injections, many clinics would also struggle to offer other vital services, such as pain management programmes and psychotherapy which is used to manage chronic pain.

Anger among medics has reached such levels that Dr Paul Watson, a physiotherapist who helped draft the guidelines, was last week forced to resign as President of the British Pain Society.

Doctors said he had failed to represent their views when the guidelines were drawn up and refused to support the letter by more than 50 of the group’s members which called for the guidelines to be withdrawn.

In response, NICE chairman Professor Sir Michael Rawlins expressed outrage over the vote that forced Dr Watson from his position, describing the actions of the society as “shameful”. He accused pain specialists of refusing to accept that there was insufficient scientific evidence to support their practices.

A spokesman for NICE said its guidance did not recommend that injections were stopped for all patients, but only for those who had been in pain for less than a year, where the cause was not known.

Iris Watkins, 80 from Appleton, in Cheshire said her life had been “transformed” by the use of therapeutic injections every two years. The pensioner began to suffer back pain in her 70s. Four years ago, despite physiotherapy treatment and the use of medication, she had reached a stage where she could barely walk.

“It was horrendous, I was spending hours lying on the sofa, or in bed, I couldn’t spend a whole evening out. I was referred to a specialist, who decided to give me a set of injections. The difference was tremendous”,

Within days, she was able to return to her old life, gardening, caring for her husband Herbert, and enjoying social occasions.

“I just felt fabulous – almost immediately, there was not a twinge. I only had an injection every two years, but it really has transformed my life; if I couldn’t have them I would be in despair”.

http://www.telegraph.co.uk/health/healthnews/5955840/Patients-forced-to-live-in-agony-after-NHS-refuses-to-pay-for-painkilling-injections.html

The Health Protection Agency (HPA), at a briefing in London, said 530 patients had been admitted to hospital in England – down on the previous week’s total of 793.

The HPA estimated there were 30,000 new cases of swine flu in England, but said the majority of cases continued to be “mild”.

“There is no sign that the virus is changing,” said the HPA. “It is not becoming more severe or developing resistance to anti-virals.”

The number of weekly GP consultations dropped over the past week, coinciding with the launch of the National Pandemic Flu Service.

Chief Medical Officer Sir Liam Donaldson said the rise in the death toll did not indicate that the virus was becoming more potent.

“I don’t think it suggests any increase in severity in the disease because we would have expected a higher proportion to be in intensive care or in hospital if the severity was increasing,” he said.

“I think we are probably seeing the level of increase in the disease that would be expected, really, from the proportion of people in hospitals with serious disease.”

Sir Liam predicted a second wave of the virus could strike after children returned to school but was unable to state exactly when this was likely to hit.

“It’s just guesswork,” he said. “We would anticipate when the schools were back, at some point after that, it will start to rise again.”

He added there were no plans to close schools or delay their opening on a national scale.

“I think we are pretty certain we will see a second wave,” said Sir Liam.

The HPA said 56 of the 530 people admitted to hospital after contracting swine flu were in “critical care”.

Globally, the total of confirmed cases has reached 193,000 and the number of deaths is 1,362.

Sir Liam said the National Pandemic Flu Service would remain in place although the briefing was told it could be “scaled up or down” depending on the number of new cases reported.

http://www.telegraph.co.uk/health/swine-flu/5983531/Swine-flu-rise-in-deaths-but-overall-numbers-decline.html

The revelation re-opens the debate about screening, which helps some women but harms others. Doctors say thousands of women undergo unnecessary treatment, including mastectomies, to investigate and treat disease that would have been better left alone.

Peter Gotzsche, director of the Nordic Cochrane Centre in Copenhagen and a critic of screening programmes, joined forces with the researcher Karsten Jorgensen to compare breast cancer trends before and after screening was introduced in the UK, Canada, Australia, Sweden and Norway. They found that the level of over-diagnosis was comparable in all five countries.

As it is not possible to distinguish lethal from harmless cancers, all detected cancers are treated.

It is known that a type of early breast cancer often detected in screening, ductal carcinoma in situ, can resolve itself without treatment but the latest study says this also applies to other cases of invasive breast cancer. The authors, whose findings are published in the British Medical Journal, say many experts find this “difficult to accept”.

Screening for cancer detects the disease earlier, when it is easier to treat. The NHS Cancer Screening Service estimates that breast cancer screening saves 1,400 lives every year, one for every eight women diagnosed.

But the researchers say that for each woman who is saved by screening, up to 10 will be overdiagnosed and have unnecessary treatment and up to 500 will have at least one false alarm, half of whom will have a biopsy (removal of a sample of breast tissue).

Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy in the US, says in an editorial published with the research: “The question is no longer whether, but how often, overdiagnosis occurs.

“Mammography is one of medicine’s close calls – a delicate balance between benefits and harms. Mammography undoubtedly helps some women but hurts others. No right answer exists, instead it is a personal choice.”

In the NHS, women between the ages of 50 and 72 are invited for breast screening every three years. The age range is to be extended to 47-73 by 2012. Figures for 2006-07 show screening detected almost 13,500 cancers.

Some doctors argue that the money spent on the breast screening programme – about £40m a year – would save more lives if it were used to provide more treatment.

The Cancer Screening Service is revising its screening advisory leaflet. A spokeswoman said the new version should be available later this year.

Dr Sarah Cant, from Breakthrough Breast Cancer, said she hoped that the research would not discourage women from attending screening: “Based on all the current evidence, we believe the benefits of detecting breast cancer early still outweigh the risks.”

Women will have a false alarm for every one saved by breast cancer screening.

http://www.independent.co.uk/breast-cancer-screening-blamed-for-false-alarms

Mike O’Brien, health minister, told the Financial Times it would be up to primary care trusts whether to recommission the treatments they provided.

Independent sector treatment centres (ISTCs) have cut waiting lists and introduced competition since the first ones opened in 2005.

However, Mr O’Brien disclosed that as the contracts expire the NHS is likely to have to pay about £200m for operations that it agreed to buy from them but has not used, and another £200m to buy back premises built by the private sector operators.

In spite of the £400m bill, he insisted that ISTCs had been “value for money”, cutting NHS waiting lists and introducing more choice for patients.

So far, they have provided more than 1.7m operations and other procedures, helping cut the maximum NHS wait to 18 weeks while recording very high satisfaction rates in patient surveys.

Leading private sector operators also expressed alarm at the labour government’s timetable for re-tendering, which they said in some cases looked likely to lead to contract renewal only after, or just as, they were due to end. With many of the centres staffed from overseas “there is a real risk that staff will leave”, one leading private sector operator said, putting services at risk.

To attract operators, the five year deals offered guaranteed volumes of patients, a buy-back clause on the buildings, and prices that, on Department of Health figures, are about 11 per cent above the NHS price.

Although some are now treating more patients than contracted for, on average they have treated only about 85 per cent of the patients they offered to take. As a result, the NHS is likely to have to pay about £200m for operations it has not used, as well as another £200m for the residual value of the ISTC buildings, Mr O’Brien said.

But he insisted that the centrally negotiated deals had cleared more than 40 per cent of a “backlog” of 250,000 NHS patients who had to be treated to get waiting times down.

In future it will be up to primary care trusts whether to recommission services from the ISTC buildings, Mr O’Brien said, and he expected those to be at standard NHS prices with no guarantees of volume – “although PCTs will be free to negotiate otherwise”.

Trusts have an incentive to renew the service as otherwise they will be left with an empty surgical centre.

http://www.ft.com/cms/s/0/9621c792-7ca0-11de-a7bf-00144feabdc0.html

Experts said the deaths were “very sad”, although not unexpected given the tens of thousands infected, but warned that any cluster of deaths could indicate the virus had mutated and become nastier.

Wendy Barclay, professor of influenza virology at Imperial College, London, said: “With so many people becoming infected we must expect that some fatalities will occur. It is very important to keep a careful look for clusters of severe cases that might indicate that a mutated virus has arisen that can be more virulent than the swine flu that has circulated until now. Each severe or fatal case should be carefully characterised using our best science to understand the reasons why this has happened.”

The first full analysis of the H1N1 virus, published in Nature, shows it causes more lung damage in animals than seasonal flu. For two strains of virus tested, five times less was needed to cause the same damage as seasonal flu. Damage to the lungs increases the risk of pneumonia which is the commonest cause of complications, severe illness and death in flu epidemics.

Professor Ian Jones, director of research at the University of Reading, said: “This complete analysis of the current H1N1 is what we’ve been waiting for. For a number of measures it shows that the new virus is more serious than seasonal H1N1 but that, nonetheless, the major outcome to infection is recovery. For the few cases of severe infection the data should help in the clinical management of hospitalised patients.”

The British Medical Association said it was saddened by the death of GP Dr Day, and the other victims, but urged the public not to panic. Dr Day, who qualified as a doctor in 1970, had recently retired from the Priory Gardens Health Centre in Dunstable but still worked there part time as as a locum.

Dr Laurence Buckman, chairman of the BMA’s GPs committee, said: “Doctors have always accepted that there are risks associated with their job. Obviously these are smaller than they used to be with the advent of modern medicine, but they can never be eliminated altogether.

“It is understandable that people will be worried when they hear that a GP has died but we urge them to follow the recommended advice and contact their family doctor, rather than physically going to the surgery if they have symptoms. The vast majority of people will recover quickly by taking paracetamol or ibuprofen, and drinking plenty of fluids. Anyone who is not recovering quickly should get extra advice as a small number will need more intensive treatment.

“We must remember that every year there are deaths from complications of seasonal flu; this is unfortunately inevitable with any strain of influenza.”

Liberal Democrat health spokesman Norman Lamb said: “Dealing with the flu crisis is a mammoth task and NHS staff need access to support and advice given the anxiety that many of them may face.

“The labour Government needs to ensure that all frontline NHS staff are given access to flu vaccines as a matter of urgency.

http://www.independent.co.uk/life-style/health-and-families/health-news/swine-flu-five-times-more-virulent-1744351.html

There have been many policy failures by this labour Government; but few can have been as spectacular as its avowed aim of reducing teenage pregnancies by half.

Since 1998, there has been a reduction of just 11 per cent – and recent trends have been upwards once more.

The strategy has involved the expansion of sex- education programmes and the provision of contraception in school. Girls under 16 can already get the morning-after pill from school nurses without their parents’ knowledge.

Yet an academic study has found that encouraging children to talk about sex could have increased the number of pregnancies, by tempting them to become sexually active at an early age.

The evidence is now overwhelming that these schemes are not effective in cutting teenage pregnancy rates.

An improvement in wider educational standards seems to be the most significant factor in reducing teenage pregnancies; yet the Government has failed there, too, especially among the children of poorer families, where the problem is greatest.

More than 12 years after this strategy was launched, and despite the expenditure of many millions of pounds, the UK still has the worst teenage pregnancy problem in western Europe.

Any parent could have told ministers that bringing children into contact with what the study calls “risky peers” might have the opposite effect to that intended. This approach undermines any attempt by parents to discourage their children from having early sexual relationships, and the consequences have been all too predictable.

Yet any suggestion that a moral dimension, or the virtues of abstinence, might be included in sex education classes is derided by those who think they know better – but who have been shown by the failure of their policy to know very little indeed.

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The antiviral drug, which is being handed out to hundreds of thousands of Britons, can also produce stomach pains, vomiting and diarrhoea, research suggests.

A study found that almost one in five youngsters experience neuropsychiatric side effects, such as poor concentration, confusion, and sleeping problems.

Thousands of schoolchildren were given the drug as a preventive measure during the early stages of the swine flu pandemic in Britain.

The findings are likely to lead to concern among parents that their children’s performance at school has been jeopardised by taking the drug.

Only people with suspected or confirmed swine flu are now being prescribed Tamiflu, and around 150,000 packs have been distributed by the newly launched National Pandemic Flu Service in the past week alone.

Two studies from experts at the Health Protection Agency (HPA) showed a “high proportion” of British schoolchildren reporting problems after taking Tamiflu.

Data was gathered from children at three schools in London and one in south west England who were given Tamiflu earlier this year after classmates became infected.

One study, of 248 children aged 11 and 12 at a school in south west England, which was closed after a pupil contracted the virus, found that more than half suffered side effects from taking Tamiflu.

The report said: “Fifty-one per cent experienced symptoms, such as feeling sick (31.2 per cent), headaches (24.3 per cent) and stomach ache (21.1 per cent).

“Although some children were ill with flu-like symptoms, those tested did not have A (H1N1) v (swine flu) infection.”

The researchers said “likely side effects were common” and the “burden of side effects needs to be considered” when deciding on giving Tamiflu to children prophylactically.

Another study of 103 schoolchildren found 45 suffered side-effects such as nausea, stomach pain, problems sleeping, vomiting and diarrhoea.

Almost one in five (18 per cent) reported a neuropsychiatric side effect, such as poor concentration, inability to think clearly, problems sleeping, feeling dazed or confused and nightmares.

The report concluded: “This may be of particular concern to exam year students (and their parents).”

The studies were carried out in the early stages of the pandemic, when everyone sharing a classroom with a child who developed swine flu was given the drug, even if they showed no symptoms.

The findings were disclosed as it emerged that Japanese authorities are advising doctors not to prescribe Tamiflu to youngsters aged 10 to 19 over fears of neuropsychiatric side effects.

A statement from Roche, which manufactures Tamiflu, said the contribution of Tamiflu to neuropsychiatric effects “has not been established”.

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