Employers will not be able to ask people who apply for a job about their health under new equality laws that came into force on Friday.
The Hattie Harperson cartoon is from: http://sgspolitics.blogspot.com/2007_11_01_archive.html

Staff who are dyslexic, have taken a large number of sick days or who look after disabled and elderly relatives will also find it easier to win unfair dismissal cases under the new law.

Other provisions will allow bankers to compare salaries, and guarantee mothers the right to breastfeed their babies in public.

Experts fear the significant strengthening of anti-discrimination law will lead to a surge in employment tribunal claims as well as increasing the burden of red tape on businesses when they are struggling to recover from the recession.

However some of the most controversial elements of the single Equality Act – driven through by Hattie Harperson just weeks before the general election – have not yet been implemented by the Coalition. These include the requirement for large organisations to publish the gap in pay between male and female employees, and the right of employers to use “positive action” to recruit more female or ethnic minority staff.

The Act aims to make rights simpler by bringing together nine pieces of legislation, and creating a list of “protected characteristics” on which it is unlawful to discriminate: age, disability, gender, gender reassignment, race, religion, sexual orientation, marriage and maternity.

Business leaders, lawyers and personnel experts agreed that the most significant change is the new ban on questions about a prospective employee’s health at first interview.

Until now, employers have routinely asked about the medical background of job applicants but under the Equality Act they will be breaking the law unless they can prove their questions were designed to monitor diversity, or check whether the interviewee can carry out an essential task.

It will be illegal to ask how much time off work a prospective employee has taken, while one HR expert claimed managers will not even be allowed to ask: “How are you this morning?”

However bosses will be able to screen by health after making an offer or drawing up a short-list.

The British Chambers of Commerce estimates it will cost £189million for business to implement the Equality Act. David Frost, its director-general, said: “At a time when the Government is trying to create as many jobs as possible in the private sector this legislation will put people off for fear of getting it wrong. The Equality Act is a very complex bit of employment legislation. If small businesses get this wrong they end up in an employment tribunal.”

A spokesman for the Institute of Directors said: “The health provision is undoubtedly an extra burden on businesses. All business will need to be very clued up on the ramifications of what the new regulations are – if you have a whole HR team that’s fine, but a lot of our members are small businesses and they don’t have that.”

Deborah Casale at Gannons Solicitors said: “This will no doubt become a grey area in the law and may open the door to more disability discrimination claims.”

However supporters of the law believe it could help injured veterans who are seeking work after leaving the Armed Forces, as well as people who have a history of mental illness.

The Equality Act will make it easier for staff to claim they were discriminated against because of a disability. This is because they no longer have to prove they were treated less favourably than non-disabled colleagues.

It is expected to lead to discrimination claims from dyslexic workers who have been barred from carrying out certain tasks because of their tendency to make spelling mistakes.

An employee who had been disciplined for taking a lot of sickness leave could also claim they had been treated unfairly.

The law also introduces the category of “discrimination by association”, which allows carers of disabled children or elderly parents to claim they suffered in the office as a result of their responsibilities at home.

Edward Wanambwa, employment and discrimination specialist at Russell Cooke Solicitors, said: “The Equality Act 2010 is the most ambitious and overarching piece of discrimination legislation for decades. Its purpose is to harmonise and clarify existing law; the impact of which will perhaps most significantly be felt by the 6million carers across the UK who now have an unambiguous right to sue for discriminatory conduct experienced as a result of an association with a disabled person.”

Another category, combined discrimination, could see staff claim they were treated badly because of a combination of their age and their gender – where an allegation under a single area would have failed.

It also becomes illegal to discriminate against someone for the “perception” that they are homosexual, for instance, even if they are not. Transsexuals are protected from discrimination even if they are not undergoing “gender reassignment” treatment.

Employment tribunal judges will be able to recommend changes to the practices of a business rather than just concentrating on the experience of the individual who brings a claim.

Elsewhere, the Act specifically allows nursing mothers to breastfeed their baby in public places. Managers in shops or cafes will not be allowed to ask a mother to stop breastfeeding, move to somewhere more private or leave because they are breastfeeding.

The new law also stops colleges from preventing teenage girls at school who are pregnant or who have had a baby from taking their A-levels.

The legislation does not cover breast feeding at work, however a mother who is discriminated against for feeding would likely have a case for sex discrimination because of existing laws, experts say.

Under the new legislation, staff particularly in the financial sector will be free to discuss their pay, and can claim victimisation if they are disciplined for sharing information about wages or bonuses.

Rachel Dineley, employment partner at law firm Beachcroft, warned that small firms were likely to be caught out, and forecast a rise in cases brought in front of tribunals.

DLA Piper, the law firm that employs Nick Clegg’s wife, said detailed guidance on the new law had only been published in the past month.

Sandra Wallace, the firm’s head of equality and diversity, said: “Unfortunately, by issuing the implementing legislation so late in the day, and not incorporating all elements of the Act, businesses have been left with a halfway house that will potentially confuse them even more than they already were, and risk protracted legal wrangles in employment tribunals that are already overstretched with a general increase in claims.”

Some groups said the Government should have gone further and implemented all of the parts of the Act drawn up by Labour. It is estimated that 90 per cent of the law comes into force today.

Ceri Goddard, chief executive of the Fawcett Society, said: “Rowing back on the requirement for big business to publish and take action on any differences in pay between men and women employees – so to conduct gender pay audits – is tantamount to endorsing the shocking gender pay gap.”

The Government likened the advance in employment rights guaranteed under the Equality Act to an equal pay campaign launched by female factory workers in 1968, commemorated in a film that opens in cinemas today.

Theresa May, the Equality Minister, said: “Thanks to pioneers like the women who feature in Made in Dagenham, the workplace is much fairer than it was in 1968, but there is still plenty of room for improvement.

“In these challenging economic times it’s more important than ever for employers to make the most of all the talent available. When a company reflects the society it serves, it’s better for the employer, the employees and the customers, so being a woman should never be a barrier to being treated fairly at work.

“From today the gagging clauses that stop people discussing their pay with their colleagues will be unenforceable, allowing women and men to find out if they’re being paid unfairly.

“This move towards transparency is just one part of the Equality Act, which also makes it easier for businesses to comply with discrimination law by streamlining the equality laws, and provides more protection to disabled people.”

From: http://www.telegraph.co.uk/Equality-Act-firms-must-not-ask-job-applicants-about-health

NICE the killer quango wants to waste taxpayers money by suggesting that the NHS should bribe fat people to lose weight and smokers to quit, and give children toys for eating their fruit and vegetables.The Killer Quango- the National Institute for Curbing Expenditure (NICE) was set up in early 1999 by the labour Secretary of State for Health Frank Dobson and has since condemned hundreds of cancer sufferers to early deaths and blighted thousands to painful existences by restricting payments- creating postcode lotteries for health care.

Now during the credit crunch nice want to waste millions of taxpayers pounds bribing people when earlier pilot studies showed that there were high drop out rates and up to 80% failed to reach their targets.

The advice, which will be published by the National Institute for Curbing Expenditure, has been greeted with anger by critics who claimed such “bribes” were draining the public purse of money which could be better spent elsewhere.

The study examined a series of schemes, including one in Kent which pays dieters up to £425 for losing weight and another in Scotland which gives pregnant women shopping vouchers worth up to £650 for quitting the habit.

It also looked at programmes in Oxford, Manchester, London and Bangor in Wales, where schools have been given toys such as juggling balls, stickers and pencils to children who have eaten their fruit and vegetables.

Fiona McEvoy, from the TaxPayers’ Alliance, said state funds should not be used to pay people to change their lifestyles,

She said: “Bribing people to lose weight or quit smoking is nothing but a quick fix which patronises the individuals in question and drains much-needed money away from the public purse. At a time when cancer drugs are being denied to sufferers due to lack of funds, many will be disgusted to learn that NICE are considering such a costly approach.”

Other schemes examined in the report include a pilot in Manchester which rewards overweight parents for walking their children to school.

As part of a £30m project, supermarket points are given to unfit people who attend keep-fit classes, weight loss clubs or go for a run in the park.

Overweight people gain credit points they can cash in for groceries just for turning up, with extra rewards depending on how much weight they lose.

In Newcastle, Bristol, Torbay, Manchester and Bury St Edmunds, those aged 16 to 22 are given subsidised gym membership if they visit at least once a week.

However, the report found limited evidence about whether the schemes make a difference.

In the Scottish antismoking project, for instance, the study acknowledged that four fifths of the women in the £43,000 scheme were smoking again within three months of giving birth.

The recommendations from NICE’s independent citizens council do not constitute its official advice to the NHS. Its board will launch a public consultation on the matter before considering the paper, which would inform future guidance.

However, the rationing body has already supported financial rewards for heroin addicts.

Originally NICE recommended that addicts who attended treatment programmes should be given the chance to win prizes, such as televisions and MP3 players.

The body dropped the idea following a public outcry but instead recommended that shopping vouchers worth up to £10 could be awarded to those who completed programmes, or showed they were clear of drugs.

NICE has been widely criticised for refusing to pay for dozens of cancer drugs on the grounds of cost. Medicines rejected include the drugs Avastin for advanced bowel cancer and Nexavar for advanced liver cancer.

Last year the institute fuelled controversy when it ruled marriage guidance counselling should be funded by the NHS, and supported the use of acupuncture for back pain, despite finding there was no good evidence it worked.

The report follows a three day meeting of NICE’s citizens council, where members were asked to vote about the use of incentives.

“More than 60 per cent said they were in favour of such schemes, as long as they were only used as a “last resort” and were not exchangeable for tobacco or alcohol.

Sir Michael Rawlins, the chairman of NICE said: “We clearly face several public health challenges in today’s society, some more obvious than others, and we must seek to improve these in ways that are likely to achieve the best outcomes to those affected.

“The majority of the council has voted in favour of the use of incentives under certain circumstances, but this clearly remains a divisive issue”.

Public consultation on the report starts today.

From:

http://www.telegraph.co.uk/NICE killer quango taxpayers-bribes-for-obese-and-smokers.html

Health Direct finds this new waste of taxpayers money a disgrace. Research in pilot studies has clearly showed that bribing people to lose weight and stop smoking DOES NOT WORK in the vast majority of cases.

On June 10, 2010 Health Direct published research :Nanny state cash bribes for good health fail three quarters of patients at http://www.healthdirect.co.uk/2010/06/nanny-state-cash-bribes-for-good-health-fail-three-quarters-of-patients.html

A Department of Health spokesman has already described them as an undesirable use of money and should only be adopted as a “last resort”.

If you would like to tell the killer quango NICE what you think of this scheme, comments should be sent to Clifford Middleton, Research and Development Project Manager at clifford.middleton@nice.org.uk by 5pm on Friday, 26 November 2010.

If email is a problem for you, please send your comments in a letter to Clifford Middleton at:

NICE,
MidCity Place,
71 High Holborn,
London WC1V 6NA.

Britain’s top GP has launched a scathing attack on widespread reckless public behaviour towards food, alcohol and cigarettes, which he claims is causing growing levels of disease and early death.
In a dramatic intervention in the public health debate, Professor Steve Field criticises parents, mothers-to-be, the very overweight, smokers and drinkers for damaging their own health, or their children’s, through irresponsible actions.

Writing in the Observer, Field, chairman of the Royal College of General Practitioners, backs the controversial call by Andrew Lansley, the health secretary, for Britons to take more responsibility for protecting their health.

“The truth is that too many of us neglect our health, and this is leading to increasing levels of illness and early death,” Field writes. Soaring levels of diabetes, much of it caused by obesity, and the medical consequences of heavy drinking, which are affecting ever-younger people, illustrate this widespread failure, he adds.

Discussion of the harmful medical consequences of ill-advised personal behaviour is curtailed because of its sensitivity, Field argues.

“Too many people do not face up to the hard facts, as they perceive them to be an attack aimed, in particular, at the poorer members of society. But it is impossible to argue on medical or ethical grounds that such behaviour is acceptable.”

While arguing for health prevention to become an individual duty and start at home, Field makes it clear that he does not want people to be left to make lifestyle changes on their own or to see personal responsibility as a total solution. Those who seek to alter their behaviour need continuing NHS and government help, he adds.

“So please don’t take offence if we [GPs] tell you to lose weight or stop smoking or drinking. You need to face facts and take responsibility. Support is out there and it could save your life – and save the NHS a fortune.”

Anne Milton, the public health minister, said greater personal responsibility was vital. Many senior doctors also agreed, but stressed that government action was needed to help create a climate in which people could swap healthy for unhealthy behaviour, such as by monitoring big food companies.

Lansley has alarmed senior doctors by saying the coalition will use much less regulation than Labour did to tackle problems such as obesity and smoking.

GPs seek to help people live healthy lives “but every day we are confronted by the harm caused by smoking, excessive alcohol consumption and the ‘tsunami’ of obesity”, adds Field, the leader of the country’s 40,000 GPs.

Irresponsible parents are damaging their children’s health by smoking around them, feeding them unhealthy food and failing to act as good role models, he says. Mothers and fathers who smoke in cars carrying their offspring – who Field says “are committing a form of child abuse” – and at home in front of their children kill more young people than do accidental injuries.

Parents who give their children unhealthy food, or serve them large portions are storing up huge problems for them, says Field. “Unless parents exert more control over their children’s diets, they are risking a lifetime of health problems, and even premature death – death before their parents, which is almost too sad to contemplate,” he adds.

Parents’ failure to safeguard their children from sunburn and using sunbeds can also lead to them developing skin cancer, he argues. Mothers who smoke while pregnant risk causing their child’s death through cot death syndrome, asthma, lung infections or house fires. Would-be mothers and women who are already expecting need to control their weight because maternal obesity can harm the mother or her baby.

Instead of becoming obese and then asking the NHS to provide liposuction or gastric bands, “it would be better if people didn’t become fat in the first place”, by eating better and exercising more.

Agreeing with Field, Milton said: “We need a new public health movement, owned by everyone, for everyone’s benefit. A movement that transforms the way in which the public’s health is improved, but also revolutionises the way we think about it. As Field points out, personal responsibility is a key part of this.”

However, Milton added: “The government recognises that it cannot force people into behaving in a certain way. But we can help people make informed decisions and ensure that they are enabled and supported to make healthy choices.”

Professor Terence Stephenson, president of the Royal College of Paediatrics and Child Health, agreed some parents let down their children. “Of course paediatricians agree that people should take responsibility for their own lives. But young children cannot do that. What they eat and the environment they live in are determined by their parents. There is a role for society to protect young children from promotion of unhealthy foods and passive smoking. Would all parents strap young children into a car seat if it was left to choice rather than law?”

He urged a twin-track approach of exhorting parents to care for children well but society also intervening to help by, for example, limiting advertising of unhealthy foods.

Dr John Middleton, vice-president of the UK Faculty of Public Health, said: “A significant amount of ill-health is due to people’s lack of personal responsibility. The NHS would have fewer burdens on it if people were more physically active, cut their alcohol consumption and ate a lower-fat, lower-sugar diet. The government and the NHS cannot do everything. But someone trying to give up smoking will find it easier if they get counselling and nicotine replacement therapy on the NHS, for instance.”

The government had a key role to play in promoting health, as shown by its crackdown on smoking and its fluoridisation of water supplies, said Professor Dinesh Bhugra, president of the Royal College of Psychiatrists. People who insisted on smoking despite all the warnings about it should retain their freedom to do so, he added.

But Tam Fry, National Obesity Forum spokesman, suggested Field was being naïve. “If Professor Field wants a world where everyone assumes personal responsibility, he is living a dream. He appears to have forgotten the 35-40% of our population who live in the same obesogenic environment as he does but simply can’t cope with it or have long since given up the unequal struggle. They are the people who are quite unequipped to resist the 24/24 battering of junk food promotion and are easy prey for the marketing men.”

However, “certainly the 40% of women entering pregnancy either overweight or obese do so simply because they have never had role model lessons in parenting from either their own mothers or health professionals”, Fry added.

From: http://www.guardian.co.uk/public-health-attitudes-leading-gp

McDonald’s, Burger King and other fast food outlets should offer diners free drugs to compensate for the risk of heart disease, cardiologists have proposed.
If burger joints offered cholesterol-lowering statins, customers would offset the unhealthy effects of a cheeseburger and milkshake, according to researchers at Imperial College London.

The pills could be placed beside the salt, pepper and tomato ketchup to encourage people to pop one after their meal.

The suggestion is made in a paper by Dr Darrel Francis, a cardiologist at Imperial’s National Heart and Lung Institute, and colleagues published in the American Journal of Cardiology.

The idea was criticised by leading doctors, who said the study could encourage ill-health by prompting even greater consumption of junk food and increasing the belief in “a pill for every ill”.

Francis said: “Statins do not cut out all of the unhealthy effects of burgers and fries. It’s better to avoid fatty food altogether. But in terms of your likelihood of having a heart attack, taking a statin can reduce your risk to more or less the same degree as a fast food meal increases it.”

People eat fast food despite knowing that it is bad for them. Given that, said Francis: “It makes sense to make risk-reducing supplements available just as easily as the unhealthy condiments that are provided free of charge. It would cost less then 5p per customer – not much different to a sachet of ketchup.”

The proposal was in line with other established risk-reducing measures such as wearing a seatbelt or buying filtered cigarettes, Francis argued.

Professor Steve Field, chairman of the Royal College of General Practitioners, denounced the proposal. “This paper just amazes me,” he said. “Let’s get real; we should be encouraging healthy lifestyles, not pill popping. This is an unwelcome addition to the ‘pill for every ill’ attitude that’s already much too common. The danger of this research is that some people will become even more complacent about eating fatty food and high calorie food, and might even increase their intake of them.”

While statins were generally safe they could increase the risk of muscle weakness and, in rare cases, of kidney failure, cataracts and liver problems, Field added.

Millions of Britons who have dangerously high cholesterol levels, and those with existing heart problems, take statins regularly to reduce the risk of a heart attack or stroke.

Professor Peter Weissberg, medical director of the British Heart Foundation, said: “The suggestion that the harmful effects of a junk food meal might be erased by taking a cholesterol-lowering statin tablet should not be taken literally. Statins are a vital medicine for people with, or at high risk of developing, heart disease. They are not a magic bullet.”

From: http://www.guardian.co.uk/fast-food-free-drugs-heart-disease

The number of 11 and 12-year-old girls prescribed the pill by a family doctor has soared five fold in the past decade, according to new figures.
More than 1,000 girls in the first year of secondary school have been given prescriptions for the pill, according to figures from GPs, while a further 200 have long-term injectable or implanted contraceptive devices.

The disclosure prompted warnings that Britain was “facilitating the sexualisation of young people at an every younger age”.

It follows the publication of guidance by the nanny state’s National Institute for Curbing Expenditue (NICE)  that sex education should be introduced from the age of five.

Trevor Stammers, chairman of the Christian Medical Fellowship and a GP in south London, told The Sunday Times: “If sex education is introduced in primary schools in the way being proposed, we will see many more 11-year-old girls seeking contraception without pointing out the risks…. We are going to make matters worse.”

He added: “These figures illustrate the fact that the UK is facilitating the sexualisation of young people at an ever younger age.”

The latest figures came from the General Practice Research Database, which collects information on medical records from 500 GP practices.

The data also shows that at least 58,000 15-year-olds were on the pill last year – more than double the number in 1999.

By law, doctors are bound by a duty of confidentiality towards children – even if they are under the legal age of consent – unless they suspect abuse.

From: http://www.telegraph.co.uk/Huge-rise-in-11-year-olds-on-the-pill

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

European rules are creating a generation of “lazy, clock-watching” junior surgeons who lack the skills to operate safely, their bosses have warned.
A year after the EU directive limiting workers to a 48-hour week was brought in for the NHS, 80 per cent of consultants polled by the Royal College of Surgeons said quality of care had already been damaged by the changes, with risks to patients who are repeatedly “handed” from one shift to the next.

The survey also found that two thirds of junior surgeons said their hours in training had been cut.

Children at risk through lack of training for doctors and nurses, report warns

Consultants who took part in the study were most damning about the impact of the changes on their trainees.

Among responses from more than 500 senior surgeons taking part were repeated warnings that the rules were creating a generation of “clock-watchers” with a “lazy work ethic” who no longer felt personal responsibility for their patients.

Trainees were now spending so little time in operating theatres that they would lack the “cutting skills” required to perform safely when they became consultants, many warned.

College president John Black urged the Government to take urgent action to address the concerns, having pledged in its Coalition agreement that it would work to limit the application of the EU rules in the UK.

He described the situation facing the NHS as “acutely urgent”.

Mr Black said: “Without action we are going to see a generation of specialists with less experience than any that have gone before.”

Many consultants responding to the survey said the changes – which began in 2007 when a 56 hour maximum working week was introduced, following EU legislation – were already changing the attitude of young doctors, who were becoming too detached from the patients in their care.

Marjan Jahangiri, Professor of Cardiac Surgery at St George’s Hospital in London said: “We have created a generation of surgeons who lack technical skills and operate within a “clocking off” culture where they do not feel personal responsibility for their patient.”

The surgeon said the change in attitude was “as fundamental and dangerous” as the lack of expertise among junior doctors, who now received far less training than their predecessors.

She said: “We have now got a system where trainees begin keen and motivated, become restless from a lack of training opportunities, and they will end up lazy and unskilled”.

The heart surgeon, 48, said that by the time she became a consultant, nine years ago, she had undertaken 900 cardiac operations. The current generation were likely to become senior doctors after performing less than 300, she said.

Consultants who used to do most of their surgery assisted by trainees said they were now often forced to operate alone.

While some juniors ignored the rules and came in on their days off, most had far less time in the operating theatre because of strictures limiting them to a maximum of 48 hours, including all time on call, as well as their night shifts, and time on wards and in Accident and Emergency departments.

One respondent to the survey described the directive as the “single most damaging factor affecting training and continuity of care”.

The surgeon added: “The most insidious problem is that it fosters the concept that you are responsible for a patient only for a shift.

“A consultant surgeon has a particular and continuing responsibility – we are training clock watchers whose work life balance is more important than anything else.”

More than half of the 982 consultants and trainees polled said they were not truly complying with the rules, with many saying they lied about the true hours they worked because of pressure from NHS managers.

Among consultants who did comply with the 48 hour limit, 56 per cent said they had only done so at the expense of patient safety.

Many of the risks came from the increased numbers of “handovers” from one shift to another, and the use of inexperienced locums to cover gaps in rotas.

While some respondents in the anonymous survey said only luck had avoided serious incidents, others described specific errors which they attributed to the new system – such as the removal of an eight year old’s ovary, instead of her appendix, by an inexperienced doctor.

Mr Black said the NHS was “skating on very thin ice” under the current system, given that most doctors said they were still working longer than the 48 hours,

Doctors described handover procedures between teams which were unsafe, inadequate and in some cases, non-existent.

Trainees also described despair about the system, with many saying their training had suffered, and others saying they were only managing to improve their skills by lying about their hours and working on their days off.

Estimates suggest the current generation of trainees will have spent about half as much time in training or on call as those who became consultants before the EU rules were introduced.

A consultant summed up the training problems as a “complete disaster”, adding: “I just hope my colleagues can look after me when I get old. The only problem is they are going to be getting old too.”

From: http://www.telegraph.co.uk/EU-rules-are-making-our-doctors-lazy-clock-watchers

Doctors have found the first clear evidence that overweight women face a heightened risk of miscarriage after undergoing IVF (in vitro fertilisation).
Obese women Women considering IVF should be counselled that being overweight or obese doubles their risk of miscarriage, say fertility experts

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

Concerns over the link between rising skin cancer rates and exposure to sunshine may have led to overly precautionary advice being given to the public about staying out of the sun at midday, according to a confidential “position statement” by leading health organisations.
The current advice to the public from the leading research charity on skin cancer, Cancer Research UK, states to spend between 11am and 3pm in the shade and to cover the skin with clothing, hats and sunscreen if out.

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

Health Direct wonders if you had a good weekend- as nearly a quarter of the UK popultaion is overweight and the number of alcohol related deaths has more than doubled since the early nineties according to the Office for National Statistics.
The latest edition of the Social Trends report also reveals that one-in-five men and one-in-seven women over 16 drink more than double the recommended daily allowance of alcohol once a week.

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