Labour MSP Jackie Baillie called on the Scottish government to end what she described as a postcode lottery on IVF treatment.

Figures obtained by the MSP under a freedom of information request showed that the longest average waiting times among the 11 boards that responded were in NHS Lothian, where patients wait three years for treatment. Patients in the Borders, referred to the same unit in NHS Lothian, had no waiting time.

In Glasgow the average wait was 22 months, while couples from Lanarkshire were referred to the same hospital, Glasgow Royal Infirmary, within an average of six months.

In Fife the average wait for IVF treatment was two years. In NHS Highland and Tayside it was one year, and in Grampian a maximum of 18 months.

“This shows clearly that it is the board of residence that determines length of wait,” Ms Baillie said. “There is no consistency in the rules. NHS Borders will fund patients for treatment in neighbouring areas if they have shorter waiting lists, but other health boards refuse to consider such a sensible step.”

Although some boards, notably NHS Greater Glasgow and Clyde, did not reveal the number of patients, Ms Baillie’s figures indicate that more than 1,000 couples across Scotland are waiting to see a specialist.

Long waiting times have a particular resonance for inferitlity treatment, as a woman’s age is critical to success rates. One expert describes the age factor as “the most monumental challenge”.

Ms Baillie said national guidelines were needed to ensure that patients were treated fairly and had access to treatment as quickly as possible.

Shona Robison, the Public Health Minister said: “There is huge demand for IVF and we know it can be very upsetting to have to wait for treatment, but we are working to make access as fair as possible.”

Jackie Sansbury, of NHS Lothian, said: “We are investing an additional £180,000 to increase the number of IVF cycles we are able to offer by about 40 per cent during 2009-2010.”

With permission from club proprietors, Measham and Moore did their fieldwork in Manchester, the epitome of the 24-hour party city. They set up a website to verify their work to clubbers, then interviewed them at the start of the evening before the drugs had made revellers too intoxicated.

One of the fundamental ironies the research uncovered is that because recreational drug users fuel the economy and cause few social problems — violent crime, aggression and antisocial behaviour are much more likely to be alcohol-related and occur outside pubs — they fail to get the support and services they need.

“There is a lack of knowledge about the types of drugs, a lack of accurate, non-judgmental and non-sensationalist information for these users,” says Moore, a lecturer in criminology. “Ketamine, for instance, does not go well with alcohol. Nor does GBL [which coverts to GHB in the body], which is widely used as an industrial cleaner, and is not illegal. I’ve been working with one man who had a serious daily dependency on GBL, but the doctors simply didn’t know what to do with him.”

Here too is highlighted another contradiction: between the growing commercialisation of the night-time economy and the increasing government policy of what Measham calls “the criminalisation of intoxication” without education, advice or treatment services attached. The people who suffer, under the present situation of tacit tolerance of drugs, are the users. “Even if the club owners wanted harmreduction literature in their club, it would acknowledge that there was drug taking on the premises. And they are concerned about being arrested or shut down.”

Last year the owner of the Dance Academy in Plymouth, Manoucehr Bahmanzadeh, and its manager, Tom Costelloe, were found guilty of allowing the venue to be used for the supply of Ecstasy and jailed for nine years and five years respectively. This despite neither man having actually sold drugs on the premises.

What is important, Measham and Moore say, is to draw the distinction between this kind of recreational drug use, and the problem drug use that dominates the political agenda and absorbs its resources. The two groups do not overlap; the dealers are different; and so are the drugs. 

The first wideranging academic study of clubbers’ behaviour in a decade, released this month, indicates that thousands of apparently successful, healthy and economically active people in their twenties, thirties and forties choose to be heavy recreational drug users at the weekend.

Not only do the findings suggest almost ubiquitous drug use in and around Britain’s clubs, in particular cannabis, cocaine and Ecstasy, but they point to the emergence of new substances on the pharmaceutical block, such as ketamine and GHB, being used increasingly by clubbers as part of assorted drug “repertoires” at the weekends.

Ketamine, a Class C drug, is an anaesthetic, sometimes used on animals, which causes temporary hallucinations. GHB — gammahydroxybutrate — is also Class C and produces a feeling of euphoria. Both can be dangerous, powerful drugs.

Dr Fiona Measham and Dr Karenza Moore, criminologists from Lancaster University, set out to explore the hidden world of pharmaceutical intoxication in Britain’s bars and night clubs. What they found, in the most thorough examination ever undertaken of drugs across the British night-time economy, was extraordinary.

They discovered evidence that almost all Britain’s thousands of clubbers routinely take drugs, in particular cocaine (tried by 83 per cent of people), cannabis (93 per cent) and ecstasy (85 per cent). Eight in ten had taken a drug within the previous month, and nearly two in three of those questioned had taken, or were going to take, drugs on the night they were surveyed.

These statistics, published in the journal Criminology and Criminal Justice, demonstrate how drug-enduced dancing and socialising has become a significant part of modern culture, albeit taking place “under the radar” with the tacit acceptance of police, politicians and economists.

Indeed, the figures indicate that much of Britain’s burgeoning night time economy, worth as much as £30 billion, and employing about one million people, is inextricably linked to the night long consumption of illegal drugs. 

More than 3,000 staff, including doctors and nurses, have gone private at the taxpayers’ expense in the past three years because the queues at the clinics and hospitals where they work are too long.

Figures released under the Freedom of Information act show that NHS administrative staff, paramedics and ambulance drivers have also been given free private healthcare. This has covered physiotherapy, osteopathy, psychiatric care and counselling — all widely available on the NHS.

“It simply isn’t fair to have one service for staff and another for everyone else,” said Norman Lamb, the Liberal Democrat health spokesman, who obtained the figures.

“If the NHS has to circumvent their own waiting lists the system isn’t working well enough. It’s an admission by the NHS that their own system isn’t able to respond to the mass of people desperate to get back to work.”

The number of health service employees sent to private healthcare facilities has more than doubled in the past three years.

In 2006-7, 708 staff working for NHS trusts received private treatment at a cost of £279,000. Last year it increased to 1,641 at a cost of £828,413.

The health department defended the practice and said sending doctors, nurses and other key staff for private treatment helped to get them back to work.

“If trusts want to get their staff back to work more quickly they can’t jump NHS waiting lists, so going private is an option,” said the spokesman.

“There is evidence that early intervention in tackling sickness absence enables staff to return to work more quickly. Other benefits include: reducing the risk of chronic illness that could result in ill health retirement, cost-saving on temporary staff and having a positive impact on staff health and wellbeing and, in turn, patient satisfaction.”

The East Midlands ambulance service recently set up a contract with a private occupational healthcare specialist worth £300,000 a year. It has sent its staff to the specialist for vaccines, health screening and to deal with needle injuries and blood tests.

Other big spenders include the south east coast ambulance service, which has sent more than 800 staff for physiotherapy, osteopathy and counselling at a cost of more than £279,000 over three years.

Humber mental health trust has spent more than £47,000 on private counselling, even though it specialises in offering this service along with psychiatric help. A spokeswoman said staff would feel awkward being counselled by NHS colleagues.

“An appropriate and professional counselling and therapeutic service has to be free from any other existing pressures in respect of relationships and therefore cannot always be provided by an organisation,” she said.

“Staff may also be referred externally due to peak of demand to meet the need in a timely manner.”

West Suffolk hospital has spent £56,000 over the past three years on private treatment for staff but said it would no longer do so.

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http://www.timesonline.co.uk/tol/news/uk/health/article6879553.ece

The Care Quality Commission said that “alarm bells” should ring in the boardrooms of 47 of the country’s 392 NHS trusts, which have been persistently rated as either weak or fair.

“They must do better for their patients… It is clear that many have significant work to do and a short time in which to do it,” said Cynthia Bower, the commission’s chief executive.

From next April all NHS organisations must be registered with the CQC in order to treat patients.

Trusts will face tough tests on quality before they will be allowed to register.

From next year the regulator will have powers to demand improvements, to fine and prosecute trusts, suspend services and even close hospitals.

However, Barbara Young, the commission’s chairman, said that they did not want to force hospital closures.

“We don’t want to get to the last one, because quite frankly that raises the major question of when you get to that nuclear option, where do people get services?,” she said.

The MRSA Working Group, together with National Concern for Healthcare Infection and the Patients Association, is calling for the early discharge of patients from hospital to try and prevent a rise in the killer superbug.

They said when hospital bed occupancy rates were high, MRSA infection rates increased.

The group has written to all NHS hospital staff, reminding them to review their policy for the early discharge of MRSA patients.

The also urge hospitals not to let increasing pressure on staff and rising bed occupancy rates during winter to reverse the good work they have done to date to reduce MRSA rates.

Department of Health research has shown that when a hospital’s bed occupancy rate exceeds 90%, MRSA rates can be as much as 40% above average.

Dr Matthew Dryden, consultant microbiologist at the Royal Hampshire County Hospital and General Secretary of the British Society of Antimicrobial Chemotherapy, said: ”The NHS has been working really hard to plan for swine flu and ensure there will be enough hospital beds available for patients who need to be admitted.

”What we don’t want to see is an increase in infections such as MRSA, which have been linked to high bed occupancy rates.

”A way to get around this is to support patients with infections to get out of hospital earlier with outpatient and home care and good antibiotic stewardship.”

The letter to hospitals outlines methods to help ensure sufficient critical care beds are available this winter through identifying MRSA patients and discharging them early. Studies have shown that providing IV treatment at home or switching eligible patients to oral antibiotics could free-up scarce hospital beds by enabling patients who are well enough to go home earlier.

”When faced with a difficult winter, it is vital that hospitals ensure sufficient beds are available,” said Dr Dryden.

”Treating patients with infections such as MRSA at home can help by reducing their length of stay in hospital, freeing up much-needed beds and easing pressure on staff and resources.

”It also helps to improve a patient’s quality of life.”

Katherine Murphy of The Patients Association, who co-signed the letter, said: ”There is a real risk that swine flu patients may block isolation beds resulting in patients with healthcare infections such as MRSA being treated on general wards.

”This coupled with a highly pressured and reduced workforce, could increase the risk of infections such as MRSA spreading to other vulnerable patients and throughout the hospital.”

Neil Manser, of the NCHI, added: ”Where possible and when it is clinically prudent, patients who have been infected or colonised with infections such as MRSA should be treated in the safety and comfort of their own homes.

”Only then can we be sure we are doing our best to effectively contain the spread of infectious diseases such as MRSA and prevent further infection of hospital patients during any winter bed crisis period.”

Records were changed to claim patients were treated within four hours at the Queen’s Medical Centre, Nottingham.

A review found 765 records were amended between March and September.

The hospital previously said it met government targets of treating 98% of patients within four hours, but the review shows in reality it did not.

The actual figure is 97.4% rather than the published figure of 98.3%, which was based on the altered records.

‘Small number’

Officials are now looking back even further to see whether records from other periods were altered.

Dr Peter Homa, chief executive of Nottingham University Hospitals NHS Trust, said: “The scale of the problem relating to the inaccurate reporting of breach numbers remains unclear at this stage.

“However our initial review, which was initiated on Friday when this first came to our notice, indicates this involves a small number of patients.

“We would like to reassure our patients and the public that this has not in any way affected the standard of care our patients have received at our hospital.

Hazel Fenton, from East Sussex, is alive nine months after medics ruled she had only days to live, withdrew her antibiotics and denied her artificial feeding. The former school matron had been placed on a controversial care plan intended to ease the last days of dying patients.

Doctors say Fenton is an example of patients who have been condemned to death on the Liverpool care pathway plan. They argue that while it is suitable for patients who do have only days to live, it is being used more widely in the NHS, denying treatment to elderly patients who are not dying.

Fenton’s daughter, Christine Ball, who had been looking after her mother before she was admitted to the Conquest hospital in Hastings, East Sussex, on January 11, says she had to fight hospital staff for weeks before her mother was taken off the plan and given artificial feeding.

Ball, 42, from Robertsbridge, East Sussex, said: “My mother was going to be left to starve and dehydrate to death. It really is a subterfuge for legalised euthanasia of the elderly on the NHS. ”

Fenton was admitted to hospital suffering from pneumonia. Although Ball acknowledged that her mother was very ill she was astonished when a junior doctor told her she was going to be placed on the plan to “make her more comfortable” in her last days.

Ball insisted that her mother was not dying but her objections were ignored. A nurse even approached her to say: “What do you want done with your mother’s body?”

On January 19, Fenton’s 80th birthday, Ball says her mother was feeling better and chatting to her family, but it took another four days to persuade doctors to give her artificial feeding.

Fenton is now being looked after in a nursing home five minutes from where her daughter lives.

Peter Hargreaves, a consultant in palliative medicine, is concerned that other patients who could recover are left to die. He said: “As they are spreading out across the country, the training is getting probably more and more diluted.”

A spokesman for East Sussex Hospitals NHS Trust, said: “Patients’ needs are assessed before they are placed on the [plan]. Daily reviews are undertaken by clinicians whenever possible.”

In a separate case, the family of an 87-year-old woman say the plan is being used as a way of giving minimum care to dying patients.

Susan Budden, whose mother, Iris Griffin, from Norwich, died in a nursing home in July 2008 from a brain tumour, said: “When she was started on the [plan] her medication was withdrawn. As a result she became agitated and distressed.

“It would appear that the [plan] is . . . used purely as a protocol which can be ticked off to justify the management of a patient.”

Deborah Murphy, the national lead nurse for the care pathway, said: “If the education and training is not in place, the [plan] should not be used.” She said 3% of patients placed on the plan recovered. 

Sir Liam Donaldson said that from today hospitals would start vaccinating priority patients, such as people receiving cancer treatment, with the first deliveries to GPs for other at-risk groups including those with chronic conditions and pregnant women from October 26.

Sir Liam said that while overall rates of infection were rising slowly, and at similar rate to recent weeks, he was more concerned at the proportion of people ending up in critical care. Of the 364 patients currently in hospital, 74 are in critical care – the highest total in the pandemic so far.

The death toll also rose at a sharper rate, with 10 recorded in the last week, taking the UK total past 100. 

Patients are being encouraged to rate their GP surgeries on a new NHS website designed to drive up standards in primary care.

At www.nhs.uk, patients will be able to post comments ranging from how they were treated to whether it was easy to book an appointment.

But mentioning staff by name will not be allowed, say health officials.

The website will compare the 8,269 GP practices in England only.

The health minister Mike O’Brien said the website was part of plans to modernise the health service.

He said: “As we open up real choice in primary care, it is vital we equip patients with enough information to make the right choice for them. This new tool allows every single GP practice in the country to see the patient’s view on what they are doing well and what needs to be improved.

“It will help drive up quality across the board, and is another step in ensuring we have a modern NHS which reflects the needs of the patient,” he added.

There are 23 million visits to GP practices and related services every month.

In September, ministers announced they wanted to abolish GP boundaries, allowing patients to register with a practice of their choice.

Yet another similar site to compare the performance of hospitals is already up and running.

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The Royal College of Surgeons said, in a hard hitting report, that lives were being lost because patients had to be switched between up to four doctors every 24 hours, instead of being cared for by the same team round the clock.

Junior doctors used to work 80 hour weeks, staying on call at all times and sleeping in the hospital. Surgeons said this guaranteed continuity of treatment.

In August, EU rules were introduced limiting their working week to 48 hours. John Black, president of the college, said that, as a result, no doctor was monitoring patients for long enough to detect changes in their condition and vital medical details were being mislaid in a chain of “Chinese whispers”.

The surgeons claim that the rapid changes in shifts mean that nobody is taking personal responsibility for patients. One surgeon who responded to the survey said: “No rapport is built with the patient and no responsibility is assumed by the junior for the patient care. An unmitigated disaster.”

The college has compiled a dossier from ward reports by surgeons, laying out the scale of the problem. This weekend the college released details to The Sunday Times of a series of “avoidable deaths” that it claims were caused by the way in which the new limits on the working week have been implemented since August.

— In one case a patient died of a rupture in her bowel because information about an obstruction had not been passed on from one junior doctor to the next when they changed shifts;

— A patient died of a brain haemorrhage following surgery that should not have been carried out. Information about the patient’s medical condition had become confused in handovers between three specialist registrars — doctors at the grade below consultant level

— A patient died of cancer after requests for tests were not passed on. An x-ray had detected an abnormality in the patient’s liver but no doctor took responsibility for chasing up the tests, and the patient was discharged from hospital. The college concedes the patient might have died even if the tests had been done.

The college also cited a series of other, non-fatal, errors that it had discovered by surveying 900 surgeons. They reported that a patient wrongly underwent surgery for a broken bone because instructions from a consultant were not passed to surgeons on the next shifts.

Another patient missed an emergency operation for a hernia because her case was not handed to the next shift. The patient then became “lost” in the hospital and was not seen by doctors on ward rounds for three days.

More than half of consultant surgeons and 44% of surgeons of all grades believe the 48-hour week has been achieved at the expense of patient safety, the survey showed. 

A review into the NHS was ordered after the inquiry suggested that badly trained doctors were being employed to look after patients at nights and weekends.

Foreign doctors hired by care firms may not be able to speak good English and staff may be overworked as adequate checks are not being carried out, the commission’s report suggests.

The review, suggests that the NHS is only “scratching the surface” when looking at the quality of GP services outside normal hours, used by 9 million patients every year.

The inquiry was prompted by the case of David Gray, 70, a retired engineer who died after he was given 10 times the normal dose of diamorphine by a foreign GP employed by Take Care Now.

Mr Gray, of Cambridge, was treated for kidney pains by Dr Daniel Ubani, who had flown in from Germany and who admitted that he was tired when he made the fatal mistake. He has been convicted of causing Mr Gray’s death by negligence.

The commission’s report finds that the five NHS organisations that have used the Take Care Now company have not been monitoring the quality of the out-of-hours care. It says there are indications that it is a “widespread problem”.

The report also says Take Care Now has not been consistently referring patients who have suffered a suspected stroke to 999 services. Delays in treatment can lead to serious disabilities.

Cynthia Bower, the commission’s chief executive, said: “Primary Care Trusts need to reassure local people that they are commissioning good quality out-of-hours services.

“To do this they have to know what those services are doing. Our visits to the five trusts that commission Take Care Now’s services showed they are only scratching the surface in terms of how they are routinely monitoring the quality of out-of-hours services.

“We believe this may point towards a national problem.”

Take Care Now is employed by care trusts, in Worcestershire, Cambridgeshire, Suffolk, Great Yarmouth & Waveney, and South West Essex, covering more than two million people.

A detailed investigation will now examine the arrangements at the care company and a final report is due next year.

Campaigners say lessons have not been learned despite a series of high profile cases. They say out-of-hours care should be removed from private companies and handed back to GPs.

Katherine Murphy, the director of the Patients Association, asked: “Why do NHS managers need to be told that they should ensure out-of-hours care is safe? It is such a vital service, sometimes dealing with very vulnerable patients.

“There have been other cases where patients died when they received poor care from out-of-hours services. Why didn’t NHS managers act then? How many alarm bells need to ring before action is taken?”

Doctors’ out-of-hours services changed in 2004 with the introduction of a contract which offered them the chance to opt out of the service in return for an average drop in income of £6,000. In most cases, the trusts took over the commissioning of the services, employing private companies or co-operatives.

Prof Steve Field, the chairman of the Royal College of General Practitioners, said more family doctors needed to get involved in commissioning out-of-hours services.

“Out-of-hours provision is patchy,” he said. “Some PCTs are not effectively monitoring the performance of some providers.

“Providers need to ensure their doctors are competent to the level of UK trained graduates, have good English skills, are not over-tired after working long shifts and are orientated to the local conditions. What happened in Cambridgeshire was a tragedy and we need to ensure this never happens again.”

Two years ago Gordon Brown said NHS services at weekends needed to improve after the death of the journalist Penny Campbell, 41.

Miss Campbell died from blood poisoning in 2005 after consulting doctors employed by the out-of-hours provider Camidoc eight times over Easter weekend.

A report concluded there had been a “major systems failure”. Crucially, each doctor was not able to see the previous one’s notes. Miss Campbell’s partner Angus MacKinnon, a journalist from London, said yesterday that responsibility for out-of-hours services should be given back to GPs.

Mike O’Brien, the Health Minister, said: “PCTs have a legal responsibility to provide high quality, out-of-hours care and are required to have in place robust performance management arrangements to ensure their out-of-hours services are delivering against contractual requirements.”

Not that long ago we were queuing in the streets for an NHS dentist, with scenes of hundreds of patients camping overnight likened to the January sales. Now, new figures suggest that many of us have given up, and are paying for private treatment or simply going without care if we cannot afford it.

Data from the NHS Information Centre released last month shows that only 58.3 per cent of the population saw an NHS dentist in the two years ending March 2009, with the number of complex treatments, such as root canals and crowns, falling dramatically, by 40 and 50 per cent respectively, since 2004.

Ironically, the parlous state of NHS dentistry seems to have been exacerbated by the very attempt to overhaul it – labour’s 2006 dental contract.

The new contract was intended to end the old “drill-and-fill” practice whereby dentists were paid for each treatment they carried out, so the more procedures they undertook the higher their earnings. The idea behind the new contract was to encourage dentists to spend more time on preventative work, teaching patients how to care for their own teeth, thereby reducing future treatment.

Dentists are now paid a fixed contract value for the amount of work they do each year. Work is measured in UDAs (units of dental activity). Dentists now essentially have “UDA targets” to meet each year. Under the new contract, their salaries have not been cut as they had been in the early Nineties, which led to an exodus to the private sector. 

Health is one of only two budgets the Opposition has guaranteed would be spared the axe if it took power and Mr Lansley, the shadow health secretary, said reducing bureaucracy was the key.

Spiralling running costs of primary care trusts, the £1.94 billion-a-year price tag for health-related quangos and the bills for Whitehall and Strategic Health Authority operations would all face the squeeze.

At least £850 million would be saved by taking PCT and quango budgets back to the level of six years ago – at which point Labour already thought there were potential savings of £750 million according to their own calculations.

The Tories, meeting in Manchester for their annual conference, said those budgets were in direct control by ministers meaning they could give a ”concrete commitment to cut them by a third”.

Mr Lansley said further savings would be found by scrapping some Whitehall imposed targets and returning powers over budgets and out-of-hours care to GPs.

He backed an assessment by NHS chief executive David Nicholson that savings of between £15-20 billion needed to be found between 2011-14 but said the Tories would ”go much further in slashing wasteful bureaucracy in the NHS hierarchy”.

”Labour have made expensive commitments on the NHS with no price tag. In contrast, we are determined to identify how we will save money before we spend it.

”To make the NHS successful we must devolve decision making closer to patients. In doing so we’ll save substantial sums of money.

”The NHS must be well managed but that’s not expensive bureaucracy, it’s about lean and good-quality management.

”Labour has allowed wasteful spending on bureaucracy to spiral. A Conservative government would cut it right back. We are determined to shift NHS funds from the back office to doctors and nurses on the front line.”

GP practices which dispense medicines are almost entirely in rural areas and 3.5million patients, particularly the elderly, rely on them so they can see their doctor and collect their drugs in one trip.

However, the labour Government is now cutting the fee it pays to the surgery for each medicine it dispenses.

NHS Employers has announced that from October 1st the fee per medicine dispensed will drop from £2.14 to £1.95, leading to a drop in income of around £850 per month for the average dispensing practice.

Dr David Baker, chief executive of the Dispensing Doctors Association, said: “If something does not happen to protect surgeries there is a risk practices will struggle hugely and certainly some will have to cut services. If we cannot cover our costs there is a major problem.”

He said surgeries would try to continue dispensing because patients rely so heavily on the service but other things like branch surgeries or nurses would have to be cut.

There are around 1,500 dispensing practices in England and Wales out of around 8,500 in total.

It comes after plans announced by Andy Burnham, Health Secretary, to abolish GP catchment areas so people can visit surgeries near to their work, rather than their homes. There are fears this will lead to them losing their younger healthier patients to surgeries near where they work and leaving the older, sicker patients who are more expensive to care for.

Dr David Bailey, negotiator for the British Medical Association on behalf of dispensing doctors, said there was little choice but to accept the cut in fee and moves to correct the discounting problem will not be solved for some time, meaning dispensing doctors will suffer in the meantime.

He said: “It makes no sense to have a situation where it costs you money to privide a service to the NHS.

“In rural areas the dispensing side of the practice subsidises the GP surgery and if that subsidy is removed there is a diseconomy in running a rural practice. It will threaten small rural practices.”

An inquiry is due to be launched next year into the costs of GPs dispensing drugs which may lead to changes and doctors said it was unfortunate that the reduction in fees could not be put off until after that was concluded.

Officials have said the changes in the fee will mean the way funding for dispensing GPs is calculated will be brought into line with non-dispensing GPs.

Expectant mothers have been designated as one of the priority groups to be given the injection because they are more likely to develop complications if they do catch the virus.

There have been 66 deaths have been linked to swine flu in Britain since the outbreak began in April, including at least two pregnant women.

But almost half, 48 per cent, of pregnant women who responded to a poll by Mumsnet, the website, said that they would probably or definitely not have the jab once it is available.

Only six per cent said that they definitely would have the vaccine, while another 22 per cent said that they probably would.

The study also reveals that many women do not plan to have their children vaccinated.

In total 46 per cent of those with children aged under five said that they probably or definitely would not take their children to receive the vaccine.

Again small numbers said that they would definitely want their child to be vaccinated, just five per cent, while 22 per cent said that they probably would.

The labour Government has received the first batches of the vaccine but it is still being tested in scientific trials.

Regulatory agencies expect to have analysed the safety data and licensed the vaccine for use by October, at which point vaccinations can begin.

However, no decision has been made at this stage on whether everyone will be given the jab.

Officials have designated priority groups, including pregnant women, “at risk” children and adults with underlying health problems and healthcare workers who will receive the vaccine initially.

The poll follows claims that children vaccinated in the first weeks could be given a vaccine only tested on adults.

Doctors have also been ordered to monitor whether the vaccine triggers a neurological disease, called Guillain-Barré syndrome, which can be deadly.

However cases of a vaccine triggering the syndrome are very rare and the World Health Organisation insists that modern vaccines are extremely safe.

In total 1,458 people responded to the mumsnet poll, including 562 pregnant women.

Mumsnet suggested that the fact that many cases of swine flu had so far been mild meant that many people were unconcerned about catching the disease.

However, the organisation also warned that the Government faces an uphill task convincing the majority of pregnant women to take the jab.

The organisation warned that many seemed more worried about the vaccine than the virus that it was designed to combat.

“It’s obvious from these results and from discussions about this on Mumsnet.com that lots of mums and mums-to be are questioning whether or not to have the swine flu vaccine or give the vaccine to their children,” said Carrie Longton, one of the founders of the website.

“Some are worried about how well it’s been tested, others about its effectiveness and side-effects. Everyone wants to do the best for their child or unborn child, but many parents seem, from our poll, to be more anxious about the safety of the vaccine than they do about catching swine flu.”

But England’s top nurse insisted that the vaccine would undergo thorough safety checks before it was used.

Christine Beasley, the Chief Nursing Officer, said: “Vaccination offers the best protection against swine flu and will be carefully assessed for safety.

“Strict processes are in place for licensing pandemic vaccines and it will not start to be used on anyone, including pregnant women, until a license has been granted.”

She added: “”Pregnant women are a top priority for vaccination because they are more at risk of complications from swine flu.”

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A report from the National Patient Safety Agency (NPSA) found a “significant” rise in the number of errors and near misses reported by NHS staff in England and Wales, including cases of avoidable deaths or serious harm.

More than 86,000 such incidents reported in 2007, compared with 64,678 in 2006 and 36,335 in 2005, the agency said.

In 96 per cent of cases, the incidents caused “no or low harm” to NHS patients, but at least 100 were known to have resulted in serious harm or death.

Martin Fletcher, the agency’s chief executive, said the increase in the figures reflected a willingness by NHS staff to report errors and a more open reporting culture.

The figures are still thought to be a vast underestimate of the incidents involving the prescription or administration of medicines.

Professor David Cousins, a senior pharmacist at the NPSA, said it was well known that only about 10 per cent of incidents were reported in most voluntary systems around the world, including Britain.

This suggests there were as many as 860,000 errors or near misses involving medicines across the NHS in 2007.

Most of the errors (82 per cent) were made in the administration or dispensing of the medicines by nurses or pharmacists, rather than in the prescription of drugs by doctors.

The report listed the top five medication errors in the NHS in England and Wales as people being given wrong doses; medicines being missed or delayed; patients being given the wrong drug; the wrong quantity (such as too much chemotherapy), or mismatching, where patient A’s medicine is given to patient B.

Examples include an anticoagulant drug given in error to a patient with a similar name, a strong sedative given to a patient instead of insulin, and heart medicine given instead of an anti-inflammatory. One patient was reported to have received 100mg of morphine instead of 10mg.

The report comes after The Times revealed new guidance from medical regulators to ensure that undergraduate medical students receive more “hands-on” experience of working in hospitals and clinics before they graduate.

The NPSA’s figures are from reports filed by NHS staff in hospital trusts, mental health trusts and in primary care. Nearly three quarters (74 per cent) of the incidents reported in 2007 were in relation to hospital care, but the agency noted that primary care services, such as GPs and community nurses, needed to improve their reporting rates.

The NPSA is in charge of monitoring and helping to reduce patient safety incidents across the NHS. It releases rapid response alerts where particular problems are noted, such as the risk of overdoses with particular medicines.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article6820090.ece

The doctor’s regulatory body, the General Medical Council (GMC), says even cases involving children with apparently accidental cuts should be reported. Currently, medics are only required to pass on to police details of patients with gunshot wounds.

Dr Henrietta Campbell, who chaired the GMC’s working group on confidentiality, which issued the guidelines, said: “Confidentiality is central to trust between patients and doctors, but it is still an area of ethics which challenges doctors more than any other.

“We are not asking doctors to force patients to speak to the police, but we are asking them to pass on information which will help the police protect patients, the public and staff from risks of serious harm.”

“There are occasions when disclosure of certain information may be justified, even if the patient refuses to consent.”

The guidelines will also say that patients with inherited conditions who want to keep their condition secret can be overruled. “Doctors should explain to a patient if their family might be at risk of inheriting a condition,” Dr Campbell added. “However, if a person refuses, it is the doctor’s responsibility to protect those who may be at risk.”

Doctors will also be advised to pass on patient details to other bodies, such as telling the Driver and Vehicle Licensing Agency if a patient is not fit to drive, or passing on information relating to benefit claims.