Text messages 'help smokers quit'

30 June 2011 Last updated at 01:22 GMT By James Gallagher Health reporter, BBC News Two-thirds of UK smokers say they want to stop Supportive text messages can double the chance of someone successfully quitting smoking, according to UK researchers.

Just over 10% of 2,900 smokers who received encouraging texts such as "you can do it" had quit after six months, but only 4.9% of a similar number who did not have the same support gave up.

The study, published in The Lancet, called for texts to be included in services to help people kick the habit.

Other scientists said a text service could be offered globally.

According to government statistics two-thirds of UK smokers say they want to stop.

This study looked at 5,800 of them. Supportive texts were sent to 2,915 of the smokers for six months. The rest received only messages thanking them for taking part.

They were sent five texts a day for the first five weeks and then three a week for the next 26 weeks.

Participants could also text back for specific advice when they had cravings or had lapsed back into smoking.

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"To make things easier for yourself, try having some distractions ready for cravings and think up some personal strategies to help in stressful situations"

"This is it! - QUIT DAY, throw away all your fags. TODAY is the start of being QUIT forever, you can do it!"

"Quick result! Carbon monoxide has now left your body!"

"Day4=Big day - cravings still strong? Don't worry tomorrow will be easier! Keep your mind & hands busy."

"Cravings last less than 5 minutes on average. To help distract yourself, try sipping a drink slowly until the craving is over."

"Don't feel bad or guilty if you've slipped. You've achieved a lot by stopping for a while. Slip-ups can be a normal part of the quitting process. Keep going, you can do it!"

Saliva tests for cotinine, which is made when nicotine is broken down by the body, were taken to determine if people had really given up.

After six months, 10.7% of those receiving texts had quit - double the proportion among those doing it on their own.

Dr Caroline Free, who led the txt2stop trial at the London School of Hygiene and Tropical Medicine, said: "Text messages are a very convenient way for smokers to receive support to quit.

"People described txt2stop as being like having a friend encouraging them or an angel on their shoulder.

"It helped people resist the temptation to smoke."

The World Health Organization says nearly six million die each year because of smoking, mostly in low and middle-income countries.

Dr Derrick Bennett and Dr Jonathan Emberson, both from the University of Oxford, said text messages could be used to help people around the world.

"The lessons learned from the txt2stop trial could... not only provide a new approach to cessation in high-income and middle-income countries, but could also provide a useful starting point for implementing behavioural change in resource-poor settings."

It has also been suggested similar text messages could be used to help people modify other behaviour.

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NI would accept prescription fees

30 June 2011 Last updated at 05:18 GMT People in NI are prepared to pay prescription charge People in Northern Ireland would pay a small charge for prescriptions, a new survey suggests.

The report published by the Patient and Client Council discovered that most of the 400 people surveyed said they would pay for their drugs.

The charge would help support the health service in the current economic climate.

Maeve Hully from the client council said some were still unprepared to pay.

"People who could pay would pay, but those who could not afford to pay - people with long term conditions felt it would be unfair to expect them to pay a charge for their prescriptions because they have so many and are on so many drugs," she said.

Prescription charges in NI were scrapped in April 2010.

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Doctors back driver smoking ban

30 June 2011 Last updated at 01:27 GMT By Nick Triggle Health correspondent, BBC News, Cardiff Doctors are calling for a ban on smoking in cars Tougher legislation is needed to curb unhealthy behaviour, doctors say.

Delegates at the British Medical Association's annual conference called for a ban on smoking in cars, and more action on alcohol pricing and promotion, such as an advertising ban.

The union accused ministers of being too close to industry by focusing excessively on voluntary agreements.

The government said there had to be a balance between legislation and partnership on improving public health.

During a series of debates about public health at the conference in Cardiff, doctors criticised the approach of government, saying ministers were "undermining" public health.

In March the Department of Health in England announced its responsibility deal with industry when more than 170 companies put their names to a series of pledges on physical activity, alcohol, health at work and food.

A total of 19 core pledges were agreed, including introducing calorie counts on menus, increasing labelling on drinks and offering more promotions on fresh fruit and vegetables.

But a host of health organisations, including the BMA, refused to back the initiative, arguing there was a lack of clarity over how industry would be held to account.

At the time Alcohol Concern went as far as to say it was the "worst possible deal".

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This government believes that if we are to find new ways of supporting people to change their behaviour we need to work in a broad partnership with public health, voluntary and commercial organisations.”

End Quote Spokesman Department of Health Dr Abi Smith, a junior doctor from Bristol, said the initiative did not go far enough.

"The government is placing private industry and profit over public health. This is a clear undermining of the voice of public health."

London-based GP Dr John Chisholm agreed. He said: "Clearly industry should be consulted and engaged with. However, I have grave concerns that the government is too averse to interventions and sanctions when appropriate."

Medics went on to vote for the BMA to push for:

A ban on smoking in cars, saying that research has shown that toxicity from smoking in cars is 27 times higher than it is in the home and 20 times higher than in the pub. Delegates said it would improve road safety as well.Forcing all firms involved in tobacco products to publish all payments to politicians and political parties.A ban on alcohol advertising, restricting licensing hours and introducing a minimum price for alcohol - something the BMA has already called for and a move which is being looked at in Scotland."Unacceptable" use of trans-fats - often found in biscuits, cakes and fast food - to be banned, although the BMA's science experts were asked to look at the issue before it became official policy as some trans-fats are naturally occurring.

But not all delegates agreed with the measures. Medical student Charlie Bell said: "We are the BMA not the BNA - the British Nannying Association."

The Department of Health rejected suggestions it was too weak, pointing out it was using legislation to ban tobacco displays in shops and was considering forcing cigarettes to be sold in plain packets.

A Department of Health spokesman added: "This government believes that if we are to find new ways of supporting people to change their behaviour we need to work in a broad partnership with public health, voluntary and commercial organisations.

"Government alone cannot improve public health. Everyone has a role to play in improving the public's health."

Miranda Watson, from the British Lung Foundation, said: "Doctors are on the front-line when it comes to dealing with the impact of passive smoking on children.

"We're thrilled the BMA is supporting the BLF's campaign to end smoking in cars carrying children. With doctors backing our campaign, the Government can't afford to stall."

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Aiding aid workers

30 June 2011 Last updated at 09:04 GMT By Dave Lee BBC World Service The pressures of working in disaster zones can have long-term psychological effects For the thousands of Western aid workers who descended on Haiti after 2010's devastating earthquake, rebuilding the tattered communities was their number-one priority.

And, for the many that remain there more than a year on, it remains a mission very much in progress.

Yet aside from the emotional toll on the families of victims, aid workers are increasingly being reminded to look out for their own needs too.

A new course run by the University of East London is aiming to help workers understand and deal with the long-lasting psychological effects working in the field can have.

"[It] comes from a fundamental belief that it's through our own self-awareness of how to look after ourselves that we are better informed about how to look after others," says course leader Dr Sarah Davidson MBE on the BBC World Service's Health Check programme.

"You get caught up in the struggle, the demand and the need out there.

"People adopt difficult habits, long working hours and burn out. It's as important to look after oneself as it is to look after the people you are responding to."

Dr Davidson is the former vice chairman of the British Red Cross, and currently its psychosocial advisor. Her experience in Haiti and other stricken areas has shown her the lengths aid workers go to try to help - only to find themselves unable to cope.

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You could see the strain, you could visibly see people change over time, just from stress and inability to deal with what we were experiencing.”

End Quote Amy Braithwaite Aid worker "People often go into the humanitarian sector wishing to make a difference," she says.

"There's an internal, 'How much difference can I make today?' that needs to be reigned back to what is manageable."

The course consists largely of distance-learning, allowing aid workers recuperating away from troubled areas to communicate with those in the midst of a crisis.

"The distance-learning part of the course enables people to be on it before they're deployed, whilst they're deployed and when they come back," Dr Davidson says.

"So that means people can share their own personal top tips about what works for them, as well as their own ideas of perhaps before they went out into the field how they had thought they would be working all hours and doing all good deeds.

"The reality is a lot of bureaucracy and a lot of time filling in papers and having to do really good assessments."

Incredible suffering

It is a method that helps both parties. Workers returning home can find "normal" life a difficult adjustment, while those away find interaction with people outside the area invaluable.

Another problem, Dr Davidson says, is in the face of incredible suffering, aid workers feel unable to discuss their comparatively minor stresses and worries.

"How do you put it into words?

"How do you describe your own pain, your own anguish at seeing what's around you when it's on such a scale and obviously has so much significant repercussion."

It is a stress Amy Braithwaite, a student on the course, has seen first hand. She has travelled the world with various non-governmental organisations, but Haiti was her most testing experience.

"It's a different kind of stress that the aid workers have.

"You could see the strain, you could visibly see people change over time, just from stress and inability to deal with what we were experiencing.

"My motivation for the course has been recognising the really under-served need that there is."

She says people react to the pressures in varied ways.

"People can drink a lot, people can smoke more.

"You're not exercising, you're not eating properly."

Amy Braithwaite is in Canada after working in Haiti

The course was able to help Ms Braithwaite identify when such things were happening to her and how to deal with it in a way that allowed her to best help the people she was there for.

"I was able to have the capacity and the awareness to recognise the impact that the stress was having on me. That was a saving grace in a way - you're able to step back and say, 'OK, I can see what's happening here.'"

Concerns about aid-worker psychology have been documented for some time.

In 1991, the International Federation of Red Cross and Red Crescent Societies established psychological support programmes, and other organisations, such as the charities Oxfam and Save the Children, have put work into studying the effects disaster aid can have on people.

This course, the university says, is all about wading through that information and providing concrete advice, expertise and help for aid workers like Ms Braithwaite.

"There's so many people that go from disaster to disaster," she says.

"It catches up with you, it's impossible to think that you are not going to be affected by the things that you're seeing, smelling, hearing… everything. It accumulates and it can really affect your health."

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Major investigation at NHS trust

29 June 2011 Last updated at 12:06 GMT Five women have died at the same maternity unit in 18 months.

A major inquiry has begun at an east London NHS trust following serious concerns about the levels of patient care, including in A&E and maternity.

The Care Quality Commission (CQC) has started a full investigation - only the second time it has done so - into the Barking, Havering and Redbridge University Hospitals NHS Trust.

In April it was told to improve its maternity services but the CQC said not enough has been done.

The trust said it welcomed the inquiry.

In April 2010, the CQC imposed eight conditions on the trust - seven of which have now been lifted - due to concerns about its performance.

Since then, inspectors have made unannounced visits, resulting in urgent demands for improvement and have carried out reviews into the maternity and A&E services.

The review of A&E, which will be published next month, found that problems with how the department was organised was affecting care.

The review of maternity services, published in April, found the trust was failing to meet six essential standards, with two areas - staffing, and care and welfare of people - a major cause for concern.

Serena Ali and her baby died after staff failed to spot a ruptured womb

At this time, staff told inspectors that patient care was being compromised by staffing issues, and the CQC warned the trust that this must be addressed as a matter of urgency.

It has since recruited 60 midwives.

The report came three months after two midwives were suspended following the death of Tebussum Ali, known as Serena, and her newborn baby at Queen's Hospital in Romford.

Staff had failed to spot signs of her ruptured womb and tried to resuscitate her with a disconnected oxygen mask.

The CQC's Colin Hough said: "CQC has now launched a full investigation into whether Barking Havering and Redbridge University Hospitals NHS Trust has the right systems in place to protect people and make sure they receive safe care.

"We'll also be looking at the bigger picture - whether the trust has the support it needs to make improvements."

The trust's chief executive Averil Dongworth said: "The CQC recognises that some improvements have already been made, although we need to go further and sustain this.

"We welcome the CQC's investigation and will be working closely with them."

The CQC has a range of powers, including the ability to close wards and hospitals.

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Care homes 'no confidence' in CQC

29 June 2011 Last updated at 04:59 GMT By Matthew Hill BBC News A Panorama reporter filmed residents being pinned down, slapped and taunted Workers in the residential care home sector have signed a petition of no confidence in the industry regulator - the Care Quality Commission (CQC).

Delegates at the National Care Homes Congress said they had no confidence the CQC could effectively "regulate" health and social care.

The issue was discussed after BBC Panorama alleged vulnerable adults at a unit near Bristol were being abused.

The CQC said no regulator "could stop all unacceptable behaviour".

The Panorama programme showed secret filming of patients at Winterbourne View, a residential hospital, being pinned down, slapped and taunted.

The unit has since closed and the firm which runs it, Castlebeck, has apologised.

Staff representing the care home industry at the congress in Birmingham on 22 June included care home owners and managers, nurses and senior care assistants.

'Tick box exercise'

Delegates said that "robust and effective regulation" of the industry was essential but they had "concluded that they have no confidence that the CQC is capable of delivering an effective system of regulation for health and social care".

Congress delegate Andrew Larpent, who runs Somerset Care, which provides 31 residential homes in the West Country, said he had no confidence in the CQC.

He said: "The CQC have set themselves up as a compliance service and not as a quality service.

"Under the previous inspectorate, we had a real sense that we were all working together to try to continually to improve services.

"Now, we seem to just be doing a tick box exercise and it's not serving the public well."

Dr Richard Hawkins, editor of the Caring Times magazine, which helped to organise the congress, said the petition was "significant".

'Stop abuse'

He said: "It's the first time anything like this has happened. I hope it's going to send a very powerful message to the commission and to the government."

A spokesman for the CQC said: "No regulator can guarantee to stop all unacceptable behaviour - it is the job of the providers and staff to make sure it doesn't happen in the first place.

"No system of regulation, however thorough, can stop abuse. But you can build systems to identify risks of harm, based on information from a range of sources, and react to these risks to try to reduce the likelihood of poor care.

"This is what CQC is trying to do. When our systems work, people are protected. The most powerful tool to stop abuse is to ensure that people working in care - whether directors, managers, health professionals or care staff - do not tolerate it."

Update: This story has been amended to make clear that the congress did not pass a vote of no confidence in the CQC but organised a petition of no confidence.

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Obesity higher among non-smokers

29 June 2011 Last updated at 09:20 GMT The study claimed non-smokers were more likely to be obese Non-smoking woman are more likely to be obese and die of associated illnesses than those who smoke, according to research.

About 8,000 women were recruited to the Renfrew and Paisley study from 1972 to 1976. Of these, 40% had never smoked.

The authors, led by Dr Laurence Gruer from NHS Health Scotland, found 60% of non-smokers were overweight or obese compared with 40% of those who smoked.

The study claimed extra weight acted as a major contributor to premature death.

However, experts stressed that smoking was a "much stronger" risk factor than obesity.

The study of women aged 45 to 64, published in the British Medical Journal, said the highest rate of obesity among non-smokers was found in low income groups.

Almost 70% of women in this category were overweight or obese, according to the research.

Dr Gruer said: "You can certainly assume that if you are obese, you are more likely to die of things like diabetes, heart attacks and strokes."

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It goes against the idea that if you live in a poor neighbourhood or came from a working class background, then your health will be worse, regardless”

End Quote Dr Laurence Gruer NHS Health Scotland Researchers also suggested declining numbers of female smokers over the past few decades may have had a direct impact on obesity levels - with fewer people using cigarettes in an attempt to suppress their appetites.

The study also found that non-smokers from a lower occupational group were no more likely to die early if they lived a healthy lifestyle.

Dr Gruer said: "If you never smoke and you keep your weight within the reasonable limit then even if you earn below average income and live in a more disadvantaged area, you can still expect to live a long and healthy life.

"You are not doomed to die early just because you happen not to have a high income or good job or live in a leafy suburb.

"It goes against the idea that if you live in a poor neighbourhood or came from a working class background, then your health will be worse, regardless."

Prof Johan Mackenbach from the Erasmus Medical Centre in Rotterdam welcomed the study but added: "It is important not to forget that smoking is a much stronger risk factor for mortality than most other risk factors, including obesity."

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MPs campaign to relax smoking ban

29 June 2011 Last updated at 14:12 GMT The ban was introduced to protect pub staff and non-smokers Three MPs are joining forces with campaigners to call for the smoking ban in UK pubs and clubs to be relaxed.

Conservative Greg Knight, Lib Dem John Hemming and Labour's Roger Godsiff argue that the ban has had a devastating impact on the industry.

They want the law to be changed to allow pubs to create a separate room for smokers if they choose.

Thousands of UK pubs have closed in recent years and many have blamed the ban for the loss of business.

The smoking ban was introduced in England in July 2007. Scotland's ban was introduced in March 2006, followed by Wales and Northern Ireland in April 2007.

Ventilation

The Save Our Pubs and Clubs campaign says that after three years, Scotland had lost 467 pubs (7.1% of the total estate), Wales 274 (7.3%) and England 4,148 (7.6%).

Campaigners also say working-men's clubs have been hit hard and many have closed or are struggling to survive.

They are arguing that the existing law is excessive and should be reviewed and relaxed to allow proprietors more choice about how they manage smoking at their premises.

Mick McGlasham, general secretary of the Clubs and Institute Union, which represents more than 2,000 working-men's clubs, said: "The ban was passed because politicians wanted to protect staff and non-smokers, but there is no reason why we cannot have a separate smoking room in what are private premises, especially with modern ventilation."

Other supporters of the campaign include the think tanks Progressive Vision and the Adam Smith Institute, and the campaign group Forest, which fights for greater freedom for smokers.

An event promoting the cause will be held at the Houses of Parliament on Wednesday with the aim of winning support from more MPs and peers.

Mr Knight, MP for East Yorkshire, said: "This is a unique opportunity for people to show how strongly they feel on this important issue.

"A modest change in the law, not a repeal of the smoking ban, is all we seek."

MPs are banned from smoking anywhere inside the House of Commons apart from on the terrace.

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Alcohol linked to suicide rise

29 June 2011 Last updated at 06:18 GMT Professor Louis Appleby has expressed concern Alcohol abuse is a major factor contributing to people taking their own lives, according to the findings of an inquiry.

The 'Suicide and Homicide in Northern Ireland' report was carried out by the National Confidential Inquiry.

It will be launched on Wednesday by Health Minister Edwin Poots.

It aims to improve mental health services in Northern Ireland.

The Department of Health says more than three hundred people here took their lives last year, the highest figure ever recorded in Northern Ireland.

Professor Louis Appleby is from the University of Manchester which led the research.

He said: "It is a concern that Northern Ireland suicide rates are high by UK standards. It is also a concern that they have been rising whereas in other parts of the UK suicide has been falling."

The report has shown there are clear links between alcohol and the increased suicide rate.

Professor Appleby said: "Of all the patients who died by suicide, 60% were thought to be misusing alcohol by their doctors. About half of these were alcohol dependent."

Dr Uzma Huda, Vice Chair of the Royal College of Psychiatrists in Northern Ireland said there needs to be a minimum pricing for alcohol.

She said: "We can no longer afford to ignore the growing trend linking alcohol and suicide, particularly in young people."

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Snacking clue to obesity epidemic

29 June 2011 Last updated at 10:50 GMT By Helen Briggs Health editor, BBC News website Foods like pizza are energy dense Snacking and super sizing are two of the dieter's worst enemies, research suggests.

The average daily calorie intake in the US has increased by almost a third in 30 years, reaching 2,374 kilocalories.

The influence of bigger portion sizes and excessive snacking outweighs the shift towards high-calorie foods, say experts.

Focussing on reducing how much and how often people eat could help tackle obesity, they report in PLoS Medicine.

Obesity levels have risen sharply in many western countries since the 1970s. In the US, where the study was carried out, a third of all adults - more than 72 million people - are now categorised as obese.

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...for those trying to control their weight, it is important to manage both how much and how often they eat.”

End Quote Dr Aine O'Connor British Nutrition Foundation A team from the University of North Carolina analysed data from food surveys carried out in the seventies, eighties, nineties and the last decade.

The surveys record all food and drink a person consumes over a 24-hour period.

The average daily energy intake of a US citizen increased from 1,803 kcal in 1977-78 to 2,374 kcal in 2003-06.

In the last decade of the study alone, the average daily calorie intake went up by 229 kcal.

Several factors are involved in energy intake - the number of calories (energy) in a specific amount of food (energy density), portion size and how many meals and snacks a day eaten.

The researchers say that while all of these have gone up, increases in the number of eating occasions and portion size seem to account for most of the change.

They suggest efforts to prevent obesity should focus on reducing the number of snacks and meals a day as well as portion size.

"These findings suggest a new focus for efforts to reduce energy imbalances in US adults," write Kiyah Duffey and Barry Popkin of the University of North Carolina in the journal PloS Medicine.

Commenting on the paper, Dr Aine O'Connor, a scientist at the British Nutrition Foundation said: "Many factors influence total energy intake that can lead to [being] overweight and obesity but it is possible that having more eating occasions through the day, for example by frequent snacking, would increase calorie consumption and so lead to weight gain.

"This study also looked at portion size and studies have shown that having larger portions of food leads to an increased intake.

"The researchers were based in the US, but many of the factors causing the obesity epidemic there are mirrored in the UK and, for those trying to control their weight, it is important to manage both how much and how often they eat."

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NHS faces 'diabetes time bomb'

29 June 2011 Last updated at 07:39 GMT High blood sugar levels can damage the body The health service could face a "diabetes time bomb" according to an audit of patients in England and Wales.

The report says 800,000 Type 1 and Type 2 patients have elevated blood sugar levels which could lead to kidney failure, limb amputation and stroke.

It warned that many of the patients were young or middle aged and could require "substantial hospital care in a matter of years".

Diabetes UK said the findings highlighted the need for urgent action.

All forms of diabetes result in raised blood sugar levels. If this is not controlled then it can cause serious damage.

The NHS Information Centre report confirmed that the number of cases of diabetes, especially Type 2, is increasing - particularly in deprived communities.

Continue reading the main story

Type 1 diabetes

The body is unable to produce any insulin. Usually starts in childhood or young adulthood.Treated with diet control and insulin injections.

Type 2 diabetes

Not enough insulin is produced or body becomes resistant to it. Tends to affect people as they get older, usually appears after the age of 40.Increasingly seen in younger, overweight people. When it came to controlling blood sugar levels, around a third of more than 2 million patients had raised levels that placed them at risk of developing complications.

This was a greater problem for the under 55s.

Nearly 300,000 people were at "high risk" and 144,000 were at "dangerously high risk" in that age category.

Poor care

The report also found nearly half of patients were not getting the appropriate checks.

The National Institute for Health and Clinical Excellence recommends patients with diabetes receive nine checks annually including: blood sugar levels, whether they are smoking, and an assessment of damage to the eyes or feet due to diabetes.

The study showed that 53% of patients with Type 2 diabetes and 32% with Type 1 received all nine tests.

Audit lead clinician, Dr Bob Young, consultant diabetologist and clinical lead for the National Diabetes Information Service, said: "These results ring alarm bells.

"They show that younger people make up a quarter of all those with diabetes yet have the highest risks of potentially preventable complications.

"If these risks could be reduced, much future disability and shortened life expectancy could be prevented."

Dr Rowan Hillson, National Clinical Director for Diabetes, said: "I am very concerned that the National Diabetes Audit shows that we still have a long way to go in delivering basic standards of diabetes care for everyone.

"In particular, young and middle-aged people with diabetes are not getting the regular checks they need to manage their condition and improve outcomes.

"These checks are vital to reduce serious but avoidable complications. All health care professionals should follow NICE's clear recommendations. There is no excuse for not doing the basics well."

Barbara Young, Chief Executive at Diabetes UK, said: "This highlights the need for urgent action to ensure that people with diabetes start to receive all the basic care processes otherwise there will be more amputations, more people going blind, and more cases of kidney failure, heart disease and stroke."

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Doctors debate changes to clocks

28 June 2011 Last updated at 23:01 GMT By Nick Triggle Health correspondent, BBC News, in Cardiff Changing the clocks could reduce deaths on the road, supporters argue Doctors are throwing their weight behind a bid to move the clocks in the UK forward by an hour in both the winter and summer.

Delegates at the British Medical Association conference in Cardiff will argue later that it will help improve health as well as save lives.

The move would bring the UK in line with Central European Time.

A bill is already progressing through Parliament calling for the issue to be looked at.

It says if an official analysis suggests there would be benefits, then the system could be piloted for three years.

Supporters have argued such a move would lead to an extra 235 hours of daylight after work each year and reduce road deaths by between 80 and 100.

Research has also suggested tourism would get a boost.

Previous attempts to change the system have faltered following opposition from Scotland where some places would not see daylight until 10am in the depths of the winter.

But Andrew Green, a GP from Hull, said the problem was confined to the north of Scotland and could be avoided by measures such as flexible starting times for schools for a few months.

He also pointed out that research suggested it was better to drive in the dark in the morning as people were more alert.

But he added: "In the end you have to go for what gives the greatest benefit for the greatest number. Changing the clocks would mean people are more likely to be active.

"It would encourage children to stop playing on the computer and go outside instead of risking getting run over in the dark."

Scottish opposition

Professor Vivienne Nathanson, the BMA's head of science and ethics, said: "I think it should certainly be looked at with a trial to see if it really would save lives."

She also said the UK could look at having different time zones if it did not work for some parts of the country - although this is something that Prime Minister David Cameron has said he would not want to see.

A range of other organisations have already given their backing to changing the system, including the Royal Society for the Prevention of Accidents, which has been campaigning for it for decades.

But the Scottish Government said it was still opposed to the move.

A spokeswoman said: "Changing the system would adversely affect Scotland, which is why we oppose it. The impact would be felt by rural communities and outdoor workers and businesses, and could potentially increase the danger of children travelling to school in the dark."

Clock changes have been tried in the past. During World War II clocks were moved forward by an hour to maximise productivity and ensure people got home safely before the blackout. Between 1968 and 1971 BST was kept throughout the year.

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NHS 'slash and burn' cuts warning

27 June 2011 Last updated at 12:12 GMT By Nick Triggle Health correspondent, BBC News The head of the British Medical Association, Hamish Meldrum says there are difficult decisions to be made

NHS chiefs are at risk of making "slash and burn" cuts to services in a drive to save money, doctors say.

Medics attending the British Medical Association's annual conference voiced concerns the cuts were being rushed through too quickly and without care.

They highlighted staff shortages and restrictions being placed on so-called "low priority" treatments such as IVF.

The NHS Confederation, which represents health managers, said any cost-saving measures must be well-thought through.

In his opening address to the union's conference in Cardiff, Dr Meldrum said the NHS was "in the grip of its greatest financial challenge".

"There is a huge difference between adapt and change and slash and burn, between carefully planned reorganisations and knee-jerk closures and redundancies, between partnership working among health professionals, managers and patients and imposed top-down, politically-motivated diktat."

Restrictions

Health budgets have been largely protected by ministers across the UK, although once inflation and the impact of factors like the ageing population and cost of new drugs are taken into account, significant savings are having to be made.

Continue reading the main story

NHS leaders must avoid such short-term tactics if they are to achieve effective change without compromising patient care”

End Quote Mike Farrar of the NHS Confederation During the debates on Monday delegates voiced concerns about signs waiting times rising, staff shortages, cuts to services and tighter restrictions on a range of treatments.

In recent months, cases have been highlighted where local health managers have restricted access to everything from treatment for varicose veins and tonsillectomies to obesity surgery and IVF.

Dr Chaand Nagpaul, a GP from north London, said most doctors would accept that the NHS cannot do everything but said restrictions needed to be done with "fairness and consistency" to avoid a postcode lottery.

Public health specialist Dr Lucy-Jane Davis pointed out that it was not just the direct cuts to the NHS that were harming the health and well-being of people.

She said reductions in services such as Sure Start centres and less support for carers were having a profound effect too.

"The scale and speed of cuts will hurt the most vulnerable," she added.

Psychiatrist Robin Arnold, from Bristol, said his patients had the "double whammy" of experiencing the fall-out of cuts to both NHS and local authority budgets.

He said one of the problems was that managers had started cutting too quickly by trying to make the bulk of the savings in a year, when they had been given five.

Mike Farrar, chief executive of the NHS Confederation, said: "NHS leaders must avoid such short-term tactics if they are to achieve effective change without compromising patient care.

"Reforming the system so that it is fit for the future will require some difficult decisions. It is essential that NHS leaders and clinical staff work together to draw up the best solutions."

A spokesman for the Department of Health added: "We agree with the BMA that the NHS should not adopt a slash and burn approach.

"We are not investing an extra ?11.5 billion in the NHS so that services can be cut.

"We have confidence that through improving innovation, prevention and productivity the NHS will continue to be able to improve quality and meet rising demands."

NHS chiefs are at risk of making "slash and burn" cuts to services in a drive to save money, doctors say.

View the original article here

Imported surgical tools 'a risk'

27 June 2011 Last updated at 00:32 GMT Microscopic shards of steel can puncture surgical gloves or become dislodged inside patients Substandard surgical tools from Pakistan are putting UK patients at risk of potentially deadly injury and infection, BBC Panorama has found.

Faults include rough edges, steel burrs that can splinter during operations and corroded metals.

All surgical instruments have to meet regulatory standards but only one of the more than 180 NHS trusts and boards conducts rigorous tests on every tool.

Barts and the London NHS Trust reject almost 20% of tools as unsafe for use.

Tom Brophy, the dedicated technologist at Barts, said the prevalence of faulty equipment that could endanger patients' lives or cause serious injuries is so worrying that he has started documenting the faults.

While he is able to return unsuitable or faulty tools to suppliers, he said there is nothing to stop those same instruments from being sold on to another UK hospital, either within the NHS or private.

"On more than one occasion a supplier has rung me up and said that the instrument you rejected, I passed it onto another hospital and they accepted it," he said. "Of course they're going to accept it, because they haven't checked it."

While most hospitals carry out some degree of visual checks on instruments, only Barts employs a dedicated technologist.

Blood traces

Poor quality surgical implements have been identified as a likely cause of MRSA infections because shards of steel have caused microscopic holes in surgical gloves.

Badly made instruments that have unwanted grooves or trenches can trap body tissue and fluids - another possible source of infection.

Continue reading the main story 100 million instruments made annually in SialkotOne in 10 sold to the UKOnly Germany and America buy more70% of manufacturers registered in the UK are based in the country12 of 19 samples collected in Sialkot by Panorama and tested in London were rejectedAll of the 916 companies making or supplying surgical instruments in the UK must be registered with the Medicines and Health Care Products Regulatory Agency (MHRA), but responsibility for quality rests with suppliers and manufacturers.

Neither the NHS or the MHRA requires suppliers to inspect manufacturers.

In a statement, the MHRA said "it has no evidence that non-compliant instruments are being supplied to the NHS", but added that if there were such evidence, it had "a range of powers and sanctions available to deal with the problem".

In addition to rejecting poor quality equipment that is sold to Barts, Mr Brophy said he has been sent used equipment - with traces of blood still on the instruments - being passed off as new.

No hygiene

Two-thirds of the world's surgical instruments are made in the city of Sialkot in northern Pakistan and 70% of the UK's registered manufacturers are based in the city.

While some of the larger companies operate state-of-the art facilities and have rigorous quality-control procedures in place, Panorama found evidence of smaller firms that do not use magnifying glasses to inspect finished instruments before putting the required quality stamp on them.

Others outsourced manufacturing to some of the 3,000 back-street workshops in the city where undercover filming revealed a complete lack of hygiene or quality control.

Professor Brian Toft, a government adviser on patient safety, said if procurement officers in both the NHS and private hospitals in the UK knew of the conditions in which the surgical instruments were being made, they would "faint at the thought of it".

"I cannot believe that anybody in the NHS knows this is going on," he said.

Panorama: Surgery's Dirty Secrets, BBC One, Monday, 27 June at 2030 BST and then available in the UK on the BBC iPlayer.

View the original article here

Measles outbreak vaccination call

27 June 2011 Last updated at 13:10 GMT Parents are being urged to get their children vaccinated Parents are being urged to get their children vaccinated immediately following an increase in measles cases in Wales.

An outbreak has been reported in Ceredigion, say health officials.

Further possible cases are being investigated in Pembrokeshire, Neath Port Talbot, Swansea, Carmarthen, Powys and the old Gwent area.

Measles can cause complications, particularly in children under five years, and can be fatal.

There are said to be 10 cases in the Ceredigion outbreak and another 20 elsewhere.

Dr Roland Salmon, regional epidemiologist for Public Health Wales, said many of the cases under investigation had not received their scheduled vaccinations.

"We are urging parents throughout Wales who have not arranged immunisation for their children to act immediately to get them vaccinated," he said.

Red eyes

Dr Richard Roberts, head of the vaccine preventable disease programme run by Public Health Wales, said MMR was a "safe and effective vaccine" that protected children from the most severe viral rash illness of childhood.

Continue reading the main story

If your child is unwell and you suspect it is measles, you should contact your GP. Your child should not attend school or nursery for five days after the rash starts”

End Quote Dr Richard Roberts Public Health Wales He explained that the only way to prevent outbreaks of measles was to ensure that at least 95% of children in Wales had received two doses of the MMR vaccine.

The latest MMR uptake figures for January to March 2011 showed that in Wales, 87% of children reaching their fifth birthday had received two doses of the MMR vaccine. Coverage ranged from 82% to 94%.

Last week, it was reported that 90% of two-year-old children in the UK had received their first dose of the MMR vaccine - the highest level for 13 years, said the Health Protection Agency.

Children should receive their first dose of the vaccine at 12 to 13 months of age and the second at around three years and four months of age.

Blotchy rash

Public Health Wales said it was never too late to catch up on missed doses.

Many people who catch measles will have a fever, cough, red eyes and blocked nose, and feel generally unwell.

The blotchy rash appears a few days later, beginning on the face and spreading downwards to the rest of the body over several days.

Dr Roberts added: "If your child is unwell and you suspect it is measles, you should contact your GP. Your child should not attend school or nursery for five days after the rash starts."

More information about measles is available from the Public Health Wales website.

View the original article here

Surgery 'lotteries'

By Adina Campbell
Newsbeat reporter Sarah Burge hits back at her cosmetic surgery critics

Health groups in the UK are calling for a ban on cosmetic surgery prize draws.

The Independent Healthcare Advisory Services (IHAS) and the British Association of Aesthetic Plastic Surgeons (Baaps) have criticised procedures like boob jobs, face lifts and botox being offered through competitions.

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

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

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

'Real life Barbie'

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

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

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

Continue reading the main story

Cosmetic surgery should not be offered as a commodity prize. This is not something that can be trivialised

Jackie Lewis Breast surgery specialist

Sarah Burge is 50 and said she's known as the UK's real life Barbie.

She was one of the organisers of the London draw and insisted events like this are not dangerous.

"We've started these prize draws following years of research," she said. "We know there are tens of thousands of people who want to change the way they look.

"It's not about having a big nose or wanting a boob job.

"This is about people who are living with facial disfigurements, mastectomy patients and those with other deformities who want their dignity back."

But Sally Taber, from IHAS, has hit out at these kinds of prize draws.

'Life-long consequences'

She said: "They're enticing people to have cosmetic surgery who may not have even thought about it.

"It's important people make an informed decision in the right environment. A party area is not the right environment.

"They should be stopped from advertising in this way."

Beryl Atkins of Transpire Cosmetic Surgery, the group behind the London event, say they "never operate on anyone straight away".

She added: "The winners have at least two weeks to think about it and we carry out thorough consultations."

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

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

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

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

View the original article here

Suspicious doctors advised to act

28 June 2011 Last updated at 00:55 GMT By Michelle Roberts Health reporter, BBC News The GMC has had to reinstate David Southall on its medical register Any doctor who suspects child abuse must raise the alarm immediately and tell parents what action they will be taking, new draft guidance says.

Doctors acting reasonably in response to concerns about abuse or neglect will not be subject to censure, it adds.

The General Medical Council is holding a public consultation on the draft.

It follows a successful appeal against the GMC by a paediatrician struck off after accusing a mother of drugging and murdering her 10-year-old son.

The GMC had to reinstate David Southall on its medical register after the appeal court ruled it had failed to give adequate reasons for his striking off in 2007.

The case has now been sent back to the GMC panel for reconsideration.

Continue reading the main story

Spotting signs of child abuse and neglect is a complex and difficult field”

End Quote Dr Amanda Thomas Royal College of Paediatrics and Child Health Speaking about the new guidelines, the GMC's chief executive Niall Dickson said: "We recognise that taking action to protect children from abuse can be challenging and distressing for everyone involved.

"This is a complex area of practice, but we believe this new guidance will provide greater clarity about what doctors need to do to protect children, even if they are uncertain about the risks involved.

"We hope it will also help give doctors confidence to make these extremely difficult decisions."

Royal College of Paediatrics and Child Health child protection officer Dr Amanda Thomas said: "Spotting signs of child abuse and neglect is a complex and difficult field.

"This new guidance is fundamental for all medical staff to protect children and young people from harm."

The UK-wide guidance applies to all doctors, not just those working in child protection, and the final version should be published by the end of the year.

It says every doctor, even those working only with adults, should be able to spot signs a child could be at risk at an early stage, for example if a parent misuses drugs or alcohol.

It is hoped cases like that of 17-month-old Peter Connelly, or "Baby P", who died in August 2007 at home in Haringey, north London, after months of abuse can be avoided.

View the original article here

NHS complaints system 'failing'

28 June 2011 Last updated at 05:49 GMT By Michelle Roberts Health reporter, BBC News The complaints system can be difficult to navigate The NHS complaints system in England is failing patients and needs an overhaul in order to ensure justice, according to a committee of MPs.

The health select committee says a "more open culture" is needed when handling complaints and criticises the Health Ombudsman's role as too narrow.

The cross-party group says too few complaints are officially investigated by the ombudsman.

The Department of Health says new plans will make the NHS more accountable.

The ombudsman's office insisted it can review cases that merit it.

It is only relatively recently that NHS patients in England have been able to take their complaints direct to the Health Ombudsman.

Before April 2009, any complaints not settled locally between the parties involved were reviewed by the Healthcare Commission and referred up to the ombudsman if necessary.

Continue reading the main story

That mismatch between patients' expectations and what the ombudsman does in practice needs to be closed”

End Quote Stephen Dorrell Health select committee chairman In a bid to simplify and speed up resolutions, the Healthcare Commission stage was scrapped.

But some critics are concerned that the streamlined system now means some complaints are falling by the wayside. In 2009-2010, the ombudsman investigated 3% of about 15,000 health complaints it received, although many more were examined unofficially.

There appears to be something of a "black hole" into which the many complaints which would have been reviewed by the Healthcare Commission and upheld have fallen, Action Against Medical Accidents said.

The committee of MPs agreed.

Chairman Stephen Dorrell said the ombudsman's current remit excluded a number of cases sent for review.

"Patients should feel entitled to an independent review. That mismatch between patients' expectations and what the ombudsman does in practice needs to be closed," he said.

A complaint is accepted for formal investigation or intervention by the ombudsman only if the person has suffered injustice or hardship as a result of poor service or maladministration, and only if there is the prospect of "a worthwhile outcome".

In one instance the ombudsman declined to investigate because missing medical records meant the family were unlikely to get a "worthwhile" response.

'Complex' system Health select committee chairman, Stephen Dorrell, on the need for a proper NHS complaints process.

The committee also wants healthcare providers to be more open and adhere to a "duty of candour", which requires them to publish information about the complaints they receive and the progress they make.

Action Against Medical Accidents chief executive Peter Walsh said: "We are very pleased that the committee has accepted our and other participants' calls for better access to independent review of complaints.

"Only a fraction of people who had independent reviews under the old system can get the ombudsman to investigate."

A spokeswoman for the Health Ombudsman said: "Where our assessment reveals clear evidence of maladministration or injustice, we consider whether we can resolve the issue quickly and effectively through our intervention rather than a full investigation."

She added: "The system for handling NHS complaints is a complex one. We welcome the report's endorsement of the current system's design and potential, its emphasis on listening to patients and support for advocacy and the committee's call for a greater focus on complaints data and learning from complaints."

A Department of Health spokesman said: "The revised plans we set out last week, in response to the independent NHS Future Forum, will safeguard the future of the NHS and put patients at the heart of our health service.

"Under the plans, patients will have a stronger voice and the NHS will be more accountable for the quality of care it provides for patients.

"In addition, Local HealthWatch will champion the views and experiences of patients, helping to drive improvements in the quality of health and social care services."

View the original article here

Lean gene 'linked to heart risk'

27 June 2011 Last updated at 10:23 GMT Slim people can still have heart risk, researchers warn Genes that result in a slender figure have been linked to heart disease and type-two diabetes, conditions normally associated with being overweight.

A study suggests variants of the IRS1 gene reduce fat under the skin, but not the more dangerous visceral fat around organs such as the heart and liver.

The Medical Research Council study, published in Nature Genetics, examined the genes of more than 76,000 people.

The link between the genetic variants and the conditions was stronger in men.

Skinny risk

The lead researcher, Dr Ruth Loos, said: "We've uncovered a truly fascinating genetic story and when we found the effect of this gene we were very intrigued.

"It is not only overweight individuals who can be predisposed for these metabolic diseases, and lean individuals shouldn't make assumptions that they are healthy based on their appearance."

Dr Iain Frame, director of research at the charity Diabetes UK, said the study could "shed light on why 20% of people with type-two diabetes have the condition despite being a healthy weight".

"It is also a clear message that people who appear slim shouldn't be complacent about their health," he added.

British Heart Foundation associate medical director Prof Jeremy Pearson said: "These results reinforce the idea that it is not just how fat you are, but where you lay down fat that's particularly important for heart risk.

"Fat stored internally is worse for you than fat stored under the skin.

"However, they don't detract from the fact that being overweight is bad for your heart health, so we should still try to stay lean and fit."

View the original article here

Cigarette firm may sue Australia

27 June 2011 Last updated at 04:21 GMT Australia has been pushing for a change in cigarette packaging to discourage smoking Tobacco giant Philip Morris has threatened to sue the Australian government over its plan to introduce plain, brandless packing for cigarettes.

Australia's government has proposed to ban logos and branding on tobacco packaging.

Hong Kong-based Philip Morris Asia said the legislation violated an investment treaty between Australia and Hong Kong.

Philip Morris is the world's largest tobacco company.

The company said it had sent a legal notice to the Australian government setting a mandatory three-month period for the two sides to negotiate on the issue.

It warned that if no agreement was reached in that time, it would seek financial compensation.

"Failing that we aim to go ahead with a compensation claim for the loss to our business in Australia that would result from plain packaging," said Philip Morris Asia spokeswoman Anne Edwards.

The company said that the amount of potential compensation would be decided by a panel operating under the United Nations International Trade rules.

"We estimate it may be in the billions (of dollars) but ultimately it will be up to this panel to decide," said Ms Edwards.

'Right decision' Continue reading the main story

We're not taking a backward step. We've made the right decision and we'll see it through”

End Quote Julia Gillard Australian Prime Minister The tobacco industry has been up in arms against the proposed changes, which are expected to be implemented from January 2012.

It has been running TV advertisements hinting that the changed laws are turning Australia into a "nanny state".

British American Tobacco, another big cigarette company, has said that the government's plans infringe international trademark and intellectual property laws.

However, Australia's Prime Minister Julia Gillard said that she would push ahead with the new packaging laws.

"We're not going to be intimidated by big tobacco's tactics, whether they're political tactics, whether they're public affairs kind of tactics out in the community or whether they're legal tactics," said Ms Gillard.

"We're not taking a backward step. We've made the right decision and we'll see it through," she added.

View the original article here

'It's good to have choice'

24 June 2011 Last updated at 03:55 GMT By Matt James Chief Executive, H5 Private Hospitals Alliance 'Individuals should be able to choose where they get their healthcare' There has been strong opposition to the idea of the private sector having more involvement in providing NHS care. But in this wek's Scrubbing Up column, Matt James of the Private Hospitals Alliance says we should not be sqeamish about using the sector's expertise - and allowing individuals to choose who gives them healthcare.

Just like the NHS, the BBC is a great institution. It's one of the things about Britain that makes us all proud. Contribution to its funding is compulsory, delivery is free.

You probably like it since you're here reading this website.

The chances are that you also read other news websites. Perhaps you read a newspaper as well or even watch a non-BBC TV channel.

But why? Why do you need a choice? Why would you want more than the BBC as a source of news and information? Why would you pay for a newspaper or put up with TV advertising when you've already paid for the BBC?

Hardly anyone thinks that we'd be better off if our only source of news was the BBC.

We also believe in a free press, and would robustly defend our right to read whatever we choose.

Although we know newspaper owners are there to make money, we believe that most editors and journalists have some integrity and are committed to bringing us accurate news.

How strange, then, that the reverse is true for the NHS.

When it comes to our health, anybody who believes in freedom of choice, as I do, has to argue that it's a good idea.

In health, a state monopoly is simply accepted, and choice and competition seem dangerous.

'Be sceptical of preaching'

I disagree.

The best thing about the NHS is fairness. It's the promise that when we need it, it will be there. We won't need to worry about how to pay for it and nobody is excluded.

Not only is this emotionally appealing, it makes economic and political sense.

The USA spends more per capita on public healthcare than we do, yet many millions more people must still pay their own way.

I believe this is a direct result of failing to care for those people who face the greatest healthcare problems.

I also believe in personal choice and freedom. There's far too much fear and anger in the debates about our health system and I encourage you to be sceptical of anyone preaching that you're better off with less choice and control, or with a one-size-fits-all approach to healthcare.

Trust

I support the NHS. Of course I do.

Despite working closely with private healthcare, I use the NHS more than I use private hospitals. My GP is an NHS GP, my daughters were born in NHS maternity wards and if they hurt themselves I'll call an NHS ambulance.

There's no such thing as a private patient, only people who choose to receive some of their healthcare privately.

People who can afford it have always had choice, control and access to private hospitals.

But, that same choice has not been shared by the vast majority of NHS patients.

So why not let more people have more choices about where and how they are treated? Choice for patients doesn't undermine or harm the NHS, it improves it.

Hundreds of thousands of NHS patients do choose independent hospitals each year.

Yet this is continues to be a tiny proportion of NHS activity, accounting for less than 1% of the NHS budget.

But in some fields it is significant. For example, Ramsay Health Care, running independent hospitals across the country, delivers more orthopaedic (bones and joints) surgery to NHS patients than any single NHS organisation.

Private hospitals have considerable expertise and are keen to share this with the NHS.

Much more could be done to take advantage of this expertise and improve healthcare for all patients.

Several million people use private hospitals each year and around 10m people buy a daily newspaper.

Neither of these activities is particularly exclusive or elitist. People know what is best for them and they like to have a choice.

I think we should trust them.

View the original article here

Boosting access

28 June 2011 Last updated at 08:10 GMT Disability groups have been protesting against cuts Meeting your MP can be a daunting experience at the best of times.

Particularly if you are disabled.

MPs like to talk about reaching out to all sections of the community but it is easy to feel, if you are in a wheelchair or have some other disability, that it does not include you.

And with so many disabled people worried about looming welfare reforms, there has probably never been a better time for a scheme that aims to get more of them face-to-face with their elected representatives.

The disability campaign group Radar runs an awareness scheme every year to encourage disabled people from across the UK to meet their MPs and raise the issues that matter to them - 51 MPs are signed up to the "MP Dialogue" scheme.

The group advises people about preparing for meetings with their MP, tells them what exactly it is that MPs do and helps Parliamentarians understand their disabled constituents' needs.

Continue reading the main story

The vast majority of people actually don't really have an inkling about what it is like to live with a disability”

End Quote Elaine Precious So far this year about 70 individuals or groups have requested more information.

Among them is Elaine Precious, who is taking a group of people with learning disabilities to meet two of her local Conservative MPs - David Gauke and Mike Penning - next month at a football club in Berkhamsted, Hertfordshire.

Elaine works for Dacorum Mencap - a local charity which supports people with learning disabilities and thinks meeting more disabled people in person will give MPs a better understanding of the issues that affect them.

"The vast majority of people actually don't really have an inkling about what it is like to live with a disability, the impact it has on every aspect of your life, particularly the poverty it causes within families," she says.

"People with learning disabilities are not likely to go to their MPs' surgery with an issue - they may have a family member who will go on their behalf, but they are not going to think: 'I'm going to speak to my MP about that'"

Verbally abused

She said her group would raise issues with the MPs that she might miss - from the effect of bus routes closing to being verbally abused in the street, they would be able to discuss problems that confronted them on a daily basis.

Other issues like local hospitals closing also caused "incredible difficulties" for them, she added - as many will suffer from related health conditions like epilepsy, which will occasionally require hospital treatment.

"Their issues about the local community are probably quite different from the general population's issues - it's quite important they get to speak to their MP about what they feel."

Elaine's son Sam was born with two chromosomal abnormalities

She said aspects of the government's welfare reforms were likely to be raised - such as the new work capability assessment for people on incapacity benefit which questions benefit claimants about what they could do, with a view to seeing if they are potentially fit for work.

"Sometimes they will way to somebody: 'I can do this' and that and actually they can't," she said.

Many of her members would like paid employment and quite a lot do voluntary work, she said, but it was difficult for them to secure paid work.

"On the one hand they do want to work but on the other hand if not able to get a job, they rely on these disability benefits."

Benefit changes

Elaine has her own issue to raise with Mr Gauke and Mr Penning. Her son Sam is seriously disabled, and she is worried about proposed changes to the Disability Living Allowance.

Last year Sam, who has severe learning disabilities, moved out of her home in Hertfordshire into full-time residential care about 20 miles away.

She uses the "mobility" part of his DLA - about ?50 a week - to pay to hire a car which she can use to take him to appointments and visit him regularly.

But the government had proposed axing that part of the allowance for people in residential care - arguing that local authority contracts with care homes should cover residents' mobility needs.

Elaine says the allowance gives her access to a reliable car that is well maintained. She is worried that, on a low income, she would not be able to afford a decent car and she and her son could be left stranded in the event of a breakdown.

"The thought of being stuck with my son, who is like a two-year-old but he's 20, on the side of a road - it's horrifying really."

She has already raised the issue with her MP in a letter - and got one back - but is hoping for a more "personal" response when she visits Mr Gauke and Mr Penning in July.

The government announced the proposal in last year's spending review - aimed at saving ?135m by 2014-15.

It has since said the policy will be rolled into a wider review of Disability Living Allowance - which is due to be replaced with a new benefit - the Personal Independence Payment.

A spokesman said while care homes were obliged to provide mobility support - a study had shown provision was "patchy" and it had never been the intention that people would be left without their mobility needs being met.

View the original article here

Nuts and fruit 'help weight loss'

23 June 2011 Last updated at 17:29 GMT No more burgers - topping up on nuts and yogurt is a better option. Eating larger portions of healthy food is more important than dieting when it comes to staying slim, say scientists.

The US team found people who increased their intake of more high-fibre food like nuts, fruit, yoghurt and vegetables actually lost weight.

The Harvard School of Public Health researchers believe consumption of these products left less room for fatty foods.

The study of 120,000 people appeared in the New England Journal of Medicine.

The participants were monitored over 20 years.

Unsurprisingly, the food linked to the greatest amount of weight gain was chips. An extra daily portion led to an increase in weight of over 3lbs in four years.

Similar results were seen among people who consumed extra portions of crisps, sugary drinks and meats.

Go nuts

However, there was less weight gain as time went on among people who ate more of certain foods, such as yoghurt, vegetables, fruits and whole grains.

For example, an extra helping of yoghurt led to a fall in weight of 0.37 kilos (0.82lbs) and for vegetables it was 0.1 kilos (0.22lbs).

Dariush Mozaffarian, associate professor at Harvard and lead author of the study, said the fibre content of these foods could explain their effect.

"Their inverse associations with weight gain suggest that the increase in their consumption reduced the intake of other foods to a greater (caloric) extent, decreasing the overall amount of energy consumed.

"Higher fibre content and slower digestion of these foods would augment satiety, and their increased consumption would also displace other, more highly processed foods in the diet."

View the original article here

Libya rebels 'face health crisis'

28 June 2011 Last updated at 04:51 GMT By Bridget Kendall BBC News, Benghazi Hospital staff say they have to share out what drugs are left among the sick children A medical crisis is looming in eastern Libya with hospitals in Benghazi running short of supplies, the rebels' health minister says.

Stocks of drugs and other items such as surgical gloves are said to be running out.

Dr Nagi Barakat told the BBC that most emergency aid donated from abroad went straight to the front line.

He said that if a new offensive broke out, hospitals would face a major crisis.

On the cancer ward of Benghazi's children's hospital, most patients are not getting the right dosage. There aren't enough drugs to go round.

Dr Amina Bayou says she and her colleagues juggle supplies to give everyone a little.

"We try to divide the drugs between this patient and that patient. It's not good," she said.

"We are treating more than 200 children. We ask parents to go to Egypt to buy medicines and when they bring them back, we divide them up like parcelling out food."

In one room, a two-year-old called Bubaker lies listlessly. His leukaemia is advanced and he is not responding to treatment, says Dr Bayou, because the dose isn't strong enough.

Next door, six-year-old Melak is doing better. She too has leukaemia and is recovering from a severe lung infection. Doctors found anti-fungal drugs to treat her after a desperate search - the last medicine of its kind in all Benghazi. Without it, she would now be dead.

It is not just cancer drugs that are running out in Benghazi's hospitals.

Shelves are rapidly being cleared of what medical supplies are left, rebel officials say

Dr Barakat, a Libyan doctor who returned from London to take up the post of health minister in the rebels' interim government, says the situation is critical.

The list of 150 items needed urgently include surgical gloves and gauze as well as a whole array of drugs needed for cardiac patients and, critically, in the intensive care units.

At the Hawari General Hospital, director Dr Ezzedin Benomran is at his wits' end.

He reckons that more than 20 patients have died since February because of the lack of medical supplies.

Stocks of the narcotics needed for anaesthetic procedures are so low that the hospital has had to close nine of its 12 operating theatres.

The surgeons only operate on emergency cases - four a day - and many of those are patients with serious gunshot wounds, transferred to Benghazi from the front line in Misrata.

Cash shortage

Dr Barakat says here is little left over for women who need caesarean sections, or casualties from car accidents or other domestic accidents.

In any case, he adds, the amounts donated by foreign governments and NGOs cannot meet the demands of all the hospitals in a large city like Benghazi, which services the entire population of eastern Libya.

Medical stocks were already low in February. Now they have been run down in some cases almost to zero, he says.

Critically wounded fighters are among those requiring scant hospital resources

"We have only 2-3 weeks' supply of cancer drugs," said Dr Barakat. "They used to be allocated to us from a central point in Tripoli. We have no access to that now."

The rebel leadership says it would willingly pay for new supplies if only it had the money, but its stock of cash has also run out.

A week ago rebel leaders appealed to the outside world to help unlock funds and loans to sort out the cash flow problem and avoid a social and medical crisis in the city.

A week on - according to senior sources in the leadership - there is still no sign of any cash being made available.

Dr Barakat says this is only one of his worries.

So far the hospitals are just about keeping afloat, despite the shortages. But if there were to be any new pressure on the system, he fears it could break it.

"If Tripoli falls tomorrow, we will have major crisis," he said.

"If there are new mass casualties on the front line here in the east because of an assault on Brega and Ras Lanuf there will be too.

"I am worried because any time the army moves forward and there are mass casualties, I am sure we will not be able to cope."

View the original article here

Doctors reject revised NHS plans

28 June 2011 Last updated at 10:26 GMT By Nick Triggle Health correspondent, BBC News, in Cardiff The NHS has to make big efficiency savings Doctors have rejected the government's revised NHS plans, urging their union to take a tougher stance.

Delegates at the annual British Medical Association conference voted in favour of calling for the Health and Social Care Bill to be withdrawn by 59%.

The union initially welcomed concessions by ministers this month on competition and patient choice.

But doctors at the Cardiff meeting said it was time to keep pushing the government "further and harder".

The plans involve opening up the health service to greater competition and giving GPs a lead role in spending the NHS budget.

Continue reading the main story

The decision by British Medical Association members to give a thumbs-down to the government's NHS concessions shows the issue has not gone away.

The compromises announced two weeks ago were given a warm(ish) welcome by critics, including the BMA.

But it is clear doctors, who after all are key to making the changes work, are still unhappy.

That presents an immediate problem for the union's leadership, which had urged delegates at the conference not to take such a hard-line.

But in the long-term it is the government that will be in the firing line.

Ministers bought themselves some time with their concessions, but as always the devil is in the detail.

Last week 180 amendments were tabled to the bill underpinning the changes. Policy experts are still trying to interpret what they mean. But in the coming weeks, perhaps months, the picture will become clearer - and so will the level of opposition.

Amid mounting criticisms the government put the changes on hold in April. Two weeks ago ministers attempted to appease opponents by watering down certain aspects of the plans.

But delegates at the BMA said they were still not satisfied - despite pleas by BMA leader Dr Hamish Meldrum not to vote in favour of a series of critical motions.

One of those was calling for the bill underpinning the changes to be withdrawn.

Dr Meldrum said he would continue to ask for more.

But he added: "If you push too far you may lose some of the ground you have taken."

But delegates were not convinced with 59% voting in favour of the motion.

Dr Jacqueline Applebee, a GP from London, said the overhaul would result in one of the "biggest ever social injustices" as it would lead to charges for services and backdoor privatisation.

"We have a duty to past, present and future generations," she said.

Paddy Glackin, who is also based in London, added: "This is a slippery government that we cannot give any wriggle room to. This is not the time to back off, this is the time to push further and harder."

Vote 'disappointing'

It is the second time the BMA has called for the bill to be withdrawn. In an emergency meeting in March doctors voted in favour of it being withdrawn, but their attitude softened when the concessions were published, with the union's leaders indicating they were willing to work with ministers to get the bill right.

That stance will now harden following the conference vote. In fact, Dr Meldrum is likely to convey the message on Tuesday afternoon when he gives evidence to the House of Common's bill committee about the reform programme.

A Department of Health spokesman said: "This vote is disappointing because only a few weeks ago the doctors' union said there was much in our response to the listening exercise that addressed their concerns, and that many of the principles outlined reflected changes they had called for.

"The bill has changed substantially since the BMA first voted to oppose government policy. Our plans have been greatly strengthened in order to improve care for patients and safeguard the future of the NHS."

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Organ donor challenge over-ruled

28 June 2011 Last updated at 10:47 GMT By Nick Triggle Health correspondent, BBC News, in Cardiff More than 3,700 donations took place last year - a 5% increase on the previous year Doctors have reiterated their support for overhauling the organ donation system.

The British Medical Association has been campaigning for presumed consent - where all people are assumed to be willing to donate organs unless they opt out - since 1999.

But some medics at the union's annual conference challenged the stance on grounds it could damage patient trust.

Delegates rejected the challenge, arguing it would save lives.

No part of the UK has introduced a system of presumed consent yet, although Wales has said it intends to.

Those in favour believe it would help boost UK donation rates, which, despite recent improvements, still lag behind many other countries.

More than 3,700 donations took place last year - a 5% rise on the previous year - but there are still about 8,000 people on the waiting list.

Over the last three years, the NHS has invested in specialist nurses and transplant co-ordinators to identify potential donors and allow for approaches to families when death becomes likely.

Dr Sharon Blackford, a dermatologist from Swansea, who proposed the motion challenging the BMA's support for presumed consent, said: "If we move to presumed consent in could damage trust in doctors. If someone is ill in intensive care, families may feel doctors just want to harvest the organs.

"It also goes against the whole idea of the moment - putting patients in charge. People may start thinking about it differently and it could turn people off."

Dr Blackford cited the experience of Spain, where organ donation hardly changed following the introduction of presumed consent in 1979.

But others argued presumed consent would be beneficial.

Laura Turkenburg, a medical student from Durham, cited research which showed three people a day die waiting for an organ transplant.

"We have a significant problem in this country. That means the system has to change."

Former Lib Dem MP Dr Evan Harris, who originally proposed the motion in favour of presumed consent 12 years ago, said: "It [presumed consent] does work. It saves lives."

Under the BMA's suggestion - dubbed soft presumed consent - families would still be able to object to organ donation even if their relative had not opted out.

A spokesperson for NHS Blood and Transplant (NHSBT) said:

"We welcome debate that raises the value and importance of organ donation as a way of encouraging discussion about this important subject.

"NHSBT is neither for nor against a change to presumed consent legislation and will work within whatever legislative framework is introduced in any of the four health administrations in the United Kingdom.

"Next week is Transplant Week (4 - 10 July) which focuses on the wait patients experience when on the organ waiting list. With three people dying every day in the UK whilst waiting for an organ transplant, we urge people to join the NHS Organ Donor Register and discuss their wishes with their family."

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Circumcision ethics

27 June 2011 Last updated at 14:44 GMT By John Sudworth BBC News Call for doctors to debate circumcision A group of circumcised men is calling on British doctors to debate the ethics of the procedure at the British Medical Association conference this week.

NORM-UK is a support group for men who say they have been harmed.

It has held its first public demonstration in the UK, lobbying delegates in Cardiff.

It wants British doctors to recognise circumcision as major, irreversible surgery that should not be carried out on new-born babies.

There are no accurate figures, but an estimated 30,000 boys are circumcised in the UK every year. The majority of them as a result of their parents' religious faith.

Islamic, Jewish and some Christian communities circumcise male children as a matter of course.

Stop

Dr Antony Lempert, a GP and chairman of the British Secular Medical Forum, has submitted a motion to the BMA conference calling for doctors to stop performing "irreversible, clinically unnecessary surgery on the genitalia of non-consenting minors."

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[It] is anathema to normal medical practice, it's an extraordinary exception”

End Quote Dr Antony Lempert British Secular Medical Forum The medical establishment, including the General Medical Council, refers to the procedure when carried out on children as "Non Therapeutic Circumcision", seemingly recognising that there is little benefit.

Some NHS trusts have decided not to carry out circumcisions requested for religious reasons.

Some doctors who support the practice have argued that research shows circumcised heterosexual men to have a reduced risk of HIV infection.

While Dr Lempert believes that adults should be free to act on this research if they wish, he believes there is no justification for carrying out the procedure on children.

"To cut off a functioning part of a boys body for no therapeutic reason, simply because the parents have a particular belief, is anathema to normal medical practice, it's an extraordinary exception," he said.

Consequences

In addition, Dr Lempert points out, circumcision carries risks; both the immediate danger of haemorrhage and infection, and the long term risk of impaired sexual function.

"The available evidence shows that the foreskin contains 20 to 30 thousand nerve endings and has a very important function in lubrication... circumcision gets rid of one of the most sensitive areas of the penis," he said.

It is not just here in the UK that campaigners are trying to force the issue into the public domain.

Later this year, San Francisco is due to become the first American city to vote on whether to ban circumcision, although Jewish and Muslim groups are challenging the vote as unconstitutional.

There are, of course, many men who see circumcision as an important part of their religious and cultural identity and who report no adverse side effects at all.

But that is not the point, according to NORM-UK.

The group argues that circumcision can have side-effects and they want the medical profession to stop viewing the procedure as minor and inconsequential, not just for children but for adults too.

Dan from London, another member of Norm-UK, had his circumcision three years ago, offered as an easy fix for the condition phimosis, a tightening of the foreskin.

He says no one told him just how much of an impact it could have on his sex life.

"Imagine having your tongue but not being able to taste," he says.

"You'd still be able to use your tongue, but if you weren't able to taste certain foods, or taste anything at all, you know, I liken it to that."

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Prescription drug website closed

28 June 2011 Last updated at 05:57 GMT Matthew Davidson had Asperger's syndrome, a form of autism A BBC investigation into the illegal sale of prescription-only medicines over the internet has resulted in an international website being shut down.

Action was taken after a 26-year-old County Down man took his own life using drugs he had purchased online.

Matthew Davidson had Asperger's syndrome, a form of autism.

After attempting suicide several times with medicine prescribed in Northern Ireland, Matthew turned to the internet to buy Tramadol.

It is an extremely strong pain medication that requires a prescription in the UK.

The drug was sent from Egypt, where no prescription is required - just a credit card. For legal reasons we are unable to give details of the website.

The agency that regulates pharmaceutical drugs, the Medicines and Healthcare Products Regulatory Agency (MHRA), said it was now pursuing an alleged doctor in Egypt.

While the man did nothing illegal, buying prescription-only medicines without a doctor's signature within the UK is a crime.

Matthew's father, Mike Davidson, found him after he overdosed.

"We broke down the door and found him lying on the floor," he said.

"He was already in a coma, his pupils had dilated and he was breathing very deeply. I realised what had happened and just put my arms around him.

"I am just really thankful that I had the opportunity to be with him when he died. It could have been very different if a policeman had come and said he had taken his own life."

In their home, near Hillsborough, Mike and his wife, Lynore, described how their son had struggled with depression.

Cash-on-delivery

The family, who are originally from South Africa, came to live here in 2004. It was only then, when Matthew was 19, that he was diagnosed with Asperger's.

The family want to highlight what they describe as a major failing in our legislation

He had been receiving help from a psychologist based at his local health trust. But after that treatment stopped, his condition became gradually worse.

Lynore Davidson said that while her son had a lot of problems, he was a good person.

"He was shy, anxious and didn't like change," she said.

"He didn't like crowds or mixing with new people. He meant everything to me, I loved him more than anything else, we just miss him every day."

The family want to highlight what they describe as a major failing in our legislation.

Currently, internet companies registered outside the country can sell and deliver medicine to addresses in the UK. This includes medicine that normally requires a prescription.

These medicines can include morphine-based drugs that can kill if taken incorrectly.

At no time was Matthew asked by the alleged doctor in Egypt to complete a health questionnaire, according to correspondence seen by the BBC.

Instead, he was asked for his credit card details and advised that cash was accepted on delivery. The package arrived at Matthew's door within three days.

According to his father, purchasing powerful and dangerous drugs is too easy.

"If you know what you want and you have the website, credit card and a post code, it can be delivered within days. It's as easy as buying a book from Amazon," he said.

The BBC has tracked down the Egyptian company that sent the drugs. We have attempted to contact the alleged doctor, but no-one has returned our calls or e-mails. We have also contacted the company involved and have had no response.

We brought this information to the MHRA. The doctor, who at this stage cannot be named for legal reasons, is known to them. Their head of intelligence is Nimo Ahmed.

"We've since identified four more websites, one of which was brought to our attention by BBC Northern Ireland," he said.

"We are now pursuing these websites and closing them down. We have also contacted the Egyptian authorities, and highlighted what this gentleman is doing is illegal in the UK.

Autopsy

"We've told them that it led to the tragic death of this young man. We have asked the Egyptian authorities to consider taking action."

Mr Ahmed explained there is a loophole in UK legislation that allows this practice to continue.

"It is very difficult to police. While prescription-only medicine can only be obtained in the UK with a prescription, if you go on the internet you can access lots of controlled drugs quite easily," he said.

"It needs to be stopped and we are doing our best to highlight to the public, the dangers involved. Some of these drugs are fake and could kill."

The Davidsons have written to 10 Downing Street and Secretary of State for Health Andrew Lansley, appealing for help.

While both conveyed their condolences, they said current legislation prevents them from taking action.

The family's MP is Jeffrey Donaldson.

"The government needs to recognise this is a problem and it's a matter we need to be dealing with," he said.

"Mr Cameron talks about the big society. Well the big society ought to be dealing with this issue and protecting the most vulnerable in our society."

Matthew Davidson's autopsy concluded he was poisoned by Tramadol.

Meanwhile, his family say they will continue with their campaign.

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Poison abortion doctor struck off

28 June 2011 Last updated at 13:20 GMT Erin did not show remorse for his actions, the GMC said A doctor who was jailed for trying to poison his lover to induce a miscarriage has been struck off the medical register.

A General Medical Council (GMC) disciplinary panel found Edward Erin had "shown no remorse" and had not "gained insight into the gravity of his actions".

Erin, of west London, was jailed for six years in 2009 for spiking Bella Prowse's drinks after she became pregnant, but refused an abortion.

Ms Prowse gave birth to a healthy boy.

She was a secretary at St Mary's Hospital in Paddington where Erin was a chest consultant.

His trial at the Old Bailey heard they were having an affair in 2008 which left her pregnant.

Erin gave Ms Prowse miscarriage-inducing drugs by grinding up tablets and spiking her coffee and then a bottle of orange juice.

'Premeditated acts'

But she became suspicious and alerted the police.

Erin, a married father-of-two, was found guilty of two charges of attempting to administer poison.

Ms Prowse did not know whether her child would be affected by the drug as traces of it were also found in her body. Her son was born in September 2008.

Bella Prowse gave birth to a healthy boy in 2008

The GMC said: "The panel noted that this case is concerned with grave breaches of good medical practice.

"It is concerned that Dr Erin's offences were premeditated acts, using his medical skills and knowledge to attempt to cause serious harm to others.

"As a doctor, he knew or should have known that Methotrexate in particular could cause long-term harm to his intended victim and her unborn child.

"The panel considers that Dr Erin has never acknowledged fault in this case and has shown no remorse for his actions and the panel has received no evidence to suggest he has now gained insight into the gravity of his actions."

The panel struck him off, saying his behaviour was "utterly unacceptable" as a medical practitioner.

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