Half were diagnosed late, increasing the risk of an early death from Aids.

Among younger age groups, a third have the HIV infection identified at a similar level of progression.

During the study period, three quarters of deaths among HIV-infected people aged 50 and over occurred within a year of diagnosis.

Compared with younger adults carrying the virus, older people were significantly more likely to have been infected through sex with men.

Older “straight” adults were more likely to acquire the virus in the UK, but there was evidence of white heterosexual men picking up the infection abroad.

Ruth Smith, a senior HIV scientist at the Health Protection Agency’s Centre for Infections, said: “We estimate that nearly half of older adults diagnosed between 2000 and 2007 were infected at age 50 or over and this highlights the importance of HIV testing – whatever your age.

“We must continually reinforce the safe sex message – using a condom with all new or casual partners is the surest way to ensure people do not become infected with a serious sexually transmitted infection such as HIV.”

The findings are published online in the journal AIDS and were presented today at the International Aids Conference in Vienna.

HPA data shows there are more than 83,000 people in the UK living with HIV, a quarter of whom do not know they are infected.

In 2008 there were 7,382 new HIV diagnoses in the UK with an estimated 32% over the age of 15 being diagnosed late.

A late diagnosis of HIV infection is defined as having a CD4 white blood cell count of less than 200 cells per cubic millimetre of blood. Healthy individuals have CD4 counts of 500 and above.

CD4 cells are a key part of the immune system. When their numbers fall too low, a person becomes vulnerable to infection.

Study co-author Valerie Delpech, head of HIV surveillance at the HPA, said: “Although adults aged 50 and over account for just 8% of all new HIV diagnoses, the fact that cases have more than doubled in recent years serves as a timely reminder that anybody is at risk of HIV infection if they do not use protection and practise safe sex.

“HIV remains a serious infection particularly when diagnosed late. The fact that we’ve seen an increase in the number of older adults getting diagnosed, and in particular getting diagnosed late, highlights the need for raised awareness in that age group.”

“Medical guidelines issued in 2008 encouraged widespread testing in areas where there is a high prevalence of HIV and the HPA fully supports any NHS or charity organisation initiative which will encourage increased testing and increased offering of testing across the UK.”

From: http://www.independent.co.uk/hiv-infection-rate-in-over-50s-doubles

A US health insurance company that recently won a multimillion-pound contract to advise primary care trusts (PCTs), has reported a surge in profits over the last three months.

UnitedHealth Group, which also operates five GP practices in Derbyshire and London, reported second-quarter profits climbed 30% on the same quarter a year ago to $1.1bn (£720m) on turnover of $23bn.

The stock market-listed firm said the bulk of its growth came in the United States after it signed up more members for the government-backed Medicare and Medicaid policies.

The company signed a contract with the Department of Health last month to advise PCTs on commissioning ahead of reforms that will give GPs the lion’s share of the NHS budget.

PCTs directly run GP practices and offer contracts to self-employed GP doctors and private firms to operate independent practices. GPs will be in charge of £90bn of the health budget under plans put forward by the health secretary, Andrew Lansley.

UnitedHealth will use its experience of private healthcare to bring efficiencies to the bidding processes.

US unions have complained about the company, which has come under fire for malpractice. In 2008, its former boss William McGuire was banned as a director and forced to repay $468m following a scandal related to backdated stock options.

In January the company agreed to pay $350m to settle a case brought by the New York attorney general, Andrew Cuomo, who accused the firm of boosting profits by artificially depressing insurance repayments to customers.

The company based repayments on “independent” assessments by a company called Ingenix, which was a subsidiary of UnitedHealth.

The company is based in Minnesota, from where it has grown to be the largest health insurer by sales in the US. The company, which has more than 50,000 staff and 60 million health plan customers, is expected to have annual revenues in excess of $80bn this year.

From: http://www.guardian.co.uk/business/2010/jul/20/nhs-health-firm-profits-surge

She was told not to work too hard. She would sit in meetings where the same things were discussed repeatedly without any decision being made. She was taken aside by a colleague when she attempted to improve efficiency and asked if she wanted to make everyone unemployed. It was shortly after this incident that she walked out.

All this was particularly galling to me at the time. I was working on a ward for elderly patients with dementia, and the ward didn’t even have its own resuscitation equipment. Instead, the clinical staff had to beg, borrow or steal from other wards. The amount of fruit that patients were given at lunchtime was cut.

I would sit in outpatient clinics and have to tell the families of people with Alzheimer’s that I wasn’t allowed to prescribe the anti-dementia drugs for their loved ones because the government had decreed that at £2.50 a day, they were too costly.

Frontline NHS staff look at the legions of paper-pushers in their offices and wring their hands in despair. Something needs to be done to prune this stratum in the health service, and last week there were the first signs that this might happen.

The Coalition government’s recent plans to improve the NHS will see PCTs and strategic health authorities scrapped. This is a bold move. In recent years, these organisations have morphed into unwieldy bodies that do little more than provide jobs for people who have no hard clinical skills, but who couldn’t quite hack it in the corporate sector.

While these organisations have responsibility for patient care, they are distant and detached, and it is difficult to see how they contribute in any meaningful way to the day-to-day care of patients. Yet, they cost millions to maintain. A report published last week found that more than 300 NHS executives have salaries larger than the Prime Minister.

Ian Miller, for example, worked as the interim director of finance and investment for South East Coast Strategic Health Authority and earned £310,000 for nine months’ work from April 2009 to January 2010. This equates to £400,000 a year, which would pay for 14 nurses. Financial experts have described these salaries as “unsustainable”.

The plans are not without potential pitfalls: will GPs, for example, be able to manage such large budgets effectively? But I wholeheartedly support the essence of these proposals, which is that pointless and costly bureaucracy and ludicrous management salaries have no place in this era of austerity.

I also believe that giving power to clinicians will benefit patients. It’s doctors and nurses who have a far greater understanding of what is needed and where resources should be directed than a person with an MBA sitting in an office well away from the action.

My friend, who is now a successful corporate lawyer, says that if the NHS wants to operate along corporate lines, it needs to heed corporate principles: no business would employ so many people who don’t do what the business is set up to do – namely to treat patients.

I hope the Government’s proposals address this once and for all, and that patients and those who care for them are put back at the centre of the NHS.

From: http://www.telegraph.co.uk/health/7895365/Banishing-the-NHS-paper-pushers.html

Milton Keynes General Hospital has been heavily criticised over shortages of beds and midwives following the deaths of baby girls Romy Feast and Ebony McCall.

Yesterday, its maternity unit faced fresh scrutiny after an inquest found Alex Broughton died within a day of being born after staff failed to recognise a problem with his heart.

Thomas Osborne, deputy coroner for Milton Keynes, said by failing to recognise the baby’s deteriorating heart condition during birth, staff “lost an opportunity” to speed up delivery and treat him.

The child suffered severe brain damage during birth and died on December 3 last year after being moved to a specialist unit at the John Radcliffe Hospital in Oxford.

Mr Osborne said the way Alex’s heart was monitored was a “major area of concern”.

He said: “The monitoring of his fetal heart rate during delivery failed to recognise his deteriorating condition prior to his birth and thus failed to trigger any concern for his well being that resulted in a lost opportunity to expedite his delivery and render further medical treatment.”

The coroner added that there had been conflicting evidence about how a midwife had monitored Alex’s heart rate.

He said an Oxford medical student observing the birth had given “surprising and unhelpful” evidence by saying that he could not recall what monitoring method had been used.

The inquest also heard that Alex’s parents, Lorna Howell and Matthew Broughton, received a hospital “birth congratulations” letter on the day Alex died.

Speaking after the hearing, Alex’s grandfather, Alan Broughton, branded the treatment as “a disgrace”. He added: “It would seem that serious problems continue to exist in the maternity unit.”

The criticisms are the latest in a string of scandals to hit the Buckinghamshire maternity unit in recent years.

Last year, Mr Osborne complained that midwife shortages were “nothing short of scandalous” after the death of Ebony McCall on an overstretched maternity ward.

An inquest heard that Ebony would probably have survived, had her mother, Amanda, been given a caesarean section when she asked for one. But staff were too busy and told her they would only carry out the procedure in an emergency, the inquest heard.

The scandal came despite having already been investigated over the death of Romy Feast in the same unit in 2007, who died after her heart condition was misinterpreted. Following the inquest into Romy’s death, Mr Osborne reported the hospital to the Department of Health, which prompted an investigation by the Healthcare Commission.

Earlier this year, the Care Quality Commission, the health watchdog, issued a damning report saying its maternity unit still had too few midwives and beds.

In March, Monitor, the independent regulator of NHS foundation trusts, intervened by sending in a team of clinical advisers to ensure that services are improved.

The hospital yesterday said the circumstances surrounding deaths of the two girls and Alex had been different and added that there was “nothing to suggest that any aspect of treatment or management (of Alex) … was in any material sense deficient”.

A spokeswoman for Milton Keynes NHS Foundation Trust said: “After the death of Ebony McCall and Romy Feast, we accepted mistakes had been made and we have been making significant improvements to our maternity services over the last year.

“While equally tragic, the circumstances around the death of Alexander Broughton were very different. His mother was given one-to-one care by a qualified midwife and appropriate procedures were followed.”

From: http://www.telegraph.co.uk/Coroner-condemns-maternity-unit-after-death-of-third-baby

The NHS is suffering potentially devastating cuts to jobs and patient services as the Government’s austerity drive hits the health service, doctors’ leaders have warned.

Despite ministers’ assurances that the health service would not face the same cuts as other departments, many hospitals are feeling the strain, according to the BMA.

Andrew Lansley, the Health Secretary, has boasted that frontline services would be protected. But it emerged yesterday that in his Cambridge constituency, Addenbrooke’s Hospital is planning to sack 170 nurses and up to 500 staff in total over the next year.

A survey for the BMA asked 361 doctors, who between them represent committees at all of Britain’s hospital trusts and some larger primary care trusts, how the NHS was being affected by the demand to make £20billion of cuts.

It comes as the Coalition faces political pressure to reverse its pledge to ring-fence health spending.

The BMA found that 43 per cent of those who responded said there was a freeze on recruiting doctors and nurses at their trust. Almost as many, 40 per cent, said that patient treatments, including varicose vein operations and blood tests, were being rationed.

GPs in Bedfordshire said they had been told not to refer patients with certain conditions, such as skin lesions and cysts, to hospitals except in exceptional circumstances.

Nearly a quarter of those who responded said that their trust was planning to make workers redundant. Although the majority of these would not affect frontline staff, the union warned that cuts to administrative workers could force doctors and nurses to spend more time on these duties and less time with patients.

The poll – to which 92 doctors responded – represents the first real evidence of how the NHS has been hit by the cuts. It found trusts were trying to make annual savings of six per cent on average. The Government has promised to guarantee NHS spending growth in real terms but the BMA says this will be “minimal”. The association called the cuts potentially “devastating”.

Dr Hamish Meldrum, the chairman of the BMA, said: “Whilst we accept that difficult decisions need to be taken in this tight financial climate, there is a real danger that cutting back on health now will have a long-lasting impact on our ability to maintain high-quality, comprehensive and universal care in the future.”

The warning came as senior Tories broke ranks to object to plans to protect health service funding.

Lord Lawson, the former Chancellor, and Nadine Dorries, a Tory member of the Commons health select committee, said that health funding should not be ring-fenced.

Ms Dorries told the BBC’s Politics Show: “I think we need to find the political courage to accept that there is excessive waste in the NHS and that it’s unfair to expect other departments to take all the hits.”

The Royal College of Nursing said earlier this year that about 5,600 jobs were under threat across 26 hospital trusts. In a “worst case scenario”, the true figure could be as high as 30,000, it said.

A spokesman for the Department of Health said: “Alongside all the public services, the NHS will need to deliver significant savings over the coming years.

“The department is very clear that savings should be implemented in a way that does not affect the quality of services and the Secretary of State has been very clear that every penny saved will be reinvested back into patient care.”

From: http://www.telegraph.co.uk/NHS-suffering-devastating-cuts-to-jobs-and-services-warns-BMA

Anthrax-related heroin deaths are extremely rare, and in the past were unheard of in the UK. There has been only one known previous outbreak among heroin users, and that took place in Norway in 2000.

The vast majority of the deaths in this new outbreak have occurred in Scotland, predominantly in Glasgow. Several heroin users have also contracted anthrax poisoning in England, and so far one person has died. There has also been one fatality in Germany and nine in Portugal, although the cause of these deaths is disputed.

Drugs counsellors have told the guardian of their frustration that, as the crisis mounted, they were unable to help worried addicts switch to alternative drugs, such as methadone, because of lengthy waiting lists.

“Often, if we have a health scare among drug users, the advice we give is to use drugs in safer ways. For instance with HIV, we encouraged people to use needle exchanges,” said Gareth Balmer, project manager of Addaction Dundee, a support centre. “But this time around, the message we were getting from government was to tell people to stop using heroin, which was as much use as a chocolate teapot.

“If we could have got people access to methadone or Subutex [another heroin substitute] very quickly, it wouldn’t have been a ridiculous message, but we were looking at six-month waiting lists and, in some parts of Scotland, a year.” Balmer said the situation had “brought home how behind we are in helping people access that treatment”.

“Heroin users don’t use heroin for fun; it’s a physical and psychological dependency. We have a constant supply of people who would like to access methadone, but we felt as drug workers it was insulting people to say: ‘There’s possibly anthrax in your heroin; my advice is to stop using.’ I was surprised I didn’t get punched in the face.”

Anthrax infection can be cured if treated early enough. Common signs of infection are redness and swelling around the injection area. The scale of the outbreak is still being assessed, with checks being conducted at the top-secret Porton Down laboratory in Wiltshire, where biological and chemical weapons are tested.

How the anthrax found its way into the heroin is still open to question. Some addicts claimed it was part of a plot by shadowy government agencies to rid the country of drug users. Others speculated that it was the work of the Taliban, who control opium production in Afghanistan, where more than 90% of the UK’s heroin comes from.

However, guidance issued to investigating police officers, states that there are two likely causes: “Heroin could be naturally contaminated after harvesting from contact with soil in an area where an animal had died from anthrax at some point, or by being stored or transported in contact with animal products, especially skins, from an animal that had died from anthrax,” the guidance states.

“The second option is that the heroin was contaminated at some stage during the cutting process… Of feasible agents, animal products are the most likely, and of these, bone meal would be suitable for cutting and has been associated with cases of cutaneous anthrax in people handling it in the past.”

But despite the unprecedented number of deaths, the issue has been largely ignored. “Media indifference on this issue, considering the number of fatalities that have occurred, has been disappointing, but not surprising,” said Martin Barnes, chief executive of DrugScope, an organisation that tracks trends in drug use. “These people are stigmatised and demonised. There is a feeling they are blameworthy and less deserving of public concern and attention.”

The deaths have refocused attention on the 300,000 heroin users in the UK, around 2% of whom will die this year as a result of their drug use. They have drawn comparisons with an earlier health crisis that plagued the addict community when a batch of heroin was infected with botulism.

Experts note that the price of heroin has fallen significantly in the past year, possibly as a result of bumper harvests in Afghanistan. Currently a £10 bag sold on the streets of Glasgow will contain 0.2g of heroin, compared with 0.1g a year ago – although prices have started to rise again as larger quantities of the drug are diverted to China and eastern Europe.

Balmer warned that the crisis could yet reignite. “Our worry is that the infected heroin will be buried somewhere until the heat dies down. It happened with the botulism scare. Somebody could still be holding on to it until we’ve all forgotten about it.”

From: http://www.guardian.co.uk/society/2010/jul/11/anthrax-heroin-deaths

The NAO says this means that from 1995-97 to 2006-08 the life expectancy gap grew by 7% for men and 14% for women.

It is calling for more investment to help GPs tackle problems like smoking and poor diet in poor communities.

The NAO says the figures mean a Labour government target to reduce the difference in life expectancy by 10% by 2010 is unlikely to be met.

Its report says it is not possible to show how much money has been spent on tackling health inequalities, as primary care trusts (PCTs) are not allocated specific funding for the task.

But it says that at present the system “does not provide enough of an incentive” to encourage family doctors to focus on the neediest groups in their practices.

The report says it would not cost “a large amount of money” – £24m a year – to take key actions which would improve health in deprived areas.

These include increasing the prescribing of drugs to reduce cholesterol and control blood pressure, and doubling the capacity of services which help people quit smoking.

The report contrasts that amount with the £3.9bn spent by PCTs in the poorest areas on treating circulatory and respiratory illness.

Life expectancy for everyone in England improved under Labour, and now stands at almost 78 years for men and 82 years for women.
MORTALITY RATES FELL SLOWEST IN THE PRIMARY CARE TRUSTS OF:
* Salford
* Bolton
* Middlesbrough
* Blackburn with Darwen
* Hartlepool
* Bradford
* Oldham
* Nottingham City
* Sandwell
* Ashton, Leigh and Wigan
* Leicester City
* Hull
* Blackpool

But the improvement rate has been slower in the most deprived communities, and currently the equivalent figures are 75.8 years for men and 80.4 years for women.

Analysis also showed that success rates in stop-smoking programmes were lower in the poorest communities than in other areas.

A spokesman for the British Medical Association, which has just concluded its annual conference, said: “We are disappointed that today’s report says that the Department of Health will not meet its target to reduce the health inequalities gap.

“At our meeting, the BMA passed a motion calling on the government to increase expenditure on prevention services to reduce health inequalities.

“It is particularly important to do this in early years to give every child the best start in life. We will also lobby for fiscal policies to narrow the income gap between the poorest and the richest in society. Doctors believe it is necessary to take this action to tackle health inequalities.”

From: http://news.bbc.co.uk/1/hi/health/10475835.stm

GPs say there is already a breakdown in communication with health visitors who work in the centres, and placing more there would make it worse.

But children’s charities say parents need a more informal approach.

Health visitors have usually worked out of GPs’ surgeries – but the growth of Sure Start children’s centres has seen more moving to them.

The children’s charity 4children says having health visitors based in these centres means there is less need for mothers to use GPs’ surgeries for non-urgent problems and advice.

The Royal College of GPs says its members are seeing a worrying pattern developing, where vital information is not being passed back to them.

It says GPs need to be more actively involved in the the care of mothers during and after their pregnancy, and health visitors have to link in more with GP practices.

Professor Steve Fields of the Royal College of GPs said: “Mums-to-be are not getting the service they could have had five or 10 years ago.

“It is an unintended consequence of children’s centres being established and health visitors moving out of GPs’ surgeries and GPs not being as actively involved the care of mums-to-be during their pregnancy.

From: http://news.bbc.co.uk/1/hi/uk/10423346.stm

It said a rise in patients who spent a day or less in hospital suggested many admissions could be avoided. NHS managers agreed action was needed to tackle the problem.

Emergency admissions include patients admitted through A&E units as well as direct into other parts of hospitals.
Ageing population

The think tank, which analysed a range of official NHS data during its research, found emergency admissions now accounted for more than a third of the total.

The rise seen since 2004-05 is costing the NHS an extra £330m a year alone and the think tank said the issue had to be a priority if the NHS was to prosper in the current economic climate.

Researchers found there was a range of factors behind the trend.

They pointed to the ageing population – the elderly were more likely to be admitted as an emergency – as well as financial incentives in the NHS which were motivating hospitals to admit more.

The report also noted there had been a significant jump in patients being admitted for one day or less.

It said this was partly related to advances in medicine which meant patients did not need to spend as long in hospital, but argued many could have been avoided with better community services.

While the report only looked in detail at the situation in England, it also noted rises had been seen elsewhere in the UK.

And it said the recent announcement by ministers that hospitals would be fined for readmissions would only have a limited impact as many of the cases did not fall into that category.

Nuffield Trust director Dr Jennifer Dixon said: “Reversing this unsustainable rise in emergency admissions must be the number one priority for the NHS – any reform to the health service that does not tackle this will fail. Our hospitals are overheating and are treating patients at great cost to the NHS.”

Nigel Edwards, acting chief executive of the NHS Confederation, which represents managers, said: “This report furthers the case for fundamentally reviewing the urgent and emergency care system.

“Hospital is often the right place for sick patients to be but we know that for many there are better, more convenient and more cost-effective alternatives to hospital admission.

Dr John Heyworth, president of the College of Emergency Medicine agreed there were pressures in the system, but questioned some aspects of the research.

“It is fundamentally incorrect to assume that admissions for less than 24 hours are unnecessary or financially inefficient. In fact, the opposite applies.”

From: http://news.bbc.co.uk/1/hi/health/10490508.stm

Sharmila Chowdhury, 51, the radiology service manager at Ealing Hospital NHS Trust, repeatedly warned the hospital’s most senior managers that doctors were dishonestly claiming thousands of pounds every month.

A Watford employment tribunal judge took the unusual step last week of ordering the trust to reinstate Ms Chowdhury’s full salary and said: “I have no hesitation in saying that you are probably going to win.”

The ruling will be a bitter blow for the trust, particularly as despite the seriousness of the allegations, it failed for two years to take any action against Miranda Harvie and Peter Schnatterback, the two doctors accused of fraud at the hearing.

Instead, Ms Chowdhury was suspended after a counter-allegation of fraud made against her by a junior whom she had reported for breaching patient safety. Radiographer Michael McWha made the allegation at the request of Dr Harvie, the tribunal heard. Ms Chowdhury was sacked for gross misconduct in June, eight months after her suspension.

This case is the latest to highlight the inadequate legal protection for whistleblowers who speak out about wrongdoing in the NHS.

It also raises the uncomfortable question about the power yielded in the NHS by senior doctors. The onus is now on the trust to prove at next February’s tribunal that Ms Chowdhury was guilty of fraud and not, as she claims, sacked because she was a whistleblower.

Speaking after the judgment, a tearful Ms Chowdhury expressed her relief after months of financial hardship. A widow with a teenage son, Ms Chowdhury has been forced to move back in with her elderly parents and rely on the goodwill of outraged lawyers.

She told The Independent on Sunday: “I cannot believe what has happened to me. I was horrified and humiliated when escorted out of the building, and for a whole month, I had no idea why I was suspended. I was just doing my job. I thought the trust would want to know consultants were doing private work on NHS time. The public has a right to know what is happening with public money.

“This whole thing has completely changed me. I’m trying to stay positive but I loved my work, my department, and there are not many jobs out there. I hope the trust sees sense and tries to resolve the situation. If it hadn’t been for Julie Morris at Russell Jones and Walker who took on my case for free, I would have lost everything I’d worked for all my life.”

Ms Chowdhury qualified as a radiographer at Hammersmith Hospital in 1983. She worked her way up the management chain before starting as Ealing’s deputy imaging manager in 2003.

The alleged fraud came to her attention after starting as service manager is 2007. It was her job to balance the books, report all staff absences and make sure X-rays, CT and MRI scans were of a high quality.

But in addition, she had a separate informal agreement with the trust to read X-rays, for which she was paid £2 per report. She did this every morning and would then work through lunch to complete her normal duties.

Mr McWha alleged that Ms Chowdhury was carrying out this extra work fraudulently. He did so after Ms Chowdhury launched an investigation upon discovering his failure to upload reports and scans from 100 patients on to the imaging system, which may have caused delays in diagnosing life-threatening conditions.

The trust admitted during the disciplinary hearing that it had failed to find any evidence to support his claim. But Ms Chowdhury was sacked for gross misconduct anyway, in order to placate the consultants who were fed up with Ms Chowdhury’s interference in their business, the tribunal heard.

From July 2007 onwards she had informed managers that Dr Harvie was being paid for 14 half-day sessions a week when she was working only seven. Evidence that Dr Harvie and Dr Schnatterback were working alternate Mondays at the Clementine Churchill Hospital in Harrow, while being paid to be at Ealing, was passed on. Dr Schnatterback also claimed £250 for evening sessions when his private commitments led to an NHS backlog, the tribunal heard. Frustrated by the trust’s apparent refusal to tackle the consultants, Ms Chowdhury wrote to the NHS Counter Fraud service in July 2009. Nothing happened.

Weeks before her suspension, she angered several consultants after reporting them for claiming four hours of overtime when working only three.

Reports of duplicate claims and extra annual leave days were also made. All these protected disclosures were made to the finance director in October 2009, who referred the issue to the trust’s fraud officer. He interviewed Ms Chowdhury in November 2009; days later she was suspended.

Ms Chowdhury’s barristers, Helen Mountfield QC and James Laddie from Matrix Chambers, suggested that the case illustrated the “long-established tradition in the NHS of power being wielded by consultants”.

In defence, Andrew Sharland, said: “This claim that there was some kind of grand conspiracy is unlikely to stand up. Ms Chowdhury is making very serious allegations against senior NHS consultants. This shows an extreme prejudice towards the NHS and towards the senior consultants.”

The trust said it was unable to comment on confidential matters relating to individual employees. Dr Schnatterback told the IoS that his twice-monthly private sessions were always approved by the clinical director and he did more NHS work than he was paid for. Dr Harvie denied the allegations. Mr McWha refused to comment.

Ms Chowdhury’s lawyers told the hearing: “The stated reason for dismissal is scandalous. It does not even survive the briefest scrutiny. This is not a mistake – it is a sham.”

The judge awarded her full pay until the hearing begins in February, including pay for the work which the trust claims was fraudulently completed.

Andrew Lansley, Secretary of State for Health, said last week the Government had plans to give the current legislation “more teeth”. It can’t come soon enough.

From: http://www.independent.co.uk/life-style/health-and-families/health-news/sacked-nhs-whistleblower-vindicated-2023809.html

In one sense it aims to complete the work of the last Conservative government – and much that the Blairites also wanted for the health service. The last Tory government tried to free NHS hospitals from direct management by health authorities.

It aimed to get GPs to buy patient care. And it briefly attempted to absolve ministers from responsibility for the day-to-day management of the NHS by creating a short-lived ministerial supervisory board with an NHS executive beneath it.

But it rapidly got cold feet over the likely impact of the quasi-market it had created, fearing the destruction it would cause would be anything but creative.

Labour, having first ditched much of this, recreated it earlier in the decade in a far more sophisticated form – with independent regulation and inspection and a tariff for NHS care that, in theory at least, encouraged purchasers to put quality above price.

It never quite sorted out who should do the purchasing – primary care trusts or GPs, who have been running a form of practice-based commissioning that, in most places, has been severely constrained.

But had the Blairite plans come to fruition, the purchasing of care would by now have been separated from its provision. All hospitals by 2008 would have been self-governing institutions, positioned part way between the public and private sectors.

Primary care trusts would have been solely commissioners, while their district nursing teams and therapists and community hospitals would now be independently run, either on a foundation trust model, or as social enterprises, or contracted out to the private and voluntary sectors.

There would also have been a more vibrant public/private/voluntary market from which purchasers could buy all sorts of care, with patients being able to choose between them.

What Labour – or more accurately Tony Blair and Alan Milburn, then health secretary – wanted is what Mr Lansley now aspires to create: a self-improving system run as a regulated market of competing providers driven by patient choice and commissioning in a way that no longer needs direct management from politicians and the health department.

From there, the step to an independent commissioning board, with ministers doing little other than continuing to raise the money for the NHS, setting its broad priorities, and then holding the board to account, would have been seen as an interesting evolution, not a revolution.

But the NHS is a long way from that. The Blairite reforms first slowed, then under Gordon Brown, pretty much stalled.

Half of hospitals are still directly managed and a chunk will never pass the financial viability test to become foundation trusts. PCT provider arms have still to be sorted out. Social enterprise in the NHS barely exists. Private suppliers have yet to demonstrate convincingly that they can consistently do things better and more cheaply than the NHS. And the best GP commissioners are still relative beginners.

Yet in a dirigiste decision that smacks more of old Labour central direction than anything else, the Conservative health secretary has decided not to allow GP commissioning to evolve into something demonstrably strong and effective but to require that all GPs – whether willing or not – do the job or acquiesce in their colleagues doing it for them. All in one big bang.

Mr Lansley’s plans amount to an NHS revolution. Virtually no part of the service will be untouched by his announcements on Monday, which aim, in barely three years, not just to complete Labour’s unfinished business but to go much further.

Issues Labour grappled with unsuccessfully, however, remain unanswered.

What, for instance, are the failure regimes for the new arrangements? And thousands of managers whose jobs are to go are expected to retain financial control throughout the upheaval while helping GPs take on their new role. The odds are many will bail out while they have the chance.

As Sir David Nicholson, the NHS chief executive, said on Monday: “The clarity of the vision is all very well. The big issue is how do we manage the transition.” With immense difficulty, is the answer. Mr Lansley, a man with a plan in a hurry, risks losing both financial control and performance.

From: http://www.ft.com/cms/s/0/7f3bc0e4-8def-11df-9153-00144feab49a.html

To get foundation trust legislation through parliament in 2003, ministers agreed to a cap on private work to ensure the hospitals remained true to their NHS traditions.

This has stopped some of the leading hospitals in the NHS competing with private firms for patients.

But that will now change under the proposals unveiled in Monday’s white paper. Health Secretary Andrew Lansley said he wanted to create a “vibrant” industry of social enterprises by scrapping the rule and ordering all NHS trusts to become foundation trusts within three years.

Sue Slipman, director of the Foundation Trust Network, said the move would make a big difference.

“It is exciting for foundation trusts. We will have to wait to see what exactly happens, but there are huge opportunities to innovate.”

She said one of the most obvious areas for expansion would be in fertility services where treatment on the NHS is severely restricted.

“In the past these patients have had their NHS cycles and then left for private treatment. That is money that has been lost to the system.”

She also said mental health trusts may be interested in offering talking therapies to businesses for their workforce health schemes.

University College Hospital in London has already gone down this route with a private US health firm which has located a private unit on its site for cancer treatment.

The firm leases the space as well as paying for the NHS services it uses, such as intensive care, radiology and cleaning and catering.

The trust has also established a joint venture with a private firm to provide pathology services.

Sir Robert Naylor, the chief executive of the trust, said: “These initiatives bring in money which can then be reinvested in NHS services.”

Many NHS hospitals also operate their own private wings, although most of these only bring in a small amount of income. The exceptions are specialist centres such as the Royal Marsden cancer hospitals and Moorfield Eye Hospital.

But John Lister, of the union-funded pressure group Health Emergency, said he had concerns.

“Hospitals could overstretch themselves in chasing private patients which in turn takes away from the NHS side of it.  It also creates perverse incentives whereby they stand to make more money by getting patients into their private wings.

“They say money is reinvested in services, but I am not sure this is always the case. Some of these hospitals have huge surpluses, the money is moved around and does not end back where it should. If we get more and more of this, it will be a step towards the privatisation of the health service.”

From: http://www.bbc.co.uk/news/10619463

The National Institute for Curbing Expenditure has turned down the drug called everolimus, also known as Afinitor, saying it does not offer enough benefit to patients to justify the cost.

Each pack of the drug costs £2,822 and the manufacturer, Novartis, had offered the first pack free to the NHS and a five per cent discount on following ones.

But even with this, and taking into account new guidance on end of life drugs which allows Nice to approve more expensive drugs that extend life for patients with rare diseases, the treatment was still too expensive, the panel decided.

An estimated eight week cycle of treatment would cost £5,264 per patient.

The cost per quality adjusted life year gained, a complex calculation taking into account improvement in quality of life as well as extra length of life versus the cost of the new drug over and above existing treatments, is almost double what Nice would normally allow.

Around 4,000 people a year in England and Wales are diagnosed with advanced kidney cancer and those who would be eligible for treatment because they had already tried the other drug, called Sutent, and were still fit enough to attempt another drug, would be much fewer, Nice said in a statement.

Patient groups hit out at the draft guidance saying people with rare cancers were being penalised.

Last year patients with advanced kidney cancer campaigned after four drugs including Sutent were turned down. Nice partially reversed the decision and Sutent is now available.

Mike Hobday, Head of Policy at Macmillan Cancer Support, said: “We are disappointed by Nice’s decision not to make everolimus available on the NHS for people living with advanced kidney cancer, who already have limited treatment options following the rejection of three clinically effective drugs last year.”

“It’s unfair that patients suffering from rarer cancers are repeatedly denied treatments that could extend their lives. Drugs like everolimus can dramatically improve people’s quality of life. They can mean the difference between patients being given a few weeks to live and a few months – valuable time that can be spent with family and friends, which means a lot to cancer patients.”

Nick Turkentine, Chief Operating Officer for the James Whale Fund for Kidney Cancer said: “Once again Nice has disappointed the thousands of kidney cancer sufferers in the UK by not approving everolimus, a drug which gives terminal kidney cancer patients and their families some hope.”

From: http://www.telegraph.co.uk/Kidney-cancer-patients-denied-drug-that-can-extend-their-lives

Overweight women are more than twice as likely to miscarry an IVF baby compared with those whose weight is healthier, fertility doctors say. The increased risk is so great they believe a warning should be included in counselling for couples before they embark on a course of fertility treatment.

Women who conceive naturally are known to have a greater chance of miscarrying if their body mass index (BMI) is 25 or higher, but the picture has been less clear for women carrying babies produced by in-vitro fertilisation (IVF), or another technique called intra-cytoplasmic sperm injection (ICSI).

“Overweight women wishing to get pregnant by spontaneous conception are already counselled to lose weight before trying for a baby,” said Tarek El-Toukhy, a fertility specialist who led the study at the assisted conception unit of Guy’s and St Thomas’ Hospital in London.

“Our findings have shown clearly that women undertaking ART [assisted reproductive technology] should be strongly encouraged to heed this advice in order that they can have the best possible chance of obtaining and maintaining a pregnancy,” he added.

Overweight mothers have a higher risk of developing other medical conditions that can threaten their pregnancy, including high blood pressure, pre-eclampsia, diabetes, premature delivery and post-partum bleeding.

El-Toukhy’s team examined the medical records of 318 women who each had one embryo implanted during fertility treatment at the clinic between January 2006 and December 2009. The women were divided into two groups: 185 had a healthy BMI between 18.5 and 24.9, while 133 had a BMI of 25 or above. Of the latter group, 19 were obese, defined as having a BMI of 30 or more.

The study, reported today at a meeting of the European Society of Human Reproduction and Embryology in Rome, found a miscarriage rate of 22% among women with a healthy BMI, compared with a 33% miscarriage rate for the overweight women.

After adjusting their data to take account of the women’s age, history of infertility and miscarriage, and lifestyle factors such as smoking, the researchers concluded that being overweight more than doubled the miscarriage rate.

“Although there is evidence that miscarriage rates are higher in overweight women who conceive spontaneously, there were conflicting views about the effect of increased weight on the outcome of pregnancies occurring after IVF and ICSI,” said Vivian Rittenberg, a fertility doctor who took part in the study.

Rittenberg said many studies that have examined the issue in the past have been hard to interpret, not least because doctors looked at miscarriage rates after implanting several embryos at once at different stages of development.

“We transferred only one embryo at a specific stage of development, and were therefore able to provide clear evidence of the deleterious effect of being overweight on the chances of miscarriage,” she said.

From: http://www.guardian.co.uk/science/2010/jun/28/overweight-doubles-risk-miscarriage-ivf

The plan, contained in a white paper to be published this week, is designed to place key decisions about how patients are cared for in the hands of doctors who know them.

Tens of thousands of administrative jobs in the health service will be lost as a result.

At present, funds are given by the Government to primary care trusts, which pay for patients from their area to be treated in hospital.

Under these plans, GPs — who are currently not responsible for paying for hospital referrals — would receive the money instead and pay the hospitals directly.

The Coalition hopes the new system will be less bureaucratic and give doctors and patients more control over treatment.

GPs will also have to organise out-of-hours services, which may see family doctors offering 24-hour care once again.

The decision represents a victory for Andrew Lansley, the Health Secretary. He has been backed by David Cameron in his fight with the Treasury over his decision to give taxpayers’ cash directly to doctors.

George Osborne, the Chancellor, raised serious concerns about putting such a vast sum of money, thought to be between £60 and £80 billion, back in the hands of GPs.

Health spending has been ring-fenced by the Coalition and will not be subject to the severe cuts that will hit other Whitehall departments.

However, it is understood that Mr Osborne has been assured by Mr Lansley that there will be safeguards in place to ensure GPs do not “waste” the money.

The acting chief executive of the NHS Confederation, Nigel Edwards, warned that the changes will be difficult to implement: “In transition to this new system there are some quite significant risks,” he said.

“Obviously it is going to take time to implement this and the PCTs at the moment are the people who keep the lid on the performance and financial management of the system.”

The move to scrap the 150 primary care trusts and strategic health authorities, which cover a range of NHS trusts and supervise local NHS services, will come as a shock to Conservative and Liberal Democrat MPs.

The Coalition agreement explicitly vowed to “stop the top-down reorganisations of the NHS that have got in the way of patient care”.

Rather than talking about scrapping trusts, the document explained the role they would continue to play.

However, Mr Lansley will point to the commitment in the joint Tory-Lib Dem document which states: “We will strengthen the power of GPs as patients’ expert guides through the health system by enabling them to commission care on their behalf.”

Commentators are calling the changes “the most revolutionary in the NHS since 1948”. Mr Lansley hopes to have the changes in place by next April, although NHS managers believe that may be over-ambitious. Under the reforms, primary care trusts will not be scrapped immediately, but will be phased out as power is passed to doctors.

A new contract which makes GPs more accountable is likely to be part of the package of measures included in the white paper.

Responsibility will be handed to GPs working in local groups, who will commission services or provide them by working in rotas through co-ops. Mr Lansley believes that if GPs are responsible for their own budgets and have to commission out-of-hours care, most will decide to go back to offering weekend and evening cover themselves or in local groups.

The loss of jobs, which The Daily Telegraph has been told will run into tens of thousands, is also likely to lead to outcry from public sector trade unions. Ministers are already braced for industrial action over plans for severe cuts in the Whitehall workforce.

The fierce dispute over the plans has led to a delay in the publication of the white paper. However, it has been resolved in the past 48 hours.

A source said: “In the end, the Prime Minister clearly said to George Osborne that this was not one he should go to war on.”

Handing over so much power to GPs will revive memories of reforms by the last Conservative government to give control back to the local level through GP fund-holding. Labour, under Tony Blair, attempted a similar plan but fell short.

However, a senior government source told The Daily Telegraph last night that the Coalition’s attempt will succeed because of the political will behind it.

The source said: “GP fund-holding was voluntary. This is going to be compulsory. This is pushing through the whole lot of policy that either Tory or Labour governments have tried in the NHS’s history but have never gone through with properly.”

The reaction of GPs to the changes will be crucial if the Coalition is to avoid confrontation. Ministers will hope that they embrace the opportunity, but some are likely to oppose the moves. Labour failed to drive through public service reforms in the face of opposition from unions and vested interests, as well as opposition from the party’s own MPs.

But Mr Cameron is determined to put his stamp on reform. In a speech to civil servants yesterday, he said his time at No?10 would not be defined solely by cuts and the deficit reduction plan.

From: http://www.telegraph.co.uk/Biggest-revolution-in-the-NHS-for-60-years

But a confidential position statement being prepared by the charity in collaboration with other health organisations – and seen by The Independent – acknowledges the changing evidence and emphasises the importance of exposing the skin to the midday sun without any protection in order to maximise production of vitamin D.

Many experts are concerned that past advice designed to protect against skin cancer may have resulted in an increased risk of other illnesses linked to a lack of vitamin D, which the body can only produce when skin in exposed to bright sunlight.

New concerns about Britain’s policy on sun exposure led to this review of the evidence about the risks and benefits of staying in the shade and covering up during the sunniest part of the day.

The confidential document, seen by The Independent, says: “The time required to make sufficient vitamin D is typically short and less than the amount of time needed for skin to redden and burn. Regularly going outside for a matter of minutes around the middle of the day without sunscreen should be enough. When it comes to sun exposure, little and often is best.

“However, people should get to know their own skin to understand how long they can spend outside before risking sunburn under different conditions.”

The wording of the draft document is being seen by come commentators as a tacit admission by Cancer Research UK that it had got it wrong in the past about telling people to avoid the midday sun, to apply sunscreen and to stay in the shade in order to avoid exposure to the cancer-causing rays of the sun.

“Cancer Research UK is working on a new position statement on vitamin D and sunshine which it expects to agree with other health organisations,” said Oliver Gillie, a health writer who has championed the case for vitamin D. “Their new position is expected to break with 20 years of advice to seek the shade and is expected to suggest that people go out in the sun in the middle of the day for at least a few minutes. Several health bodies have agreed to the wording but others are still discussing the details.”

Organisations such as the British Heart Foundation, the Multiple Sclerosis Society, Diabetes UK and the National Osteoporosis Society are discussing what their public position should be on sunshine and vitamin D in the light of several new studies suggesting a link between various illnesses and a chronic lack of the vitamin.

The draft position statement says: “Cancer Research UK’s SunSmart campaign encourages people to enjoy the sun safely and avoid exposures that lead to sunburn. However, for most people, sunlight is also the most important source of vitamin D, which is essential for good bone health.

“It is important to ensure that skin cancer prevention messages are balanced with the need to make enough vitamin D, and reflect the latest scientific evidence.” Sara Hiom, director of health information at the charity, said that the draft consensus statement has not yet been finalised, agreed or released. “It is not our advice to the public and should not be interpreted in that way,” Ms Hiom said.

“Even once we reach a consensus we will not be advising the public to go in the sun in the middle of the day without sunscreen. This is because, for some people – those most likely to be at risk of skin cancer – a few minutes in the middle of the day is enough for them to burn and cause serious and lasting skin damage.

“The very fact that messages around safe sun exposure times cannot be generalised to the population means that our advice needs to be general and is, and will remain, to enjoy the sun safely, spend time in the shade around midday and know your own skin type.”

From:http://www.independent.co.uk/public-advice-on-suntanning-may-mean-vitamin-deficiency-risk

But manufacturers and supporters of homeopathy disputed the report, saying the MPs had ignored important evidence.

It is thought about £4m a year is spent on homeopathy by the NHS, helping to fund four homeopathic hospitals in London, Bristol, Liverpool and Glasgow and numerous prescriptions.

Homeopathy is a 200-year-old system of treatment that uses highly diluted substances – sometimes so none of the original product is left – that are given orally in the belief that it will stimulate the body’s self-healing mechanism.

Supporters believe the remedies help relieve a range of minor ailments from bruising and swelling to constipation and insomnia.

But the MPs said homeopathy was basically sugar pills that only worked because of faith. In medicine it is recognised that some people will get better because they believe the treatment they take is going to work.

The MPs said the NHS should not fund treatments on this basis. They argued the effectiveness was often unpredictable and involved a deception by the medical establishment.

They also warned it could lead to a delay in diagnosis if symptoms were cured but the underlying reason for them was not tackled.

The MPs also criticised the drugs regulator, the Medicines and Healthcare products Regulatory Agency, for allowing medical claims to be made.

The bar for licensing for homeopathic remedies is not set as high as for medical treatments, partly because they have been used since the NHS was set up in 1948 before the current system of regulation was brought in.

Committee chairman Phil Willis said this approval and the fact they were funded by the NHS in the first place lent the remedies “a badge of authority that is unjustified”.

But the report acknowledged there was a public appetite for homeopathy with surveys showing satisfaction rates of above 70%.

The British Medical Association said it was concerned about NHS funds being used on homeopathy and called for an official review into its effectiveness.

From: http://news.bbc.co.uk/1/hi/health/8524926.stm

The trend was clearest if the fasting was done early in the women’s pregnancy, and during the summer months, when long hours of daylight called for them to go longer without food.

Ramadan is the ninth month of the Islamic calendar and a time when Muslims across the world fast from dawn until sunset. Three in four Muslim pregnancies overlap with Ramadan and surveys indicate that the majority of pregnant Muslims observe the fast. This year, it falls between 11 August and 9 September.

Although pregnant women may request an exemption from fasting, they are expected to “make up” the fasting days missed during pregnancy after their baby is born.

Previous research has suggested that this requirement may discourage pregnant women from seeking the exemption, since they do not want to be the only member of their household fasting. Some Muslims also interpret Islamic law as requiring pregnant women in good health to fast.

Since fasting during Ramadan is one of the five pillars of Islam and is a central part of Muslim culture, many women may fear a loss of connection with their communities or would feel guilty if they did not observe Ramadan.

The study, which used census data from the US, Iraq and Uganda, also discovered long-term effects on the adult’s health and his or her future economic success.

Douglas Almond, of Columbia University, and Bhashkar Mazumder, of the Federal Research Bank of Chicago, the authors of the research, concluded: “We generally find the largest effects on adults when Ramadan falls early in pregnancy.

“Rates of adult disability are roughly 20 per cent higher, with specific mental disabilities showing substantially larger effects. Importantly, we detect no corresponding outcome differences when the same design is applied to non-Muslims.”

Sheikh Ibrahim Mogra, an imam from Leicester, said sharia (Islamic law) would never expect a woman to fast if it had an adverse effect on either the mother or child.

“Sharia would not want the mother to unnecessarily burden herself,” he said. “There’s no point being needlessly brave. When Ramadan falls during the winter months, more women will fast. But when it falls during the summer, when you might have to fast for 16 or 17 hours, it is understandable that fewer mothers will be fasting.”

From:
http://www.independent.co.uk/pregnant-women-who-fast-for-ramadan-risk-damage-to-their-babies-study-finds

Screening tests can harm in two ways. First, there’s the positive result that triggers further investigation and treatment but which turns out to be a false alarm, thus subjecting the individual to unnecessary anxiety and pain. And second, there’s the negative result that lulls the individual into a false sense of security – until the disease that has been lurking undetected strikes.

In a joint statement, Hamish Meldrum, chairman of the BMA and Professor Sir Neil Douglas, chairman of the Academy, warn that there are “significant risks” with direct-to-consumer tests. They say private companies are highlighting the benefits of screening while ignoring or playing down the risks.

“Many are unreliable and inaccurate. Patients may be falsely reassured, or undergo unnecessary and sometimes invasive follow-up tests and treatments. Unnecessary procedures may have long-term or permanent complications. These problems often create unnecessary burdens for mainstream NHS services.”

The statement does not mention specific tests but one that is widely promoted is a blood test for prostate cancer which measures the level of prostate specific antigen (PSA).

Research shows that seven in 10 men with a high reading will not have cancer. Worse, two in 100 with a low reading will have significant cancer. So a lot of men will get treatment they don’t need, and some will not get treatment they do.

For those with a high reading, the next stage is a biopsy. This is a painful procedure in which a hollow needle is inserted into the gland close to the rectum and a sample of tissue removed to be examined for the presence of malignant cells.

As the PSA level is a poor predictor of prostate cancer, there is no NHS screening programme. Men are advised to be tested only if they have symptoms, such as difficulty urinating, or a family history of the cancer.

If cancer is found, it may lead to surgery – with its risks – followed by radiotherapy and chemotherapy, which have side effects. But the cancer may not need treating. Prostate cancer is often slow-growing, and many men die with it rather than from it. For them, screening and treating the cancer brings pain and anxiety – and no health benefit.

In the case of whole body scans, sometimes marketed as the “ultimate health check” or “health MOT” for a milestone birthday at 40, 50 or 60, the promise is that it can offer more accurate checks than are usually carried out by old-fashioned family doctors.

The problem is that most scans throw up abnormalities – and if the patient is paying £1,000-plus they are unlikely to feel satisfied with a report that says simple “all’s well”. The clinic may feel under pressure to highlight any abnormalities.

But distinguishing those that are benign from those that indicate serious disease is often difficult. The risk is instead of bringing extra years of life the scans will bring years of anxiety.

In their letter Dr Meldrum and Professor Douglas call on the government to introduce tougher regulations on the marketing of private screening tests to ensure it is factual and balanced. They say clinics must include information on the risks and limitations of the tests, the implications of the results, the procedures not included in the price and the evidence of health benefit.

Dr Meldrum said: “Some private companies are taking advantage of vulnerable people by claiming the health screening they offer will detect diseases early or reduce an individual’s risk of developing specific illnesses.

“However, the NHS has safeguards in place to ensure the public can be confident the tests are supported by sound research evidence. This ensures that anyone having a test is aware of the benefits, risks and limitations involved.

“Such safeguards often do not exist in the private sector which makes it impossible for people to distinguish between private testing services that may do some good, and those that are of no value or potentially harmful.”

Professor Douglas said: “There are significant risks with direct-to-consumer tests. Many are unreliable and inaccurate. Patients may be falsely reassured, or undergo avoidable and invasive follow-up tests and treatments.

“Unnecessary procedures may have long-term or permanent complications which can place a burden on the NHS.”

From: http://www.independent.co.uk/the-1631000-body-scans-that-ought-to-come-with-a-health-warning

The ONS has been capturing statistical data since the 1970′s on the way that we live.

During that time, life expectancy has increased by almost 10 years for men, who on average live until they are 77.8 years old, and seven years for women, who lived on average until they are 82.

The number of heavy smokers has fallen from 26 per cent of men and 13 per cent of women to seven and five per cent respectively.

Mr Hughes said: “Health is undoubtedly an important indicator and life expectancy is a good indicator of the national health.”

Mr Hughes said: “The statistics highlight some of the main social changes over the last four decades. We are now living longer, less of us get married, and household sizes are smaller.”

“More of us have cars, women are having babies later in life, and more of our household spending goes on housing, water and fuel.”

Mr Hughes said: “It is interesting that more than two thirds of people aged 18 and over in Great Britain believe that they do not need a partner to be happy and fulfilled in life.”

The latest analysis of the way we live also shows that UK residents are taking nearly 40 million more foreign holidays than in the 1970s, with Spain remaining the most popular destination.

This year’s edition of Social Trends will be the last available in paper form, showing how even our statistical analysis is moving with the times, Mr Hughes said.

From: http://www.telegraph.co.uk/Britons-are-drinking-more-getting-fatter-but-living-longer-official-figures-show

She denied the contingency plans amounted to an overreaction and said that it was important that the relative success did not make us complacent.

She concluded that the UK’s response to last year’s outbreak was “proportionate and effective”.

“It is imperative that the experience of 2009 doesn’t lead to complacency,” she said. “It is a bit like childbirth – when it’s all over, you forget quite how serious and how difficult it all was.

“The threat of a flu pandemic remains very high. Both the successes and the lessons from this pandemic should inform policy and planning for the next one because there will be a next one, and the next one might be more severe.

“If the UK government had not responded to the unexpected threat. Had it turned out to be more severe then we would have been having a very different press conference today.”

She highlighted the lack of flexibility in the contracts signed by the Government for vaccines against the H1N1 virus, meaning that Britain was left with many doses it did not need, many of which were donated to the Third World.

There were 457 reported and confirmed swine flu-related deaths across the UK between the outbreak in April last year and March this year.

Figures in the report show that Britain spent £654 million preparing for a possible flu pandemic, and £587 million responding to the H1N1 outbreak – a total of £1.24 billion.

This includes £1.01 billion on drugs, among them antivirals, doses of vaccine and antibiotics.

The report said there was a lack of flexibility once the Department of Health (DoH) signed contracts for swine flu vaccine with drug manufacturers GlaxoSmithKline (GSK) and Baxter.

Baxter agreed to a “break clause” allowing the Government to cancel its order for some of the doses but GSK refused.

The report noted that the DoH eventually agreed to take 35 million doses of the vaccine from GSK.

“I think we have got to set these figures, which seem enormous, against the potential for saving lives,” she said.

“It is fairly clear, although we can’t actually identify the number, that there probably were lives saved of very young people, young children and so on. These are extremely valuable lives.”

From: http://www.telegraph.co.uk/Swine-flu-killed-457-people-and-cost-1.24-billion-official-figures-show

Mr Lansley, who has scrapped several of Labour’s key targets, including the guarantee of a GP appointment within 48 hours, insisted the new standards were not just another set of targets.

Speaking at the launch of the standards, which have been developed by the National Institute for Health and Clinical Excellence (Nice), Mr Lansley said they were not mini-targets as they were ”evidence-based” measures identified by the NHS itself.

”These are standards, not diktats. It is not politicians establishing these, I am not picking them out. ‘If I started doing that, I would be distorting clinical standards.”

The latest standards from Nice are drawn from various sources, including existing Nice guidelines, and reports from the Royal Colleges, the Department of Health and the National Audit Office.

It will be up to local managers – or possibly GPs in the future – to check if the NHS is meeting them.

If trusts fail to reach the standards, they could face losing contracts to carry out services, such as stroke care, which could be commissioned from other hospitals instead.

It is unclear how data will be collected nationally so patients can assess whether standards are being met.

Dr Tim Kendall, who led development of the dementia standard, said it would help transform the experience of dementia patients but also support carers.

”Some carers suffer far more than they should. People with dementia effectively die while the person caring for them watches them disappear,” he said.

The stroke standard sets out how patients can expect to receive a minimum of 45 minutes, five days a week, of therapies to help them improve, such as speech therapy or help with movement.

From: http://www.telegraph.co.uk/NHS-quality-standards-set-out-by-Andrew-Lansley