Almost one in five girls say they have been pregnant at least once by the age of 18, according to a Government survey.
Just under half (46 per cent) decided to keep their baby, while more than a third (36 per cent), had an abortion, the figures show.

The statistics are part of wider research on the experiences of 18-year-olds in England, published by the Department for Education.

The responses of thousands of 18-year-olds questioned for the Youth Cohort Study and the Longitudinal Study of Young People in England were analysed.

The findings show that of the 18-year-old girls questioned about pregnancy, 18 per cent had been pregnant at least once.

Of these, almost eight in 10 (79 per cent) had been expecting a baby on just one occasion, nearly one in five (18 per cent) had been pregnant twice, and 3 per cent had been pregnant at least three times.

The survey concluded there was a “noticeable trend” between the young women who fell pregnant by 18, and their GCSE results.

A third (33 per cent) of those who gained between one and four GCSEs at grades D-G had been pregnant at least once by the time they were 18, compared to just 6 per cent of those who scored eight or more GCSEs at Grades A*-C.

Teenage girls who were eligible for Free School Meals – a measure of poverty – at age 16, or who had parents who left school at 16, were also more likely to get pregnant by the age of 18, the figures showed.

According to figures published by the Office for National Statistics, there were 25.3 births for every 1,000 women under 20, in 2009.

Girls aged 15 to 19 accounted for 39,020 abortions carried out in England and Wales in 2009.

The figures show that 18 per cent of girls who said they were sexually active had been pregnant by the age of 18.

More than eight in ten (83 per cent) of the boys and girls questioned said they were sexually active by the time they turned 18.

From: http://www.independent.co.uk/a-fifth-of-girls-pregnant-by-18-survey-reveals-2032952

A policymaker’s dream. A pragmatist’s nightmare. That has to be the verdict on Andrew Lansley’s white paper “Liberating the NHS”, published on Monday.

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

Pregnant muslim women who fast during Ramadan are likely to have smaller babies who will be more prone to learning disabilities in adulthood, according to new research.
Scientists in the United States also found that the women were 10 per cent less likely to give birth to a boy if they had fasted during Ramadan.

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

The National Institute for Curbing Expenditure (NICE) wants to set a minimum price for a unit of alcohol in its latest wheeze to crack down on problem drinking.
The public health quango, which labour set up as the Government’s drugs rationing body, has spent two years looking at how to reduce alcohol-related health problems.

One in four people drink at levels that could be putting their physical and mental health at risk, according to official figures.

The move will reignite debate about how best to deal with the problem.

Deaths from alcohol abuse have more than doubled in the last 16 years, with almost 9,000 a year now succumbing to conditions such as alcohol poisoning and liver cirrhosis

More than 860,000 people a year are also admitted to hospital because of alcohol and the cost to the nation of excessive drinking is put at an estimated £27 billion a year.

Health experts and charities have all backed calls for a minimum price per unit to curb Britain’s binge drinking culture.

But many in the drinks and retail industries are strongly opposed to such a move and believe a minimum price would disproportionately hit responsible drinkers.

The move has already been backed by the British Medical Association (BMA) and the Royal College of Physicians.

Analysis by Sheffield University found that setting a minimum price of 50p a unit would save up to 3,400 lives a year without hitting moderate drinkers.

A draft of the Nice guidance, published in October last year, recommended the introduction of a minimum price per unit and said there was “sufficient evidence … to justify the introduction of a minimum price per unit.”

As well as overall consumption levels, a minimum price would also help to reduce binge and underage drinking, advocates believe.

Minimum pricing is expected to have a much harder impact on supermarkets and off licenses than pubs and restaurants, which sell alcohol at higher prices.

Supermarkets in particular have been criticised for selling alcohol at very low prices, including cans of beer for as little as 22p each.

The Wine and Spirit Trade Association said that minimum pricing “would punish millions of innocent consumers” without solving the problem of alcohol misuse.

From: http://www.telegraph.co.uk/Minimum-price-for-alcohol-to-be-backed-by-Nice

The NHS is facing upheaval and cutbacks as a decade of budget increases comes to an end and £20 billion of savings must be found over the next five years.

Despite pledges from Labour and the Conservatives to protect front line services, there is evidence that their promises may have come too late.

A list of cuts has already been identified – including job losses, banning certain operations, closing casualty departments, downgrading maternity services and reducing the number of junior doctors. But these have been mostly quietly ignored by the three main parties.

The Conservatives pledged to stop all closures until they could be reviewed but, with billions of pounds of savings needed to cope with growing demand, cuts and closures are almost inevitable.

David Cameron emphasised that he was personally in favour of the NHS, after his experiences with his disabled son Ivan, who died last year, to combat arguments that the health service was not safe in Tory hands. The party manifesto contained promises about dentistry and round-the-clock GP services which appear too expensive in the current climate.

Both the major parties were accused of chasing the “fear of cancer” vote. The Tories said they would fund cancer drugs turned down by Nice, the health rationing watchdog, but did not mention drugs for other illnesses such as arthritis or dementia.

Labour said cancer patients would see a specialist and have test results back within a week. The party was criticised for unveiling its manifesto at a new hospital in Birmingham. It is against the rules to use NHS premises for election events.

But Labour pointed out that the hospital was still in the hands of the private finance initiative organisation – a policy which means the NHS will be repaying billions of pounds for new hospitals for decades.

Nick Clegg refused to ring-fence NHS spending given the size of the national debt.

The Liberal Democrat campaign focused on cutting waste on managers, scrapping regional strategic health authorities and pledging more power to communities to direct the health service locally.

From: http://www.telegraph.co.uk/General-Election-2010-cuts-inevitable-as-NHS-must-make-savings

The NHS is sending millions of patient records and confidential medical notes to India for processing — despite a pledge by Labour that personal information would not be sent overseas.
It is the first time that databases of names, addresses and NHS numbers of patients have been sent abroad, along with private information about medical appointments.

NHS managers, under pressure to cut costs, are implementing the changes despite warnings about poor security in some offshore centres.

The Sunday Times has identified seven primary care trusts in northeast London, serving more than 1.5m people, that have begun to send patient details overseas. The databases are administered by about 200 workers in Pune, western India.

Although companies handling the records in India said security was “paramount”, there is a risk of patients being identified if the NHS numbers are matched with anonymised clinical notes carrying NHS numbers, already being sent to India by more than 30 trusts.

Typically, a set of clinical notes will be based on a consultant’s findings during a session with a patient, which he will read into a voice recorder during or after the appointment.

The recording is then transferred to a computer and sent to India, where it is transcribed. One source involved in processing the information said patient names can crop up during the appointment and may then inadvertently be included with the clinical data.

Workers in India are also producing letters for patients with appointments for cervical smear tests and breast screenings.

Pilot schemes for NHS offshore transcription services began more than four years ago and have rapidly expanded. The Royal Free hospital in London, the Derby hospitals trust and the Newham University hospital trust are among those sending clinical notes overseas.

Labour ministers have been anxious to allay concerns about the confidentiality of patient information since the launch of a £12 billion scheme to computerise health records.

In January 2007 Caroline Flint, then health minister, told parliament the project would “expressly preclude the transfer of patient information outside the United Kingdom”.

Trusts, however, believe they may send patient information outside the UK if it does not come under the electronic records project.

John Hemming, the Liberal Democrat MP for Birmingham Yardley and an expert on IT projects, said: “Given the government’s track record of losing data in this country, it is worrying that data are being sent overseas. Every transfer of information adds to the risk of it being lost.”

The possible risks of transferring patient data overseas were exposed last year when undercover reporters from ITV1’s Tonight programme were able to buy health records from a private hospital in London, processed in India. The sellers claimed to have access to thousands of UK medical records.

The transfer of primary care trust records is being handled by NHS Shared Business Services, a joint venture between the Department of Health and the IT company Steria.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7086816.ece

Health Direct urges you to opt out of labour’s snoopers charter- whilst you still can!

On election day Health Direct quotes this cancer specialist- The internal market has been a costly disaster. Let the professionals manage medicine.

It’s election time, and our glorious political classes are marching forward on the massed ranks of the electorate with banners that claim that their party, only their party, will save the NHS.

Politicians clamour to praise its world-class status and laud the dedication of nurses and the skill of its doctors. And all parties are united in the view that, despite the need for austerity measures, frontline staff and services will not be cut. So where are the savings planned? Watch the hand and not the mouth.

When I started in medicine, the hospital was run by about three people. Things were so much more simple when doctors and nurses treated patients, doing their best without the guidance of guidelines and targets, doing their best … yes … to make the patients better.

How did we manage without forms to fill and waiting times compliance? Quite well actually. The medical director ran the medical side of things while matron and the accountant handled the rest. It wasn’t much of a business then: it didn’t have to be, because there was no internal market to manage.

The internal market — Mrs Thatcher’s plan to introduce efficiency by having hospital compete against hospital to provide patient treatment — has wreaked havoc. It has spawned a nation of administrators, here today and gone to another post tomorrow — while doing nothing to bring costs under control.

The internal market’s billing system is not only costly and bureaucratic, the theory that underpins it is absurd. Why should a bill for the treatment of a patient go out to Oldham or Oxford, when it is not Oldham or Oxford that pays the bill — there is only one person that picks up the tab: the taxpayer, you and me.

And there are big problems with the billing process. For example, if a patient is seen in an outpatient clinic then there is a charge made by the hospital for his or her first attendance — but follow-up appointments are not charged. And if many treatments are given in a hospital to a patient, only the most expensive of the treatment episodes is charged.

There are savings to be made. It is alleged that there are just 75,000 administrators at work in the NHS but this figure is laughably mythological. Doctors and nurses know that there are many more than this. They look around and see the numbers increasing.

One report by the Centre for Policy Studies published in 2003 indicated that there were 250,000 administrative staff employed in the NHS: at least one administrator for every nurse. In recent times the rate of increase of admin staff within the NHS has exceeded that of nursing staff.

There is a general feeling in the NHS of disempowerment of the professionals. People can’t face up to the incredible struggle, the disapproval that faces any of them if they have the temerity to suggest that things should be run differently.

The principle of care for all from cradle to grave is worthy and wonderful. But the current reality is a cradle rocked by accountants who are incapable of even counting the number of times that they have rocked it. The reality is gravediggers working with a cost improvement shovel made of rust.

Over the years politicians have made dramatic changes to the way that the NHS has been run. Recent changes have caused fragmentation and not led to any cost saving. Moving patients from one place to another does not save the nation’s money, though it might save a local hospital some dosh. So the internal market has failed because it does not consider the health of the nation as a whole, merely the finances of a single hospital department, a local hospital or GP practice.

So what should we do? Let us go back to the old discipline of the NHS. Let the professionals manage medicine, empower the professionals, the doctors and nurses and shove the internal market in the bin and screw down the lid.

At this election time please let us hear from all political parties that they will ditch this absurd love-affair with the internal market. Instead let them help the NHS do what it does best — treat patients, and do so efficiently and economically without the crucifying expense and ridiculous parody of competition.

Professor Jonathan Waxman is a consultant oncologist

http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article7112167.ece

Heroin should be routinely prescribed on the NHS as a way of weaning drug users off their addiction, the head of the country’s top nursing union has said.

Peter Carter, the general secretary of the Royal College of Nursing (RCN), also said he was in favour of “drug consumption rooms” to enable addicts to take drugs safely under medical supervision, and to cut rates of drug-related crime.Nurses gathering at the RCN’s annual congress in Bournemouth had earlier discussed providing heroin to addicts where other attempts at treatment have failed.

Results of pilot studies in London, Brighton and Darlington suggest that allowing users to inject themselves with the Class A drug under medical supervision can cut local crime rates by two thirds over six months.

Aberdeen has been considered as a potential future pilot location in Scotland.

But some experts are concerned at the prospect of providing legitimate “shooting galleries” in publically-funded clinics, despite the increasing use of methadone, the heroin-subsitute, and a lack of abstinence-based programmes.

Amid controversy over how to treat chronic drug users, members of the RCN, the country’s largest nursing union, discussed the possibility of providing heroin on the NHS today but did not hold a vote for or against the move.

Speaking in a personal capacity after the debate, Dr Carter, the former head of Central and North West London Mental Health NHS Trust, said that he believed in providing drugs, needle exchanges and locations for users to inject substances safely.

“The fact is heroin is very addictive,” he said. “People who are addicted so often resort to crime, to steal to buy the heroin. It obviates the need for them to steal.

“It might take a few years but I think people will understand that if you are going to get people off heroin then in the initial stages we have to have proper heroin prescribing services.” Dr Carter added that more research was needed into consumption rooms, which have been tested in Sydney and Amsterdam.

Experts found the programme stopped users injecting in school playgrounds and stairwells.

“Critics say you are encouraging drug addiction but the reality is that these people are addicts and they are going to do it anyway,” he added.

Radical proposals for the most chronic drug users were first advocated in 2002 by the then Home Secretary David Blunkett. The gave rise to pilot programmes in England in which users inject themselves with pharmaceutical diamorphine imported from Switzerland, under medical supervision.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article7108342.ece

The NHS reported the highest number of serious data breaches of any UK organisation since the end of 2007, the Information Commissioner’s Office says.

David Smith, deputy commissioner at the ICO told the Infosec security conference the NHS had highlighted 287 breaches to it in the period.

That accounts for more than 30% of the total number reported.

The NHS – the UK’s largest employer with 1.7m staff – has only started the process of rolling out digital patient records.

Most of the breaches (113) were the result of stolen data or hardware, followed by 82 cases of lost data or hardware.

Mr Smith said the problems were not confined to the public sector and that results could be skewed because the public sector has a culture of reporting all breaches whereas not all private sector firms did.

Richard Vautrey, the deputy chair of the British Medical Association’s GPs committee thinks the number of breaches reflect the size and complexity of the NHS as well as its culture of openness.

“So many people have access to data and often human error is to blame. There is an increased attempt to be open and honest about what happens to data,” he said.

He added that he was not aware of a specific case where a data breach had affected patient privacy or care.

“We need to keep their breaches in perspective,” he said.

As part of its plans to digitise patient records, the NHS is asking patients if they want their data stored on national databases. It is important that people are given the chance to opt out, said Mr Vautrey.

Currently the reporting procedure for data breaches in the UK is voluntary although the ICO is “moving towards” a compulsory system.

In April the ICO introduced fines of up to £500,000 for serious data breaches.

The European Union’s Telecoms Package requires telecom firms to report data breaches and Mr Smith said he expected this requirement to expand beyond telcos.

Data encryption firm PGP welcomed the tough new approach to data security.

“Finally the ICO, which has long demanded greater powers, will be able to severely punish those in serious breach of the Data Protection Act. For too long, organisations have continued to ignore the warning signs – risking both the privacy of their customers and the reputations of their brands,” said Jamie Cowper, European marketing director at PGP.

He anticipates “severe fines” for the next private sector company to be involved in a serious data breach although he does not imagine the ICO will pursue the NHS.

PGP calculated that data breaches cost companies, on average, £67 per piece of data lost.

From:

http://news.bbc.co.uk/1/hi/technology/10089066.stm

Health Direct asks- given that the NHS has the worst record of data security and that labour politicans have already sent 250,000 political letters to cancer sufferers- are you CERTAIN that your medical records will be safe on the Snoopers Charter database? If not OPT OUT NOW- whilst you still can!

Hundreds of cancer patients may have been left to die without access to life prolonging medication, despite the drugs being approved by the labour government.

A postcode lottery means hundreds of people are missing out on life-prolonging care

Now figures obtained under the Freedom of Information Act show that a cancer patient’s chances of overruling health authorities who deny them access to drugs depends on where they live.

Some NHS trusts, such as Torbay in Devon and Salford in Manchester, granted all appeals while in others, such as Kingston in southwest London, only 7% were granted. In about one-third of trusts, fewer than half of the requests for drugs that can cost thousands of pounds a month were approved.

Access to cancer drugs has become an election issue, with the Conservatives saying they will ensure the National Health Service directs £200m more into supplying new drugs. The money will come from what the health service would otherwise have had to pay to meet Labour’s hike in National Insurance, which the Tories have said they would partially reverse.

The drugs concerned have all been approved by the labour government’s National Institute for Curbing Expenditure (Nice). However, each of 152 primary care trusts (PCTs) in England is allowed to use its own interpretation of Nice’s regulations.

In some cases patients who have already had two courses of chemotherapy are not allowed the drugs; in other cases they must have tried cheaper alternatives before being eligible. Those who do not meet the conditions must appeal to an “exceptional case” panel.

Widespread variation in attitudes between health trusts emerged in research to be published in Health Insurance magazine. It asked how many “exceptional-case funding requests” for cancer were received by trusts in 2009.

It named five drugs, including Rituxan for leukaemia; Tarceva for lung cancer treatment and Revamid for blood cancer.

All such appeals were granted by 17 healthcare trusts, with the areas benefiting ranging from Walsall and Manchester, to Torbay and Suffolk. However, Kingston and Northamptonshire refused most of the appeals made to them.

Forty one of 122 primary care trusts that responded granted fewer than half requests. The figures present an incomplete picture because some trusts may prescribe medicines without the need for patients to appeal. Critics, however, say they still show unacceptably wide variations in practice.

Specialists also complain that the NHS trust officials who decide whether or not to grant the appeals are rarely experts in the disease, so they help to create the wide discrepancies.

Karol Sikora, a cancer specialist at Hammersmith hospital, west London, said his department has a wallchart that marks both sympathetic and unhelpful PCTs. “You find yourself talking to office temps and all sorts of unlikely people who are apparently making these life-or-death decisions,” said Sikora.