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UK government backs three-person IVF

Written By Unknown on Sabtu, 29 Juni 2013 | 21.24

27 June 2013 Last updated at 19:33 ET By James Gallagher Health and science reporter, BBC News

The UK looks set to become the first country to allow the creation of babies using DNA from three people, after the government backed the IVF technique.

It will produce draft regulations later this year and the procedure could be offered within two years.

Experts say three-person IVF could eliminate debilitating and potentially fatal mitochondrial diseases that are passed on from mother to child.

Opponents say it is unethical and could set the UK on a "slippery slope".

They also argue that affected couples could adopt or use egg donors instead.

Mitochondria are the tiny, biological "power stations" that give the body energy. They are passed from a mother, through the egg, to her child.

Defective mitochondria affect one in every 6,500 babies. This can leave them starved of energy, resulting in muscle weakness, blindness, heart failure and death in the most extreme cases.

Continue reading the main story

Every time Sharon Bernardi became pregnant, she hoped for a healthy child.

But all seven of her children died from a rare genetic disease that affects the central nervous system - three of them just hours after birth.

When her fourth child, Edward, was born, doctors discovered the disease was caused by a defect in Sharon's mitochondria.

Edward was given drugs and blood transfusions to prevent the lactic acidosis (a kind of blood poisoning) that had killed his siblings.

Five weeks later Sharon and her husband, Neil, were allowed to take Edward to their home in Sunderland for Christmas - but his health slowly began to deteriorate.

Edward survived into adulthood, dying in 2011 at the age of 21.

Now Sharon is supporting medical research that would allow defective mitochondria to be replaced by DNA from another woman.

Research suggests that using mitochondria from a donor egg can prevent the diseases.

It is envisaged that up to 10 couples a year would benefit from the treatment.

However, it would result in babies having DNA from two parents and a tiny amount from a third donor as the mitochondria themselves have their own DNA.

'Clearly sensitive'

Earlier this year, a public consultation by the Human Fertilisation and Embryology Authority (HFEA) concluded there was "general support" for the idea and that there was no evidence that the advanced form of IVF was unsafe.

The chief medical officer for England, Prof Dame Sally Davies, said: "Scientists have developed ground-breaking new procedures which could stop these disease being passed on, bringing hope to many families seeking to prevent their future children inheriting them.

"It's only right that we look to introduce this life-saving treatment as soon as we can."

She said there were "clearly some sensitive issues here" but said she was "personally very comfortable" with altering mitochondria.

Scientists have devised two techniques that allow them to take the genetic information from the mother and place it into the egg of a donor with healthy mitochondria.

Continue reading the main story

The result is a baby with genetic information from three people.

They would have more than 20,000 genes from their parents and 37 mitochondrial genes from a donor.

It is a change that would have ramifications through the generations as scientists would be altering human genetic inheritance.

Dr David King

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Dr David King says the move crosses "a crucial ethical line"

Objections to the procedure have been raised ever since it was first mooted.

Dr David King, the director of Human Genetics Alert, said: "These techniques are unnecessary and unsafe and were in fact rejected by the majority of consultation responses.

'Designer baby'

"It is a disaster that the decision to cross the line that will eventually lead to a eugenic designer baby market should be taken on the basis of an utterly biased and inadequate consultation."

One of the main concerns raised in the HFEA's public consultation was of a "slippery slope" which could lead to other forms of genetic modification.

Draft regulations will be produced this year with a final version expected to be debated and voted on in Parliament during 2014.

Newcastle University is pioneering one of the techniques that could be used for three-person IVF.

Prof Doug Turnbull, the director of the Wellcome Trust Centre for Mitochondrial Research at the university, said he was "delighted".

A baby's hand

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He said: "This is excellent news for families with mitochondrial disease.

"This will give women who carry these diseased genes more reproductive choice and the opportunity to have children free of mitochondrial disease. I am very grateful to all those who have supported this work."

The fine details of the regulations are still uncertain, yet it is expected to be for only the most severe cases.

It is also likely that children would have no right to know who the egg donor was and that any children resulting from the procedure would be monitored closely for the rest of their lives.

Sir John Tooke, the president of the Academy of Medical Sciences, said: "Introducing regulations now will ensure that there is no avoidable delay in these treatments reaching affected families once there is sufficient evidence of safety and efficacy.

"It is also a positive step towards ensuring the UK remains at the forefront of cutting-edge research in this area."


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Bid to end social care 'lottery'

28 June 2013 Last updated at 14:22 ET

The government is attempting to end the "postcode lottery" over care for elderly and disabled people in England.

Under new draft rules all councils in England would have to fund services for those judged to have "substantial" needs, from 2015.

Charities say that threshold is too high and would exclude many people who need help with everyday tasks.

And councils say they want assurances that any extra costs incurred will be fully funded.

Local authorities run social care services, such as home help with washing, eating and dressing or residential care, and decide who they will provide them to and whether they will pay for them.

Little consistency

Councils can assess people as having "critical", "substantial", "moderate" or "low" needs. Only four councils provide care for people in all four categories - 16 councils fund those with "moderate" needs while most, 130, only fund those with "substantial" or "critical" needs.

Continue reading the main story

Analysis

This policy is attacked from both sides.

Charities fear it could mean less care. Councils that help people with lower levels of need will stop, they argue, even though they won't have to.

Some councils fear it could force them to provide too much care.

So many people will be entitled to help, they say, that cash-strapped local authorities could run out of money.

Everyone says something must be done about adult social care.

Actually doing it rarely proves popular.

We will not know the full facts until the consultation is over, the plan published and the bill safely through Parliament.

And many will reserve their final judgement until they see its effect in the real world.

Three councils only fund those with in highest category.

The government says a national minimum would stop councils reducing services due to budget cuts and would level out variations between local authorities.

Mr Lamb said the draft regulations, which are being published for discussion ahead of a formal consultation next year, would set the minimum threshold at "substantial" - the level at which most councils currently operate. That would be a "starting point for local councils to base their care provision on".

Under the draft regulations, adults who are unable to carry out basic personal and household tasks without putting themselves at risk are among those who would be eligible for funded care.

But Age UK's Michelle Mitchell said it would effectively set the minimum level too high and exclude hundreds of thousands of elderly people with moderate needs. She welcomed the move to introduce national criteria - but said the minimum level should be set at those with "moderate" needs.

"Although this may sound like a technicality the final decision about these criteria is crucial.

'Shut out'

"As it stands millions of older people and their families who have assumed they will benefit from the government's social care reforms will miss out. But there is still time for the government to change their minds and Age UK will be campaigning to persuade them to do so."

Richard Hawkes, head of the disability charity Scope, said the aim of ending the "postcode lottery" was welcome but added: "Under the proposals more than a hundred thousand disabled people who need care to get up, get washed and dressed and get out would be shut out of the system. "

Continue reading the main story

"Start Quote

There's no point providing clarity over who is eligible for care if the money isn't in the system to then provide appropriate, effective and responsive services "

End Quote Local Government Association

Mr Lamb told the BBC councils would still be required to provide broader preventative services for those with moderate needs and to give practical guidance and support to everyone who was assessed.

He said there would be a system of appeal for those denied social care if they believed they should be eligible. And he said assessments would be "broadly similar to what has happened in the past, but it will be this national basis so that local authorities won't be able to work out their own way of doing it".

"Beyond that, we're also starting work on trying to make these assessments more sophisticated to try to find ways of providing help earlier to stop your condition deteriorating," he added.

Councils currently spend about £16bn on social care but have had to trim the amount they spend in recent years because of spending cuts.

In the Spending Review this week, George Osborne announced plans to put more money from the NHS budget into social care provided by local authorities to stop people falling "between the cracks" in the two services.

A spokesman for the Local Government Association, which represents councils, said most councils had to prioritise those in the greatest need or "risk going bankrupt" - owing to rising demand and "chronic underfunding".

"There's no point providing clarity over who is eligible for care if the money isn't in the system to then provide appropriate, effective and responsive services," he said.

He said councils needed assurances that the government's definition of "substantial" care needs would be "equivalent to the current level outlined by councils, and that any additional costs of implementing the new system will be fully funded".


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Heart risk warning over painkiller

29 June 2013 Last updated at 00:08 ET

People with heart problems have been advised to stop using one of the most commonly prescribed anti-inflammatory drugs in the UK.

The medicines regulator said painkiller diclofenac could significantly increase the risk of a heart attack or stroke for some patients.

The advice has been updated after a European review of the risks.

Millions of people take diclofenac for a range of conditions including headaches, back pain and arthritis.

The Medicines and Healthcare Products Regulatory Agency (MHRA) said the drug should not be used by people with serious underlying heart conditions.

People who have suffered heart failure, heart disease or a stroke should stop using it completely.

Smokers and people with high blood pressure, raised cholesterol and diabetes have been advised to use the drug only after consulting their GP or pharmacist.

The MHRA said diclofenac would continue to provide safe and effective pain relief, apart from patients in certain "at risk" groups.

Dr Sarah Branch, deputy director of the MHRA's vigilance and risk management of medicines division, said: "Whilst this is a known risk and warnings have been included in patient and healthcare information for some time, this advice is now being updated."

Six million prescriptions were written for diclofenac last year and the drug is also available over the counter.


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Cells 're-grown' after spinal injury

Written By Unknown on Rabu, 26 Juni 2013 | 21.24

25 June 2013 Last updated at 21:46 ET By Helen Briggs BBC News

US scientists say they have made progress in repairing spinal cord injuries in paralysed rats.

Rats regained some bladder control after surgery to transplant nerve cells into the spinal cord, combined with injections of a cocktail of chemicals.

The study, published in the Journal of Neuroscience, could raise hopes for one day treating paralysed patients.

But UK experts say it will take several years of research before human clinical trials can be considered.

Scientists have tried for decades to use transplants of nerve cells to restore function in paralysed animals by bridging the gap in the broken spinal cord.

However, coaxing the cells to grow and form new connections has proved elusive.

One problem is the growth of scar tissue as the body's responds to injury, which seems to block cell regeneration.

Continue reading the main story

If we can show in a larger animal that our technique works and does no additional harm I see no reason why we couldn't move rapidly in humans"

End Quote Dr Jerry Silver Case Western Reserve Medical School, Cleveland, Ohio

US scientists carried out complex surgery to transplant nerves from the rodents' ribs into the gap in the middle of their spinal cord.

They also used a special "glue" that boosts cell growth together with a chemical that breaks down scar tissue in an attempt to encourage the nerve cells to regenerate and connect up.

The researchers found for the first time that injured nerve cells could re-grow for "remarkably long distances" (about 2cm).

They said that while the rats did not regain the ability to walk, they did recover some bladder function.

Lead author Dr Jerry Silver of Case Western Reserve Medical School, Cleveland, Ohio, said: "Although animals did not regain the ability to walk, they did recover a remarkable measure of urinary control."

Co-author Dr Yu-Shang Lee of the Cleveland Clinic, Ohio, added: "This is the first time that significant bladder function has been restored via nerve regeneration after a devastating cord injury."

The findings may help future efforts to restore other functions lost after spinal cord injury.

They also raise hope that similar strategies could one day be used to restore bladder function in people with severe spinal cord injuries.

Dr Silver said further animal experiments will be needed to see if the technique could work in humans.

He told BBC News: "If we can show in a larger animal that our technique works and does no additional harm I see no reason why we couldn't move rapidly in humans."

'Remarkable advance'

Commenting on the study, Dr Elizabeth Bradbury of King's College London said several challenges must be overcome before the therapy can be trialled in patients.

"There are a number of challenges before this therapy can be brought to the clinic," she said.

"Nevertheless this is a remarkable advance which offers great hope for the future of restoring bladder function to spinal injured patients and if these challenges can be met we could be reaching clinical trials within three to five years."

Dr John Williams, head of neuroscience and mental health at the Wellcome Trust, said the implications for people are not yet clear.

"This is one of a number of ways that one can approach restoration of bladder function in paralysed patients, but careful studies will be needed to optimise which of the technologies under investigation might be of most benefit to patients."


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Cutlery 'can influence food taste'

26 June 2013 Last updated at 02:52 ET By Helen Briggs BBC News

Our perception of how food tastes is influenced by cutlery, research suggests.

Size, weight, shape and colour all have an effect on flavour, says a University of Oxford team.

Cheese tastes saltier when eaten from a knife rather than a fork; while white spoons make yoghurt taste better, experiments show.

The study in the journal Flavour suggests the brain makes judgements on food even before it goes in the mouth.

More than 100 students took part in three experiments looking at the influence of weight, colour and shape of cutlery on taste.

The researchers found that when the weight of the cutlery conformed to expectations, this had an impact on how the food tastes.

For example, food tasted sweeter on the small spoons that are traditionally used to serve desserts.

Continue reading the main story

Even before we put food into our mouths our brains have made a judgment about it, which affects our overall experience"

End Quote Charles Spence and Vanessa Harrar University of Oxford

Colour contrast was also an important factor - white yoghurt eaten from a white spoon was rated sweeter than white yoghurt tasted on a black spoon.

Similarly, when testers were offered cheese on a knife, spoon, fork or toothpick, they found that the cheese from a knife tasted saltiest.

"How we experience food is a multisensory experience involving taste, feel of the food in our mouths, aroma, and the feasting of our eyes," said Prof Charles Spence and Dr Vanessa Harrar.

"Even before we put food into our mouths our brains have made a judgment about it, which affects our overall experience."

Past research has shown that crockery can alter our perception of food and drink.

For example, people generally eat less when food is served on smaller plates.

The new research into how the brain influences food perceptions could help dieters or improve gastronomic experiences at restaurants, said Prof Spence.

He told BBC News: "There's a lot more to food than what's on the plate. Many things we thought didn't matter do. We're going to see a lot more of neuroscience design around mealtimes."


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Seamless care a priority for Osborne

26 June 2013 Last updated at 09:00 ET By Nick Triggle Health correspondent

The NHS budget in England has been protected again - but the health service has been told it must do more to help councils with social care.

Chancellor George Osborne said he wanted to see £3bn set aside in 2015-16 for integrated services.

He said this was to stop vulnerable elderly patients from falling into "the cracks" between the two sectors.

It comes after he announced local government would get a 10% cut.

The NHS is already committed to spending £1bn a year on joint projects with local government so this represents an extra £2bn.

The chancellor told the House of Commons: "Many older people do not just use the NHS they also use the social care system and if we're honest they often fall between the cracks of the two, being pushed form pillar to post and not getting the care they want."

He said this money would be spent on services that would be jointly commissioned between the health and social care - although it would come from the NHS pot.

"Let's stop the tragedy of people being dropped in A&E on a Friday night to spend the weekend in hospital because we can't look after them properly in social care," he added.

Continue reading the main story

It is easy to understand why ministers want to encourage a better working relationship between health and social care.

As budgets have been squeezed, the two sectors have drifted further apart. Not only has that been bad for vulnerable elderly people, but it has not made economic sense either.

A recent analysis by Age UK showed that hospital patients were waiting for more than 30 days on average for a care home place - 13% longer than three years ago. A similar rise in waits has been seen for those needing care packages at home.

That is costly. A hospital bed costs £250 a day on average, while a week in a care home costs just over £500 and home help even less.

Creating a joint budget like this is also convenient politically. It allows the government to say it is keeping its commitment that the NHS budget would be protected, while also enabling it to say it is giving more money to social care.

Council cuts

Councils currently spend about £16bn on social care so in theory the £3bn joint fund represents a significant sum.

However, councils have had to trim the amount they spend in recent years because of the cuts that have already taken place.

And with another tranche announced for local government in this spending review some question the impact it will have.

Sandie Keene, president of the Association of Directors of Social Services, said: "The benefits gained from closer integration with the services provided by our health colleagues will be rendered less valuable if the intricate relationship with other services is threatened by severe downward pressures on local government as a whole."

Overall, the NHS budget will be £110.4bn in 2015-16, which represents an annual rise of 0.1%.

Before the last election the Tories had promised to increase the NHS budget during the parliament.


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Women offered NHS breast cancer drug

Written By Unknown on Selasa, 25 Juni 2013 | 21.24

25 June 2013 Last updated at 04:47 ET By Michelle Roberts Health editor, BBC News online

Thousands of women across Britain with a family history of breast cancer are to be offered drugs on the NHS to help prevent the disease.

The National Institute for Health and Care Excellence says tamoxifen or raloxifene taken daily for five years can cut breast cancer risk by 40%.

Its guidance for England and Wales means 500,000 women now have a choice other than mastectomy.

The Scottish government says it will offer tamoxifen to women at risk.

One in every five breast cancers has a family link.

Having close relatives - a mother, sister or aunt - with breast cancer increases a woman's chance of getting the disease, as does inheriting certain genes such as BRCA1 and BRCA2.

Hollywood actress Angelina Jolie revealed last month that she had undergone a preventative double mastectomy to cut her own chance of developing breast cancer because she carries one of these risky genes.

Risk reduction
Continue reading the main story
  • Women in general have a 1-in-8 chance of developing breast cancer
  • But some are at higher risk than this because of their family history
  • Having a mother or sister diagnosed with breast cancer doubles your risk of breast cancer, for example
  • If several members of your family have had particular types of cancer, or if a relative was diagnosed with breast cancer at a young age, your risk of developing breast cancer may be increased further
  • Moderate risk means you have at least a 1-in-6 risk of getting breast cancer by the end of your life, while high risk means you have a 3-in-10 risk
  • Inherited genes - like BRCA1 and BRAC2 - increase your lifetime risk by up to 90%
  • Most breast cancers have no family link

The new guidelines from NICE - which says the decision about the best treatment should be a joint one between the patient and the medical team - are the first in Europe to recommend that healthy women are given drugs to prevent breast cancer. It is likely that Northern Ireland will soon follow suit.

The Scottish government says women with two or more family members who have had breast cancer will be offered the treatment for five years.

It was announced last month that genetic testing would also be offered in Scotland to those with a 10% risk of a faulty gene.

NICE says women in England and Wales who are aged over 35 and at "moderate" or "high" risk of breast cancer as a result of their family history or genes should be considered for preventative drug therapy.

By this they mean women with at least a one in six chance of developing the disease.

Wendy Watson

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Wendy Watson, who has had a preventative double mastectomy, says "it has to be what is right for the individual"

The Welsh government said it welcomed the changes and expected health boards to make the drugs "available to patients who meet the clinical criteria".

Taking a tamoxifen or raloxifene tablet every day for five years could nearly halve breast cancer risk and this protective effect should last for at least a decade, studies suggest.

But experts say women need to carefully weigh up their options.

Surgery to remove both breasts would bring a woman's lifetime risk down to virtually zero.

And tamoxifen can be unpleasant to take, causing side-effects such as hot flushes and blood clots.

Up to half of breast cancer patients prescribed the drug as a treatment for their tumour give up taking it, research suggests.

Wendy Watson chose to have a preventative double mastectomy at the age of 37 because she knew of nine relatives who had breast cancer.

Ms Watson, who runs a helpline for those at high risk of breast cancer, told BBC Breakfast: "For me, personally, I'm more than happy with the decision that I made and I've been able to take control and get on with my life and do lots of things."

But she said "risk-reducing surgery is not for every woman and I think what we need to do is offer these women as many choices as they can".

Breast nurse specialist Susan Heard, a member of the NICE guidelines development group, told BBC Radio 4's Today programme: "Tamoxifen is not an expensive drug - to give a woman five years of tamoxifen would only cost about £130 - it can cost £12,000 to treat a woman for breast cancer in a year.

"Tamoxifen has been used for 40 years in the treatment of breast cancer very successfully to stop it coming back and I think the healthcare professionals are very familiar with the drug and that experience can be passed on to our patients."

Breast cancer is the most common cancer in the UK, with about 50,000 women and 400 men diagnosed with the condition each year.


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Curious food reactions 'go to heart'

25 June 2013 Last updated at 09:05 ET

Eating honey made from the pollen of rhododendrons can trigger heart arrhythmias, warn experts.

Cardiologists told a European meeting about an unusual case of what is called "mad honey poisoning" in two patients they had treated.

The father and son from Turkey developed heart-related symptoms after eating honey from the Black Sea region.

Although very rare, experts say people should be aware of this possible risk.

'Mad honey poisoning'

Mad honey poisoning occurs after people consume honey contaminated with grayanotoxin, a chemical contained in nectar from the species Rhododendron ponticum and luteum.

Grayanotoxin interferes with chemical messages in the body - in this case, the heart.

Both father and son were admitted to the Izmir emergency department at the same time with symptoms of vomiting and dizziness.

Heart traces known as ECGs revealed they had potentially dangerous heart rhythm disturbances.

The men made a full recovery and were discharged from hospital after a few days.

Dr Ugur Turk, who treated them, said wide distribution of honey around the world meant that physicians anywhere could potentially be faced with honey poisoning - although it was rare.

He said anyone buying honey from Turkey - and particularly the Black Sea area where bees feed on rhododendrons - might want to first consume a small amount and leave it a few days before eating any more to check that they do not experience strange side effects.

There are more common causes of arrhythmia, such as stress, caffeine, tobacco, alcohol and certain medications, including some diet pills and cough and cold medicines.

Not all arrhythmias are dangerous but if you think you have one, you should get it checked by a doctor.

Symptoms include palpitations or awareness of your heartbeat, tiredness, dizziness and fainting.

Doctors attending the European Society of Cardiology meeting heard how people who drink too much cola risk arrhythmias.

One case described was that of a 31-year-old woman from Monaco who, since the age of 15, had stopped drinking water and drunk only cola.


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NHS chief admits culture of 'denial'

25 June 2013 Last updated at 09:32 ET

The NHS in England has a culture of denial and defensiveness when it comes to handling complaints from patients, its outgoing head has admitted.

Sir David Nicholson said efforts were underway to change that in the wake of the Mid Staffs and Care Quality Commission scandals.

But he told a committee of MPs some NHS managers were struggling to adapt.

He also said he regretted not listening to patients when he was head of the body overseeing Mid Staffs.

Sir David has faced a high profile campaign for him to quit over his involvement in the Mid Staffs scandal, in which high death rates and patient mistreatment were ignored.

Giving evidence to the public administration committee, he echoed criticisms in the Francis report into care at Mid Staffs and comments by Health Secretary Jeremy Hunt, who has accused NHS managers of being too defensive, after recent revelations about serious failings at the Care Quality Commission.

'Reputation management'

Sir David told the MPs: "I do think there a real issue about defensiveness and a lack of transparency in the way that we work."

Continue reading the main story

I had an opportunity to meet patients' groups at some stage and I didn't take it... that is the only thing I regret"

End Quote Sir David Nicholson

Asked whether complaints should be viewed as a "good" rather than a "bad" thing in the NHS, Sir David said: "There has been a tradition and a culture in the NHS, for some time which has been counter to that."

Referring to his own time as a complaints manager in an NHS trust, he said: "There is a very strong medical legal litigation culture in organisations and at that time, I know, the answer to any complaint was to deny - because of the potential litigation responsibilities for that.

"So you have got a culture of that in the NHS which... you have got to tackle."

He said "reputation management" was also more of a concern that it should be when failures came to light, which he said was part of the problem at Mid Staffs.

"There is quite a lot of pressure on you as an individual, particularly from your staff, to represent and support your organisation publicly. So they are quite powerful things to combat. My argument is they absolutely have to be combated."

'Regrets'

He said there was a "dramatic" transformation going on in the NHS's relationship with patients, with a more "open" and transparent approach to publishing data and in the organisation's own complaint handling systems.

But he added: "The leadership of the NHS - not everywhere - is having difficulty coming to terms with that and is slightly behind it."

He said NHS managers had been more concerned with meeting targets and pleasing their bosses, such as him, than responding to the needs of patients.

Sir David was in charge of the regional health authority responsible for Mid Staffordshire for a short period while patients were being mistreated.

Reflecting on his time in that role, he said: "I had an opportunity to meet patients' groups at some stage and I didn't take it... that is the only thing I regret."

He said he "felt apologetic" for that but said the data on mortality rates "did not cross my desk" - a situation he said would not happen to managers in the future.

Earlier, an article for the NHS England website Sir David attacked the media and social media for a "lack of balance" in its "views and comments" on the NHS.

He has admitted the fact that he had "become the story" contributed to his decision to retire in March 2014, after seven years as the boss of NHS England.


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Antidepressants 'risk to babies'

Written By Unknown on Senin, 24 Juni 2013 | 21.51

23 June 2013 Last updated at 19:26 ET

The risk posed by some popular antidepressants in early pregnancy is not worth taking for women with mild to moderate depression, an expert has warned.

Professor Stephen Pilling says evidence suggests SSRIs can double the risk of a child being born with a heart defect.

The drugs have been used by up to one in six women of child-bearing age.

A manufacturer contacted by the BBC denies any link to major foetal malformations.

Panorama has spoken to eight mothers who had babies born with serious heart defects after taking a commonly used SSRI (selective serotonin reuptake inhibitors) antidepressant while pregnant. Currently, prescription guidelines for doctors only warn specifically against taking the SSRI, paroxetine, in early pregnancy.

But Prof Pilling, of the National Institute for Health and Care Excellence (NICE), says that advice is about to be updated.

"The available evidence suggests that there is a risk associated with the SSRIs. We make a quite a lot of effort really to discourage women from smoking or drinking even small amounts of alcohol in pregnancy, and yet we're perhaps not yet saying the same about antidepressant medication, which is going to be carrying similar - if not greater - risks," he said.

When Anna Wilson, from Ayrshire, had her 20-week scan, doctors realised her son had a serious heart problem and would need immediate heart surgery when he was born.

Now eight months old, David was hooked up to machines for the first five weeks of his life. He will need more open-heart surgery before he starts school and doctors say he may not live beyond 40.

"He's got a lot of suffering ahead of him before anything else," his mother said. "We know that's a certainty and that's pretty awful."

Four years before she became pregnant, Mrs Wilson was prescribed the drug Citalopram by her GP because she was suffering from anxiety.

Her doctor told her it was fine to continue using the drug when trying for a baby. But after David was born she asked what might have caused his heart condition.

"We did meet with a cardiologist at one of the scan appointments, and he explained that as far as he knew there were no environmental factors and it wasn't because of anything we as parents had done. It was just one of those things - couldn't be prevented," she said.

Prof Pilling says the guidance will now be re-written to take in to account evidence that the SSRI antidepressants, as a group, are linked to heart defects.

He says the risk of any baby being born with a heart defect is around two in 100; but the evidence suggests if the mother took an SSRI in early pregnancy that risk increases to around four in 100.

Professor Stephen Pilling

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Professor Stephen Pilling: "I don't think those risks are really worth taking"

He says that women not suffering from the most severe depression who become pregnant whilst taking the drug are taking an unnecessary risk.

"You've got double the risk. And for women who are mild to moderately depressed, I don't think that those risks, in most cases, are really worth taking" he said.

"It's not just when a woman who's pregnant is sitting in front of you. I think it needs to be thought about with a woman who could get pregnant. And, that's the large majority of women aged between 15 and 45."

Mrs Wilson will never know for sure what caused David's heart defect, but said if she had known there was even a very small risk associated with the drug she would have stopped taking it.

"If David's condition was preventable, and it wasn't prevented, that's really, really awful.

"If somebody had given me the choice in pregnancy and said 'there's a risk of this', I would have stopped taking those tablets in a flash."

Lundbeck, the manufacturer of Citalopram, says a recent review of scientific literature concluded that the drug "does not appear to be associated with an increased risk of major foetal malformations".

"The decision not to prescribe anti-depressants to a woman who is depressed... may generate greater risks to the woman and her foetus than the risks of exposure to the medication."

Panorama: The Truth about Pills and Pregnancy is broadcast on BBC One on Monday 24 June at 20:30 BST.


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Alert over petting farm sickness

24 June 2013 Last updated at 06:47 ET

Public health experts are reminding people to be vigilant against diarrhoeal infections that can be caught by visiting petting farms.

Public Health England says, so far this year, there have been 12 disease outbreaks linked to petting farms across England, affecting 130 people.

People get infected by touching animals or surfaces contaminated by droppings.

The advice is to wash your hands with soap and water - antibacterial gels and wipes will not always work.

Continue reading the main story
  • Do not put hands on faces or fingers in mouths while petting animals or walking round the farm
  • Do not kiss farm animals nor allow children to put their faces close to animals
  • Do not eat or drink while touching animals or walking round the farm
  • Wash your hands thoroughly with soap and water after you have touched animals, fences or other surfaces in animal areas and before eating or drinking
  • Remove and clean boots or shoes that might have become soiled and clean pushchair wheels

Source: Public Health England

For example, gels and wipes do not remove the bacterium E.coli 0157.

It should be assumed that all cattle, sheep and goats will be carrying this infection, say experts.

Dr Bob Adak, head of gastrointestinal diseases at Public Health England, said: "These outbreaks of illness serve as a reminder for anyone visiting a petting farm of the need to wash their hands thoroughly using soap and water after they have handled animals or been in their surroundings - particularly before eating.

"Although we can avoid obvious dirt there will be millions of invisible bacteria spread all around the farm which can get onto our hands.

"Ahead of the seasonal rise in cases of E. coli linked to petting farms we want to remind people not to rely on hand gels and wipes for protection because these are not suitable against the sort of germs found on farms.

"Children should also be closely supervised to ensure they wash their hands properly, as they are more at risk of serious illness.

"By being aware and by doing these simple things we can help to avoid illness and enjoy a fun day out."


21.51 | 0 komentar | Read More

Tesco-style NHS plan 'ridiculous'

24 June 2013 Last updated at 07:31 ET Nick TriggleBy Nick Triggle Health correspondent

Calls to create a 24/7 "Tesco NHS" are ridiculous, according to the leader of the British Medical Association (BMA).

Dr Mark Porter said it was simply not possible when the health service could "barely afford its current model".

Dr Porter spoke out at a BMA conference amid calls to create the same standard of care in hospitals at weekends and nights as during normal hours.

Delegates at the same meeting also passed a vote of no confidence in Health Secretary Jeremy Hunt.

Out-of-hours pressure

The NHS has made 24/7 care one of its key priorities in its review of urgent and emergency care.

Data shows that mortality rates increase during out-of-hours provision.

Continue reading the main story

"Start Quote

Like many of you I work nights and weekends as well, at time when much of the private sector is fast asleep and ministers are tucked up soundly in their beds"

End Quote Dr Mark Porter British Medical Association

Last week NHS England highlighted figures that showed if the same standard of care could be provided seven days a week more than 4,400 lives could be saved each year.

There have also been suggestions routine care - non-emergency operations such as knee and hip replacements, for example - should be made available.

Urgent care

But Dr Porter told the BMA's annual conference in Edinburgh: "Like many doctors here, I feel personally offended by the terms in which this debate has been couched.

"Like many of you I work nights and weekends as well, at time when much of the private sector is fast asleep and ministers are tucked up soundly in their beds.

"Let us be clear. We all want urgent care at weekends and evening to be of the same high standards as patient can expect on weekdays.

"But the calls we sometimes hear for a Tesco NHS, full service, 24/7, are just ridiculous when the health service can barely afford its current model."

'Utter folly'

London GP Dr Chaand Nagpaul said he agreed.

Continue reading the main story

"Start Quote

Doctors are working extremely hard and continue to provide a high quality of care in the face of rising healthcare demands"

End Quote Dr Dan Poulter Health Minister

"It is utter folly to compare the NHS to seven-day supermarket working."

He went on to say that Tesco opened on Sundays because it made a profit, but making the NHS provide a comprehensive service at the weekend would cost money for a "public service with a fixed inadequate budget".

He added it was a "luxury the NHS simply cannot afford".

Faced obstacles

Dr Porter also warned that doctors were struggling to make an impact in the new NHS.

Reforms to give medics more power to shape health services were introduced in April.

But Dr Porter said a combination of cuts, red-tape and relentless pressure meant they were often finding it "impossible" to make improvements.

The BMA received feedback from 1,000 medics about the current conditions.

Nine in 10 complained they had faced obstacles when trying to make improvements.

Facing challenges

Half cited a lack of time as a barrier, 39% financial constraints and a third too much bureaucracy.

Mr Porter said: "It is a grave cause for concern."

Continue reading the main story

"Start Quote

We have been betrayed"

End Quote Jacky Davis Hospital consultant

Addressing the concerns about the current working environment for doctors, Health Minister Dr Dan Poulter said he accepted the health service was facing challenges.

But he praised the work doctors were doing.

"Doctors are working extremely hard and continue to provide a high quality of care in the face of rising healthcare demands. It is thanks to this hard work that the NHS is performing well."

And in a sign of just how angry doctors are, delegates at the conference also passed a vote of no confidence in Health Secretary Jeremy Hunt.

Jacky Davis, a hospital consultant, told the conference: "We have been betrayed."

Last year they also passed a vote of no confidence in then Health Secretary, Andrew Lansley.


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'Big fall' in excess diabetes deaths

Written By Unknown on Minggu, 23 Juni 2013 | 21.24

20 June 2013 Last updated at 19:07 ET By Adam Brimelow Health Correspondent, BBC News

The extra risk of dying for people with diabetes has fallen sharply since the mid 1990s, research suggests

It found in 2009 people with diabetes were 1.5 times more likely to die than those without it in a given period - down from two times as likely in 1996.

The study, in journal Diabetologia covering millions of Canadian and UK patients, concludes this may be due to better treatment and earlier diagnosis.

Diabetes UK says thousands of patients are still dying prematurely every year.

Since the mid 1990s the number of people diagnosed with diabetes in the UK has climbed from fewer than one and a half million to three million.

The disease and its often-fatal complications - including heart disease, stroke and kidney failure - pose a huge and growing challenge for the NHS.

But this study points to progress in cutting deaths. In the mid 1990s, it suggests, people with diabetes were almost twice as likely to die in a given period as those without the disease. By 2009, it indicates, that figure had fallen to about one and a half times the risk.

Mortality rates

The findings are based on population-based databases from Ontario and the UK over the years 1996 to 2009. The researchers compared mortality rates in people with diabetes - including types I and II - and those without.

Continue reading the main story

This paper shows a marked reduction in excess mortality for those with diabetes in the UK from 1996 to 2009 and this is good news for patients"

End Quote Dr Jonathan Valabhji NHS England

In the UK cohort, covering more than three million patients, the excess risk of death for people with diabetes in 1996 was 114%.

By 2009 this had fallen to 65%. In the Ontario database, comprising about 10 million patients, it fell from 90% to 51%.

This narrowing of the mortality gap was seen across all adult age-groups, men and women. However, the authors acknowledge their findings should be treated with caution.

'Aggressive treatment'

They speculate that the improvements may be due to more aggressive treatment, including control of blood pressure and blood sugar levels. But they say the findings may also reflect improved screening, meaning more patients nowadays have not had diabetes for so long.

Dr Alasdair Rankin, director of research for Diabetes UK, said the research was "really good news" - but he warned there was still a long way to go.

"Every year many thousands of people with diabetes in the UK are still dying before their time. This is unacceptable and urgent action is needed to further improve the situation."

Dr Jonathan Valabhji, NHS England's national clinical director for obesity and diabetes, also welcomed the findings, but he said there was still more work to do.

"There are wide regional variations across the country in helping patients manage their condition and this is now a key focus for us."

"By supporting patients to better manage their diabetes, we can work towards reducing the number of patients who suffer complications including amputations or loss of sight," he said.


21.24 | 0 komentar | Read More

Stroke drug 'boosts quality of life'

21 June 2013 Last updated at 07:00 ET By Caroline Parkinson Health editor, BBC News website

Patients given a clot-busting drug within six hours of a stroke are more likely to have a good quality of life 18 months afterwards, an international study suggests.

However, the review of more than 3,000 patients found the drug - alteplase - offered no improvement in survival rates.

The drug is increasingly being used in specialist stroke units in the UK.

The Stroke Association said the Lancet Neurology research was "encouraging".

Quality of life

The treatment is given to patients who have had an ischaemic stroke, when the brain's blood supply is interrupted by a clot.

Continue reading the main story

"Start Quote

The sooner patients receive treatment the more likely they are to make a better recovery"

End Quote Dr Clare Walton, Stroke Association

A stroke can cause permanent damage such as paralysis and speech problems, and can be fatal.

Without treatment, a third of people who suffer a stroke die, with another third left permanently dependent and disabled.

This international trial, led by researchers at the University of Edinburgh, followed patients from 12 different countries - half had the alteplase treatment, which is given intravenously, and half did not.

It was funded by the UK and Australian governments, the UK Stroke Association, the Medical Research Council and Health Foundation UK, with no funding from the pharmaceutical company that makes the drug.

The researchers suggest that for every 1,000 patients given the drug within six hours of stroke, by 18 months, 36 more will be able to manage independently and will have less pain and discomfort than if they had not had it.

However that is the average - and more of those given alteplase within the first hour or two after a stroke will see such benefits.

'Difficult decision'

The drug does carry a risk of causing a potentially fatal bleed in the brain in the first week after treatment for around three in 100 patients.

The experts behind the study say patients and their families have to weigh up the risks as well as the potential benefits.

Continue reading the main story

"Start Quote

It is personal choice, comparing immediate risk versus long-term benefits"

End Quote Prof Peter Sandercock, University of Edinburgh

Prof Peter Sandercock, of the University of Edinburgh's Centre for Clinical Brain Sciences, who led the study, said: "What doctors need to do is to say this is a difficult decision for patients and their families. They have to say this is a treatment that carries risks."

He said someone who had experienced a major stroke which would affect their ability to live and work as they had previously may wish to take the drug, despite the bleed risk, whereas a patient who had a more minor stroke which did not affect them so badly may not.

"It is personal choice, comparing immediate risk versus long-term benefits."

Prof Sandercock added: "In the UK in 2002, the estimated annual cost of long-term care of an independent survivor of stroke and a dependent survivor were £876 and £11,292 respectively, so even a small difference in the proportion of survivors who are able to look after themselves will have a substantial economic impact."

Dr Clare Walton, of the Stroke Association, said: "There are over 150,000 strokes in the UK each year, and around 85% of these are caused by a blood clot in the brain.

"If these patients can get to hospital within four-and-a-half hours, some are eligible for clot-busting treatments which can greatly reduce brain damage and disability after stroke."

She said it was "encouraging" to see that the positive effects of treatment were maintained over the longer term.

Dr Walton added: "When a stroke strikes, time lost is brain lost. The sooner patients receive treatment the more likely they are to make a better recovery."


21.24 | 0 komentar | Read More

Burnham denies CQC pressure claims

23 June 2013 Last updated at 09:33 ET

Ex-health secretary Andy Burnham has denied claims Labour put England's healthcare watchdog under pressure to tone down its reports ahead of the 2010 general election.

The Care Quality Commission has been accused of a cover-up over its response to complaints about several deaths at Furness General Hospital in Cumbria.

The Sunday Telegraph said it had seen papers suggesting Labour pressure.

But Mr Burnham told Sky News he had never said "don't say that" to the CQC.

The controversy stems from the deaths of babies and mothers from 2008 at the Morecambe Bay NHS Trust-run hospital and how they were investigated.

More than 30 families have now taken legal action against the hospital.

The trust was given a clean bill of health in 2010 by the CQC.

But an investigation by consultants Grant Thornton into how deaths and injuries had gone unnoticed found a CQC report into the trust remained unpublished because it was decided it was too critical of the regulator.

Grant Thornton concluded this "might well have constituted a deliberate cover-up" by the CQC employees who deemed it should not be made public.

'Serious questions'

The Sunday Telegraph said it had seen a cache of documents "which detail a regulator apparently intent on suppressing negative publicity about the NHS, amid political pressure from then-Labour ministers and their advisers before the election".

Continue reading the main story

I don't know whether concerns were raised as part of a more general meeting and I would have to review all the paperwork to provide that reassurance"

End Quote Andy Burnham on the Morecambe Bay NHS Trust

And, on Saturday, Morecambe and Lunesdale's Tory MP David Morris wrote an open letter to Mr Burnham saying there were "serious questions" for Mr Burnham and Labour to answer over the cover-up scandal including "how much pressure did you put on the CQC to tone down its criticism of hospitals?"

Mr Burnham, now shadow health secretary, told Sky News' Murnaghan programme he had "no immediate recollection" of having conversations about the Morecambe Bay NHS Trust.

"I don't know whether concerns were raised as part of a more general meeting and I would have to review all the paperwork to provide that reassurance," he added.

"But I'm prepared to do that."

He said it was significant that he speeded up the introduction of a system for assessing and registering NHS hospitals while he was health secretary.

"The central allegation that I was kind of, in that period, trying to say 'don't do anything, don't say anything, don't bring any problems out, keep them all hidden' is fundamentally disproved by the decisions I took in relation to the expediting the registration of hospitals," he said.

He said it was important to stress that "this cover-up, the deletion of the report, happened on this government's watch - not on our watch."

On Friday, Health Secretary Jeremy Hunt said there should be "very, very serious consequences" for anyone found guilty of a cover-up at the CQC.


21.24 | 0 komentar | Read More

'Big fall' in excess diabetes deaths

Written By Unknown on Sabtu, 22 Juni 2013 | 21.24

20 June 2013 Last updated at 19:07 ET By Adam Brimelow Health Correspondent, BBC News

The extra risk of dying for people with diabetes has fallen sharply since the mid 1990s, research suggests

It found in 2009 people with diabetes were 1.5 times more likely to die than those without it in a given period - down from two times as likely in 1996.

The study, in journal Diabetologia covering millions of Canadian and UK patients, concludes this may be due to better treatment and earlier diagnosis.

Diabetes UK says thousands of patients are still dying prematurely every year.

Since the mid 1990s the number of people diagnosed with diabetes in the UK has climbed from fewer than one and a half million to three million.

The disease and its often-fatal complications - including heart disease, stroke and kidney failure - pose a huge and growing challenge for the NHS.

But this study points to progress in cutting deaths. In the mid 1990s, it suggests, people with diabetes were almost twice as likely to die in a given period as those without the disease. By 2009, it indicates, that figure had fallen to about one and a half times the risk.

Mortality rates

The findings are based on population-based databases from Ontario and the UK over the years 1996 to 2009. The researchers compared mortality rates in people with diabetes - including types I and II - and those without.

Continue reading the main story

This paper shows a marked reduction in excess mortality for those with diabetes in the UK from 1996 to 2009 and this is good news for patients"

End Quote Dr Jonathan Valabhji NHS England

In the UK cohort, covering more than three million patients, the excess risk of death for people with diabetes in 1996 was 114%.

By 2009 this had fallen to 65%. In the Ontario database, comprising about 10 million patients, it fell from 90% to 51%.

This narrowing of the mortality gap was seen across all adult age-groups, men and women. However, the authors acknowledge their findings should be treated with caution.

'Aggressive treatment'

They speculate that the improvements may be due to more aggressive treatment, including control of blood pressure and blood sugar levels. But they say the findings may also reflect improved screening, meaning more patients nowadays have not had diabetes for so long.

Dr Alasdair Rankin, director of research for Diabetes UK, said the research was "really good news" - but he warned there was still a long way to go.

"Every year many thousands of people with diabetes in the UK are still dying before their time. This is unacceptable and urgent action is needed to further improve the situation."

Dr Jonathan Valabhji, NHS England's national clinical director for obesity and diabetes, also welcomed the findings, but he said there was still more work to do.

"There are wide regional variations across the country in helping patients manage their condition and this is now a key focus for us."

"By supporting patients to better manage their diabetes, we can work towards reducing the number of patients who suffer complications including amputations or loss of sight," he said.


21.24 | 0 komentar | Read More

Stroke drug 'boosts quality of life'

21 June 2013 Last updated at 07:00 ET By Caroline Parkinson Health editor, BBC News website

Patients given a clot-busting drug within six hours of a stroke are more likely to have a good quality of life 18 months afterwards, an international study suggests.

However, the review of more than 3,000 patients found the drug - alteplase - offered no improvement in survival rates.

The drug is increasingly being used in specialist stroke units in the UK.

The Stroke Association said the Lancet Neurology research was "encouraging".

Quality of life

The treatment is given to patients who have had an ischaemic stroke, when the brain's blood supply is interrupted by a clot.

Continue reading the main story

"Start Quote

The sooner patients receive treatment the more likely they are to make a better recovery"

End Quote Dr Clare Walton, Stroke Association

A stroke can cause permanent damage such as paralysis and speech problems, and can be fatal.

Without treatment, a third of people who suffer a stroke die, with another third left permanently dependent and disabled.

This international trial, led by researchers at the University of Edinburgh, followed patients from 12 different countries - half had the alteplase treatment, which is given intravenously, and half did not.

It was funded by the UK and Australian governments, the UK Stroke Association, the Medical Research Council and Health Foundation UK, with no funding from the pharmaceutical company that makes the drug.

The researchers suggest that for every 1,000 patients given the drug within six hours of stroke, by 18 months, 36 more will be able to manage independently and will have less pain and discomfort than if they had not had it.

However that is the average - and more of those given alteplase within the first hour or two after a stroke will see such benefits.

'Difficult decision'

The drug does carry a risk of causing a potentially fatal bleed in the brain in the first week after treatment for around three in 100 patients.

The experts behind the study say patients and their families have to weigh up the risks as well as the potential benefits.

Continue reading the main story

"Start Quote

It is personal choice, comparing immediate risk versus long-term benefits"

End Quote Prof Peter Sandercock, University of Edinburgh

Prof Peter Sandercock, of the University of Edinburgh's Centre for Clinical Brain Sciences, who led the study, said: "What doctors need to do is to say this is a difficult decision for patients and their families. They have to say this is a treatment that carries risks."

He said someone who had experienced a major stroke which would affect their ability to live and work as they had previously may wish to take the drug, despite the bleed risk, whereas a patient who had a more minor stroke which did not affect them so badly may not.

"It is personal choice, comparing immediate risk versus long-term benefits."

Prof Sandercock added: "In the UK in 2002, the estimated annual cost of long-term care of an independent survivor of stroke and a dependent survivor were £876 and £11,292 respectively, so even a small difference in the proportion of survivors who are able to look after themselves will have a substantial economic impact."

Dr Clare Walton, of the Stroke Association, said: "There are over 150,000 strokes in the UK each year, and around 85% of these are caused by a blood clot in the brain.

"If these patients can get to hospital within four-and-a-half hours, some are eligible for clot-busting treatments which can greatly reduce brain damage and disability after stroke."

She said it was "encouraging" to see that the positive effects of treatment were maintained over the longer term.

Dr Walton added: "When a stroke strikes, time lost is brain lost. The sooner patients receive treatment the more likely they are to make a better recovery."


21.24 | 0 komentar | Read More

Hunt: 'Action if CQC cover-up found'

21 June 2013 Last updated at 15:58 ET
Jeremy Hunt MP

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Jeremy Hunt, Health Secretary: "We are moving very fast to turn it round"

Health Secretary Jeremy Hunt has said there should be "very, very serious consequences" for anyone found guilty of a cover-up at the Care Quality Commission.

He said he would support disciplinary action if allegations against individuals are proved.

Mr Hunt said the healthcare regulator for England was "fundamentally flawed" when it was set up four years ago.

But he backed the new management team now running the CQC.

However, Amanda Pollard, a former CQC inspector who left after she became disillusioned, warns there may be more scandals ahead.

She told the BBC: "The managers were very concerned about their own reputations and keeping the reputation of the CQC squeaky clean.

"But in doing so they lost sight of what they ought to be doing, and that was properly inspecting."

The Care Quality Commission was formed in 2009 by the merger of three other regulators: the Healthcare Commission, the Commission for Social Care, and the Mental Health Act Commission.

As well as hospitals, the CQC oversees GPs, dentists, and thousands of care homes.

But critics say the regulator is now too big to do its job properly.

A spokeswoman for the National Care Association said the CQC was "not really fit for purpose".

Legal action
GP and elderly patient filling in a form

Please turn on JavaScript. Media requires JavaScript to play.

The current controversy stems from the deaths of babies and mothers in Cumbria from 2008 at Furness General Hospital, run by the Morecambe Bay NHS Trust, and how that was investigated.

More than 30 families have now taken legal action against the hospital.

The trust was given a clean bill of health in 2010 by the CQC.

But an internal review was ordered by the hospital regulator in 2011 into how the deaths and injuries had gone unnoticed.

An investigation by consultants Grant Thornton, made public this week, found that that report remained unpublished because it was decided it was too critical of the CQC.

Grant Thornton concluded this "might well have constituted a deliberate cover-up" by the CQC employees who deemed it should not be made public.

Denials

The CQC said the officials alleged to have been involved were former chief executive Cynthia Bower, her deputy Jill Finney and media manager Anna Jefferson.

They were all said to be present at a meeting where deletion of a critical report was allegedly discussed.

Ms Bower and Ms Jefferson have denied being involved in a cover-up.

Ms Finney said that any suggestion she had asked for the report to be deleted was untrue, adding that she had made sure it was given to Grant Thornton for their review.

She has been sacked from her current job as chief commercial officer at Nominet, which controls the .co.uk web domain, because of "increasing public scrutiny".

Mr Hunt acknowledged he did not have very much confidence in the CQC at the moment, but said he had confidence that new people appointed would turn the organisation around.

He told the BBC: "What I really wanted to do was to start inspecting hospitals in a rigorous way, in a way that we have, for example, with schools under Ofsted, where the public know just how good their local school is, because someone they trust, someone who's an expert, has come in and looked at that school without fear or favour and given a verdict."


21.24 | 0 komentar | Read More

'Big fall' in excess diabetes deaths

Written By Unknown on Jumat, 21 Juni 2013 | 21.24

20 June 2013 Last updated at 19:07 ET By Adam Brimelow Health Correspondent, BBC News

The extra risk of dying for people with diabetes has fallen sharply since the mid 1990s, research suggests

It found in 2009 people with diabetes were 1.5 times more likely to die than those without it in a given period - down from two times as likely in 1996.

The study, in journal Diabetologia covering millions of Canadian and UK patients, concludes this may be due to better treatment and earlier diagnosis.

Diabetes UK says thousands of patients are still dying prematurely every year.

Since the mid 1990s the number of people diagnosed with diabetes in the UK has climbed from fewer than one and a half million to three million.

The disease and its often-fatal complications - including heart disease, stroke and kidney failure - pose a huge and growing challenge for the NHS.

But this study points to progress in cutting deaths. In the mid 1990s, it suggests, people with diabetes were almost twice as likely to die in a given period as those without the disease. By 2009, it indicates, that figure had fallen to about one and a half times the risk.

Mortality rates

The findings are based on population-based databases from Ontario and the UK over the years 1996 to 2009. The researchers compared mortality rates in people with diabetes - including types I and II - and those without.

Continue reading the main story

This paper shows a marked reduction in excess mortality for those with diabetes in the UK from 1996 to 2009 and this is good news for patients"

End Quote Dr Jonathan Valabhji NHS England

In the UK cohort, covering more than three million patients, the excess risk of death for people with diabetes in 1996 was 114%.

By 2009 this had fallen to 65%. In the Ontario database, comprising about 10 million patients, it fell from 90% to 51%.

This narrowing of the mortality gap was seen across all adult age-groups, men and women. However, the authors acknowledge their findings should be treated with caution.

'Aggressive treatment'

They speculate that the improvements may be due to more aggressive treatment, including control of blood pressure and blood sugar levels. But they say the findings may also reflect improved screening, meaning more patients nowadays have not had diabetes for so long.

Dr Alasdair Rankin, director of research for Diabetes UK, said the research was "really good news" - but he warned there was still a long way to go.

"Every year many thousands of people with diabetes in the UK are still dying before their time. This is unacceptable and urgent action is needed to further improve the situation."

Dr Jonathan Valabhji, NHS England's national clinical director for obesity and diabetes, also welcomed the findings, but he said there was still more work to do.

"There are wide regional variations across the country in helping patients manage their condition and this is now a key focus for us."

"By supporting patients to better manage their diabetes, we can work towards reducing the number of patients who suffer complications including amputations or loss of sight," he said.


21.24 | 0 komentar | Read More

Stroke drug 'boosts quality of life'

21 June 2013 Last updated at 07:00 ET By Caroline Parkinson Health editor, BBC News website

Patients given a clot-busting drug within six hours of a stroke are more likely to have a good quality of life 18 months afterwards, an international study suggests.

However, the review of more than 3,000 patients found the drug - alteplase - offered no improvement in survival rates.

The drug is increasingly being used in specialist stroke units in the UK.

The Stroke Association said the Lancet Neurology research was "encouraging".

Quality of life

The treatment is given to patients who have had an ischaemic stroke, when the brain's blood supply is interrupted by a clot.

Continue reading the main story

"Start Quote

The sooner patients receive treatment the more likely they are to make a better recovery"

End Quote Dr Clare Walton, Stroke Association

A stroke can cause permanent damage such as paralysis and speech problems, and can be fatal.

Without treatment, a third of people who suffer a stroke die, with another third left permanently dependent and disabled.

This international trial, led by researchers at the University of Edinburgh, followed patients from 12 different countries - half had the alteplase treatment, which is given intravenously, and half did not.

It was funded by the UK and Australian governments, the UK Stroke Association, the Medical Research Council and Health Foundation UK, with no funding from the pharmaceutical company that makes the drug.

The researchers suggest that for every 1,000 patients given the drug within six hours of stroke, by 18 months, 36 more will be able to manage independently and will have less pain and discomfort than if they had not had it.

However that is the average - and more of those given alteplase within the first hour or two after a stroke will see such benefits.

'Difficult decision'

The drug does carry a risk of causing a potentially fatal bleed in the brain in the first week after treatment for around three in 100 patients.

The experts behind the study say patients and their families have to weigh up the risks as well as the potential benefits.

Continue reading the main story

"Start Quote

It is personal choice, comparing immediate risk versus long-term benefits"

End Quote Prof Peter Sandercock, University of Edinburgh

Prof Peter Sandercock, of the University of Edinburgh's Centre for Clinical Brain Sciences, who led the study, said: "What doctors need to do is to say this is a difficult decision for patients and their families. They have to say this is a treatment that carries risks."

He said someone who had experienced a major stroke which would affect their ability to live and work as they had previously may wish to take the drug, despite the bleed risk, whereas a patient who had a more minor stroke which did not affect them so badly may not.

"It is personal choice, comparing immediate risk versus long-term benefits."

Prof Sandercock added: "In the UK in 2002, the estimated annual cost of long-term care of an independent survivor of stroke and a dependent survivor were £876 and £11,292 respectively, so even a small difference in the proportion of survivors who are able to look after themselves will have a substantial economic impact."

Dr Clare Walton, of the Stroke Association, said: "There are over 150,000 strokes in the UK each year, and around 85% of these are caused by a blood clot in the brain.

"If these patients can get to hospital within four-and-a-half hours, some are eligible for clot-busting treatments which can greatly reduce brain damage and disability after stroke."

She said it was "encouraging" to see that the positive effects of treatment were maintained over the longer term.

Dr Walton added: "When a stroke strikes, time lost is brain lost. The sooner patients receive treatment the more likely they are to make a better recovery."


21.24 | 0 komentar | Read More

CQC head 'no value' to police case

21 June 2013 Last updated at 09:57 ET By Tom Bateman Reporter

The Care Quality Commission told police that their former chief executive, Cynthia Bower, would not "add value" to their investigation into the deaths of babies at Furness General Hospital.

The regulator said police did not need to take a witness statement from her.

Emails seen by the BBC show officers in Cumbria had asked to speak to Cynthia Bower and two others at the CQC, which regulates healthcare in England.

Police were investigating the death of baby Joshua Titcombe at the hospital.

But the CQC told police Ms Bower and a second official had no day-to-day involvement in the case.

They added that witness statements would therefore not "add any value to the investigation".

The details of the police enquiries are revealed in email correspondence over four days in January 2012.

In one message, a detective says: "I have listed the names of the people I need to speak to and the reason for obtaining a statement."

Ms Bower's name is then listed alongside the names of two other senior officials at the watchdog with the sentence: "I need to obtain a statement from you and your involvement in the CQC investigation."

The police acknowledge that the individuals may only have been copied into emails about the case and in which case a statement would not be required.

A CQC official later tells the police that Ms Bower and another official did not have "direct day to day involvement" with the case, and would only have been copied into correspondence about it as a matter of procedure.

The CQC official then says that neither Ms Bower nor another official "are able to furnish police with witness statements that would add any value to the investigation".

'Series of errors'

Cumbria police were looking into the case of nine-day-old Joshua Titcombe who died from a treatable infection after being born at the maternity ward of Furness General Hospital.

A coroner's report identified a series of errors by medical staff and police later widened their inquiry to include the deaths of a number of other babies at the hospital.

This week an independent report into the CQC's handling of events at the local health trust in Morecambe Bay was highly critical of the watchdog, listing a series of failures and "missed opportunities".

The report also found evidence of an alleged cover-up, in which Ms Bower was said to be present at a meeting where an instruction was given to delete an internal review critical of the CQC.

Ms Bower denies having any note or recollection of the instruction being to given to delete a report and says she would have countermanded it.

The meeting is said to have taken place in March 2012, less than two months after the exchange of emails between the CQC and Cumbria Police.

Joshua Titcombe's father James says he was "surprised" when he first learned that police didn't see any value in a witness statement from Cynthia Bower, describing the situation as "questionable".

"There's an urgent need now for police to investigate Cynthia Bower's actions," he said.

Cumbria police say they were not investigating the CQC and they obtained witness statements from those people they needed to speak to at the watchdog.

In a statement the force says: "Any decisions regarding investigating the CQC will be considered in due course when all the relevant information is available."

The CQC says it stands by its position from last year regarding witness statements to Cumbria Police.

Ms Bower could not be reached for comment regarding the decision not to give police a witness statement.


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Naked mole-rat gives cancer clues

Written By Unknown on Kamis, 20 Juni 2013 | 21.24

19 June 2013 Last updated at 13:01 ET By Helen Briggs BBC News

A rodent that never gets cancer could hold the key to preventing or treating malignant tumours, say scientists.

Lab studies show the skin cells of the naked mole-rat are high in a natural sugary substance that stops tumours developing.

The findings could lead to new human cancer therapies in the long term, researchers report in Nature journal.

A similar version of the chemical is used as a medicine to treat arthritis and in anti-wrinkle jabs.

A team led by researchers from the University of Rochester, New York, US, investigated the anti-cancer properties of the naked mole-rat.

Unlike other small rodents, such as rats and mice, the curious creature does not get cancer in later life.

Tissue repair
Continue reading the main story

"Start Quote

This fascinating research builds on previous work revealing the biological tricks mole rats have evolved to prevent cancer"

End Quote Oliver Childs Cancer Research UK

The US team, led by Andrei Seluanov and Vera Gorbunova, cultured skin cells from the rodent in the laboratory.

They found that the animal's tissues were rich in high molecular weight hyaluronan (HMW-HA), a gooey sugar that is involved in tissue repair.

Similar versions of the substance are licensed to relieve pain in arthritis and are used as cosmetic fillers to treat wrinkles, say the researchers.

Experiments show that when HMW-HA is removed from naked mole-rat cells, they become susceptible to cancer, suggesting it plays a role in making the rodent "cancer-proof".

Dr Gorbunova told BBC News: "Studying animals that are naturally cancer-resistant can be very rewarding and can lead to discovery of mechanisms that can benefit humans in terms of treatment and prevention of cancer."

Flexible skin

The researchers think the substance gives the naked mole-rat its distinctive, elastic "baggy" skin, which it needs to squeeze through underground tunnels.

Continue reading the main story

The naked mole-rat

  • Naked mole-rats can live for around 30 years, an age unprecedented in small rodents
  • Mice, in comparison, live for no longer than 4 years
  • The rodent has no fur and spends its life living underground in dark tunnels in a colony

While it has probably evolved to provide the rodent with an exceptionally flexible skin, it also gives protection against cancer, possibly by stopping cancerous cells from dividing.

The next step, they say, is to test the chemical in mice, then human cells.

Dr Seluanov added: "There's indirect evidence that HMW-HA would work in people.

"It's used in anti-wrinkle injections and to relieve pain from arthritis in knee joints, without any adverse effects.

"Our hope is that it can also induce an anti-cancer response."

The study, carried out with scientists in China and Israel, is published in the journal Nature.

No beauty

Commenting on the research, Oliver Childs of Cancer Research UK said new cancer treatments from the research were "a long way off".

"They're not going to win any beauty contests, but these curious creatures have long interested scientists because of their exceptionally lengthy life spans and resistance to cancer," he said.

"This fascinating research builds on previous work revealing the biological tricks mole-rats have evolved to prevent cancer.

"It's a long way off, but it will be interesting to see if further research can find a way to use hyaluronan to help prevent or treat cancer in humans."


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Alarm over scale of abuse of women

20 June 2013 Last updated at 09:01 ET

More than one in three women worldwide have experienced physical or sexual violence, a report by the World Health Organization and other groups says.

It says 38% of all women murdered were killed by their partners, and such violence is a major contributor to depression and other health problems.

WHO head Margaret Chan said violence against women was "a global health problem of epidemic proportions".

The study also calls for toleration of such attacks worldwide to be halted.

And it says new guidelines must be adopted by health officials around the world to prevent the abuse and offer better protection to victims.

'Fear of stigma'

The report on partner and non-partner violence against women was released by the WHO, the London School of Hygiene and Tropical Medicine (LSHTM) and the South African Medical Research Council (SAMRC).

Its authors say it is the first systematic study of global data, detailing the impact of the abuse on both the physical and mental health of women and girls.

The key findings are:

  • violence by an intimate partner is the most common type of abuse, affecting 30% of women across the globe
  • 38% of all women murdered were killed by their partners
  • 42% of women physically or sexually abused by partners had injuries as a result
  • Victims of non-partner attacks were 2.6 times more likely to experience depression and anxiety compared with women who had not experienced violence
  • Those abused by their partners were almost twice as likely to have similar problems
  • Victims were more likely to have alcohol problems, abortions and acquire sexually transmitted diseases and HIV

"This new data shows that violence against women is extremely common," said report co-author Prof Charlotte Watts from the LSHTM.

"We urgently need to invest in prevention to address the underlying causes of this global women's health problem."

The document adds that "fear of stigma" prevents many women from reporting sexual violence.

It stresses that health officials around the world need to take the issue "more seriously", providing better training for health workers in recognising when women may be at risk of violence and ensuring an appropriate response.

The WHO says it will start implementing new guidelines together with other organisations at the end of June.

Women who have suffered violence from a partner (%)

WHO region Prevalence

Source: WHO, London School of Hygiene & Tropical Medicine, South African Medical Research Council

Low and middle-income regions

AFRICA (Botswana, Cameroon, DR Congo, Ethiopia, Kenya, Lesotho, Liberia, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Uganda, Tanzania, Zambia, Zimbabwe)

36.6%

AMERICAS (Brazil, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, El Salvador, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Paraguay, Peru, Bolivia)

29.8%

EASTERN MEDITERRANEAN (Egypt, Iran, Iraq, Jordan, Palestinian territories)

37.0%

EUROPE (Albania, Azerbaijan, Georgia, Lithuania, Rep of Moldova, Romania, Russia, Serbia, Turkey, Ukraine)

25.4%

SOUTH-EAST ASIA (Bangladesh, East Timor, India, Burma, Sri Lanka, Thailand)

37.7%

WESTERN PACIFIC (Cambodia, China, Philippines, Samoa, Vietnam)

24.6%

High income(Australia, Canada, Croatia, Czech Republic, Denmark, Finland, France, Germany, Hong Kong, Iceland, Ireland, Israel, Japan, Netherlands, New Zealand, Norway, Poland, South Korea, Spain, Sweden, Switzerland, UK, US)

23.2%

Women who have suffered violence from someone who was not their partner (%)

WHO region Prevalence

Source: WHO, London School of Hygiene & Tropical Medicine, South African Medical Research Council

Low and middle income

Africa

11.9%

Americas

10.7%

Eastern Mediterranean

No data

Europe

5.2%

South-East Asia

4.9%

Western Pacific

6.8%

High income

12.6%


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CQC 'to reveal NHS cover-up names'

20 June 2013 Last updated at 09:46 ET By Nick Triggle Health correspondent, BBC News
David Behan

Please turn on JavaScript. Media requires JavaScript to play.

David Behan "We've commissioned a review of that legal advice to see if we can put this information into the public domain"

England's NHS regulator will name some officials accused of covering up a failure to investigate deaths of babies at a Cumbria hospital, ministers say.

Health Secretary Jeremy Hunt said the move - which has yet to be confirmed by the Care Quality Commission - was pleasing.

It comes after mounting pressure on the regulator to name managers who apparently blocked publication of a critical report.

CQC managers are currently in a meeting discussing the issue.

Although ahead of that meeting, CQC chief executive David Behan said he was exploring all legal means possible to see if the names could be released.

Mr Hunt said he was "very pleased".

Continue reading the main story

How inspection regime has improved

The Care Quality Commission has been quick to point out that its inspections have been improved. But what does this mean in practice?

Over the last two years more than 200 extra inspectors have been taken on, bringing the total close to 1,000.

These include people with a background of working in hospitals, care homes and other health settings as well as people from other professions, such as the police, who have an expertise in investigations.

The inspection teams are made up of people from these different backgrounds.

There is also a network of 200 external experts, such as surgeons, senior nurses and pharmacists who are on hand to lend specialist advice and help when needed.

"I think this is a sign that the NHS is changing - because we've had a history of cover-ups going on many, many years and now what's happening is that when there was an issue the new management of the CQC immediately asked for an independent report.

"They published that report yesterday and now as I understand it they've got legal advice that says they can issue the names of the people mentioned in that report. And I think that's so important because there has to be accountability inside the NHS for people's actions and people have to know where the buck stops when something goes wrong."

The alleged decision to block publication of the report emerged on Wednesday when the CQC published a report it had commissioned from consultants Grant Thornton.

The firm was asked by the health regulator to investigate its failure to spot the problems at Furness General Hospital, run by the Morecambe Bay NHS Trust.

In 2010 it gave the hospital a clean bill of health despite problems emerging about the maternity unit.

More than 30 families have now taken legal action against the hospital in relation to baby and maternal deaths and injuries from 2008.

Grant Thornton found that in 2011 an internal review was ordered into how the problems had gone unnoticed.

But in March 2012 it was decided the findings should not be made public because the review was highly critical of the regulator.

That order is said to have come from a senior manager who has not been named and who denies the allegations.

The Grant Thornton report said this "might well have constituted a deliberate cover-up".

'Good faith'

The CQC though removed the names of those involved, arguing it would be a breach of the Data Protection Act.

But this was then rejected by Information Commissioner Christopher Graham.

Continue reading the main story

Data protection laws

The 1998 Data Protection Act details how personal information is used by organisations, businesses and government.

It demands that information is used fairly and legally, is accurate, used for specifically stated purposes and is kept secure.

There have been numerous occasions where data protection has been wrongly cited as a reason something should not happen.

In 2010 the Information Commissioner was forced to warn schools that they could not use it to ban parents from taking pictures of their children in nativity plays.

Its use by police as a defence for not sharing information about Soham killer Ian Huntley was also described as wrong.

In this case the application of the law hangs on whether the public interest outweighs the expectation that actions in a private meeting should not lead to an individual being named.

He said: "What appeared to be going on yesterday was a sort of general duck-out saying, 'Oh, data protection, sorry can't help you,' that's all too common and in this case it certainly looked as if data protection really wasn't the issue."

He said he could not order the CQC to reverse its decision but said he was glad it was looking at the issue.

"So far as the Data Protection Act is concerned, we all have a right to the protection of our personal privacy but if you are a senior official then there are issues about the point at which your privacy is set aside because of over-riding public interest. That's really the issue at stake here," he said.

Mr Behan said he had been advised that "to put people's personal data [into the report] would be a breach of their rights".

"I was acting on the legal advice I was given, I acted in good faith," he told Newsnight.

He said he had "listened to what the information commissioner has said".

He added: "We've decided today that we will review that legal advice and we've commissioned a review of that legal advice to see if we can put this information into the public domain."


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Food labels system to be rolled out

Written By Unknown on Rabu, 19 Juni 2013 | 21.24

18 June 2013 Last updated at 19:10 ET By Nick Triggle Health correspondent, BBC News

A new consistent system of front-of-pack food labelling is to be introduced in the UK, the government says.

A combination of colour coding and nutritional information will be used to show how much fat, salt and sugar and how many calories are in each product.

But as yet only just over 60% of foods will be covered by the system because it will remain voluntary.

The announcement comes after a decade of debate about the issue and has been welcomed by consumer groups.

The introduction of a consistent system has proved problematic partly because of the difficulty of getting industry leaders to agree on the labels and because mandatory regulations require agreement on a European level.

The problems have resulted in a variety of different systems being introduced.

The unveiling of new labels comes after a public consultation last year and months of talks with the food industry.

The deal has been welcomed by campaigners, who have argued a clear and consistent system of food labelling would help combat obesity.

One of the key steps has been the inclusion of colour coding.

Research by the Food Standards Agency has shown that consumers prefer traffic light labelling because it offers key information "at a glance".

Over the next 18 months the new labels will be rolled out across many of the major food groups.

They include retailers such as Tesco, Sainsbury's, Asda, Morrisons, the Co-operative and Waitrose, which will display the labels on their own brand foods, as well as manufacturers Mars, Nestle, PepsiCo and Premier Foods.

'Big step forward'

Public health minister Anna Soubry said: "By having all the major retailers and manufacturers signed up to the consistent label, we will all be able to see at a glance what is in our food - this is why I want to see more manufacturers signing up and using the label."

Richard Lloyd, of consumer group Which?, said it was a "big step forward".

Charlie Powell, director of the Children's Food Campaign, also said the move was pleasing.

But he added: "There are now no excuses - all food companies should follow suit and the government should name and shame any which drag their feet."

He also urged ministers to do more to protect children from junk food marketing.

Among the major names not to have signed up are Coca-Cola and Cadbury - both of which released statements saying they felt the use of guideline daily amounts was a better system.

Andrew Opie of the British Retail Consortium, said of the new labels: "This is great news for consumers.

"A consistent scheme across all the major supermarkets means wherever we shop we will see the same front-of-pack labelling.

"That will help improve understanding of the label and make healthier choices easier."

Source: Institute of Grocery Distribution

Women

Men

Children (5-10 years)

Calories (kcal)

2000

2500

1800

Protein

45g

55g

24g

Carbohydrate

230g

300g

220g

Fat

70g

95g

70g

Fibre

24g

24g

15g

Sodium

2.4g

2.4g

1.4g


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