New GP contract for seven-day service

• From the sectio

Image copyrightScience Photo Library

GPs in England are to be offered a voluntary contract to provide seven-day-a-week cover for patients, David Cameron has announced.

Seven-day hospital services will also be extended to "half the country" by 2018 and the whole of England by 2020.

Mr Cameron made the announcement as the Conservatives gathered in Manchester for their annual conference.

The Royal College of GPs has warned a recruitment crisis was making plans for seven-day working "unrealistic".

• Follow the latest Tory conference developments

Mr Cameron's comments came as the government denied pressuring officials behind the scenes to delay the publication of figures which show the financial performance of the NHS.

A report in the Observer claimed officials at Monitor and another NHS regulator were leaned on to delay financial and other performance figures such as treatment waiting times in order to avoid embarrassment at the Conservative conference, which is taking place this week.

Health officials have said the data will be published shortly.

'Clear goals'

On the BBC's Andrew Marr Show, Mr Cameron insisted a seven-day-a-week NHS was "a really exciting prospect".

He said: "We said that we are going to have to make difficult decisions elsewhere, but the NHS will not just be protected.

"It's getting an extra £10bn of money during this Parliament, over and above inflation, and that enables us to meet some really clear goals.

"Parents and people in our country want to access the NHS on a seven-day basis.

"Let me be clear, this doesn't mean that all staff in the NHS have to work every seven days, it just means the services are available.

"So, I can announce today that we will be publishing a new GP contract to get rid of the box-ticking and the form-filling."

---

NHS weekend: Want to know more?

Image copyrightOther

• Visit the BBC's special report page on 7-day services (This link will not work on the BBC app but some of the key content can be seen below)
• Action demanded over weekend death risk
• Nick Triggle: Does a Monday to Friday culture exist in hospitals?
• 'My long weekend as a consultant'
• The picture in the rest of the UK

---

The new contract for GPs will be voluntary, with family doctors able to decide whether they want to join forces with neighbouring GPs to form federations and networks of practices delivering seven-day care to populations of at least 30,000 patients.

Grouping GPs together in federations or networks will allow them to deliver better integrated care, the prime minister argues.

They will also be able to work more closely with community nurses, hospital specialists, pharmacists and other health and care professionals, he added.

Destabilising care

Trials of seven-day GP access have already begun, with 18 million patients getting extended availability by March this year.

But a recent survey found practices in some areas had scaled back weekend opening due to limited demand.

The Royal College of General Practitioners has warned that seven day opening in England is unachievable in this Parliament and risks destabilising care.

Conservative sources said the voluntary GPs contract will be funded from the additional £10bn of NHS investment promised by the prime minister over the course of the Parliament.

Labour's Jonathan Ashworth said: "You can't trust [David Cameron's] promises on a seven day NHS - he has made them before but hasn't delivered.

"What the Tories have done is take the health service backwards - under them it is harder to see your GP and waiting lists are higher."

Share this story

Nobel Prize for anti-parasite drug discoveries

Image copyrightScience Photo Library

The Nobel Prize for physiology or medicine has been split two ways for groundbreaking work on parasitic diseases.

William C Campbell and Satoshi Ōmura found a new way of tackling infections caused by roundworm parasites.

Youyou Tu shares the prize for her discovery of a therapy against malaria.

The Nobel committee said the work had changed the lives of hundreds of millions of people affected by these diseases.

Jump media player

Media player help

Out of media player. Press enter to return or tab to continue.

Media captionSecretary of the Nobel Academy at Karolinska Institutet Urban Lendahl made the announcement

The mosquito-borne disease malaria kills more than 450,000 people each year around the world, with billions more at risk of catching the infection.

Parasitic worms affect a third of the world's population and cause a number of illnesses, including river blindness and lymphatic filariasis.

Deadly parasites

After decades of limited progress, the discovery of the two new drugs - ivermectin for river blindness and lymphatic filariasis, and artemisinin for malaria - was a game-changer.

Image copyrightCDC

Efforts to eradicate malaria had been failing - older drugs were losing their potency - and the disease was on the rise.

Prof Youyou Tu, who in the 1960s had recently graduated from the Pharmacy Department at Beijing Medical University, looked to traditional herbal medicine to find a potential therapy.

She took an extract from the plant called Artemisia annua, or sweet wormwood, and began testing it on malaria parasites.

The component, later called artemisinin, was highly effective at killing them.

Image copyrightReuters

Image captionYouyou Tu is Chief Professor at the China Academy of Traditional Chinese Medicine

Today, the drug is used around the world in combination with other malaria medicines. In Africa alone, this is saving more than 100,000 lives every year.

Tu is the 13th woman to win this Nobel Prize.

She shares the award with two men who found a treatment for another parasite - roundworm.

Their research led to the development of a drug called ivermectin, which is so successful that roundworm diseases are on the verge of eradication.

Satoshi Ōmura, a Japanese microbiologist, focused on studying microbes in soil samples. He selected a number of promising candidates that he though might work as a weapon against diseases.

Irish-born William C Campbell, an expert in parasite biology working in the US, then explored these further and found one was remarkably efficient against parasites.

Image copyrightTrinity College Dublin

Image captionDr Campbell now works at Drew University in the US

The active ingredient, avermectin, went on to become a drug known as ivermectin which is now used to treat river blindness and lymphatic filariasis.

River blindness is an eye and skin disease that ultimately leads to blindness. Lymphatic filariasis, also known as elephantiasis, causes painful swelling of the limbs. Both affect people living in some of the poorest countries in the world.

'Out of the blue'

Dr Colin Sutherland, of the London School of Hygiene and Tropical Medicine, said it was immensely gratifying that the achievements in tackling these important diseases had been recognised.

"It's come out of the blue but we are very excited that the committee recognised the importance of parasitic diseases."

The Nobel committee said: "The two discoveries have provided humankind with powerful new means to combat these debilitating diseases that affect hundreds of millions of people annually.

Image copyrightReuters

Image captionSatoshi Ōmura has discovered more than 470 compounds during his career as a scientist

"The consequences in terms of improved human health and reduced suffering are immeasurable.''

Omura told Japanese broadcaster NHK: "I have learned so much from microorganisms and I have depended on them, so I would much rather give the prize to microorganisms.

"This is kind of a low-profile research area, but microorganisms are extremely important for humans. They can be our partners. I hope the area gets more attention because of the prize so that it can further contribute to human beings."

Previous winners of the Nobel Prize for physiology or medicine

Image copyrightSCOTT CAMAZINE/SCIENCE PHOTO LIBRARY

Image captionLast year's winners helped us to understand the brain's orienting 'GPS'

2014 - Three scientists - John O'Keefe, May-Britt Moser and Edvard Moser - fordiscovering the brain's navigating system.

2013 - James Rothman, Randy Schekman, and Thomas Sudhof for their discovery of how cells precisely transport material.

2012 - Two pioneers of stem cell research - John Gurdon and Shinya Yamanaka - were awarded the Nobel after changing adult cells into stem cells.

2011 - Bruce Beutler, Jules Hoffmann and Ralph Steinman shared the prize after revolutionising the understanding of how the body fights infection.

2010 - Robert Edwards for devising the fertility treatment IVF which led to the first "test tube baby" in July 1978.

2009 - Elizabeth Blackburn, Carol Greider and Jack Szostak for finding thetelomeres at the ends of chromosomes.

Nigeria will need three years without polio cases to be declared free of the disease

Image copyrightWHO/T.Moran

Image captionNigeria will need three years without polio cases to be declared free of the disease

Nigeria has been removed from the list of polio endemic countries in what is being regarded as a "milestone" on the quest to eradicate the disease.

The announcement by the World Health Organization (WHO), was made at a meeting of the Global Polio Eradication Initiative (GPEI) in New York.

It follows Nigeria going more than a year without a case of wild - naturally occurring - polio.

Three years without cases are required before it can be declared polio free.

The decision means there are just two endemic countries - Pakistan and Afghanistan - where transmission of the paralysing virus has never been interrupted.

Jean Gough, Unicef country representative in Nigeria, told me: "This is an important milestone, but it is too early to celebrate. We need to continue the efforts at every level if polio is to be eradicated."

Polio is spread by poor sanitation and contaminated water and usually affects children.

The virus attacks the nervous system and can cause irreversible paralysis - usually of the legs - within hours.

Image copyrightGetty Images

Image captionThis Egyptian stele (an upright stone carving) dating from 1403-1365 BC shows a priest with a walking stick and foot, deformities characteristic of polio. The disease was given its first clinical description in 1789 by the British physician Michael Underwood, and recognised as a condition by Jakob Heine in 1840. The first modern epidemics were fuelled by the growth of cities after the industrial revolution.

GPEI was established in 1988 when tens of thousands of children in more than 125 countries were paralysed by polio each year.

Partner organisations include the WHO, Rotary International and the Bill and Melinda Gates Foundation.

Challenge

Nigeria's progress against polio has been hard-fought.

In 2003, some northern states boycotted the oral polio vaccine for nearly a year after scare stories that it caused sterilisation.

It led to the virus spreading to many countries that had been declared polio free.

In 2013 nine vaccinators were shot dead in Kano. But instead of being a deterrent, it galvanised support at every level.

The Nigerian government declared polio a national health emergency and greatly increased the number of vaccinators.

And community and religious leaders voiced their support.

As a result, the number of families refusing to have their children immunised has decreased sharply.

Boko Haram

The success has come despite the Islamist militant insurgency in north-east Nigeria.

Earlier this month Unicef said half a million children had fled attacks by Boko Haram over the past five months.

Vaccine teams have been focussing attention on displaced families who have moved elsewhere in Nigeria, as well as fleeing to neighbouring countries like Cameroon, Chad and Niger.

I last visited Kano in northern Nigeria in 2005 and met Aminu Ahmed, and his son Umar - both of whom have been paralysed by polio.

Image copyrightFergus Walsh

Image captionAminu Ahmed and his son Umar both have been paralysed by polio

Like other children, Umar did not get the drops of polio vaccine and was infected, partially paralysing his right leg.

His father - who runs a charity making hand-operated tricycles for polio sufferers - has become a campaigner for polio immunisation.

I went back to meet the family. Umar is doing well at school and he now joins his father in persuading families to be immunised.

Aminu Ahmed told me: "Ten years ago, it was very common to see families saying no to the vaccine - now they all want it.

"We say you do not want your children to be unable to walk, like me."

---

Polio progress

Image captionBy 1988, polio had disappeared from the US, UK, Australia and much of Europe but remained prevalent in more than 125 countries. The same year, the World Health Assembly adopted a resolution to eradicate the disease completely by the year 2000.

Image captionIn 2015, polio remains endemic in only two countries - Pakistan and Afghanistan. No new cases have been reported in Africa for the past year.

---

Wild polio

Nigeria, like the rest of the world, is switching from the oral polio vaccine, given in two drops into the mouth, to an injectable, inactivated form of polio vaccine (IPV).

The oral vaccine, which contains a weakened vaccine virus, can in extremely rare cases, cause a form of polio - circulation vaccine-derived poliovirus (cVDPV).

There has been one case of cVDPV in Nigeria this year.

I met the family of the last child to be infected with wild polio.

Isau was 16 months old when he was infected in July 2014.

His right arm lies lifeless at his side - the muscles have withered and he cannot use them.

His mother, Kanduwa Ahmadu, has just given birth to another boy. She told me: "I will make sure my baby son gets all the doses of polio vaccine he needs. I know that life will be very hard for Isau."

It's more than a year since there has been a case of wild polio in Africa.

Eradicating the disease from the continent would be a huge achievement.

But health officials fear a resurgence of the disease unless efforts are continued to immunise every child.

India was declared polio free last year.

So far this year there have been 41 cases of wild polio worldwide, compared to 200 at the same point last year.