Nanny state bans children with no MMR vaccinations

Labour’s latest nanny state wheeze to cover up their MMR vaccinations fiasco is to ban children from starting school until they receive the MMR jab.

Parents will have to provide proof their offspring have had a full range of vaccinations when they put in applications for primary schools.

The plan, designed to increase the take-up of the measles, mumps and rubella triple jab, has been drawn up by Mary Creagh, the Labour MP in charge of the party’s health manifesto for the next general election.

“Parents need to protect their children and science gives them a way to do that,” said Creagh. “We need to get that message across.”

However, doctors’ leaders warned that the idea was “morally dubious”.

Dr Hamish Meldrum, chairman of the British Medical Association, said: “A Stalinist approach like this would be likely to backfire.”

Andrew Lansley, the shadow health secretary, accused Labour of “playing politics” with children’s lives.

Take-up of the MMR jab fell dramatically after research – now discredited – appeared to show a link between the triple vaccination and autism.

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article3909515.ece

Health Direct finds the latest labour “thinking” plain incredible. The highest proportion of children who do not have the vaccine live in inner London, so labour’s plans will compound the disadvantage that these children will endure.

NHS hospitals’ care standards vary in postcode lottery

Most patients staying overnight in hospital are happy with their care, but this masks problems in key areas and variations in standards, a survey says.

Nine in 10 inpatients in England said their care was good, very good or excellent, the Health Commission poll of almost 76,000 people showed.

But problems with the quality of food, information on treatment and the use of mixed sex facilities were reported.

The government said it would look to drive up standards where necessary.

But campaigners said the results were worrying and demonstrated that the NHS was struggling to give patients the respect and dignity they deserved.

OVERALL APPROVAL RATINGS
Top five trusts:
Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry: 92
Queen Victoria Hospital NHS Foundation Trust, East Grinstead, West Sussex: 91
The Cardiothoracic Centre, Liverpool NHS Trust: 90
Christie Hospital NHS Trust, Manchester: 90
Royal Marsden, London: 90

Bottom five trusts:
Ealing Hospital, London: 65
Homerton University Hospital, London: 67
Mayday, Croydon: 67
Barking, Havering and Redbridge Hospitals NHS Trust, London: 68
North Middlesex University Hospital, London: 69
On a scale of 0 (poor) to 100 (very good)

Overall, one in four patients said they shared a sleeping area with patients of the opposite sex when first admitted – but in some of the 165 trusts this rose to nearly half, while others had almost no sharing.

For non-emergency care, which is where the labour government has promised to eradicate the use of mixed-sex accommodation, one in 10 said they had shared a sleeping area.

On the quality of food, just over half described it as good, while 15% said it was poor.

A fifth of those needing help with eating also said they did not get it, but again there were big variations, with more than 40% reporting a lack of help in some trusts.

Patients also reported problems with the way they were kept informed about decisions relating to their care. One in five said they were not given enough information.

Mixed sex wards

The numbers saying their wards or rooms were very clean has also fallen slightly in the last five years to 53%, despite the focus on hospital infections such as MRSA.

However, overall attitudes to the care patients received were largely positive.

The numbers saying their care was excellent rose from 41% to 42% in the last year. Overall, 92% said it was good, very good or excellent.

Healthcare Commission chief executive Anna Walker said the findings were “encouraging”. But she added: “Some hospitals are struggling to deliver on some of the basics of hospital care.

“There are striking variations in performance in key areas. Those performing poorly must learn form those who perform well.”

And Charlotte Potter, of Help the Aged, added: “Scores in some trusts were worryingly low when it came to being treated with dignity and respect or receiving help with eating – areas of care particularly important to older people.”

From:
http://news.bbc.co.uk/1/hi/health/7397037.stm

5,000 cancer beds facing axe in NHS cancer shake-up

The labour government plans to close up to 5,000 beds on cancer wards in a reorganisation of the way patients are treated, according to a report by experts in the disease.

Labour government figures show the National Health Service aims to save up to £500m a year from an “inpatient management programme” that it describes as preventing unnecessary hospital admissions and reducing the length of time patients spend in hospital.

Cancer doctors and health economists say the changes could make better use of money for cancer treatment but accuse the government of hiding the extent of the bed closures from the public.

The report by Nick Bosanquet, professor of health policy at Imperial College School of Medicine, London, and Professor Karol Sikora, medical director of CancerPartnersUK, a private cancer treatment company, comes as a shake-up of NHS hospitals, led by Lord Darzi, the health minister, is expected to include widespread closures of maternity hospitals and accident and emergency units.

Bosanquet and Sikora have analysed figures published by the government as part of its Cancer Reform Strategy in December. They reveal the efficiency savings the NHS will need to make in order to pay for better radiotherapy and screening programmes.

“My worry,” said Sikora, “is that the only way the Cancer Reform Strategy adds up financially is by massive bed closures to produce the funding for the huge deficits in both radiotherapy and cancer drugs.

“Up to 5,000 beds will need to disappear in England to make the spreadsheet balance. How else will the money be saved? Interestingly, the financials are not in the strategy document but hidden in an obscure corner of the Department of Health website.”

The government said cancer services must change so that patients can receive chemotherapy and radiotherapy during day trips to local clinics without going to hospital. It is also centralising specialist cancer care in larger hospitals where there is the expertise to get the best results.

The government has been forced to review NHS cancer treatment after studies showed that, despite spending comparable amounts on the disease as other European countries, Britain still has some of the worst survival rates.

Bosanquet, who was chairman of the Cancer Reform Strategy value for money group, said cutting beds could make better use of NHS funds but added the government should be more open about its plans.

“The Department of Health has put forward aspirations that must inevitably be to lower bed use in cancer services by around 5,000,” he said. “To save £500m, which is urgently needed to build up these community centres, they will need to reduce bed use in cancer services and the best estimate is that it would be by about 5,000 beds. I would urge the Department of Health to be a lot more open about it.”

From:
http://www.timesonline.co.uk/tol/life_and_style/health/article3908507.ece

Health Direct thinks that Professor Sikora is spot on when saying some cancer patients are so sick after chemotherapy and radiotherapy that they need to stay in hospital and also that they just need nursing as opposed to high tech beds in large hospitals.

Postcode lottery claims heart attack victims

Patients are dying unnecessarily from heart attacks in rural areas because of a new postcode lottery in care standards, Health Direct has learnt.

Heart attack victims in London and other major cities are diverted past their nearest A&E; to special hospital units where they have an operation to stop the attack.

But in many rural areas patients are either given less-effective drugs in the ambulance or receive them at their local hospital.

Patients who receive the operation, known as primary angioplasty, are at least twice as likely to survive, suffer less damage to their heart, leave hospital on average two days sooner and have a better quality of life afterwards.

The operation involves inflating a balloon in the blocked artery to reopen the blood flow. Last year only a fifth of heart attack patients received the treatment.

Data has shown it is most effective when carried out within two hours of the onset of chest pain. If more centres were set up, all patients in rural areas could be picked up by air ambulance and be in the operating theatre within that time.

The mortality rate from heart attacks within the M25 has halved since the network of specialist units started providing round-the-clock primary angioplasty. The treatment is provided round-the-clock in London, the West Midlands and Greater Manchester.

Patients in East Anglia, Hereford, Worcestershire, Cheshire, Merseyside and Kent receive only clot-reducing drug treatment known as thrombolysis.

Thrombolysis has a 60-70 per cent success rate and the number of patients who go on to suffer a further clot is relatively high. With a primary angioplasty, the success rate is about 90 to 95 per cent.

Prof Martin Rothman, the development director of the London Chest Hospital, said: “It is a turf issue between doctors, and different ambulance services have trained their paramedics to use the thrombolysis drugs instead.

“Thrombolysis is a dark ages approach. If you give the drugs to the wrong patients, those who are not having heart attacks, it can be fatal, and that does not happen with primary angioplasty.

“Data clearly shows primary angioplasty is better. It is a postcode issue. There is no reason why primary angioplasty should not be rolled out across the country.”

Prof Peter Weissberg, the medical director of the British Heart Foundation, said Britain is moving towards a primary angioplasty service but it should not be attempted overnight as this would damage the “first class” thrombolysis service.

From:
http://www.telegraph.co.uk/Postcode-lottery-claims-heart-attack-victims.html

NHS shake up to axe hospital services

Scores of hospital departments such as maternity units and cancer clinics will be closed or merged across the country under plans for a radical shake-up of the NHS.

Labour ministers are preparing for a summer of protest as residents campaign against proposals that could mean local hospitals losing specialist services to large regional centres.

In an attempt to head off the reaction that could mar the 60th anniversary of the NHS in July, Lord Darzi, the health minister, has pledged that patients would be involved in decisions and hospital units would not close before new ones opened.

Lord Darzi, a surgeon, said specialist services would be moved into larger regional centres only where there was evidence to prove that doing this would provide better care.

But critics argue that this will mean patients having to travel much farther for an operation or an appointment.

The plans, which appear to have been held back until after last week’s local elections, will be released over the next four weeks by the nine Strategic Health Authorities in England.

They include setting a local target of reducing the four-hour wait in A&E; to two hours, setting up dedicated trauma centres and better co-ordination of out of hours services.

However, in many cases, the changes – which result from Lord Darzi’s continuing review of the NHS – will lead to services provided by cottage and district hospitals being moved out of the area.

He acknowledged that the plans would bring protest and said that in the past, officials were poor at communicating the reasons behind such changes.

Lord Darzi said that where care did not need to be provided in hospitals it could be moved into health centres, GP clinics and cottage hospitals closer to patient’s homes.

He is convinced that when doctors have led previous changes and explained that they were not being carried out for financial reasons but in the interests of better care, the local community eventually agreed to the plans.

In an interview with The Telegraph, Lord Darzi said the plans were not about closing local hospitals or shutting down good services but were aimed at improving standards of NHS care.

“We need to be much more ambitious,” he said. “We spend £110 billion a year on the NHS and we have to challenge ourselves in raising the clinical bar.”

He said the challenges of an ageing population and increasing numbers of patients with long-term conditions such as asthma, diabetes and cancer meant changes were needed.

But campaigners and opposition MPs expressed concern. Residents and patients in Ipswich are already furious at proposals to move the head and neck cancer service from the local hospital to Norwich.

“Patients want to be treated in their local hospital safely,” Katherine Murphy, of the Patients Association, said.

“To be admitted to a hospital 60 miles away from your home is not convenient. It is all very well having specialist centres around the country but it is not want the public want.”

Andrew Lansley, the shadow health secretary, said: “We value our local NHS services and don’t want to lose them. Labour seem completely out of touch with that feeling.

“The hints Lord Darzi has given today about his plans for the NHS sound extremely ominous.

“We already know about the huge upheaval and loss of local services there’s likely to be in London; now we learn that something similar will happen in every single region.

“Lord Darzi is tripping over himself to say there isn’t another big, top-down reorganisation of the NHS coming; unfortunately he has only heightened suspicion that that’s exactly what this is.”

Councillors will be able to raise objections with Alan Johnson, the Health Secretary. He can ask for an independent panel of experts for advice and where this has happened in the past, the verdict has usually been accepted.

Dr Hamish Meldrum, the chairman of the British Medical Association, said: “These principles are all positive – in fact they’re impossible to disagree with. The problem is that the public and health-care staff have yet to see much evidence of them being delivered.”

From:
http://www.telegraph.co.uk/news/uknews/1939162/NHS-shake-up-to-axe-hospital-services.html

Health Direct asks what became of joined up thinking and a green focus? By closing local health facilities- patients, relatives and friends will have to fork out more on brown’s transport stealth taxes to travel further to visit the victims.

Labour ministers ignored junior doctor recruitment warnings

Thousands of junior doctors had their careers thrown into chaos last summer because of “inept” decisions at the highest levels, according to a report by MPs.

Warnings over a new recruitment system and possible job shortages were ignored by the Department of Health, says the Commons health committee.

The labour government’s failure to restrict the access of overseas doctors to training posts in Britain was also “inexcusable”, it says.

The report also singles out Sir Liam Donaldson, the Chief Medical Officer for England, saying that confidence in his abilities among the medical profession has been “seriously damaged” by the debacle.

Doctors’ groups said the report was a “damning indictment” of the Government’s failure to listen to warnings from the medical profession.

Thousands of junior doctors found themselves in limbo last year when a combination of factors, including a new computerised recruitment process, left their search for jobs in disarray.

Hundreds marched in protest, which prompted an apology from Patricia Hewitt, the former health secretary.

From:
http://www.telegraph.co.uk/news/1936349/Ministers-%27ignored%27–junior-doctor-warnings.html

£77m to improve stroke services as UK ‘lags behind major Western nations’

The UK lags behind other developed nations in caring for thousands of patients who have suffered a stroke, and the labour Government is far from meeting its own targets in England, a new critical report says.

It comes as the Government announced that £77 million will be spent over the next three years as part of a national stroke strategy, unveiled last year.

Ministers said that every local health authority in England should appoint a dedicated stroke care coordinator to support stroke survivors and their carers.

But a report by The Health Foundation, an independent charity which seeks to promote good practice within the NHS, and seen by The Times, concludes that “stroke services are still not good enough”.

It shows that less than half of patients in England (43 per cent) receive a brain imaging CT scan within 24 hours of suffering a stroke. This is despite national guidelines which state this is required for all patients who have suffered a major blood clot or bleeding in the brain, to be given a brain scan within three hours, or one hour after arriving at hospital.

There are nearly 900,000 people in England living with the consequences of a stroke, and it is the third biggest cause of death in the UK. In England alone there are more than 110,000 strokes each year, and it is the leading cause of long-term severe disability in adults.

The report adds that Britain lags behind other major Western countries in deaths due to cerebrovascular disease — a disease of the blood vessels supplying the brain, which often leads to a stroke.

The UK achieved a 16 per cent fall in mortality between 1997-2004, whereas Germany saw more than double (33 per cent) this reduction during the same period.

The charity is funding a NHS programme in the North West of England, which aims to boost the number of people who could survive a stroke by 30 per cent by 2010, and increase the number of stroke survivors walking out of hospital without a long-term disability. The programme is being run in partnership with the Stroke Association and the Royal College of Physicians.

But the foundation’s report also stressed the importance of preventative checks and treatments, suggesting that as many as 69 per cent of strokes in inner London could be prevented by prior screening and reductions in blood pressure, treating abnormal heart rhythms, stopping smoking and prescribing statins to at risk patients.

Bread and cereal manufacturers could also prevent 8,000 strokes a year in England by reducing their salt content, it suggests.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article3889634.ece

Cannabis U Turn as labour again disregards scientists

Cannabis is to be reclassified as a class B drug, Jacqui Smith has said. The home secretary’s statement to MPs came despite the Advisory Council on the Misuse of Drugs’ review – commissioned by Gordon Brown – saying it should stay class C.

She added that the government’s change of heart – which is subject to parliamentary approval – was part of a “relentless drive”.

Ms Smith told MPs: “There is a compelling case for us to act now, rather than risk the future health of young people.

In its report, Cannabis: Classification And Public Health, the advisory council described cannabis as a “significant public health issue”.

But it said it should still remain a class C drug, as the risks were not as serious as those of class B substances, such as amphetamines and barbiturates.

The report said the evidence suggested a “probable, but weak, causal link between psychotic illness, including schizophrenia, and cannabis use”.

However, in the population as a whole, it played only a “modest role” in the development of these conditions.

Council chairman Sir Michael Rawlings told BBC Radio 4’s World at One: “The strength of things like skunk hasn’t really changed very much over the last few years but it’s now more widely used… The question of potency is a very complex area.”

Sir Michael added: “The government may want to take other matters into account. That’s their right. They are the government.”

In its report the council called for a campaign to reduce the use of cannabis, particularly focusing on young people.

From:
http://news.bbc.co.uk/1/hi/uk_politics/7386889.stm

Health Direct notes that once again labour dithers over another dilemma. One which ignores there own advisers and the science.

On August 02, 2006 Health Direct posted: Risks of taking drugs compared– Scientific review of dangers of drugtaking- Drugs, the real deal

Health Direct reproduced the first ranking based upon scientific evidence of harm to both individuals and society. It was devised by government advisers – then ignored by labour ministers because of its controversial findings.

The analysis was carried out by David Nutt, a senior member of the Advisory Council on the Misuse of Drugs, and Colin Blakemore, the chief executive of the Medical Research Council. Copies of the report have been submitted to the Home Office, which has failed to act on the conclusions.

Superbugs deaths now at 10,000 a year

Superbugs kill at least 10,000 people in Britain each year — 20 times the number who die of Aids. Why isn’t the labour government spending more on finding out why?

Warnings about the dangers of antibiotic overuse started to emerge from laboratories, but because relatively few patients were affected and nobody knew what to do about it, the situation was ignored. Antibiotics continued to be consumed in ever-growing quantities by sick humans and farm animals alike.

The problem took off in 1991, when Britain contributed its own supercharged strain to the world lexicon of multi-drug-resistant superbugs. MRSA-16 first appeared in Northamptonshire, rapidly infecting 400 patients and 27 staff in three hospitals.

Within 18 months it had been reported in 135 more hospitals. Nobody knows how it spread. Along with another British strain, MRSA-15, it went on to infect patients around the world, a pattern that continues.

A meticulous Health Protection Agency study, mapping how the new strains popped up unexpectedly in new hospitals, was published in the Journal of Clinical Microbiology in 2004. But it was too long after the event to shed any light on how the infection had carried. Now research funding is focused on firefighting – casting around for ways to damp down the effects of the pathogens.

It is not just MRSA that is sweeping across Britain like a plague.

Streptococcus, enterococcus and Escherichia coli (E coli) are among a host of bugs emerging in resistant forms and causing everything from pneumonia to tuberculosis, bone destruction and lethal damage to the heart. In addition, we are facing “hyper-virulent” new strains of the bacteria Clostridium difficile (C diff), which have colonised the sites left free by the effect of antibiotics, which kill off many harmless bacterial colonies in their path.

Although C diff is not resistant to treatment, its spores linger indefinitely and, until recently, NHS staff were largely unaware of how to kill them. Consequently, it is the biggest killer of the current superbugs.

In 2006 it was mentioned on the death certificates of 6,480 people, against 1,652 deaths officially attributed to MRSA. However, these figures are recognised to be underestimates, as many superbug deaths are never identified.

Mandatory surveillance of MRSA bloodstream infections is a recent innovation, the number of people carrying it with no symptoms is not recorded, and the formal collection of figures for death and disease associated with C diff (which causes unstoppable diarrhoea or gut perforation) only began in April 2007. The government estimates the annual cost of treatment for such cases to be over £1 billion.

Officially, the total number of MRSA infections is 7,000-8,000 a year, while C diff is running at an annual 55,600 cases. Many experts believe the real total for all superbug infections is nearer 300,000 – how many are fatal is believed to be vastly higher than the official figures suggest. There is no way of knowing the true figure, as relatively few people are tested.

Meanwhile, a variety of new resistant pathogens are waiting in the wings. In September 2006, a variation of Staphylococcus aureus that produces a toxin called Panton-Valentine leukocidin (PVL) claimed its first British victims. Since then, anxiety over this threat has escalated. The pathogen selectively attacks the young rather than the old; it gets into bones and joints, causing crippling damage.

A multi-drug-resistant version of a common food-poisoning bug, ESBL (extended-spectrum beta-lactamase) E coli, is also causing anxiety. First identified in the 1980s, it has spread steadily to cause an average of 30,000 cases of blood poisoning and urinary-tract infections a year.

Although it has officially been blamed for 57 deaths so far, the true total is believed to be many thousands. Government scientists think the source is meat and milk, colonised by superbugs as a result of overuse of agricultural antibiotics.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article3582299.ece

Health Direct laments the disaster that is labour’s superbug strategy. Which causes between 3 and 4 times the number of deaths compared to UK traffic accidents.

Drug companies win Alzheimer’s Aricept appeal against NICE watchdog

The pharmaceutical industry won a stunning victory in the Court of Appeal over the labour government’s “value for money” watchdog NICE.

NICE, the National Institute for Curbing Expenditure, had acted unfairly in refusing to allow Eisai and Pfizer full access to a computer model used to assess the cost-effectiveness of Aricept, an Alzheimer’s drug, the court ruled.

NICE had decided that the drug should not be prescribed on the NHS to patients with mild Alzheimer’s disease.

But Eisai and Pfizer, which market Aricept in a partnership, were disadvantaged in appealing against this guidance by NICE’s refusal to let them have a “fully executable” version of the economic model it had used.

Had the companies had the full version, they could have tested it using a variety of assumptions and be in a better position to challenge the guidance. The Court of Appeal decision means that NICE must now make such a version available.

Lord Justice Richards, giving the ruling of the appeal judges, said NICE had supplied a spreadsheet of the economic model used to evaluate the drugs and had refused an Eisai request for full details.

“The view I have come to is that, notwithstanding NICE’s considered position to the contrary (to which in itself I am prepared to give some weight), procedural fairness does require release of the fully executable version of the model.”

Refusal to do so, said the judge, put drugs companies at “a significant disadvantage” in challenging the reliability of the model.

He allowed the appeal by Eisai, who will now receive the full details and make new representations to NICE, which will then make a new appraisal of the drugs.

NICE is now considering whether to appeal to the House of Lords. It has always believed that the full details of the computer programs are the intellectual property of the academic teams who developed them, and who are entitled to have them protected.

Andrew Dillon, chief executive of NICE, said: “We will be considering very carefully the findings and the implications for the time it takes us to provide advice to patients and the NHS on the use of new treatments.

“The ruling will increase the complexity of our drug appraisals in some cases and they may take longer as a result. In the meantime, and in accordance with the judges’ ruling, we will provide Eisai with an executable version of the economic model used in our appraisal, so that they comment on it.”

From:
http://www.timesonline.co.uk/tol/news/uk/health/article3854121.ece

Health Direct notes that the ruling – the first time that NICE has been successfully challenged in court – could open the door to other companies seeking access to the economic models on the same basis. NICE often uses computer models developed for it by outside teams.

The ruling will not make Aricept available to Alzheimer’s sufferers. It will simply enable Eisai and Pfizer to review the model and see if doing so reveals any flaws in NICE’s reasoning. If it does, they will be able to appeal against the guidance.

Neil Hunt, chief executive of the Alzheimer’s Society, said: “The decision is a damming indictment of the fundamentally flawed process used by NICE to deny people with Alzheimer’s disease access to drug treatments.