Osborne confirms extra £2bn for NHS

30 November 2014 Last updated at 14:23

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George Osborne and Ed Balls spoke to the BBC's Andrew Marr about their spending plans

George Osborne has told the BBC he will put an extra £2bn into frontline health services across the UK.

The chancellor said the money was a "down payment" on a plan drawn up by NHS bosses calling for an extra £8bn a year above inflation by 2020.

He said he could make the commitment because the economy was strong.

Labour said the re-organisation of the NHS had created a crisis and accused Mr Osborne of making billions of pounds of unfunded spending commitments.

Shadow chancellor Ed Balls said Labour would commit an extra £2.5bn above Mr Osborne's plan adding that the NHS was "in real crisis".

Mr Osborne's pledge - to be officially announced in his Autumn Statement on Wednesday - comes after NHS England bosses warned of a need for an extra £2bn funding this year, to cope with immediate, unprecedented pressure on NHS budgets.

The chancellor told BBC One's Andrew Marr Show: "Because we have a strong economy and we've got the public finances under control, we can afford to put £2 billion into the frontline of the NHS across the United Kingdom.

"I can tell you we can go further and use those fines that have been paid by the banks for a permanent improvement in GP services.

"This is a down-payment on the NHS's own long-term plan and it shows you can have a strong NHS if you have a strong economy."

Service	Target	Performance
A&E	95% of patients admitted, discharged or transferred in four hours	Missed in recent weeks with average for 2014-15 running at 94.7%
Cancer	Several. Most high-profile is the 62-day target for treatment	Missed for the last nine months
Hospital operations	90% of operations to be done in 18 weeks of a referral	Missed for four months - part of allowed breach to tackle long waiters

Further details are expected on Wednesday when Mr Osborne will update Parliament on his tax and spending plans, based on the latest predictions for the economy.

He rejected claims public services would suffer if funding was cut further and said he would outline how the UK would "stay the course to prosperity".

"We shouldn't face this false choice of either bankrupting the country or having decent public services," he said.

But he added that "difficult decisions" might lie ahead on welfare - possibly freezing working age benefits, although he appeared to rule out cuts to pensioners' benefits.

Health Secretary Jeremy Hunt will make a statement on Monday, in which he is expected to explain where the extra £2bn for the NHS is coming from.

Analysis

By Louise Stewart, BBC political correspondent

For months, NHS leaders have been warning politicians about a growing shortfall in their budget. Today the message from the chancellor was that he's heard their call.

So where will the money come from? Of the £2bn - around £1.3bn of it is new money - the Treasury said it would be found from savings in other government departments. The remaining £700m will come from the existing Department of Health budget and will be put into front line.

The Liberal Democrats are keen to take credit, saying they've fought hard to secure it. Labour say they want to go further and have pledged £2.5bn a year to be spent on the NHS, on top of today's announcements, paid for by a so-called mansion tax and other tax crackdowns.

NHS funding is going to be one of the key battlegrounds ahead of the next election but with figures due out this week expected to confirm that government borrowing is not coming down in line with the Treasury's plans, all parties will face tough questions about how they can increase spending without increasing borrowing yet further.

It is understood that around £1.7bn will go to NHS England, with the remainder going to the devolved administrations, if they wish to spend it on extra health resources.

And it is thought that £1.1bn will be spent over the next Parliament from fines levied on banks for their attempted manipulation of foreign exchange rates.

Mr Hunt will also announce that the government is committed to implementing the five-year plan - NHS Forward View - unveiled by six national bodies last month. Many of the measures put forward are designed to curb the rise in hospital admissions and the impact of the ageing population.

The plans involve increasing spending on the health service in England by £8bn a year in real terms by 2020.

Simon Stevens, chief executive of NHS England, who drew up the proposals, said they had made the case to the chancellor that services were under pressure and "genuine new investment" was needed.

"Of course there will still be pressures and difficult choices, but the government has played its part and the NHS will step up and play our part too. Today represents an extremely welcome vote-of-confidence in the NHS' own five year plan." .

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Simon Stevens, the head of NHS England, has suggested a range of measures, as Dominic Hughes reports

Shadow chancellor Ed Balls blamed the Conservatives for causing a crisis in the NHS through its re-organisation and questioned whether the money would be "an actual long-term investment in the nurses and doctors we need".

He said it was a "typical Tory pattern" of a "winter crisis, and crisis money coming after it".

Mr Balls said Labour's proposed 'mansion tax' on properties worth £2m and over would raise the money to invest £2.5bn "over and above" the government's spending plans into the health service.

Higher deficit

Labour had called for an extra £1bn next year, paid for by banking industry fines.

The Conservatives' coalition partners, the Liberal Democrats, had called for an emergency injection of £1.5bn and a party spokesman said they had "fought to make sure that extra funding for the NHS next year is in the Autumn Statement".

"The easy choice would have been to put off this decision until after the election for the next government to deal with, but that would have betrayed patients. The NHS needs this money urgently and we have acted in the national interest to make it a priority."

Paul Johnson, of the Institute for Fiscal Studies think tank, told the BBC that Mr Osborne would have to admit on Wednesday that the deficit would probably be "a bit higher" than had been predicted in March because of "relatively poor" earnings growth and other tax receipts.

He told BBC1's Sunday Politics programme that by 2018 there would have to be big cuts to other public services including local government and police.

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Ill teenager found care after appeal

29 November 2014 Last updated at 20:11

A teenage girl with mental health problems who was kept in police cells for two days because of a lack of care beds has been found a place to stay.

Concerns for her welfare were raised by Paul Netherton, assistant chief constable at Devon and Cornwall Police.

He spoke out on Twitter on behalf of the girl, who had been held in a cell since Thursday because, he said, no beds were available anywhere in the UK.

NHS England said the 16-year-old would be moved on Saturday night.

A spokesman said: "After details were provided to NHS England about the girl and her condition, a place was found locally within a few hours.

"We are grateful for the help of the NHS in the area in identifying the place.

"It is worth noting that mental health crisis services have been expanding so that the number of people ending up in police cells is in fact down - but clearly more needs to be done."

'Unacceptable'

Earlier on Twitter, Mr Netherton had described the situation as "unacceptable".

He tweeted: "We have a 16yr old girl suffering from mental health issues held in police custody. There are no beds available in the uk!

"The 16yr old was detained on Thursday night, sectioned Friday lunchtime and still no place of safety available. This can't be right!

"Custody on a Fri & Sat night is no place for a child suffering mental health issues. Nurses being sourced to look after her in custody !?!"

He later tweeted: "Just heard that a place of care has been found for our 16yr old. Good result."

Mr Netherton told BBC News the girl had been arrested at Torbay Hospital on Thursday after a breach of the peace and sectioned under the Mental Health Act on Friday because she was "obviously very unwell".

"We shouldn't have children, a schoolgirl, staying overnight in a custody block," he said.

According to the officer, 750 mental health patients had been placed in police cells across Devon and Cornwall so far this year.

'Costing lives'

Shadow health minister Luciana Berger described the teenager's predicament as "an appalling reflection of the crisis in mental health services".

"People shouldn't face the indignity of being kept in police cells when they are at their most vulnerable," she said.

Mark Winstanley, chief executive of mental health charity Rethink, said: "Each year thousands of people with serious mental health problems are being held in police cells, including many children and teenagers, because the right services either don't exist in their community or are completely overstretched.

"Many people are being turned away from places of safety, because of staff shortages or lack of spaces.

"In some parts of the country, there are no health-based places of safety full-stop.

"As a result, people end up being held in police stations, or are simply left to fend for themselves. This has to change, as it's costing lives.

"Someone going through a physical health emergency would never be treated this way, so why should it be acceptable for people experiencing a mental health crisis?"

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Protein 'key to heart muscle defect'

30 November 2014 Last updated at 01:49 By Emma Wilkinson Health reporter, BBC News

The structure of a key protein implicated in diseases affecting the heart muscle has been uncovered, scientists say.

Researchers, including some from King's College London, say they now understand why faulty alpha-actinin stops muscles from working properly when people have the heart disease cardiomyopathy.

Their conclusions could lead to better screening and potential treatment for other conditions caused by the defect.

The research took eight years.

In striated muscle, in the heart as well as skeletal muscles, alpha-actinin holds the layers at regularly spaced intervals over huge distances.

After working out the structure of the protein, the researchers, from King's College London as well as institutions in Russia, Norway and Austria, looked at what happened when it was mutated.

They showed, by tinkering with the structure, that when key parts of the protein were faulty, heart muscle grown in the laboratory did not form the striations needed for it to withstand contractions.

In recent months, genetic analysis has identified several gene mutations in alpha-actinin.

Understanding the structure of the protein will now enable researchers to identify which mutated genes are actually causing problems and which have little effect.

It will have implications for other disease where alpha-actinin has a role, such as some types of muscular dystrophy.

Prof Mathias Gautel, professor of molecular cardiology from King's College London, said: "We have worked out the structure of a major protein responsible for muscle layering.

"This gave us new insights into how muscle is built and how its movement is controlled.

"We hope that this will help geneticists make accurate diagnoses of muscle diseases and may ultimately lead to designing new therapies."

Prof Jeremy Pearson, associate medical director at the British Heart Foundation, which helped fund the research, added: "There is currently no cure or treatment for cardiomyopathy and these findings demonstrate the value of funding laboratory research to answer fundamental questions that could ultimately lead to treatments for patients."

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Anxious teens 'need tailored therapy'

8 November 2014 Last updated at 02:17

A one-size-fits-all approach to treating teenagers with anxiety problems may be putting their futures at risk, a study suggests.

University of Reading psychologists say current childhood therapies are simply being adapted for teenagers.

But they argue that adolescents face distinct issues and call for tailored treatments to address them.

Charities say adolescent and child mental health services are at breaking point and need to change.

Social anxiety

Anxiety problems affect some 300,000 children and adolescents in the UK.

Continue reading the main story

We found teenagers were often receiving treatment designed for younger children which is then simply being adapted or made cooler"

End Quote Dr Polly Waite Lead researcher

Young people are diagnosed with anxiety disorders if anxious feelings seriously affect their everyday lives - for example preventing them from going to school or attending social events.

Those who are offered specialist help are often given cognitive behavioural therapy (CBT) - a talking treatment that involves helping people understand triggers for their anxiety and encourages them to change the way they think about and behave in anxiety-inducing situations.

The study, published in the Journal of Affective Disorders, compared the symptoms of 100 children (aged six to 12 years) with those of 100 teenagers (13 to 18 years) referred for CBT in Berkshire.

Some were given an online version of cognitive behavioural therapy, where participants read about fictional characters and their responses to situations that could make them anxious.

Researchers found teenagers with anxiety disorders were more likely to have serious symptoms and to have anxiety surrounding social situations.

Adolescents were also more likely than children to suffer from depression or low moods.

But lead researcher Polly Waite said: "We found teenagers were often receiving treatment designed for younger children which is then simply being adapted or made cooler.

"For example, some of the pictures used in the online therapy were simply changed from teddy bears to images of grungy teenagers."

Dr Waite added: "Many teenagers therefore will be receiving treatment that does not specifically address symptoms that occur in adolescence.

"This may mean they have poorer treatment outcomes, putting their futures at risk.

"By targeting more effectively, we could stop teenagers developing mental health problems, leading to fewer suicides and incidence of drug and alcohol problems."

'Breaking point'

Researchers say people designing the therapies need to work closely with adolescents to find out what types of words and images are most acceptable to them.

Lucie Russell, of the charity YoungMinds, said: "It is absolutely right we recognise that adolescents have a different set of needs, experiences and challenges to younger children and therefore it is vital that treatments are developed for anxiety that work specifically for them.

"Child and adolescent mental health services are at breaking point with too few resources to meet an ever increasing demand.

"It is worrying but not surprising that sometimes adolescents are not able to receive specific treatment for their needs.

"This needs to change if we want to stop the slide of many young people from children's to adult mental health services because their problems weren't addressed appropriately when they first started to suffer."

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Parkinson's stem cell 'breakthrough'

7 November 2014 Last updated at 00:56

Stem cells can be used to heal the damage in the brain caused by Parkinson's disease, according to scientists in Sweden.

They said their study on rats heralded a "huge breakthrough" towards developing effective treatments.

There is no cure for the disease, but medication and brain stimulation can alleviate symptoms.

Parkinson's UK said there were many questions still to be answered before human trials could proceed.

The disease is caused by the loss of nerve cells in the brain that produce the chemical dopamine ,which helps to control mood and movement.

To simulate Parkinson's, Lund University researchers killed dopamine-producing neurons on one side of the rats' brains.

They then converted human embryonic stem cells into neurons that produced dopamine.

These were injected into the rats' brains, and the researchers found evidence that the damage was reversed.

There have been no human clinical trials of stem-cell-derived neurons, but the researchers said they could be ready for testing by 2017.

Malin Parmar, associate professor of developmental and regenerative neurobiology, said: "It's a huge breakthrough in the field [and] a stepping stone towards clinical trials."

A similar method has been tried in a limited number of patients.

It involved taking brain tissue from multiple aborted foetuses to heal the brain.

Clinical trials were abandoned after mixed results, but about a third of the patients had foetal brain cells that functioned for 25 years.

Using embryonic stem cells may be preferable, as it is easier to get hold of the large numbers of cells needed for transplant by growing them in the laboratory.

It also opens up the possibility of using less ethically charged sources of stem cells, such as those made from adult tissue.

The charity Parkinson's UK said the research "could be a stride towards clinical trials in people with Parkinson's".

Its director of research and development, Arthur Roach, said: "This important research is a key step along the way in helping us to understand how stem cells might shape future Parkinson's treatments.

"There are important potential advantages of these cells over the foetal-derived cells used in past cell transplantation work.

"This study could be a stride towards clinical trials in people with Parkinson's but there are still many questions that need to be answered before this development can be tested in people with the condition."

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Testes 'most distinct human tissue'

8 November 2014 Last updated at 02:13 By James Gallagher Health editor, BBC News website

The testes have been identified as the most distinct type of human tissue by the Royal Institute of Technology in Sweden.

The team have detailed which proteins are active in which tissues of the human body.

It shows the testes needed the most distinct suite of proteins to function.

The Human Protein Atlas has been described as a "really important foundation" for scientific research that could help develop new drugs.

Human DNA contains the instructions for building about 20,000 proteins - the little bits of biological machinery that run our body.

The combination of proteins active in a cell decides its function - a cell for filtering the blood in the kidney works differently to a neuron in the brain.

'Housekeeping'

Scientists have now pieced together which proteins function where and hope the findings could have important implications for medicine.

"Surprisingly for us, there is altogether very little proteins which are enriched in the different parts of the human body and almost half of the 20,000 genes are coding for proteins which are expressed in all cells and tissues of the body," Prof Mathias Uhlen, the project leader, said.

These are described as "housekeeping" proteins necessary to keep every cell functioning.

But 999 proteins were significantly more active in testicular tissue than anywhere else in the body.

The cerebral cortex of the brain had 318, the liver 172 and smooth muscle zero.

Prof Uhlen told the BBC News website: "If you're interested in the brain or neurological disorders or even degenerative diseases like Alzheimer's obviously it is interesting to know which proteins are elevated in the brain."

He speculated the testes were unique because of the complicated method of producing sperm, which need to have half as much DNA as a normal cell.

"Also there are about 600 proteins which are targets for all the pharmaceutical drugs, so you can say where are these targets located in the human body because that gives you indications about side effects."

Antibodies

The team used antibodies designed to latch on to different proteins.

They then exposed 32 types of tissue - representing all the major organs and tissues in the body - to the antibodies to see which ones stuck and therefore which proteins were active.

The team aim to develop a "pathology atlas" that will show what goes wrong during disease and which proteins are involved.

Dr Ewan Birney, the associate director of the EMBL-European Bioinformatics Institute, said the project would complement the rapid advances in understanding DNA.

He told the BBC: "It's looking great - it's going to be a really important foundational resource on top of the bedrock of the Human Genome Project.

"It is going to accelerate both basic and clinical research. It's much closer to the action than genomes.

"About half of proteins we're really head-scratching about what they do... [now there are] proteins we know exist, we know they do something, but now we know where to look."

He argued the testes had more distinctive proteins because of their focus on producing large numbers of sperm without any errors in their genetic code.

Mutations in a normal cell may eventually lead to cancer. However, a mutation in sperm could stop it being able to fertilise an egg, he said.

Meanwhile, the unique brain proteins may be down to a "sheer logistics problem" involved in operating really long nerve cells stretching across the brain, he argued.

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Ashya 'not receiving chemotherapy'

6 November 2014 Last updated at 22:30 By David Fenton Health correspondent, BBC South Today

The hospital in Prague which treated five-year-old Ashya King for a brain tumour, has confirmed he received no chemotherapy - a key part of his original treatment plan.

His father said he did not need it as the tumour was now "in remission".

But a leading UK cancer expert has said, without chemotherapy, children's chances of survival could be reduced.

Ashya is being cared for at a private hospital in Spain and is receiving physiotherapy and speech therapy.

He is said to be doing well, and even saying a few words.

Ashya's story received global attention in August when he was taken from Southampton General Hospital without medical consent, sparking an international hunt.

His parents Brett and Naghemeh, of Southsea, Hampshire, took him to Spain where they were arrested and held in a prison in Madrid.

They had wanted him to undergo proton beam therapy, which had not been recommended by doctors treating him.

The couple were later released and the NHS agreed to fund his treatment in September.

Speaking after Ashya finished a course of proton beam therapy at a special clinic in Prague, his father, Brett King, said he did not need a separate course of chemotherapy.

He said: "We came to a conclusion [with] the doctors that, really, he doesn't need it... They've done MRIs that don't show any visible signs that there's a tumour - it's in what they call remission."

'It responds well'

The Motol Hospital, where Ashya had been staying, confirmed no chemotherapy had been given.

But a leading cancer expert said, without chemotherapy, the survival rate for children with medulloblastoma - the type of tumour Ashya had - could be significantly reduced from 80% to about 50%.

Prof Roger Taylor, vice president of clinical oncology for the Royal College of Radiologists, said chemotherapy in conjunction with radiotherapy was the "standard course of treatment - without exception" for children with that type of brain tumour.

He said: "For the last 15 years or more we have been using chemotherapy routinely for all children. It's been known for several decades that medulloblastoma responds well to chemotherapy."

NHS England is expected to pay up to £80,000 for Ashya's treatment in Prague. It has so far not commented on the latest development.

Dr Cortes Funes, who is caring for Ashya in Spain, told the BBC the boy was doing well and the medical team was waiting to decide what treatment to give him next.

He said one option may be a course of immunotherapy, which uses antibodies and stem cells to boost the body's defence against cancer.

What is proton beam therapy?

• It uses charged particles instead of X-rays to deliver radiotherapy for cancer patients
• The treatment allows high-energy protons to be targeted directly at a tumour, reducing the dose to surrounding tissues and organs
• In general, it gives fewer side effects compared with high-energy X-ray treatments
• It can be used to treat spinal cord tumours, sarcomas near the spine or brain, prostate cancer, lung cancer, liver cancer and some children's cancers

Sources: NHS England, Cancer Research UK

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Parkinson's stem cell 'breakthrough'

7 November 2014 Last updated at 00:56

Stem cells can be used to heal the damage in the brain caused by Parkinson's disease, according to scientists in Sweden.

They said their study on rats heralded a "huge breakthrough" towards developing effective treatments.

There is no cure for the disease, but medication and brain stimulation can alleviate symptoms.

Parkinson's UK said there were many questions still to be answered before human trials could proceed.

The disease is caused by the loss of nerve cells in the brain that produce the chemical dopamine ,which helps to control mood and movement.

To simulate Parkinson's, Lund University researchers killed dopamine-producing neurons on one side of the rats' brains.

They then converted human embryonic stem cells into neurons that produced dopamine.

These were injected into the rats' brains, and the researchers found evidence that the damage was reversed.

There have been no human clinical trials of stem-cell-derived neurons, but the researchers said they could be ready for testing by 2017.

Malin Parmar, associate professor of developmental and regenerative neurobiology, said: "It's a huge breakthrough in the field [and] a stepping stone towards clinical trials."

A similar method has been tried in a limited number of patients.

It involved taking brain tissue from multiple aborted foetuses to heal the brain.

Clinical trials were abandoned after mixed results, but about a third of the patients had foetal brain cells that functioned for 25 years.

Using embryonic stem cells may be preferable, as it is easier to get hold of the large numbers of cells needed for transplant by growing them in the laboratory.

It also opens up the possibility of using less ethically charged sources of stem cells, such as those made from adult tissue.

The charity Parkinson's UK said the research "could be a stride towards clinical trials in people with Parkinson's".

Its director of research and development, Arthur Roach, said: "This important research is a key step along the way in helping us to understand how stem cells might shape future Parkinson's treatments.

"There are important potential advantages of these cells over the foetal-derived cells used in past cell transplantation work.

"This study could be a stride towards clinical trials in people with Parkinson's but there are still many questions that need to be answered before this development can be tested in people with the condition."

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Inherited bugs may help weight loss

7 November 2014 Last updated at 08:45

Our genes influence whether we are fat or thin by shaping which types of microbes thrive in our gut, scientists say.

The discovery suggested healthy bacteria might one day be used to treat obesity, they told the journal Cell.

By studying human twins, they found a type of bacteria that was not only associated with being thin but also seemed to run in families.

Transplanting some of these microbes into mice slowed down weight gain.

The study is the first to suggest certain types of naturally occurring gut bacteria are inherited.

Analysing faecal samples from 416 UK twin pairs, the researchers found the abundance of Christensenellaceae bacteria was more similar in identical twins, who share exact DNA, than in fraternal twins, who are genetically just like ordinary siblings.

The results also showed Christensenellaceae was more common in lean individuals.

When the researchers treated mice with a specific member of this bacterial family, isolated from the twin study, the animals gained less weight than mice that did not get this treatment.

Study leader Dr Ruth Ley, associate professor in the department of microbiology at Cornell University, said even though their initial findings had suggested the bacterium could be contributing to a "lean phenotype", they had been fairly stunned to see its effect in mice and had repeated the experiment several times.

They are now working to identify what genes seem to influence the presence of Christensenellaceae bacteria and why it would have this effect on weight.

"Once we have found out how it works in mice, if it seems like we can apply that to humans we can look into developing this as a probiotic to regulate weight."

However, Dr Ley pointed out that the overarching factor contributing to obesity was a sedentary lifestyle.

Prof David Haslam, chairman of the National Obesity Forum, said the results took the argument further away from poor personal choice "when you realise we have millions of gut bacteria that are making these decisions for us".

"It is very exciting data and a rapidly evolving field. It is like science fiction - these small creatures that we can't identify and we're full of them."

He added: "It begs so many questions like if you take too many antibiotics what does that do to your gut bacteria?"

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'Ethical duty' to cut NHS waste

6 November 2014 Last updated at 11:35 By Adam Brimelow Health Correspondent, BBC News

Doctors have an ethical duty to prevent waste in the NHS, argues a report by the Academy of Medical Royal Colleges.

Its authors point to potential savings of nearly £2bn. Examples include better use of medication, tests, hospital beds and operating theatres.

The British Medical Association said doctors were ideally placed to identify savings, but patients must come first.

The health secretary said he was determined to tackle avoidable waste in healthcare.

Unnecessary scans

The report is based on the premise that one doctor's waste is another patient's delay, and may even mean treatment is withheld.

The authors argue it is better to develop a culture of finding the best way to do something, and then do it right across the health service.

Continue reading the main story

We need to be innovative to tackle the huge financial challenges we are facing"

End Quote Sir Bruce Keogh NHS England Medical Director

There are 16 examples of changes to clinical practice which have saved money and benefited patients.

They include medication reviews to prevent adverse drug reactions, which account for 6% of all hospital admissions. The report says eradicating this problem would save £466m.

It also suggests more than £200m could be saved by stopping unnecessary scans.

Other recommendations include:

• Prescribing lower-cost statins, which could save £85m
• Reducing unnecessary face-to-face contact between patients and healthcare professionals by using technology such as e-mail and Skype
• Cutting the number of X-rays for lumbar spine or knee problems, which could save £221m
• More frequent consultant ward visits to ensure patients can be discharged promptly

The report does not provide a definitive total of potential savings, but indicates what a change in culture - where doctors resolve to eradicate waste - could potentially deliver.

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Consultant Jeremy Lavy explains how his team reduced the number of tools they needed in surgery

Savings in surgery

Surgeons at the Royal Throat Nose and Ear Hospital in London have reduced the number of instruments required for cochlear implant operations, from 96 to 28.

This has saved money on cleaning and wear and tear. And it has reduced the risk of cancellations or costly delays caused by incomplete equipment.

A surgeon at the hospital, Jeremy Lavey, said doctors were well-placed to identify savings.

"We have a responsibility because we're in the best position to say I can use this one, I don't need to use that.

"A manager can't make that decision whereas we are ideally positioned and we have a responsibility to make sure we do that properly," he said.

Professor Terence Stephenson, chairman of the Academy of Medical Royal Colleges, said: "Maintaining NHS services in the future depends on doctors ensuring the best use of resources today.

"Quality of care is a doctor's prime concern. But delivering quality care and promoting value are really two sides of the same coin," he said.

'Improve efficiency'

Speaking to BBC Radio 5 live, co-leader of the National Health Action Party Clive Peedell welcomed some of the recommendations, but noted that "a lot of this is already being done" and warned that efficiency savings had already "created real problems".

Areas of potential savings

Source: Academy of Medical Royal Colleges
Improved liaison with psychiatric services	£568m
Cost of bed days caused by adverse drug reactions	£466m
Wasted medicines	£300m
Reducing radiology (x-ray) referrals	£221m
Access to specialist care	£104m
Prescribing lower cost statins	£85m
Using telehealth clinics	£16m
Total potential savings	£1.76bn

Professor Sir Bruce Keogh, the NHS England Medical Director, welcomed the report.

"We need to be innovative to tackle the huge financial challenges we are facing, but there are also some more everyday changes that we can make to improve efficiency. This report neatly embodies some practical ideas for more efficient practice," he said.

Health Secretary Jeremy Hunt said: "We have launched a safety campaign aiming to halve avoidable harm and recently published a report showing the costs of unsafe care may be as high as £2.5 billion a year.

"Today's report builds on this and underlines the potential for savings."

Dr Ian Wilson from the British Medical Association said doctors had already played a leading role in helping to find more efficient ways of delivering patient care.

He added a note of caution: "While staff and management should work closely to maximize the use of the NHS's very limited resources, a doctor's primary duty is to their patient, and it is vitally important that decisions around patient care are around clinical value."

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Savile hospital abuse inquiry widens

6 November 2014 Last updated at 12:48 By James Gallagher Health editor, BBC News website

The number of NHS organisations investigating allegations of abuse by Jimmy Savile has been extended to 41, the Health Secretary Jeremy Hunt says.

The findings of inquiries at 28 hospitals were published in June.

A further wave of allegations has since emerged at some of those hospitals, and meanwhile a further eight hospitals and one ambulance service are starting investigations.

The results are expected in January 2015.

The former BBC presenter of Top Of The Pops and Jim'll Fix It, who also worked as a Radio 1 DJ and received a knighthood in 1990, died aged 84 in October 2011.

He was an opportunistic and prolific sex offender, who took advantage of his celebrity status to carry out abuse in dozens of NHS hospitals, according to the reports published in June.

Assaults on victims aged from five to 75 were described in reports into Leeds General Infirmary and Broadmoor.

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"Jane" was abused by Savile when she was staying in hospital aged 16

Wider net

Reports from four hospitals which were also due in June - Stoke Mandeville, Rampton Hospital in Nottinghamshire, Springfield Hospital in London and Crawley Hospital in West Sussex - but have been delayed.

Eight further hospitals are starting fresh inquiries:

• Birch Hill Hospital in Rochdale
• Scott House Hospital in Rochdale
• Bethlem Royal Hospital in London
• Shenley Hospital in London
• St Martin's Hospital in Canterbury
• Queen Elizabeth Hospital in Gateshead
• Meanwood Park Hospital near Leeds
• Calderdale Royal Hospital

West Yorkshire Ambulance Service is also investigating allegations.

Not all the hospitals mentioned are still in existence, including Shenley psychiatric hospital and Meanwood Park, while others have changed function.

The allegations at Scott House Hospital relate to a period the site served as a children's home. And Calderdale Royal Hospital is built on the site of the former Halifax Royal Infirmary where the alleged abuse took place.

The precise details of Savile's links with all these institutions or the number of alleged offences are unknown.

The Queen Elizabeth Hospital has launched an investigation after it found records of visits by Savile, but there have been no specific allegations of abuse by the public.

'Sports event'

Continue reading the main story

It seems that his net spread very far and wide"

End Quote Peter Garsden Association of child abuse lawyers

The Shenley Hospital closed in 1998, but the Central and North West London NHS Foundation Trust is conducting the investigation.

It said: "The allegation is about a teenager, not a patient, who took part in a sports event held there when Savile was present.

"We have spoken to this person, our report will be published in line with all the others."

The South London and Maudsley NHS Foundation Trust, which runs Bethlem Royal Hospital, said: "We are investigating this evidence thoroughly and if necessary will ensure that any lessons are learnt for the future."

Meanwhile, Leeds General Infirmary, Stoke Mandeville and the Royal Victoria Infirmary in Newcastle are investigating fresh allegations that have emerged since June.

Peter Garsden, from the association of child abuse lawyers, told the BBC: "It's quite shocking, I'm sure we all thought we'd heard the last of the Savile locations, but here we are with several more allegations.

"It seems that his net spread very far and wide, which is perhaps not surprising considering he was constantly visiting hospital under the guise of doing charity work and inevitability he behaved the same way wherever he went."

He said the inquiries helped victims of abuse in the "journey to justice".

Delayed

In a written ministerial statement, Health Secretary Jeremy Hunt said: "At the request of the Crown Prosecution Service, the publication of the NHS investigations into Jimmy Savile is being delayed until the conclusion of ongoing legal proceedings.

"Therefore, I wish to advise the House that there will be a delay in the publication of the outstanding NHS investigation reports.

"We now hope trusts will publish their reports in January 2015."

The investigation at Leeds, published earlier this year, found patients, including teenagers recovering from surgery, had been abused in their beds and one 10-year-old boy had been sexually assaulted while waiting on a trolley for an X-ray on his broken arm.

When the reports came out, Mr Hunt apologised on behalf of the government and the NHS.

He said there was a "deep sense of revulsion" over the findings, adding: "We let them [the victims] down badly."

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Use 'old drugs' to treat cancer call

6 November 2014 Last updated at 14:01

Fatal cases of breast cancer could be prevented if a bill to repurpose existing drugs wins government support, Breast Cancer Campaign has said.

It is thought multiple sclerosis, Parkinson's and Alzheimer's disease patients could also benefit.

The charity called on the government to seek licences for drugs that are no longer patented.

Using old drugs in this way could cost as little as 6p a day so treatment could be routinely available, it said.

'Seize the opportunity'

Breast Cancer Campaign was joined by doctors and other charities, such as the Alzheimer's Society and the Association of Medical Research Charities, in calling for the government to consider the move through a bill to change the law.

The bill will be presented to Parliament for a second reading on 7 November.

The charity said there was no incentive for pharmaceutical companies to seek a new licence for repurposing a drug, once a patent for the drug had expired, as they no longer had a monopoly on providing it.

There was no organisation responsible for seeking a licence, said Breast Cancer Campaign, which called for the government to take action to seek licences for such drugs.

It pointed towards evidence that old drugs repurposed in this way could be clinically effective.

Clare Keeling, at the MS Society, said simvastatin was a drug originally licensed for treating high cholesterol, but in recent clinical trails it had been shown to be effective in treating the disease.

"If successful, simvastatin for MS would address a significant unmet need as there is currently no treatment that can slow or stop the deterioration seen in progressive MS," she added.

Conservative MP Jonathan Evans, leading the bill, said: "I still hope that the government will seize the opportunity to commit to taking the straightforward step of supporting this important bill.

Evidence from MS

"This is a real chance to significantly improve access to low-cost treatments, some of which would bring a step change in improving mortality rates."

He said the bill would save many lives and urged the government to "show the clear support needed" for it to become law.

The MS Society said it "fully supports" the bill.

Mia Rosenblatt, at Breast Cancer Campaign, said it was "incomprehensible" the government was not supporting the bill and asked why existing drugs were not given the same priority and focus as new drugs when they "cost next to nothing".

A Department of Health spokesperson said: "Doctors can already prescribe drugs without needing to wait for a new licence, if they believe it is right for their patients.

"Licensing is not the real problem here: we need to look at other ways to support appropriate off label prescribing of drugs.

"The government will set out its full position on this Bill at its Second Reading on Friday 7th November."

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Child mental health services 'unfit'

5 November 2014 Last updated at 01:23 By Michelle Roberts Health editor, BBC News online

There are "serious and deeply ingrained problems" with child and adolescent mental health services, officials warn.

The Health Select Committee says the whole system - from prevention and early intervention through to inpatient services - has issues.

While demand for care is rising, in many parts of the country funding is being frozen or cut.

The government said it had launched a taskforce to drive up standards, and was investing money in mental health.

Turned away

The Health Select Committee, which received the most written submissions for any inquiry it has held this Parliament, was particularly concerned about children and young people being taken to police cells rather than hospital.

Police can detain people under the Mental Health Act if there is no "safe space" in hospitals available.

A recent analysis by the Care Quality Commission found people were being turned away because of full wards, staff shortages or violent behaviour.

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'Jane' explains what access to good mental health care has done for her

Often when beds are found, they may be in distant parts of the country.

The committee also heard how young people with mental health problems and their parents had to battle to access appropriate services.

In some areas, it has been reported that services will not kick in unless the young person has attempted suicide.

'Psychosis'

Those planning and running services have been operating in a "fog" without a clear national vision or adequate funding, says the committee.

Sarah Brennan, chief executive of Young Minds, said: "We have been told countless times of the intense frustration of mental health professionals as they attempt to do their best for children, young people and their families who are suffering on a daily basis."

Dr Hilary Cass, president of the Royal College of Paediatrics and Child Health, accused policy makers of dragging their heels.

Care and Support Minister Norman Lamb said: "I am determined to make sure young people get the mental health care they need.

"We've invested £7m in new beds, I've launched a taskforce to improve services, and we are introducing a new waiting time standard to make sure young people with psychosis get prompt treatment."

Estimates suggest one in 10 children aged between five and 16 has a mental disorder, such as anxiety, depression or a conduct/behavioural disorder.

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Drug users 'unaware of hepatitis C'

5 November 2014 Last updated at 11:16

About 20% of people in England who inject drugs do not know they have hepatitis C infections, according to Public Health England (PHE).

In 2013, 90% of the 13,570 people diagnosed with hepatitis C had injected drugs such as heroin, cocaine and amphetamines, it said.

Two out of five drug users who used needles had the infection and half of these did not know it, said PHE.

The viral infection can lead to liver cancer, which can be fatal.

It can be spread through the blood of an infected person, which is why drug users sharing needles are at risk. More than 200,000 people in the UK currently have the infection.

PHE said early diagnosis was key to prevent the disease being spread and called for interventions to flag up infections earlier.

Blood spot testing

Dr Vivian Hope, at the organisation, said increasing the diagnosis rate would help reduce the high level of infection he was seeing among people who injected drugs.

He added: "Obtaining blood from people living with hepatitis C who inject drugs can be difficult due to poor venous access.

"Dry blood spot testing is an alternative method that avoids puncturing veins - which has been proven to be reliable and simple, and acceptable to both people who inject drugs and drug service staff."

Dr Hope said using the new testing method had started to help diagnose more cases of hepatitis C.

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Sierra Leone gets UK Ebola centre

5 November 2014 Last updated at 11:32

A British-run facility to treat people with Ebola is opening in Sierra Leone.

The 92-bed site in Kerry Town will be run jointly by the Department for International Development (DfID) and charity Save the Children.

The centre is the first of six which are being constructed by the British government as part of the effort to stop the spread of the disease.

The UK's Disasters Emergency Committee says it has raised £13m for tackling Ebola, a week after its appeal launch.

The DEC, which is made up of 13 British aid charities, is helping to run treatment facilities and care centres.

The British Red Cross's Ebola response manager, John English, described the British public's response as "very generous" and said he hoped it would continue.

Meanwhile in the UK, Manchester Airport has begun screening passengers arriving from the worst-affected countries.

The facility at Kerry Town south of the capital Freetown includes a new blood testing laboratory. Six hundred more beds are planned at UK centres around the country in the coming months.

The centre also provides dedicated beds for infected healthcare workers and separate sites for confirmed and suspected cases.

Save the Children chief executive Justin Forsyth said there was a "race against time" to stop the disease spreading.

He added: "The Ebola crisis that's affecting Sierra Leone, but also Liberia and Guinea, is so enormous.

"We're in a race against time to make sure we can prevent it spreading but also to treat people who have got Ebola and to build on for the future.

"But we've never done something like this treatment centre. It's enormous for us and it was a risky decision, but it's something I feel very proud about."

'Huge impact'

The head of the DfID-led UK Ebola Taskforce, Donal Brown, predicted that the new centres "will have a huge impact".

He told BBC Radio 4's Today programme that the facilities were part of a wider strategy that includes community care centres and improved burial practices.

"We are making progress," he said, pointing out that that four weeks ago "very few" bodies were being picked up for burial but now 100% of bodies reported were being buried within 24 hours.

International Development Secretary Justine Greening highlighted the current shortage of beds: "Patients are being turned away from hospitals, reducing their chance of survival and allowing the disease to spread."

British Army engineers and Sierra Leonean construction workers had been "working round the clock" to complete the new treatment centre, she added, with "the potential to save countless lives."

'Overwhelming'

Royal Marines and medics who arrived in Sierra Leone on a Royal Fleet Auxiliary ship on 30 October say they have been greeted by an "overwhelming" reception.

RFA Argus also transported food, medical equipment and 32 pick-up trucks to help keep hard-pressed Ebola treatment centres going.

The Ebola outbreak in West Africa has killed some 5,000 people. Most of the deaths have been in Guinea, Liberia and Sierra Leone.

Ebola screening began at London's Heathrow and Gatwick Airports, and at Eurostar terminals, in October.

Manchester Airport has now begun its screening programme for passengers from Liberia, Sierra Leone and Guinea.

People flying into Manchester from the at-risk countries will have their temperature taken, complete a risk questionnaire and receive advice on what to do if they think they have been affected.

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'Sponge on a string' test for cancer

4 November 2014 Last updated at 01:42 By Michelle Roberts Health editor, BBC News online

Cancer of the gullet could be diagnosed with a cheap and simple sponge-on-a-string test, latest trial results show.

Swallowed and then retrieved from the mouth by pulling on the string, the Cytosponge capsule expands in the body to collect cells on its way out.

In tests on more than 1,000 UK patients, it was found to be well tolerated, safe and accurate at diagnosing Barrett's oesophagus.

One in 10 people with this condition later develops cancer of the food pipe.

Continue reading the main story

Death rates are unacceptably high in oesophageal cancer, so early diagnosis is vital"

End Quote Dr Julie Sharp Cancer Research UK

In Barrett's, acid comes back up the food pipe from the stomach, which can cause symptoms such as indigestion and heartburn as well as changes in the normal cells that line the gullet.

Conventionally, doctors have diagnosed and monitored these patients for signs of cancer using biopsy - taking a small sample of cells - during a procedure called endoscopy, where a long, flexible tube with a camera is inserted down the throat.

But researchers from the Medical Research Council Cancer Unit at the University of Cambridge say the Cytosponge could replace this test.

Unlike endoscopy, Cytosponge can easily be used in GP surgeries and doesn't require any sedation, say Prof Rebecca Fitzgerald and colleagues.

As well as being less invasive, Cytosponge is also cheaper, costing £25 compared with the £600 cost of a traditional endoscopy.

The trial invited more than 600 patients with Barrett's to swallow the Cytosponge and to undergo an endoscopy. Almost 500 more people with symptoms like reflux and persistent heartburn did the same tests.

Many patients in the trial said they preferred it to endoscopy. More than nine in 10 patients were able to successfully swallow the capsule. Larger studies are now planned.

Dr Julie Sharp, of Cancer Research UK, the charity that funded the trial, said: "These results are very encouraging and it will be good news if such a simple and cheap test can replace endoscopy for Barrett's oesophagus.

"Death rates are unacceptably high in oesophageal cancer, so early diagnosis is vital."

Jacqui Graves, of Macmillan Cancer Support, said a less invasive test that hastened diagnosis would be welcome, but she said it would be some time before any such test would be available across the UK on the NHS.

The trial findings will be presented at the National Cancer Research Institute's annual conference in Liverpool this week.

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Shift work dulls your brain - report

4 November 2014 Last updated at 01:39 By James Gallagher Health editor, BBC News website

Working antisocial hours can prematurely age the brain and dull intellectual ability, scientists warn.

Their study, in the journal Occupational and Environmental Medicine, suggested a decade of shifts aged the brain by more than six years.

There was some recovery after people stopped working antisocial shifts, but it took five years to return to normal.

Experts say the findings could be important in dementia, as many patients have disrupted sleep.

The body's internal clock is designed for us to be active in the day and asleep at night.

The damaging effects on the body of working against the body clock, from breast cancer to obesity, are well known.

Now a team at the University of Swansea and the University of Toulouse has shown an impact on the mind as well.

Three thousand people in France performed tests of memory, speed of thought and wider cognitive ability.

The brain naturally declines as we age, but the researchers said working antisocial shifts accelerated the process.

Those with more than 10 years of shift work under their belts had the same results as someone six and a half years older.

The good news is that when people in the study quit shift work, their brains did recover. Even if it took five years.

'Substantial decline'

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Dr Philip Tucker explains how shift work impairs cognitive performance

Dr Philip Tucker, part of the research team in Swansea, told the BBC: "It was quite a substantial decline in brain function, it is likely that when people trying to undertake complex cognitive tasks then they might make more mistakes and slip-ups, maybe one in 100 makes a mistake with a very large consequence, but it's hard to say how big a difference it would make in day-to-day life."

He said he would not do night shifts "if I could possibly help it" but they were a "necessary evil" that society could not do without.

"There are ways to mitigate the effects in the way you design work schedules and regular medical check-ups... should include cognitive performance tests to look for danger signs," he added.

Dr Michael Hastings, from the UK Medical Research Council's Laboratory of Molecular Biology, told the BBC: "The reversibility is a really exciting finding because no-one else has shown it and no matter how compromised a person may be there's always hope of recovery."

He said the findings may have important consequences in dementia, which is known to damage sleeping patterns in a similar way to shift work.

"If you can keep the sleep-wake cycle as solid as possible you're unlikely to reverse neurodegeneration, but you can ameliorate one of the consequences.

"In nursing homes one thing you can do to help is to set a very clear daily routine to encourage a sensible 24-hour pattern of activity; it needs bright lights in the day, resting at night and appropriate medication such as melatonin before bed."

Prof Derk-Jan Dijk, from the Surrey Sleep Centre, cautioned that retired shift workers still had lower sleep quality than people who had never done nights.

"So some of these effects may not be so readily or rapidly reversed."

He added: "We now accept that shift work may not be good for your physical health, but this shows your brain function is affected, and I think that finding will surprise many people."

Continue reading the main story

Do you work shifts? What do you think of the findings in this study? You can share your experience by emailing haveyoursay@bbc.co.uk If you are willing to be contacted by a BBC journalist, please leave a contact number.

Have your say

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Appeal over foetal alcohol syndrome

4 November 2014 Last updated at 09:47 By Luke Walton Radio 4 PM programme

Campaigners and doctors are calling for stronger warnings about drinking during pregnancy, ahead of a legal test case on foetal alcohol syndrome.

The case will decide if a child born with serious disabilities caused by her mother's alcohol consumption should be compensated as a victim of crime.

Some estimates suggest thousands are born every year in the UK with serious health defects caused by alcohol.

Senior health officials have said there are mixed messages on the issue.

NHS guidance states "women who are pregnant or trying to conceive should avoid alcohol altogether".

But it continues: "If they do choose to drink, to minimise the risk to the baby, we recommend they should not drink more than one or two units once or twice a week, and should not get drunk."

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A mother explains how drinking during pregnancy hurt her daughter

The Royal College of Obstetricians and Gynaecologists has said "current scientific opinion points to there being no hard evidence that very small amounts of alcohol consumption during pregnancy are harmful".

But advice and research can seem inconclusive.

'Safest option'

According to the Foetal Alcohol Spectrum Disorder (FASD) Network, which supports families affected by the problem, health defects caused by alcohol include learning difficulties as well as behavioural and emotional problems.

Pregnant mothers need to be educated to steer clear of alcohol, said Maria Catterick, FASD Network's founder. "We are told that alcohol is a poison on the one hand, but on the other hand we are told that maybe it's OK to drink one or two units."

Alcohol-related pregnancy risks

• Foetal Alcohol Spectrum Disorder (FASD) - umbrella term covering a range of neurological, physical and behavioural impairments caused by exposure to alcohol in the womb. Many can be hard to diagnose.
• Foetal Alcohol Syndrome (FAS) - a serious form of FASD that is associated with distinctive facial features that make it easier to recognise.

Dr Shonag MacKenzie, lead obstetrician at Northumbria Healthcare NHS Trust, believes the advice can be confusing: "A small amount can lead to more drinks," she said, "we do know that actually the only absolutely safe policy is no alcohol at all in pregnancy."

In September, 12 directors of public health in the North East of England wrote an open letter complaining that there were "a lot of mixed messages about how much alcohol is 'safe' during pregnancy".

"We want to send a clear message to parents-to-be that alcohol and pregnancy don't mix - the safest option is an alcohol free pregnancy," they said in the letter.

"This needs to be the advice given during all stages of pregnancy from conception to birth by all healthcare professionals," they added.

A Department of Health spokesman said the chief medical officer for England was reviewing alcohol guidelines, with new draft guidelines expected next year.

One woman who lives in the North East and asked not to be identified adopted baby girls who were later diagnosed with Foetal Alcohol Syndrome (FAS).

"Due to the brain damage both my children have problems with ADHD, bits of autism, sensory dysfunction, memory problems," she said.

She said there was a shortage of support services for children with FAS, and her girls would need help into adulthood. "When they are both around 18 to 20 years old chronologically, they are only going to be like a 10-year-old socially."

Criminalising women?

The Court of Appeal will decide later this month whether a seven-year-old with FAS and now in local authority care is entitled to a payout from the government-funded Criminal Injuries Compensation Scheme.

Continue reading the main story

Most women would never drink alcohol, knowingly harming their baby"

End Quote Maria Catterick FASD Network

Neither the council, which is in the North West of England, nor the child can be named for legal reasons.

Solicitor Neil Sugarman, who represents the council that is taking the claim on behalf of the child, said the mother "had been warned on a number of occasions that if she continued to drink excessively the child would be harmed".

"It's for the court of appeal now to decide whether recklessly taking alcohol was tantamount to poisoning the foetus," Mr Sugarman said.

He said his firm, Bury-based GLP Solicitors, represented about 80 other children damaged by foetal alcohol.

But campaigners fear the compensation claim could end up labelling mothers as criminals.

"I don't believe at all it is worth going down this route to criminalise women," said FASD Network's Maria Catterick.

"Most women would never drink alcohol, knowingly harming their baby. The messages have been totally unclear," she added.

Mr Sugarman denies the compensation claim will criminalise women.

He said the case was "simply about proving that if there was recklessness and it has resulted in damage, the child is then entitled to an award which will improve their lives".

Listen to PM from 17:00 BST on BBC Radio 4, Monday to Saturday each week.

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GP funding 'puts patients at risk'

2 November 2014 Last updated at 00:02

The Scottish government's failure to adequately fund GPs is putting patients at risk, according to the organisation that represents general practitioners.

The Royal College of General Practitioners (RCGP) warned of "dangerous consequences for patients in the light of continued underfunding".

A study by the body suggested one in four Scots cannot get an appointment with their GP within a week.

The Scottish government said GP funding in Scotland was at record levels.

But the RCGP said the Draft Budget for next year showed a real-terms funding drop of 2.2% for GPs.

It also claimed long waiting times for appointments, short consultations and weakening relationships between doctors and patients were contributing to a "crisis in general practice".

Later appointment

The RCGP said it had based its conclusions on an analysis of figures from the Scottish government's Health and Experience Survey 2013/14 and a ComRes poll carried out earlier this year.

The poll suggested that a majority of people believe there are too few GPs and would like to see funds moved from other parts of the health service to GPs.

One in four of those surveyed said they were unable to obtain an appointment with their GP within a week and, when this happened, 11% of people said they would neither take the later appointment nor seek help elsewhere.

RCGP said this raised concerns about untreated conditions.

The professional body also highlighted figures in the government's Health and Experience Survey which showed that on more than 3.3 million occasions, patients were unable to get to see either a doctor or a nurse until the third working day.

The figure represented almost one in every seven times a request was made.

And the survey found that on 1.6 million occasions, patients did not feel they had enough time with their GP - an increase of 8.25% since 2011/12.

Dr John Gillies, chairman of RCGP Scotland, said it was "incumbent on the government to act" in order to safeguard patient safety.

'Substantially higher'

He added: "Further cuts to the resources GPs have with which to care for patients can only exacerbate the problem.

"A real-terms drop in funding share of 2.2%, as outlined in the Draft Budget 2015/16, can only deepen the current, very real crisis.

"This drop stands directly against the 71% of Scots who would like to see funding move from other parts of the health service to general practice.

"General practice requires 11% of the NHS spend to adequately look after our patients. If the situation is not rectified, the consequences for the NHS in Scotland and for patients could be even more severe."

The RCGP said a petition with thousands of signatures calling for the situation to be a addressed situation would be handed to the first minister next week.

Health secretary Alex Neil said GP funding was at a record level in Scotland "despite cuts in our overall budget from Westminster".

He said: "The number of GPs in Scotland has increased by 5.7% under this government and the number of GPs per head of population is substantially higher in Scotland than England.

"This year our £8.2m increase in funding for the GP contract was double that recommended by the GPs' pay body, and was warmly welcomed by the BMA."

Mr Neil added: "Last year, 87% of patients rated their overall experience of care by the GP surgery as excellent or good.

"While this is a strong record, we are continuing to improve access and the latest GP contract substantially cuts bureaucracy to allow GPs more time with patients.

"It also requires every single GP surgery in Scotland to review their access arrangements to ensure patients could get prompt access to appointments."

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Weight surgery lowers diabetes risk

3 November 2014 Last updated at 01:39 By James Gallagher Health editor, BBC News website

Weight loss surgery can dramatically reduce the odds of developing type 2 diabetes, according to a major study.

Doctors followed nearly 5,000 people as part of a trial to assess the health impact of the procedure.

The results, published in the Lancet Diabetes and Endocrinology journal, showed an 80% reduction in type 2 diabetes in those having surgery.

The UK NHS is considering offering the procedure to tens of thousands of people to prevent diabetes.

Obesity and type 2 diabetes are closely tied - the bigger someone is, the greater the risk of the condition.

The inability to control blood sugar levels can result in blindness, amputations and nerve damage.

Around a tenth of NHS budgets are spent on managing the condition.

Surgery

The study followed 2,167 obese adults who had weight loss - known as bariatric - surgery.

They were compared to 2,167 fellow obese people who continued as they were.

There were 38 cases of diabetes after surgery compared with 177 in people left as they were - a reduction of nearly 80%.

Around 3% of morbidly obese people develop type 2 each year, however, surgery reduced the figure to around 0.5%, which is the background figure for the whole population.

What is bariatric surgery?

Bariatric surgery, also known as weight loss surgery, is used as a last resort to treat people who are dangerously obese and carrying an excessive amount of body fat.

This type of surgery is available on the NHS only to treat people with potentially life-threatening obesity when other treatments have not worked.

Around 8,000 people a year currently receive the treatment.

The two most common types of weight loss surgery are:

• Gastric band, where a band is used to reduce the size of the stomach so a smaller amount of food is required to make someone feel full

• Gastric bypass, where the digestive system is re-routed past most of the stomach so less food is digested to make someone feel full

NHS Choices

Calculate your BMI

The National Institute of Health and Care Excellence is considering a huge expansion of obesity surgery in the NHS in order to cut rates of type 2 diabetes.

Current guidance says surgery is a possible option for people with a BMI above 35 who have other health conditions.

But new draft guidelines argue much thinner people should be considered on a case by case basis and those with a BMI of 35 should automatically considered for surgery.

Diabetes UK says around 460,000 people will meet the criteria for an automatic assessment under the guidance.

But the total jumps nearer to 850,000 when those with a BMI of 30 are also considered, it says.

NICE anticipates figures in the tens of thousands. However, the surgery can cost between £3,000 and £15,000 and the move by NICE has raised concerns that the NHS will not be able to afford the treatment, even if there are savings in the longer term.

Obesity statistics

• One in four adults in England is obese
• A further 42% of men are classed as overweight
• The figure for women is 32%
• A BMI of 30-35 cuts life expectancy by up to four years
• A BMI of 40 or more cuts life expectancy by up to 10 years
• Obesity costs the NHS £5.1bn every year

Source: National Institute of Health and Care Excellence

BBC News: Where are you on the global fat scale?

Prof Martin Gullford, from King's College London, told the BBC News website: "The key thing would be not only how effective is weight loss surgery but how safe is it in the long-term?

"And we need to know about the cost effectiveness of weight loss surgery and how that balances against the costs of diabetes, it does raise some complex issues."

Simon O'Neill, the director of health intelligence at Diabetes UK, said: "This is interesting research that reinforces what we already know about weight loss being important for both preventing and managing type 2 diabetes.

"But it must be remembered that surgery carries risks and so bariatric surgery should only be considered if serious attempts to lose weight have been unsuccessful.

"Looking at the bigger picture, as a society we also need to focus more on stopping people becoming overweight, we need to look seriously at how we can make sure people are getting support to lose weight through access to the right services to encourage them to make healthy choices."

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UK's Ebola appeal reaches £10m mark

3 November 2014 Last updated at 12:42

An appeal to help people affected by the Ebola crisis in West Africa has raised more than £10m in its first five days, organisers have said.

The Disasters Emergency Committee said the "milestone" was reached after the UK government matched the first £5m.

The appeal was launched on Thursday, with the DEC saying it had been "humbled" by the public's response.

Buckingham Palace confirmed the Queen had also made a donation to the appeal, but did not reveal the amount.

The DEC said it had already helped more than 2.5 million people affected by the Ebola outbreak, which has killed nearly 5,000 people, nearly all in West Africa.

It is the first time the organisation, which brings together 13 UK aid charities to tackle major crises, has sought funds in response to a disease outbreak.

'More to do'

DEC chief executive Saleh Saeed said the group wanted to thank "each and every person who has given", and also thanked the government for its "significant boost".

"Our member agencies have already achieved so much - providing protective clothing, educating communities and supporting safe and dignified burials - but there is so much more to do," he said.

The DEC said member agencies were scaling up their aid efforts in West Africa, reaching some of the worst-affected and most remote areas of Sierra Leone and Liberia.

The latest figures, released on Friday by the World Health Organization, suggest 4,951 people have died in the current outbreak, with 13,567 reported cases up to 29 October.

But the DEC said experts believed the real figures could be far higher because of under-reporting.

Ebola virus disease (EVD)

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How Ebola survivors' blood is saving lives

• Symptoms include high fever, bleeding and central nervous system damage
• Spread by body fluids, such as blood and saliva
• Fatality rate can reach 90% - but current outbreak has mortality rate of about 70%
• No proven vaccine or cure
• Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

Ebola special report

The UK, which has pledged £205m in aid, is leading the international response to the disease in Sierra Leone, a member of the Commonwealth which won independence from Britain in 1961.

In all, the UK is deploying about 750 military personnel to the country to help establish and run treatment facilities and a training academy.

It has also sent casualty ship the Royal Fleet Auxiliary Argus, along with three Merlin helicopters, which are offering offshore support to the effort.

Who else has the DEC raised money for?

• A total of £71m was raised by the Pakistan Floods Appeal which affected more than 18 million people. The floods swept across the country in July and August of 2010
• The UK public donated £95m for the Philippines Typhoon Appeal which has to date helped more than 900,000 people. The appeal was launched in November 2013
• The Syria Crisis Appeal opened in March 2013 and has raised about £25m
• An appeal for people affected by the fighting in Gaza was launched in January 2009 and raised £8.3m
• A total of £107m was raised for people adversely affected by the earthquake in Haiti

The DEC brings together 13 UK aid charities - ActionAid UK, Age International, British Red Cross, Cafod, Care International, Christian Aid, Concern Worldwide, Islamic Relief, Merlin, Oxfam, Plan UK, Save the Children, Tearfund and World Vision.

To make a donation to the DEC Ebola Crisis Appeal visit www.dec.org.uk

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Ebola appeal receives £4m in two days

1 November 2014 Last updated at 19:02

A public appeal to help people affected by the Ebola crisis in West Africa has received £4 million in donations in its first two days, organisers have said.

The Disasters Emergency Committee (DEC) said it had been "overwhelmed" by the "extraordinary generosity" of the UK public since the appeal was launched.

The UK government is to match the first £5 million of donations made.

Ebola has killed almost 5,000 people and infected more than 13,000 in West Africa since the start of the year.

On Friday, the World Health Organisation said 4,951 people had died during the current outbreak, with 13,567 reported cases up to 29 October.

Protective clothing

Donations have been made after appeals were aired by the main UK broadcasters on Thursday.

It is the first time the DEC has sought funds in response to a disease outbreak.

"We are extremely grateful to the UK government for the aid match funding which is a significant boost to the appeal," chief executive of DEC Saleh Saeed said.

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Donations help pay for nurses and doctors on the ground, says Save the Children's Justin Forsyth

"The UK government will match a further £1 million raised, so we encourage the UK public to donate as soon as possible to double the amount of their donation.

"Our member agencies have already achieved so much - providing protective clothing, educating communities and supporting safe and dignified burials - but there is so much more to do."

Agencies have been increasing their aid efforts in West Africa, where they have already helped more than 2.5 million people affected by the Ebola crisis, a DEC spokesman said.

They included people in some in the worst-affected and most remote areas of Sierra Leone and Liberia, the spokesman added.

Deaths from Ebola

Justin Forsyth, chief executive of the charity Save the Children, said donations would make "a massive difference" by helping to pay for nurses and doctors on the ground.

Speaking to the BBC from Sierra Leone, he said officials needed additional staff and equipment and called on more governments around the world to offer financial support.

"It is getting worse, not better, on the ground here; we are not yet ahead of the curve, we are in a race against time and we need to urgently act on the ground - and money if very, very important," he said.

It comes after Canada announced it was to suspend visa applications from residents and passport-holders from West African countries affected by the Ebola outbreak.

The decision follows a similar decision by Australia, which drew criticism from the World Health Organization (WHO).

The ban would apply to countries with "widespread and persistent-intense transmission", Canada said.

Other Disasters Emergency Committee (DEC) appeals:

• A total of £71m was raised by the Pakistan Floods Appeal which affected more than 18 million people. The floods swept across the country in July and August of 2010
• The UK public donated £95m for the Philippines Typhoon Appeal which has to date helped more than 900,000 people. The appeal was launched in November 2013
• The Syria Crisis Appeal opened in March 2013 and has raised about £25m
• An appeal for people affected by the fighting in Gaza was launched in January 2009 and raised £8.3m
• A total of £107m was raised for people adversely affected by the earthquake in Haiti

To make a donation to the DEC Ebola Crisis Appeal visit www.dec.org.uk

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