Britons "bumped off" EU medical research grant applications, MPs told

British medical researchers are being removed from applications for EU research grants by European colleagues because of Brexit, MPs have been told.

Prof David Lomas, representing UK university hospitals, told MPs that Britain’s position at the forefront of medial advancement was threatened were it no longer able to access the European Research Council, one of the world’s leading funders of scientific research.

“One big issue for most of hospital academics is applying for grant applications, and we’ve seen people bumped off grant applications to the EU,” he told the health select committee.

Applications to the ERC are usually made by consortiums of researchers from a variety of EU countries. Britain has a strong track record of taking the lead in these groupings.

“Previously having a British member would help you in your application to get funding … Nowyou are less than an asset, so we have had academics removed from grant applications,” Lomas said.

He said it was vital for patients that Britain continued to be part of leading edge research and was pressing the government to argue the case for continuing to contribute to the ERC on a pay-as-you-go system.

“If we don’t get the very best people we don’t drive the research and innovation where we punch above our weight. If we can’t attract the very best, we can’t lead in the innovations that will lead to patient benefits.”

Lomas said his own university, University College London, where he is vice-provost of health, and the University of Cambridge were huge beneficiaries of the ERC, as was the UK.

“We raised €760m [£642m] between 2007 and 2013 from the ERC. My own university and Cambridge are neck and neck for bringing more in to any university [than any other] in the EU,” he told the committee.

Brexit was also affecting recruitment of high-calibre staff in medical schools, with teaching hospitals in Leeds and Glasgow reporting people pulling out of job offers, he continued. “So we have lost stellar people who would have come otherwise.”

Concern over the right to live and work in the UK after Brexit was already affecting recruitment across the board, said Danny Mortimer, chief executive of NHS Employers.

Giving evidence before the select committee, he said the controversial application process for permanent residency cards involving an 85-page application form had proved counterproductive, and was deterring valuable healthworkers from planning to stay in the UK after Brexit.

Both men were speaking just weeks after the Nursing and Midwifery Council reported a sharp decline in registrations from Europe.

Just 101 nurses and midwives from the EU27 registered to work in the UK in December, down from 1,300 in July, the committee heard. About 5% of nurses and 10% of doctors in the NHS are EU nationals.

Mortimer said EU staff were critical to the smooth running of the the health service. “We cannot believe that the NHS can do without our EU national colleagues,” he said.

One area that could be more heavily impacted than hospitals is social care, with EU nationals plugging the gaps, particularly in rural areas where it was difficult to recruit British staff, MPs heard.

“Some areas it has been very difficult to recruit, rural areas are very difficult to recruit people in social care, so EU [nationals] have come into this area,” said Martin Green, chief executive of Care England.

Britons "bumped off" EU medical research grant applications, MPs told

"I felt pushed away": Beth Grant on having to move 380 miles for anorexia treatment

Beth Grant, 25, has been receiving treatment for anorexia on and off since she was 13, including five months in a hospital in Glasgow earlier this year, 380 miles from her home in Hertfordshire.

I was 13 when I was first diagnosed with anorexia. I didn’t have my first stay in hospital until I was in my 20s. Before that I received outpatient treatment, first through children’s and late adults mental health services. I was discharged when I went to university aged 21.

I got support while at university from the university’s counselling services, though I gradually declined while on my course. During the last month of my third year in 2015, I was admitted to the Priory hospital in Chelmsford, Essex, about 45 minutes from my family home near St Albans in Hertfordshire. It was a great place. As you progressed you got more freedoms, for example unsupervised snacks and home visits if you managed to get your Body Mass Index up to 15. That gave many of us something to aim for.

I left having regained a suitable amount of weight but was still not completely healthy. Then in February this year I relapsed after a family bereavement. I was told I couldn’t go back to Chelmsford. It’s my understanding that there are just over 300 beds in the country and there are thousands of people who need help. Chelmsford only has 12-14 beds, was small, intimate and a nice group of people.

I was told that the only place available was in Glasgow, 380 miles and a six-hour drive from my home. I resisted the move at first because I really didn’t want to be that far from home. My family were similarly concerned. The problem was that I needed more help than my parents could offer. I was worried that if I lost any more weight I would end up on a medical ward. I didn’t want to leave, but I felt I had no choice.

My parents were so incensed that I had to go so far away that they refused to drive me up. So the NHS decided to transport me by taxi, which must have cost them over £1,000. After that I didn’t see my family for five weeks. My mum was going through treatment for breast cancer at the time so found it hard to come up. I stayed in Glasgow for the next five months but saw my mum a total of four times.

I felt let down. I felt I had been sent away originally just so people could get rid of me, like I was being pushed aside. During my time in Glasgow, no friends came up to visit. I know it sounds silly, but I felt ashamed about being in an inpatient unit and I didn’t want to tell too many people. The nurses were for the most part OK. Some clearly cared more than others, though they could be dismissive at times and sometimes they would simply ignore you. Staff weren’t as hands-on as they should have been and some of my friends were left for five hours during the day without being checked on. But the daily group programmes were very helpful, such as ‘nutritional education’ and ‘understanding your eating disorder’.

In June this year, I was eventually transferred because I was so homesick and depressed. Knowing I was so ill didn’t help as I blamed myself and believed that I deserved to continue to feel that bad. It felt even worse not to be near my mum and unable to physically support her while she was going through radiotherapy as well. I wasn’t putting on weight and it was decided that it would be better for me to be treated closer to home.

Having an eating disorder is extremely isolating; as a normally sociable person it feels like torture. Being so far from home just made it worse. I absolutely love food so for me anorexia is more of a self-punishment. I was bullied from a young age and withholding food became a way of controlling something in my life. I didn’t deserve food. I am also extremely driven, which is maybe linked to it somehow, although it holds me back.

I’ve been an inpatient at one other place since then, in Ealing in west London, which is not too far from my home. The very strict regime there meant I put on weight, but my mental health was no better. I left two weeks ago. I didn’t want to have to stay there over Christmas and I didn’t like the unbelievably strict, inflexible guidelines. I’m now in treatment through my old outpatient team and see a counsellor twice a week, a dietician and a social worker. Constant support is really important and having someone to talk to, or simply to sit with and be near when you don’t want to be alone, is what you need most when you are this unwell.”

"I felt pushed away": Beth Grant on having to move 380 miles for anorexia treatment

If medical professionals concern getting sued, taking away that dread may possibly assist patients | Richard P Grant

You’re sitting in the chair at the GP’s surgical treatment, or perhaps you are lying in a bed in the intensive care unit, and the physician looks into your eyes, or holds your hand, or perhaps even talks in excess of your head to your mum, and says,

“I’m sorry, there’s nothing more we can do.”

Is she talking to you? About you? About your only son? About your dad? Your wife?

Isn’t going to matter.

The phrases ring in your ears.

Absolutely nothing…

Except?

A glimmer, the faintest spark, of uncertainty, of hope.

“Is there absolutely nothing, nothing at all at all?” you (or your mum or your brother) inquire.

“Well,” the medical professional says, “There is this experimental treatment method that appears promising…”

“But?”

“But I will not want to be sued.”

How do you truly feel?

When there is no hope left and you truly feel like your heart has been torn out and crushed in a vice, how do you come to feel about this merest sliver of hope, this a single bright light in a globe of dark, that is currently being refused to you since the 1 person who at this second need to care about nothing at all else is concerned that their malpractice premiums haven’t been paid this month?

Possibly, actually, it truly is not all that negative.

Maybe it’s nothing terminal, not cancer, not that bad, just some niggling factor you have been struggling with for 15 years, mustn’t grumble, worse things come about at sea, nothing at all to complain about really, but by Christ you wish it’d go away and this moist-behind-the-ears mugglehead just out of med college is telling you there’s practically nothing that can be carried out simply because of an infestation of attorneys.

How very likely is this situation?

To be sincere, I have no thought. But a sufficient amount of individuals think it is a widespread ample scenario that there is a draft bill, sponsored by Lord Saatchi as a result of his wife’s death from ovarian cancer, proposing to “handle issues to innovation in bringing forward new health care treatment options”.

Health care treatment these days is driven by tips. You present with a problem and the attending physician employs their judgement and the suggestions to figure out what therapy to give you. The tips are (for the most part) evidence-based mostly they are informed and modified by the final results of trials and new scientific analysis. When proof is not offered they are shaped by expert viewpoint. Adherence to tips improves outcomes – and there is really a literature on strengthening adherence to recommendations.

But what happens when a patient is taken care of by a conscientious attending doctor, treated to the guidelines, and isn’t going to get better? Typically we are left with the dreaded phrase, “There is absolutely nothing far more we can do.” And when doctors do in desperation go off the beaten path – nicely, this is how an acquaintance of mine place it: “Most of my individuals are referred to me possessing repeatedly failed to reply to all acknowledged published guidelines. I get criticised for not sticking to guidelines.”

Would not it be better for individuals if doctors felt they could, in all obligation and with the duty of care of their patient centremost in their ideas, attempt experimental treatment options that look promising but have not however been confirmed in a phase III clinical trial?

The Health-related Innovation Bill aims to make this possible – or at least make it much more most likely by mitigating the threat of litigation. The bill is developed to safeguard against homoeopaths and other quacks by requiring medical doctors to comply with essential transparent and accountable procedures, to responsibly take into account new treatment options and tips, and by exposing the “medical professional who acts alone and in a reckless way”:

The patient’s health-related physician will be obliged to examine the patient’s case with specialists and experts, generally within their very own hospital or clinic, seeking consensus from them about the best course of action for the patient.

It may possibly be made the decision that the normal process is not going to be successful and that giving the patient an innovative treatment method that deviates away from regular procedures is a excellent issue to do.

The choice – and it will only be an choice – need to be explained meticulously to the patient. This includes explaining the hazards. In some instances this may possibly mean explaining that the risks are unknown – especially when the treatment on provide is new.

The [crew of professionals and experts] may not attain a unanimous view. If that happens, the medical professional have to allow the patient know.

The patient will always have the choice to go via with common procedures, or consent to the modern treatment method.

As it transpires, I’m acquainted with some of the named supporters of the bill, and if it carries any weight with you I can vouch for their non-quackness.

The bill has been by means of a public consultation phase and is now with the Department of Health. If you feel it is a very good notion, you could write to your MP, and you can also let the supporters of the bill know.

Richard P Grant is all for experimental science and is interested in far also a lot of things for his very own good. He is on Twitter at rpg7twit

If medical professionals concern getting sued, taking away that dread may possibly assist patients | Richard P Grant

Is Arkansas" "Personal Option" A Block Grant? Insurance Skilled Bob Laszewski Thinks So, But He Is Wrong

Throughout the previous couple of months, insurance coverage industry insider Bob Laszewski has chronicled a lot of of the failures of ObamaCare’s launch. He has raised some very critical questions and concerns from the insurance business about future policy and premium bumps that lay ahead below the ACA. Sadly, his recent assault on Republican governors and state lawmakers who have rejected ObamaCare’s misguided Medicaid expansion totally misses the mark. He contends that Arkansas’ “Private Option” is genuinely just a block grant for Medicaid. But the truth lies in the fine print, and even though there is no question the Private Option puts state taxpayers at risk, it also produces a new entitlement and ceded most of the manage for the plan to the federal government. It’s like putting the fox in charge of the hen property.

Laszewski praises the Obama administration for getting “very cooperative and flexible” on Medicaid expansion, by permitting states to improve Medicaid eligibility via applications this kind of Arkansas’ “Private Choice.” There’s just one dilemma: the promised “flexibility” in no way materialized.

We not too long ago talked to Arkansas State Senator Bryan King, chairman of the Legislative Joint Auditing Committee, who has been monitoring Private Option implementation. Here’s what he had to say about that promised versatility:

Arkansas’ negotiations with the Obama Administration manufactured 1 factor clear: the bureaucrats in Washington hold all the cards and their primary concern is implementing ObamaCare, not providing states with any true flexibility. They could relent on tweaks that quantity to nothing at all more than window dressing, but their intent is for states to expand Medicaid and enroll much more Americans into government-run well being care. Arkansas produced a grave error in trusting the Obama Administration’s false promise of flexibility and our state’s sense of buyer’s remorse grows worse by the month. I only hope that leaders in other states are not fooled by these empty guarantees.

Senator King is correct: Arkansas was given no meaningful flexibility at all.

The Federal Government Did not Grant Arkansas A Medicaid Block Grant

The Private Alternative Medicaid growth produces a new entitlement for in a position-bodied, operating-age grownups.  It is not a Medicaid block grant. By definition, a block grant calls for a state to acquire a fixed amount of funding in exchange for meeting particular policy goals. Although the federal government positioned a per-individual cap on Private Option spending—though kept an open-ended funding scheme for an unlimited amount of eligible individuals—it did not accompany that cap with accurate versatility. It’s the worst of each worlds for Arkansas: capped per-individual funding from the federal government and no meaningful flexibility to manage charges.

The Federal Government Did not Grant Arkansas Versatility On Who To Cover

The Personal Choice Medicaid growth covers all of the ready-bodied grownups that ObamaCare envisioned. The vast bulk of these ready-bodied grownups are operating age, have no dependent young children and are ineligible for most other sorts of welfare, such as money support and extended-term foods stamps.

In order to safe its waiver, Arkansas was forced to guarantee to cover men and women who have been already purchasing private insurance coverage – either via an employer or in the personal industry – as well as people who would otherwise qualify for federal subsidies on the ObamaCare exchange.

Other states that have explored partial expansions or various prepare types, like South Dakota and Indiana, have been smacked down by the Centers for Medicare and Medicaid Services—the choice-making arm of the U.S. Division of Well being and Human Services when it comes to Medicaid-associated negotiations with the states.

Is this the cooperation and flexibility that Mr. Laszewski praised the Obama Administration for?

The Federal Government Didn’t Grant Arkansas Flexibility On What To Cover

Personal Alternative enrollees are assured the same Medicaid rewards they would acquire below a conventional growth. All positive aspects not typically covered by private insurance coverage, like non-emergency medical transportation (NEMT) and early and periodic screening, diagnosis and treatment (EPSDT) benefits, are merely delivered through the traditional fee-for-support Medicaid program.

The Federal Government Did not Grant Arkansas Flexibility On What To Charge

Beneath the terms of the waiver, the vast bulk of enrollees in Arkansas’ Private Option have no cost-sharing whatsoever. Even between these who have to shell out nominal copays, cost-sharing is reduced than what existing Medicaid principles allow.

The Federal Government Didn’t Grant Arkansas Versatility To End The Expansion Whenever It Wishes

Practically nothing in the Personal Alternative waiver provides the state new authority to roll back its ObamaCare Medicaid growth. Federal law and regulation nonetheless classifies the growth population as a new “mandatory population” for states that opt into the expansion, which authorizes the federal government to consider away all federal Medicaid money if a state were to roll back eligibility for that group.

Is Arkansas" "Personal Option" A Block Grant? Insurance Skilled Bob Laszewski Thinks So, But He Is Wrong