Number of NHS managers still growing as GP posts fall again

The number of NHS managers has grown by almost 18% in the four years since the government introduced a “bureaucracy-busting” shakeup of the health service, according to the latest official data.

The rise of about 4,650 in total management posts since April 2013, when the controversial Health and Social Care Act came into force, contrasts with an alarming fall in the number of GPs over recent months at a time of unprecedented demand for health care. The figures have drawn criticism from the British Medical Association (BMA), who say ministers are failing in their central objective of shifting more resources and manpower from back-office posts to the front line.

NHS Digital figures show management posts have risen from 26,051 in April 2013 – the month when the highly controversial act pioneered by then health secretary Andrew Lansley came into force – to 30,724 at the end of last year, the latest date for which data has been released. This is a serious embarrassment to the government, which insisted when pushing through the legislation in the last parliament – in the teeth of huge opposition from the medical profession – that a key benefit would be a freeing of resources to redirect effort to the front line.

The BMA said that it would be distressing for patients to learn that management posts were rising as GP numbers continued to fall. The latest data shows 92 GP practices closing in 2016 as GP numbers fell by 400 between October and December. Dr Richard Vautrey, deputy chair of the BMA’s GP committee, said: “Patients will be bemused that when their care is being undermined by GP and nurse staff shortages, the number of administrative posts has risen again. With the NHS at breaking point, we need ministers to get their priorities right. They need to follow through on their election pledges and invest in recruiting more GPs so that we can offer enough appointments to the public.”

Under David Cameron’s premiership, the coalition government said its health reforms, which handed control over commissioning services to GPs, would “cut the number of health bodies to help meet the government’s commitment to cut NHS administration costs by a third, including by abolishing primary care trusts and strategic health authorities”.

The process now appears to have gone into reverse. Between 2015 and 2016 the number of managers and senior managers in the NHS in England increased by about 3.5% in hospitals, trusts and clinical commissioning groups.

At the 2010 election the Tories put a promise to cut NHS bureaucracy at the heart of their pitch to voters. Before unveiling the Health and Social Care Act, they began cutting management posts, which were reduced by 12,000 between 2010 and early 2013. But as the requirements of the changes became clear, many who had been handed redundancy payoffs were then hastily re-employed only months later, some on six-figure salaries, to help run the new-look service.

The current health secretary Jeremy Hunt announced plans in 2014 to “train and retain” 5,000 more GPs by 2020, a pledge since watered down to also include doctors in training. According to the latest NHS England figures, however, 92 practices closed in 2016, up 114% on GP surgery closures in 2014. While 34 merged with other practices, the remainder shut completely.

Last week a survey carried out by the University of Exeter found that two out of every five GPs in the south-west of England were planning to leave the profession, with many citing workload and low morale as reasons.

There are also fears that an exodus of doctors and nurses from other EU countries will accelerate as the UK prepares to leave the EU. A total of 2,348 doctors from the 27 other EU states left NHS England between July and September 2016 compared with 1,281 in the same period in 2015 – a rise of 83%.

An NHS England spokesperson said: “The OECD says that on a like-for-like basis we spend only 2p in the pound on NHS administration, compared to 5p in Germany and 6p in France, and we have one of the most efficient health services in the world. But over the next three years we’re going to cut at least another quarter of a billion pounds from administrative costs to reinvest in frontline patient care.”

Number of NHS managers still growing as GP posts fall again

Beyond Gluten Free – Still having digestive problems and migraines?

For those of you who’ve been diagnosed with Celiac Disease, you’re inundated with a wide variety of packaged gluten free food products in the grocery stores. Initially, this sounds like a good idea. But when you look a bit closer, you realize that the vast majority of these products are loaded with bad ingredients.

Various studies have been done that have found significant numbers of people continue to have digestive and other Celiac symptoms even after they’ve switched to the standard gluten free diet.

• 
  

  Varying Sensitivity

  
  

The exact sensitivity to gluten varies, with some people being triggered with as little as 3 parts per million (ppm), which is much lower than the 20 ppm the FDA standards set as the limit to label a product Gluten Free. Because of this, many of you will still be getting gluten in your diet.

• 
  

  Other Food Allergies and Sensitivities

  
  

Many people are sensitive, allergic or unable to properly digest a variety of other common foods. These will also cause many of the same or related symptoms. Some of them include:

» Cereal grains (oats, corn, rice, etc.)

» Soy (oil, flour, food additives made from soy, etc.)

» Processed vegetable oils (canola, safflower, sunflower, corn, soy, etc.)

» Sugar (all processed forms)

» Dairy

• 
  

  Thyroid Disorders

  
  

Celiac sufferers also have a much higher rate of thyroid problems. These can be much harder to diagnose and to treat. The key to solve these issues, once you’ve tried to resolve your problems with a variety of diet changes, is to find a doctor or practitioner that actually has experience successfully treating these conditions. This is actually much harder to treat than you’d expect. Very few doctors know how to do anything other than the old fashioned thyroid treatments, such as killing the thyroid and putting you on medication the rest of your life. They just don’t know anything about the more extreme diet changes that are needed to put these kinds of issues into remission. The Functional Medicine field is starting to gain more traction in spreading the word about the successful protocols they’re creating and customizing for patients.

• 
  

  Other Triggering Substances

  
  

The vast majority of food additives come with varying degrees of side effects. Since the sheer number of food additives makes it virtually impossible to test them individually to see which of them causes you the worst problems, it really is wise to simply eliminate them all. This may seem daunting, but there are a number of food plans available that do a very good job of eliminating these toxins. The Paleo diet is an example. If you make a point of avoiding buying all the packaged foods that are becoming more popular for Paleo (and any other food plan), and stick to making your own food, these can go a very long way to setting you on the right path.

Almost all of the 3,000 + food additives have side effects of varying degrees, so when you have any sort of health problem, it just makes sense to remove them from your diet. Most of these additives are highly processed, and derived from unnatural ingredients, or ingredients that have been so highly processed and stripped and chemically manipulated, that they don’t behave in the body like normal food. The sheer volume of information out there on how bad some of these substances are for humans, and the fact that nothing is done to remove these substances from the food supply, raises a red flag about the entire industry. Though the main stream media does not cover this topic, it doesn’t change the fact that the evidence is overwhelming, when you look for it, and that these substances are bad for us.

The Functional Medicine field is also starting to really gain some momentum in documenting success with patients via diet changes. These diet changes involve cleaning up the diet, getting the toxins out, and then customizing a diet plan just for you. For those who are eating a gluten free diet, this field of medicine can really help root out some hidden gluten, as well as knowing the other substances that are common, and not so common, that need to be removed from your diet. Some of them have the experience on how to fine tune what should be added, and how to customize a treatment plan for the stubborn cases where you just can’t find all the problems yourself.

When you first start eating Gluten Free, or make any other major diet change, it does take a bit of an adjustment to get used to planning out what to eat. At first it can seem very daunting. But with practice, it does become much easier, and will eventually become second nature. I’ve been eating a restricted diet for over 15 years, and it truly has become automatic. I’m an avid label reader, but even that has become automatic; I just look at the label, and know if it has bad food additives in it.

It can be easier, when you start, to create a menu for yourself. Then, once you’ve got a list of recipes you know are gluten free, you can build your shopping list from that. That way you’re not wandering around the grocery store trying to figure out what’s for dinner; that’s where it becomes overwhelming. This can work whether you create an entire weeks worth of recipes, or just a couple of days at a time. If you know you’re going to have days you’re not prepared for, then preplan out a couple of fallback recipes. You can either make sure you always have those ingredients on hand, or keep a couple recipe cards in your purse or wallet. Then you know you’ll have something good to eat, even if you didn’t have time to properly plan.

My favorite fallback recipe is chicken soup. I just throw in a whole chicken, water, salt, pepper and whatever vegetables I have on hand. Since it actually contains a chicken, I don’t even need flavoring (which is a No-No when trying to clean up your diet). The “power” flavor vegetables for chicken soup are fresh onions, fresh garlic, and fresh celery. Then throw in whatever other fresh veggies you want, and your favorite fresh herbs. You can either freeze the soup to eat later, or if you like to eat the same thing for a few days, then keep it in the fridge.

As you build the new habits, and start to make progress on your digestive issues, it really does motivate you to stick to it. And don’t worry too much if you make a slip up. Take it as a lesson learned, and remind yourself later on, when you want to do it again, how bad you felt. Use it as a motivator to find some other recipes for things you like, that don’t make you feel bad.

We often get in the routine of buying our groceries at the same places. Adding some new places to buy from, and different kinds of places that you may not have normally thought of, can help bring some variety to your diet. When you’re on a restrictive diet, it can sometimes feel like there’s nothing left to eat. Bringing in some new flavors, and new foods, can help overcome this feeling. If you ask the clerks in these new stores, especially the smaller ones, you’ll be pleasantly surprised that many will know a lot about special diets.

Taking control of your health can seem like a big task at first. I’d suggest just getting started, with the goal of making progress. There won’t likely be instant success. Sometimes it can take a while to figure out what you need to cut out. Every person is different, every person is unique.

Start by making yourself a plan, and know that the plan is not set in stone. It will be a moving plan, with changing goals, and shifting priorities. Try to avoid letting people tell you there is only one path, one solution. Some of the diet plans out there, especially those really heavy into the promotion of their plan, and their products, will try to sell you on their “magic,” one size fits all solution, or their magic powder, or magic pills. There is no magic solution. It’s a plan you will build, and mold, and shape, in the years to come.

I’d like you to know that you’re not alone. There are a lot of us out there who’ve cleared the path for you, and can help you on your food journey, on your recovery journey.

—
Further Details to Help You Build New Habits – from Thora Toft’s Site – Feast for Freedom

Gluten Free “Eat Real” Quick Start Guide with Membership – FREE
https://feast-for-freedom.com

Changing Habits for Transformation – Article
https://feast-for-freedom.com/plan/grocery/item/37-change-routine/57-changing-habits-for-transformation

Finding New Places to Buy Food – Article
https://feast-for-freedom.com/plan/grocery/item/36-find-stores/51-finding-new-places-to-buy-food

Research and Sources

Do You Still Have Symptoms, Even Though You’re Gluten-Free?

I’m Eating Gluten-Free, But I Still Have Symptoms. What’s Going On?

Dr. Tom O’Bryan – information about autoimmune diseases and gluten-related disorders

New Glutens Discovered to be Harmful To Health

Gluten Sensitivity Genes and the Flaws of Lab Testing

Leaky Gut & Gluten Interview – with Karen Brimeyer & Dr. Peter Osborne

Dr. Izabella Wentz, Pharm. D.

Gut Microbiota for Health

Data gaps in toxicity testing of chemicals allowed in food in the United States

Food Forensics – The Hidden Toxins Lurking in Your Food and How You Can Avoid Them for Lifelong Health

The #1 Reason You Must Read Ingredient Lists: The FDA Admits They Can’t Do Their Job

Toxic Chemicals Deemed Safe Due to ‘Chemical Safety’ Loopholes

Thora shares her insights on eating gluten free while also eating “Real” via her website – Feast for Freedom. Thora has overcome chronic migraines and digestive problems by eating gluten free and removing all the toxic chemicals that have invaded the modern food supply. She combines her lifetime love of cooking with the concept of eating real, clean food. Get the FREE “Gluten Free Eat Real Quick Start Guide”.

Beyond Gluten Free – Still having digestive problems and migraines?

An afternoon with Stan Bowles: the twinkle is still there but the memories are gone

The smile has not changed, as puckish as it always was; nor has the mischievous glint in Stanley Bowles’s sea-blue eyes. I remember it all like yesterday, when Bowles bedazzled football, weaving, winding through a humiliated defence yet again, in the hoops of Queens Park Rangers, atop the league, back in the 1970s.

But at a pub in his native Manchester, Stan himself remembers none of this. His Alzheimer’s disease is now, as they say, “100%”, both sides of the brain, “and something at the back”, adds his daughter Andria, nowadays, as she describes herself, “full-time carer” – and lifeline. Of course, we recall a few goals of yore: “We’re talking about you playing football, Stan.”

“Football?”

Fifty years ago last weekend, QPR won one of the most remarkable cup finals in football history: from the Third Division, they overcame a two-goal deficit to defeat First Division West Bromwich Albion 3-2, and win the League Cup. I was at Wembley that unforgettable day, aged 12, with my father and brother, dizzy with disbelief.

Little did we know, though, that 1967 was just the beginning for hitherto humble Rangers. Within 10 years the club came within 14 minutes (during which Liverpool put three past Wolves, in a deciding game) of the First Division title, equivalent to today’s Premier League. But memory of the zenith decade casts a shadow over QPR’s half-centennial, for that achievement in 1975-76 was synonymous with the uncanny brilliance and waggish personality of one player: Bowles. The man who, as his best friend Don Shanks says, “can hardly remember who he is. It’s heartbreaking, soul-destroying.”

My God, those days. I travelled every long weekend either back from university to west London or up and down the M6, M1, usually in a Morris Minor driven by my best friend Patrick Wintour (of this parish), brother Tom and a friend, William, whose family had shared our house. We went to watch the Superhoops and above all the greatest player ever to wear them, Bowles. My sister, now a professional illustrator, started her career by winning, aged 15, a “Draw Stan Bowles” competition. My first ever article was published in The Superhoop supporters’ club magazine.

QPR’s Stan Bowles eludes Leeds’ Norman Hunter and Trevor Cherry in April 1976. Photograph: Stewart Fraser/Colorsport

We would drive to Sunderland or Manchester, take supporters’ club chartered trains to Stoke, hitchhike back from Everton. After listening to that last terrible Wolves v Liverpool game on the wireless, Patrick said: “I’ve never felt so philosophical in my life. Nothing’s ever meant so much.” His girlfriend was furious. At the centre of it all: Bowles’s flair, long hair, gawkish gait but spellbinding ability to accelerate, decelerate, anticipate. His late winner at Newcastle, voodoo with the ball against Middlesbrough, a perfect winning goal at Leicester, then what could have been a title-clincher against Leeds in our last game of the season.

Among those also watching was the former home secretary Alan Johnson, who says: “Bowles’s impish wizardry left so many Rangers fans with wonderful memories. I am privileged to be one of them.” The broadcaster Robert Elms insists: “The bond between QPR and Stan Bowles is more complete than between any other single player and a football team. This wayward, wondrous, magical, yet totally down-to-earth street genius is the embodiment of our Queens Park Rangers.” The composer Michael Nyman says: “My love of Stan goes back to a muddy match when he first played at Loftus Road against Rangers for Carlisle in 1972 [we signed him five months later]. He was as astonishing then as in every subsequent match I saw him play in.”

Stan’s golden years were shared, on and off the pitch, with Shanks, the QPR defender famous for “stealing” Miss World Mary Stavin from Liverpool’s Graeme Souness. Bowles reputedly took every opportunity during a game at Anfield to remind Souness of his mate’s conquest. “Stan played football without stress or pressure,” Shanks recalls. “While other players would be in a panic during a big game, or poor shape for a bad one, Stan would just play. ‘Give me the ball, I’ll do the rest.’ A football pitch was Stan’s natural home.”

Stan can hardly remember who he is. It’s heartbreaking, soul-destroying

Don Shanks

The manager Dave Sexton stressed then what he called Rangers’ “continental” football, inspired by Dutch games, and Shanks places Bowles in the history of what has happened to British football since. Shanks says: “Stan was like players who come from Europe now, before their time: Costa, Agüero. A star, but unselfish; he was a team player … amazing rapport. We knew what Stan would try to do – the amazing thing is that he did it. Round the back of the defence, with pace – and magic.”

But it was Stan the man that Shanks – and QPR fans and players – loved too. “Everyone was equal to Stan,” he says. “It didn’t matter if you were collecting rubbish or a pop star. If QPR were up in Manchester, he might stay over and play for a Sunday league team.” Bowles would stop over at Shanks’s parents’ flat on the White City estate, next to Loftus Road: “Always polite – ‘Thank you Mr Shanks, thank you Mrs Shanks’ … I used to say: ‘It’s OK Stan – no one else talks to them like that.’”

I remember Bowles joining fans in The Crown & Sceptre near QPR’s ground on Christmas Eve – his birthday. He was offered more pints than even he could manage, and bought a few himself, for total – albeit adoring – strangers.

Most famously: “Stan loved a bet,” says Shanks, who was also his partner at the White City dog track or bookmakers. “Not big money – it was a pastime, 50 quid between two dogs, for the adrenaline rush. He hardly went to a casino, but if he did, he’d put £20 here, £20 there. Later, he’d go to those card schools and play for six hours.” A barman at the dog track was John O’Mahony, now among fans campaigning for a Bowles testimonial. He says: “Stan always drew people round him, but he never showed off. He was always just himself.”

England’s Stan Bowles celebrates with Kevin Keegan after scoring against Wales in 1974. Photograph: Colorsport/Rex/Shutterstock

And he still is, but actually not. Bowles moved back from London to Manchester before the family announced his condition in 2015. And here he is, at the Whitegate Inn on the road to Oldham, enjoying lager-and-lemonade-top with Andria, his friend Mike, a builder who visits every day, and Joanne Connolly, a fan whose dad – “Taxi Teddy” – knew Bowles from outings to the dogs; Joanne calls Stan the “adolescent fervour that lasted a lifetime”.

Stan wears a dapper woollen overcoat, tartan tweed hat and smart scarf. Now he puts on a pair of sunglasses. “Dino!” he says. “That’s Robert De Niro,” explains Mike. “Dino!” repeats Stan. “It’s hard to speak Stan-ish,” says Andria. “He’s having a good day today, but it’s not always like this. On bad days, he’s a rabbit in the headlights, very anxious and confused.” Andria, the modern-day matriarch of Moston, is a woman of humbling strength and commitment, but insists to the contrary: “It’s something I do,” she says of her charge. She admits: “He was a selfish Dad, but he’s mellowed, he’d started to do that before the disease. Now he’s home, with us, where my own Nan and Grandpa lived.”

There are moments of sudden clarity from Bowles. I mention Gerry Francis, the QPR captain with whom Stan had telepathic rapport: “Gerry, he’s alright he is.” And when you call him Stan he corrects you: “It’s Stanley!”

In comes Stanley’s great-granddaughter, Macie, aged five. Andria used to run another pub down the road “where my Nan used to drink”, but gave it up to look after Macie (“my son’s daughter, but …”) before Stanley was diagnosed. “So it’s like having two children now,” says Andria. I ask: “Macie, does he do what he’s told?” “No, ’cause he doesn’t know what you’re saying. He can’t talk proper because he’s poorly. But I understand him.”

Stan Bowles’s great-granddaughter Macie says: ‘He can’t talk proper because he’s poorly. But I understand him.’ Photograph: Christopher Thomond for the Guardian

Mike says he still takes Stanley for a bet: “He’ll write ‘2.15C’ – it could be Cheltenham, it could be Catterick. Once he put a tenner on a winner, worth £130, but he’d thrown away the chit.”

“London!” Stanley repeats. Mike takes him “up” to the smoke occasionally, and they stay around Brentford, Bowles’s last professional club. Mention of the Bees starts another, urgent, conversation: that club staged a benefit game in 1987, and this season published a commemorative programme to raise funds for Stan’s welfare. “I see myself looking after him for the rest of his life,” Andria insists, but talk inevitably turns to the possibility that Stan will need residential care one day. “There are two options,” Shanks had said, “go the NHS way or get private so he can be comfortable and his family can visit.” “There’s a place down the road,” says Andria, “£600 a week.”

Bowles played in days when footballers even at his level were unable to plan for what might follow. The announcement that Billy McNeill – the first captain of a British team, Celtic, to hoist the European Cup, half a century ago – suffers from dementia reopened the dual debates over welfare and head injuries. Bowles’s condition – and dire financial straits – is an example of the game’s reluctance to look after its own; Nobby Stiles also suffers from Alzheimer’s, but there is scant care from mighty Manchester United. Alex Young, who died last week from a short illness after suffering from dementia, had better luck having played for Everton who operate, says O’Mahony, “a role-model system for former players”.

Stan Bowles, left, with Gerry Francis, Frank McLintock and manager Dave Sexton after QPR beat Leeds 2-0 in May 1976 amid a thrilling title run-in. Photograph: Reg Lancaster/Getty Images

QPR has an ex-players association, but with no benevolent welfare charge. “Sometimes,” says Shanks, “I wonder what the PFA is there for if not to help people like Stan and Frank Sibley [Rangers midfielder in that 1967 Wembley final, now battling Parkinson’s]. I also wonder if the people running QPR understand the legacy, who Stan was, what he meant to the club and its fans.”

The club did organise a Stan Bowles Day in 2015, at which he waved to adoring crowds before a game with Rotherham. Fifty pence from each programme went to Bowles, and there’s a fund with over £15,000 in it – but the matter of a proper testimonial at QPR has embittered some corners of Shepherd’s Bush.

Discussions began in 2015, when supporters met the club soon after Bowles’s family made his condition public. “The first meeting was positive,” says O’Mahony, “but it was down to us to arrange it all, and raise funds. Now we’re two years down the line, and Stan has deteriorated.”

A spokesman for the club referred to a statement a fortnight ago from the CEO, Lee Hoos, who said: “To set the record straight: QPR, as a club, welcome the proposal of a Stan Bowles benefit match. We are determined to help put on an event for Stan that supports his care and raises money … We are today starting the steps to ensure this event is a success.”

“There’s no coming back from where Stan is now,” says Shanks. “But …” He recalls Stan Bowles Day – “when Stan walked out at Loftus Road he knew exactly where he was, for some reason; a moment of knowing who he was. The family’s been fantastic, and now this should be testimonial year for Stan – he was the greatest, this is a special case. I’ve got a lump in my throat saying this, but we don’t have long. We can’t get to that situation of: ‘Oh, should’ve done this, should’ve done that.’ It has to be now.”

Stan Bowles in action for QPR in a Division One win against Manchester United in September 1975. Photograph: S&G and Barratts/Empics Sport

We raise another glass in Manchester. “We all love you Stan!” Bowles puts down his beer, takes my hand with a vice-grip, and stands. “Stay still,” he says, takes my head between his palms and plants a smacker on my cheek. I glance towards the others and, as Mike says, “I’ve got glass in my eyes”. Stanley sits and says: “I’m still going.” His eyes twinkle. And again: “I’m still going.”

• Additional research by Joanne Connolly

An afternoon with Stan Bowles: the twinkle is still there but the memories are gone

Most Still Don’t Know ObamaCare Penalties Waived by Trump Executive Order

The I.R.S has been instructed by the Trump Administration via Executive Order  not to collect ObamaCare Penalties. Giving millions of Americans and small businesses a huge break and boosting the economy. Ordering the I.R.S. not or ask about your healthcare situation makes sure no further penalties can be assessed. Effectively throwing a monkey wrench into the ObamaCare tax and penalty system that has wrecked the American economy. As Congress sits on their hands and does nothing this one act alone has given millions of families much needed help. Millennials who don’t get ObamaCare will actually get a tax return this year. Small business can expand not having to worry about the mandates. Majorly boosting the consumer confidence and adding to the stock market rally. Trump can do this because the President has the responsibility to direct all employees of the federal government. Congress may wait and try to introduce ObamaCare Lite but Trump has beat them to the punch back on January 20th.

Why is this not more widely reported on mainstream fake news? Nothing on nightly news. A couple begrudging mentions in the national papers. Local or city newspapers and television? Forget about it. Alternative sources and conservative economic media have reported on it. The answer is obvious. It is not politically convenient.

This is such cause for celebration for all Americans yet almost nothing is being done by the 5th column to advertise the fact to the people. This is important. A lot senior citizens who rely on these “news sources” are not even aware of this. Lower income people and even low information consumers are still making financial and healthcare decisions based on old information.

Executive Order Minimizing the Economic Burden of the Patient Protection and Affordable Care Act Pending Repeal

Section 2 of the Executive Order of Jan 20th reads.

Sec. 2.  To the maximum extent permitted by law, the Secretary of Health and Human Services (Secretary) and the heads of all other executive departments and agencies (agencies) with authorities and responsibilities under the Act shall exercise all authority and discretion available to them to waive, defer, grant exemptions from, or delay the implementation of any provision or requirement of the Act that would impose a fiscal burden on any State or a cost, fee, tax, penalty, or regulatory burden on individuals, families, healthcare providers, health insurers, patients, recipients of healthcare services, purchasers of health insurance, or makers of medical devices, products, or medications.

Small businesses over 50 people that don’t comply with the Obamacare can pay as much as $ 5000 per employee as places like Macdonalds get waivers. The penalty to an individual can be as high as $ 2800 in the higher tax brackets. Even at the lower end even $ 600 can be be a low income earner’s entire tax return. The effect goes far beyond that.

Now families and individuals can effectively ignore the disastrous law all together. No longer saddled with having to get useless health insurance with high premiums. Saving many hundreds of dollars a month for an average family. Choosing alternative means of healthcare not prescribed under the draconian ObamaCare. If they know about it.

Sources:

RaptormanReports

https://www.whitehouse.gov/the-press-office/2017/01/2/executive-order-minimizing-economic-burden-patient-protection-and

https://www.forbes.com/sites/kellyphillipserb/2017/01/20/trump-signs-executive-order-to-roll-back-obamacare/#7858a7643eeb

Most Still Don’t Know ObamaCare Penalties Waived by Trump Executive Order

China may still be using executed prisoners" organs, official admits

An official in charge of overhauling China’s organ transplant programme has said the country may still be using organs from executed prisoners in some cases, even though there is technically zero tolerance for the practice.

The admission by Huang Jiefu, a former Chinese deputy health minister, came as human rights activists and medical ethics experts voiced strong objections to his inclusion at a Vatican summit designed to tackle illicit organ trafficking.

The activists said that by giving Huang a platform, the Vatican risked giving China’s practices an air of legitimacy. Huang told reporters on Tuesday that the controversy was “ridiculous” and repeated assertions that the use of organs from prisoners is now “not allowed”.

“There is zero tolerance. However, China is a big country with a 1.3 billion population so I am sure, definitely, there is some violation of the law,” he told reporters at a conference in Rome.

Pope Francis has called illicit organ trafficking a form of modern slavery. At the start of the conference on Tuesday participants painted a bleak picture of the scale of the problem, with patients who are desperate for life-saving procedures flocking to countries like Egypt, India, and Mexico to buy organs cheaply.

Huang, who has long been a controversial figure in the world of transplantation, said trafficking could be stemmed through the creation of a global task force headed by the World Health Organisation.

But experts have questioned Huang’s assessment of the situation, saying China probably still systematically uses the organs of executed prisoners in order to meet an overwhelming demand.

Last year, China’s alleged use of prisoners’ organs was debated at an international conference after two doctors said it was premature to declare China an ethical partner in the international transplant community.

Nicholas Bequelin, the east Asia director for Amnesty International, said it was known at the time that the vast majority of organ transplants in China came from executed prisoners.

The number of prisoners China executes annually is a state secret, but Bequelin said estimates ranged from 3,000 to 7,000. He said experts had cast doubt on Huang’s claims that China had outlawed the practice. “They haven’t stopped the practice and won’t stop. They have a need for organ transplants that far outpace the availability of organs,” Bequelin said.

Details of the process are grim. Bequelin said China did not adhere to World Health Organization recommendations on how doctors should determine whether a person is legally dead. In some cases, organs have been removed before the prisoner would be considered medically dead by international standards.

“The timing of the execution is – we think – sometimes dependent on the need of a particular transplant surgery. You will execute this person at this time on this day, because that is when the patient has to be ready,” Bequelin said. “It is very secret and there is not a lot of reliable information.”

The Vatican has released new bioethics rules that say organ transplantation must involve the free consent of living donors or their representatives and that in ascertaining the death of a donor, it must be diagnosed with certainty, especially when a child is involved.

China may still be using executed prisoners" organs, official admits

I’ll say it again: E-cigarettes are still far safer than smoking

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Despite evidence suggesting e-cigarettes are far less harmful than smoking, more people than ever believe them to be just as harmful. Professor Linda Bauld discusses the evidence

January is a time for New Year’s resolutions and if you’re one of the world’s one billion smokers, your resolution may be to stop smoking. For some people, this year’s quit attempt might involve an electronic cigarette, and a recent study in England, published in the BMJ, suggested that these devices helped at least 18,000 smokers to stop in 2015 who would not otherwise have done so. That’s very good news, but will there be as many quit attempts in 2017 as there have been in the past with e-cigarettes? I’m not so sure.

Since I last wrote about e-cigarettes in this column one year ago, headlines about the dangers of these devices have continued to appear and show no sign of abating. The result is clear. More people believe today, compared with a year ago, that e-cigarettes are as harmful as smoking. In fact these incorrect perceptions have risen year on year, from fewer than one in ten adults in Great Britain in 2013 to one in four this past summer. Surveys of smokers show similar patterns, with an increasing proportion believing that e-cigarettes are more or equally harmful than tobacco.

Related: Why can’t scientists agree on e-cigarettes?

Related: Does a tobacco-free world need to be nicotine free?

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I’ll say it again: E-cigarettes are still far safer than smoking

Revealed: dozens of children still treated on adult psychiatric wards

Dozens of children and young people with mental health problems are still being treated on wards containing adults with sometimes severe psychiatric problems despite ministers having supposedly outlawed the practice in 2010, the Guardian can reveal.

Mental health campaigners condemned the persistence of the problem and said it was “completely unacceptable” for vulnerable minors to be subjected to what many find a “terrifying” experience. The Liberal Democrat health spokesman Norman Lamb, who was the minister for care, including mental health care, in the coalition government, said putting children on adult wards was “scandalous” and must be ended at once.

Official figures from mental health hospitals collated by NHS Digital, the health service’s statistical arm, show that in July 47 children and young people aged 17 or under were treated on adult psychiatric wards. Of those 21 were aged 17, another 18 were 16-year-olds and the other eight were aged 15 or under. There is particular anxiety that under-16s are still receiving treatment in adult settings as the government made clear six years ago that this should never happen.

Gordon Brown’s Labour administration placed the “age-appropriate environment duty” on NHS mental heath trusts in April 2010 in a bid to end a practice that parents, charities, MPs and the children’s commissioner for England had criticised as unpleasant and traumatising for children.

“The simple truth is that this has to end completely. It’s scandalous that the practice continues. It is unsafe and wrong. There must be a clear and unequivocal commitment from this government to eradicate the practice completely without delay”, said Lamb.

The duty legally obliges managers of mental health units, under section 131A of the Mental Health Act 1983, to ensure that “the patient’s environment in the hospital is suitable having regard to his age (subject to his needs)”. While it allows 16- and 17-year-olds to still be looked after on adult wards occasionally in “exceptional circumstances”, such as if they need to be admitted as an emergency, it forbids totally under-16s ever being treated there.

The figures, which the Guardian requested from NHS Digital, cover January to July this year. A total of 39 under-18s were treated on adult wards in that time, though some may have shown up in the figure for more than one month, NHS Digital said. One hundred and thirty 17-year-olds and 90 children aged 16 were also treated during that time. If the same trend is maintained in the rest of the year that would result in a total of 446 under-18s being treated there, which would the highest for many years. A total of 391 children were treated in such wards in 2014-15.

Under-18s spent 1,938 days on adult mental health wards between them during April and June, almost double the 1,102 days they spent there from January to March. Most of those occurred in the north of England, which saw such bed days soar from 35 in the first three months of the year to a massive 1,405 in the second quarter. In that same period there were 225 such bed days in the Midlands and East of England (down 650 the previous quarter), 185 in London (down from 220) and 125 in the south of England (down from 195), NHS Digital’s data show.

Responding to the figures, the health secretary, Jeremy Hunt, said the number of children in psychiatric wards had fallen by 60% since 2010 and such places should be used rarely. He is set to make a major speech on children’s mental health care on Tuesday, weeks after condemning adolescent and child mental health services as the NHS’s most glaring area of failure to meet need.

“However, this type of care should be an absolute last resort, once all other avenues have been exhausted,” Hunt said. “But to help ease demand, we recently opened 50 new beds, increasing the total number to the highest there has ever been.” Those 50 took the NHS’s supply of beds in children and young people’s mental health services up to 1,442, though the continued use of adult wards suggests that is not enough.

Sarah Brennan, the chief executive of the charity Young Minds, said: “It’s completely unacceptable that vulnerable children are still being treated on adult mental health wards, six years after the government changed the law to stop this from happening. Young people often find it terrifying to be placed alongside much older patients, and say that it adds to their distress rather than helping them.”

Meanwhile, new research to be released on Monday reveals huge frustration among parents of children and young people with mental health conditions at the difficulty of obtaining help for them.

Two-thirds (66%) of such parents surveyed by Young Minds complained that their child had to wait a long time to get treatment, and almost half (49%) said no one believed them when they first raised concerns about their offspring’s mental welfare.

Two in five (41%) of the 316 parents said thresholds for accessing treatment were too high, which meant their child was deemed not ill enough to warrant NHS care, while 36% had paid a private counsellor, psychologist or other therapist to help their child because NHS care was unavailable.

“Not only are many thousands of young people suffering with mental health problems but their parents are suffering too. They feel helpless, unheard and are desperate to help their young people but don’t have the knowledge or tools”, said Emma Rigby, chief executive of the Association for Young People’s Health.

Revealed: dozens of children still treated on adult psychiatric wards

Why is heart disease still killing millions every year?

The heart is a remarkable muscle. It sits behind the rib cage, pumping 100,000 times a day to carry nutrients to the furthest extremities of the body.

But it is also a vulnerable organ, prey to the excesses of a modern western lifestyle – and as excessive lifestyles have spread around the globe, they have had a predictable effect.

Around the globe, the morbidity burden of cardiovascular disease (CVD) has increased by 40% in the past 25 years. The gains in the west – since the 1960s, deaths from heart attacks and strokes in the UK have nearly halved – have been outweighed by the fact that the global population is increasing in number and ageing. There were 12.3m CVD deaths worldwide in 1990 – this had risen to 17.3 million by 2013. That’s over three times the number caused by Aids, TB and malaria combined.

The World Health Organisation (WHO) and World Heart Federation have said the risk of premature death from CVD could be cut by 25% by 2025 with a three-pronged attack to reduce high blood pressure, curb smoking, and provide at least half of those who have already had a heart attack or stroke with secondary prevention, such as medication.

But a panel of international experts – which I chair – say in a highly critical report to be presented at the World Innovation Summit for Health (Wish) in Doha this month that the response from policymakers has been weak.

Given the fact that the disease develops slowly and does not create the panic caused by a flu pandemic, there is a lack of urgency and responsibility is fragmented, with governments facing opposition from powerful lobby groups such as the tobacco industry, says the report.

Hypertension affects 1 billion people worldwide. Smoking kills 6 million annually and although its use is falling the number of smokers worldwide has increased from 721 million in 1980 to 967 million in 2012. In secondary prevention, a single measure – controlling low-density lipoproteins in those who have already had a heart attack – reduces the risk of a further one by 40%.

Some countries have launched bolder initiatives, leading the way for the rest.

• New Zealand set a goal in 2011 to reduce smoking prevalence to 5% by 2025 and provided NZ$ 5m (£2.9m) a year.
  


• Brazil uses community health workers to visit every household in their catchment area once a month. The scheme covers half the population. This has led to a significant cut in hospital admissions, with a 20% drop in age-standardised deaths from heart disease and stroke over the course of the 20-year programme.
  


• In South Africa a scheme called Practical Approach to Care Kit (Pack) supports nurses to provide care in the community, leading to improvements in prescription, referral and screening, and reductions in the length of hospital stays.
  


• In India, the mTobaccoCessation service – a text based programme sending free, customised messages to help smokers give up, launched in January 2016 – enrolled 800,000 people in the first 60 days, showing the extent of demand. Trials have shown the programme can double or triple smoking cessation rates.
  


• In the UK, a trial is underway in Cheshire and Merseyside, in collaboration with the WHO, to raise awareness of blood pressure and develop a suite of text messages to help people keep it under control. Tests have shown that this can lead to “statistically significant improvement”.
  

These are conditions that kill more people than any other, yet policymakers rarely make CVD prevention a major focus of their attention, despite the high health and economic burden and the unnecessary loss of life. It does not get as much attention as diseases that are perceived as more life-threatening, or as posing a greater risk, such as cancer or Ebola.

We in the UK cannot afford to be complacent. Although the total number of cardiovascular deaths has come down – from 320,000 in 1961 to 180,000 in 2009 – CVD is still the biggest killer, accounting for 32% of all deaths in 2009 [pdf].

Nearly every single country worldwide shares the same burden and faces the same challenge. That means that there are many innovators around the world testing new ideas and trialling new solutions. But they need political and financial support if they are to find an answer to the most significant public health threat in the world today.

Lord Darzi is a surgeon and executive chair of the World Innovation Summit for Health (Wish), an initiative of the Qatar Foundation.

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Why is heart disease still killing millions every year?

Why do one in seven US citizens still have to fight to vote? | Mary O’Hara

The spectacle of Donald Trump repeatedly demeaning and insulting just about every minority group in the US during his campaign for the presidency has been toxic and unprecedented. High up on the long list of ignominious behaviour was the contempt he displayed for people with disabilities in his mocking of a disabled reporter, captured on video.

As with the battles disabled people have fought in Britain against austerity policies from the bedroom tax to the work programme, Trump’s casual disdain is a potent reminder of how fragile inclusion and hard-fought-for disability rights can be.

Beyond the media focus on the race for the White House a new report explores evidence that, regardless of political rhetoric, people with disabilities in the US routinely encounter barriers within the broader electoral process. There are at least 35 million voting-age people [pdf] with disabilities in the US – one in seven of the electorate. According to the study, co-authored by Norman Ornstein of the American Enterprise Institute for Public Policy Research, many are treated like “second-class citizens” as a result of obstacles to voting. The wide-ranging paper points out how “despite a patchwork of legislation” to ensure access to voting serious problems persist.

Donald Trump mocks reporter with disability – November 2015

Pulling on an array of research and interviews it details the scope of the issue, including how in parts of the US people with disabilities are unable to reach polling stations because of a lack of public or adapted transport and inaccessible buildings. Alternative options such as absentee ballots or assistance with casting a vote aren’t adequate substitutes for a fully accessible, inclusive system it argues because, among other things, these can impede a voter’s right to choice and privacy.

Other hurdles it lists involve election materials and online voter registration (for example for people with visual impairments), poll workers who are poorly trained in disability access and limited resources to improve services. In 2013, the US Government Accountability Office [pdf] estimated that in 2008 73% of polling stations had “a potential impediment”, something this latest report rightly concludes is “stunning and troubling”. Almost three-quarters translates as millions of disabled voters possibly being denied their vote.

The report also says stigma is a huge problem, especially for people with learning and mental disabilities. According to research, in 27 US states large numbers of people in these groups are barred from or have restrictions placed on voting.

It might be tempting to think of voting access for people with disabilities as a predominantly US problem but as the last UK general election showed, it is far from alone. During that election activists including Operation Disabled Vote, which campaigned on voter registration, highlighted the obstacles in place across Britain. Meanwhile a report from the charity Scope, found two-thirds of polling stations had at least one significant barrier to access. Research published in 2014 by Mencap revealed that 60% of people with a learning disability reported difficulties registering to vote.

When it comes to mental health, charities including Mind and Rethink Mental Illness have argued for years that vulnerable people such as those who are homeless with mental health problems can face multiple barriers to voting. None of these problems, be they in Britain or the US, are universal or irreversible. During the 2016 presidential campaign it has been encouraging to see positive perspectives on disability. Hillary Clinton has repeatedly highlighted disabled people’s employment rights and other areas where exclusion and underrepresentation are common.

And in the run-up to next week’s election, activists in the US have been mobilising and political engagement is high. The American Association of People With Disabilities launched a successful campaign in the summer promoting voting accessibility and registration among the millions of people with disabilities who are eligible to vote. Grassroots activism has also been spurred into action with networks such as SignVote, for people who are deaf and hard of hearing, and Crip the Vote, an online campaign encouraging disabled people to participate in local and state elections as well as voting for president.

The right to vote, and not being precluded from exercising that right, is fundamental to citizens in any society wishing to call itself democratic or inclusive. It is intolerable that people continue to face barriers to voting because of their disability.

Why do one in seven US citizens still have to fight to vote? | Mary O’Hara

Homeless people with brain injuries are still invisible to the NHS

Homelessness is on the rise and has been for the past five years, with government statistics suggesting a 55% increase in the number of people homeless in 2015. Despite this, people living on the streets still remain largely invisible to regular NHS services, leading to a big problem in health inequalities.

Brain injury presents a particular challenge. Homeless people are five times more likely to be hospitalised due to head injury, compared to the general population and US research suggests that roughly half of all homeless people may have had a traumatic brain injury. . These figures are higher still if we include dementia and substance-related brain injury, such as alcohol-related brain damage. Yet we still do not have properly-funded support for homeless people who have sustained such traumas.

The most common type of brain injury among homeless people is traumatic brain injury, often caused by a blow to the head during an incident such as an assault or traffic accident. Other forms include strokes, brain cancers, dementias, and damage caused by drug or alcohol use.

Symptoms can include changes in personality, speech problems or walking difficulties, as well as issues with concentration and memory. Behaviour changes may also occur, such as becoming more aggressive.

Sheffield’s head injury and homelessness research group recently carried out research to explore the interaction between homelessness and brain injury. It was led by someone who had suffered a brain injury and been homeless

The research focused on the experience of homeless people themselves. Where previously they may have reproached themselves for being clumsy, lacking motivation, being aggressive, or an alcoholic or a “junkie waste of space”, the programme helped them to stop blaming themselves for what had happened to them.

The research has also resulted in a film, made with support from Deaf Pictures, telling the story of Michael, one of the participants in the research. His story is painful, but not unusual. Yet the interaction between brain injury and homelessness is rarely mentioned in homeless research and policy, meaning people like Michael often become invisible to society and to services.

[embedded content]

Deaf Pictures’ short film on homelessness and brain injury.

Homeless people too often get bounced between drug and alcohol teams, re-housing schemes, accident and emergency units, and mental health services. Even if they are fortunate enough to have a sympathetic GP, a homeless person is still likely to be expected to attend a brain injury clinic at a scheduled time. Many won’t attend, and simply end up being discharged.

If services are to meet the needs of homeless people, then they must be built with homeless people and, most importantly, must be provided where they are, rather than in clinics far removed from the everyday life of the person struggling with the effects of a brain injury.

Services can and should be developed and funded to bring brain injury assessments and follow-on support to those in need. In doing so, we can expect better longer-term outcomes for such individuals and find ways together to reduce the invisible cycle of homelessness and brain injury.

Stephen Weatherhead and Rebecca Forrester are clinical psychologists

Some names have been changed.

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Homeless people with brain injuries are still invisible to the NHS

Female genitals are still in the closet. We need to talk more about vaginas | Catharine Lumby

When I was a young law student I went for my first pap smear at a local GP. As he was removing the speculum he commented casually, “You know, you have a really nice pussy”.

It took me five years to go for another test. I was 19 and I didn’t think about complaining to anyone. I just took a very long shower.

I also did something else that day. I got out a mirror and had a proper look. The whole shebang – outer lips, inner lips, clitoris and urethra. And my vagina – the opening that my beautiful babies eventually came out of.

Like many young women, I’d never acquainted myself with the features of what my GP had taken a way too interested look at. Male genitalia is out there. It’s dangly. Boys joke and talk about it all the time.

But female genitals are still in the closet – despite some fabulous feminist attempts to get them out of our undies and proudly on display. The Guardian has recently posted a fabulous series on our VGs. Vagina isn’t technically a catch-all term but it’s the best one we have for now, which shows us what many of us don’t know about our downstairs bits.

A disturbing new study by Dr Magdalena Simonis from the University of Melbourne’s department of general practice, published in the British Medical Journal, found that there has been a threefold increase in women requesting labiaplasty – cosmetic surgery to their vaginas.

She interviewed over 400 GPs, most of them specialising women’s health. They reported an alarming rise in the number of women requesting advice on labiaplasty.

So what are we to make of this? Vaginas come in all sizes, shapes and colours. Like all good things. But do most women, particularly young women, know that?

Simonis is concerned that fashion, online pornography and beauty ideals are playing into this new trend. And she’s probably right. The reality is we don’t really know. We need more interdisciplinary research across medical science and the humanities to understand this trend.

Many young women in my study told me how shamed they felt about their bodies

As someone who has done recent large scale research into young people and online media, I’m aware that most young people are not watching the Barbie Doll style porn older generations associate with porn. You know – the 90s Hollywood porn where women called Bambi, Mandi and Candi pretend to be lesbians with fake breasts and nails? You can take the Fifth Amendment if you want but you do know.

That’s not the kind of sexually explicit material that most younger people look at. A lot of it they create themselves. Old people call it “sexting”. Young people don’t. They call it sharing images of their bodies, which suggest there are many kinds of vaginas involved.

Young women don’t go looking for online porn. On the other hand, they are drowning in a culture where perfecting their bodies is seen as paramount.

Many young women in my study told me how shamed they felt about their bodies – if they flaunted their conventional attractiveness too much they were shamed for that. If they didn’t stack up to male ideals of beauty they were shamed for that.

And when I asked young women, in an age-appropriate way, about whether they had access to information about how to have sexual pleasure, many of them averted their gaze. The young guys laughed it up when I asked the same question.

There’s a core issue here – we don’t talk about vaginas. We don’t talk about how they can be a source of pleasure for women. We don’t talk about how they are all different. And we don’t tell young women and men that there’s no “normal” vagina.

I understand that young men are increasingly coming under pressure about their bodies and their genitalia too. But a good start in changing the relationship young women have to their bodies – and young men do too – might be to start talking more openly about women’s vaginas.

I’d like to see sex education classes where someone explains the role of the clitoris. Then we could move onto talking about how fabulously multitasking vaginas are – a bit like breasts. Western society obsessively sexualises breasts and vaginas but ignores the wonderful work they also do in bringing children into this world and feeding them.

In the meantime, we should applaud Simonis for her study. We need to know a lot more about young women and why they are so anxious about their bodies.

Her research confirms a large study conducted in the UK in 2012, which found there is a growing trend for women to request cosmetic surgery – for all areas of the body. Figures have continued to increase since then and the vast majority are still women.

As a feminist I was hoping things would have changed by now. Time, perhaps, for all us girls to get out that mirror and say, “Looks fab to me.”

Catharine Lumby is a professor of media at Macquarie University. She led a 2014 Australian Research Council funded project examining young people, media, sex and relationships.

Female genitals are still in the closet. We need to talk more about vaginas | Catharine Lumby

6 Reasons You Are Still Gaining Belly Fat

6 Reasons You Are Still Gaining Belly Fat

Kids" school packed lunches still full of junk food, research finds

Parents are still packing their children’s school lunchboxes with junk food, despite high-profile awareness campaigns on childhood obesity and guidance provided by consumer groups, research has found.

The Leeds University study published on Tuesday found just 1.6% of packed lunches for primary school children met tough nutritional standards set for their classmates eating in the school canteen.

About half of all primary school pupils take a packed lunch to school. Researchers found that only 1 in 5 lunchboxes contained any vegetables or salad, while 52%-60% contained too many sweet and savoury snacks, or sugary drinks (42%), leading to high levels of saturated fat, sugar and salt and not enough minerals and vitamins.

The study, described as “eye opening” by lead researcher Dr Charlotte Evans, saw only a fractional improvement from a decade ago, when 1.1% of lunches passed the standard set for school meals. The minority of children (17%) who eat vegetables and salad had not altered since 2006, it found.

The report found some progress: for instance the majority of packed lunches examined by researchers passed the standards for protein (95%) and vitamin C (75%). There was also a significant reduction in sugary drinks, 46% in 2016 compared with 61%, and a reduction in chocolate-based snacks. But there was no improvement for savoury snacks, such as crisps, found in 60% of packed lunches.

Three out of the 300-odd lunchboxes examined by researchers, in 12 different English primary schools, scored zero – a similar proportion to that found in 2006. One contained blackcurrant squash, a packet of hula hoops and a chocolate roll.

The first statutory school meal standard was introduced in 2006 due to growing evidence linking poor health in adults with obesity or poor diet in children. They limit the amount of foods high in salt, sugar and fats and stipulate that school meals should provide a third of a child’s nutritional requirements. However, although Ofsted says schools must have a policy on packed lunches, there is no law requiring them to abide by the same standards.

Evans, a nutritional epidemiologist, said that she believed the wealth of information on sugar in sweetened drinks may have had an impact on the reduction in the numbers in lunchboxes. But she added that more needed to be done by retailers, food manufacturers and schools if improvements are to be made overall.

Evans said: “I hope the results of the study are an eye-opener, highlighting that more stringent policies need to be introduced if we want to see real change in the nutritional value of children’s packed lunches. New policies for schools, food manufacturers and retailers are needed, which will require strong support from government and stakeholders if progress is to be made.”

The report recommends that primary schools introduce a policy restricting sweetened drinks and encouraging water, salad and fruit. It also suggested parents pack smaller portions of the unhealthy snacks, such as packets of crisps that are around 15g rather than 26g and chocolate cakes and biscuits of 20g. More choices of snacks low in saturated fats and sugars and higher in fibre were needed, it said.

The children’s lunches that met the standard all contained sandwiches with a protein filling and some salad.

Evans said: “Parents struggle, and there are many reasons why children don’t have better quality lunches – cost, peer pressure, convenience, time. Providing information to parents is a start.

“However, we do need to do more than provide information to parents to see a greater impact, such as improving school policies, reformulating products and reducing portions of snacks given to young children. For example, providing a small portion of crisps in a sealed container rather than the full bag.”

Few packed lunches met the standards for energy (12%), vitamin A (17 %), iron (26%) or zinc (16%), due to the lack of fresh salad and vegetables, the dearth of non-processed meat or fish as well as the lack of whole-grain bread.

Sharon Hodgson MP, chair of the all-party parliamentary group for school food, said: “The research highlights the need for more action to be taken on food put in children’s packed lunches, something which the school food APPG has recently called for. Despite positive moves with regards to the food provided as part of a school meal, food brought in by children in their packed lunches is lagging behind. Therefore we need more action to be taken if we want to see positive changes.”

Flora, which commissioned the research, is calling on the government to raise awareness and to do more to ensure the national standards for school food are being met in packed lunches. It has distributed 631,000 lunchboxes containing a healthy lunch planner and made available tips online.

Kids" school packed lunches still full of junk food, research finds

Organ donation rates for transplants still too low in UK, says NHS

A record number of organs were donated and transplanted in the UK in 2015-16 but the consent rate is still one of the lowest in Europe, with a worrying shortfall of donors from black or Asian communities.

In the 12 months to the end of March, 1,364 people became organ donors when they died and their donations resulted in 3,519 transplants taking place, figures published on Thursday show.

The consent rate stood at 62%, slightly up on 2012-13 when it was 57%, but well short of the target of 80% by 2020 with the biggest obstacle being family refusal, mostly when they were unaware of their deceased relative’s intentions.

The consent rate was much lower (34%) among potential black, Asian and minority ethnic (BAME) donors, which is of particular concern as 26% of the current waiting list are BAME.

Sally Johnson, NHS Blood and Transplant director of organ donation and transplantation, said: “Think about what we would want others to do for us if we ever need a transplant and be prepared to donate. Talking to your relatives about what you want is crucial as it is much more difficult to agree to donation when you don’t know what the patient would have wanted. There are about 6,500 people waiting for a transplant now and they need people to agree to donate for them to get the organ transplant they so desperately need.

“It is especially important for people from our black and Asian communities to talk about organ donation. I realise that this is a very difficult subject but there are many black and Asian people who need a transplant. While some are able to receive an organ from a white donor, others will die if there is no donor from their own community.”

Last year, 466 patients died in need of an organ and a further 881 were removed from the transplant waiting list, many whom would also have died shortly afterwards.

NHS Blood and Transplant estimates that if 80% of families approached to donate a relative’s organs said yes, more than 1,000 additional transplants would take place across the UK each year.

People from black and Asian communities have a higher incidence of conditions such as diabetes and certain forms of hepatitis, making them more likely to need a transplant, and make up a third of the active kidney transplant waiting list. But in 2015-16 only 67 (5%) of all deceased organ donors were from black and Asian backgrounds.

Lloyd Dalton-Brown, 65, who lives in Exeter, agreed to donate his half-sister Jane’s organs when she died aged 29 after being hit by a truck in 2000. Their father was from Trinidad. “Because of that gift [of organs] five people had transplants, which is utterly fantastic. One of them was a mother of children of three and four; she got one of Jane’s kidneys and because of that ended up with quality of life and was able to bring up her children.

“A lot of people from Caribbean backgrounds are quite susceptible to kidney disease. Her organs were going to be really beneficial to someone in that category. There’s a positive outcome after a very sad ending.”

The Welsh government, which on 1 December became the first part of the UK to introduce a “soft opt-out” system, expressed satisfaction at a 24% rise in the number of its citizens whose lives have been saved or improved by organ transplants, compared with a 4% increase in the UK as a whole. The effect of the change in system was relatively small in the period analysed, during which there were nine cases where consent was deemed.

Charities including Live Life Give Life and the British Heart Foundation urged people to join the organ donor register and communicate their decision to their loved ones.

To join the NHS Organ Donor Register visit www.organdonation.nhs.uk or call 0300 123 2323.

Organ donation rates for transplants still too low in UK, says NHS