Saturday 30 July 2011

Pilgrim Hospital student nurses removed over 'concerns'

The hospital has been recently criticised by the Care Quality Commission

About 100 student nurses have been removed from Boston's Pilgrim Hospital after the Nursing and Midwifery Council expressed "serious concerns" about it.

The Universities of Nottingham and Lincoln, and the Open University, have confirmed their students are affected.

The Patients Association said the move was a "damning condemnation" of care at the hospital.

The United Lincolnshire Hospitals Trust said patient safety was not affected as students only supported core staff.

'Support students'

Fifty-two of the affected nurses are from courses run by the University of Nottingham, with another seven from the University of Lincoln and the rest from The Open University.

In a statement, the Nursing and Midwifery Council (NMC) said: "Following serious concerns that have formally been raised with the NMC, we have asked The University of Lincoln, The University of Nottingham and The Open University to withdraw around 100 nursing and midwifery students with immediate effect.

"We are working with the universities to review the suitability of the learning environment at Pilgrim Hospital and to support all students affected at this time."

Sylvia Knight, director of nursing and patient services at United Lincolnshire Hospitals Trust, said: "Although students form a valuable part of the nursing teams, they work in addition to our core staff, therefore our ability to deliver safe services for patients is not reliant on the presence of student nurses and midwives.

"At the present time, we are seeking further clarification from the NMC regarding the reason for their actions."

'Lack of care'

NHS East Midlands said: "We are now working closely with the Nursing and Midwifery Council, NHS Lincolnshire and the hospital itself to understand the concerns of the NMC that have led to them removing student nurses and midwives from the Pilgrim Hospital site."

The chief executive of the Patients Association, Katherine Murphy, said: "How many times do we have to hear about the lack of essential care in this hospital before something is done?

"Patients deserve better - if this hospital is performing so badly that it is not thought suitable to train nurses then it is certainly not suitable to care for sick and vulnerable patients.

"What is the trust going to do about this?," she said.

Last month the hospital was criticised by the Care Quality Commission (CQC), which said it had not met required standards in 12 of 16 categories.

'Normal working relationship'

In a statement, the CQC said it had shared information about the United Lincolnshire Hospitals NHS Trust with the NMC.

"This is part of our normal working relationship and the information had previously been shared with the trust.

"The CQC is carrying out a wider investigation into the trust and we will publish the findings of this in due course," a CQC spokesperson said.

Police have confirmed a separate inquiry into reports of mistreatment of patients by a member of staff is continuing.

NHS chiefs 'abuse system by delaying treatment'

Insisting patients wait a certain length of time before treatment has been used as a way to save money

NHS managers are abusing the system by making patients wait longer for treatment, the health secretary says.

Andrew Lansley was speaking out after a competition watchdog criticised the way non-emergency operations, such as knee and hip replacements, were being run.

The Co-operation and Competition Panel said some primary care trusts had introduced minimum waiting times to save money and level-down performance.

It said some patients were forced to go private or died before they got care.

But managers reacted angrily to the claims.

David Stout, director of the Primary Care Trust Network, said: "Making claims without evidence that patients are dying as a result of longer waiting lists will cause unnecessary public anxiety and alarm.

"Commissioners take very seriously their role to ensure that patient health is not put at risk waiting for the care they need."

The panel was unable to say how many places were adopting such practices and the report did not name any individual trusts.

It is also unclear what patients were dying from as the treatment they were waiting for was not life-saving care.

But the report cited an anonymous example where one trust was insisting patients wait at least 15 weeks for treatment. Such a time frame is within the 18-week limit, but many hospitals can see patients more quickly than that.

'Delay treatment'

Mr Lansley said the findings justified his reform programme, which aims to put doctors in charge of decision-making.

"This is exactly why we need to put patients' interests first," he said.

“Start Quote

Too many PCTs have been operating in a cynical environment where they can game the system”

End Quote Andrew Lansley Health Secretary

"Too many PCTs have been operating in a cynical environment where they can game the system - and in which political targets, particularly the maximum 18 week waiting time target, are used to actually delay treatment.

"When GPs, specialist doctors and nurses are making the decisions, as they will under our plans, they will plan care on the basis of the clinical needs of patients and their right to access the best service, including the least possible waiting time."

The effect of minimum waiting times is two-fold. Firstly, it can be used to save money if treatment is knocked into the next financial year.

And private health firms seeing NHS patients have argued it erodes their competitive advantage. Since 2006 patients have had a right to choose where they go for treatment including private hospitals given official approval.

They tend to be able to see people more quickly than NHS centres and therefore making patients wait longer negates one of their selling points, some firms have argued.

The CCP report also looked at a whole host of other anti-competitive and patient unfriendly practices being employed by NHS trusts.

As well as introducing minimum waiting times, these included giving local NHS hospitals guaranteed levels of treatment, rationing the range of treatments private hospitals could provide to the NHS and capping the number of patients that could go outside the local area.

PCTs had argued the measures were needed to protect local hospitals.

Wednesday 27 July 2011

A widow has accused the NHS of criminal behaviour for "hiding" evidence that her husband might still be alive if he had been properly treated in an am

Her comments came after a Sky News investigation uncovered a culture of secrecy surrounding incompetent paramedics.

Relatives of patients who die are not routinely informed about disciplinary procedures by ambulance trusts or the paramedics' regulator the Health Professions Council (HPC).
Marion Giles, 64, from Warkworth in Northumberland, was not told that her husband Grahame’s death in 2008 followed a catalogue of failures by a paramedic from the North East Ambulance Service.
The HPC heard that three junior doctors and two nurses at Wansbeck Hospital in Ashington thought Mr Giles "could have survived" a heart attack if he had been given the correct treatment.
Mrs Giles only learned the truth after Sky News found clues to her husband's identity buried in a heavily-redacted transcript of an HPC misconduct hearing.
In line with its standard practice, the regulator had not publicised the hearing locally, Mr Giles' name had not been mentioned, and his wife had not been invited.

With proper treatment, Mr Giles might have survived a heart attack

"It's criminal really, that all this went on, hidden, and they didn’t have the guts to tell me and to be honest about what had happened," she said.
"It's left me horrified to think that I’d put my trust in medical staff and now it’s made me feel they've let me down, they haven't told me the truth and it's very hurtful."
Solicitor Mary-Ann Charles, from Shaw and Company in Newcastle, says the secrecy is preventing victims' families from seeking justice and compensation.
"It sounds like a cover-up, it smells like a cover-up, and it really is acutely concerning that people can't find out what’s going on, especially when it could be of such significance to them," she said.
Peter Walsh, a campaigner for greater transparency in the NHS and chief executive of the charity Action against Medical Accidents, said Sky's findings demonstrate a "staggering" lack of ethics.
"Action should be taken to ensure that any NHS body that is complicit with this unacceptable behaviour is held to account," he said.
Sky News studied documents from a handful of the 95 HPC misconduct hearings since 2005 that led to paramedics being struck off.
In the case of Grahame Giles, paramedic Brian Jewers had refused to follow a doctor's telephone instruction to administer a potentially life-saving drug and failed to carry out two other vital procedures.

It sounds like a cover-up, it smells like a cover-up, and it really is acutely concerning that people can't find out what’s going on, especially when it could be of such significance to them.

Mary-Ann Charles, solicitor from Shaw and Company in Newcastle

Wansbeck Hospital, which raised the alarm, told Sky News it assumed the ambulance service would inform his family.
The North East Ambulance Service has not responded to requests for an explanation about why Mrs Giles was not told.
At his home in Shilbottle, Northumberland, Jewers declined to answer questions, saying: "That was three years ago, I've forgotten about it."
Earlier this year, the North East Ambulance Service paid £40,000 in compensation to James and Kerry-Ann Hopper after failing to tell them that Jewers had given "incompetent" treatment to their mother.
Their solicitor Mary Ann Charles had discovered by chance that Jewers was disciplined over the death of 40-year-old Denise Hopper in 2007.
In another case, the truth was deliberately withheld from an elderly man in Greenock, near Glasgow, whose wife had died in 2006 following misconduct by two paramedics.

The truth was withheld from an elderly man in Greenock, near Glasgow, whose wife had died in 2006

The truth was withheld from one elderly widower in Scotland

A general manager for the Scottish Ambulance Service told the HPC that he "didn't really see any benefit to us" in telling the unidentified man the truth.
The manager said that, if the man was told, he could have concluded that his 72-year-old wife "might still have been here if someone else had come and done a different job.
"He is more comfortable thinking that everything that could have been done was done," he said.
The HPC panel member replied: "OK, thank you very much. I have no further questions."
A spokesman for the Scottish Ambulance Service could not say if the man had subsequently been informed and could not locate the trust's policy on contacting the relatives of negligence victims.
The London Ambulance Service did not inform the family of a man who died in New Malden in 2007 that a paramedic was being disciplined for failing to give him prompt treatment.
The trust's first contact was made when relatives wrote a letter two years later. The trust confirmed that no compensation claim was made, but refused to discuss the correspondence.

It's left me horrified to think that I’d put my trust in medical staff and now it’s made me feel they've let me down, they haven't told me the truth and it's very hurtful.

Marion Giles, widow of Grahame

A trust spokeswoman said they contact relatives if they have made the complaint that leads to disciplinary action, "in line with the Department of Health's 'Being Open' policy".
In August 2010, a paramedic from the Yorkshire Ambulance Service was struck off over his treatment of three patients including a seven-year-old girl who died in June 2008.
The paramedic pronounced the girl dead without giving her advanced life support treatment - but the complaint was not made by the girl's family.
The Yorkshire Ambulance Service will not say whether the girl's parents know about what happened to their daughter, citing patient confidentiality.
The HPC issued a statement confirming it was aware of "some instances" where families are not told that misconduct hearings are being held.
"We are taking steps to ensure that they are informed of the hearing, where appropriate and in-line with patient confidentiality," it said.
A spokeswoman clarified the statement, saying there is no guarantee that families will be informed, and no attempts will be made to contact relatives of victims where the case has already been heard.
Marion Giles says the HPC's response has made her lose faith in the National Health Service.
"I just don't know how they could go down that line. I don't know why they're doing that, for what reason? Just to cover their own backs, I presume," she said.
As a result of Sky's findings, the coroner for North Northumberland has launched an investigation into the circumstances of Grahame Giles' death.
"Further information which it seems was not available to the previous coroner, is being clarified before deciding whether to review the case or to hold an inquest," he said.

Rickets cases reported in Cardiff by health workers

Coloured X-Ray of the legs of a child with rickets

Rickets can lead to bone deformities and stunted growth

Cases of the crippling children's bone disease rickets are being seen in Cardiff, BBC Wales has learned.

Caused by a lack of vitamin D, the disease can lead to deformities like bowed legs and stunted growth, but it largely disappeared last century.

Eye on Wales has learnt health professionals working in communities in south Cardiff are reporting incidents.

Public Health Wales does not hold statistics on the number of cases as rickets is not a notifiable disease

Dr Elspeth Webb, a reader in child health at Cardiff University, spends half her time working as a paediatrician within Splott and Tremorfa in the city.

She told the programme: "We're still seeing rickets in children in Cardiff in the 21st Century - which a lot of people might be very shocked and surprised by, thinking of it as a Victorian illness. But no, it's not.

"You get women living in certain communities that perhaps don't go out much because of religious, cultural traditions.

"They're covered up when they do. They don't get enough access to sunlight. So they get vitamin D deficient."

“Start Quote

You don't see rickets in rich, advantaged, educated, middle-class South Asian people”

End Quote Dr Elspeth Webb Cardiff University

"Every pregnancy, you use up your vitamin D stores and if you're not making enough to replenish them, you gradually get more and more depleted.

"By your third or fourth child, that child is born already without enough vitamin D."

"So they'll be presenting with rickets at around 18 months."

While her experience suggests that rickets is confined within certain communities in south Cardiff, Dr Webb says that poverty and poor access to services are also reasons why the disease is occurring.

"You don't see rickets in rich, advantaged, educated, middle-class South Asian people. So it's a mixture of religious, cultural practices with poverty."

'Quite startling'

As co-ordinator of the Butetown Communities First project, Nathan Evans has been involved in the response to rickets and believes progress can be made towards eradicating the disease.

"For me this is something from the past. This is something that is alive and kicking in the 21st Century? This was quite startling for me."

“Start Quote

Within Cardiff you've got quite dramatic contrasts between the northern area of Cardiff and the old docks area where life expectancy is considerably lower”

End Quote Prof Gareth Williams Cardiff University School of Social Sciences

"But then some of the remedies surrounding it are around that up-take of Vitamin D. So it's around diet, it's around lifestyle."

"The Local Health Board have this big drive around vitamin up-take. This has proved quite successful locally."

"As long as active promotion of where people can access vitamins, how they can maybe modify their behaviour in order to attract more sunlight into their lives then I believe this is something that can be reversed."

The cases of rickets serve to highlight the health inequalities - and differences in life expectancy - that exist within Wales' capital city.

Those differences have always existed, but Gareth Williams - a professor of sociology at Cardiff University - said the gap was widening, not shrinking.

"Within Cardiff you've got quite dramatic contrasts between the northern area of Cardiff and the old docks area where life expectancy is considerably lower. There's a 10-year life expectancy difference."

"Everyone's life expectancy is getting better. The life expectancy of people in poor communities has been getting better very slowly.

"Whereas the life expectancy of people in wealthier places is getting better quite quickly."

Earlier this month, First Minister Carwyn Jones committed the Welsh Government to passing a Public Health Bill to deliver improved life expectancy and reduce health inequality within the life of this assembly.

Saturday 23 July 2011

Animals with human DNA

Researchers can add human genes and tissues to mice

It was one of the great comedy sketch moments from Not the Nine O'Clock News. Mel Smith is a scientist on a talk-show, sitting next to a gorilla (Rowan Atkinson in a costume) and begins explaining how he has taught him to speak.

Smith: "When I caught Gerald in '68 he was completely wild."
Gerald/Atkinson: "Wild. I was absolutely livid."
Funny, yes, and truly far-fetched, but experiments on animals that lead to possible human characteristics are something the Academy of Medical Sciences has spent nearly two years considering.
It looked at the vast and growing area of research involving the insertion of human DNA or cells into animals.
This sort of research has been going on for decades. It can involve a single gene being inserted in a mouse genome, or the transplantation of human cells or tissue into animals, creating what are known as chimaeras.
The point is to study human development and disease - anything from cancer, stroke or dementia to Down's syndrome.
People know that experimentation on animals takes place, but probably very few know much about this area. The academy commissioned a consortium led by the polling organisation Ipsos Mori to look at public opinion.
Great Apes
The public consultation showed strong support as long as people felt it would produce genuine benefits for medicine and that these would be widely available.
Most of this area of research involves mice, but rats, fruit flies and zebra fish are also used.
One of the key areas of potential concern outlined in the report is research involving the brain: "The predominant question is whether populating an animal's brain with human-derived cells could result in the production of an animal with human cognitive capacity" - areas such as consciousness, awareness and sentience and human-like behavioural capabilities.
The academy thinks if human brain stem cells were transplanted into a mouse in the womb, it would still probably end up acting like a mouse. But it is less certain about the potential consequences for a similar experiment with a larger animal, for example a sheep or pig.
Professor Martin Bobrow, who chaired the working group which compiled the report, suggested what he called the "Great Ape test". He said there is a consensus that experiments should not be carried out on Great Apes (chimpanzees, orangutans and gorillas). So if experiments to add human material gave a sheep or a pig the same level of cognitive ability as a gorilla, then it should probably not be allowed.
Science fiction
The academy is not suggesting that anyone wants to do this, but it says public discussion should occur now, long before scientists have the idea for unusual experiments.
So what else might make you feel uncomfortable? Animals with human physical features would be a step too far for many - bringing to mind HG Wells science fiction novel The Island of Dr Moreau.
And what about language? The report says: "Creating characteristics such as speech and behaviour in animals would be very complex." Considerable potential benefits would need to be justified before that was allowed.
After all, as one of the report authors said: "If you come home and your parrot says - 'who's a pretty boy?' - that's one thing. If you come home and your monkey says it, that's quite another."

US targets Iceland on whalemeat exports

A whale carcass is dragged into the processing plant at Havlur

Fin whale carcasses are landed and flensed at the Hvalfjordur plant

The US has opened the door to trade sanctions on Iceland over its hunting of fin whales and exports of whalemeat.

Commerce Secretary Gary Locke has formally told President Obama that Iceland's hunt threatens the species, which is globally endangered.

The president has 60 days to give his response, which can include trade bans.

Iceland resumed commercial whaling in 2006, and the fin whale catch has since risen to about 150 per year, with most of the meat exported to Japan.

But Iceland's fisheries minister said the country's whaling was based on "sound science".

"Iceland's disregard for the International Whaling Commission's (IWC) global moratorium on commercial whaling is unacceptable," said Mr Locke.

"Its harvest of whales and export of fin whale meat threaten an endangered species and undermine worldwide efforts to protect whales.

"It's critical that the government of Iceland take immediate action to comply with the moratorium."

He also notes the country's smaller annual catch of minke whales. Most of this meat is eaten locally, though some has been exported.

Stock take

Iceland left the IWC in 1992, but controversially re-joined a decade later with the condition that it could resume commercial whaling in 2006, which it did.

The Legalities of Whaling

Objection - A country formally objects to the International Whaling Commission (IWC) moratorium, declaring itself exempt. Example: Norway
Scientific - A nation issues unilateral "scientific permits"; any IWC member can do this. Example: Japan
Indigenous (aka Aboriginal subsistence) - IWC grants permits to indigenous groups for subsistence food. Example: Alaskan Inupiat

Generally, commercial whaling has been banned since 1986.

Iceland's Fisheries Minister Jon Bjarnason said he was surprised at the US move given that Icelandic whaling was "based on sound science" and sustainable.

"The annual quota of minke whales is 216 from a stock of approximately 70,000 animals, and the annual quota of fin whales is 154 from a stock of approximately 20,000 animals," said a ministry statement.

"The fin whale stock in the North Atlantic is abundant and in very good shape, and is in no way connected to the stock in the Southern Ocean which is in a poor state."

The fin whale quota is calculated by Icelandic scientists based on computer models developed under the IWC's aegis.

The models can be "tuned" to produce quotas that are more or less cautious.

The current Icelandic quota is about three times higher than the figure the IWC would recommend based on the more conservative tuning it has decided is appropriate.

Sanctions call

The process Mr Locke has instigated is "certification" under the Pelly Amendment to the Fishermen's Protective Act of 1967.

Guide to the oceans' great whales

He recommends measures stopping short of a trade sanction, including instructing diplomats to raise the issue in talks with their Icelandic counterparts, and reviewing any projects in which the US co-operates with the Arctic nation.

One possible casualty could be a proposed pan-Arctic search and rescue station near Reykjavik, for which Iceland is seeking US support.

But his letter to Mr Obama notes that "the Pelly Amendment authorises you to direct the Secretary of the Treasury to prohibit the importation into the United States of any products from Iceland..."

A number of anti-whaling groups have been calling on the US to take such a step; and the Whale and Dolphin Conservation Society (WDCS) described Mr Locke's action as "a massive step forward".

"The only way to make sure that whaling is finally ended in Iceland is for the president to send a strong and unambiguous message to Iceland's whaling industry - and that means sanctions," said Kate O'Connell.

The US has certified Iceland on several previous occasions over whaling, but has yet to impose trade restrictions.

However, there is a feeling among US officials that the size of the whalemeat trade to Japan, plus smaller exports to other countries, presents a new and serious threat to the well-being of Atlantic fin whales.

The company behind the fin whale trade, Hvalur hf, has not hunted any this year because of poor market conditions in Japan following the March earthquake and tsunami.

But it does intend to take to the seas again if and when the market improves.

Friday 22 July 2011

Teens 'not getting enough fruit and vegetables'

The government recommends that five portions of fruit and vegetables are eaten each day

Just one in 13 teenage girls is getting their recommended five portions of fruit and vegetables a day, official government data shows.

But boys in the 11 to 18 age group did little better, with just one in eight eating the right amount, the National Diet and Nutrition Survey found.
Adults ate more on average, with a third getting their five-a-day.
The poll of more than 2,000 adults and children also raised concerns about other areas of diet.
Consumption of saturated fats for adults aged 19 to 64 was a tenth above recommended levels, while the majority of participants were found to be not getting enough oily fish.
But it was the diet of teenagers that raised the most concern.
The average consumption of fruit and vegetables for girls aged 11 to 18 was 2.7 portions with just 7% getting five-a-day. Nearly half of them are not getting enough iron in their diet either.
For boys, the average was 3.1 portions with just 13% getting five-a-day.
'Long way to go'
Chief Medical Officer Professor Dame Sally Davies said she was concerned about the figures for teenagers.
"Eating and being active can help prevent serious illnesses such as cancer and heart disease later in life," she added.

The five-a-day challenge

Girls aged 11 to 18 eat 2.7 portions of fruit and vegetables a day on average. Just 7% get five-a-day.
Boys in the same age group consume 3.1 portions on average with 13% getting the right amount.
Adults under 65 eat 4.2 portions with 30% getting five-a-day.
Those 65 and over fair a little better with the average daily consumption standing at 4.4. Some 37% get five-a-day.

The survey drew on findings from interviews, diaries and blood and urine samples taken during 2008 and 2010. It marks the start of an ongoing programme of research which will inform government policy.

As such, direct comparisons with previous studies are difficult - although similar research was carried out in the 1990s which showed on most counts eating habits were improving slightly.
But Dr Alison Lennox, one of the nutrition experts involved in the research, said there was still a "long way to go".
However, she did highlight the progress being made with younger children who seemed to be eating fewer sweets, fizzy drinks and chocolate.
Health minister Paul Burstow said the government was rolling out a a new campaign to increase fruit and vegetable consumption.
He added: "We have not seen the improvements we should have."

Mandrill monkey makes 'pedicuring' tool

This crude pedicure is an example of deliberate tool manufacture and use

A crude "pedicure" carried out by a mandrill at Chester Zoo suggests the monkeys are capable of more advanced tool use than previously thought.

Scientists from Durham University, UK, filmed the mandrill stripping a twig and using the resulting tool to clean under its toenails.

They published the findings in the journal Behavioural Processes.

Mandrills are the fifth species of Old World monkey seen deliberately modifying tools.

Non-human apes, including chimpanzees and orangutans, can adapt basic tools for specific jobs.

One well-known example of this behaviour is termite fishing in chimpanzees, where the animals strip down grasses to make fishing rods that they then poke into termite mounds to snag the nutritious insects.

“Start Quote

Mandrill at Chester Zoo (Image: Riccardo Pansini)

The gap between monkeys and great apes is not as large as we thought it was”

End Quote Riccardo Pansini Durham University

More on animal tool-use from BBC Nature

"It is an ability that, up until a few years ago, was thought to be unique to humans," said Dr Riccardo Pansini, who led the research.

The new findings, he said, indicate that monkeys' intelligence may too have been underestimated.

"The gap between monkeys and great apes is not as large as we thought it was in terms of tool use and modification," he told BBC Nature.

Dr Pansini captured the footage while studying stress-related behaviour in the zoo's mandrills.

His research during that time helped inform the design of a specially landscaped enclosure, which contained shrubs to give the animals hiding places. The design won an animal welfare award in 2007.

In the footage that Dr Pansini captured, a large male mandrill strips down a twig, apparently to make it narrower. The animal then uses the modified stick to scrape dirt from underneath its toenails.

Though the scientist was excited to witness this deliberate tool modification, he said it was not entirely surprising.

"Mandrills have been seen to clean their ears with modified tools in the wild," he told BBC Nature. "This was thought to help prevent ear infections and therefore might be an important behaviour in terms of hygiene."

He thinks the captive setting may have helped bring out this behaviour.

"Animals have more time in captivity to carry out tasks that are not focused on looking for food or mating," he said. "So in zoos, you can occasionally pick up behaviours that are a little bit strange.

Mandrills are the fifth species of Old World monkey seen to modify tools

"In the wild this 'pedicuring' would be considered trivial," he explained. "But cleaning their ears with the same modified tool probably gave the animals some relief from the pain in their ears.

"So we're witnessing the same behaviour that's used in quite important tasks being adapted for a less important task," Dr Pansini said.

Dr Amanda Seed, an expert in primate tool-use from the University of St Andrews, UK, praised the researchers for capturing such interesting footage.

She added, though, that it was not entirely clear that the mandrill was deliberately modifying the stick for the specific goal of producing a "sharpened toenail-cleaning tool".

She told BBC Nature: "For me, the behaviour is closer to what we already know from other species, using a stick for self-cleaning purposes, than the tool modification of say chimpanzees - which rake their stick tools through their teeth to produce a brush for gathering termites.

"But these definitions are always tricky. You could say that as soon as an animal pulls a branch from a tree, they're modifying that branch."

Dr Sonya Hill a research officer at Chester Zoo, added that research findings from zoos could have a "direct impact on evidence-based conservation and husbandry practices".

"They can also contribute to a wider body of scientific knowledge, as this mandrill study has shown."

Mandrills at Chester Zoo (Image: Sonya Hill/ Chester Zoo)

The enclosure the researchers helped design earned the zoo an award

Animal testing 'requires tighter regulation'

Researchers can add human genes and tissues to mice

Better regulation is needed to govern rapidly expanding research in animals containing human tissue or genes, the Academy of Medical Sciences says.

It said such studies were necessary for medical research, but that new ethical issues could emerge and called for a national body of experts.
It said "category three" experiments on monkey brains, resulting in "human-like" behaviour, should be banned.
The government said it would consider the recommendations.
Dr Robin Lovell-Badge, from the National Institute for Medical Research, said: "Everyone laughs at talking meerkats and cats with opposable thumbs, but if we were actually doing that in the labs I don't think people would be so happy."
Cancer drugs
Introducing human material into animals has furthered medical research.
Putting human breast tumour cells into mice has allowed researchers to test cancer drugs on human tissue.

“Start Quote

Experiments on animals that lead to possible human characteristics are something the Academy of Medical Sciences has spent nearly two years considering”

Stroke damaged mice showed some recovery when their brains were injected with human neural stem cells, which has led to human clinical trials.

Mice with Down's syndrome have had a whole human chromosome added to their genome to help researchers learn more about the illness.
Professor Christopher Shaw, from King's College London and one of the report's authors, said animals with human material were "hugely important. Is [the field] going to shrink and go away? No. I'm confident it will lead to new treatments."
The academy report said it was anticipating "a major increase in the use of these techniques".
However it raised concerns that some cases would fall through gaps in the regulation.
The authors said that, for example, experiments on an embryo which contained predominantly human material would be controlled by the Human Fertilisation and Embryology Authority and the embryo would not progress beyond 14 days. For embryos which are mostly animal, but contained some human material, they said there was "no regulation at all".
Animal research is regulated by the Home Office's animal procedures committee.
Professor Martin Bobrow, chair of the Academy of Medical Sciences, said: "Our report recommends that the Home Office puts in place a national expert body, within the existing stringent system of animal research regulation, to provide specific advice on sensitive types of 'animals containing human material' research."
The academy recommended three classifications for research on animals containing human material.
Most would be "category one" and have no more restrictions than any other study on animals.
'Valuable study'
Category two experiments could be allowed but "would require strong scientific justification". The report suggested this would include adding genes to non-human primates and significant changes to an animal to make it "more human-like".
Category three experiments would not be allowed, such as letting any mixed embryo develop past 14 days or breeding animals with human influenced sperm or egg cells and modifying non-human primates to create human-like awareness or behaviour.
Professor Bobrow was keen to stress that "nobody has done any of these things", but the Academy of Medical Sciences said it wanted guidelines in place rather than waiting until the horse had bolted.
Home Office Minister Lynne Featherstone said: "We welcome the valuable contribution of this study to the understanding of the complex ethical, scientific and animal welfare issues involved in this area of research.
"We will consider the recommendations carefully."

Thursday 21 July 2011

NHS competition extended to community care

Choice is being extended to neck pain care under the latest plans

NHS shake-up

Patients are getting greater choice over a host of community services as part of the government push to increase competition in the NHS in England.

Choice is already available over the full range of hospital operations.

But ministers now want that extended to treatments such as podiatry, hearing services and counselling from 2012.

It will lead to greater opportunities for charities, social enterprises and private firms to get NHS work - prompting accusations of privatisation.

Non-NHS groups are already involved in some community services, but patients are often given little say over whether they can use them or not as it is largely dependent on what contracts the local health service has in place.

By September 2012, patients should be given choice over at least three community services which could also include back and neck care, diagnostic testing, wheelchair services and wound healing under the Department of Health directive.

In time, this could be extended to other areas such as home chemotherapy, the Department of Health said.

“Start Quote

This is the final step in outsourcing NHS care to the private sector”

End Quote Dr Jacky Davis Keep Our NHS Public

Analysis: The NHS and the private sector

However, officials played down the opportunity for the private sector to greatly expand its role, pointing out that just 200,000 of the 4.6 million hospital operations done each year are performed by the private sector - five years after that policy started being rolled out.

Instead, they hope it will incentivise those already doing NHS work to improve performance.

Private sector involvement has been a controversial area of the NHS in recent months.

Last month the government was forced to water down its reform plans amid criticism they would lead to the privatisation of the health service.

While ministers agreed some of the policies needed amending, they insisted competition still had a role to play and this latest announcement sets out how they are planning to proceed.

Health Secretary Andrew Lansley said: "This is a big day for patients - real choice over how and where they are treated is becoming a reality."

But Dr Jacky Davis, of the Keep Our NHS Public campaign group, accused the government of trying to "bury bad news" during the hacking scandal.

She added: "This is the final step in outsourcing NHS care to the private sector."

NHS competition extended to community careBy Nick Triggle

Health correspondent, BBC News

Choice is being extended to neck pain care under the latest plans Continue reading the main story
NHS shake-upAnalysis: Why the NHS wants to move on
Step-by-step guide to NHS changes
Q&A: The NHS shake-up
How the NHS works in rest of UK

Patients are getting greater choice over a host of community services as part of the government push to increase competition in the NHS in England.

Choice is already available over the full range of hospital operations.

But ministers now want that extended to treatments such as podiatry, hearing services and counselling from 2012.

It will lead to greater opportunities for charities, social enterprises and private firms to get NHS work - prompting accusations of privatisation.

Non-NHS groups are already involved in some community services, but patients are often given little say over whether they can use them or not as it is largely dependent on what contracts the local health service has in place.

By September 2012, patients should be given choice over at least three community services which could also include back and neck care, diagnostic testing, wheelchair services and wound healing under the Department of Health directive.

In time, this could be extended to other areas such as home chemotherapy, the Department of Health said.

Continue reading the main story
“
Start Quote
This is the final step in outsourcing NHS care to the private sector”
End Quote
Dr Jacky Davis

Keep Our NHS Public

Analysis: The NHS and the private sector

However, officials played down the opportunity for the private sector to greatly expand its role, pointing out that just 200,000 of the 4.6 million hospital operations done each year are performed by the private sector - five years after that policy started being rolled out.

Instead, they hope it will incentivise those already doing NHS work to improve performance.

Private sector involvement has been a controversial area of the NHS in recent months.

Last month the government was forced to water down its reform plans amid criticism they would lead to the privatisation of the health service.

While ministers agreed some of the policies needed amending, they insisted competition still had a role to play and this latest announcement sets out how they are planning to proceed.

Health Secretary Andrew Lansley said: "This is a big day for patients - real choice over how and where they are treated is becoming a reality."

But Dr Jacky Davis, of the Keep Our NHS Public campaign group, accused the government of trying to "bury bad news" during the hacking scandal.

She added: "This is the final step in outsourcing NHS care to the private sector."
More on This Story
NHS shake-up Analysis and comment
Analysis: Why the NHS wants to move on
The pause in the overhaul of the NHS has ended. For the health service it is time to get going.

--------------------------------------------------------------------------------
Step-by-step guide to NHS changes Q&A: The NHS shake-up How the NHS works in rest of UK News
PM agrees major NHS concessions No party politics over NHS - PM GPs want 'more NHS concessions' Cameron unveils NHS rethink NHS reforms may change - Lansley NHS 'listening exercise' to close
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Saturday 16 July 2011

Whaling meeting 'ignores needs of whales'

Whaling meeting 'ignores needs of whales'

The whaling body finds itself entangled in conflict - some would say hopelessly so Continue reading the main story
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The International Whaling Commission's (IWC) annual meeting has closed after a tense final day when relations between opposing blocs came close to collapse.

Latin American nations attempted to force a vote on a proposal to create a whale sanctuary in the South Atlantic.

Pro-whaling countries walked out, but eventually it was decided to shelve any vote until next year's meeting.

Environment groups said the delays and wrangling meant important issues for whale conservation were neglected.

But a number of nations pledged new funding for research on small cetaceans, some of which are severely threatened.

Earlier in the meeting, governments agreed new regulations designed to prevent "cash for votes" scandals that have plagued the IWC in the past, and passed a resolution censuring the Sea Shepherd Conservation Society for putting safety at risk during its annual missions to counter Japanese whalers in the Southern Ocean.

But the sanctuary issue threatened to derail the entire session.

"Whale species and populations from the Southern Atlantic oceanic basin were amongst the ones that suffered the most due to commercial whaling on a large scale," Roxana Schteinbarg, from the Argentina-based Institute for the Conservation of Whales, told delegates.

Continue reading the main story
“
Start Quote
Acrimony is often the enemy of conservation”
End Quote
Wendy Elliott, WWF

"Fifty-four species live in the waters where the sanctuary is proposed - it is therefore appropriate that the protection of these species in the Southern Ocean Sanctuary be extended and complemented in the reproduction areas in the Atlantic Southern basin."

The 14-strong Buenos Aires bloc of nations knew it did not command the three-quarters majority needed to win, but remained determined to put it to the test.

"We didn't come here to win the sanctuary on the vote, but we wanted to put it to a vote - we believe our conservation agenda cannot be put forward, be stressed, be highlighted, be defended in some issues without a vote," said Brazil's commissioner Marcus Henrique Paranagua.

"Why not vote on things that are controversial?"

Voting with feet
Delegates from pro-whaling countries walked out in protest when a vote was called
The pro-whaling bloc said this could herald a return to the fractious days of the past, and walked out in an attempt to bring the meeting below the quorum needed for votes to count.

"We fear that the fact of voting will probably damage the very good atmosphere we have established, and might trigger a landslide of many votes for next year which might disrupt the progress we have made," said Japan's alternate (or deputy) commissioner Joji Morishita.

"This was not a hostile move to the Latin American countries - our effort is to try to save this organisation, and it turned out ok."

The good atmosphere, he added, had survived a "very difficult day".

Critics, however, said the pro-whaling countries had tried to hold the commission to ransom by their walkout.

Explosive meeting

The compromise eventually hammered out, after private discussions lasting nearly nine hours, asks countries to strive to reach consensus during the coming year.

The vaquita was among the casualties here
If that proves impossible, next year's meeting will start with a vote on the South Atlantic Sanctuary.

That could prove a particular concern for the US, which will be aiming at that meeting, in Panama, to secure renewed quotas for its indigenous hunters.

US commissioner Monica Medina agreed the potential vote "put a hand-grenade" under next year's meeting.

"I'm more than a little concerned - we've made good progress on improving the IWC's governance and that's a good thing," she said.

"But as long as we choose to continue fighting, all of the IWC's members will lose; and the world's whales deserve better."

The US played a leading role in the two-year "peace process" that attempted to build a major compromise deal between the various parties, and which collapsed at last year's meeting.

Missing in action

Huge delays during the four days of talks meant that many items on the agenda pertinent to the health of whales and other cetaceans did not get discussed.

Continue reading the main story
Guide to the oceans' great whales

How to prevent whales from being killed by collisions with ships, how to reduce floating debris and how to tackle the growth of noise in the oceans were among the issues that received no discussion.

"Acrimony is often the enemy of conservation - in this case, it meant that a critical meeting on whales failed to address the greatest threats they face," said Wendy Elliott, head of environment group WWF's delegation.

"Several whale and dolphin species are in crisis - teetering on the brink of extinction - and conservation must be front and foremost at next year's IWC meeting, for the sake of the whales and the commission."

The research programmes of the cash-strapped commission received something of a boost with France, Italy and several non-governmental groups pledging a total of about £80,000 ($130,000) for small cetaceans, which include the critically endangered Mexican vaquita.
More on This Story
Related StoriesWhaling: Reflections from Japan 14 JULY 2011, SCIENCE & ENVIRONMENT
Whale body joins cashless world 13 JULY 2011, SCIENCE & ENVIRONMENT
A world built on ice and whales 13 JULY 2011, SCIENCE & ENVIRONMENT
Antarctic whaling 'to continue' 13 JULY 2011, SCIENCE & ENVIRONMENT
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Thursday 14 July 2011

European Parliament backs return of animal feed protein

Animal feed news

European Parliament backs return of animal feed protein

//08 jul 2011

Members of the European Parliament have backed plans to allow processed animal protein back into EU animal feed. MEPs voted in favour of the Roth-Behrendt report, which recommends allowing pigs to be fed poultry protein and poultry to be fed pig protein.

The Commission's TSE Roadmap 2 proposes a possible gradual lifting of the prohibition on the feeding of processed animal proteins (PAP) to non-ruminants.

Given the EU's "protein deficit", MEPs back this idea, subject to strict conditions and safeguards. These include stipulating that the PAP must come from species not linked to TSE, and may be fed only to non-herbivores.

Prohibitions on cannibalism must remain and only processed animal proteins fit for human consumption should be used, MEPs add.

Further relaxations

The report recommends a number of relaxations to BSE rules to reflect the declining risk posed by the disease, although it stresses that any changes must maintain high animal and public health standards.

Apart from the relaxation of the animal protein feed ban item, changes to current EU laws, which the Commission is about to review, could also include new rules on removing specific risk materials from animal feed, changes to cohort culling policy and a higher age limit for BSE testing, says the non-legislative resolution, drafted by Dagmar Roth Behrendt.

MEPs reject a Commission proposal to reduce EU funding on research into transmissible spongiform encephalopathies (TSEs), including BSE.

TSEs cause degeneration of brain tissue leading to death in man and animals. They include Creutzfeldt-Jakob disease and Kuru in humans, bovine spongiform encephalopathy in cattle and scrapie in sheep and goats

UK 'has too many hospital births'

Comments (37)

By Branwen Jeffreys Health correspondent, BBC News

Click to play

Dr Anthony Falconer: 'We all have a moral responsibility to create the best services we can'

Maternity services across the UK need a radical rethink, the Royal College of Obstetricians and Gynaecologists says.

It wants the number of hospital units cut to ensure 24-hour access to care from senior doctors and says more midwife-led units are needed for women with low-risk pregnancies.

The National Childbirth Trust welcomed the report but says the proposals do not go far enough.

NHS managers said maternity care desperately needed to be reorganised.

'Serious complications'

Too many babies are born in traditional hospital units, says the college, which also warns the current system is neither acceptable nor sustainable in its report on maternity care.

RCOG president Anthony Falconer told the BBC that most out-of-hours care was being provided by junior doctors.

“Start Quote

You need the right person, as senior person, there immediately”

End Quote Dr Tony Falconer Royal College Obstetricians and Gynaecologists

The college estimates there are about 1,000 too few consultants to provide adequate round-the-clock cover for hospital units.

Dr Falconer said: "There is no doubt if you look at the worst scenario of serious complications, you need the right person, a senior person, there immediately."

Previous attempts to re-organise maternity care around a smaller number of hospital units have proved controversial, but Dr Falconer said if women could be convinced of the greater safety they would be prepared to travel to have their babies.

The need for change would be largely in cities or large towns, because in rural areas it might be more important to support smaller units.

The report estimates that across the UK there are 56 units with fewer than 2,500 deliveries of babies a year.

In order to take the pressure off busy hospitals, the college is also calling for an increase in the number of midwife-led units.

'Joined-up care'

Midwives have welcomed the report, saying it could improve the experience for about a third of women who have straightforward deliveries.

The proposals for maternity are part of a wider vision of delivering all women's gynaecology and obstetrics care in networks, similar to the model which has helped improve cancer treatments in England.

The National Childbirth Trust said the idea of having a network to provide joined-up care for women was one it could support but it would prefer care during pregnancy and maternity to be concentrated in one NHS organisation in each area.

The NHS confederation, which speaks for managers, described maternity care as a classic example of a service which desperately needed to be reorganised.

Chief executive Mike Farrar said politicians needed to be prepared to speak up for change.

"Where the case for change is clear, politicians should stand shoulder-to-shoulder with managers and clinicians to provide confidence to their constituents that quality and care will improve as a consequence of this change."

That has not always been the case, with two ministers in the last Labour government campaigning against the closure of units in Greater Manchester.

Hundreds of people turned out to a rally to oppose the closure of maternity services in Salford last autumn. After a review under the coalition, the NHS is pressing ahead with plans to reduce the number of units across the area from 12 to eight.

Although Scotland has reorganised some of its maternity services, there are likely to be pressures for change elsewhere in the UK.

In North Wales maternity care across three hospitals is expected to change after an initial review recently concluded improvement was needed.

Saturday 30 July 2011

Pilgrim Hospital student nurses removed over 'concerns'

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NHS chiefs 'abuse system by delaying treatment'

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Wednesday 27 July 2011

Rickets cases reported in Cardiff by health workers

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Saturday 23 July 2011

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Friday 22 July 2011

Teens 'not getting enough fruit and vegetables'

The five-a-day challenge

Mandrill monkey makes 'pedicuring' tool

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Animal testing 'requires tighter regulation'

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Thursday 21 July 2011

NHS competition extended to community care

NHS shake-up

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Saturday 16 July 2011

Thursday 14 July 2011

Animal feed news

European Parliament backs return of animal feed protein

UK 'has too many hospital births'

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