Gay couples and women over 40 will be entitled to the same free IVF treatment as heterosexual couples on the NHS for the first time under new guidelines published today.Same sex couples will be given the same rights as heterosexual couples under guidance issued by the killer quango National Institute for Curbing Expenditure (NICE).

The NHS will also extend the upper age limit for IVF by three years to 42, following advice that suggests many women in their late 30s and early 40s could conceive after treatment.

Fertility experts questioned whether health authorities could afford to widen eligibility criteria, when only a quarter currently fund three cycles of IVF for infertile couples, as recommended by Nice.

Gedis Grudzinskas, emeritus professor of obstetrics and gynaecology at Barts and the Royal London Hospital, said that while the new guidance reflects “social changes” there were questions over whether NHS trusts could afford it.

“How do we reconcile the changes in society and equality of access to healthcare, with the economic predicament?” he said.

The new guidelines call on health authorities in England and Wales to fund fertility treatment known as intra-uterine insemination (IUI), using donor sperm, for people in same-sex relationships.

The move follows a relaxation in the law, made under Labour in 2008, to put same sex parenting on an equal legal footing.

The recommendation follows implementation of the Human Fertilisation and Embryology Act 2008. It abolished requirement for fertility clinics to take into account a child’s need for a father or a male role model before agreeing to treatment. Gay couples or single women now need only show they can provide “supportive parenting”.

Demand from gay couples paying privately for fertility services has subsequently boomed, say clinics. Official figures show the number of lesbian couples undergoing IVF rose from 178 in 2007 to 417 in 2010.

One cycle of IVF can cost up to £8,000 privately. Because success rates are low – typically 20 per cent for a 38-year-old – couples can spend tens of thousands on treatment.

Meanwhile Josephine Quintavalle, founder of Comment on Reproductive Ethics, described the same-sex move as “absurd”.

She said: “We are not prepared to accept what constitutes fertility from a biological perspective. Fertility treatment is very important but in this case what we are trying to do is rewrite biology.”

Under the Nice guidelines, women aged 40 to 42 deemed to have no chance of conceiving naturally should be offered one full IVF cycle. In this age group one in eight will give birth after one cycle.

From: http://www.telegraph.co.uk/Gay-couples-and-women-over-40-to-get-free-IVF-treatment-on-NHS

Everyone over the age of 50 should be given statins because they reduce the risk of a heart attack even in healthy people, a study has found.The risk of a heart attack or stroke is cut by a fifth in those who have no sign of heart disease, shows research by scientists at Oxford University.

Treatment guidelines should be reviewed in light of the findings, the experts said, and the NHS should impose a blanket policy of prescribing up to 20 million people statins at a potential cost of £240million a year.

Currently, the only people considered at high risk, those with a one in five chance of having a heart attack in the next 10 years, are given the cholesterol-lowering drugs.

Half of men aged 50 or over and almost a third of women qualify for statin treatment. About five million people are thought to take them.

National guidelines should be amended to lower the threshold for treatment to those with a one-in-10 risk over a decade, the experts said.

As the majority of people in their fifties would qualify for statins under this criteria, it would be cheaper and easier to implement a blanket policy to save money on screening tests — which cost up to £700 per patient — to identify them, it was argued.

The cost of statins, which can cost as little as £1 for a month’s course, would also be offset by the savings they would bring to the NHS in preventing costly operations, rehabilitation and by freeing ward space and places in care homes. A total of £1.3billion is spent annually on cardiovascular drugs alone.

The proposed statins programme would be controversial, as many believe it is unnecessary to medicate otherwise healthy people, and it is not clear how many would take the tablets if they were not experiencing symptoms.

Prof Colin Baigent, co-author of the study, said: “If we want to prevent heart attacks and strokes that come out of the blue in people with no previous evidence of problems — and about half of such events happen in the absence of any prior history of disease — then we have to identify and treat people who are currently healthy but are known to be at increased risk of developing heart disease. Such treatment should, of course, be in addition to obvious things like encouraging better diet, more exercise and avoidance of cigarette smoking.”

A National Institute for Curbing Expenditure (NICE) spokesman said the study findings will be included in the ongoing review of the clinical guidelines on cardiovascular risk assessment and treatment.

The study analysed data from 175,000 people in 27 random trials which compared people on statins with those on a dummy pill.

Researchers found that for every one point reduction in levels of bad cholesterol in the blood, there was a 21 per cent reduction in the risk of serious events, including heart attacks, strokes or surgery for blocked arteries among those with no symptoms of heart disease.

The risk of dying from a heart attack or stroke among those at lowest risk was cut by 15 per cent.

For every 1,000 people in the low-risk group treated with statins for five years there would be 11 fewer major heart attacks or strokes. “A benefit that greatly exceeds any known hazards of statin therapy,” the authors wrote.

Side effects of statins can include muscle aches, stomach disturbances, and altered liver function. Patients have also reported sleep and memory problems, depression and headaches.

From: http://www.telegraph.co.uk/All-over-50s-should-be-taking-statins

NHS hospitals had to be bailed out to the tune of almost £415 million last year after running out of cash according to Department of Health figures.In total 31 hospitals had to be given extra emergency funding to keep them going in 2011-12, up from 21 the previous year.

The payments have risen dramatically since 2009-10, when the department started collating full figures.

That year, they were £187.1 million, while in 2010-11 they rose slightly to £223.0 million, before jumping to £414.2 million.

The big rise coincided with a tighter budget settlement for the NHS as a whole,which has resulted in drops in referrals to hospitals and tighter restrictions on surgery for operations like hip and knee replacements.

Andrew Lansley said: “Labour left us a dismal legacy of challenged hospitals, burdening some of them with PFI deals they could not afford, huge debts, and poor financial governance.

“Even with the Government’s decision to protect NHS spending, the challenges of an ageing population and rising costs mean that these problems cannot be swept under the carpet any longer.

“For some hospital trusts, the challenges they face may be too great for them to take on alone.  That is why we are helping them overcome their problems, with short-term support if necessary, so that they become sustainable in the long-term.”

The largest single bailout was for South London Healthcare Trust, which received £79.2 million last year. Over three years it has been handed £168.7 million. Barking, Havering and Redbridge University Hospitals NHS Trust was the second biggest recipient in 2011-12, taking £57.7 million in total.

From: http://www.telegraph.co.uk/Hospital-bailouts-top-400m

Medicine shortages are having an “adverse” impact on patients, including vulnerable groups such as those with mental health problems, the House of Commons All Party Pharmacy Group said.In a report detailing its inquiry into medicine shortages, the group said the shortages had been mainly caused by the export of medicines intended for the UK market to other EU countries.

This exporting is conducted by speculators and is legal under EU and UK law, the report noted.

Highly qualified pharmacists are having to spend time locating medicines in short supply, the MPs noted.

But in spite of the best efforts of pharmacists, the group said it had been told of cases involving vulnerable patients not receiving the medicine they need because of shortages.

These included patients with mental health problems, epilepsy sufferers, diabetics, and even pregnant women in need of medicine to stabilise their pregnancy.

“Evidence we received highlights the stress, anxiety and sometimes harm that patients suffer,” the MPs said in their report.

The group warned that the UK has been experiencing shortages of NHS prescription medicines for four years.

“We have no objection to the export of medicines in principle, so long as this practice does not harm patients,” they said.

“However, throughout this inquiry, we have seen evidence that patients are suffering and that pharmacists’ time and resources are being diverted away from patient care as a result of medicines being in short supply.”

In its report, the group calls for a “renewed sense of urgency” to deal with the problem by those organisations involved in the supply of medicine.

The Government must “unequivocally” state that the interests of UK patients must come first and not provisions concerning the free movement of goods, it said.

Katherine Murphy, chief executive of the Patients Association, said: “The very least patients should be able to expect is for prescribed medicines to be available to them when required.

“However, all too often this simple expectation is not being met and as a result patients, some of whom have serious medical conditions that require medicine to remain stable, are being put at risk.

“The Government needs to investigate this problem as a matter of urgency, using the findings of this report as a starting point.”

Savage cuts to nursing are stretching resources “to breaking point”, the largest nursing union says today at it’s conference.Government plans to shift care out of hospital and closer to patients’ homes are being used as a cover for the cuts, the Royal College of Nursing warns. It is also leading to patients being discharged too early, the RCN reports.

Over 26,000 nursing posts have been cut in the last two years and a further 61,000 are at risk, according to the RCN.

The college says that, despite government rhetoric claiming more care is being provided outside hospital, there has been less than a 1 per cent increase in the community nursing workforce in the last decade and community nursing is “stretched to breaking point”.

The figures come as Andrew Lansley, the Health Secretary, prepares to address the RCN congress today. In an interview with The Independent ahead of the speech, Mr Lansley denied there were mass reductions in nurse numbers.

He also said staffing numbers were not the only factor in providing good patient care. “In some hospitals the staffing ratios are exactly what we would expect, but some wards are really excellent and some are really bad. This is about leadership,” he said.

Mr Lansley added that a recent staff survey shows that, across the NHS, only 65 per cent of staff would recommend their hospital to friends or family.

A poll conducted for the college on the eve of its annual congress in Harrogate found 90 per cent of respondents agreed patients were being discharged sooner from hospital and with more complex needs than a year ago.

Dr Peter Carter, chief executive of the RCN, said: “Nurses are stretched too thin and many are approaching breaking point. Inevitably patients are going to suffer.” The RCN supported a shift from hospital to community care but nurses reported patients being discharged from hospital before social-care support was in place.

The Health minister Simon Burns said he did not recognise the RCN’s figures: “There are only 450 fewer qualified nursing staff in England than in 2009 and in 2011-12 we expect to train 2,300 community nurses and health visitors.”

From: http://www.independent.co.uk/government-is-cutting-nursing-numbers-by-stealth

The NHS risks becoming the “World Health Service” because even visitors to the country can claim free treatment, immigration campaigners warn.Ministers have confirmed that GPs do not need to ask prospective patients for ID or proof of address when registering them, raising fresh fears over “health tourism”.

It allows foreign nationals who arrive in England on a six month visitors visa to begin receiving health care immediately.

But the pressure group Migration Watch UK says that it could also mean illegal immigrants getting NHS treatment.

Sir Andrew Green, chairman of the organisation, said: “What this means is that someone getting off a plane with a valid visitors visa, is, in effect, able to access the GP services of the NHS without ever having paid a penny into the system. Over one and a half million such visas were issued last year.”

“And once registered with a GP it is, in practice, an easy step to potentially highly expensive and long term treatment – all at the expense of the UK taxpayer with little or no prospect of the beneficiaries ever being charged for it.”

He went on: “‘It is clearly not the job of doctors to act as an arm of the immigration service but there are clear and substantial risks of abuse in such a lax system and controls must be put in place.”

“The present situation is outrageous. Everyone knows the pressure the NHS is under and its ever increasing cost to the taxpayer. To allow such easy and potentially hugely expensive access without any entitlement must be stopped at once, otherwise the NHS risks becoming the ‘World Health Service’.”

The “lax” rules were confirmed in response to a parliamentary written question asked by Frank Field, the veteran Labour MP.

From: http://www.migrationwatchuk.org/

The number of patients forced to remain in hospital despite being fit enough to leave has increased by a quarter in under two years as councils struggle to find places for elderly people.New figures from the Department of Health show that the total number of days patients have been delayed in hospital has increased by 10 per cent in the last month.

The problem – often referred to as “bed blocking” – has increased 29 per cent when compared with figures from August 2010.

Patients are frequently delayed in hospital and cannot be discharged until suitable care has been arranged, either in a nursing home or in their own home, to aid their recovery.

Councils have faced significant cuts to their budgets and experts have previously warned there would be a knock-on effect on the NHS.

However, patients can also be delayed because they need to be transferred to other hospitals.

The figures show there were 71,450 delayed days in hospitals in March, up from 64,590 in February 2012 and 55,330 in August 2010. However, officials said it was not fair to compare summer figures with statistics from the winter period, when hospitals and councils are busier.

The cost of the delays to the taxpayer has now reached more than £18.5 million a month – around £600,000 every day. The total bill for delayed discharges since August 2010 is £324 million.

The Health Minister Simon Burns said: “No one should stay in hospital longer than they need to.  We know that there is always room for improvement when the NHS faces challenges from an ageing population and rising costs of new treatments.”

From: http://www.telegraph.co.uk/25pc-more-patients-forced-to-remain-in-hospital-beds

Planned births at home and in midwifery units are more cost-effective than giving birth in hospital, particularly for women who have given birth before University of Oxford research concludes.The research, in the British Medical Journal, compared the costs of giving birth in different places and the health outcomes for mother and baby.

More than 60,000 low-risk women in England were studied over two years.

The Royal College of Midwives says all women should receive one-to-one care.

For women having their first baby, however, planned home birth was more risky for the baby but still the most cost effective option.

The study used data from the Birthplace in England national study to calculate the cost, and health effects, of women at low-risk of complications giving birth.

It looked at planned births in obstetric units, midwifery units located in the same hospital as an obstetric unit, free-standing midwifery units not in a hospital and at home.

The study takes into account all NHS costs associated with the birth itself – such as midwifery care during labour and immediately after the birth, the cost of pain relief in hospital, and the cost of any stay in hospital or neonatal unit immediately after the birth, either by the mother or the baby.

The costs for planned home and midwifery unit births take account of any hospital care a woman may receive if she is transferred into hospital during labour or after the birth.

But the costs do not include any longer term costs, for example the life-long cost of caring for babies who suffer serious birth injuries.

The study found that the average cost per low-risk woman planning birth at the start of labour was £1,631 for an obstetric unit, compared with £1,067 at home.

When the researchers analysed women who had already given birth or who had no complicating conditions, the cost differences between planned places of birth narrowed.

The authors of the study conclude that giving women the opportunity to give birth at home or in a midwifery unit saves the NHS money and is safe for baby and mother, resulting in fewer expensive interventions.

AVERAGE COST OF BIRTH

• £1,066 – births planned at home
• £1,435 – births in freestanding midwifery units
• £1,461 – births in midwifery units alongside hospitals
• £1,631 – births in hospital obstetric unitsSource: BMJ study

The study found that individual care at home is cheaper than a planned hospital birth because hospital overheads tend to be higher and women who plan birth in an obstetric unit tend to have more interventions, such as caesarean section, which are expensive.

The Office of Fair Trading (OFT) has asked the Competition Commission to launch an investigation into the UK’s £5.5 billion private healthcare market.Following a public consultation in January, the OFT said that it suspected competition was being restricted.

It said it “continues to hold the view that the private healthcare market could work better for patients”.

The market is of growing importance due to an ageing population and improved medical outcomes, according to the OFT.

Among the concerns raised by the OFT are:

• a lack of information about the pricing and quality of services that would enable patients to compare healthcare providers
• the small number of healthcare providers and insurers nationally, which limits choice and competition
• practices that make it harder for new competitors to break into the market, such as loyalty payments to consultants.

The Competition Commission has the power to demand that firms change business practices and spin off specific business interests, if it deems these to be harmful to market competition.

The investigation could take up to two years to complete.

Surgeons have been warned to stop using a particular type of metal hip implant because it has an “unacceptably” high failure rate.The UK health regulator, the MHRA, said after four years, over 10 percent of the implants needed to be replaced.

An estimated 270 patients in England and Wales have had them fitted.

Surgeons are being advised to closely monitor all affected patients. The implants are no longer being manufactured or distributed.

Hip implants are made up of an artificial cup and head, replacing the original hip joint. They can be made entirely of metal, of ceramic, or of a combination of metal and plastic.

The implants in question are a particular combination of metal cup and metal head- with the brand names Mitch TRC and Accolade.

Surgeons are being advised to stop using them because the National Joint Registry for England and Wales shows a revision rate of 10.7% after four years of implantation, much higher than average.

The advice follows a recent study warning that metal-on-metal total hip replacements fail more frequently than other options.

The Medicines and Healthcare Products Regulatory Agency has already recommended annual checks for people with large head metal-on-metal implants.

It is thought tiny pieces of metal break off implants and leak into the blood. This might cause muscle and bone damage as well as neurological issues.

The clinical director of the MHRA, Dr Susanne Ludgate, said the revision rate for this particular combination of hip implant was unacceptably high.

“That is why we have advised surgeons to stop using this combination and to monitor their patients closely,” she said.  “We have previously taken prompt action in February to investigate safety concerns and provided advice on patient management to relevant healthcare professionals.”

From: http://www.bbc.co.uk/news/health-17590832