UK children receive swine flu jab

The first children in Britain to receive a vaccine against swine flu have begun to be immunised.

Doctors at five sites in England are comparing vaccines from two manufacturers to see which works best and has the fewest side-effects.

Over the next two weeks 1,000 children aged six months to 12 years are being recruited in Oxford, Bristol, Southampton, Exeter and London.

Both vaccines are expected to be licensed in the coming weeks.

One has already been recommended for use.

Professor Andrew Pollard, from the University of Oxford, says vaccines are the best way to protect against flu and any side effects should be limited to sore arms or sometimes a fever.

This clinical trial comes just a month before more than 11 million people considered to be most at risk from flu will be offered the swine flu vaccine.

It will also be made available to more than two million front-line health workers.


MRSA infections warning for care homes

Poor communication between hospitals and care homes in England may be putting people at risk of MRSA and other superbug infections, the regulator says.

The Care Quality Commission found nearly a fifth of homes were not being told if patients discharged from hospitals are or had been infected.

Even when they were told, the data was sometimes incomplete or illegible, the survey of more than 1,000 homes showed.

Latest figures show that MRSA levels in hospitals – they are not measured in care homes – have fallen in the past year.

C difficile figures have also been falling. But the CQC report said the progress being made could be compromised by communication problems.

Hospitals are meant to include infection history on discharge summaries.

However, the survey revealed 17% of care homes said they did not receive information from hospitals, while another 28% complained of incomplete and ineligible data.

The regulator also highlighted poor practice by care homes – a quarter were not following guidelines covering issues such as isolating residents with infections and antibiotic management.

It said care homes had until next year to follow the guidelines or face being refused registration.

CQC chief executive Cynthia Bower said: “Infection prevention and control is not simply an issue for hospitals – care needs to be clean and safe wherever it is provided.

“If we are to tackle infections effectively we need to check that all providers of care are talking to each other.”

Health minister Mike O’Brien said while there had been good progress on infections, he agreed closer working was needed.

“People have the right to the same standards of clean, safe care whether in health or social care.”

A separate CQC report also criticised the way patient information was being used.

The regulator said it had concerns about privacy – a third of staff said they had not been given training on confidentiality – while delays in hospitals sending GPs information after discharge were also noted.


Patients to be able to choose GP in new labour spin

Patients will be allowed to register with the GP of their choice within the next year, Andy Burnham , the health secretary, announced.

The scrapping of existing GP catchment areas would allow commuters to register with a family doctor near work, or choose another practice locally, outside the catchment area of their primary care trust.

“I want to open up real choice in primary care,” Mr Burnham said in a speech to the King’s Fund health think-tank. Patients should be able to choose a practice “based on their needs, not by lines on a map” or by postcode.

Wider choice of GP is already Conservative policy and, according to the British Medical Association, this will be the fourth attempt by Labour to widen the choice of a family doctor, with previous efforts foundering over the cost and complexity of what appears a simple change.

Dr Laurence Buckman, chairman of the British Medical Association’s GP committee, said: “Most GPs would be comfortable with flexible boundaries.”

But “major logistical barriers would need to be overcome for a patient to be able to register with practices a long way from home”, he warned.

The issue of home visits would need to be sorted out, Dr Buckman said. But a bigger problem was that patients came with an amount of money attached to them, which funded hospital and community as well as GP services. Without some compensation system, big movements of young, fit patients, whose fees help subsidise sicker and older patients, could hit funding formulas for rural and suburban services.

“Practices in rural and suburban areas could lose significant numbers of young, healthy patients, destabilising their funding and threatening their viability,” Dr Buckman said.

“Meanwhile, city centre practices would be inundated with requests for appointments at lunchtimes and evenings, which would effectively limit patient choice.” Dr Buckman said the problems “are not insurmountable”. But they needed “a lot of careful thought” and could prove costly to solve.

Mr Burnham appears determined to do that. Dual registration – allowing patients to register both with a practice near work and one at home – has been raised in the past, but ruled out because of the cost.


Health Direct wonders quite where the funding will come from for the new paperpushers that will be needed to balance the doctors’ surgery budgets- as well as transferring patients’ data as the much promised NPfIT white elephant is still years away from completion.

Increasing obesity pushes diabetes drug bill to £600m

The rising problem of obesity has helped to make diabetes treatments the biggest drug bill in primary care, with almost £600 million of medicines prescribed by doctors last year, according to the NHS Information Centre.

Analysts said that young people contracting the condition, which is often associated with obesity, were helping to push up costs as doctors tried to improve their long-term control of the disease and prevent complications.

A total of 32.9 million diabetes drugs, costing £599.3 million, were prescribed in the past financial year. In 2004-05 there were 24.8 million, costing £458 million.

More than 90 per cent of the 2.4 million diabetics in England have type 2 diabetes, with the remainder suffering from type 1, the insulin-dependent form of the disease caused when the body’s immune system destroys insulin-producing cells in the pancreas. There are thought to be 500,000 undiagnosed cases of diabetes.

While rates of type 1 have shown slight increases in recent years, type 2 has risen far more rapidly — a trend linked to the increasing number of people who are overweight or obese. Almost one in four adults in England is obese, with predictions that nine in ten will be overweight or obese by 2050. Obesity costs the NHS £4.2 billion annually. This year the Government started a £375 million campaign aimed at preventing people from becoming overweight by encouraging them to eat better and exercise more.

An NHS Information Centre spokeswoman who worked on the report, which was published yesterday, said that diabetes was dominating the primary care drug bill as better monitoring identified more sufferers and widely used medications such as statins became cheaper. She said that the data suggested a growing use of injectable insulin in type 2 diabetes care, which was helping to push up costs.

Doctors agreed that more expensive long-acting insulin, which can cost about £30 per item, was being used more often, as well as more expensive pills and other agents.

The report, an update of the centre’s June publication Prescribing for Diabetes in England, shows that the number of insulin items prescribed last year rose by 300,000 to 5.5 million, at a total cost of £288.3 million. It marked an 8 per cent rise on the £267 million spent in the previous year. However, while the number of anti-diabetic drugs, which are mostly in tablet form, also rose, the cost dropped slightly to £168.1 million.

“Type 2 is increasing. We are seeing it in younger people, and because it is a progressive disease people are needing an increasing number of interventions as time goes by,” the spokeswoman said, adding that long-acting insulins such as Glargine were now common. “For people who are struggling to control their type 2 diabetes it makes sense, but it is quite a big clinical change from five or ten years ago.”

Other anti-diabetic items, such as use of the subcutaneous injection exenatide, have also increased and cost £14.3 million.

Laurence Buckman, chairman of the British Medical Association’s general practice committee, said that he had observed a trend with drugs such as exenatide, which costs £80 per item. He said that younger patients could start on cheaper tablets such as metformin, which costs £3.70 per box, but were needing increasingly sophisticated treatments to keep their condition in check.

“You are talking about an ever larger number of people getting a large range of drugs to reduce long-term complications. Type 2 is a common chronic illness that is getting commoner. It’s in everyone’s interest to treat people early and with the most effective drugs, and these are the more expensive tablets and long-acting insulins,” he said.


Convict wins right to NHS cosmetic treatment

A double murderer serving a life sentence has won a High Court victory in his long running legal campaign for the right to undergo cosmetic surgery to remove a large facial birthmark.

The publicly funded legal challenge by Dennis Harland Roberts, 59, could prompt other prisoners to seek treatments they might otherwise have been denied because of an undisclosed policy operated by Jack Straw, the Justice Secretary.

The policy restricts prisoners’ access to cosmetic and certain other treatments regarded as non-urgent — even though the labour Government has said that they are entitled to the same NHS care as the rest of the population.

Roberts won a declaration at the High Court in London that Mr Straw had acted unlawfully and “contrary to good administration”in failing to disclose his full policy.

Coincidentally, Roberts, a Category A prisoner, was represented in court by Adam Straw, a barrister who is a nephew of the Justice Secretary.

The court case led to the full policy being publicly revealed last week. After its disclosure, the Ministry of Justice agreed to reconsider Roberts’s application to be escorted to hospital for laser treatment, if he could show that the birthmark was having a negative impact on his health. But Roberts and his lawyers continued their legal action to obtain a formal High Court declaration, making the position clear for other prisoners.

Roberts said that the large, congenital port-wine stain on the left side of his face, neck and shoulder had led to his being bullied at school and was linked to a violent temper. He had previously had hospital treatment to remove it on three occasions, the last one in July 2007. But his appointments last year were cancelled.

Roberts, from Newhaven, Sussex, was convicted at Lewes Crown Court in March 1991 of stabbing to death Stephen and Iris Hadler, both in their 70s, after breaking into their home in the summer of 1989. He is now at Frankland Prison, Durham.

A consultant dermatologist recommended him for treatment for the birthmark in 2006.

The consultant stated: “This has always been an embarrassment to him, but he is now developing small vascular nodules within it and I think that laser treatment on the NHS is entirely justified.”

Roberts said in a written statement to the court that the treatment he had already received appeared to have had some success, lightening and removing some 30 per cent of the birthmark. He said he was “extremely pleased” and was expecting an estimated further four sessions of treatment but delays over further treatment caused by the failure to provide him with hospital escorts had sent him into depression.

Adam Straw told the court that, as a result of being bullied at school, “he has a low tolerance for people commenting on his face. He “feels self-conscious and fearful of his own reaction when he becomes aware of others looking at the mark. When the treatment was halted in July 2007, Roberts slid into depression and his violent temper re-emerged.”

The Government’s full policy, which had now come to light, allowed “elective treatment” only if there was “a negative impact on the prisoner’s mental or physical health”. The policy required the need for treatment to be balanced against “public acceptability” issues, and the fact that Category A escorts were “resource intensive, both for staffing and expenditure”.

This differed from the published policy relied on by the Government in a case last year, which gave inmates “access to the same range and quality of services as the general public receives from the NHS”.

Had Roberts known about the unpublished policy, his lawyer said, he would have sought a medical report to show the impact that the birthmark was having on his health, and legal proceedings would have been avoided.

Mr Straw said that it had been necessary to seek a High Court declaration “to prevent prejudice to many other prisoners with similar claims”. Prisoners were entitled to know the correct policy so that they had a proper and fair chance to make their case.

Agreeing with Mr Straw, Michael Suppertone, QC, a deputy High Court judge, declared in a judgment revealed: “In my judgment it is contrary to good administration, and unlawful, for the defendant’s full policy on medical appointments not to be published.”


Doctors urge ban on alcohol advertising

Doctors have called for a total ban on alcohol advertising, including happy hours and sponsorship of music and sporting events.

A tough package of measures is needed to “tackle the soaring cost of alcohol related harm” in Britain, said a report from the British Medical Association (BMA).

Young people are particularly affected by such advertising, which encourages them to binge-drink and stock up on cheap alcopops, it said.

The BMA also renewed its calls for a minimum price to be set per unit of alcohol, for alcohol to be taxed at a higher rate than inflation and for a ban on two-for-one offers.

It follows a report last year from the union which said there should be a curb on the sale of cut-price alcohol, such as in supermarkets.

The latest study – Under The Influence – said alcohol consumption in the UK has “increased rapidly” in recent years among all age groups.

It blames advertising and heavy discounting, the availability of cheap alcohol and 24-hour licensing laws.

The report said: “The population is drinking in increasingly harmful ways and the result is a plethora of avoidable medical, psychological and social harm, damaged lives and early deaths.

“As consumption has increased, so the market for alcohol has grown. In 2007, sales (including supermarket, off-licence, restaurant and bar sales) were high enough to put virtually every British adult over Government guideline drinking levels.

“These sales are driven by vast promotional and marketing campaigns that dwarf health promotion efforts: the UK alcohol industry spends approximately £800 million each year encouraging consumption of its wares.”

The report said current controls on promoting alcohol are “completely inadequate” because they are based on voluntary agreements with the industry and focus on their content, rather than the amount of alcohol advertising.

“Even in their control of content the rules are weak with, for example, prohibitions on advertising which associates drink with youth culture or sporting success sitting alongside alcohol sponsorship of iconic youth events like music festivals and premiership football.”

Dr Vivienne Nathanson, head of science and ethics at the BMA, said the body was not “anti-alcohol” but doctors were right to focus on the health of their patients.

She added: “Over the centuries, alcohol has become established as the country’s favourite drug.

“The reality is that young people are drinking more because the whole population is drinking more and our society is awash with pro-alcohol messaging and marketing. In treating this we need to look beyond young people and at society as a whole.”

According to the World Health Organisation (WHO), alcohol is the leading risk factor for premature death and disability in developed countries after smoking and high blood pressure.

It is related to more than 60 medical conditions, costs the NHS millions of pounds every year and is linked to crime and domestic abuse, the report said.

Professor Gerard Hastings, who was an author on the study, said: “Given the alcohol industry spends £800 million a year in promoting alcohol in the UK, it is no surprise that we see it everywhere – on TV, in magazines, on billboards, as part of music festival or football sponsorship deals, on internet pop-ups and on social networking sites.

“Given adolescents often dislike the taste of alcohol, new products like alcopops and toffee vodka are developed and promoted as they have greater appeal to young people.

Don Shenker, chief executive of Alcohol Concern, said: “There’s no longer any doubt – the heavy marketing and promotion of alcohol, combined with low prices – are encouraging young people to drink at a level our health services are struggling to cope with.”


Given that the labour govt actively promotes alcolohol drinking via extended drinking hours and that they ignored scientific advice about the dangers of alchohol Health Direct wonders if MPs will once again ignore qualified practitioners- see yesterday’s post and  Risks of taking drugs compared- Scientific review of dangers of drugtaking- Drugs, the real deal when Health Direct reproduced the first ranking based upon scientific evidence of harm to both individuals and society. 

It was devised by labour government advisers – then ignored by 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.

Jack Straw wants legal heroin as Health Sec’s son is charged for cocaine possession

Jack Straw, the Justice Secretary, has called for the NHS to give out heroin on prescription to addicts where other forms of treatment have failed whilst the former health secretary Patricia Hewitt’s 21-year old son Nicholas has been charged with possessing cocaine.

Justice secretary Jack Straw has called for imaginative solutions to tackling to the problems of drug addiction

He called for “imaginative” solutions to hard-drug abuse and said there could be “huge benefits” to issuing the drug to chronic addicts.

At the moment addicts can be prescribed heroin substitutes designed to wean them off the drug, but the idea of prescribing the drug itself is aimed at keeping long-term addicts away from drug dealers and crime.

“For the most problematic heroin users it may be the best means of reducing the harm they do themselves, and of stamping out the crime and disorder they inflict on the community,” said Mr Straw.

The Justice Secretary is the first cabinet minister to get involved in the debate following the results of a pilot scheme involving 127 heroin addicts in three cities, published last week.

The trial, which involved users injecting themselves under medical supervision in London, Brighton and Darlington, showed that crimes committed by addicts who had been prescribed heroin dropped by two thirds after six months.

Mr Straw said prescription heroin was “no magic bullet” but claimed it could reduce the £15 billion a year cost of the abuse of hard drugs.

The trials were set up in 2002 by David Blunkett, the then home secretary, but Mr Straw is the first cabinet minister to endorse prescribing the drug.

Harry Shapiro of Drugscope, which represents 800 drug projects, said: “It’s important to do everything possible to discourage Britain’s 300,000 problem drug users from injecting their drugs, and we should allow injecting heroin users to be provided with foil as part of a harm-reduction programme.”


Meanwhile, Nicholas Hewitt Birtles, a sales rep, was arrested when police raided a car parked near his home in Camden, north London, on Saturday evening, Scotland Yard said.

Officers observed three men sitting inside the vehicle parked in Camden Square and went to investigate at about 7.45pm.

They searched the car and allegedly recovered a small amount of white powder, arresting two of the occupants while the third was allowed to go.

The pair were taken to a nearby police station for questioning.

Mr Hewitt Birtles, whose father is Judge William Birtles, was later charged with possessing cocaine while the other man, who has not been named, was released on bail while tests are carried out on the powder.

The former Cabinet minister’s son was released on Sunday but ordered to appear in court next week. His friend is to answer police bail next month.

Australian-born Miss Hewitt, who served as Trade and Industry Secretary before moving to the Department of Health, left the Government in 2007 and is stepping down as an MP at the next election.

A Scotland Yard spokesman said: “Nicholas Hewitt Birtles, a sales representative of NW1, is bailed to appear before Highbury Corner Magistrates’ Court on Sept 30 charged with possession of a class A drug, namely cocaine, on Saturday Sept 19 at Camden Square.


Health Direct has long question the “logic” of labour’s drugs policy.

On August 02, 2006 we 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 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.

Labour to cut £20bn off NHS budget

The National Health Service will have to find savings of £15bn ($24bn) to £20bn, Andy Burnham, the labour health secretary, has acknowledged.

Hospitals are to get their first indication in the autumn of just how far and fast they will have to cut costs to help achieve that. His acknowledgement of  the scale of the challenge comes as Gordon Brown and Alistair Darling, prime minister and chancellor, have begun a series of meetings with cabinet ministers to discuss priorities and potential candidates for cuts in the run-up to the pre-Budget report in the autumn.

Labour Government insiders played down suggestions that the autumn statement would be a mini spending review, setting out departmental spending limits beyond March 2011.

But after the prime minister’s use of the “c” word this week, promising to “cut unnecessary programmes and cut lower priority budgets”, the chancellor is likely to offer some totemic sacrifices in the pre-Budget report, while possibly spelling out areas likely to be protected from the worst of the squeeze.

It is already clear that the capital intensive areas of transport and housing are set to take a hammering given previously announced plans to halve capital spending from this year’s level.

“They will almost certainly be amongst the hardest hit,” said Robert Chote, director of the Institute for Fiscal Studies.

Health is likely to be relatively protected, not least because the Conservatives are promising some real terms growth. That, however, will still leave the NHS having to make massive savings in the face of rising demand from medical advances and an ageing population, which together with pay and price inflation tend to outstrip economic growth.

Mr Burnham indicated this week that he would like to set out an “overall spending settlement” for the NHS in the autumn, while acknowledging that is a matter for the chancellor.

But whether that happens or not, he told the King’s Fund health think-tank, he will take the unprecedented step of spelling out the prices the NHS is likely to pay hospitals for treatment over the next four years.

That “will set out the scale of the efficiency and productivity challenge year on year, building up over time, with the most demanding savings coming later,” he said. In turn, he said, that “will begin the process of showing how we realise [the] challenge of finding £15bn to £20bn of savings” up until 2014.

Nigel Edwards, head of policy for the NHS Confederation, which itself has calculated that the NHS needs to make up to £15bn of savings by 2015, said: “This is the first ministerial acknowledgement that I have seen of the scale of the challenge.

“The good news is that it has been publicly acknowledged, and we welcome that realism. The bad news is that it is at least as bad as we thought”. 

“The price schedule, or tariff, covers about 70 per cent of hospital activity, which itself accounts for only some 40 per cent of the NHS budget. So spelling that out will give an indication but not a firm projection of likely level of NHS spending.


Women and older people less likely to receive heart attack drugs

Thousands of women and older people who suffer heart attacks are dying unnecessarily because they are not being prescribed the gold standard treatment which could prevent another attack.

One in five people who have had a heart attack in Britain do not receive all four drugs recommended to prevent a second, a study of 60,000 people have found.

NICE guidelines say heart attack patients should be prescribed two blood pressure drugs, a cholesterol lowering statin and aspirin to thin the blood.

However research based on a database of all surviving heart attack patients in England and Wales has found one in 20 people received only one or two drugs.

Women and older people are less likely to receive all four drugs, the study by University of Leicester has found.

Only 29 per cent of people leaving hospital on all four drugs were women. In addition the average age of those on one drug was 82 while the average age of those on four was 67.

Lead author Prof Iain Squire, professor of cardiovascular medicine at University of Leicester and consultant at the Leicester Royal Infirmary, calculated that 2,000 out of the 5,000 deaths over the two year study period had been undertreated and ‘could potentially have been avoided’.

He said: “The patients who are most likely to get undertreated are the elderly and females but they get incremental benefit for each drug they take so we should not be withholding these therapies based on age and gender alone.”

People aged 65 to 74 were 20 per cent less likely to get all four drugs compared with those under 55; while people aged over 85 were three times less likely to get all four medicines.

The findings, based on an analysis of the national registry called the Myocardial Infarction National Audit Project collected between January 2004 and December 2005, were presented at the European Society of Cardiology Congress in Barcelona.

It is thought doctors believe the drugs are less beneficial and more difficult to use in older people, and that women do not gain as much as men from them.

But the study showed that the survival benefits are similar in women as in men and in the elderly, the research showed.

The chances of surviving for one year after a heart attack increased with the number of drugs prescribed.

When other factors such as age, gender, and other illnesses were taken into account, people on four drugs were 54 per cent more likely to be alive one year later compared with people on just one drug.

Those on three drugs were 42 per cent more likely to be alive 12 months on than people on one drug; and people on two drugs were 27 per cent more likely to survive for one year than patients receiving one drug.

The effect was the same in men and women and the graded benefits of multiple drugs remained evident for patients aged 80 and over, the authors said.

Prof Squire said: “Our data indicate that provision of equitable management in these high-risk groups has the potential to deliver major improvements in prognosis for patients with acute myocardial infarction.”

Prof Adam Timmis, co-author and professor of clinical cardiology at the London Chest Hospital, said the majority of people are receiving all four drugs but improvements could still be made.

He said: “If you optimised the use of exisiting drugs and people were all managed appropriately across the country that would have a very large effect on cardiovascular outcomes.”

Prof Timmis said the guidelines, complied by the National Institute for Curbing Expenditure, Nice, are clear that there should be no discrimination on the basis of age or gender.

He said: “There is a general feeling that women don’t get this [heart attacks]. But we are not dealing with a condition that is rare in women, but there has been this perception.”

Prof Peter Weissberg, Medical Director of the British Heart Foundation, said this data was four years old.

He said: “We can pretty reasonably assume we are better now then we were then. We are getting better because we have this audit, hospitals are named and shamed when they are poor performers.

“There is a way to go and, generally speaking, women get a poorer deal in cardiovascular disease. That is improving but still less than perfect.”

Around 113,000 people in Britain each year suffer a heart attack and about one in three die before reaching hospital.


The new CRB check nanny state paranoia won’t stop another Soham

“I helped to catch Ian Huntley and I know these new stupid rules would not have prevented his crimes.” Health Direct reproduces the article below by Chris Stevenson who is a retired detective chief superintendent. 

In 2002 I was a senior detective with Cambridgeshire police. That August two ten year old girls disappeared, and I took over the investigation. Two days later I set up the surveillance operation that led to the arrest of Ian Huntley and Maxine Carr a few hours later.

Huntley has not been a free man since. He was convicted of the murders of Holly Wells and Jessica Chapman in December 2003.

Last weekend my actions came back to haunt me. My wife and I went to Benson, Oxfordshire, to celebrate the birthday of my nine-year-old grandson. We went off to see him play as goalkeeper for his village under-10s football team. Mum and dad, sisters, uncles and both grandparents were there to cheer him on.

One of my hobbies is photography, so I took my camera to take a few “action shots” of my grandson. Ten minutes later I was approached by the manager, who said: “Can I ask you not to take photographs, it’s against the regulations. You have to get permission in writing from every parent of every child.”

I felt humbled. I am now a suspected paedophile — along, I fear, with millions of other parents and grandparents. 

I looked at the pictures I had taken. They were of my grandson making saves as his team came under pressure. I am sure he would have liked to look back on them in the future. Who knows, he may be England’s goalkeeper at a future World Cup, although it’s a remote chance. I deleted the photographs.

The furore that has gripped the nation since the Soham murders has made us all paranoid. Is this in children’s interests? The latest “regulations” will require us to be checked by the Criminal Records Bureau if we give lifts to children going to Scouts or similar activities.

Commentators constantly refer to Huntley and the events in Soham as the reason for this. I am sure Sir Michael Bichard, who chaired the inquiry into the murders, did not intend such a wave of recrimination over one case. Yes, changes were necessary: Huntley lived a charmed life in Humberside, where he was investigated for a number of crimes. He was charged with rape, but after he spent a week in custody the case was dropped for lack of evidence.

As a result of poor intelligence, Huntley was appointed a school caretaker in Soham. Did that give him access to children? Yes, hundreds. Did he abuse them? No. In fact he reported to the headteacher that several teenage girls had made inappropriate comments. 

What Huntley did to Holly and Jessica was as bad as it gets, but did he come into contact with them through being a caretaker? Not exactly — he was caretaker of Soham Village College, a school for the over-11s. The two girls attended St Andrew’s Junior School. Different building, different caretaker. Huntley had contact with them because Carr was employed at St Andrew’s as a classroom assistant. 
She worked in a class with Holly and Jessica, who both liked her. Holly’s mother sent Carr a box of chocolates on the last day of term to say thank you for helping her daughter.

The girls were sorry when Carr was not given a permanent job. This was what led them to Huntley.

Out for a ramble around Soham on the Sunday evening, they stopped outside Huntley and Carr’s house to ask after Carr. Huntley told the media that they were sorry she hadn’t got the job.

Tragically, she was away, visiting her family in Grimsby. It was the first time they had been apart overnight since their relationship started. Huntley was in a bad mood as Carr had told him she was going to her second party in successive nights. He was alone. Somehow he conned the girls into the house and they were never seen alive again.

Did he achieve this because he was a caretaker? He could have been in any occupation, lorry driver, architect, anything, and lived with a woman that the two girls knew and trusted. And were right to, as I am convinced that Carr would never have done anything to hurt them.

How do we prevent such chance encounters happening? We can’t. No amount of legislation, record keeping or checking could prevent this type of crime completely. Thankfully it is extremely rare. Children are far more likely to be killed by a family member or on the roads.

Only recently a young girl was murdered by her mother’s partner. There is a suggestion that she had been sexually abused. He then hanged himself. The girl’s mother described him as loving, caring and the last person she would expect to do anything like that. We await the inquest, when it will be asked if the killings could have been prevented. I doubt that the answer will be yes.

We are subjecting our whole community to paranoia. On Friday a BBC journalist announced on breakfast television that “a million children are being abused”.

Where do these figures come from? How do we know? Are we feeding the paranoia that stops a grandfather taking a picture of his nine-year-old grandson playing football? Surely this cannot continue. Someone needs to put things back on an even keel.

Chris Stevenson is a retired detective chief superintendent