The Government is trying to reassure women fitted with PIP implants to prevent a rush for NHS surgery to remove faulty breast implants.

Almost £135,000 is being spent by the Department of Health on the campaign, which will also run in social media sites. Posters will appear in GPs’ surgeries and hospitals as well.

The advert reads: “The latest advice from the NHS and plastic surgery experts is that women with PiP breast implants do not need to have them removed unless they have symptoms such as pain and tenderness.

“There is no link to cancer and there is no clear evidence of an increased risk of harm compared to other brands of breast implants.”

However, it also states, in large-type at the top of the advert: “The NHS will support women with PiP breast implants.”

Clarifying the situation for those who received implants as part of private breast enlargement operations, it states: “”The NHS will remove your implants if your doctor agrees, but the NHS will not replace implants unless it is clinically necessary.”

It advises those worried about whether they have implants made by Poly Implant Prothese (PIP), which contain industrial-grade silicone, to find out if they have them, to speak to their specialist or GP, and “agree what’s best for you”.

Despite the campaign, Fazel Fatah, president of the British Association of Aesthetic Plastic Surgeons (BAAPS), said the organisation’s stance remained that all 40,000 women fitted with them in Britain should have them removed.

He said: “We remain steadfast in our recommendation to the public of precautionary removal of these defective devices. Although there is no immediate health risk, the gel within these implants is simply not meant to be inside the human body.”

A survey of its 230 members found 95 per cent agreed that “it should be the clinics and hospitals that should pay for the replacement surgery, rather than burden the taxpayer with these costs”.

Women given the PIP implants are due to protest in London on Saturday at the reluctance of private firms like Harley Medical Group, The Hospital Group and Transform Cosmetic Surgery to fund removal and replacement surgery.

Explaining the rationale for the campaign, Andrew Lansley, the Health Secretary, said: “The refusal of some clinics to help their patients has left some of those women worried and confused.

“That’s why we are running this ad campaign, to give women clear, definitive advice about what course of action they should take. I hope it helps women decide what is best for them. We have made it very clear to private companies what we expect of them – to provide their patients with the aftercare that they need and deserve.”

“I do not think it is fair to the taxpayer or other NHS patients for the NHS to foot the bill.  We will pursue private clinics with all means at our disposal to avoid this.”

Professor Sir Bruce Keogh, NHS medical director and leader of an expert group on PIP implants convened by Mr Lansley, said: “At present there is insufficient evidence to recommend routine removal of these implants.

“But I know women will be worried. That’s why the expert group supports the NHS offer and believes the private industry should do the same.”

From: http://www.telegraph.co.uk/Breast-implant-scandal-Government-campaign-to-reassure-women

Officials say the implants – thought to have been fitted in some 52,000 women who wanted larger breasts for cosmetic reasons or after cancer surgery – only need to be replaced if they have ruptured but will also carry out the procedure if the patients are worried about them.

Most independent providers have agreed to provide free surgery for their patients who received implants made by the now-defunct Poly Implant Prothèse (PIP) – which were filled with non-medical grade silicone intended for use in mattresses – at least one is holding out while another has so far refused to reveal its policy.

Transform Cosmetic Surgery said the Government needed to “accept its responsibility” for the problem as the implants had been approved for use by a watchdog, the Medicines and Healthcare products Regulatory Agency.

Transform carries out 6,000 breast augmentation procedures a year, and estimates it has fitted some 4,000 women with PIP implants in recent years.

The clinic is currently refusing to pay for them to be removed and replaced and is charging women £2,800 per procedure, although it insists most implants are not at risk of malfunctioning. Some patients have already been booked in for the operation.

It said it would review its stance this week, but if it remains unchanged it could mean the Government has to step in and pay for these women’s operations, at a cost of up to £11.2m.

Nigel Robertson, the chief executive of Transform Cosmetic Surgery, said in a statement: “Transform is fully committed to supporting the Department of Health in its efforts to end the uncertainty and anxiety of British women affected by the PIP situation and awaits a response to its request for an urgent meeting to discuss the way forward.

“It is important to recognise that this crisis is the result of failed regulation of breast implants, which were approved for use. The Government needs to accept its responsibility for this situation and work constructively with us to find a workable solution.”

The other major clinic yet to announce its decision is The Hospital Group.

It is telling patients there is “no evidence to suggest routine removal” of PIP implants but will replace those that have already ruptured “free of charge”.

Other leading providers including BMI Healthcare, Nuffield Health and Spire have agreed to offer free removal of the PIP implants.

Michelle Victor, a solicitor at Leigh Day & Co, said the firm had already been contacted by women seeking help to make private clinics pay for the replacement of their PIP implants.

She said that although the clinics themselves were not responsible for making them, the implants were “not fit for purpose” and so cosmetic surgery groups should remove them.

From: http://www.telegraph.co.uk/Leading-cosmetic-surgery-group-refusing-to-fund-new-breast-implants

Mr King said the number of care home places in the UK will fall unless operators get “fairer fees”.

His comments came as he unveiled a sharp rise in Bupa’s overall global profits, but a fall in the UK division.

About 70% of Bupa’s 18,000 care residents, in its more than 300 homes, are paid for by local authorities- and local authorities pay for well over half of England’s 390,000 care home residents.

But Mr King said operators are seeing a real terms fall in fees as authorities’ budgets come under pressure.

Bupa believes there could be a 100,000 care home bed shortfall within 10 years, if investment in the sector is not increased and current funds are not ring fenced.

This could put pressure on the NHS to take in people who would normally go into care homes.

Bupa, which is a provident company with no shareholders, said its global care services division lifted revenues by 1% to £589 million and profits by 2% to £67.7 million in the half year to June.

But the UK care arm saw a “marginal” fall in profits and occupancy, a situation that could worsen.

Mr King said: “We are calling for the chronic underfunding of the social care system to be urgently addressed. At the absolute minimum, there must be a real terms increase in funding for local authority purchased care home places over 2012-15.”

A nationwide lottery offering couples the chance to win IVF fertility treatment was strongly criticised.

The lottery is being organised by the charity To Hatch, founded by Camille Strachan, 38, to help people who are struggling to conceive. The winner of the lottery, which is licensed by the UK Gambling Commission, will be randomly selected by a computer in September. Further monthly draws are then planned.

Ms Strachan says she hoped the lottery “can ease the burden on the NHS and reduce the stress on some of those who are struggling.”

It is understood that a number of UK clinics have refused to participate, sparking rumours that a clinic in Barbados would be one of the destinations. Ms Strachan has declined to reveal which “top” clinics would offer the treatment.

The Human Fertilisation and Embryology Authority (HFEA) have criticised the move as “wrong and entirely inappropriate”. They described it as running “counter to the ethos that underpins our regulatory system and clinical practice”.

Dr Allan Pacey, a fertility expert at the University of Sheffield and a spokesperson for the British Fertility Society, said: “In my view it’s a slippery slope to be dishing out healthcare like this, particularly when it comes to children. My mother and father used to say they found me under a gooseberry bush – can you imagine telling a child that he or she was won in a raffle?

“Ethics aside, I think it is precisely the current postcode lottery of NHS funding which makes this charity think it can make this venture a success. Couples either find they can’t get access to NHS treatment or they get only a single attempt and therefore need to fund any further treatment privately if that is unsuccessful.”

Despite criticism of the charity, public responses on internet chat forums were mixed. Although the majority expressed misgivings, hundreds of people indicated on Facebook and Twitter that they intended to buy tickets.

Many took the view that the lottery is a good idea, given what is widely perceived as a cut in the provision of IVF treatment on the NHS.

A spokesman for the Gambling Commission, which regulates lotteries, said: “The commission plays no statutory role in judging ethical questions that fall outside of the Gambling Act 2005. A licence is granted if all the criteria are met.”

From: http://www.independent.co.uk/fertility-doctors-attack-unethical-16320-ivf-raffle

A Paris court ruled on Tuesday that there was nothing libelous about Dr Cohen’s comments, and ordered Dukan to pay £2,700 in damages for “abusive procedure.”

Dr Cohen had warned that Dr Dukan’s methods could lead to serious health problems among some patients.

Dr Dukan issued a statement on Tuesday defending the safety of his diet and suggested Dr Cohen was jealous of the “Dukan phenomenon.”

Dukan’s book was France’s best-selling publication last year and is also a US best-seller. The protein-based diet urges against counting calories, instead allowing dieters to eat as much as they like from a limited list of foodstuffs.

Dr Cohen’s diet says readers can eat anything they like providing they stick to one of four calorie-based programmes of up 1,600 calories a day. The overall aim is to foster good eating habits and take regular exercise.

From: http://www.telegraph.co.uk/Weight-loss-guru-Pierre-Dukan-loses-libel-suit

The researchers said they were surprised to find the chromosome defects which appeared to have occurred during the second stage of the specialised process of cell division that leads to the creation of the human egg cell.

Chromosome defects in eggs were previously considered to have resulted in the first stage of cell division, which occurs when a woman was herself a foetus in the womb. Finding them during the second stage, which occurs at ovulation, therefore suggests they may have resulted from the hyperstimulation of the ovaries during IVF treatment.

The defects included abnormal variations from the usual number of 23 pairs of chromosomes. Three copies of chromosome 21 instead of the normal two, for instance, leads to babies with Down’s syndrome. As women get older it becomes increasingly difficult for them to produce enough viable eggs for IVF treatment. It is common practice for older women to have their ovaries stimulated with stronger doses of drugs than is the case for younger women.

The results of the study are to be presented at a fertility conference in Stockholm this week but the scientists behind the research said that they wanted to reassure older women considering IVF treatment. They said further work needs to be done fully to explain the findings and there is no evidence to suggest that IVF babies of older women are at any higher risk of birth defects than babies conceived naturally by women of the same age.

“We found that some IVF eggs have up to seven chromosome abnormalities. This suggests the possibility that ovarian stimulation during the treatment may have caused some of these defects,” said Professor Alan Handyside, director of the London Bridge Fertility, Gynaecology and Genetics Centre, who led the study.

“These defects are unexpected and it may be that this is just an undiscovered aspect of biology. At the moment all we can say is that this is part of the natural process as women get older.”

The study, which will be presented at the European Society of Human Reproduction and Embryology, analysed more than 100 egg cells from 34 couples undergoing IVF treatment. The average maternal age was 40.

Scientists screened the chromosomes of the eggs and structures known as “polar bodies” that result from a type of cell division known as meiosis. Meiosis is a specialised form of division that results in eggs with half the normal complement of chromosomes – crucial to ensuring that the fertilised egg has the full complement of 46 chromosomes when it fuses with a sperm cell.

The first stage of meiosis occurs when the woman’s ovary is developing in the foetus before birth, when the dividing chromosomes are held together by a kind of cellular “glue” ready for the second stage of division at ovulation.

However, when the ovary of an older women is stimulated with synthetic hormones it is possible that this dislodges the glue prematurely. This might result in abnormal numbers of chromosomes to segregate into the resulting egg cell.

“Our evidence demonstrates that, following IVF, there are multiple chromosome errors in meiotic divisions, suggesting more premature separation of single chromosomes resulting in more random segregation,” Professor Hanyside said.

Stuart Lavery, a consultant gynaecologist at Hammersmith Hospital in London, said “This provides evidence that there is a problem, but it does not prove that it’s treatment related,” Mr Lavery said.

The most important conclusion to be reached from this research isn’t so much the “why” but that the screening process for eggs to be used in IVF must be improved.

It is possible to screen the chromosomes of so-called First Polar Body eggs, at least as part of research. This paper stresses the importance of also screening Second Polar Body eggs, those that have been fertilised.

Doing so will, we can now see, allow us to better identify eggs that have developed abnormalities that result in conditions like Down’s Syndrome.

The issue of whether drugs used to stimulate ovulation are having a role is two-fold. Are the drugs damaging the eggs or simply releasing those that would otherwise be discarded naturally because of abnormalities? Or it could be the drugs have no role at all? We don’t know.

One intriguing point is that if the drugs are a factor we would have anticipated having seen more cases of Down’s Syndrome among older mothers. They may be there but we haven’t detected any such increased risk yet – it means we need to research the possibility.

From:  http://www.independent.co.uk/ivf-drugs-may-be-linked-to-genetic-defects-discovered-in-embryos

They claim cosmetic surgery promotions are becoming more popular, especially over the last three months.

As well as prize draws, they say loyalty card schemes, divorcee packages, magazine competitions and online deals are also big concerns.

Some health experts believe advertising surgery in this way is encouraging young people to get treatments they don’t want or need.

Their concerns come days after My Big Fat Plastic Surgery Prize Draw, the first of a series of monthly events across the UK.

Tickets cost £25, with free entry into a lottery to win £4,000 worth of surgery of your choice.

The event was hosted in a nightclub in London and sponsored by a cosmetic surgery group. Runner-up prizes included fillers and semi-permanent make-up.

Jackie Lewis from Baaps specialises in breast surgery and criticised the draws.

“Cosmetic surgery should not be offered as a commodity prize,” she said. “This is not something that can be trivialised.

“If you’re going to subject yourself to a procedure which is irreversible with lifelong consequences, we recommend you think about it carefully first.”

The Government says you are free to choose where you have cosmetic surgery and the Advertising Standards Agency (ASA) insist all adverts must be socially responsible and not misleading.

From: http://www.bbc.co.uk/newsbeat/13908448

But it found as many as one in five breast augmentation patients had the implants removed within 10 years.

The FDA released a 63 page report on the safety of the silicone gel filled implants that compiled studies performed by the two companies approved to manufacture the the products.

Approximately five to 10 million women across the world have breast implants, the FDA said.

In 2006, the FDA approved two brands of silicone gel implants for women over 22, Allergan’s Natrelle implants and MemoryGel implants from manufacturer Johnson and Johnson’s Mentor division.

Silicone implants had been off the market since 1992, when the FDA removed them amid concerns about implant rupture and silicone leakage.

The agency allowed saline filled implants to remain on the market, and allowed limited distribution of silicone implants for mastectomy patients and other cases of medical necessity.

According to the new report, as many as one in five breast augmentation patients and half of breast reconstruction patients had to have the implants removed within 10 years.

Studies found no association between the silicone implants and connective tissue disease, breast cancer, or reproductive problems, the FDA reported.

But they did find a “very small” increased risk of anaplastic large cell lymphoma.

The most frequent complications from the implants included implant rupture, wrinkling, asymmetry, scarring, pain, and infection.

The report found that the risk of those local complications increases with time.

“Breast implants are not lifetime devices,” the FDA cautioned women. “The longer you have your implants, the more likely it will be for you to have them removed.”

But the agency also found that most women who had breast implants “report high levels of satisfaction with their body image and the shape, feel and size of their implants”.

“Despite frequent local complications and adverse outcomes, the benefits and risks of breast implants are sufficiently well understood for women to make informed decisions about their use,” the FDA concluded.

From: http://www.bbc.co.uk/news/world-us-canada-13883267

The process will be overseen by a restructuring committee consisting of representatives from the Darlington-based company and its 80 landlords.

Social services directors in England welcomed the announcement, but called for more information about the plans.

The process is still expected to lead to hundreds of its care homes being run by other operators.

Government representatives were not present at the meeting, but a Department of Health spokesman said the government had been “in constant contact over the course of discussions and remains ready to talk to all parties”.

“There is likely to be a series of meetings in coming days over the future of Southern Cross. Government is clear that all parties must work together to agree on a plan that will safeguard the continuity of care of residents,” the spokesman said.

Southern Cross and its landlords issued a joint statement after the meeting.

“The company and the landlords will work towards a consensual solution to the company’s current financial problems, which will be delivered over the next four months,” it said.

“The business, including the delivery of care, will continue to be the responsibility of the Southern Cross board, management team and staff who have the full support of both the landlords and lenders in the delivery of this important task.”

At the end of the process, Southern Cross is expected to end up operating under a different name with between 250 and 400 of its current 751 care homes.

Other operators will run the rest of the homes.

However, while welcoming the announcement as providing “great comfort” to thousands of older people, the group which represents social services directors in England said it wanted more information about the restructuring.

“It is clear that despite today’s (Wednesday’s) hard work by the parties involved, directors and their colleagues in local authorities throughout England and beyond will not have been given sufficient details of the shape of the future company: details which would help the important and well thought through contingency planning in which we have all been involved,” said Peter Hay, president of the Association of Directors of Adult Social Services (ADASS).

“The issue is the important one of confidence, and of ensuring that current residents of Southern Cross homes, as well as people who might be considering buying a place in one for themselves or for a relative, share in that confidence.”

The ADASS, whose members buy places in Southern Cross homes, added that unless the firm acted rapidly, there was a real danger it would lose business and market share.

Last month, Southern Cross said that it would stop paying about a third of its rental bill.

It is the UK’s largest care home operator with 31,000 residents, employing 44,000 staff, of which the company has already said it will cut 3,000.

From: http://www.bbc.co.uk/news/business-13786633

In response, Downing Street offered a “guarantee” that elderly and disabled people in Southern Cross homes would not lose out, but declined to say whether any emergency funding would be available.

The crisis comes as the public spending watchdog, the Audit Commission warns that the quality of services for elderly people will be under further threat as councils are forced to negotiate lower fees for private care places.

Southern Cross, which made a £311 million loss in the six months to the end of March, has blamed its problems on reduced council spending on long-term care. The group announced this week that it will be forced to cut the rent it pays to the landlords of the homes it runs by 30% for four months.

Saga, the over-50s group, called on ministers to draw up an urgent “rescue plan” for care homes in trouble. Ros Altmann, Saga’s director general, said: “The government and local authorities may have to step in and take control of the situation.

“There must be a plan for rescuing failed care homes, to protect their elderly residents properly. Of course some homes do fail, but not on a massive scale like this.

“Lives could be at risk as a result of Southern Cross collapsing.”

The GMB union, which has around 12,000 members working in the care homes, urged politicians across the UK to take action to help secure the future for the staff and the residents.

General secretary Paul Kenny said politicians must “sort out the uncertainty” the residents face. “These are not factories facing closure, they are a vital part of the social fabric of every community,” he said.

The Prime Minister’s official spokesman gave a guarantee that affected residents would not “lose out”.

“We are clear that we are putting the interests of residents at the top of the list,” he said. “It may well be in their interests to keep them in the same place. But I think we have to look at that very carefully and we have got to let this process continue with the company and the various other interested parties.”

However, he declined to discuss whether there was any contingency in care budgets to cover extra costs. Southern Cross is in talks with its landlords, who could force the group into deeper trouble if they refuse to agree to the rent cut.

Jamie Buchan, chief executive of Southern Cross, said he believed the company would survive, with fewer homes, but there would be no “need” for a government bail out. He told The Daily Telegraph: “I don’t think the Government would or would need to provide financial support.”

From: http://www.telegraph.co.uk/Southern-Cross-residents-need-government-rescue-plan

They are also commonly neglecting to offer patients a scale and polish alongside a check-up, which should both be covered under the lowest tier of work, and are instead trying to sell it as a private add-on.

Dentists should provide NHS patients with all the treatment that is “clinically necessary in order to keep your mouth, teeth and gums healthy”, according to a Department of Health leaflet.

Patients should pay a single charge depending on the complexity of the work, even if more than one procedure needs to be carried out.

The leaflet makes clear: “If your dentist says that you need a particular type of treatment, you should not be asked to pay for it privately.”

However, an undercover reporter for Channel 4′s Dispatches programme, who needed root canal work and a new crown, was mis-quoted by three dentists he went to see.

Under current NHS rules, they should have said both procedures were covered under Band 3 pricing, costing the patient a single charge of £198.

But one quoted him £725 for both pieces of work; the second said the crown was covered by the £198 NHS fee, but that the root canal work would cost him £480 as a private piece of work; while the third gave a similar quote, saying the root canal work would cost £400.

Seven more undercover patients went for check ups at different dentists. None of them was offered a scale and polish as part of NHS treatment, although they all needed one, even though this should be included under Band 1 treatment, which at the time carried a £16.50 charge.

Three of them were told they could opt to see a hygienist privately, a service typically costing £25 to £40.

Dentists say the way the banding system works pushes them towards wrongly charging extra for treatment – known as ‘gaming’.

Danny Pretorius, who stopped doing NHS work last year, told the programme: “If you had to do everything by the book like you should do, it would be virtually impossible to earn a reasonable living.”

The current “payment by procedure” system, which was introduced by Labour in 2006, has been very unpopular with dentists.

Last December the Coalition announced it was to be abolished and replaced with a “payment by patient” system, to encourage more preventive work.

Pilots of three variants of the new scheme are due to start around the country this summer.

A Department of Health spokesman said: “We are committed to improving dental access, and we will achieve this sustainably by replacing the existing dental contract with one that pays dentists for the number of patients registered and the quality of the care they provide, rather than the number of treatments carried out.”

*Dispatches: The Truth About Your Dentist was broadcast on Channel 4 at 8pm last night (Monday).

Other councils are planning to shut centres altogether or dramatically tighten up the eligibility for places over coming years.

The disclosure will fuel warnings over a crisis in care for the elderly.

It follows warnings last year that growing numbers of pensioners are being forced to sell their homes to cover expensive care home fees amid spiralling costs.

Emily Thornberry, the shadow care services minister, who obtained the latest figures, said the Government was failing to protect social care. Miss Thornberry’s office surveyed 50 councils providing care services.

Almost all said they were being forced to make sweeping changes to residential accommodation because of a combination of cuts and increasing pressure on services.

Some 88 per cent confirmed plans to increase care charges. A quarter of these were pegging increases to inflation, but others were introducing new and additional charges, raising or abolishing the maximum contribution from users or making other increases.

Almost two-thirds of councils said they were being forced to close care homes or day centres to save money.

Many confirmed plans to close homes in the next two years, while others said money was being saved by putting more emphasis on providing services in residents’ own homes.

A previous survey carried out by the Care and Support Alliance, whose members including more than 40 leading charities, has found that 23 per cent of disabled and older people have already seen their services cut.

Many said they can no longer afford essentials such as food and heating as a result of having to pay for care, while more than half said their health had suffered after support was reduced.

Paul Burstow, Minister of State for Care Services, said: “Under Labour social care was always the poor relation. Under the Coalition social care is receiving a £2bn spending boost including an unprecedented transfer of funds from the NHS to support integration.

“In 13 years Labour failed to reform the way we fund social care. Labour’s survey results are the product of that failure. Without the Coalition’s decision to priorities social care Labour’s legacy of underfunding would have been even greater.

“We are determined to put in place a lasting and fair settlement to the funding question. This Government has acted quickly to set up the Dilnot Commission on funding.”

From: http://www.telegraph.co.uk/health/Councils-planning-sharp-rise-in-care-home-fees

For the first time, new regulations will allow only long-established and quality-controlled medicines to be sold.

But both herbal remedy practitioners and manufacturers fear they could be forced out of business.

To date, the industry has been covered by the 1968 Medicines Act, drawn up when only a handful of herbal remedies were available and the number of herbal practitioners was very small.

But surveys show that about a quarter of all adults in the UK have used a herbal medicine in the past two years, mostly bought over the counter in health food shops and pharmacies.

The regulations will cover widely used products such as echinacea, St John’s Wort and valerian, as well as traditional Chinese and Indian medicines.

But safety concerns have focused on the powerful effects of some herbal remedies, as well as the way they interact with conventional drugs.

For example, St John’s Wort can interfere with the contraceptive pill, while ginkgo and ginseng are known to have a similar effect to the blood-thinning drug warfarin.

From now on only products that have been assessed by the Medicine and Healthcare products Regulatory Agency (MHRA) will be allowed to go on sale.

Manufacturers will have to prove that their products have been made to strict standards and contain a consistent and clearly marked dose.

And to count as a traditional medicine, products must have been in use for the past 30 years, including 15 years within the EU.

They will also only be approved for minor ailments like coughs and colds, muscular aches and pains, or sleep problems.

The manufacturers of herbal remedies have had seven years to prepare for the new rules after the European Directive on Traditional Herbal Medicinal Products was introduced in 2004.

These regulations apply to over-the-counter sales, which form the bulk of herbal remedies sold in the UK.

But some manufacturers and herbal practitioners have expressed concern, arguing the new rules are too onerous for many small producers.

Michael McIntyre, chairman of the European Herbal and Traditional Medicines Practitioners Association, says there will be a significant impact on herbal medicine practitioners and their suppliers, but admits the rules do need bringing up to date.

“Products that go on the market now will definitely do what it says on the bottle, while we didn’t know how good they were in the past.

“But registration is expensive so perhaps there may be fewer products on the market and a smaller range.

“It’s difficult to argue that the market should stay as it is, without any regulation, but how many businesses will pack up and walk away? I can’t say.”

A Department of Health spokesperson said: “We have swiftly introduced a system to register herbal practitioners using unlicensed herbal medicines, so consumers will be able to continue to use unlicensed herbal medicines if they wish.”

The World Health Organization says the situation has reached a critical point.

A united push to make new drugs is urgently needed, it says.

Without a concerted effort, people could be dealing with the “nightmare scenario” of worldwide spread of untreatable infections, says the WHO.

One example is the New Delhi or NDM-1 superbug recently found in UK patients. They have brought the infection back with them from countries like India and Pakistan, where they had visited for medical treatment and cosmetic surgery.

The Cardiff University researchers, who made the discovery last August, now say bacteria with this new genetic resistance to antibiotics have contaminated New Delhi’s drinking water supply, meaning millions of people there could be carriers.

Dr Timothy Walsh and his team collected 171 swabs of seepage water and 50 public tap water samples from sites within a 12km radius of central New Delhi between September and October 2010.

The NDM-1 gene was found in two of the 50 drinking-water samples and 51 of 171 seepage samples.

Worryingly, the gene had spread to bacteria that cause dysentery and cholera, which can be easily passed from person to person via sewage-contaminated drinking water.

“Oral-faecal transmission of bacteria is a problem worldwide, but its potential risk varies with the standards of sanitation.

“In India, this transmission represents a serious problem… 650 million citizens do not have access to a flush toilet and even more probably do not have access to clean water,” the researchers warn in the journal Lancet Infectious Diseases.

The scientists are calling for urgent action by health authorities worldwide to tackle the new strains and prevent their global spread.

Zsuzsanna Jakab, WHO regional director for Europe, said: “Antibiotics are a precious discovery, but we take them for granted, overuse and misuse them: there are now superbugs that do not respond to any drugs.

“Given the growth of travel and trade in Europe and across the world, people should be aware that until all countries tackle this, no country alone can be safe.”

The UK’s Health Protection Agency said it was monitoring the spread of NDM-1 closely.

“The first case of a bacterial infection with this resistance was identified in January 2008. Monitoring of this resistance began in 2009 as more cases were identified.”

So far, there have been around 70 cases of the infection recorded in the UK.

The HPA insists that the risk of infection to travellers to the Indian subcontinent who are not treated in hospital is minimal.

“If members of the public are travelling for surgery overseas they should satisfy themselves that appropriate infection control measures are in place,” says the HPA.

From: http://www.bbc.co.uk/news/health-12975693

The Adult Dental Health Survey, which is carried out every decade, also found a quarter said cost influenced the kind of treatment they opted for.

NHS dental care is subsidised, but patients still pay towards their care.

There are three price bands ranging form £16.50 for a basic check-up to £198 for complex procedures, including crowns.

Pregnant women, those on low incomes and children are exempt from paying.

As well as highlighting cost, more than one in 10 said extreme anxiety deterred them from the dentists, while a fifth cited dissatisfaction with previous treatments.

Of those surveyed, 58% said they had tried to make an NHS dental appointment over the past three years, of which 92% were successful. However, that does not mean the rest did not have dental treatment as some would have paid for private care.

From: http://www.bbc.co.uk/news/health-12849853

One such measure involves preventing anyone owing the health service £1,000 or more from staying or entering the UK until their debt is paid off, and as such the NHS will be expected to pass details of foreign patients who have failed to pay for treatment on to the UK Border Control Agency.

According to the government, this action alone should capture 94% of outstanding charges owed to the health service.

In other changes for NHS patients in England, the time UK residents can stay abroad and keep their entitlement to free hospital treatment has been extended from three to five months.

In addition, the small number of failed asylum seekers co-operating on registered Home Office support schemes will be exempt from charges, while all unaccompanied children under local authority care will also be guaranteed free hospital treatment.

However, the government feels that the existing system is still too complex, generous and inconsistently applied, and so has launched a wider review of practice.

This, it says, will look at changing the residency criteria for treatment, whether GPs should and other ex-hospital services should charge non-residents, and whether visas should be dependent on health insurance, in order to ensure that the system is both fair and affordable.

According to health minister Anne Milton, the changes will “begin the process of developing a clearer, robust and fairer system of access to free NHS services which our review of the charging system will complete”, with the aim of creating a system that “maintains the confidence of the public while preventing inappropriate free access and continuing our commitment to human rights and protecting vulnerable groups”.

From: http://www.pharmatimes.com/Government_cracks_down_on_health_tourism

Private hospitals bucked the recession in 2009 – but only by massively expanding the amount of work they carry out for the National Health Service, according to the analysts Laing and Buisson.

However, work for NHS patients, who now have the right to go to any private hospital willing to treat them at the NHS price for waiting-list type treatments, rocketed.

Their numbers almost quadrupled between 2007 and 2009, up from 55,900 to 212,000, so that NHS patients made up almost 22 per cent of private hospital cases, up from 6.3 per cent in 2007.

The result was a rise in independent hospital activity, with about 975,000 patients treated, against 888,000 in 2007.

Some NHS patients are sent by NHS hospitals to keep waiting times down.

But the numbers exercising their right to choose are rising sharply – running at a rate of 200,000 procedures a year in July this year, according to Laing’s Healthcare Market Review, the bible on private sector activity. That is business worth £400m a year.

William Laing of the review said senior health department officials believe patient choice activity in the private sector could triple. His own estimate is that it might ultimately rise five fold to about £2bn a year – although that would still be less than 20 per cent of NHS waiting list activity.

“Expanding the services they provide for the NHS has obvious attractions for independent hospitals because the publicly paid market is massively greater than the traditional private healthcare market.

“But it has great dangers as well, since too much focus on publicly paid patients could compromise their appeal to traditional, privately paying customers. There is a conflict which independent hospital providers have not yet fully resolved.”

If the independent sector seriously wanted to address the potentially huge public market, he said, it would “have to grow a lot more capacity”.

That could come from a mix of the existing players and new hospital providers entering the market with lower cost business models that generate reasonable profits from the prices that the NHS is prepared to pay.

The figures came on the day the Office of Fair Trading launched a wide ranging review into the private healthcare market – among other issues examining the barrier to new entrants joining it.

From: http://www.ft.com/cms/s/0/675afcb4-07b7-11e0-a568-00144feabdc0,s01=1.html#axzz18ALgaS00

The OFT said its preliminary research had raised questions about whether the market was working well for private patients.

It aims to formally launch its investigation in spring next year.

Meantime, it is seeking views on the proposed scope of the study.

The OFT says the private healthcare market is worth £5.5bn and is of growing importance due to an ageing population, improved medical outcomes and higher life expectancy.

It added that it was of growing importance to the NHS because of government initiatives that allow NHS patients to seek treatment from private healthcare providers in certain circumstances.

Sonya Branch, OFT senior director of services and public markets said: “We are keen to focus on whether patients and buyers of private healthcare, including the NHS, are getting the full benefit of choice and competition.”

She added that as the area was a complex one, the OFT would be speaking to providers, patients and government to make sure that it focussed on the correct issues.

Under proposals put forward in July by Andrew Lansley, the Health Secretary, GPs are to be given the power to manage £80 billion of the NHS budget to buy care from hospitals and other doctors, while tiers of management are to be axed.

The BMA said today- Friday, that while it was “interested” in these proposals, the greater efficiencies they could bring might be undermined by more private sector involvement.

Dr Meldrum said: “There are proposals in the White Paper that doctors can support and want to work with. But there is also much that would be potentially damaging.

“The BMA has consistently argued that clinicians should have more autonomy to shape services for patients, but pitting them against each other in a market-based system creates waste, bureaucracy and inefficiency.”

Dr Meldrum said that while he was “not ideologically against markets” he did not believe the evidence showed they had worked in the NHS so far.

Private finance initiatives and privately-run treatment centres, which sold their services to the NHS, resulted in taxpayers’ money leaving the service, he said.

“The private sector is not doing this out of some great social generosity, they want to make a profit,” he argued.

He was talking as the BMA submitted its response to the White Paper: Equity and Excellence: Liberating the NHS.

From: http://www.telegraph.co.uk/BMA-says-White-Paper-reforms-potentially-damaging

Unions criticised the plan saying it was privatisation and that NHS Professionals was set up to stop the NHS being ripped off by private agencies charging large sums for staff to work unfilled shifts.

NHS Professionals has 50,000 staff on its books who cover around two million shifts in 77 organisations around England.

Karen Jennings, head of health at Unison, said: “The whole reason that NHS Professionals was set up, was because private agencies were ripping off hospitals by charging them outrageous fees for recruiting or finding staff for shifts. It makes no sense at all to bring back private companies who will want their slice of the action in return.

“This proposal is purely about Tory plans to promote privatisation and hive off parts of the NHS to private companies, regardless of the consequences on patient care.”

A Department of Health spokesman said: “This is about exploring ways that the commercial skills of the independent sector can make NHS Professionals Ltd a more efficient business and save the NHS money.

“NHS Professionals Ltd is a business, not a public service, and like any business it must ensure its services are as efficient and effective as possible. We want to discuss options with potential independent sector investors that could help to achieve this, and ultimately improve services outcomes for patients.”

It comes as the Royal Berkshire Hospital Trust announced up to 600 jobs will be cut to make £60 million worth of savings in the next few years, pledging that frontline staff would not be affected.

The Royal College of Nursing said last month that thousands of NHS jobs were being cut despite Government promises to protect frontline services.

The nurses’ group said it was aware of almost 10,000 posts lost through recruitment freezes, redundancies and people not replaced when they retired, or which face cuts in the future.

From http://www.telegraph.co.uk/Ministers-accused-of-privatising-NHS-nursing-agency

NDM-1 spread in India, Pakistan, and Bangladesh.  But it was also found in 37 patients from the UK, who travelled to India or Pakistan for medical procedures including cosmetic surgery, according to an article published in The Lancet.

“The potential of NDM-1 to be a worldwide public health problem is great, and co-ordinated international surveillance is needed,” Timothy Walsh of Cardiff University and his international colleagues wrote.

The gene was mostly found in E Coli, a common cause of urinary tract infections and pneumonia, which is highly resistant to antibiotics.

The authors said it could be easily copied and transferred between different bacteria, suggesting “an alarming potential to spread and diversify among bacterial populations”.

The paper said several of the UK patients had travelled to India or Pakistan for surgical procedures within the past year.

They wrote: “India also provides cosmetic surgery for other Europeans and Americans, and it is likely NDM-1 will spread worldwide.”

Study co-author Dr David Livermore, director of antibiotic resistance monitoring at the Health Protection Agency, said: “The findings of this paper show that resistance to one of the major groups of antibiotics, the carbapenems, is widespread in India.

“This is important because carbapenems were often the last ‘good’ antibiotics active against bacteria that already were resistant to more standard drugs.

“We have now also identified bacteria with this type of resistance – NDM – in around 50 patients in the UK.  Most, not all, had previously travelled to the Indian subcontinent, and many had received hospital treatment there.”

“International travel gives a great potential for spread of resistant bacteria between countries.  Few antibiotics remain active against these bacteria. Their spread underscores the need for good infection control in hospitals both in the UK And overseas, and the need for new antibiotic development.”

A Department of Health spokesman said: “We are working with the Health Protection Agency on this issue. The HPA alerted the NHS in January and July last year to be vigilant about these bacteria and take appropriate action where necessary.

“Hospitals need to ensure they continue to provide good infection control to prevent any spread, consider whether patients have recently been treated abroad and send samples to HPA for testing.

“So far there has only been a small number of cases in UK hospital patients. The HPA is continuing to monitor the situation and we are investigating ways of encouraging the development of new antibiotics with our European colleagues.”

From: http://www.independent.co.uk/new-superbug-spreads-to-uk-hospitals

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Almost one in ten people in Britain says they go to work with a hangover at least twice a week, and one in five of those admits it has an adverse effect on their work, according to the research.

Seventeen per cent of those who conceded to working with a hangover said it caused them to make mistakes and fall behind with their work, while seven per cent said they had to go home early because they felt too unwell.

The survey of more than 1,000 adults also raised fears that bosses are not doing enough to curb excessive weekday drinking by their employees, despite its negative impact on productivity.

Almost 90 per cent of people accepted having a hangover at work is “unacceptable”, but three out of five respondents admitted having joked with a boss or colleague about suffering the morning after the night before.

Dr Katrina Herren, Medical Director, Bupa Health and Wellbeing, said: “As an employer, it is important not to ignore the effects of alcohol on employees or the adverse effects it can have on the workplace environment.”

According to Drinkaware, the alcohol charity that commissioned the survey, workforce productivity is set to plummet even further during the World Cup as drinking increases.

Chris Sorek, CEO of Drinkaware, said: “An international sporting event like the World Cup will inevitably capture the attention of the nation and is a great time for people to come together, but hangovers at work are likely to increase.”

An estimated 1.2 million pints of lager were drunk by 70,000 England fans at the 2006 World Cup, according to German officials – an average of 17 pints each.

http://www.telegraph.co.uk/Half-a-million-work-with-hangovers-every-day

The Tory analysis, based on figures for 2008-09, suggests that 6.8 million slots could have been made available to those without access to an NHS dentist had they not been used for excessive appointment-setting or needless splitting of courses of treatment into separate sessions.

The Tories calculate the cost to NHS patients of “unnecessary charges” at £117 million, up from £109 million the year before. The burden represents a fifth of the £572 million charged each year for treating NHS patients.

Andy Burnham, the outging Health Secretary, acknowledged last year that dentisty remained “unfinished business” after the failure of a new dentists’ contract to address problems with a so-called drill and fill culture.

An independent review ordered by the labour Government, led by Jimmy Steele, of Newcastle University, found that dentistry was too preoccupied with treatment rather than prevention, and that dentists should be paid according to the number of patients on their list and penalised for poor work that leads to repeated visits.

Professor Steele’s proposals, which were accepted by the Government and put into pilot schemes, include rewarding dentists for registering new patients and building relationships with existing ones. Income is determined by the size of the patient-list, quality of care and the number of courses of treatment.

Andrew Lansley, the Tory health spokesman, who acquired the figures from parliamentary questions in February, said that the lack of political drive to rectify problems with dentistry was shown by its absence from the manifestos of Labour and the Lib Dems.

From: http://www.timesonline.co.uk/tol/life_and_style/health/article7115298.ece

The number of reported mistakes a t the 138 fertility clinics in England and Wales nearly doubled in the year to April 2009, rising to 334 from 182 the previous year. One leading patient safety expert has now warned that blunders which have occurred as record numbers of women seek treatment, may be “systemic”.

The increase comes as one clinic, IVF Wales, is at the centre of a fresh scandal after losing the last two remaining embryos it had frozen for one of its patients. It is the second time in less than 12 months that a mix up at the centre, based at University Hospital of Wales in Cardiff, has left patients devastated.

The Cardiff-based couple has had their eight-year quest to have a baby put on hold as a result of the blunder, which followed an initial, unsuccessful course of IVF. The pair, identified only as Clare and Gareth, are suing Cardiff and Vale University Health Board, which last year paid out a five-figure sum in compensation for negligence after another mix up.

Guy Forster, a solicitor at the law firm Irwin Mitchell who is representing the couple, said the incident raised questions about the Government’s IVF watchdog, the Human Fertilisation and Embryology Authority.

“This raises concerns about the HFEA’s ability to regulate the IVF industry properly. I think it should be doing a lot more to follow up when an incident occurs, especially at a clinic with a poor track record,” he said, adding: “These problems appear to be on the rise.”

An official review last year found that the HFEA was failing to punish badly run fertility clinics by not using the “full range of sanctions” at its disposal. Professor Brian Toft, a patient safety expert at Coventry University, said: “If the HFEA fails to clamp down when something has gone wrong then things will continue to go wrong.”

He said the rise in reported incidents, uncovered by BBC Radio 5 Live, implied clinics were not learning from their mistakes, adding: “I have been told there are not enough qualified staff doing the work. HFEA do not make any recommendations for staffing levels per number of patients. If you have a lot of patients and not enough staff, this could account for an increase in errors. This problem may well be systemic.”

Professor Sammy Lee, an IVF expert, said the watchdog must ensure clinics comply with regulations. “They need to obtain staff that have experience of enforcement and are able to make sure that regulations are put into place,” he said.

An HFEA spokesman played down the increase in blunders, which he said was partly due to new rules requiring clinics to include incidents when patients suffered from ovarian hyperstimulation syndrome (OHSS). “The number of reported incidents has increased as the sector has responded positively to the opportunity to share lessons learned from incidents which have been reviewed and investigated,” the HFEA added in a statement.

From: http://www.independent.co.uk/errors-at-ivf-fertility-clinics-double-in-just-one-year

Jenny Whitehead, a breast cancer survivor, paid £250 for an appointment with the orthopaedic surgeon after being told she would have to wait five months to see him on the NHS. He told her he would add her to his NHS waiting list for surgery.

She was barred from the list, however, and sent back to her GP. She must now find at least £10,000 for private surgery, or wait until the autumn for the NHS operation to remove a cyst on her spine.

“When I paid £250 to see the specialist privately I had no idea I would be sacrificing my right to surgery on the NHS. I feel victimised,” she said.

The case will reopen the debate over NHS policy towards patients who pay for some of their care privately. Following a Sunday Times campaign in 2008, the government ordered the NHS to stop withdrawing care from patients who received additional private treatment or drugs.

Cancer sufferers were being barred from further NHS treatment after buying potentially life saving medicines not offered by the health service.

Whitehead’s case, which has shocked her local Labour MP, reveals that patients who go private in despair at long waiting lists still risk jeopardising their NHS treatment. Department of Health officials admit it remains official policy.

Whitehead, 64, a former museum assistant from Yorkshire who works as a volunteer at a hospice, went to her GP in December for back pain. Because of her breast cancer history, she was immediately offered an MRI scan to check the disease had not returned. It revealed a cyst on her spine, pressing against her sciatic nerve. Her GP referred her to a consultant at Airedale NHS hospital.

She was told the next available NHS appointment was in May, so she accepted the offer of a private slot to see him the following week.

“My husband and I are retired and don’t have a lot of money, but I am in intense pain and couldn’t face the thought of waiting months just for an initial consultation,” she said.

The specialist promised to add her to his NHS waiting list for surgery. After two months, however, hospital managers told her she had been barred from the waiting list because she had seen the surgeon privately.

Now her only alternative to paying £10,000 privately is to go back to her GP, seek another referral to the same specialist, this time on the NHS, and face another 18-week wait.

“We will scratch together the money if we absolutely have to, but I feel it’s incredibly unfair,” said Whitehead. “I’ve paid full National Insurance contributions all my working life and feel I should get this operation on the NHS.”

Ann Cryer, who is standing down as Labour MP for Keighley, has written to the hospital urging it to reconsider. She told Whitehead that she had been “badly let down and ill advised”.

Bradford and Airedale NHS trust said it was looking into the case “as a matter of urgency” but added: “Anyone who chooses to pay for a private outpatient consultation cannot receive NHS treatment unless they are then referred on to an NHS pathway by their consultant.”

From:http://www.timesonline.co.uk/tol/life_and_style/health/article7100968.ece

Analysis by the Rarer Cancers Forum (RCF) suggests that the National Institute for Curbing Expenditure (NICE) is “failing to follow the spirit” of guidelines designed to improve access to end-of-life cancer treatments.

It claims that as many as 16,000 patients have been denied access to drugs because the watchdog had concluded unfairly that they did not meet the criteria for consideration, or they were deemed too expensive — without proper negotiation with pharmaceutical companies.

The report, Exceptional Progress?, looks at improvements to treatment access for people with rarer cancers following a review carried out by Sir Mike Richards, the Government’s national clinical director for cancer.

Sir Mike’s review was prompted by complaints from patients who were denied NHS care after having paid privately for treatment. The Government subsequently lifted the ban on so-called “top-up payments” and said that cancer drugs that were more expensive than NICE normally allowed, but which could offer patients a few more months of life, should be considered.

Andrew Wilson, chief executive of the RCF, said that although progress had been made in improving access to treatments since the publication of the review, there were still serious shortfalls which required urgent review.

“It is unacceptable that many thousands of patients are still missing out on the treatment they need, and which their doctors want to give them, because NICE has decided that their treatment does not meet some arbitrary criteria,” Mr Wilson said.

He added that NICE was failing to assess drugs quickly enough — taking 21 months to appraise new cancer drugs, rather than the six months promised by ministers by 2010.

Until the Richards review, NICE would not approve drugs that cost more than £30,000 to £40,000 for a year of good quality life. The ceiling has since been raised to £80,000.

Sir Andrew Dillon, NICE chief executive, said the watchdog had, in conjunction with the Department of Health, introduced “significant additional latitude in its appraisal of treatments, particularly where they are designed to extend life, at the end of life. NICE and the Department of Health are working together to assess ‘patient access schemes’ – proposals from companies for ways of managing the entry of expensive new treatments into the NHS by sharing some of the costs, and the Innovation Pass – a scheme to support a small number of promising new drugs with funding at a national level.”

From: http://www.timesonline.co.uk/tol/news/uk/health/article7061769.ece