Man jailed for worst ever breach of medicines supply chain

A British man has been sentenced to eight years in prison for his role in what law enforcers describe as the “most serious known breach” of the regulated UK medicines supply chain.
Man jailed for worst ever breach of medicines supply chainFollowing a four month trial in Croydon Crown Court, 64-year old Peter Gillespie was found guilty for working with an international network of criminals to introduce fake drugs into the UK’s legitimate supply chain during a five month period in 2007.

The case, known as Operation Singapore, centred on the importation of more than two million doses of counterfeit life saving medicines into the country.

More than half of these were captured by the Medicines and Healthcare products Regulatory Agency, but a huge amount – almost 900,000 doses – initially reached pharmacies and patients.

Despite an immediate recall of Eli Lilly’s antipsychotic Zyprexa (olanzapine), Bristol-Myers Squibb’s bloodthinner Plavix (clopidogrel) and AstraZeneca’s prostate cancer drug Casodex (bicalutamide), 700,000 doses were left unaccounted for, putting the health of many Britons in jeopardy.

Mick Deats, the MHRA’s head of enforcement, also revealed that plans to bring in three other counterfeit drugs – Pfizer/Eisai’s Alzheimer’s drug Aricept (donepezil), UCB’s antiepileptic Keppra (levetiracetam) and Johnson & Johnson’s antipsychotic Risperdal (risperidone) – had been foiled.

“They didn’t get to bring them in but they were definitely well on the way to being prepared to receive them,” he told the media, according to Reuters.

“This is serious criminal activity and puts people’s lives at risk,” Deats said, and stressed that the Agency would not hesitate “to take all appropriate action to eliminate the risks posed by counterfeit medicines and take action against those engaged in their supply”.

However, he also noted current evidence suggests that medicines supplied through the UK legitimate supply chain are genuine and safe to take.

Since 2004 there have been just 15 known instances of counterfeit medicines in the UK regulated supply chain, and given that 850 million prescriptions are dispensed every year in the UK, the likelihood of receiving a counterfeit medicine remains extremely rare, the MHRA said.


Nurses call for annual MOT health check

Nurses have suggested they should undergo an annual health and well-being “MoT”.
Nurses call for annual MOT health checkThe physical and psychological assessment could take place alongside yearly appraisals, according to nurses at the Royal College of Nursing (RCN) conference in Liverpool.

They believe the plan would help staff set a healthy example to patients and argued that there are more checks on wheelchairs than NHS staff.

Claire Topham-Brown, a critical care nurse from Peterborough, said: “There is no denying that nursing is a physically demanding job. You do need a certain level of physical fitness.”

She told delegates during a discussion on the issue that one activist had “observed that we take better care of wheelchairs than we do of the staff.

“Bizarre but true – we now risk-assess everything, yearly, monthly, weekly and sometimes daily. But when do we ever assess that vital, delicate and most valuable part of the machine – namely me and you?”

She said it was not just about the physical and psychological nature of nursing work but also the culture and environment in which they operated.

“Don’t we deserve an annual MoT?” she said. “It would allow our employers to be more proactive and supportive instead of reactive.”

Ms Topham-Brown was supported by other nurses, including Karen Webb, the RCN’s director of the eastern region of England.

She suggested support was even more important given the expansion in nurses in training in recent years, which could lead to an increase in the numbers not fit for a career in nursing.

She said students had a health check before joining a course but their psychological suitability was not tested.

“It is about making sure people have the right attributes,” she added.

In her local area, screening had been launched to “make sure that the people coming in have the right attitude to what is essentially customer care”.

She said nurses also had a duty to deal with public health issues, such as obesity and well-being.

And those nurses who were overweight themselves could be supported.

“It would be about supporting those people in that position to help them lose the weight.”

The Government’s NHS Health and Wellbeing report, published a year ago, said the NHS needed to do more to improve the health of staff.

NHS staff take an average of 10.7 days off work a year – more than the public sector average and nearly double the 6.4 figure for the private sector. Staff sickness is thought to cost the NHS £1.7 billion a year.


NHS should stop wasting money on “ineffective” operations warns bean counter quango

Health authorities should stop wasting money on “ineffective” operations like tonsil removals and wisdom teeth extractions, according to the quango Audit Commission.
NHS should stop wasting money on "ineffective" operations warns bean counter quangoIt has calculated that the NHS could save £500 million a year by doing so, that could be put towards more worthwhile treatments.

Its briefing, Reducing expenditure on low clinical value treatments, found that a clearer approach among primary care trusts (PCTs) to what it called “ineffective or inefficient treatments” would ensure more consistency across the country.

It came as another report, by the health think-tank The King’s Fund, criticised “persistent and widespread variations across England in patients’ chances of undergoing surgery for common medical problems”.

Both reports, by coincidence issued on the same day, agreed that some patients were undergoing operations “that do not benefit them”, in the words of The King’s Fund.

However, while the Audit Commission report focused on the potential cost savings of reducing operations, The King’s Fund called for an end to the “unfair” and “inefficient” variations in accessing worthwhile surgery.

The former identified tonsil removals as “relatively ineffective” and hysterectomies in cases of heavy menstrual bleeding as less cost-effective than alternatives.

Wisdom teeth extraction was often not worthwhile, because of a “close benefit and risk balance”, while some procedures, such as orthodontics, were nothing more than “potentially cosmetic”.

Some PCTs, of which there are about 150 in England, could save more than £12 million a year by reducing such operations, the soon-to-be-abolished spending watchdog calculated.

Andy McKeon, its managing director of health, said: “PCTs across the country are currently paying for treatments that cost the taxpayer money, and according to clinical experts have little or no real value to patients. This needs to change.”

The King’s Fund report – Variations in Health Care: the good, the bad and the inexplicable – found that tonsil removal operations in children were 10 times more common in Coventry than in Kingston, even though the procedure “has been queried since the 1930s”.

But it concentrated on lack of access to operations that did work.

For example, it found that rates of admission for hip and knee replacement varied by up to 400 per cent, with people in poorer areas much less likely to receive one.

Rates of coronary artery bypass grafts varied from 34 per 100,000 in Westminster to 197 per 100,000 in Berkshire.

John Appleby, chief economist at The King’s Fund, said: “This report confirms research over decades, both in the UK and internationally, which has shown persistent and unwarranted variations in use of and access to even the most common surgical procedures. This is unfair to patients and inefficient for the NHS.

“Remedying this is urgent given the need to improve quality of care while the NHS grapples with the biggest financial challenge in its history.”


NHS funding pressures hitting frontline- Accident & Emergency chief warns

Hospital casualty departments are struggling to cope with growing demand for emergency care because they have too few staff and not enough beds, Britain’s top accident and emergency doctor has warned.
NHS funding pressures hitting frontline- Accident & Emergency chief warnsAs new figures pointed to a steep rise in A&E waiting times and 890 ambulance jobs were lost, John Heyworth, president of the College of Emergency Medicine, joined a growing chorus of doctors warning that the NHS funding pressures are already hitting frontline services.

“The emergency care system is struggling to cope at the moment,” he said. “Many departments spend their time firefighting because of the number of patients coming in, the limited number of emergency department staff and limited availability of beds.”

David Cameron and the health secretary, Andrew Lansley, have insisted that the NHS will not be affected by the deep cuts to public spending elsewhere and that frontline services will be protected during their shakeup of the health service.

But medical organisations, health charities and patients’ groups are increasingly sceptical that the pledge can be kept as health spending fails to keep pace with the rising cost of treating Britain’s ageing population.

“The line that the NHS is being protected from cuts – even to frontline services – is looking increasingly absurd”, Dr Hamish Meldrum, chairman of the British Medical Association’s ruling council, told the Guardian on Tuesday. “The financial pressures are really starting to bite and these are yet more examples of vital services that are showing signs of the strain and that will be stretched to the limit.”

Heyworth pointed to NHS figures showing a steep rise in patients waiting more than four hours for A&E treatment, saying they showed “an increasing mismatch between ever rising demand, ever limited emergency medicine consultant numbers, which are woefully inadequate, and limited hospital bed capacity for emergency patients.”

The hospital statistics reveal that 292,052 people in England were not treated within the four-hour target between July and December last year, soon after Lansley announced in June that he intended to scrap the rule. That was up from 176,522 patients in the same period in 2009 – a 65% leap inside one year.

The A&E statistics coincided with the axing of 890 jobs by the London Ambulance Service (LAS) and the disclosure that services in which specialist nurses help people with diseases such as cancer and diabetes are also facing cuts.

The ambulance service cuts in London will see 560 frontline posts disappear, including paramedics. The capital may also see some of its ambulance stations close, while, according to LAS chief executive Peter Bradley, solo paramedics rather than two-person crews will start responding to more callouts from September as part of a drive to save £53m over the next five years.

“Unfortunately we are not immune to the financial pressures facing the NHS,” he said. “With nearly 80% of our budget spent on staff costs it would be impossible to make the savings required without removing posts.” The health union Unison’s regional organiser, Phil Thompson, warned the cuts could endanger patient safety. “These cuts are so deep they may not heal. With demand escalating and nearly 1,000 fewer staff no one can now be sure of a safe service.”

The ambulance cuts prompted the NHS chief executive, Sir David Nicholson, to issue his second reminder in 72 hours to health service managers that there should be no cuts to patient services as part of the drive to make £15bn to £25bn in “efficiency savings” by 2015.


Children are significantly fatter than their parents were at the same age

Today’s generation of 11-year-olds are significantly taller – and fatter – than their parents were at the same age, a survey suggests.
Children are significantly fatter than their parents were at the same ageAccording to the first ever nationwide sizing survey using 3D body scanners, both typical waist-lines and height have increased over the last 30 years.

The findings are based on measurements of more than 2,500 children aged four to 17, taken in 2009-10.

High street retailers will use the results to provide more accurate sizes. Several of them sponsored the research, and they will also use the data to better design children’s clothes.

Girls are typically 2cm taller, with waist measurements up by 8cm, and boys are 4cm taller, with waists up by 7cm.

The survey, called Shape GB and carried out by Select Research, suggests that two current beliefs prevalent among retailers are wrong: that boys’ and girls’ body shapes do not differ significantly before the age of seven, and that the average height of five-year-old boys is 110cm when it is actually 115cm.

An average 11-year-old girl today is 148.8cm tall, compared with 146cm in 1978, an increase of 2.8cm or 1.9%.

Because the 3D scanner does not compress the skin like a tape measure does, and the scanner also measures the small of the back, it produces waist measurements around 1.9cm larger than a tape measure.

Accounting for that difference, the average 11-year-old girl’s waist has increased by 8.3cm, or 13.9%, to 70.2cm.

The last major survey on the topic was released by the British Standards Institute in 1990, based on measurements taken from more than 8,300 children in 1978.

The average boy of 11 now stands 148.2cm tall, up from 144.6cm in 1978, a 3.6cm or 2.5% increase. His waist is up by 7cm to 70cm.

Richard Barnes, of Select Research, said the 3D measurements could help to develop a body volume index (BVI), which may prove to be more useful than body mass index (BMI) in assessing the health risks posed by childhood obesity.

Mr Barnes said: “The increases in waist circumference since 1978 show that children have got bigger. However, increases in height and chest size show that children in the UK have grown over the years in many ways.

“Measuring body shape in 3D and where a child’s weight is distributed may provide us with new insights on the actual risk to health and change perceptions of what health interventions are required.”


Health Direct mentions that if you are looking for weight loss assistance, some of these links might help you: Bariatric surgery Gastric band surgery or weight loss surgery

Patients are denied high cost drugs by NHS trusts’ managers

Family doctors are being prevented from prescribing drugs for conditions such as diabetes, heart disease and osteoporosis as NHS managers attempt to make drastic budget cuts, an investigation has found.
Patients are denied high cost drugs by NHS trusts' managersPrimary care trusts are adding more medicines to their so-called “red lists” which means they can only be prescribed by a hospital consultant and not a GP.

The measure is designed to save money by restricting access to drugs that are often among the more expensive. It also means that many patients find it more difficult to obtain the most effective drugs free on the NHS, even though they have been approved by the medicines rationing watchdog Nice.

Patients’ groups described the disclosure as “outrageous” and “extremely worrying”.

Examples of medications moved to red lists include a class of diabetes drugs called gliptins; treatments for Parkinson’s disease; a drug that helps lower the risk of fractures in osteoporosis sufferers; and certain types of statins for those at greater risk of heart disease.

One health authority has added 32 drugs to its red list in the past year, while another said it intended to fine doctors who wrote letters requesting that such medicines be prescribed.

Last night, the Department of Health suggested that trusts should look to make savings elsewhere before trying to restrict access to drugs.

According to a survey carried out by Pulse, a magazine for GPs, 73 out of 134 primary care trusts which responded to Freedom of Information Act requests said they had put more drugs on red lists, or added new restrictions on GPs prescribing them, in the past year.

Drugs are prescribed using a “traffic lights” system. If a medication is deemed “green” then GPs are free to prescribe it; if it is “amber” they have to discuss prescription with a specialist; if it is “red” then only a specialist can do so.

Dr Bill Beeby, the chairman of the British Medical Association’s clinical and prescribing committee, said the status of drugs should be based solely on clinical grounds.

But he added: “There are lots of people who try to put drugs on these red lists on the basis of cost.”

With trusts under pressure to make savings estimated at £1.9 million each this year, the study suggests that increasing numbers are restricting access to drugs.

NHS Cambridgeshire has added 32 drugs to its red list over the past year, Pulse found, taking the total to more than 100.

NHS Warrington has added 25 “areas” of prescribing to its list, including the statins Crestor (also known as rosuvastatin) and Lipitor (atorvastatin).

The “areas” include drawing to a halt to “routine prescribing for longer than three months for patients who live abroad”.

NHS Derby City estimates that it will save £781,000 by “decommissioning” 13 drugs, including Intanza, a flu vaccine which uses a very short needle for those who dislike jabs, and Grazax, a grass allergy tablet.

Katherine Murphy, chief executive of the Patients Association, described the bans as “a real worry”. “What’s the point of Nice approving medicines if they are not being made available?” she said.

Barbara Young, chief executive of Diabetes UK, said: “People’s health must not be compromised with an attempt to cut costs. This would be a very short-sighted policy as complications of diabetes, such as kidney failure, are hugely expensive.”

Most drugs prescribed by GPs are so-called “generics”, meaning they are cheap versions of drugs that are no longer subject to a monopoly of production. However, there are no alternatives for some newer, more expensive drugs.

Dr Dermot Neely, an expert on statins at the charity Heart UK, said of the increased use of red lists: “It is an extremely indiscriminate and ill-advised policy, if it’s being used by PCTs to constrain costs.”

Studies show that switching from branded statins to generics results in more heart attacks and deaths, he added.

Richard Hoey, the editor of Pulse, said: “Many of the drugs approved by Nice or other national bodies are not only cost-effective, but are likely to recoup some of the price in the long-term by reducing rates of illness.

“These bans on prescribing drugs are therefore not only damaging to the care of patients, but quite possibly a false economy.” Although its budget has been protected, the NHS is committed to making efficiency savings of up to £20?billion a year by 2014.

Although the red list is only for guidance, GPs often feel pressured into following the advice because trusts hold the purse strings.


Private company pulls out of NHS contract after Tower Hamlets PCT row

A private company that won a 10 year contract to run a failing GP surgery in east London has pulled out after three years- doctors are warning that it is a taste of things to come.
Private company pulls out of NHS contract after Tower Hamlets PCT rowIt was billed as a move that would transform the quality of healthcare for patients in one of Britain’s poorest areas. In late 2007, the primary care trust (PCT) in the east London borough of Tower Hamlets handed Atos Healthcare, a subsidiary of the French multinational IT firm Atos Origin, a 10-year contract to manage a failing NHS GP surgery.

The decision to choose a private firm with a limited record in providing healthcare in the face of rival bids from two well-regarded local NHS GP practices sparked controversy. Local doctors passed a motion of no confidence in Tower Hamlets PCT.

Angry medics and patients, fearful of the potential impact of the privatisation of this part of the NHS, staged a protest march, and wrote to MPs and the PCT to complain about the decision.

Alwen Williams, chief executive of the embattled PCT, assured patients that Atos’s stewardship of the St Paul’s Way medical centre in Bow would mean much-needed “major new service improvements”.

Although Atos ran an NHS walk-in centre in nearby Canary Wharf, it was better known for its expertise in healthcare technology rather than primary healthcare. And Tower Hamlets faces some difficult challenges. It has the third highest level of multiple deprivation in England, significant numbers of children living in families that depend on benefits, the highest rate of overcrowding in London and a 49% non-white population.

“As a multi-ethnic community, we have a disease spectrum that’s a lot wider than many areas,” says Abdur Rahim, a GP at Chrisp Street health centre in Tower Hamlets, which was part of one of the losing bids. “This is a very challenging area.”

Now, barely three years on, Atos has just walked away from its deal, having failed to revive St Paul’s Way’s fortunes. The PCT says that in November, it and the firm “mutually agreed to terminate the contract with an exit date of 31 March 2011 in order to allow for safe transfer of patient care and for effective plans for staff to be made.”

Local GPs, whose expertise was overlooked in 2007, have been put in temporary charge of the centre while the PCT decides its next step.

“Atos never had any experience of running GP surgeries. They didn’t know Tower Hamlets or the health needs here. They put their bid in with the lowest cost, but that isn’t the same as showing they could best meet the local people’s needs,” says Rahim.

Now doctors are warning that the company’s failure is a foretaste of what lies in store if health secretary Andrew Lansley’s attempt to impose a competition-driven model of healthcare on to the NHS in England becomes reality.

“St Paul’s Way is a very cautionary tale. There’s an unavoidable contradiction between running something to maximise profit as opposed to running a service designed to meet the needs of patients,” says Anna Livingstone, a GP who opposed Atos’s takeover. She feels that the case offers a telling example of the pitfalls of competitive commissioning and questions the ethics of a system where big companies can walk away from contracts after outbidding smaller providers.

“There really was a huge amount of anger. Patients and ourselves were angry not only about privatisation but privatisation with a company that we had never worked with before and that had no track record in general practice,” she says. “Still, we thought this might be a testing ground for Atos, that they would work hard to provide a good practice. They had good doctors there. But we were naive. The low-cost contract they had won was impossible to deliver on.”

Data from Ipsos Mori’s GP Patient Survey shows Atos failed to lift St Paul’s Way from the bottom of Tower Hamlets’ patient satisfaction league table.

In 2009-10, only 41% of St Paul’s Way patients said they could access a doctor’s appointment within 48 hours, compared with the Tower Hamlets average of 72%. Just over a quarter said they were able to see their preferred doctor most of the time, less than half of the borough average and way below the national average in England.

Doctors working at St Paul’s Way concede that patients have been unhappy with appointment arrangements for some time. Fahim Chowdhury, clinical lead at the surgery, insists that the practice could get patients seen within 48 hours, but says that it often struggled to arrange appointments for patients with specific doctors. He says improvements were made to the continuity of care, thanks to Atos replacing locum GPs with a stable staff of five doctors, all of who still work at St Paul’s Way.

Chowdhury says lessons can be learned from Atos’s experience. He was impressed by the company’s employee relations, the stability it brought to a practice that had undergone turbulent times, the administrative and managerial support, and its readiness to leave clinical matters in the doctors’ hands. Yet it highlights the difficulties facing private providers looking to get involved in frontline healthcare provision, which the coalition’s “any willing provider” vision of the NHS will encourage.

“The NHS can learn from the efficiency of private business. In this day and age GP practices can’t ignore things like budgets,” Chowdhury says. “If a private company is going to make money in this area, it will be one that is well established in providing primary care. Atos didn’t have that. It came to St Paul’s Way at a tough time. There was a financial crisis and it was taking over a practice that is incredibly demanding.”

Clare Gerada, chair of the Royal College of GPs, says the saga raises troubling questions about how healthcare in the new era will operate. “What will the failure regime be for private providers? What will happen if such providers go bankrupt and can’t deliver services they promised?” she asks.

“The risk is that patients could be left in the lurch, and without access to the appointments or operations they were expecting. St Paul’s Way shows that some people may not be able to sustain a service at the price they’ve taken it on at and that the promised quality of patient care may not be delivered. Competition should always be on quality rather than price.”


Type 2 diabetes cut after weight loss surgery

The UK’s first large scale study on the impact of weight loss surgery has reported a large reduction in type 2 diabetes and other health problems.
Type 2 diabetes cut after weight loss surgeryThe National Bariatric Surgery Registry said type 2 diabetes fell by 50% and on average patients lost nearly 60% of their excess weight a year after surgery, based on 1,421 operations.

The Royal College of Surgeons says the NHS should prepare for rising demand.

Ministers say it is up to the local NHS to provide weight management services.

The report says the world has been engulfed by a pandemic of obesity. In the UK, it says there are about one million people who could benefit from bariatric surgery – which includes gastric bypasses and gastric bands.

Out of an estimated 10,000 such operations carried out in the UK during the financial years 2008/09 and 2009/10, the audit looked at 7,045.

The report includes detailed one-year follow up data for 1,421 operations. Of these, 379 patients had type 2 diabetes before surgery, while one year later that figure had fallen to 188.

There were also improvements in blood pressure and in everyday tasks such as climbing stairs.

The authors argue that by reducing the associated costs of obesity, such as treatment for diabetes, bariatric surgery offers “a real bargain for the health economy and for wider society”.

Alberic Fiennes, a bariatric surgeon and chairman of the National Bariatric Surgery Registry (NBSR) Data Committee, said the treatment should be made more widely available on the NHS.

“An approach that limits treatment to a fraction of those who would benefit is one which the NHS will rue in years to come as these patients become an unsustainable burden on the health service,” he said.

“Prevention strategy alone has proved ineffective; there are at least two generations of morbidly obese patients who are now presenting with diabetes, stroke, heart disease and cancer for whom preventative measures are utterly irrelevant.”

When asked about the morality of the surgery, he said: “There is no question people become overweight because the eat more food than they need.”

Royal College of Surgeons president John Black said the problem was not going to “miraculously disappear” and called on the government to develop a long-term plan.

“Surgeons have been saying for years that the NHS is on the brink of being swamped by obesity-related referrals,” he said.

However, the chairman of the charity Diabetes UK, Professor Sir George Alberti, emphasised that people who were obese should try to lose weight through diet and lifestyle changes first.

“We agree that bariatric surgery should be used as an alternative treatment to help people lose weight if all other attempts have been unsuccessful and their diabetes remains poorly controlled,” he said.

David Stout, deputy chief executive of the NHS confederation, which represents bodies such as foundation hospitals, primary care trusts and doctors’ groups, said it was not just a question of cost.


Health Direct mentions that if you are looking for weight loss assistance, some of these links might help you: Bariatric surgery Gastric band surgery or weight loss surgery

I’m sorry- Andrew Lansley tells nurses conference

Looking uncomfortable and sounding contrite, Andrew Lansley came to face his nursing critics yesterday – apologising four times and promising to listen to them in future.
I'm sorry- Andrew Lansley tells nurses conferenceJust hours after members of the Royal College of Nursing had voted overwhelmingly in favour of a “no-confidence” motion in Mr Lansley’s management of NHS reforms, the Health Secretary spent an hour and a half answering questions and listening to their concerns.

During the meeting he hinted that when the Government outlined its concessions to the Health and Social Care Bill in June, nurses would be given a greater role, particularly in deciding where NHS funds are spent. Nurses are likely to be given a statutory role on the new GPs’ commissioning boards, ensuring that at least one nurse is represented. The boards are also likely to be renamed to show that they represent other healthcare workers.

Mr Lansley tried to reassure the 60 RCN representatives who had been chosen to meet him that he did care about the NHS. He ruled out accepting any other job in Government, suggesting he would resign rather than be moved in any cabinet reshuffle.

“I believe in the NHS,” he said. “I am in politics for that. I am not here to do some other job. If there is an ideology behind what I am doing it is a belief in the NHS and a desire to protect it and make it stronger.”

Asked how he felt about being the only health secretary to receive a vote of no-confidence from nurses, he said: “It’s not something I sought out.

“I think it’s a rebuke and from my point of view I take it as a rebuke and I think listening to nurses this afternoon it was very clear some of the reasons why that happened is because they thought I was too focused on general practitioners when I was taking about clinical commissioning, GP commissioning.

“I know that nurses are not only the largest healthcare profession but are responsible for the delivery of most healthcare, and are often in the best place to be able to see the whole of care.

“From that point of view is it a rebuke in the sense that I didn’t get to the right place? Absolutely.”

Many nurses appeared partially mollified by Mr Lansley’s approach. But they all said they would wait to see how his “listening” materialised into concessions.

One of the problems Mr Lansley faces, however, is that it is not just the contents of his contentious Bill that the nurses object to. In the earlier no-confidence debate most were angered at cuts to frontline services as a result of the Government’s plans to try to make £20bn worth of efficiency savings over the next four years.

This is not something Mr Lansley has much control over as an ageing population means that the NHS will have to do “more for less” and savings will have to be found.

Earlier in the day delegates in Liverpool had voted 99 per cent in favour of the no-confidence motion, to 1 per cent against.

The RCN’s leadership had attempted to amend the motion to delay any no-confidence vote until after the conclusion of the Government’s listening exercise. But amid angry and passionate scenes on the conference floor the amendment was dropped when nurse after nurse took to the stage to condemn the Government.

“What this is about is how Andrew Lansley has introduced these reforms,” said Geoff Earl. “They are being driven by ideological dogma, not by what is best for our patients. This [vote] is about our patients, not about us.”

Another nurse went on to the platform and played a tape of David Cameron’s promise in 2010 to “stop the pointless reorganisation of the NHS”. Birmingham nurse Bethann Siviter added: “If these reforms go through, the NHS is dying.”

Andrew Frazer, an emergency care nurse, said: “When Andrew Lansley addressed us last year we listened to him politely and decided to adopt a wait-and-see policy. Well, we’ve waited and we’ve seen, and I for one don’t like what I’ve seen.

“We’ve been trimmed to the bone for years. Trying our damnest to deliver excellent care with limited resources. Here’s a message for Mr Lansley: if you cut frontline services, in the short-term care may be a little cheaper, but in the long-term care will be poorer and people will die.”


Cannabis could be used to treat epilepsy medical researchers discover

Researchers at the University of Reading have discovered that three compounds found in cannabis leaves can help to reduce and control seizures in epilepsy.
Cannabis could be used to treat epilepsy medical researchers discoverThey are now using extracts from the plants grown in huge industrial-sized greenhouses in the south of England to develop new drugs that could ease the misery of millions of epilepsy sufferers around the world.

In the UK alone there are more than 500,000 people who suffer from epilepsy.

Dr Ben Whalley, who is leading the research at the department of pharmacy at the University of Reading, said tests in animals had shown the compounds effective at preventing seizures and convulsions while also having less side effects than existing epilepsy drugs.

He said: “There was a stigma associated with cannabis that came out from the 60s and 70s associated with recreational use, so people have tended not to look at it medicinally as a result.”

“Cannabis is thought of being a treasure trove of compounds that could be used for pharmacological development. We have a list of around a dozen potential candidates for epilepsy and have tested three that show promise.”

“These compounds are very well tolerated and you are not seeing the same kind of side effects that you get with the existing treatments.”

Epilepsy is caused by sudden bursts of electrical activity in the brain that disrupt the normal way in which messages are transmitted. This can cause debilitating seizures and fits that can lead to sufferers injuring themselves.

Dr Whalley, together with his colleagues Dr Claire Williams and Dr Gary Stephens have been working with drug company GW Pharmaceuticals to develop and test new treatments for the disease from cannabis.

Two of the compounds they have identified, one called cannabidiol and the other called GWP42006, have been highly effective at controlling seizures in animals and the researchers now hope to begin clinical trials in humans within the next three years.

Neither of the compounds produce the characteristic “high” associated with cannabis use.

The scientists, whose latest findings on the compounds are published in the scientific journal Seizure, believe they work by interfering with the signals that cause the brain to become hyper-excitable, which leads to epileptic seizures.

Until now the main medicinal use that has been explored for cannabis has been in treating Multiple Sclerosis and for pain relief in cancer patients.

GW Pharmaceuticals has been given a license to grows around 20 tonnes of cannabis a year at its facilities in a rural part of southern England for medicinal research. In each glasshouse the temperature is carefully maintained at 77 degrees F while the crops are protected by electric fences and 24 hour security.

Mark Rogerson, from GW Pharmaceuticals, said: “Medicinal cannabinoids can treat a wide range of diseases like MS and pain.

“The work by Dr Whalley and his team is taking us into a whole new area where there is a real unmet need. The stigma is counterbalanced by the fact that it is a serious medicine for a serious condition.”

A spokesman for Epilepsy Action said: “Epilepsy is a condition that can be very difficult to treat.

“We are aware of some people with epilepsy who have used cannabis for medicinal purposes. However, it should be noted that although taking cannabis may reduce seizures in some people, it could actually increase seizures in others.

“We therefore welcome research into this treatment area. It could help our understanding of alternative therapies and may prove useful in the long-term for people whose epilepsy does not respond to more traditional methods.”