MRSA Action UK’s fears for government’s continued failings over hygiene

MRSA Action UK’s dismay at the government’s continued failings to inform the public of the need to protect themselves from Swine Flu and other infectious illnesses that have become a modern day plague.
MRSA Action UK's fears for government's continued failings over hygieneWith H1N1 (Swine Flu), norovirus and the continuing threat from MRSA and Clostridium difficile in the community setting MRSA Action UK is dismayed that their calls for a public information campaign on both hand and respiratory hygiene have not been forthcoming.

Whilst there has been considerable efforts put into preventing avoidable infections in hospitals, the public are still largely unaware of the simple actions that can be taken to reduce the burden of avoidable infections in the wider community.

Resistant pathogens continue to concern many in the field of microbiology, but not all healthcare professionals are in tune with the need to inform their patients on the sensible use of antibiotics. Posters in surgeries are few and far between, workplaces, supermarket notice boards, schools and public transport could all help spread the word.

There are some NHS Hospital Trusts and Strategic Health Authorities that have taken the initiative to raise awareness, but with cuts in budgets for many this has been a lower priority, despite the fact that preventing infections is far more cost effective than trying to manage the consequences of contracting them in the first place, which can often be fatal.

The Swine Flu epidemic has served to heighten the need for information and more needs to be done to raise awareness not only of the need for those at higher risk to come forward for vaccination, but also to take the necessary precautions to help prevent and fight infections like the Swine Flu.

With cases of flu in England and Wales soaring by 45% in a week, Swine Flu reaching epidemic proportions in under-fives and 39 dead from flu, 36 from the H1N1 virus, it’s time for the government to put promised resources into a public information campaign.

The previous administration was criticised by the present Health Secretary Andrew Lansley for making promises it didn’t keep, the Labour government stepped down the resources that were earmarked for raising awareness by curtailing the “cleanyourhands” campaign and ignored the research findings that they themselves commissioned proving the need for a public information campaign. We had hoped the new administration would heed our warnings, but to date little has changed as the campaign has not come to fruition.

By Derek Butler Chair MRSA Action UK

Flu vaccination call for all children from doctors

The doctor parents of a three year old girl who died from swine flu have called for all children to be vaccinated against the virus.
Flu vaccination call for all children from doctorsLana Ameen, who had no underlying health problems, died in hospital on Boxing Day, two days after apparently catching a cold and developing a high temperature.

Her parents, a doctor and nurse, have described how they were “shocked” at losing their daughter and said it was wrong that not all children were given the swine flu jab this winter. During the 2009 swine flu outbreak, it was recommended that all under-fives be vaccinated.

In the past fortnight, the Government has come under fire for restricting use of the seasonal flu jab, which protects against swine flu and two other strains, to under-fives who suffer from health problems, such as neurological disorders or asthma.

Ministers insist they are legally bound to follow the recommendation of the Joint Committee on Vaccination and Immunisation, which last July decided against vaccinating all children against this winter’s flu strains, a position they reaffirmed over Christmas.

But Gemma and Zana Ameen from Quinton, Birmingham, said the “price was too high” not to vaccinate children against the potentially deadly swine flu (H1N1) virus.

Mrs Ameen, 28, who is 12 weeks pregnant, said: “I want to say to people, to parents, ‘If you can get the vaccine don’t hesitate’. The risk of not having it and the price you might pay is just too high.

“We have been so shocked by what has happened and we feel very strongly that everyone, particularly children, should have the vaccine. The Government has made the swine flu vaccine from last year available now — we should all be having it.

“Even financially, surely it makes sense. The swine flu vaccine is inexpensive and has already been bought — it cost £1,700 just to care for Lana in intensive care for one day.”

The Ameen family were visiting relatives in Stockport, Greater Manchester, when Lana became ill on Christmas Eve. At about 2am on Christmas Day, her parents took her to Stepping Hill Hospital, where they had formerly worked, where she was diagnosed with an infection and her temperature stabilised before being sent home.

When she woke she seemed slightly better, opening Christmas presents and eating a little lunch. But after falling asleep that afternoon, she started having fits and was taken in an ambulance back to the hospital. She was eventually transferred to Alder Hey Hospital in Liverpool and died the next day.

Since October, five of the 50 patients known to have died of flu have been under-fives.


Casualty units shut to pay for labour’s private finance hospital contracts

NHS trusts are closing accident and emergency departments to help pay for hospitals built under Labour’s Private Finance Initiative (PFI) an investigation by The Daily Telegraph has found.
Casualty units shut to pay for labour's private finance hospital contractsSince 2007, more than a fifth of England’s hospital trusts with active PFI hospitals have closed casualty departments, or published proposals to do so. In the same period, only four per cent of trusts without PFI hospitals have closed, or proposed to close, A&E units.

Fewer than a quarter of England’s 168 NHS hospital trusts have significant PFI hospitals in operation. But these trusts account for almost two-thirds of A&E closures or proposed closures.

Health campaigners said there was a “clear connection” between the “inflated” costs of the PFI and the cuts in A&E.

Most trusts insisted there was no connection — not all A&E closures are necessarily done on financial grounds and some are supported by local clinicians.

In recent days, The Daily Telegraph has disclosed how some PFI hospitals – built and operated by the private sector, and effectively rented back to the taxpayer – will end up costing the public purse more than 10 times their capital value.

The new Princess Royal University Hospital in Bromley, south London, cost £118million to build. It will end up costing taxpayers £1.2billion, including facilities management. South London Healthcare, the NHS trust responsible for the Princess Royal, has a second PFI hospital, the Queen Elizabeth in Woolwich.

The trust’s annual deficit was raised to £100million by the two deals. It has closed the A&E unit at one of its non-PFI hospitals, Queen Mary’s in Sidcup.

In internal documents seen by The Daily Telegraph, the trust stated that the “occupation costs” of the PFI hospitals were roughly double those of its non-PFI hospital.

A spokesman admitted that its PFI contracts placed “some undeniable restrictions on our flexibility”. But she insisted that the decision to close A&E at Sidcup was “entirely unrelated” to PFI.

Other trusts closing A&E units include Coventry and Warwickshire NHS Trust, which recently opened a new PFI hospital and plans to shut the full A&E unit at its non-PFI hospital in Rugby.

Barking, Havering and Redbridge Trust, which opened a new PFI hospital in Romford, wants to close the A&E unit King George’s Hospital in Ilford.

East Lancashire Trust has closed A&E at its Burnley hospital to help pay for a new PFI hospital at Blackburn. In Nottinghamshire, Sherwood Forest NHS Trust has downgraded A&E services at Newark after opening a new PFI hospital in Mansfield. At least four other trusts with PFI hospitals have similar plans.

Under its PFI contract, Queen Elizabeth Hospital, Woolwich, must have 64 visits a year from pest controllers, even when there are no pests to control. When there are pests, the hospital must pay for further visits, which it did 10 times last year.

Food served at the Queen Alexandra PFI hospital in Portsmouth is cooked in south Wales, then driven 100 miles to Hampshire.

Early PFI hospitals had on average 20 per cent fewer beds than the hospitals they replaced, according to research. Because of high service charges, several PFI hospitals cannot afford to keep even these reduced numbers of beds fully open.

In an effort to disguise their private ownership, a number of PFI hospitals have changed their names to include a royal connection. Greenwich District Hospital became Queen Elizabeth Hospital. Salford Hope Hospital is now Salford Royal. Oldchurch Hospital, Romford, became Queen’s Hospital. Farnborough Hospital, in Bromley, was renamed after Princess Anne.


Lucrative NHS overtime for consultants questioned

Some health consultants are making more than £100,000 a year in overtime payments from the NHS.
Lucrative NHS overtime for consultants questionedThe sums – paid on top of basic salaries and bonuses – have been criticised at a time when the health service is trying to save money.

Consultants have been accused of playing the system, but doctors said poor planning by managers was to blame.

Overtime rates vary, but are often about £600 for four hours – treble what senior medics get for contracted work.

Basic pay for consultants stands at just under £90,000 a year on average. For full-time consultants, this pays for 10 separate four-hour blocks a week.

Consultants who do private work are also obliged to do an extra four hour session paid at their basic rate if their NHS trust needs them.

Any extra work beyond that is then done at a higher rate under a system known as waiting list initiative payments (WLIs).

These are negotiated individually by each trust so there are no figures for how much is spent nationally.

The Department of Health stressed the need for the efficient use of money in the current climate.

Depending on what speciality they are in, consultants can earn tens of thousands of pounds on top of their basic pay.

Consultants involved in common forms of surgery, such as ear, nose and throat and hip and knees, tend to do the most overtime alongside anaesthetists. Others, working in areas such as geriatrics, are likely to get very little.

At Coventry and Warwickshire NHS Trust, one ear, nose and throat specialist made more than £105,000 in 2009-2010 in overtime. Another three consultants from other areas made in excess of £80,000.

Similar figures were also seen in the previous years.

Ed Burns, from Newton Europe, a consultancy which has carried out work for NHS trusts to improve productivity, said figures in excess of £60,000, including those above £100,000, would not be seen in every trust but were “not unusual” either.

He said poor job planning was the most common cause of high overtime payments, but added sometimes consultants fought against giving them up by employing tactics such as under-booking theatre sessions to make sure there was a need for overtime.

The total bill for the waiting list initiative payments has nearly doubled in two years to £2.35m in 2009-10 for the trust, which runs two major hospitals for a population of over 1m in the West Midlands.

And despite attempts to curb the amount being spent this year, latest figures suggest it will rise again.

Like many NHS trusts, consultants are offered up to £600 for a four-hour session. Some are only too happy to accept.

One ear, nose and throat consultant made more than £105,000 in overtime payments last year. Another three from other specialities got in excess of £80,000.

Not everyone gets the extra work. In total, 123 consultants out of a total of 350 did overtime.

A spokeswoman for the trust said such payments were unavoidable to ensure patients received “timely” care. She added the trust always sought to use resources “as responsibly as possible”.

“Consultants work hard to provide the best possible patient care, and by volunteering for WLIs they help keep waiting times down. However, for a few, WLI payments can serve as a disincentive to working more efficiently because they face a loss of earnings.”

His claims are supported by the experience of some NHS trusts.

Managers at Mid Staffordshire NHS Trust tried to reduce the rate for overtime for orthopaedic surgeons from £1,000 to £500 for a four-hour session. But minutes from official meetings showed consultants would be “downing tools” if they did so. In the end, managers had to compromise on a fee of £750.

Paul Flynn, from the British Medical Association, admitted some of the higher sums “sounded unhealthy”, but pointed out research by the union also suggested consultants were doing six hours a week extra for free.

He also rejected suggestions that consultants were blocking moves to make hospitals more productive.

“WLI is a quick fix and consultants certainly would not want to come to rely on the payments as they are unpredictable.”

He said hospitals could reduce the reliance on overtime by easing the load on consultants by recruiting extra staff or giving admin tasks and duties such as routine follow-ups to other staff.
‘Publish data’

News of the overtime payments comes after the BBC reported at the end of last year that doctors were getting bonuses of up to £75,000 a year.

It means overall pay, once basic salary, bonus and overtime are totted up, can be well in excess of £200,000 a year.


Pregnant women denied flu jabs say midwives

Pregnant women were denied the seasonal flu jab in some parts of the UK, before swine flu began claiming more lives, because not all GPs were aware that mothers-to-be had been made a priority group to receive the jab this winter.
Pregnant women denied flu jabs say midwivesLouise Silverton, deputy general secretary of the Royal College of Midwives, told the Guardian that a number of pregnant women had been refused the vaccine by family doctors in autumn.

“In October, when GPs started telling patients to come for immunisation, some pregnant women got it and some didn’t. GPs sent some of them away because they thought they didn’t need it, because no one had told them that pregnant women had been added to the list of groups of people considered ‘at risk’,” she said.

Research shows pregnant women are four times more likely to develop serious complications if they catch H1N1 swine flu, which is the main strain of seasonal flu circulating this winter. There has been concern that takeup of the jab protecting against all three strains of flu has been low among pregnant women.

Silverton also criticised the decision by the health secretary, Andrew Lansley, to cancel the usual advertising campaign intended to prompt the 16 million Britons classed as vulnerable to have the jab.

“It was short-sighted of the Department of Health not to have the usual campaign, she said. “It was done to save money. I agree with the government’s overall aim of reducing government advertising, but they should have been more selective and kept the campaign for all at-risk groups.

“Usually there are posters on buses and all sorts, but this year there was nothing. It was a wasted opportunity not to have the awareness campaign stressing the importance of people in at-risk groups being vaccinated.”

A majority of the 50 people to die from flu so far this winter had not had the three-in-one jab at least two weeks before falling ill, the Health Protection Agency said.

The outbreak has so far claimed 50 lives and left 783 people in intensive care, amid vaccine shortages and low takeup rates of the seasonal flu jab.


High doses of common painkillers like ibuprofen increase stroke risk warn researchers

Commonly used painkillers increase the risk of heart attacks and strokes when taken at high doses or over the long term, according to research.
High doses of common painkillers like ibuprofen increase stroke risk warn researchersExperts analysed more than 30 clinical trials on more than 116,000 patients to examine the effects of painkillers on people’s health.

The fears relate to non-steroidal anti-inflammatory drugs as well as newer anti-inflammatory drugs known as Cox-2 inhibitors.

Doctors regularly prescribe such drugs to treat painful conditions, including osteoarthritis.

They are given at much higher doses than those found in over-the-counter remedies, which are used for occasional headaches, aches and pains.

The study, in the British Medical Journal, found that compared with a dummy drug lumiracoxib increased the risk of heart attacks, while ibuprofen was linked to the highest risk of stroke (more than treble the risk).

Diclofenac almost tripled the risk, while etoricoxib and diclofenac were associated with around a fourfold increased risk of suffering death from cardiovascular causes.

The authors, from the University of Bern in Switzerland, said: “Although uncertainty remains, little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms.”

In an accompanying editorial, Prof Wayne Ray, from the department of preventive medicine in Nashville, said: “Naproxen seemed least harmful.

“Cardiovascular risk needs to be taken into account when prescribing any non-steroidal anti-inflammatory drug.”

Overall, the number of heart attacks and strokes reported was low compared to the number of patients.

In 29 of the trials, there were a total of 554 heart attacks and in 26 trials there were 377 strokes. In 28 trials there were 676 deaths.


Cancer- GPs given money and powers to help save 5,000 lives

The lives of more than 5,000 cancer sufferers will be saved each year under an £800 million government drive to make England’s survival rates among the best in Europe, the Health Secretary announced this week.
Cancer- GPs given money and powers to help save 5,000 livesThe strategy will focus on increasing the number of lives saved by the NHS with a series of measures to improve cancer survival rates that currently lag behind those in most other developed nations, Andrew Lansley said.

Under the plans, GPs will be given the power to order a range of cancer tests direct from hospitals without having to refer the patient first to a consultant.

A £10 million awareness campaign will encourage people to see their doctor sooner if they develop symptoms. Funding will also be announced for 1,200 additional cancer specialists and new screening technologies to improve detection.

The total funding package will be worth about £800 million. Health is one of only two Whitehall departments whose spending has been ring-fenced by the Coalition, although there will inevitably be questions about whether this is achievable.

Cancer claims more than 150,000 lives a year in Britain. One in four of all deaths is caused by the disease, with survival rates for cervical, bowel and breast cancer among the worst in the developed world.

Previous studies have suggested England’s survival rates are on a par with Poland, despite the NHS spending significantly more on health care.

Late diagnosis is usually to blame, Mr Lansley told MPs. That will govern the new strategy, which will try to ensure far more people adiagnosed at an early stage of the disease so that cancers can be caught and treated sooner.

Mr Lansley said “Cancer affects us all. Everyone will have a story of someone they love battling the disease.” He will add: “Our ambition is simple, to deliver survival rates that are among the best in Europe and this strategy outlines how we will make our first steps towards this.

“The Coalition Government’s reforms of health and care services will drive improvements in what matters most to patients and their families — cancer outcomes, lives saved — that is what we will be measuring our success against.”

The new cancer strategy for England will explicitly commit to saving an extra 5,000 lives a year by 2014-15.

GPs will be able to send patients directly for diagnostic tests such as X-rays to help diagnose lung cancer, ultrasounds to detect ovarian, liver and pancreatic cancers; colonoscopies for bowel cancer and MRI scans to aid brain cancer diagnosis.

The strategy will also pledge £50 million of funding for additional cancer drugs; a £200 million Cancer Drugs Fund until 2013; the expansion of radiotherapy services and the introduction of bowel cancer screening technology that could save thousands of lives a year.

It will also announce a £10.75 million awareness campaign to focus on breast, lung and bowel cancer.

Providing patients with quicker access to diagnostic tests, through GPs, is seen by Mr Lansley as the key to improving survival rates.

The move to give GPs power to directly order tests fits with the Government’s health plan of giving more power to family doctors.

Progress has been made on survival rates, particularly with breast cancer. The chance of surviving for five years from diagnosis has risen from 74.8 per cent between 1995 and 1999 to a projected rate of 81.6 per cent between 2005 and 2007, beginning to catch up with countries such as Norway and Sweden.

However, a report in The Lancet last month showed that survival rates for other cancers continue to trail those of other leading nations.

While five-year survival rates for lung cancer rose from 7.0 to 8.8 per cent here, in Canada they increased from 15.7 to 18.4 per cent. Separate research by the National Cancer Intelligence Network has found that nearly a quarter, 23 per cent, of all cancer cases go undetected until the emergency admission stage.


IVF quango battles for it’s own life against closure

The HFEA was one of 192 quangos listed for abolition in October as one of the coalition’s flagship money saving initiatives. IVF quango battles for it's own life against closureThree months after the formal announcement of its abolition, the authority is continuing its work and gently fighting a low-key, behind-the-scenes battle for survival.

Its office does not have the aura of a body that has been freshly culled. Staff are preparing for a general meeting in Cardiff, where the 2011-12 business plan will be agreed. Inspectors are reviewing recent inspections of IVF clinics. Employees are still pinning crayoned pictures by their children above their workstations and watering the plants.

A parliamentary committee’s withering conclusion last week that the government “botched” its mission to “reduce the number and cost of quangos” is met with no surprise by staff here, who remain bemused by the decision to close down their organisation.

News of the HFEA’s planned closure, and distribution of its functions to other organisations, has been greeted with dismay by doctors and research scientists, who warn that it threatens the government’s ability to make sound decisions about crucial ethical issues.

Of all the dull-sounding, bureaucratic bodies crossed out in a pen stroke last October, the HFEA has the least arcane function. Responsible for inspecting and regulating IVF clinics, it also deliberates on the ethical boundaries of creating life and using embryos for research, a sector that is developing with rapacious speed.

Anyone planning to undergo fertility treatment in the UK depends on the HFEA to ensure that clinics are safe. Children who have been born as a result of donated sperm or eggs may want to turn to the organisation to discover information about the donor.

Practitioners rely on the body to help set out moral guidelines: is it ethical (to give one example under consideration at the moment) to allow a woman to use frozen embryos left to her by her grandmother, which would result in her giving birth to her own aunt or uncle?

The HFEA’s chair, Professor Lisa Jardine, the high-profile and outspoken academic, has reined in any personal impulse towards protest or defiance, and is mounting a delicate campaign to ensure that the organisation can be preserved.

She insists that her job is to comply with what the government has ruled, but makes it clear that she will be working to promote an alternative, which would see the HFEA continue broadly unchanged, swept into the folds of another government-run organisation.

“It’s the most controversial area of medicine, apart from assisted dying. It’s the most morally difficult area, it’s the most carefully legislated-for area, and the most tightly regulated area. I’m totally committed to doing this job of regulating assisted reproduction, above all IVF and research on embryonic tissue,” she says. “My only aim is to keep doing that until someone else can do it properly.”

She believes the HFEA was included on the list of quangos to be abolished by accident. “I feel very passionately that this is a mistake,” she says, stressing that no steps have been made towards closure. “We’re nowhere near. We haven’t even started.”

Provisional Department of Health plans indicate that the HFEA’s functions are to be transferred and split between other DH bodies. None of the 79 staff members know whether they will keep their job when the quango is wound down, nor when that might happen. Employees, from computer technicians to policy experts, seem united in their loyalty to the organisation, and voice anxiety not only for their own job security, but for the ability of a restructured HFEA to perform the range of services it was created to provide. The staff are civil servants, not inclined towards intemperate expressions of outrage. Instead, their laments cautiously warn that the proposed course of action may prove to have been ill-advised.

In a side room in the quiet central London office, Peter Thompson, the HFEA’s director of strategy, says staff had not expected the body to be scrapped, because as recently as 2008 parliament had debated its role and there had been “almost no voices at all saying this organisation ought to be abolished”.

He says: “Having had that endorsement in 2008, from all sides of parliament, to have this decision only two years later did come as a bit of a shock”

At the last authority meeting the governing body agreed it was a “very difficult” process for staff and “asked that efforts were made to minimise their stress”. Someone has cut a slit out of an empty cardboard box, and stuck a label on it marked “Worry Box”, inviting colleagues to post their concerns.

“My job as one of the senior people here is to lead and manage people through that uncertainty. Keeping our focus on doing the job well, maintaining morale, keeping people’s spirits up,” Thompson says.

The bonfire of the quangos appeared to herald a straightforward, hard-nosed money-saving exercise. The reality is much messier. Only a few bodies are to be closed outright. The others will have their functions transferred to new bodies, at some uncertain point in the future.

Cabinet Office minister Francis Maude insisted last week that the axing would save “significantly more” than £1bn. However, the public administration select committee warns that the “current approach is not going to make significant cost savings or result in greater accountability”.

Ian Magee, a senior fellow at the Institute for Government (IFG), and co-author of Read Before Burning, a report into the closure of the quangos published last year, says that unless the functions performed by the organisations are also abolished, very little money will be saved.

“It’s not going to contribute much to the budget deficit reduction,” he says. Closing down quangos is a complex process, he adds. “You can’t just turn the tap straight off.”

Maude is confident that the correct decisions have been made. “We think the process has gone pretty well. All three parties fought the election with a commitment to reducing significantly the number of quangos. There is a uniform view across the political spectrum of the desirability of doing so,” he says.

On the decision to wind down the HFEA, he adds: “You have a very complicated landscape of health regulatory bodies. The view taken by the health minister was that there is scope for simplifying that operation and making it a much more efficient and streamlined operation.”

The government has said that the HFEA will continue working “for the time being”, but that its functions will be transferred by the end of the current parliament. Government officials are examining the “practicalities (and legal implications) of how to divide the HFEA’s functions between a new research regulator, the Care Quality Commission and the Health and Social Care Information Centre”.

But the announcement was so confused when it was made that many people – staff included – thought the closure would be immediate. On the HFEA’s website a notice states prominently: “You may have seen reports in the press that the HFEA ‘has been abolished’. This is not so.”

The notice points out that the government cannot scrap the HFEA without first introducing new legislation.

“At the moment, we have no – literally zero – idea of what the Department of Health plan is,” Jardine says.

With such a delayed death knell, staff were uncertain whether to be devastated or sanguine at the news. Paula Robinson, head of business planning, says: “The time frame was so long, I can’t say it really rocked my world. It’s not brilliant to hear that an organisation is going to be abolished, but if you hear that it is going to be a matter of years, it eases the pain. I am not sitting here wringing my hands. I am a change-friendly person.”

But one of the inspectors, who carries out regulatory checks on IVF clinics, was aghast. “I felt very worried. I have just bought my first house. My husband works for the NHS. Two jobs that are very uncertain,” she says.

In a proposal aimed at streamlining the bodies regulating medical research, the Academy of Medical Sciences today suggests that the HFEA’s research and ethical functions should be transferred to a new Health Research Agency. But any move towards splitting up its responsibilities is not welcomed by employees.

“I think that the decision ignored the fact that because all our functions are together in one body, that enables us to be a more intelligent, more efficient regulator,” Thompson says. “This body has dedicated people who know what they are doing. These are people who care about the sector they regulate and the patients. I think by having all of those functions in one place, we do a more efficient and intelligent job than by scattering those functions to other places.”

Policy manager Helen Richens leads a campaign to reduce the number of multiple births from IVF clinics. Historically, she says, doctors would transfer multiple embryos, but the health risks to the mother and the embryos were very high. Now, if the woman is under 40, doctors can transfer no more than two embryos; over 40, no more than three. The HFEA has imposed a 20% maximum multiple births target on each of the country’s 138 clinics, enforced with the threat of losing a licence.

“One of the reasons we are good at this is that we have the policy staff and inspectors, who are going and seeing what is happening; we hold all the data on all the fertility treatment in the UK, we can analyse it and monitor it, so when we make policy it is proper, evidence-based policy,” she says. “We will be moving from a world-leading model to something that is a less than gold-standard regulatory model.”

She adds: “I think I feel maybe a bit unappreciated. You do your job well, other countries look towards us … there is a collective feeling, what is the point of moving us on, breaking us up? It is not going to save money. If there isn’t a measurable benefit, what is the point of getting rid of this quango?”

The HFEA has an annual budget of £7m, only £2m of which is provided by the government; the remaining £5m is funded by the clinics, which pay to be regulated. The body charges clinics, both private and NHS, £104 for an IVF cycle and £52 for donor insemination.

Jardine, who has just been reappointed for a three-year term, hopes to be able to trim the amount needed from the government to around £1m. “There will be additional expenditure. There will certainly be no saving,” she says of the planned abolition. “We are incredibly cheap.”

Collectively, the senior management have taken a clear decision not to campaign noisily against closure. They point to the unsuccessful campaign mounted to save the UK Film Council, whose demise was announced at the same time. Despite the appointment of a PR adviser and the involvement of director Steven Spielberg, the abolition went ahead.

Instead, they set out the value of their work.

“Any couple can walk into any clinic in the British Isles and know that their IVF or other reproductive treatment has been fiercely vetted and that they will come to no harm. No person walking into a plastic surgery clinic has that assurance,” Jardine says.

Supporters of the decision argue that as IVF has become much more common in the 20 years since the HFEA has been operating, there is less need to regulate it so closely. Jardine disagrees.

“IVF is not routine. There are people out there who still think that we shouldn’t be doing any of what we are doing. Some of them have seats in the House of Lords.”

The issues are too ethically and politically explosive to be dealt with by politicians, she argues. “There are too many pressures on parliament, and civil servants are not trained to deal with those kinds of issues. I believe that these morally fraught issues must be held at arm’s length from government.”

Pregnant women win £200,000 payout over pill implant contraceptive failures

Nearly £200,000 in compensation has been paid to women who have become pregnant or been hurt after they were fitted with a popular contraceptive implant.

Pregnant women win £200,000 payout over pill implant contraceptive failuresThe NHS has received more than 1,000 complaints about Implanon, a device that had been hailed as the future of family planning.

The procedure involves injecting a plastic implant under a woman’s skin, which releases the “pill” hormone progesterone, guarding against pregnancy for up to three years.

The procedure is regularly given to under-16s who are not deemed responsible enough to remember to take oral contraceptives on a daily basis.

Figures obtained by Channel 4 News show that 584 women who had the hormone-filled tube inserted into their arms have reported unwanted pregnancies to the Medicines and Healthcare Regulatory Agency.

There have been a total of 1,607 complaints about scarring and other problems associated with the device, the majority made by doctors and nurses who claimed it was difficult to insert properly and could not be checked afterwards. In the most serious cases, NHS Trusts have offered settlements to seven women totalling nearly £200,000.

Some women who took Implanon terminated pregnancies and suffered the breakdown of relationships.

One woman, named as Lara, said her marriage collapsed due to the stress. “I don’t want kids at this time. It really disturbed me,” she said.

MSD, which manufactured the implant, said it was replacing Implanon with a new contractive implant named Nexplanon.

In a statement, it added that the active ingredient would remain the same but, unlike Implanon, the new implant would show up on X-rays and CAT scans. The applicator has been modified, the company said.

It added that a training programme was available for health professionals involved in fitting the devices.

Family planning clinics in England have reported rapidly increased use of contraceptive implants, from 16,000 women in 2005 to nearly 82,000 in 2010. Implanon, which cost £90 per treatment, was more than 99 per cent effective.

A spokesman for the MHRA said: “The reports we received from health care professionals and consumers played a strong role in the update of the device.”


We cannot afford not to reform NHS says David Cameron

The Government cannot afford to delay essential reform of Britain’s public services, David Cameron warned yesterday.
We cannot afford not to reform NHS says David CameronAs ministers prepared to publish legislation to radically overhaul the NHS, the Prime Minister said that failure to modernise was draining resources away from the public sector.

The Government’s plans for the NHS were denounced by six health service unions – including the British Medical Association and the Royal College of Nursing – as “potentially disastrous”.

But Mr Cameron insisted that change was essential.

“Every year without modernisation the costs of our public services escalate. Demand rises, the chains of commands can grow, costs may go up, inefficiencies become more entrenched.

“Pretending that there is some ‘easy option’ of sticking with the status quo and hoping that a little bit of extra money will smooth over the challenges is a complete fiction.

“We need modernisation, on both sides of the equation. Modernisation to do something about the demand for healthcare, which is about public health. And modernisation to make the supply of healthcare more efficient, which is about opening up the system, being competitive and cutting out waste and bureaucracy.

“Put another way: it’s not that we can’t afford to modernise; it’s that we can’t afford not to modernise.”

With the Government also set to publish details of its school reforms next week, Mr Cameron cited the experience of Tony Blair, who found that delaying public service reform simply resulted in “institutional inertia” against change.

He acknowledged that in the past the Conservatives had not always shown sufficient respect for those who worked in public services, but insisted he would “revere, cherish and reward” an ethos of public service.

“I believe previous Conservative governments had some really good ideas about introducing choice and competition to health and education – so people were in the driving seat. But there was insufficient respect for the ethos of public services – and public service,” he said.

“The impression was given that there was a clear dividing line running through our economy, with the wealth creators of the private sector on one side paying for the wealth consumers of the public sector on the other.

“This analysis was – and still is – much too simplistic. Public sector employees don’t just provide a great public service – they contribute directly to wealth creation.”

He denied he was planning “a kind of public service version of a laissez-faire economic policy” with the Government’s reforms for schools and hospitals, “where winners are created at the expense of those who get left behind”.

“The state has a hugely important responsibility to ensure clear, basic standards are met, the rights of users are maintained and independent inspection is carried out in our public services and we are in no way abrogating that,” he said.

The Prime Minister also rejected suggestions that the Government was trying to do “too much at once” in pushing through change.

“Every year we delay, every year without improving our schools is another year of children let down, another year our health outcomes lag behind the rest of Europe, another year that trust and confidence in law and order erodes,” he said.

“These reforms aren’t about theory or ideology – they are about people’s lives. Your lives, the lives of the people you and I care most about – our children, our families and our friends. So I have to say to people: if not now, then when? We should not put this off any longer.”

Mr Cameron also explained comments in which he appeared to describe the NHS as a second rate National Health Service as a slip of the tongue.

His slip-up came during a radio interview this morning on BBC Radio 4’s Today programme.

Asked if he would apologise for using the term, Mr Cameron said: “I think if you listen to the interview, I immediately said we shouldn’t settle for second best and that is exactly what I meant to say.

“I speak often quickly, I don’t just have a pre-arranged order of saying things and sometimes you can get a little word out of place and I immediately said, if you listen to the clip, we shouldn’t settle for second best, that was the point I was making.”

To widespread guffaws from the assembled media, he added: “We shouldn’t settle for second best is what I meant, it’s largely what I said, if you skip over a quick word in the middle.”

In a letter to The Times today ahead of Wednesday’s publication of the Health and Social Care Bill, the heads of six health unions expressed their “extreme concerns” about plans to create greater commercial competition between the NHS and private companies within the health service.

The signatories, including BMA chairman Hamish Meldrum, RCN chief executive Peter Carter and the heads of health for the Unison and Unite unions, said: “There is clear evidence that price competition in healthcare is damaging.”

It follows a report by the NHS Confederation which acknowledged the potential benefits of the changes, which will give GPs power over commissioning treatment, but warned they were “extraordinarily risky” at a time when the NHS is facing its toughest financial constraints for a decade.