Wednesday 22 August 2012

NHS hospital trusts invited to expand abroad

NHS staff from Great Ormond Street Hospital took part in the London 2012 Olympic Opening Ceremony

An agency will aim to link hospitals such as Great Ormond Street with foreign governments that want access to British-run health services.High-profile NHS hospitals in England are to be encouraged by the government to set up profit-making branches abroad to help fund services in the UK.

Investment would have to be drawn from hospitals' private UK work, but with profits ploughed back into the NHS.

A patients' group said the move was a "distraction" at a time of "upheaval".

The drive, building on an initiative first started under the Labour government, is set to be launched by the Department of Health and UK Trade and Investment this autumn.

The BBC understands the initiative is unlikely to involve regular district or general hospitals but would target world-renowned hospitals like the Royal Marsden, Great Ormond Street and Guy's and St Thomas'.

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'Benefit patients'

NHS staff taking part in the London 2012 Olympic opening ceremony

It would mirror schemes such as that of Moorfields Eye Hospital in London, which in 2007 built a unit of the same name in Dubai. Children's hospital Great Ormond Street also has interests abroad.

In 2010, Labour's Health Secretary Andy Burnham set up NHS Global to help the health service make the most of the global market for healthcare and the coalition now wants to build on this.

A source close to current Health Secretary Andrew Lansley emphasised that hospitals would be able to pay for their investments abroad using only revenue generated from their private patients in the UK.

Any profits made overseas would be ploughed back into the health service and so benefit NHS patients, the source added.

The Health and Social Care Act, which was passed by Parliament earlier this year, eased the way for hospital trusts to expand their work in the private sector.

Health Minister Anne Milton said: "This is good news for NHS patients who will get better services at their local hospital as a result of the work the NHS is doing abroad and the extra investment that will generate.

"This is also good news for the economy, which will benefit from the extra jobs and revenue created by our highly successful life sciences industries as they trade more across the globe.

"The NHS has a world-class reputation, and this exciting development will make the most of that to deliver real benefits for both patients and taxpayers."

Moorfields medical director Chris Canning said no taxpayers' money had been spent on its Dubai venture and it had been in profit for the past three years while "raising the reputation and profile" of the NHS and the hospital, and making money to reinvest in UK health services.

David Stout, deputy chief executive of the NHS Confederation, which represents organisations around England, denied the scheme would divert attention away from health services and said an international exchange of ideas could in fact improve local services.

"This is not about distorting what the NHS offers to UK citizens, this is about how we can exploit the brand of the NHS internationally," he told BBC Radio 4's Today Programme.

When asked if the NHS could end up under-funded by taxation because of increasing funds raised abroad, he said: "We are not talking about completely skewing the way the health service funding comes in - this will be marginal in the scheme of a £100bn organisation organisation in the NHS."

'Rampant commercialisation'

However, the move was criticised by the Patients Association.

"The key and only focus of an NHS hospital should be to provide treatment to patients on the NHS. We would be very concerned by any moves which would see commercial ventures, which are naturally going to be important for hospitals because they need to use them to raise revenue, would simply result in the attention of the hospitals being taken away from the core purpose - to treat patients in the UK and instead be focused on these hospitals abroad," said Michael Watson, of the group.

Andy Burnham, Labour: "The government's plan fundamentally alters the character of the NHS"

Labour began the initiative while in government, but shadow health minister Jamie Reed criticised the coalition's plans.

He said: "At a time when staff are losing their jobs and waiting times are rising, the government's priority should be sorting out the mess it has created in our NHS.

"Under David Cameron we're seeing a rampant commercialisation of the NHS. He needs to get a grip and start focusing on patients, not profits."

Tony Nicklinson's legal fight for right to die

Tony Nicklinson lost his fight at the High Court for help to end his life

Tony Nicklinson began his fight for the right to die after he said he was "fed up" of living with locked-in syndrome.

The condition left him unable to speak or move and relying on a computer to communicate.

It was caused by a stoke in 2005 which he suffered while on a business trip to Athens and left him paralysed from the neck down.

Mr Nicklinson said he did not want to potentially live with the debilitating syndrome for another 20 years.

One of his daughter's, Lauren, said the stroke had turned him from a "loud, active ex-rugby player" to "someone who's wheelchair bound who watches telly all day".

The father of two and former engineer said he wished the doctors in Greece had left him to die.

"If I had my time again, and knew then what I know now, I would have not called the ambulance but let nature take its course," he said in 2010.

Two years ago he began legal proceedings to clarify whether his wife, Jane, would have been prosecuted for injecting him with a lethal dose of drugs.

His legal team argued that the current murder law would have infringed his right to respect for his private life as part of the European Convention on Human Rights.

Mrs Nicklinson said he wanted to "take his own life at a time that he chooses".

This led to her husband giving evidence before the Commission on Assisted Dying where he said there was a "fundamental injustice with the present law".

"A new law should restore the right of self-determination and would also help to protect those people who need protection," he said.

"Once this is sorted out people like me can die in peace."

The release of the commission's report in 2011 dashed Mr Nicklinson's hopes.

It said there was a "strong case" for allowing assisted suicide but only for people who are terminally ill.

This saw Mr Nicklinson take his case to the High Court where he asked judges to give a doctor a "common law defence of necessity" against any possible murder charge.

Tony Nicklinson, wife Jane and daughters Beth and Lauren

There, his legal team said Mr Nicklinson could face "20 years or more" and he "does not wish to live that life".

But less than a week ago a tearful Mr Nicklinson was told he had lost the case.

He said he was "devastated" and "utterly miserable".

"I am saddened that the law wants to condemn me to a life of increasing indignity and misery," he said.

In his final months he took to social networking site Twitter to tell of the light in his life.

"My wife Jane deserves your collective praise because without her it would be impossible for me to do what I do," he said.

And in one of his final messages he said he was "still down" after the High Court verdict but said his wife and children - Lauren and Beth - were "fantastic".

Following Mr Nicklinson's death, his lawyer said he had been "gutsy, determined and a fighter to the end"

MRSA and C. diff deaths falling

Deaths from MRSA fell by a quarter, from 485 in 2010 to 364 in 2011.

There were 2,053 C. difficile infections last year, compared with 2,704 the year before.

Earlier this year, the Health Protection Agency warned other infections were taking their place.

Both infections have shown large declines over the past five years after being repeatedly targeted by government policies.

However, there is some concern other infections such as E.coli appear to be rising.

The health minister, Simon Burns, said: "The news that MRSA deaths are lower than at any point in the last 15 years is a testament to the hard work and dedication of NHS staff across the country."

Sunday 29 July 2012

Whooping cough

Whooping cough outbreak spreads to very young babies

By James GallagherHealth and science reporter, BBC News

Babies are offered a whooping cough vaccine at two, three and four months of age

The outbreak of whooping cough in England and Wales has spread to very young babies who are most at risk of severe complications and death, the Health Protection Agency has warned.

There were another 675 cases in June bringing the total to 2,466 for 2012 so far.

At this stage last year there had only been 311 cases.

Increased levels of whooping cough have also been reported in Northern Ireland and Scotland.

The main symptoms are severe coughing fits which are accompanied by a "whoop" sound as children gasp for breath.

Surges in the number of whooping-cough cases are seen every three to four years. This latest outbreak began at the end of 2011.

Before routine vaccination in 1957, whooping cough outbreaks in the UK were on a huge scale. It could affect up to 150,000 people and kill 300 in one year.

'Very concerned'

There have been 186 cases reported in infants under three months this year compared to 72 in the same period last year. Five babies have died from the infection.

Dr Mary Ramsay, the head of immunisation at the Health Protection Agency, said she was "very concerned" with the increase in cases.

She said: "Whooping cough can be a very serious illness, especially in the very young. In older people it can be unpleasant but does not usually lead to serious complications.

Whooping cough

It is also known as pertussis and is caused by a species of bacteria, Bordetella pertussis
It mostly affects infants, who are at highest risk of complications and even death
The earliest signs are similar to a common cold, which then develop into a cough and can even result in pneumonia
Babies may turn blue while coughing due to a lack of oxygen
The cough tends to come in short bursts followed by desperate gasps for air (the whooping noise)

"Anyone showing signs and symptoms, which include severe coughing fits accompanied by the characteristic 'whoop' sound in young children, but as a prolonged cough in older children and adults, should visit their GP."

In the UK, the whooping cough vaccine is given to babies after two, three and four months. A booster dose is given just before primary school.

Babies are not fully protected until the third jab. It is in the following years that protection is at its peak then it gradually fades. It means you can get whooping cough as an adult even if you had the infection or the jabs as a child.

The Department of Health's Joint Committee of Vaccination and Immunisation is considering ways to tackle the outbreak, such as giving teenagers or pregnant women a booster jab.

Vaccinations for medics working with young babies have already been recommended to protect them and prevent them from spreading the infection.

Figures for the end of March showed 27 confirmed cases in Northern Ireland, compared to 13 in the whole of 2011. At the end of March there had been 150 cases reported in Scotland compared to 22 in the first three months of 2011.

Prof Adam Finn, from University of Bristol, said: "The current vaccination programme has reduced whooping cough in children, but also pushed it back into older age groups.

"Immunity due to vaccine does not last as long as immunity due to infection so as the number of people who have had whooping cough in the past falls, population immunity falls and rates go up.

"This is happening everywhere, not just in the UK."

Wednesday 25 July 2012

Botox doctor suspended

Leading Harley Street Botox doctor suspended

By Guy LynnBBC News, London

Dr Harrison said he had performed more than 50,000 remote consultations since 2005

A Harley street doctor exposed in a BBC London investigation encouraging nurses to order potentially dangerous Botox drugs in one person's name for use on another has been suspended.

Dr Mark Harrison will not be able to practise as a doctor for up 18 months pending a review.

The General Medical Council (GMC) will decide whether he will face a fitness to practise panel.

Botox can normally only be prescribed by doctors or designated professionals.

If Dr Harrison faces a panel he will be assessed by the GMC's Medical Practitioners Tribunal Service.

It comes after the GMC banned doctors remotely prescribing injectable cosmetic medicines, such as Botox, on the phone, fax or online, without a face-to-face consultation.

Niall Dickson, chief executive of the GMC, said: "There are good reasons why these are prescription-only medicines, and we believe doctors should assess any patient in person before issuing a prescription of this kind."

Remote prescribing was common practice at Dr Harrison's company Harley Aesthetics - one of the UK's largest purchasers of the anti-wrinkle drug.

Nurses who have independent prescribing qualifications are able to prescribe any drug, including Botox, without the involvement of a doctor.

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I take my professional and moral obligations to both the patients who have treatments and the nurses who use the service extremely seriously”

Dr Mark Harrison

And nurses without this qualification are legally allowed to inject the drug under a doctor's direction, but risk being struck off for doing this remotely, unless in an emergency.

Dr Mark Harrison, the director of Harley Aesthetics, had built up a network of hundreds of nurses who phoned him on his mobile from across the UK to receive authorisation to inject patients immediately with Botox.

They paid Dr Harrison £30 for each conversation.

After concerns were raised to the BBC, an undercover researcher secretly recorded one of Dr Harrison's training days and joined his team of nurses.

Dr Harrison was secretly recorded explaining how prescriptions for Botox could be obtained in the names of friends and family and the stock of drugs could be used on walk-in patients.

If nurses were unable to reach him on his mobile at any time when they had a patient expecting immediate treatment, he encouraged them to inject their patients anyway and he would phone the patient later.

'Little bit naughty'

"If you can't get a signal, what you might do is do the treatment and then you ring through with the details and the phone number and we guarantee we'll always ring the client after the event," Dr Harrison was secretly recorded saying.

"That may be after the event, which is a little bit naughty."

The BBC then phoned him to see if this would really happen, claiming a new patient had already been injected.

Dr Harrison left a message on the voicemail of the "patient" and later sent a prescription.

Botox is a potentially dangerous medicine and should usually only be prescribed by a doctor

Senior doctors have said this amounts to a potential safety risk and would mean the nurse was breaking the law by injecting Botox without a prescription.

In a statement, Dr Harrison said he had performed more than 50,000 remote consultations since 2005, with no adverse affects on patient health.

He said the use of prescriptions in one person's name for the treatment of others was "common, almost universal practice throughout the aesthetics industry" and had "no consequence for patient safety".

Dr Harrison said the practice of a doctor phoning a patient after an injection "would never be encouraged and would never be acceptable for a new patient".

He added: "The decision to treat has been taken by the nurse and the doctor informed retrospectively."

Dr Harrison went on: "I can confirm that I take my professional and moral obligations to both the patients who have treatments and the nurses who use the service extremely seriously."

Dr Nigel Mercer, a leading cosmetic surgeon and former president of the British Association of Aesthetic Plastic Surgeons, was shocked by the BBC's findings.

He said: "This is a wake-up call. It's not an appropriate way for providing a medical service."

Thursday 5 July 2012

mengele: Elderly denied NHS care

Probe into 25 deaths after trust admits 'poor records'

By Jane DreaperHealth correspondent, BBC News

Imperial College Healthcare NHS Trust sign

The trust said it had been open and transparent about the matter

The deaths of 25 patients are under review by one of the UK's biggest NHS trusts, after it admitted "poor record keeping".

Westminster and two other London local authorities have expressed "extreme concern" about lost data on referrals at Imperial College Healthcare.

BBC News understands Imperial is still unaware of the outcomes of 86 patients who were referred for cancer tests.

The trust says it does not believe any patient has come to serious harm.

Imperial, which runs four big hospitals in London, has however admitted that patients may have faced "discomfort, worry and possible deterioration as a result of a delay".

In an unprecedented move, the trust was allowed to suspend the reporting of its waiting times for planned operations and diagnostic tests to the government for the first six months of this year.

Waiting longer

The trust has been unable to make contact with 86 people who were referred for a possible cancer diagnosis.

It made efforts to trace 87 patients, through GPs and by sending letters by recorded delivery to the last available address.

Seven letters were returned undelivered and just one patient contacted the hospital to be seen directly.

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The safety of our patients is an absolute priority”

Sir Richard SykesImperial College Healthcare chairman

And at the height of the problems in February, around 3,500 patients were waiting longer than the 18-week NHS target for treatment or operations. Currently the figure stands at 1,600.

Some of these patients - and some of the suspected cancer cases - were recorded as having been on the waiting list since 2009.

So far, 74 deaths have come under the spotlight. A review group is satisfied that 49 were unrelated to any problems caused by delayed treatment.

In a joint letter, Westminster, Hammersmith and Fulham, and Kensington and Chelsea Councils complained to the trust about its handling of the problem.

The letter said: "It seems to us there could be a possibility of clinical harm as a result of delays in the diagnosis and commencement of treatment arising from the trust's failings.

"We are unhappy that the trust appears to have responded to the scrutiny function of local authorities with a lack of openness and transparency."

Westminster Council's scrutiny committee will question Imperial's interim chief executive, Mark Davies, at a meeting on Thursday night.

An NHS source described the discovery of such long-waiting patients as "dynamite" and "appalling".

The source said: "I would be surprised if there were not similar scandals waiting to be uncovered at other London hospitals.

"London has problems because that is where so many of the long-waiters and financial problems are."

'Extremely sorry'

Imperial has blamed issues arising from multiple computer and record-keeping systems.

A spokeswoman said: "To date we have found no evidence that these patients have come to clinical harm as a result of our poor record keeping.

"We are extremely sorry that this situation was not identified and resolved earlier."

In a letter responding to the councils, the trust's chairman, Sir Richard Sykes, said: "The safety of our patients is an absolute priority.

"We have been handling this in an open and transparent manner. We did not want to raise undue concerns for people when the issue was actually with our data collection."

In a statement, the Care Quality Commission said it would continue to monitor the trust closely "to make sure that it complies with the essential standards of treatment and care that people are legally entitled to expect".

Thursday 21 June 2012

'oldest cave art'

Bristol researchers removing samples for dating from Tito Bustillo Cave

The El Castillo Cave has numerous red discs on its walls. One was dated to 40,800 years ago

Red dot becomes 'oldest cave art'

A look inside the Altamira Cave in northern Spain

Red dots, hand stencils and animal figures represent the oldest examples yet found of cave art in Europe.

The symbols on the walls at 11 Spanish locations, including the World Heritage sites of Altamira, El Castillo and Tito Bustillo have long been recognised for their antiquity.
But researchers have now used refined dating techniques to get a more accurate determination of their ages.
One motif - a faint red dot - is said to be more than 40,000 years old.
"In Cantabria, [in] El Castillo, we find hand stencils that are formed by blowing paint against the hands pressed against the wall of a cave," explained Dr Alistair Pike from Bristol University, UK, and the lead author on a scholarly paper published in the journal Science.
"We find one of these to date older than 37,300 years on 'The Panel of Hands', and very nearby there is a red disc made by a very similar technique that dates to older than 40,800 years.
"This now currently is Europe's oldest dated art by at least 4,000 years," he told reporters. It is arguably also the oldest reliably dated cave art anywhere in the world.
The team arrived at the ages by examining the calcium carbonate (calcite) crusts that had formed on top of the paintings.
This material builds up in the exact same way that stalagmites and stalactites form in a cave.
In the process, the calcite incorporates small numbers of naturally occurring radioactive uranium atoms. These atoms decay into thorium at a very precise rate through the ages, and the ratio of the two different elements in any sample can therefore be used as a kind of clock to time the moment when the calcite crust first formed.
Uranium-thorium dating has been around for decades, but the technique has now been so refined that only a tiny sample is required to get a good result.
This enabled the team to take very thin films of deposits from just above the paint pigments; and because the films were on top, the dates they gave were minimum ages - that is, the paintings had to be at least as old as the calcite deposits, and very probably quite a bit older.
The oldest dates coincide with the first known immigration into Europe of modern humans (Homo sapiens). Before about 41,000 years ago, it is their evolutionary cousins, the Neanderthals (Homo neanderthalensis), who dominate the continent.
Dr Pike's and colleagues' work therefore raises some intriguing questions about who might have authored the markings.
If anatomically modern humans were responsible then it means they engaged in the activity almost immediately on their arrival in Europe.
If Neanderthals were the artisans, it adds another layer to our understanding of their capabilities and sophistication.

The Panel of Hands: Produced by blowing paint over a hand pressed against the wall

The great antiquity of the paintings leads co-author Joao Zilhao, a research professor at ICREA, University of Barcelona, to think the Neanderthals produced the motifs. Finding even older paintings than the red dot at El Castillo might confirm that "gut feeling", he said.
"There is a strong chance that these results imply Neanderthal authorship," Prof Zilhao explained.
"But I will not say we have proven it because we haven't, and it cannot be proven at this time.
"What we have to do now is go back, sample more and find out whether we can indeed get dates older than 42, 43, 44,000.
"There is already a sampling programme going on. We have samples from more sites in Spain, from sites in Portugal and from other caves in Western Europe and so eventually we will be able to sort it out."
Tracing the origins of abstract throught and behaviours, and the rate at which they developed, are critical to understanding the human story.
The use of symbolism - the ability to let one thing represent another in the mind - is one of those traits that set our animal species apart from all others.
It is what underpins artistic endeavour and also the use of language.

Saturday 16 June 2012

Milk fats may alter gut bacteria

Milk fats may alter gut bacteria causing bowel diseases

By James GallagherHealth and science reporter, BBC News

Inflammatory bowel diseases are becoming more common

The rise of inflammatory bowel diseases could be down to our shifting diets causing a "boom in bad bacteria", according to US researchers.

Mouse experiments detailed in the journal Nature linked certain fats, bacteria in the gut and the onset of inflammatory diseases.

The researchers said the high-fat diet changed the way food was digested and encouraged harmful bacteria.

Microbiologists said modifying gut bacteria might treat the disease.

Inflammatory bowel diseases (IBDs), such as Crohn's and ulcerative colitis, affect one in every 350 people in the UK. When the gut becomes inflamed it can lead to abdominal pain and diarrhoea.

The researchers at the University of Chicago said the incidence of the diseases was increasing rapidly.

They used genetically modified mice which were more likely to develop IBDs. One in three developed colitis when fed either low-fat diets or meals high in polyunsaturated fats. This jumped to nearly two in three in those fed a diet high in saturated milk fats, which are in many processed foods.

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They also suggest an effective means of dealing with such diseases, by simply reshaping the microbial balance of the gut”

Dr Roy SleatorCork Institute of Technology

These saturated fats are hard for the body to digest and it responds by pumping more bile into the gut. This changes the gut environment and leads to a change in the bacteria growing there, the researchers said.

Treatments

One bacterium in particular, Bilophila wadsworthia, was identified. It thrives in the extra bile produced to break down the fats. It went from being incredibly rare to nearly 6% of all bacteria in the gut in the high-fat diet.

Prof Eugene Chang, of the University of Chicago, said: "Unfortunately, these can be harmful bacteria. Presented with a rich source of sulphur, they bloom, and when they do, they are capable of activating the immune system of genetically prone individuals."

However, he said this could lead to possible treatments as the gut bacteria could be "reshaped" without "significantly affecting the lifestyles of individuals who are genetically prone to these diseases".

Commenting on the research, Dr Roy Sleator, from the Cork Institute of Technology, said: "Not only do the authors provide, what is in my opinion, the first credible explanation as to how Western diet contributes to the unusually high incidence in inflammatory bowel disease; they also suggest an effective means of dealing with such diseases, by simply reshaping the microbial balance of the gut."

mengele plus

Wednesday 22 August 2012

NHS hospital trusts invited to expand abroad

NHS hospital trusts invited to expand abroad

“David Stou

Tony Nicklinson's legal fight for right to die

Tony Nicklinson's legal fight for right to die

MRSA and C. diff deaths falling

MRSA and C. diff deaths falling

Sunday 29 July 2012

Whooping cough

Whooping cough outbreak spreads to very young babies

Whooping cough

Wednesday 25 July 2012

Botox doctor suspended

Leading Harley Street Botox doctor suspended

“Start Quote

Thursday 5 July 2012

mengele: Elderly denied NHS care

Probe into 25 deaths after trust admits 'poor records'

Probe into 25 deaths after trust admits 'poor records'

“Start Quote

Thursday 21 June 2012

'oldest cave art'

Red dot becomes 'oldest cave art'

Saturday 16 June 2012

Milk fats may alter gut bacteria

Milk fats may alter gut bacteria causing bowel diseases

“Start Quote

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NHS hospital trusts invited to expand abroad

“David Stou

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