E-cigarette use 'high among teens'

Many teenagers, even those who have never smoked, are experimenting with e-cigarettes, researchers in north-west England say.

Questionnaires completed by 16,193 14 to 17-year-olds, published in BMC Public Health, showed one in five had tried or bought e-cigarettes.

The researchers said e-cigarettes were the "alcopops of the nicotine world" and needed tougher controls.

Experts said it was important to find out how many were becoming addicted.

Electronic cigarettes mimic the effects of real ones, producing a vapour that is less harmful than cigarette smoke, but the vapour usually contains nicotine, the addictive substance in cigarettes.

They divide opinion. Some see them as a vital tool for helping people to quit, while others argue they "normalise" smoking and may act as a gateway.

One major area of contention is the impact they have on children.

The analysis by Liverpool John Moores University showed that 19% of those who responded had tried "vaping".

E-cigarettes were used by 5% of teenagers who had never smoked, 50% of former smokers and 67% of light smokers.

The link was even stronger in children who drank alcohol or whose parents smoked.

Prof Mark Bellis told the BBC News website: "To many people the numbers we've identified might come as a bit of a shock.

"This is just being drawn into a repertoire - another drug that people can use to experiment with rather than being seen as an alternative to tobacco.

On nicotine, he said e-cigarettes were "providing a concentrated form of a highly addictive substance, with known problems associated with it, and we need to be very cautious about that and how we protect our young people."

A ban on the sale of electronic cigarettes to under-18s will be introduced in England, Wales, Scotland and Northern Ireland.

Electronic cigarettes are mainly used to help smokers quit, the Office for National Statistics says

Katherine Devlin, president of the Electronic Cigarette Industry Trade Association, told the BBC: "Obviously, teenagers accessing vaping products is a serious concern.

"[However] since the survey only records a single access, it doesn't provide any information about whether or not they go on to regular use.

"Other statistical data indicate that this is unlikely. Nevertheless, we hope that the newly introduced mandated age restrictions can reduce this number."

Data from the Office for National Statistics does suggest that those who use e-cigarettes are almost entirely current or former smokers.

Dr John Middleton, of the Faculty of Public Health, said: "We need to protect children and young people from the harms of nicotine by regulating electronic cigarettes.

"Our concern is that if we wait for proof that electronic cigarettes could act as a gateway to smoking cigarettes, it will already have happened and the tobacco industry will have been given the opportunity to recruit its next generation of smokers."

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Parents rarely spot child obesity

Parents hardly ever spot obesity in their children, resulting in damaging consequences for health, doctors warn.

In a study of 2,976 families in the UK, only four parents thought their child was very overweight. Medical assessments put the figure at 369.

The researchers, writing in the British Journal of General Practice, said obesity had become the new normal in society.

Experts said the study showed the "enormity" of the obesity epidemic.

Around one in five children in Year 6 is obese and a further 14% are overweight, the National Child Measurement Programme shows.

Blind spot

The team, from the London School of Hygiene and Tropical Medicine and the UCL Institute of Child Health, gave questionnaires to nearly 3,000 families asking if their child was obese, overweight, underweight or a healthy weight.

The results showed that nearly a third, 31%, of parents underestimated the weight of their child.

An accurate diagnosis kicked in only at the very high end of the scales.

Prof Russell Viner, from the Institute of Child Health, told the BBC News website: "Modern parents don't recognise children as obese.

"If parents don't recognise a child is obese then they're very unlikely to do anything to help their child move to a more healthy weight.

"Then it's a potential major public health crisis being stored up."

The main explanation for parents not identifying their child's weight problem is that society as a whole has become so fat we have collectively lost our sense of a healthy weight.

The chief medical officer, Dame Sally Davies, raised this issue of overweight becoming the new norm in her annual report last year.

"We need to find some tool to educate parents, when their child is born, what they should expect a child's size to be and not to be afraid of talking to parents over fears they, or the child, will react badly," Prof Viner said.

'Role models'

Commenting on the findings, the chief executive of the Royal Society for Public Health, Shirley Cramer, said: "School education from a young age should focus on the importance of active lifestyles and healthy diets to ensure our society is one that understands the relationship between diet and good health.

"Parents are key role models for their children and it is imperative they are aware of all the factors that can influence health.

"However, it is not just the role of the parents, society as a whole needs to help enforce messages about eating well."

She said restricting junk food advertising would help as would better calorie labelling on food.

Tam Fry, from the Child Growth Foundation, told the BBC: "To the obesity specialist it is incomprehensible that parents cannot tell if their children are overweight.

"You sometimes have to wonder if they are in total denial, but when you realise that even health professionals may often have difficulty in recognising obesity in their patients, the enormity of our obesity epidemic sinks in.

"The knock-on risk of extreme overweight to the individual's and country's health cannot be emphasised enough."

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More veterans seek mental health aid

The charity Combat Stress said more veterans of conflicts in Afghanistan and Iraq were seeking help

Mental health referrals for ex-servicemen and women have increased by 26% in the last year, says a specialist mental health charity for veterans.

Combat Stress said referrals for ill mental health or post-traumatic stress disorder rose from 1,802 to 2,264.

It said an increase in veterans from Iraq and Afghanistan seeking help was the main reason for the rise.

The charity said it wanted to increase its clinical resources to meet the rising demand.

Combat Stress said it believed those who had fought in recent conflicts were now coming forward for treatment sooner, but there remained a stigma surrounding ill mental health.

Dr Walter Busuttil, director of medical services at the charity, said: "We are very concerned at the significant rise in those coming forward with military PTSD.

"It is the biggest increase we have seen in recent years and we expect it to continue so we want to build up our clinical services accordingly.

"The recent Budget announcement of increased funding for NHS veterans mental health services is helping but as the need for specialist treatment appears to be expanding we will we need additional funding and resources."

Combat Stress currently works with more than 5,900 ex-servicemen and women from all conflicts since World War Two - a figure it said was higher than at any time since it was founded in 1919. The youngest veteran it works with is 18.

Of those the charity works with, 1,185 served in Iraq and 971 served in Afghanistan.

On average it takes veterans more than 13 years from the time they leave military service to seek help from the charity.

Combat Stress helps veterans with conditions such as PTSD, depression and anxiety using a range of measures, from intensive specialist programmes to short-stay clinical treatments.

Funding for the charity's six-week intensive treatment programme is currently funded by the NHS.

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Cameron promises 'seven-day NHS'

All hospitals in England will provide "a truly seven-day NHS" by 2020 under a future Conservative government, David Cameron has said.

At the party's spring forum, Mr Cameron said that more hospitals must provide top-level treatment at the weekend, starting with emergency care.

In a wide-ranging speech, he said his party's message to various sections of the population was: "We're with you."

Labour said Tory plans for "extreme" spending cuts threatened the NHS.

It has put the health service at the forefront of its own election campaign, with leader Ed Miliband promising on Friday to cap the amount of profit private firms can make from the NHS in England.

Analysis

By Ben Wright, BBC political correspondent

This spring forum is about fighting back against Labour on the NHS.

Polls show a clear, large consistent lead for Ed Miliband's party on the NHS. It is the foundation stone of Labour's campaign.

But the Conservatives are desperate to chip away at it with promises of protected real-terms increases in funding and an extra £2bn a year.

The Conservatives are committing to providing full weekend hospital care in England - in line with the NHS's own five-year plan.

The big question of course is, "Where will the money come from?", but this is about politics.

This is an attempt to try to neutralise the NHS and enable the Conservatives to return to what they want to be talking about - the economy.

'Properly staffed'

Speaking at the forum in Manchester, Mr Cameron warned that figures showed patients were "more likely to die" if they were admitted at weekends.

According to the Conservatives, official studies suggest mortality rates for those admitted on Saturdays and Sundays are 11% and 16% higher respectively than for those admitted on Wednesdays.

This is at best an empty pledge and at worst shameless political game-playing

Dr Mark Porter, British Medical Association chairman

"For years it's been too hard to access the NHS out of hours. But illness doesn't respect working hours. Heart attacks, major accidents, babies - these things don't just come from nine to five," Mr Cameron said.

At weekends, he said, "some of the resources are not up and running. The key decision-makers aren't always there.

"With a future Conservative government, we would have a truly seven-day NHS.

"Already millions more people can see a GP seven days a week but by 2020 I want this for everyone, with hospitals properly staffed especially for urgent and emergency care, so that everyone will have access to the NHS services they need seven days a week by 2020 - the first country in the world to make this happen."

'Financial distress'

During his speech, Mr Cameron also reiterated a number of election campaign pledges, including:

• No tax on the first £12,500 of earnings

• No 40p rate until earnings reach £50,000

Andy Burnham, Labour's shadow health secretary, said the plans were not credible without investment in extra NHS staff.

"With the NHS in increasing financial distress, David Cameron must set out clearly how it will be paid for," he said.

The Liberal Democrats said NHS England already had plans to open hospitals and GP surgeries seven days a week, while UKIP said the Tories had "degenerated the NHS beyond all recognition" during the last five years in government.

Dr Mark Porter, chairman of the British Medical Association, said that the Conservatives' funding commitment was not even enough to maintain existing services, and that a funding gap of up to £30bn a year was predicted to open up.

He said: "Without a detailed, fully-costed plan to provide the staff and resources needed to deliver more seven-day services, this is at best an empty pledge and at worst shameless political game-playing with the NHS ahead of the election."

'Efficiency changes'

The Conservatives have pledged to guarantee a real-term increase in funding for the NHS during the next Parliament, extending the ring-fence in place for the past five years. Labour has said it will spend £2.5bn more than its opponents.

Health Secretary Jeremy Hunt said government reforms of the NHS were saving £1.5bn a year but that the NHS "will need more money".

He added that the NHS's own sums suggested the predicted £30bn annual shortfall could be "reduced with efficiency changes, and we're backing that plan".

New clinical standards set out in 2013 require hospitals to provide seven-day access to diagnostic tests, such as X-rays, ultrasound, MRI scans and pathology, as well as providing access to multi-disciplinary teams, which include expert nurses and physiotherapists.

In its blueprint for services over the next five years, published last October, NHS England said hospital patients should have access to seven-day services by 2020 - "where this makes a clinical difference to outcomes".

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Meningitis B vaccine deal agreed

All UK babies will soon have access to a vaccine against meningitis B, after a deal with drug manufacturers, Health Secretary Jeremy Hunt has announced.

The agreement with GlaxoSmithKline will mean the vaccine can be introduced on the NHS "this year", Mr Hunt said.

Government advisers said in 2014 that every child over two months old should be given the vaccine, but negotiations over costs have delayed this process.

Mr Hunt said it was important to get value for money.

Campaigners had warned the delays put children's lives at risk.

The drug will now be added to the national childhood immunisation scheme, meaning babies will receive the first vaccine at two months old, followed by two further doses.

Scotland's health secretary, Shona Robison, said the vaccine would be provided to all infants in Scotland "as quickly as possible" following the deal - which was also made on behalf of the devolved government.

A Welsh government spokesman said a price for the vaccine had been negotiated and the Welsh government was "committed to being included in the UK-wide procurement for the vaccine" and to make it available in Wales "as soon as practicable".

Northern Ireland's health minister, Jim Wells, also welcomed the outcome of the negotiations "to secure an effective, safe and cost-effective vaccine".

Price negotiations

Mr Hunt said he was "delighted" to have secured an agreement with GSK - the company that now manufactures the vaccine.

It followed lengthy negotiations with another supplier - Novartis - which used to own the vaccine, called Bexsero.

GSK acquired the vaccine from Novartis, which resulted in the price of the vaccine being reduced and the deal being struck, Mr Hunt said.

Case study

Ten-year-old Sofia Crockatt lost her left leg below the knee to meningitis when she was two. Despite this, she has no mobility issues and runs, goes horse riding, and takes part in athletics.

Her father Nick said the day she became sick in 2007 was "one of the worst days of our life".

"Sofia went from being ill with what looked like a regular flu bug, to fighting for her life within hours. The speed of it is scary.

"We found out a year ago that the vaccine was available and was ready to go - we then celebrated a year ago that this vaccine was available.

"It's just frustrating and disappointing that some people have lost their lives and limbs and bits and pieces as a result of this vaccine not being available."

Announcing the agreement, the health secretary said he was "very proud that we will be the first country in the world to have a nationwide MenB vaccination programme".

He said that although it was "disappointing" the deal had taken so long, it was important to follow the advice of independent scientific advisors on vaccines and their costs.

"We follow that advice, because we can't afford every single medicine, every single new vaccine on the NHS."

Mr Hunt added: "[The deal] means we can now go ahead this year with rolling out the meningitis B vaccine and I think that's something that families, particularly ones with young children, will really welcome."

Sue Davie, chief executive of charity Meningitis Now, said: "To know that babies will be protected against MenB is fantastic and another great step forward in our fight against meningitis."

Chris Head, chief executive of the Meningitis Research Foundation, said: "We are delighted that vaccinating all babies against this devastating disease is now within sight, cementing the UK's position as a world leader in meningitis prevention."

Linda Glennie, also of the foundation, said the vaccine was predicted to cover more than 80% of meningitis B cases.

It would protect against a more virulent strain of meningitis B increasingly found in the UK, she added.

Meningitis B is a bacterial infection that particularly affects children under the age of one. It commonly affects children under five years of age, and is also common among teenagers aged 15 to 19.

There are about 1,870 cases of meningitis B each year in the UK.

Symptoms include a high fever with cold hands and feet, confusion, vomiting and headaches. Most children will make a full recovery with early diagnosis and antibiotic treatment.

It is fatal in one in 10 cases. About one in four of those who survive is left with long-term problems, such as amputation, deafness, epilepsy and learning difficulties.

What is meningitis?

• Meningitis is an infection of the meninges - the membrane that surrounds the brain and spinal cord
• Meningococcal bacteria are common and carried harmlessly in the nose or throat by about one in 10 people
• They are passed on through close contact
• Anyone can get meningitis but babies and young children are most vulnerable
• Symptoms include a high fever with cold hands and feet, agitation, confusion, vomiting and headaches

Q&A: Meningitis B vaccine

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Parents rarely spot child obesity

Parents hardly ever spot obesity in their children, resulting in damaging consequences for health, doctors warn.

In a study of 2,976 families in the UK, only four parents thought their child was very overweight. Medical assessments put the figure at 369.

The researchers, writing in the British Journal of General Practice, said obesity had become the new normal in society.

Experts said the study showed the "enormity" of the obesity epidemic.

Around one in five children in Year 6 is obese and a further 14% are overweight, the National Child Measurement Programme shows.

Blind spot

The team, from the London School of Hygiene and Tropical Medicine and the UCL Institute of Child Health, gave questionnaires to nearly 3,000 families asking if their child was obese, overweight, underweight or a healthy weight.

The results showed that nearly a third, 31%, of parents underestimated the weight of their child.

An accurate diagnosis kicked in only at the very high end of the scales.

Prof Russell Viner, from the Institute of Child Health, told the BBC News website: "Modern parents don't recognise children as obese.

"If parents don't recognise a child is obese then they're very unlikely to do anything to help their child move to a more healthy weight.

"Then it's a potential major public health crisis being stored up."

The main explanation for parents not identifying their child's weight problem is that society as a whole has become so fat we have collectively lost our sense of a healthy weight.

The chief medical officer, Dame Sally Davies, raised this issue of overweight becoming the new norm in her annual report last year.

"We need to find some tool to educate parents, when their child is born, what they should expect a child's size to be and not to be afraid of talking to parents over fears they, or the child, will react badly," Prof Viner said.

'Role models'

Commenting on the findings, the chief executive of the Royal Society for Public Health, Shirley Cramer, said: "School education from a young age should focus on the importance of active lifestyles and healthy diets to ensure our society is one that understands the relationship between diet and good health.

"Parents are key role models for their children and it is imperative they are aware of all the factors that can influence health.

"However, it is not just the role of the parents, society as a whole needs to help enforce messages about eating well."

She said restricting junk food advertising would help as would better calorie labelling on food.

Tam Fry, from the Child Growth Foundation, told the BBC: "To the obesity specialist it is incomprehensible that parents cannot tell if their children are overweight.

"You sometimes have to wonder if they are in total denial, but when you realise that even health professionals may often have difficulty in recognising obesity in their patients, the enormity of our obesity epidemic sinks in.

"The knock-on risk of extreme overweight to the individual's and country's health cannot be emphasised enough."

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British medic declared free of Ebola

A UK military medic who has been discharged from hospital after being declared free of Ebola said it was thanks to medics that she is alive.

Cpl Anna Cross was the first person in the world to be given the experimental Ebola drug MIL 77, her doctors said.

Cpl Cross, aged 25, from Cambridge, caught the virus while working as a volunteer nurse in Sierra Leone.

During her illness she lost 22lb (10kg) and spent 14 days being treated at London's Royal Free Hospital.

They are an incredible bunch of clinicians - incredibly skilled, incredibly dedicated and incredibly professional

Anna Cross, Military medic

Doctors at the hospital said they were "absolutely thrilled" she had made a full recovery.

They described the drug she was given as a close relative of the medicine ZMapp - which British nurse William Pooley received when he was treated for Ebola.

Experts at the Royal Free said MIL 77 was made in China and that a limited supply was available, should anyone need it.

It is too soon to know what role the drug played in Cpl Cross's recovery, they added.

'Clinging on'

The army reservist thanked the team at the hospital, saying they were, in her opinion, "the best in the world".

She said: "They are an incredible bunch of clinicians - incredibly skilled, incredibly dedicated and incredibly professional.

"Thanks to them I'm alive."

The military medic had been working at the British Kerry Town treatment centre in Sierra Leone for three weeks before she became ill.

British military personnel were deployed to Sierra Leone to assist with the Ebola crisis

But Cpl Cross, who is an intensive care nurse in the UK, said an investigation had not been able to determine how she caught the virus.

'Complete chicken'

When first told she had Ebola she said "it was really hard for a few hours".

She added: "Then something within me just kicked in, as it does in difficult situations."

But when it came to telling her family about the virus she was "completely chicken".

The military sent people to support her relatives during this time.

Doctors said she is now completely free of Ebola after being cared for in an isolation unit.

But she added: "It's going to take time until I can just be normal and get about my normal day. Then I have to be military fit, that might take months."

Prof Jonathan Ball, a virus expert at the University of Nottingham, said: "This is fantastic news that another individual admitted to the Royal Free has recovered from Ebola.

"She was given an experimental drug, but it is impossible to say whether or not this directly contributed to her clearing the virus.

"In order to know whether a drug does work we need experimental trials and thankfully trials of various drugs are underway in West Africa, where Ebola virus is still doggedly clinging on."

Ebola has claimed more than 10,000 lives across the worst-affected countries of Sierra Leone, Guinea and Liberia in the past 12 months.

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Meningitis B vaccine deal agreed

All UK babies will soon have access to a vaccine against meningitis B, after a deal with drug manufacturers, Health Secretary Jeremy Hunt has announced.

The agreement with GlaxoSmithKline will mean the vaccine can be introduced on the NHS "this year", Mr Hunt said.

Government advisers said in 2014 that every child over two months old should be given the vaccine, but negotiations over costs have delayed this process.

Mr Hunt said it was important to get value for money.

Campaigners had warned the delays put children's lives at risk.

The drug will now be added to the national childhood immunisation scheme, meaning babies will receive the first vaccine at two months old, followed by two further doses.

Scotland's health secretary, Shona Robison, said the vaccine would be provided to all infants in Scotland "as quickly as possible" following the deal - which was also made on behalf of the devolved government.

A Welsh government spokesman said a price for the vaccine had been negotiated and the Welsh government was "committed to being included in the UK-wide procurement for the vaccine" and to make it available in Wales "as soon as practicable".

Northern Ireland's health minister, Jim Wells, also welcomed the outcome of the negotiations "to secure an effective, safe and cost-effective vaccine".

Price negotiations

Mr Hunt said he was "delighted" to have secured an agreement with GSK - the company that now manufactures the vaccine.

It followed lengthy negotiations with another supplier - Novartis - which used to own the vaccine, called Bexsero.

GSK acquired the vaccine from Novartis, which resulted in the price of the vaccine being reduced and the deal being struck, Mr Hunt said.

Case study

Ten-year-old Sofia Crockatt lost her left leg below the knee to meningitis when she was two. Despite this, she has no mobility issues and runs, goes horse riding, and takes part in athletics.

Her father Nick said the day she became sick in 2007 was "one of the worst days of our life".

"Sofia went from being ill with what looked like a regular flu bug, to fighting for her life within hours. The speed of it is scary.

"We found out a year ago that the vaccine was available and was ready to go - we then celebrated a year ago that this vaccine was available.

"It's just frustrating and disappointing that some people have lost their lives and limbs and bits and pieces as a result of this vaccine not being available."

Announcing the agreement, the health secretary said he was "very proud that we will be the first country in the world to have a nationwide MenB vaccination programme".

He said that although it was "disappointing" the deal had taken so long, it was important to follow the advice of independent scientific advisors on vaccines and their costs.

"We follow that advice, because we can't afford every single medicine, every single new vaccine on the NHS."

Mr Hunt added: "[The deal] means we can now go ahead this year with rolling out the meningitis B vaccine and I think that's something that families, particularly ones with young children, will really welcome."

Sue Davie, chief executive of charity Meningitis Now, said: "To know that babies will be protected against MenB is fantastic and another great step forward in our fight against meningitis."

Chris Head, chief executive of the Meningitis Research Foundation, said: "We are delighted that vaccinating all babies against this devastating disease is now within sight, cementing the UK's position as a world leader in meningitis prevention."

Linda Glennie, also of the foundation, said the vaccine was predicted to cover more than 80% of meningitis B cases.

It would protect against a more virulent strain of meningitis B increasingly found in the UK, she added.

Meningitis B is a bacterial infection that particularly affects children under the age of one. It commonly affects children under five years of age, and is also common among teenagers aged 15 to 19.

There are about 1,870 cases of meningitis B each year in the UK.

Symptoms include a high fever with cold hands and feet, confusion, vomiting and headaches. Most children will make a full recovery with early diagnosis and antibiotic treatment.

It is fatal in one in 10 cases. About one in four of those who survive is left with long-term problems, such as amputation, deafness, epilepsy and learning difficulties.

What is meningitis?

• Meningitis is an infection of the meninges - the membrane that surrounds the brain and spinal cord
• Meningococcal bacteria are common and carried harmlessly in the nose or throat by about one in 10 people
• They are passed on through close contact
• Anyone can get meningitis but babies and young children are most vulnerable
• Symptoms include a high fever with cold hands and feet, agitation, confusion, vomiting and headaches

Q&A: Meningitis B vaccine

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Cameron promises 'seven-day NHS'

All hospitals in England will provide "a truly seven-day NHS" by 2020 under a future Conservative government, David Cameron has said.

At the party's spring forum, Mr Cameron said that more hospitals must provide top-level treatment at the weekend, starting with emergency care.

In a wide-ranging speech, he said his party's message to various sections of the population was: "We're with you."

Labour said Tory plans for "extreme" spending cuts threatened the NHS.

It has put the health service at the forefront of its own election campaign, with leader Ed Miliband promising on Friday to cap the amount of profit private firms can make from the NHS in England.

Analysis

By Ben Wright, BBC political correspondent

This spring forum is about fighting back against Labour on the NHS.

Polls show a clear, large consistent lead for Ed Miliband's party on the NHS. It is the foundation stone of Labour's campaign.

But the Conservatives are desperate to chip away at it with promises of protected real-terms increases in funding and an extra £2bn a year.

The Conservatives are committing to providing full weekend hospital care in England - in line with the NHS's own five-year plan.

The big question of course is, "Where will the money come from?", but this is about politics.

This is an attempt to try to neutralise the NHS and enable the Conservatives to return to what they want to be talking about - the economy.

'Properly staffed'

Speaking at the forum in Manchester, Mr Cameron warned that figures showed patients were "more likely to die" if they were admitted at weekends.

According to the Conservatives, official studies suggest mortality rates for those admitted on Saturdays and Sundays are 11% and 16% higher respectively than for those admitted on Wednesdays.

This is at best an empty pledge and at worst shameless political game-playing

Dr Mark Porter, British Medical Association chairman

"For years it's been too hard to access the NHS out of hours. But illness doesn't respect working hours. Heart attacks, major accidents, babies - these things don't just come from nine to five," Mr Cameron said.

At weekends, he said, "some of the resources are not up and running. The key decision-makers aren't always there.

"With a future Conservative government, we would have a truly seven-day NHS.

"Already millions more people can see a GP seven days a week but by 2020 I want this for everyone, with hospitals properly staffed especially for urgent and emergency care, so that everyone will have access to the NHS services they need seven days a week by 2020 - the first country in the world to make this happen."

'Financial distress'

During his speech, Mr Cameron also reiterated a number of election campaign pledges, including:

• No tax on the first £12,500 of earnings

• No 40p rate until earnings reach £50,000

Andy Burnham, Labour's shadow health secretary, said the plans were not credible without investment in extra NHS staff.

"With the NHS in increasing financial distress, David Cameron must set out clearly how it will be paid for," he said.

The Liberal Democrats said NHS England already had plans to open hospitals and GP surgeries seven days a week, while UKIP said the Tories had "degenerated the NHS beyond all recognition" during the last five years in government.

Dr Mark Porter, chairman of the British Medical Association, said that the Conservatives' funding commitment was not even enough to maintain existing services, and that a funding gap of up to £30bn a year was predicted to open up.

He said: "Without a detailed, fully-costed plan to provide the staff and resources needed to deliver more seven-day services, this is at best an empty pledge and at worst shameless political game-playing with the NHS ahead of the election."

'Efficiency changes'

The Conservatives have pledged to guarantee a real-term increase in funding for the NHS during the next Parliament, extending the ring-fence in place for the past five years. Labour has said it will spend £2.5bn more than its opponents.

Health Secretary Jeremy Hunt said government reforms of the NHS were saving £1.5bn a year but that the NHS "will need more money".

He added that the NHS's own sums suggested the predicted £30bn annual shortfall could be "reduced with efficiency changes, and we're backing that plan".

New clinical standards set out in 2013 require hospitals to provide seven-day access to diagnostic tests, such as X-rays, ultrasound, MRI scans and pathology, as well as providing access to multi-disciplinary teams, which include expert nurses and physiotherapists.

In its blueprint for services over the next five years, published last October, NHS England said hospital patients should have access to seven-day services by 2020 - "where this makes a clinical difference to outcomes".

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Labour to cap private profits in NHS

Labour would cap the amount of profit private firms can make from the NHS in England, Ed Miliband has said as he launched the party's election campaign.

He pledged to halt the "the tide of privatisation" he claims has taken place in the health service since 2010 and ensure a "proper" level of funding.

Private firms will have to reimburse the NHS if they exceed a 5% profit cap on contracts, he told activists.

The Conservatives said the move was an "ill-thought through gimmick".

Speaking at the site of the 2012 London Olympics in east London, Mr Miliband placed the NHS front and centre of Labour's campaign and claimed the election is "neck and neck" and "may come down to the wire".

The Labour leader said his party are "the optimists" and the UK can "do better" than another five years of a Conservative-led government, whose "extreme spending cuts would led to the disintegration of public services".

Although the election campaign is not officially due to start until Monday, when Parliament is dissolved, Labour is seeking to get out of the blocks early and to emphasise the choice facing the electorate on 7 May.

In other developments on Friday:

• Plaid Cymru leader Leanne Wood says Wales' future is in "its own hands" at the party's campaign launch
• David Cameron highlights the Conservatives' help for first-time buyers, including the extension of the Help to Buy Scheme to 2020
• Chancellor George Osborne hosts a group of US politicians - including House of Representatives Speaker John Boehner - on a trip to Cheshire to showcase his plans for a "northern powerhouse"
• Reaction continues to Thursday's Channel 4/Sky News leader interviews - the first of four major TV events during the campaign - in which Mr Miliband insisted he was "tough enough" to be prime minister
• Leaked documents seen by the BBC suggest the Conservatives are considering options for scrapping several benefits

Labour is saving the majority of its new policy announcements for its manifesto launch but Mr Miliband used Friday's speech to set out clear dividing lines between Labour and the Conservatives on the NHS.

NHS treatment is free at the point of delivery for patients but external contractors are paid for providing a range of services to the health service.

Ed Miliband said there was "stark choice" between the parties at the election

Mr Miliband hit the campaign trail with senior colleagues after his speech

Under a Labour government, profits on all private sector contracts worth more than £500,000 will be capped, Mr Miliband said, suggesting that private sector involvement was "draining money away" from the NHS.

The cap will be set at a default level of 5%, although this could raised or lower to reflect the specific terms of different contracts.

Any returns that firms make above this level would have to be ploughed back in full into the NHS to support patient care - while NHS commissioners will have the power to terminate private contracts early in the event of unacceptable performance.

Analysis by BBC Health Editor Hugh Pym

Amidst Ed Miliband's rhetoric on the "drive to privatisation" of the NHS which he claims is happening under David Cameron is a new policy - imposing a cap on profits made by private providers.

Currently around 6% of health service provision in England comes from companies in the private sector.

Labour wants to limit profit margins to 5% on all contracts above £500,000.

But what we haven't been told is how widely the net would be cast.

Would the cap, for example, include dentistry and the private finance initiative?

Margins on some contracts like catering and cleaning are probably below 5%.

But the private sector argues that companies need a return if they invest up front to provide clinical services and that some might be deterred from bidding if there was a profit cap.

What Labour, if elected, will have to decide is whether a shrinking pool of private contractors would make it harder for the NHS to keep up with rising demand for care.

Mr Miliband also committed to new controls to stop private firms "cherry picking" the most straightforward cases and to stop the forced tendering of services, making clear the NHS must be the preferred provider for the majority of services.

"Privatisation cannot meet the needs of a 21st Century health service," he said.

"The money we pay for our health care should be invested for patient care and not for the excess profits of private firms."

David Cameron spent the morning highlighting the Conservatives' housing record

The restrictions, in combination with the £2.5bn in extra funding already promised by Labour, will provide a "double lock" to protect the NHS, he added.

The Conservatives responded by saying outsourcing to the private sector rose twice as fast under the previous Labour government than it had done since 2010.

"This is no more than a gimmick to scare people about privatisation that isn't happening," said Health Secretary Jeremy Hunt.

"It risks higher infection rates, higher waiting times and chaos for our NHS."

With little to split the Conservatives and Labour in the opinion polls, Mr Miliband stressed the contest is too close to call.

"Like so many races here during the Olympics, it will go down to the wire. Neck and neck," he said.

"But there is one thing that is clear. There are only two possible outcomes in this election - a Conservative government or a Labour government."

He argued the UK cannot afford another five years of a Conservative-led government, claiming David Cameron has raised taxes 24 times since 2010, delivered the "worst record on living standards since the 1920s" and is planning "deeper cuts" after 7 May.

"They say that's as good as it gets. We say Britain can do better than this," he said.

At Friday's event, Labour also unveiled its campaign "battle bus", which will travel round the country rallying support in key marginal seats. Ten senior Labour figures will be on the bus as it makes its first visit to a seat in east London.

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British medic declared free of Ebola

A UK military medic who has been discharged from hospital after being declared free of Ebola said it was thanks to medics that she is alive.

Cpl Anna Cross was the first person in the world to be given the experimental Ebola drug MIL 77, her doctors said.

Cpl Cross, aged 25, from Cambridge, caught the virus while working as a volunteer nurse in Sierra Leone.

During her illness she lost 22lb (10kg) and spent 14 days being treated at London's Royal Free Hospital.

They are an incredible bunch of clinicians - incredibly skilled, incredibly dedicated and incredibly professional

Anna Cross, Military medic

Doctors at the hospital said they were "absolutely thrilled" she had made a full recovery.

They described the drug she was given as a close relative of the medicine ZMapp - which British nurse William Pooley received when he was treated for Ebola.

Experts at the Royal Free said MIL 77 was made in China and that a limited supply was available, should anyone need it.

It is too soon to know what role the drug played in Cpl Cross's recovery, they added.

'Clinging on'

The army reservist thanked the team at the hospital, saying they were, in her opinion, "the best in the world".

She said: "They are an incredible bunch of clinicians - incredibly skilled, incredibly dedicated and incredibly professional.

"Thanks to them I'm alive."

The military medic had been working at the British Kerry Town treatment centre in Sierra Leone for three weeks before she became ill.

British military personnel were deployed to Sierra Leone to assist with the Ebola crisis

But Cpl Cross, who is an intensive care nurse in the UK, said an investigation had not been able to determine how she caught the virus.

'Complete chicken'

When first told she had Ebola she said "it was really hard for a few hours".

She added: "Then something within me just kicked in, as it does in difficult situations."

But when it came to telling her family about the virus she was "completely chicken".

The military sent people to support her relatives during this time.

Doctors said she is now completely free of Ebola after being cared for in an isolation unit.

But she added: "It's going to take time until I can just be normal and get about my normal day. Then I have to be military fit, that might take months."

Prof Jonathan Ball, a virus expert at the University of Nottingham, said: "This is fantastic news that another individual admitted to the Royal Free has recovered from Ebola.

"She was given an experimental drug, but it is impossible to say whether or not this directly contributed to her clearing the virus.

"In order to know whether a drug does work we need experimental trials and thankfully trials of various drugs are underway in West Africa, where Ebola virus is still doggedly clinging on."

Ebola has claimed more than 10,000 lives across the worst-affected countries of Sierra Leone, Guinea and Liberia in the past 12 months.

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Cameron promises 'seven-day NHS'

All hospitals in England will provide "a truly seven-day NHS" by 2020 under a future Conservative government, David Cameron has said.

At the party's spring forum, Mr Cameron said that more hospitals must provide top-level treatment at the weekend, starting with emergency care.

In a wide-ranging speech, he said his party's message to various sections of the population was: "We're with you."

Labour said Tory plans for "extreme" spending cuts threatened the NHS.

It has put the health service at the forefront of its own election campaign, with leader Ed Miliband promising on Friday to cap the amount of profit private firms can make from the NHS in England.

Analysis

By Ben Wright, BBC political correspondent

This spring forum is about fighting back against Labour on the NHS.

Polls show a clear, large consistent lead for Ed Miliband's party on the NHS. It is the foundation stone of Labour's campaign.

But the Conservatives are desperate to chip away at it with promises of protected real-terms increases in funding and an extra £2bn a year.

The Conservatives are committing to providing full weekend hospital care in England - in line with the NHS's own five-year plan.

The big question of course is, "Where will the money come from?", but this is about politics.

This is an attempt to try to neutralise the NHS and enable the Conservatives to return to what they want to be talking about - the economy.

'Properly staffed'

Speaking at the forum in Manchester, Mr Cameron warned that figures showed patients were "more likely to die" if they were admitted at weekends.

According to the Conservatives, official studies suggest mortality rates for those admitted on Saturdays and Sundays are 11% and 16% higher respectively than for those admitted on Wednesdays.

This is at best an empty pledge and at worst shameless political game-playing

Dr Mark Porter, British Medical Association chairman

"For years it's been too hard to access the NHS out of hours. But illness doesn't respect working hours. Heart attacks, major accidents, babies - these things don't just come from nine to five," Mr Cameron said.

At weekends, he said, "some of the resources are not up and running. The key decision-makers aren't always there.

"With a future Conservative government, we would have a truly seven-day NHS.

"Already millions more people can see a GP seven days a week but by 2020 I want this for everyone, with hospitals properly staffed especially for urgent and emergency care, so that everyone will have access to the NHS services they need seven days a week by 2020 - the first country in the world to make this happen."

'Financial distress'

During his speech, Mr Cameron also reiterated a number of election campaign pledges, including:

• No tax on the first £12,500 of earnings

• No 40p rate until earnings reach £50,000

Andy Burnham, Labour's shadow health secretary, said the plans were not credible without investment in extra NHS staff.

"With the NHS in increasing financial distress, David Cameron must set out clearly how it will be paid for," he said.

The Liberal Democrats said NHS England already had plans to open hospitals and GP surgeries seven days a week, while UKIP said the Tories had "degenerated the NHS beyond all recognition" during the last five years in government.

Dr Mark Porter, chairman of the British Medical Association, said that the Conservatives' funding commitment was not even enough to maintain existing services, and that a funding gap of up to £30bn a year was predicted to open up.

He said: "Without a detailed, fully-costed plan to provide the staff and resources needed to deliver more seven-day services, this is at best an empty pledge and at worst shameless political game-playing with the NHS ahead of the election."

'Efficiency changes'

The Conservatives have pledged to guarantee a real-term increase in funding for the NHS during the next Parliament, extending the ring-fence in place for the past five years. Labour has said it will spend £2.5bn more than its opponents.

Health Secretary Jeremy Hunt said government reforms of the NHS were saving £1.5bn a year but that the NHS "will need more money".

He added that the NHS's own sums suggested the predicted £30bn annual shortfall could be "reduced with efficiency changes, and we're backing that plan".

New clinical standards set out in 2013 require hospitals to provide seven-day access to diagnostic tests, such as X-rays, ultrasound, MRI scans and pathology, as well as providing access to multi-disciplinary teams, which include expert nurses and physiotherapists.

In its blueprint for services over the next five years, published last October, NHS England said hospital patients should have access to seven-day services by 2020 - "where this makes a clinical difference to outcomes".

What has your experience been of using NHS hospitals in England at weekends? You can email haveyoursay@bbc.co.uk with your experience. Please include a telephone number if you are willing to be contacted by a BBC journalist.

Send your pictures and videos to yourpics@bbc.co.uk or text them to 61124 (UK) or +44 7624 800 100 (international). Or you can upload here.

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Labour to cap private profits in NHS

Labour would cap the amount of profit private firms can make from the NHS in England, Ed Miliband has said as he launched the party's election campaign.

He pledged to halt the "the tide of privatisation" he claims has taken place in the health service since 2010 and ensure a "proper" level of funding.

Private firms will have to reimburse the NHS if they exceed a 5% profit cap on contracts, he told activists.

The Conservatives said the move was an "ill-thought through gimmick".

Speaking at the site of the 2012 London Olympics in east London, Mr Miliband placed the NHS front and centre of Labour's campaign and claimed the election is "neck and neck" and "may come down to the wire".

The Labour leader said his party are "the optimists" and the UK can "do better" than another five years of a Conservative-led government, whose "extreme spending cuts would led to the disintegration of public services".

Although the election campaign is not officially due to start until Monday, when Parliament is dissolved, Labour is seeking to get out of the blocks early and to emphasise the choice facing the electorate on 7 May.

In other developments on Friday:

• Plaid Cymru leader Leanne Wood says Wales' future is in "its own hands" at the party's campaign launch
• David Cameron highlights the Conservatives' help for first-time buyers, including the extension of the Help to Buy Scheme to 2020
• Chancellor George Osborne hosts a group of US politicians - including House of Representatives Speaker John Boehner - on a trip to Cheshire to showcase his plans for a "northern powerhouse"
• Reaction continues to Thursday's Channel 4/Sky News leader interviews - the first of four major TV events during the campaign - in which Mr Miliband insisted he was "tough enough" to be prime minister

Labour is saving the majority of its new policy announcements for its manifesto launch but Mr Miliband used Friday's speech to set out clear dividing lines between Labour and the Conservatives on the NHS.

NHS treatment is free at the point of delivery for patients but external contractors are paid for providing a range of services to the health service.

Under a Labour government, profits on all private sector contracts worth more than £500,000 will be capped, Mr Miliband said, suggesting that private sector involvement was "draining money away" from the NHS.

The cap will be set at a default level of 5%, although this could raised or lower to reflect the specific terms of different contracts.

Any returns that firms make above this level would have to be ploughed back in full into the NHS to support patient care - while NHS commissioners will have the power to terminate private contracts early in the event of unacceptable performance.

Analysis by BBC Health Editor Hugh Pym

Amidst Ed Miliband's rhetoric on the "drive to privatisation" of the NHS which he claims is happening under David Cameron is a new policy - imposing a cap on profits made by private providers.

Currently around 6% of health service provision in England comes from companies in the private sector.

Labour wants to limit profit margins to 5% on all contracts above £500,000.

But what we haven't been told is how widely the net would be cast.

Would the cap, for example, include dentistry and the private finance initiative?

Margins on some contracts like catering and cleaning are probably below 5%.

But the private sector argues that companies need a return if they invest up front to provide clinical services and that some might be deterred from bidding if there was a profit cap.

What Labour, if elected, will have to decide is whether a shrinking pool of private contractors would make it harder for the NHS to keep up with rising demand for care.

Mr Miliband also committed to new controls to stop private firms "cherry picking" the most straightforward cases and to stop the forced tendering of services, making clear the NHS must be the preferred provider for the majority of services.

"Privatisation cannot meet the needs of a 21st Century health service," he said.

Mr Miliband has said he has been continually "under-estimated" as Labour leader

"The money we pay for our health care should be invested for patient care and not for the excess profits of private firms."

The restrictions, in combination with the £2.5bn in extra funding already promised by Labour, will provide a "double lock" to protect the NHS, he added.

The Conservatives responded by saying outsourcing to the private sector rose twice as fast under the previous Labour government than it had done since 2010.

"This is no more than a gimmick to scare people about privatisation that isn't happening," said Health Secretary Jeremy Hunt.

"It risks higher infection rates, higher waiting times and chaos for our NHS."

With little to split the Conservatives and Labour in the opinion polls, Mr Miliband stressed the contest is too close to call.

David Cameron spent the morning highlighting the Conservatives' housing record

"Like so many races here during the Olympics, it will go down to the wire. Neck and neck," he said.

"But there is one thing that is clear. There are only two possible outcomes in this election - a Conservative government or a Labour government."

He argued the UK cannot afford another five years of a Conservative-led government, claiming David Cameron has raised taxes 24 times since 2010, delivered the "worst record on living standards since the 1920s" and is planning "deeper cuts" after 7 May.

"They say that's as good as it gets. We say Britain can do better than this," he said.

At Friday's event, Labour also unveiled its campaign "battle bus", which will travel round the country rallying support in key marginal seats. Ten senior Labour figures will be on the bus as it makes its first visit to a seat in east London.

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Office workers 'too sedentary'

Office workers need to get off their backsides and move around more, according to a new campaign.

On Your Feet Britain says sitting for long periods at work is linked to a host of health problems, which are not undone by working out in the gym.

It is calling on people to stand regularly, walk around more and embrace ideas such as standing meetings or standing desks.

Experts described inactivity as "one of the biggest" challenges in health.

Heart disease, type 2 diabetes, cancers and poor mental health have all been linked to sedentary behaviour.

The effect is found even in people who class themselves as fit, such as those who cycle to work, if they also spend long periods of time sitting.

Prolonged sitting is thought to slow the metabolism and affect the way the body controls sugar levels, blood pressure and the breakdown of fat.

The campaign is a partnership between the group Get Britain Standing and the British Heart Foundation (BHF) charity.

Their survey of 2,000 office workers suggested:

• 45% of women and 37% of men spend less than 30 minutes a day up on their feet at work
• More than half regularly eat their lunch at their desk
• 78% office workers felt they spent too much time sitting down
• Nearly two-thirds were worried sitting at work was having a negative impact on their health

Gavin Bradley, from Get Britain Standing, told the BBC News website: "We're all victims of our environment, we've taken a lot of activity out of the workplace and we're sitting longer and longer.

"We need new and innovative ways of addressing the issue.

"Stand up when you're on the phone or in meetings, do everything you can to avoid sitting."

Other ideas including using the stairs instead of a lift, eating lunch away from your desk, taking a break from your computer every 30 minutes and walking to a colleague's desk rather than phoning or emailing them.

Get Britain Standing says standing burns an extra 50 calories per hour than being seated.

Dr Mike Loosemore, head of exercise medicine at University College Hospital, told the BBC: "Inactivity and sedentary behaviour is one of the biggest challenges we have in public health today.

"Compared with 100 years ago, our levels of activity are tiny, the number of manual jobs are continually reducing, even if you dig a road up you sit in a little tractor.

"It's about changing attitudes to how people behave at work and changing the culture of the workplace that just means moving around at little bit more, even just standing up can make a big difference to calories burned and how alert, creative and productive you are."

Lisa Young, project manager for the BHF's Health at Work programme, said: "We're all guilty of being too glued to our screens sometimes, but these results show just how far the couch potato culture has infiltrated the workplace.

"Too many of us are tied to our desks at work, which could be increasing our risk of developing cardiovascular disease.

"That's why we want workers to get up and get moving on 24 April and take a stand against cardiovascular disease.

"A bit of healthy competition in the workplace could go a long way to reversing this trend whilst raising vital funds for our ground-breaking research."

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British medic declared free of Ebola

British military personnel were deployed to Sierra Leone to assist with the Ebola crisis

A UK female military medic who tested positive for Ebola has been released from the Royal Free Hospital in London after being declared free of the virus.

She was the first person in the world to be given the experimental Ebola drug MIL 77.

Corporal Cross, aged 25, caught the virus while working as a volunteer nurse in Sierra Leone.

She is the third UK worker with Ebola who has recovered at an isolation unit in the London hospital.

Doctors at the Royal Free said they were "absolutely thrilled" she has made a full recovery.

They described the drug she was given as a close relative of the medicine ZMapp - the treatment British nurse William Pooley received.

Experts at the Royal Free said it was made in China and that a limited supply is available should any one need it.

It is too soon to know what role the drug played in her recovery, they said.

Corporal Cross, 25, thanked the team at the hospital, saying they were in her opinion, the best in the world.

She does not know how she caught the disease. Public Health England officials previously announced they are investigating how the military worker was exposed to the virus.

She says she is now looking forward to doing "normal things like eating food and watching TV".

While in the UK she works as an intensive care nurse in the NHS.

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NHS problems worst 'since 1990s'

Services in the NHS in England are deteriorating in a way not seen since the early 1990s, according to a leading health think tank.

The King's Fund review said waiting times for A&E, cancer care and routine operations had all started getting worse, while deficits were growing.

It said such drops in performance had not been seen for 20 years.

But the think tank acknowledged the NHS had done as well as could be expected, given the financial climate.

Professor John Appleby, chief economist at the King's Fund, which specialises in health care policy, said: "The next government will inherit a health service that has run out of money and is operating at the very edge of its limits.

"There is now a real risk that patient care will deteriorate as service and financial pressures become overwhelming."

He said in terms of how standards were slipping - not how low they had reached - the situation was the worst it had been since the "early 1990s".

The report noted much of the deterioration has happened in the second-half of the Parliament with many measures of performance being maintained in the first few years.

It said the next government had to address the funding situation, adding the extra £8bn a year NHS England says is needed by 2020, was the "minimum" that would be required.

The report - a review of performance this Parliament - highlights a range of problems as well as achievements. These include:

• Waiting time targets for A&E, hospital treatment and cancer care all being missed towards the end of the parliament.
• Bed occupancy increasing to "very high levels", while delays in discharging patients have "risen significantly".
• Funding being increased by 0.8% a year on average - higher than was predicted mainly because of the low levels of inflation.
• Hospital infections, such as MRSA and Clostridium difficile, dropping to historically-low levels.
• Public satisfaction levels reaching their second highest levels ever.
• The number of doctors and nurses increasing, while management costs had been "significantly reduced".
• Levels of deficits increasing though as the NHS struggles to keep up with demand.

The report is the second part of the King's Fund pre-election review of the NHS this Parliament.

Last month it warned the coalition government's reforms of the health service had been "damaging and distracting".

The King's Fund report should make worrying reading. The reference to the 1990s conjures up images of - for the NHS at least - a bygone era.

The think tank's point was not that waiting times had reached the level they were at then, rather that this is the first time in two decades of almost continuous improvement that there has been a sustained drop in performance.

In many ways, that had to happen. Services cannot keep getting better for ever.

Nonetheless, the findings are crystal clear: the NHS is at a critical juncture.

But what is less easy to determine is to what extent the coalition's policies have contributed to the difficulties.

The think tank has already provided a critical analysis of the government's reforms - and when pushed, acknowledged the health service may have been "in better shape" if they had not happened.

But the more significant issue for the health of the health service this Parliament has been the squeeze on finances. Even though the budget has been increased, it has felt more like a cut to many because demands have risen so quickly.

On this though, the King's Fund accepted that the government's hands were tied. Given the state of the economy, ministers did about as much as they could have.

Read more from Nick

Royal College of Nursing general secretary Peter Carter said politicians needed to take note of the warnings made by the King's Fund.

"Morale is low, and more and more staff are being made sick with stress because of the intolerable pressure they are under," he added.

Katherine Murphy, of the Patients Association, said: "The findings echo what we are hearing on a daily basis on our helpline. It is clear to the public that the future of the NHS is one of the most important issues facing the nation and it should be a central issue in the election campaign."

Shadow Health Secretary Andy Burnham said: "Five years ago David Cameron stood on a promise to protect the NHS. This report provides authoritative proof that he has broken that promise."

But a Department of Health spokesman said: "As the King's Fund says, the NHS has 'performed well in the face of huge challenges', but if we are to continue to invest in the NHS going forward it needs to be backed by a strong economy."

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