School sun care policy 'must change'

15 July 2011 Last updated at 00:30 GMT By Richard Clifford Skin Cancer UK charity Who should be responsible for making sure a child is protected? Should schools be insisting that teachers and dinner-ladies supervise the application of sunscreen on pupils before they go out to play? Similar policies are in place in nurseries and pre-schools, but there is often no such provision in primary and secondary schools, despite good evidence that sunburn in childhood can lead to skin cancer in later life.

We all need a little bit of sunshine in our lives. It not only boosts our wellbeing but also helps our body to make vitamin D.

But too much sun is damaging, and children are particularly vulnerable to over-exposure.

For example, more than 80% of exposure to the sun occurs during childhood.

Time spent playing outdoors at breaks and lunchtime as well as during sports lessons means children spend, on average, one and a half hours outside during school time.

And a recent survey of 1,000 parents, commissioned by MPs on the All-Party Parliamentary Group on Skin, found almost 40% of pupils have suffered sunburn while at school.

Unprotected

Prolonged over-exposure to the sun and episodes of sunburn under the age of 15 are major risk factors for skin cancer in later life.

The British Association of Dermatology estimates that four out of five skin cancer deaths are preventable.

Simple measures like seeking shade, covering up and using sunscreen, can prevent these dangers.

But there is no real onus on schools to provide these basic things.

Guidelines do recommend that schools have a sun policy, but they are not prescriptive or mandatory.

The National Institute for Health and Clinical Excellence says children should be encouraged to seek shade whenever possible.

But provision of shade is seemingly disregarded in many UK schools.

And it says sunscreen (of at least SPF 15 strength) should be applied liberally half an hour before and after going out in the sun and reapplied every two hours thereafter.

Lessons from Australia

But how can schools realistically achieve this?

Admittedly teachers cannot be expected to apply sunscreen due to simple time pressures.

There is also the inevitable question regarding their concerns over child abuse and the strong advice they receive from local authority education departments and trade unions.

However, there is no reason whatsoever why they should not supervise the application, perhaps with the assistance of the school nurse or indeed parents who attend on a pre-arranged rota system.

NICE suggests parents could provide sunscreen for their children who could, in turn, be taught how to apply it for themselves. Children could even be encouraged to help their school-friends put theirs on, says NICE.

The guidelines also recommend schools run awareness campaigns to alert children to the harms of too much sun exposure.

In Australia over 75% of schools qualify for Sunsmart status - a code of conduct which even includes making sunglasses part of the school uniform.

Similar support schemes are available to UK schools, but uptake is patchy.

Again, in Australia, sun protection is now an accepted part of the educational programme. But in the UK it is not part of the curriculum.

Instead, it is left to the individual teacher to decide as to whether or not to introduce the subject of UV awareness. This is simply not good enough.

Skin cancer and UV awareness have always been regarded as a public health issue and not educational - the fact is that they are inextricably linked and if only the two government departments would "get together", in the long-term huge health cost savings can be achieved.

The resource for this change which has lain dormant for far too long, is after all, already in place - the school, the classroom and the teacher - applying the subject at the appropriate times to the huge long term benefit of our children.

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Case for change

30 June 2011 Last updated at 16:24 GMT By Nick Triggle Health correspondent, BBC News Social care is currently means-tested Everyone agrees the social care system is out-of-date.

When it was created after the Second World War under the 1948 National Assistance Act the idea was to create a safety net for the most vulnerable in society.

But the support was only ever meant to be short-term. Back in the late 1940s people tended to only live a few years after retiring.

Now the situation is very different. Many live for 20 years after stopping work and children born today will probably spend a third of their life in retirement.

Granted, advances in medicine mean people are living for longer in relatively good health.

But that does not mean they will not need some help with basic tasks like washing, dressing and eating.

Research suggests three quarters of people over the age of 65 still develop a care need.

Similar patterns have emerged for people with disabilities. For example, even 30 years ago many people with Down's syndrome died before they were 25. Sixty is not uncommon now.

Rationing

Unsurprisingly, the effect of people living longer has been to put the social care system under greater strain.

Concerns have been raised about the quality of services people have been receiving.

A recent report by the Equality and Human Rights Commission described cases of people being left in bed for 17 hours or more between care visits and a failure to wash people regularly.

But those are the "lucky" ones who get help at all.

Councils are increasingly having to ration access to state-funded support. Six years ago half of councils provided help to those with moderate needs, but that has now fallen to 15%.

It means in most areas of England support is only provided to those with the most acute problems - effectively people who need round-the-clock help.

Continue reading the main story About 1.8m people get state-funded social care - a third adults with disabilities and two thirds elderlyNearly 500,000 people are paying their own costsAnother 800,000 are estimated to go without formal care despite being in need of helpThe average lifetime cost of care is ?30,000, but for one in 10 it will total ?100,000More than ?14bn is spent on social care by councilsBut once inflation is taken into account funding has hardly changed in the past seven yearsIn reality, the system has been rationed as much as it can be.

The situation has been further exacerbated by the feeling of unfairness that has been associated with people having to sell their homes.

The rise in the value of property over the past few decades has pushed many above the means-tested threshold, forcing them to pay for their care if they have to go into a residential home.

For some - an estimated 50,000 a year - the only option is to relinquish the family home.

But if that is not enough, the problem is about to get much worse.

As is the case with NHS reform, the ageing population demands that new solutions are found.

The baby boomer generation is approaching old age - and that means a tidal wave of new people who will need help.

Over the next 20 years the number of over 70-year-olds will jump by 50% in the next 20 years to top 9.6m, according to the Office for National Statistics.

Without radical change, many believe the safety net created all those years ago will break.

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NHS reforms may change - Lansley

2 June 2011 Last updated at 06:59 GMT Health Secretary Andrew Lansley promised he would "never privatise our NHS" Health Secretary Andrew Lansley has said he is ready to accept "substantial and significant" alterations to plans for changes in the NHS in England.

He told the Daily Telegraph there could be changes to the health bill "if they help us improve care for patients".

But Mr Lansley warned the NHS would face "financial crisis within a matter of years" unless it was reformed.

Labour, as well as Lib Dem leader Nick Clegg, have called for the bill to be sent back to MPs for reconsideration.

'Threaten values'

With the government's "listening exercise" on its proposed changes drawing to a close, Mr Lansley said: "We have always been clear that we are ready to accept any changes - substantial and significant - if they help us improve care for patients.

"When the Health and Social Care Bill comes back to Parliament, people should have every confidence that we will make the changes necessary to ensure the NHS is protected for our future generations.

"We will never privatise our NHS.

"But if we choose to ignore the pressures on it, the health service will face a financial crisis within a matter of years that will threaten the very values we hold so dear - of a comprehensive health service, available to all, free at the point of use and based on need and not the ability to pay.

Continue reading the main story

Our health service is facing huge challenges that, if not dealt with today, will almost certainly mean a crisis tomorrow”

End Quote Andrew Lansley Health Secretary "I will not allow that to happen."

Mr Lansley said reform was necessary in the face of "enormous financial pressures" caused by an ageing population and the rising cost of treatment.

He said the number of people in the UK aged above 85 had almost trebled over the past 25 years and was set to double again over the next 20 years. By 2034, one in 20 of the population would be aged over 85.

As a result the NHS would have to perform two million more operations a year and health spending would double to ?230bn, he said.

Mr Lansley said this was a figure the UK "simply cannot afford".

'Disgracefully unethical'

Prime Minister David Cameron has "paused" the legislative progress of the reforms, which aim to hand control of budgets to GPs and increase competition in the NHS.

The move was to allow further consultation on the proposals, a process which came to an end on Tuesday, with the NHS Future Forum, which is overseeing the exercise, expected to report later this month.

The forum brings together doctors, nurses and other health professionals.

Health officials said they had received about 15,000 website responses and 720 letters.

Mr Clegg has said he would oppose the idea of a regulator promoting competition in the health service, a key part of the planned changes.

Confidence vote

The deputy prime minister has indicated that Lib Dem MPs could vote against the bill unless changes are made.

The British Medical Association (BMA) has described a system of incentive payments for GPs known as "Quality Premium", another important part of the reform programme, as "disgracefully unethical".

Dr Laurence Buckman, chairman of the BMA's General Practitioners Committee, said: "We don't understand what the Quality Premium means. We don't understand where it will come from. We rather fear it will come out of our pay and be paid back to us if we do certain things."

In April, delegates at the Royal College of Nursing conference in Liverpool passed a vote of no confidence in the health secretary.

Nurses said they were angry about the changes and the way the government was running the consultation.

'Care passionately'

Mr Lansley said the vision set out by the government would deliver "a truly world-class NHS, with doctors and nurses leading the design of health services, patients taking more control and budgets controlled by locally-accountable people".

"Our health service is facing huge challenges that, if not dealt with today, will almost certainly mean a crisis tomorrow," he said.

"I care passionately about protecting the NHS for the future. This is why doing nothing is not an option. I will not leave the NHS to neglect."

However, for Labour, shadow health secretary John Healey said Mr Lansley was "just adding to confusion and uncertainty in the health service".

"He makes a case for change but not the Tory-led government's top down re-organisation of the NHS," he said.

"As Labour has argued from the outset and as the chorus of criticism during the 'pause' has underlined, these are the wrong reforms for the NHS.

"They are being forced through for reasons of political ideology not improved patient care.

"The huge upheaval of re-organisation is making it harder not easier for the NHS to deal with the financial and efficiency squeeze."

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