Woman, 89, trapped in hospital for six months despite being fit to leave

An NHS trust has launched a formal inquiry after an 89-year-old woman who was medically fit to leave hospital was trapped on a ward for six months, costing the NHS more than £80,000.

Iris Sibley and her family were left feeling “distressed and let down” after she was kept isolated on a hospital ward at Bristol Royal infirmary because the community healthcare provider failed to find her a suitable nursing home place.

The situation put a huge strain on the family and left her 90-year-old husband deeply unhappy, said her son John Sibley. “It’s pretty scandalous,” he said. “It’s not until you get caught up in it that you realise how serious the situation is. I decided to speak out about it because I wanted to stand up for ordinary people like my mum.”

In a case which highlights the deepening social care crisis in the UK, Iris was taken into hospital last June after a fall in her residential home. She was assessed by Bristol Community Health (BCH) on behalf of the South Gloucestershire clinical commissioning group, the NHS body responsible for local healthcare services.

On 11 August, BCH said she needed 24-hour nursing care, which would be covered by the NHS – but a place in a suitable nursing home was only found on 4 January this year, a few weeks after the agencies involved had been contacted by the Guardian for comment about the case.

Her son John Sibley said: “It’s pretty scandalous. It’s not until you get caught up in it that you realise how serious the situation is. I decided to speak out about it because I wanted to stand up for ordinary people like my mum.”

Sibley said the staff who looked after his mother were amazing. “They just don’t stop, they are always working – nothing is too much trouble for them. I call them angels and they are – but they shouldn’t have to do it,” he said.

The family were offered two places, one on 13 September and the other on 4 October, but both were too far for Iris’s husband to visit. The first was also a very poor choice, said Sibley. “I read the CQC report and it was appalling, and when I visited it I thought I wouldn’t put a sick dog in there let alone my mum. It smelt of urine, the paper was peeling off the wall in the room they wanted to put her in. It was disgusting.”

To make matters worse, Iris was diagnosed as being a carrier of C diff, a bacterium that can cause diarrhoea, so spent much of her time alone in a side room. Sibley said the family constantly had to chase for information about her future. According to BCH, the ongoing health team “actively communicated” with the family on nine occasions.

Iris’s physical and mental health deteriorated significantly, Sibley said. “She was mixing with other people [in the residential home], it stretched her mind a bit,” he said. “But in the hospital there is nothing. They are wonderful people, they do the best they can – but my mum was in a hospital, not in a place where she could call home.”

Ambulances wait outside Bristol Royal infirmary. Photograph: Matt Cardy/Getty Images

That was very common in older people whose discharge from hospital was delayed, said Caroline Abrahams, the charity director at Age UK. “People in hospital lose confidence, they lose muscle mass. Their families can see their situation deteriorating before their eyes and that is very distressing,” she said.

Robert Woolley, the chief executive of University Hospitals Bristol NHS foundation trust, said it had launched a formal investigation into the case.

Iris’s protracted hospitalisation – which her family described as “traumatic for all concerned” – cost the NHS £450 a night, approximately £81,000 in total.

Although her experience is extreme, it is not unusual. In a typical week in January, 60 patients at Bristol Royal infirmary were “green to go”, waiting for an assessment or care package for about three weeks. Patients who could not be discharged could result in medical patients occupying surgical beds and surgeries cancelled, said Woolley.

“I’m very sorry for what happened to Mrs Sibley and apologise to her family for the massive frustration that all of us have caused,” Woolley said. “There is a critical interdependency between social care and the NHS and, if we get the capacity wrong in social care, it’s the NHS that bears the consequences, that is plain for all to see.

“We are doing everything we can to deal with a constant and growing demand. I think it is very difficult and we are having to look at more and more radical ways to cope with the pressure.”

BCH, which was charged with finding Iris a nursing home place, said it had contacted 24 homes “sometimes multiple times”. Of these, 11 had no vacancies, 11 were not able to meet Iris’s needs and two were too far away. All were privately run.

Iris’s case was unusual, said chief executive Julia Clarke, BCH’s chief executive. “In Mrs Sibley’s case, we are really sorry she was in hospital for that length of time – it is not what we were working towards,” she said. After an internal investigation, BCH was reviewing its communication with patients and had changed its processes so individual cases were flagged to senior leaders after a few weeks.

Anne Morris, the director of nursing at South Gloucestershire CCG, said Iris’s case was under review and it was “extremely sorry when any patient is kept in hospital any longer than they need to be”.

The Department of Health said it had published guidelines to improve coordination between the NHS and councils and was working with all agencies to improve the transfer of patients from hospitals. A spokesperson said: “We are supporting councils with up to £7.6bn of dedicated funding for social care over the course of this parliament.”

If this is how bad it is now, what is it going to be like in another 20 year​s’ time?

John Sibley

Iris has since been reassessed and her family has been told she no longer qualifies for complete NHS funding. Her care will be funded by the council, but the family – who are appealing against the decision – may face top-up payments.

According to a joint King’s Fund and Nuffield Trust report published in September, about four in 10 people pay for their own social care, with 300,000 fewer people receiving council-funded help than four years ago. According to Age UK, 1.2 million people do not get the social care they need, up 48% since 2010.

The Local Government Association (LGA) estimates the social care funding gap will be about £4bn by the end of the decade, leaving council short by a thirdCllr Izzi Seccombe, who chairs the LGA’s community wellbeing board, said: “The scale of underfunding is placing the care provider market under huge pressure, making it more difficult to discharge people from hospital into care.”

More than 100 care home businesses have collapsed since 2010, and more are struggling after councils’ social care budgets were slashed by up to 50% as the government pressed on with austerity measures.

People who pay for their own care pay more than a local authority for an identical care home placement, which, said Sibley, was leaving people like his mother at the bottom of the pile. “As result, my dear old mum who I love to bits was stuck in a hospital for six months with her dementia getting worse and worse,” he said.

“I don’t want to make this political, but this is a problem that has been waiting to happen for 25 years. Government after government have put their head in the sand. But now we have to make a decision: if this is how bad it is now, what is it going to be like in another 20 years’ time?”

Woman, 89, trapped in hospital for six months despite being fit to leave

Thatcher pushed for breakup of welfare state despite NHS pledge

Margaret Thatcher secretly tried to press ahead with a politically toxic plan to dismantle the welfare state even after a “cabinet riot” and her famous declaration that the “NHS is safe with us”, newly released Treasury documents show.

The plan commissioned by Thatcher and her chancellor Sir Geoffrey Howe included proposals to charge for state schooling, introduce compulsory private health insurance and a system of private medical facilities that “would, of course, mean the end of the National Health Service”.

Some of her cabinet ministers believed they had buried the plan, drawn up by a seconded Treasury official, Alan Bailey, from the Central Policy Review Staff (CPRS), at a special cabinet meeting on 9 September 1982.

Nigel Lawson in his memoirs said the paper of “long-term public spending options” had been buried after what he described as “the nearest thing to a cabinet riot in the history of the Thatcher administration”. In her own memoirs, Thatcher claimed to have been “horrified” by the CPRS paper and insisted that she and her ministers had never seriously considered it.

The CPRS paper had been partially leaked and she was only able to quell the subsequent furore by famously pledging the “NHS is safe with us” at the October 1982 Tory party conference. Downing Street briefed that the toxic plan had been “shelved”.

Photograph: Handout

But Howe’s Treasury private office papers released by the National Archives on Friday confirm that not only had that special cabinet meeting taken place to discuss the plan but that two months later, far from being buried, Thatcher was still secretly trying to press ahead with it.

The Treasury papers show that once a clutch of tricky byelections were out of the way she was keen to keep pushing the plan and held a series of meetings in December to “to soften up the big three spenders” under her chairmanship “to resolve any immediate political anxieties”.

The papers also show after the 9 September cabinet showdown Howe rejected an approach from the Adam Smith Institute, the rightwing libertarian thinktank, to back their “slightly oddly-named Omega Project” despite it being personally endorsed by Thatcher’s own economic adviser, Sir Alan Walters.

The Omega Project papers said the plans were modelled on research by a rightwing US thinktank for the incoming Ronald Reagan administration. It also argued for many state services to be replaced by “more efficient alternatives from the private sector”.

Photograph: HM Treasury

Howe rejected the approach in a note on 29 September not because he objected to their proposals to dismantle the welfare state but because he feared its “ill-researched proposals, which will be portrayed as strongly resembling our own, might prove an embarrassment”. The then chancellor added: “Every proposal will be seized on and hung (round) our necks. Cf CPRS Report. I see v. (underlined twice) great harm.”

The Treasury papers show that “no real action” was taken on the CPRS “radical right manifesto” until November 1982. “The prime minister (we understand privately) did not want to stir this up before the cabinet discussions on the 1982 survey, nor risk any adverse publicity while the last two byelections were pending. The leaks of the CPRS report did not help,” a senior Treasury official, Peter Mountfield, told Howe in a confidential note entitled “Follow-up of cabinet discussion on long-term public expenditure”.

Margaret Thatcher secretly continued to pursue the politically explosive plans even after ministers thought they had been killed off by a cabinet revolt. Photograph: PA

“The prime minister has arranged a series of meetings with the main spending ministers to discuss the follow-up to the discussion in cabinet on 9 September. The ministers involved are Sir Keith Joseph (7 Dec, 11 am), Mr Fowler and Mr Nott (14 Dec, 9.30 and 15 Dec 5.30.). You and the chief secretary will be invited to each meeting.”

Joseph was education secretary, Norman Fowler was health secretary and John Nott was defence secretary. The CPRS paper proposed to cancel Trident and halt the growth in defence spending.

“The only paper formally before the meetings will be the original interdepartmental report on long-term trends in public expenditure … The CPRS paper on options is technically a non-paper, but will be in everyone’s minds (and no doubt in their briefing folders too),” Mountfield told Howe.

The chancellor was told the objective of the meetings was “designed to soften up the three big spenders. Without their support the operation will not work. Your main aim, I suggest, should be to ensure that no sacred cows are prematurely identified. Given the prime minister’s concern about the NHS, this may be difficult. But we want to make sure that the ministers concerned do not close off any options at this stage, and, if possible, put their personal weight behind the exercise.’’

Photograph: HM Treasury

These papers flatly contradict Thatcher’s claim that the CPRS proposals were never seriously considered by ministers. The Treasury files released on Friday do not record what happened at the meetings with the big three spenders.

But a Treasury official’s note on 28 October 1982 to the then chief secretary to the Treasury, Leon Brittan, gave an indication of the depth of internal opposition Howe and Thatcher faced. “DHSS (health and social security) officials say there is no chance that Mr Fowler would agree to a further study of this idea. I imagine in the circumstances, and especially given the prime minister’s speech at Brighton it is difficult to press them.”

In his memoirs, Howe reflects that although the row had postponed the “fundamental debate” he had hoped to start, until after the 1983 general election, “nothing from the Treasury’s point of view is ever as quite as bad as it seems”.

He reported that the impact of what he called the “CPRS furore” had ensured ministers made no new spending pledges and had “set the pace for our forthcoming 1983 manifesto”.

Thatcher pushed for breakup of welfare state despite NHS pledge

GSK sales rise despite weak pound and Brexit uncertainty

GlaxoSmithKline has reported better than expected quarterly results thanks to strong sales of its flu vaccine and a weaker pound.

The UK’s largest drug company has emerged as a big beneficiary from sterling’s 18% decline since the Brexit vote. GSK generates 96% of its sales overseas but makes many products in the UK, including Sensodyne and Aquafresh toothpastes, at its Maidenhead factory.

Sales rose by 23% to reach £7.5bn in the third quarter. At constant exchange rates, sales were up 8% and earnings rose 12%. Analysts had forecast sales of £7.3bn, according to Thomson Reuters estimates.

Another area where GSK could benefit is “parallel trade,” which involves the shipment of drugs from low-cost countries such as Greece and Spain to countries such as Britain and Germany, where prices are higher.

The outgoing chief executive, Sir Andrew Witty, who will hand over to the company’s consumer healthcare chief Emma Walmsley at the end of March, said parallel trade could “cease in entirety,” depending on the terms of Britain’s exit from the EU.

Emma Walmsley will succeed Sir Andrew Witty at the helm of GlaxoSmithKline in March. Photograph: AFP/Getty

There had been a decline in parallel trade since the referendum, he said, and “if the pound remains suppressed or at these new lower levels, you would expect to see less import, more export”.

GSK’s vaccine sales exceeded City expectations in the third quarter, in particular flu vaccines, while new HIV and lung medicines also sold well, offsetting declining demand for ageing blockbuster drugs such as Advair for asthma.

Witty said the vaccine business had “never been healthier,” despite the company’s decision to withdraw its cervical cancer vaccine Cervarix from the US market. Shingrix, a new shingles vaccine which is seen as a potential blockbuster with annual sales of more than $ 1bn, has been filed for approval in the US and is due to be filed in the EU before the end of the year.

Witty said after Walmsley’s appointment a month ago, the “feedback from the overwhelming majority of shareholders has been positive and constructive”. “That is the right response, given Emma’s tremendous credentials for this role and her personal passion for GSK,” he said.

Walmsley will be the most powerful woman in the global drugs industry and one of seven female FTSE 100 chief executives. However, her appointment came as a disappointment to some investors who had hoped for the arrival of an outsider to push through a spin-off of the consumer healthcare arm.

Witty said GSK was on track to achieve core earnings growth of 11-12% at constant exchange rates this year, marking a turnaround after several years of poor performance and a bribery scandal in China.

He said the company saw no need to make any contingency plans around immigration after the Brexit vote. EU nationals account for 14% of GSK’s UK based workforce. Witty was optimistic that “ultimately there are going to be some pragmatic decisions made” that would ensure companies were able to attract global talent.

GSK sales rise despite weak pound and Brexit uncertainty

Captured and cut: FGM returns to Sierra Leone despite official ban | Umaru Fofana

Khadija Balayma Allieu sits on her hospital bed, grimacing at every movement of her legs. It has been five days since she was forcibly genitally mutilated, she says.

As she receives treatment in the eastern Sierra Leonean town of Kenema, Khadija, 28, recounts what she went through at the hands of five cutters. She is now in hiding because the soweis – as the cutters are known locally – are looking for her.

Khadija says she was blindfolded and held by five or six women. “They gagged me as I shouted. Then [one of them] started cutting. They held my head down. I started bleeding profusely. I tried screaming but there was cloth inside my mouth.”

Khadija, the mother of a 12-year-old boy, says she was left locked inside the house for four days “without food or medicine”. Eventually, the police were alerted. They raided the house, extracting her through a smashed window.

Living in fear of FGM in Sierra Leone: ‘I’m not safe in this community’

As Khadija explains her nightmare, she constantly wipes away tears and turns her sunken eyes towards the window, to be sure no one is coming to get her. She is in genuine fear for her life.

The woman accused of cutting her, Elsie Kondoromoh, is an influential figure in Sierra Leone. Initially detained by police, she was released when hundreds of cutters mounted a protest outside the police station. Kondoromoh’s supporters have been to the courthouse to make a case for legal investigations against her to be dropped.

Police inspector Marty Tarawille said: “[Kondoromoh] was with us [at the police station] but the sowei people came in numbers …They were singing, they were shouting that we should leave that lady [alone] … If we had not released her it would have been a problem for us in this station.”

The case highlights the challenges facing anti-FGM campaigners in Sierra Leone. The minister for social welfare, Sylvia Blyden, has said the government’s focus is on children under 18. This is seen as leaving adult women free to decide what they do with their bodies.

— diasporan hands (@diasporanhands) September 16, 2016

Sierra Leone minister on fgm pic.twitter.com/aGJi4Sy7Es

FGM has been banned in the country since emergency health measures were introduced after the Ebola outbreak in 2013. But despite the continued ban, the practice has returned through all-female secret societies, the Bondoand condemnation by the authorities has become increasingly absent.

In August, a young woman died in the northern town of Makeni shortly after undergoing the procedure, prompting the arrest of several soweis. In another recent case, police say children were rescued from a disused house in Magburaka, also in the north, after undergoing an initiation ceremony.

The World Health Organisation estimates that 88% of women in Sierra Leone between the ages of 15 and 49 have undergone FGM.

That the women who converged on the police station were able to secure Kondoromoh’s release is indicative of the power soweis wield in Sierra Leonean culture. Civil society organisations have called for Khadija to be evacuated from the town, expressing concern for her safety, but fear of the soweis is such that campaigners are afraid to come to the fore.

“The soweis are so powerful that nowhere in Sierra Leone will be safe for her again,” one activist says.

Soweis protest in Kenema after police detained a local leader. Photograph: Umaru Fofana

Kondoromoh, who is national vice-president of the Sowei council, admits she carried out the procedure but says she did not force Khadija to go through with it. She claims Khadija asked for it.

“She met me at home saying she was being taunted by her fellow women because she had not been circumcised,” says Kondoromoh. “She came to me to initiate her and asked how much it would cost. I told her that I did not want anything from her because she was being provoked. I took her to a nearby society bush to initiate her”.

Kondoromoh says Khadija asked to stay with her until she recovered because she would be taunted if she went back home: “I bought her provision. I woke up every morning to prepare food for her before leaving home.”

Medics treating Khadija say her condition is improving, but predict it will take some time for her to heal both medically and psychologically. One nurse described her as “badly traumatised”.

“With elections in early 2018, it is unlikely the government will take any serious action against the soweis, who will now be emboldened by their apparent success in having their way,” says a local journalist whose radio station has been threatened if it continues to cover the issues surrounding FGM.

He believes that even if the matter reaches court – “which is unlikely” – the victim will be in danger if she testifies.

Captured and cut: FGM returns to Sierra Leone despite official ban | Umaru Fofana

NHS at breaking point despite deficit reduction, say trusts

A combination of growing demand, staff shortages and future slowdowns in funding increases mean the NHS is at breaking point despite a reduction in deficit compared with the same period last year, trusts have said.

The deficit in the first quarter of the financial year (April to June) was £461m, less than half the amount in the same period last year (£930m), but without emergency injections of cash it probably would have been little changed.

As well as a spending increase of 3.7% in real terms this year, trusts have been helped by the £1.8bn sustainability and transformation fund (STF), which contributed £450m to the results published on Thursday.

The funding increase is set to fall to 1.3% next year and 0.4% in 2018/19, and while demand is increasing at a rate of around 3% for many services.

Chris Hopson, the chief executive of NHS Providers, which represents trusts, said: “Our guys are saying to us we’re really struggling to make this work at the moment and we can’t see – we have only half made it work in a year of plenty – how can we do it in a year of 1.3% and 0.4% increases?

“Effectively they are coming under more and more pressure to deal with these demand increases without the money to employ staff, without the staff being available … We are now at breaking point.”

This month St Helens Clinical Commissioning Group (CCG) in Merseyside proposed a temporary ban on non-vital operations in an attempt to tackle funding problems. Hopson said more would follow.

The regulator NHS Improvement has asked hospitals to identify “marginal services”, often those led by one consultant, such as dermatology and rheumatology, which could be axed. But these cuts are unlikely to be enough and may just transfer demand – and cost – elsewhere.

Hopson said that unless funding was boosted, decisions would have to be made akin to those already made in other government departments: either cut workforce, change eligibility or stop providing certain services.

“Either put more money in or … we’ve got to make a conscious decision of what we’re going to deliver as a result,” he said. “We simply can’t go on doing everything we’re being asked to do.”

Polling by the King’s Fund, a health charity, released to coincide with the figures found that 38% of trusts were not confident of meeting the financial targets set by regulators for the end of the financial year. A third were unsure and the final third were “fairly confident”.

The charity’s director of policy, Richard Murray, said: “This is the year when the money still flowed. The growth in funding for the NHS in the next couple for years slows very sharply. What you want to do is finish this year in a good position; that’s not [what appears to be] happening here.”

There was also a suggestion that finance managers at trusts would have pulled out all the stops in the first quarter, using all available legal means to gain access to the STF.

Nuffield Trust’s senior policy analyst Sally Gainsbury said: “Access to the special £1.8bn fund which trusts desperately need to keep paying staff wages is tied to them reporting the ‘right’ figures at the end of each quarter. So although today’s results reflect a lot of hard work from managers and professionals, we should be ready for the possibility of a nasty surprise towards the end of the year.”

NHS at breaking point despite deficit reduction, say trusts

The NHS is possibly the best program in the world, despite getting given a kicking | Ann Robinson

‘A&ampE departments are overflowing since of a complex combine of causes.’ Photograph: Christopher Thomond for the Guardian

The NHS may be “palpably fraying at the edges” according to Dr Mark Porter, chairman of the British Healthcare Association, but as a jobbing GP, I would say it is not unravelled but.

Undoubtedly, as well many individuals pitch up at A&ampE. And when asked to account for their actions, a quarter say it’s since they can’t get entry to their GP. Typically that’s true. Often it truly is not. Unpublished information from a nearby research of A&ampE attendances that I worked on 3 years in the past showed no correlation in between GP opening times, variety of appointments (booked as opposed to stroll-in surgeries), and size of practice. Access to GPs is a dilemma in some areas but some patients never even attempt to get an appointment.

People from nations that do not have GPs are used to obtaining direct access to professionals or going to A&ampE. I have individuals from the US who think it really odd that I can do a smear check, see their child with a sore throat and treat their diabetes. It will take a even though to show my competence and earn their believe in. NHS principal care is an unfamiliar model to many whereas A&ampE is universally recognised as a location you can go to get aid.

And individuals get baffled by the assortment of options now obtainable. There are extended opening hours at GP surgeries, stroll-in centres, and out-of-hours care for when surgeries are shut. Many individuals dial 111 for non-urgent wellness guidance but call-handlers are not medically trained, and comply with cautious pathways that usually outcome in tips to seek health care help when straightforward reassurance would suffice.

Of course it can make sense to wait and see your own GP but some folks like to phone at 3am. I have just looked at the out-of-hrs calls manufactured by our patients this weekend. Almost all could have waited right up until Monday morning but they chose not to. And there is no situation about obtaining an appointment here we operate a stroll-in surgery every morning for any individual who wants to display up.

So A&ampE departments are overflowing simply because of a complex mix of causes. But it fits the government to blame GPs and it suits the BMA to highlight the need to have for better resourcing. And while the government’s received the boot in, why not throw in a random concept that when cancer diagnosis is delayed, the GP should be “named and shamed”?

But let us contrast this gloomy and scary image with some other aim details. Earlier this month, the Commonwealth Fund judged United kingdom healthcare to be the greatest out of eleven countries studied. And in the most current national GP survey, these had been some important findings: 75% sufferers identified it is simple to get by way of to someone at their GP surgery on the cellphone 86% of patients were capable to get an appointment to see or communicate to someone 83% of sufferers come to feel their GP was excellent at treating with care and concern and 87% of patients have had a excellent total knowledge of their GP surgical treatment.

Honestly, the NHS is not excellent. It needs far more cash and there is no spot for complacency. Good knowledge must be celebrated and shared. Undesirable experiences should be used to enhance the services by operating with the provider and patient advocacy groups. But politicians, doctors’ representatives and patients who rubbish the system in a nihilistic way should temper their remarks. It truly is most likely the best method in the globe. Where’s the proof that other nations do it better?

The NHS is possibly the best program in the world, despite getting given a kicking | Ann Robinson

Government invested further £49m on Tamiflu despite known doubts about it

Antiviral drug Tamiflu tablets made by Roche Pharmaceuticals. Photograph: Per Lindgren/REX

The government has spent an further £49m inside of the last 12 months on renewing its stockpile of Tamiflu, the drug which independent scientists say could do nothing at all to avert a flu pandemic.

The decision to spend however more funds on a stockpile of controversial medicines that has already price above £500m “verges on the reckless, given that the proof base was presently extremely shaky”, according to Richard Bacon, Conservative MP and senior member of the public accounts committee.

The revelation of the additional spending came in the government’s response to the committee’s report in January, which recommended that no a lot more Tamiflu should be purchased till the Department of Well being had reviewed the need to have for it.

At the time, the committee was informed the division had invested £424m on Tamiflu and £136m on a equivalent, but inhaled, flu drug known as Relenza. The extra £49m will take the total invest to £609m.

On Thursday, independent scientists from the Cochrane Collaboration published an examination of all the data from the clinical trials carried out by manufacturers Roche and GlaxoSmithKline prior to licensing of the medication, which took them above four many years of negotiations to acquire.

They concluded that the medication shorten a flu bout by approximately half a day, but there is no evidence that they avoid hospitalisations or complications such as pneumonia and, when utilised to avert flu, they cause some men and women significant problems like psychiatric and kidney difficulties.

The organizations keep the drugs are risk-free and beneficial, but Bacon says the doubts about the drugs had been evident at the time of his committee’s inquiry final yr, ahead of the further £49m had been invested. A important member of the Cochrane staff gave proof. “You do not devote £400m to decrease flu signs by a day or half a day. You buy Lemsip for that. You commit millions of pounds on it to avert pandemic flu,” he advised the Guardian. “They must have held off and waited till the more analysis was available.”

In its response to the PAC report, the government explained that the 2013-14 programme to replace drug stocks going out of date with new batches was currently in location. The selection to go ahead “supports the department’s dedication to be prepared for a more serious influenza pandemic and to pay the prices agreed in the current contract.”

The government also dismissed calls by the committee for all clinical trials – past and potential – to be registered and the information from them created available for wider independent scrutiny, saying it was “not feasible” to do it retrospectively.

“What is wrong with opening it up to wider independent scrutiny?” asked Bacon. “Are we to believe the perform undertaken by regulators has some kind of magic charm about it and that there is a priestly caste referred to as government-appointed scientists who have obtainable to them insights that are not available to other individuals? Are they asking us to go back to the 13th century or the 16th century or back to alchemy? Is this what they want? That’s what it sounds like to me and I feel it is ridiculous.”

A developing variety of senior scientists feel the issue lies with the piecemeal way in which clinical trials are completed. They are not set up to reply distinct concerns that are of agreed worldwide crucial, such as, in the situation of Tamiflu, exactly what problems it can avoid and what use it would be in a pandemic.

Jeremy Farrar, director of the Wellcome Trust and a professor of tropical medication at Oxford University, mentioned regulators, scientists, medical doctors, policymakers and other individuals concerned in drug advancement have to come together to work out what the vital queries are that require to be answered, so that when there are many trials, usually of broadly comparable medication, the benefits can be aggregated for a clear image of what works and what does not. On Tamiflu, he stated, “the trustworthy reality is we merely do not know”, because the trials have been not made to look for the appropriate solutions.

We could find out from the approaches that have been taken to ailments in poor countries, such as malaria and HIV, he stated, in which employing income and time value-efficiently to come to the right answers is vital.

Government invested further £49m on Tamiflu despite known doubts about it

Volunteer paramedics face street visitors prosecution despite "seeking to do good"

Lady Justice Rafferty, sitting with Mr Justice Jay in London, mentioned she was saddened that medically skilled volunteers “seeking only to do good” had been efficiently constrained.

On Oct 14, 2012, the two men attended an accident at 8.17pm involving a car and motorcycle on the outskirts of Bury.

They recognized themselves to police as Hatzola Quickly Response personnel and have been allowed to give health care care just before an NHS ambulance arrived eight minutes later on.

The two men have been then told they would be reported for utilizing “blues and twos”.

At their original trial, District Judge Richardson was told that the Hatzola crew originated in America about 40 many years ago with the objective of saving lives. It has since spread to Britain.

It aims to give emergency very first help cover in defined locations, such as Salford and components of Bury, mainly but not exclusively for the Jewish neighborhood. In Salford there are 20 Hatzola members, ten of whom are skilled paramedics, such as Mr Issler and Mr Bamberger.

Their typical response time is “under two minutes”, compared with 7 to 10 minutes for NHS ambulances, the court was informed.

Their massive vehicles can carry health-related products, including defibrillators, oxygen and neck braces, as effectively as dressings and some medication.

Judge Richardson stated Hatzola’s 24-hour-a-day care was funded by voluntary contributions from the Jewish neighborhood.

“I discovered Hatzola to be a responsible, devoted and public-spirited organisation with properly-qualified and motivated operatives, of whom the defendants were two,” he stated.

He acquitted each men of the traffic charge, saying their cars had been getting “used for ambulance purposes”.

But the High Court judges ruled on Wednesday that his choice was incorrect. They agreed “with regret” that the appeal must be allowed.

Mr Justice Jay stated road traffic legislation did not supply an exemption for “first responder” voluntary organisations such as Hatzola to escape the restrictions on the use of “blues and twos”.

Edited by Andrew Marszal

Volunteer paramedics face street visitors prosecution despite "seeking to do good"

Police will have "backdoor" access to overall health information despite opt-out, says MP

Patients’ data at a GP surgical procedure. According to David Davis, in the past police would need to have to track down the GP who held a suspect’s data and acquire a disclosure purchase. Photograph: Christopher Thomond for the Guardian

The database that will shop the whole nation’s overall health records has a series of “backdoors” that allow police and government bodies to access people’s medical information.

David Davis MP, a former shadow property secretary, advised the Guardian he has established that police will be able to accessibility the wellness data of patients when investigating crimes even if they had opted out of the new database, which will hold the entire population’s medical data in a single repository for the 1st time from May possibly.

In the previous, Davis said, police would need to track down the GP who held a suspect’s information and go to court for a disclosure buy. Now, they would be able to merely strategy the new arms-length NHS data centre, which will hold the data.

“The thought that police will be capable request information from a central database with out a warrant completely undermines a prolonged held belief in the confidentiality of the medical professional-patient romantic relationship,” he stated.

The information will incorporate mental overall health situations, medication prescribed, as well as smoking and drinking routines – and will be developed from GP information and linked to hospital information.

Ministers have defended the incoming technique – which supporters say could carry huge rewards to care and research – saying it has mechanisms to de-identify information and a series of committees which will consider requests from thinktanks, firms, universities and government bodies, as nicely as providing opt-outs for patients concerned about the use of their information.

But the database will suck up all records, and state agencies in some situations will be able to get accessibility.

In the case of the police, officers will be in a position to request all of the medical data held for particular suspects with their correct identities, irrespective of regardless of whether they had opted out. With a nationwide database in place the request only has to be deemed by officials at the info centre, who will not know the patient personally.

Davis, who established the existence of these “backdoors” in a parliamentary question answered by health solutions minister Dan Poulter, explained he had “no problems with the data getting used for licensed health-related analysis, but when we have police accessing from a database that people have opted out from, and organizations getting capable to purchase this data, I think we need to have a debate about whether or not my property, which are my patient information, can be sold and used”.

Advocates say that sharing information will make health-related advances easier and in the end save lives due to the fact it will permit researchers to investigate drug side effects or the efficiency of hospital surgical units by tracking the impact on patients. But privacy professionals warn there will be no way for the public to operate out who has their health-related information or to what use their information will be put.

The extracted data will incorporate NHS numbers, date of birth, postcode, ethnicity and gender. After dwell, organisations this kind of as university research departments – but also insurers and drug companies – will be capable to apply to the new Health and Social Care Data Centre (HSCIC) to gain accessibility to the database, called care.information. Final 12 months it emerged that Bupa, a overall health insurer, was among four companies that had been cleared to entry “sensitive” patient data.

If an application is accredited then companies will have to shell out to extract this details, which will be scrubbed of some personalized identifiers but not adequate to make the information fully anonymous – a process recognized as “pseudonymisation”.

Speaking usually about the new program, Davis stated that healthcare information were a person’s “fingerprint”. “I have had my nose broken 5 instances. As soon as you know that, I am possibly in a group of 100 men and women in England. Then you figure out when I had my diptheria jab, generally done at birth, and bang you received me. Let me be clear: people can be identified from this data.”

This week the info commissioner’s office warned that information presented to individuals on care.data is not clear sufficient about how to opt out of the programme.

Brian Jarman, the co-founder of Dr Foster and professor of wellness economics at Imperial School, said the program must be “opt in, not opt out”.

“There is simply too significantly data and the hazards that something leaks are also excellent. We need to slow this procedure down to make certain we have the correct checks in area,” he mentioned.

Phil Booth of medConfidential advised the Guardian: “This is exactly the danger when you generate a giant database of hugely sensitive data about people – all kinds of other folks want to go rifling through it, like the government. There is often yet another very good reason to go digging, but no 1 thinks of the catastrophic breach of trust this represents.”

“The lack of independent oversight and transparency is what is most worrying. People trust their GP, but who’s heard of the Well being and Social Care Information Centre or the 4 men and women who indicator off on accessibility to all our healthcare information?”

A Department of Health spokesperson said: “There are robust legal safeguards in location to defend patients’ confidentiality. If individuals do not want their data to be shared, they can speak to their GP and info will not depart the surgical procedure. Any release of identifiable data with no consent would only be in a quite restricted number of excellent conditions, the place there is a clear basis in existing law – this kind of as for the police to investigate a serious crime.”

Police will have "backdoor" access to overall health information despite opt-out, says MP

NFL Players Kick Off Concussion Summit Super Bowl Week Despite Ongoing Litigations

Genuine innovation is typically driven by these who feel outdoors the box these who consider the apparent and make it an actionable reality. The week major up to Super Bowl XLVIII, a group of entrepreneurs produced a distinctive and transformative meeting of the minds. At the Coalition for Concussion Summit (#C4CT), Brewer Sports activities International and Amarantus BioScience Holdings, Inc. joined forces at the United Nations’ (UN) New York headquarters to carry scientists, biotech organizations and skilled athletes together, with the aim of creating awareness and advancing scientific and health care options for traumatic brain damage (TBI), continual traumatic encephalopathy (CTE) and concussions. Include in the bodyweight of fast policy implications of the Nationwide Football League dealing with litigation for not appropriately informing or guarding players and Northwestern University’s football staff attempting to unionize in hopes of enhancing athlete’s rights, and a best storm is created to demand change. Collectively, the week of the Super Bowl produced into an best time, location and platform for altering requirements of health care and advertising developments in mental medical care that are patient-centric.

Summit Panelists such as Jack Brewer, Andrew Brandt, Clinton Portis, EJ Henderson, Ramses Barden, Lance Johnstone, Isaiah Kacyvenski, Robert Griffith, Jermichael Finley

NFL Litigation

In the months preceding the 2014 Super Bowl, the NFL and the NFL Players Association (NFLPA) located themselves in a heated battle more than the allegations that the NFL withheld information from the players about the depth and breadth of study indicating that concussions, memory loss and memory deterioration are linked. The NFL has since agreed to a $ 765 million settlement, which was just lately denied by Judge Anita Brody who claims that the in the suit, “not all retired NFL football gamers who in the end get a qualifying diagnosis, or their associated claimants, will be paid.”

Although that determination is pending, much more lawsuits are beginning to surface from person gamers. Final Tuesday, former Detroit Lions operating back Jahvid Ideal sued the NFL and helmet maker Riddell, claiming that concussion problems contributed to ending his occupation early.

Nonetheless, in accordance to Robert Griffith, a 13-yr veteran of the league, it doesn’t consider a career-ending hit to drastically influence lengthy-term functioning. “Guys suffer the very same signs and symptoms even following a handful of many years in the league, like, rest deprivation, depression, mood swings, addictions and self really worth issues.”

The exact same week of the Super Bowl, the Northwestern University football staff also dropped a bomb on the sports activities globe, despite efforts from the Nationwide Collegiate Athletic Association (NCAA) to curb player concussions. The group needs to alter the way university’s view, treat and educate student athletes, claiming more players’ rights are essential. This comes in tandem with a more than two-yr long effort by a number of school gamers to sue the NCAA for failing to safeguard pupil athletes from concussions. An irony, pointed out by Chris Nowinski, writer and former professional wrestler with World Wrestling Entertainment (WWE), who mentioned that “We have pitch counts for shoulders, even in higher college, but we really do not have hit counts.”

Health Policy at the Forefront

When the NFL, the United States’ most effective sports activities league, is on the sizzling seat for neglecting players’ psychological and bodily overall health, it is only a matter of time before public outrage demands policy modify. Not only does the NFL itself have the potential to change overall health policy for the better, but the trickle down influence could save numerous young athletes around the nation the trauma that present and past gamers have suffered.

In the long run, a new standard of care is possible in the close to long term. Since, as Jermichael Finley advised me, “100% or 50%, it doesn’t matter how a single methods on the field. It isn’t if you get harm, it is when you will get hurt.” More, as 1 conference goer attested, “We are speaking on the floor of the United Nations about brain trauma. This has never ahead of been achievable.”

With that in thoughts, researchers and clinicians this kind of as Andrew Maas, MD, PhD, Robert Stern, PhD, Kim Heidenreich, PhD and Jay Clugston, MD came together with individuals and biotech businesses to examine the existing state of trauma, neuroscience, degenerative illnesses, sports activities medication and public policy.

Meeting Of The Minds

Regardless of the exorbitant power of the NFL, remarkably minor has been done to advance the conversation between athletes and the scientists who perform diligently to understand and protect our brains. Until now.

As the nation’s ideal football players ascended on New York and New Jersey, Brewer Sports activities Worldwide and Amarantus BioScience Holdings, Inc. gathered a area total of athletes and scientists to educate 1 yet another and discuss the actual globe of traumatic brain damage, concussions and memory reduction.

“As a former NFL player, I am passionate about generating strides to increase the health and safety of my fellow specialist athletes, both former and recent,” mentioned Jack Brewer, CEO of Brewer Sports Worldwide. “Instead of pointing fingers, we have put together a world class panel of researchers to talk about TBI-induced neurodegeneration and CTE with those right affected by and equally passionate about the cause as we strive to increase awareness and perform to discover viable therapies.”

Gerald Commissiong, President and CEO of Amarantus reinforced the originality of the concept saying that, “The correct innovation in #C4CT lies in bringing all of the stakeholders on the concussion issue into one particular forum. Conferences that are medical in nature virtually usually overlook essential groups this kind of as sufferers, caregivers and advocates. By permitting patients to be part of the process, we are creating a paradigm shift that we hope will galvanise the broader local community into action.”

NFL Players Kick Off Concussion Summit Super Bowl Week Despite Ongoing Litigations

Stent Remains Available Despite Trial Displaying Dangers

A top critic says that the FDA has been remiss for not getting rid of a stent from the marketplace even though strong evidence exists that its use prospects to more deaths and strokes.

The Wingspan intracranial stent, produced by Stryker Neurovascular, was approved in 2005 by the FDA by means of the humanitarian device exemption (HDE) for the uncommon situation of intracranial atherosclerosis. The approval was based mostly on one single-arm review of 45 sufferers. But then in 2011 came the startling results of a considerably greater and well controlled trial from the NIH. 451 sufferers were randomized in the SAMMPRIS trial to both aggressive health-related treatment or the same medical treatment plus stenting with the Wingspan stent technique. The trial was terminated early due to a considerably higher price of stroke or death in the Wingspan group. In response to SAMMPRIS the FDA narrowed the indication for Wingspan but did not remove it from the marketplace.

Now, in a paper published in BMJ, a group of doctors led by Rita Redberg say that by not removing Wingspan from the marketplace the FDA is shirking its “responsibility to protect the public’s well being.”

The Wingspan saga demonstrates how large chance products can come to the market based on lower good quality clinical information. Moreover, the Wingspan device has not been removed from the market, even although a higher good quality randomized trial was prematurely terminated since of harms and no benefit. When gadgets are approved beneath the humanitarian exemption, restriction of their use to within randomized controlled trials could stop probably unsafe products from obtaining seemingly everlasting marketplace approval.

Though the FDA issued a safety communication in response to SAMMPRIS, Redberg and colleagues write that it is “vague in its terminology” and that the Wingspan web page on the Stryker site does not mention the more restricted indication. The authors cite data from Stryker displaying that the business shipped eleven,000 Wingspan products in the 6 many years following the first HDE approval study.

Stent Remains Available Despite Trial Displaying Dangers