The only scientist in the House of Commons has called for all MPs to be required to take a crash course in basic scientific techniques.
Julian Huppert, a research biochemist who became the Liberal Democrat MP for Cambridge at the last election, said he was alarmed at the lack of scientific knowledge among colleagues.

In an interview with The Independent, he also accused political leaders of paying “lip service” to the importance of scientific proof and warned that looming cuts to university research budgets could provoke a “brain drain” from Britain.

Although there are other backbenchers with scientific backgrounds, Dr Huppert is the sole MP to have practised past PhD level, specialising most recently on DNA structures.

He said it was a real concern that the Commons – which is full of career politicians, lawyers and economists – lacked scientific expertise. Dr Huppert, a fellow of Clare College, Cambridge, argued that all MPs should be obliged to take a short science training course, covering areas such as how research is conducted, numeracy and the use of statistics.

“It would be really important for all MPs to have some exposure, because some of them will not have studied any science since they were 15 and it’s important to understand how to engage with it,” he said. “You would then have a lot of MPs who were able to understand the information they were being presented with.”

Accusing some MPs of being “anti-science”, he said: “They have a set of beliefs and they will argue that regardless of the science.”

Dr Huppert said political leaders tended to come up with a stance and then tried to make the evidence fit it, rather than being driven by the science. He cited the previous government’s decision to make the drug mephedrone a banned substance after claims about the role it played in the deaths of several young people.

“What we saw was a policy based on media reports, rather than based on evidence, and that does happen too much, ” he said. “As a researcher I will come up with a hypothesis, which I may talk about to people, I’ll then do some experiments and test it and will then change my hypothesis based on what I find. If you do that in politics, that’s a U-turn and a defeat.”

Although he absolved the Science minister, David Willetts, from criticism, he said a “tricky” relationship had developed between MPs and scientists. “Generally, they are two separate camps who do not communicate,” he said.

Dr Huppert gained a seat on Cambridgeshire County Council when he was 22 – the same age at which he gained his PhD. He pursued the two careers in parallel until the election in May, when he succeeded fellow Liberal Democrat David Howarth, who stood down as the MP for Cambridge to return to academia.

Dr Huppert said: “Science in some senses is what I am good at, but politics is what I care about.” He also hit out at suggestions that university research budgets could fall victim to the public spending squeeze being undertaken by the Government.

From: http://www.independent.co.uk/only-scientist-in-commons-alarmed-at-mps-ignorance

Finger on the Pulse- pointless and costly bureaucracy and ludicrous management salaries have no place in this era of austerity.
Several years ago, a friend worked as a temp in the NHS. She was the secretary to a group of middle management in a primary care trust (PCT) and spent the summer holiday before going to law school running their office. Within a few weeks, she quit. Not because she couldn’t do the job, but because she was disgusted with the waste she witnessed.

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

A coroner yesterday condemned a “scandalous” hospital maternity unit over the death of a third baby in its care.

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 rise in emergency admissions to hospitals is “overheating” the system in England and is “unsustainable” in the future, a health think tank says.
Analysis by the Nuffield Trust found there were now 4.9 million unplanned admissions a year – a rise of 12% since 2004-05 – costing the NHS £11bn a year.

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

An NHS worker with an unblemished 27-year career was sacked after she blew the whistle on senior doctors who were moonlighting at a private hospital while being paid to diagnose NHS patients, an employment tribunal has heard.

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

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

GPs and Doctors are to be given sole responsibility for overseeing front line care to patients under Coalition plans described as the biggest revolution in the NHS since its foundation 60 years ago.
About £80 billion will be distributed to family GPs in a move that will see strategic health authorities and primary care trusts scrapped.

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

Doctors’ leaders are demanding curbs on the boom in private screening clinics offering services ranging from simple blood pressure checks to full body scans costing more than £1,000.
Patients are being exploited by “irresponsible” marketing of private health screening tests, the British Medical Association and the Academy of Royal Medical Colleges say in a letter to health secretary Andrew Lansely.

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 first NHS nanny state scheme to offer cash rewards for losing weight has helped more than 100 obese people shed nearly two stone each in a year.

Cash payments of up to £425 were offered by an NHS primary care trust in Kent to 402 volunteers who signed up for the year-long “Pounds for pounds” trial in January 2009.

Among the 100 who completed the course, the average weight loss over the year was 25lb. However, they represented only a quarter of the total. In all, two-thirds of the volunteers failed to reach their weight loss target.

The mixed results are a disappointment to advocates of the use of financial incentives to change unhealthy behaviour. A growing body of experts say cash rewards may offer the best hope of persuading people to alter their lifestyles and head off the epidemic of chronic disease associated with smoking, drinking and overeating which threatens Western nations.

Last month, the National Institute for Clinical Excellence (NICE) held a two-day hearing to discuss the use of cash incentives in health. In addition to helping people lose weight and give up smoking, other schemes have offered rewards to addicts to stay off drugs and £10 record vouchers to young people who agree to have a test for chlamydia.

An independent evaluation of the Kent weight loss scheme by the University of Sheffield concluded that financial incentives worked for some people, but the high drop-out rate meant the true impact was unclear.

Claire Martin, acting assistant director of public health for NHS Eastern and Coastal Kent PCT, said: “Very often people lose weight, but when they stop their diet the weight returns. We need to invest in programmes that return a sustained weight loss and produce long-term health benefits.

“There were high drop-out rates and so it is very difficult to interpret the results to show how successful this would be across our population.”

The cost of the Kent scheme, run by a private company, Weight Wins, is around £180 per head. A spokeswoman for the Department of Health said the cost to the NHS of treating obesity-related conditions was £4.2bn.

Winton Rossiter, chief executive of Weight Wins, said 745 people had joined the scheme, more than half through the NHS Kent scheme and the remainder as private customers, paying a monthly fee. The average weight loss after one year was 15.8lb.

“These results suggest that long-term financial incentives could be the best single weapon in the war on obesity,” he said. Weight Wins is now offering a maximum payout of £3,000 to private customers who lose 150lb over 21 months and keep it off for three months. Customers pay £135 to join the scheme and £30 a month.

Healthy dividends

* In Essex, pregnant women who smoke have been offered up to £60 in food vouchers if they give up.
* In Hammersmith, west London, and in Bournemouth, the NHS has offered those under the age of 25 a £10 HMV voucher to have a chlamydia test.
* Weight Wins, a private company, charges a £10-£30 monthly fee and offers £150 to clients who lose 50lb and up to £3,000 for people who lose 150lb.
* In the US, employees of General Electric were paid up to $750 (£500) if they gave up smoking for at least 12 months.
* Several companies in the US offer a similar service, including Virgin Health Miles, StickK and HealthyWage.

From: http://www.independent.co.uk/pounds-for-pounds-scheme-helps-obese-people-shed-stones

The chairman of NHS London has resigned after stating his vision of healthcare delivery had “little in common” with that of the new government.In a letter to the health secretary Andrew Lansley, Sir Richard Sykes said he thought his work had made real improvements for Londoners.

Other NHS London board members may also leave, Sir Richard also claimed.

Mr Lansley said he was sorry that Sir Richard did not wish to lead NHS London in developing improvements.

The news follows the government’s announcement last week that it was ordering NHS London to scrap its plans for changing the way hospitals and GPs worked in the future.

However, the new government says it wants the plans re-drawn – with more input from patients and doctors.

In his letter, Sir Richard said: “I have reflected on what you said and concluded that our visions of healthcare delivery bear so little in common that it would make no sense for me to continue in this role.

“I am, therefore, writing to give notice of my resignation from this office, with effect from 7 July.”

Sir Richard, who was appointed to the role in 2008, also said that he had “relished” the task of delivering change as outlined by the Healthcare for London report.

Responding, Mr Lansley said that the Healthcare for London approach should be to set out a range of innovative and challenging solutions for how to improve quality of care.

He said: “Neither the government nor NHS London should dictate decisions made. The decisions that patients make through choice, and which GPs make through commissioning, should not be pre-empted from on high.”

From: http://news.bbc.co.uk/1/hi/england/london/10165196.stm