Social care reviewer condemns UK system and calls for new tax

Andrew Dilnot, who carried out the government review into the funding for care and support in England, has condemned Britain’s social care system as “the most pernicious means-test in the whole of the British welfare state” and called for a new tax to fund adult social care for everyone who needs it.

The chair of the Dilnot commission on funding of care and support said a tax was needed to provide lifelong adult social care that was not means-tested.

The average person will need social care worth about £20,000 during their lifetime, with slightly more than a fifth of the population dying before they require any support. But for 10% of the population care costs are high: a couple with arthritis requiring residential care for the last 20 years of their lives will need care costing over £1m.

Andrew Dilnot believes social care should not be means-tested. Photograph: David Levene for the Guardian

The current system provides care for adults of working age and older people with disabilities, mental health problems, sensory loss or general frailty. Personal and practical support can be provided in a care home, in the community, in hospital or in someone’s home.

For those with less than than £14,000 in capital and savings the system covers the cost of all care, but pays nothing for those with more than £23,250. Dilnot said that in its present form it creates a “massive sense of inequity and encourages a significant amount of cheating”.

Changes to the means test were due to come into effect in April 2016 but have been delayed until April 2020, after which the £23,250 upper limit will be raised to £118,000 and the lower limit to £17,000.

Dilnot, however, believes social care should not be means-tested. On Thursday, he used his first speech since his five-year term as chair of the UK Statistics Authority ended last week, to return to the issue of social care – adding that he was relieved that he could now finally “speak about almost anything” since joining the authority in December 2011.

Using a Resolution Foundation lecture, he said the controversial state pension triple lock (which sees pensions rise each year by the highest of the rate of inflation, average earnings or a minimum of 2.5%) should be rewritten to include a new, non-means tested, social care guarantee.

The Dilnot commission report concluded that individuals should pay the first £35,000 of their care if they have more than £100,000 in assets. Once that excess has been paid, the government would provide free social care. The findings were never implemented despite being welcomed by the then health secretary, Andrew Lansley, the then prime minister, David Cameron, and the then leader of the opposition, Ed Miliband.

But Dilnot said social insurance with an excess for social care was now urgently required for “staggeringly striking, massive welfare-inefficiency reasons”.

“I think it would be entirely reasonable to look again at the triple lock and say, ‘Let’s substitute some of the more expensive elements of the triple lock. Let’s turn them into a new triple lock with social care as part of the triple lock’,” he added.

Dilnot’s proposal is that the money saved by shedding the most costly of the triple lock’s conditions could be used to pay for the cap.

This means, he said, that providing non-means-tested social care to every British citizen would not require more money from state coffers. “There are many ways in which the scale of money we’re talking about could be reallocated in the upcoming budget without looking for extra money.”

Dilnot rejected claims that Britain can’t afford a “decent care system”. “There’s plenty of money,” he said. “GDP in real terms is more than 5.5 times as big as it was in 1948. So if anyone says to you, we can’t afford X, Y or Z, the appropriate response is: ‘That is not a well-formed formula”. We may choose not to afford it but the notion that we can’t afford something, given what has happened to our income is striking and quite surprising, and doesn’t strike me as correct.”

Social care reviewer condemns UK system and calls for new tax

Dementia sufferers to receive devices to block nuisance calls

The UK government is to fund high-tech call-blocking devices to protect dementia sufferers and vulnerable people from nuisance phone calls, although only around 1,500 people will be given the gadgets under the initial funding.

The £500,000 project will install trueCall devices in the homes of elderly and vulnerable people identified by doctors. The machines block all recorded messages, silent calls and calls from numbers not pre-identified by the homeowner, which the government says will offer particular protection for dementia sufferers.

Around £300,000 of the budget will be spent on the devices themselves, with the remaining funds allocated to management of the service and raising public awareness of scam calls.

Ministers have been pressed by health and consumer campaigners to do more about nuisance calls. One firm alone has been fined £350,000 for making more than 46m automated calls.

Announcing the fund, prime minister Theresa May said: “We want to create a fairer society by cracking down on unscrupulous practices which target the most vulnerable. This new, targeted scheme is the latest step in the government’s fight against nuisance calls, protecting those who are most at risk, including those with dementia.

“We have seen people tricked out of thousands of pounds by scam callers and this government is determined to clamp down on their activities once and for all.”

A trial of the devices last year by the National Trading Standards scams team resulted in 93% of participants feeling safer in their homes, the government said, including one person who had previously paid £150,000 to a scam caller.

Hilda Hayo, chief executive of Dementia UK, said the funding was a step in the right direction. “These calls can not only have a negative financial impact but can also lead to psychological affects such as anxiety, depression and a loss of self-esteem,” she said.

“We frequently receive calls to our national helpline from family members who are concerned that their relative with dementia has fallen prey to rogue traders.”

Further plans are being drawn up to combat the wider problem of nuisance calls, the government said, including a plan to issue fines of up to £1m if companies are found to be in breach of privacy and electronic communications regulations.

Dementia sufferers to receive devices to block nuisance calls

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

There have been fresh calls for restrictions on the sale of the painkiller ibuprofen after another study found it heightens the risk of cardiac arrest.

Taking the over-the-counter drug was associated with a 31% increased risk, researchers in Denmark found.

Other medicines from the same group of painkillers, known as non-steroidal anti-inflammatory drugs (NSAIDs), presented an even higher risk, according to the findings published on Wednesday in the European Heart Journal.

Diclofenac, available over the counter in the UK until 2015 and still taken on prescription, raised the risk by 50%.

Prof Gunnar Gislason of the University of Copenhagen, who led the study, called for tighter controls on the sale of ibuprofen and other NSAIDs. He said: “Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe.

“The findings are a stark reminder that NSAIDs are not harmless. Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest.”

The findings are the latest to raise alarm about the use of NSAIDs. Last September a study in British Medical Journal found they were linked to an increased risk of heart failure. Previous studies have linked the drugs to abnormal heart rhythm – which can cause heart failure – and an increased risk of heart attack and stroke if taken regularly.

Gislason urged people with heart problems to avoid ibuprofen and other NSAIDs. “NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors,” he said.

“I don’t think these drugs should be sold in supermarkets or petrol stations where there is no professional advice on how to use them.”

Gislason suggested they should only be taken after consulting a doctor. “Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and in low doses,” he said.

He added: “The current message being sent to the public about NSAIDs is wrong. If you can buy these drugs in a convenience store then you probably think: ‘They must be safe for me.’

“Our study adds to the evidence about the adverse cardiovascular effects of NSAIDs and confirms that they should be taken seriously and used only after consulting a healthcare professional.”

The Danish investigators studied data on almost 29,000 patients who suffered an out-of-hospital cardiac arrest recorded in Denmark between 2001 and 2010. They found that use of any NSAID raised the likelihood of cardiac arrest by 31%.

The researchers speculated that the results could be explained by the effect of the drugs on the cardiovascular system, as they influence platelet aggregation and the formation of blood clots. They may also cause arteries to constrict, increase fluid retention and raise blood pressure.

Gislason said people should not take more than 1,200mg of ibuprofen in one day.

The Proprietary Association of Great Britain, the trade body representing manufacturers of over-the-counter medicines said the study had “several limitations,” and insisted that NSAIDs are safe.

John Smith, its chief executive, said: “Information about daily dosage was only based on estimates rather than accurate data and didn’t account for over-the-counter use. Prescribed NSAIDs would normally contain a higher dosage than those medicines available over-the-counter and would typically be used for longer durations.”

He added: “NSAIDs available over-the-counter, such as ibuprofen, are an effective and appropriately safe way to provide short-term pain relief if used in accordance with the clear on-pack instructions and the patient information leaflet inside. NHS Choices recommends NSAIDs to help relieve pain, reduce inflammation, and bring down a temperature.

“It is important for people with a history of heart disease or other long term condition to speak to a pharmacist before taking any over the counter medicine to check for any potential drug interactions or health concerns.”

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

Calls for "porno chic" Saint Laurent ad campaign to be banned

Campaigners have accused the French fashion house Saint Laurent of featuring models in degrading poses for a publicity campaign they say should be banned.

The poster campaign in Paris consists of one image showing a reclining woman in a fur coat and fishnet tights opening her legs, and another of a model in a leotard and roller-skate stilettos bending over a stool. It has caused fury on social media.

The French advertising authority said most of the complaints were from people who saw the images as an “incitement to rape”. Its director, Stéphane Martin, said the brand appeared to have “incontestably breached” the rules.

“I am not sure that [Saint Laurent’s] female clients would like to be associated with these images,” he said. “We had a similar type of porno chic [in fashion advertising] a decade ago, and here we have it coming back again, which isn’t acceptable.”

sophiasept (@sophiasept)

@YSL Tout y est : culture du #viol, #soumission, #objectivation, #infantilisation invisibilisation et invitation à l’#anorexie ! pic.twitter.com/ozBDHQKtrL

March 4, 2017

Martin said they would decide on what action to take after a meeting with the label on Friday. The authority bars all “degrading and humiliating representations of people” and can demand that advertisers withdraw or change their campaigns.

France’s leading women’s group, Oséz le Feminisme! (“Dare to be Feminist!”), called for the campaign to be pulled, saying this was not the first time Saint Laurent had crossed the line.

It had previously raised hackles with another campaign that used “a very young hypersexualised woman”, its spokeswoman, Raphaëlle Rémy-Leleu, said.

She said this time the subtext was “extremely violent”. “It ticks all the sexist boxes. The women are objectified, hypersexualised and put in submissive positions,” she said.

“How do they think they will sell anything today to women with that? But you have to ask if that wasn’t intentional, that this was all about creating a scandal so we would talk about them.”

Saint Laurent was not available for comment.

Britain’s advertising watchdog banned a Saint Laurent advert two years ago that featured a model whose ribcage was showing.

Martin, who said the latest campaign had been created by the brand’s in-house team, questioned whether its new young designer, Anthony Vaccarello, had gone too far.

The Belgian creator has flirted with bad taste in his first two shows for the brand in which he radically ramped up the sex factor. In his latest show last Tuesday, he gift-wrapped models in tight shiny leather mini dresses while his debut collection featured a dress that exposed one breast.

“We have a rather young designer known for his rather ‘specific’ looks,” Martin said. It is possible that “in this rather closed world, with its specific codes, that they did not realise” the effect the adverts would have.

Calls for "porno chic" Saint Laurent ad campaign to be banned

BMA calls for extra £10bn a year for NHS in Hammond"s budget

The British Medical Association has urged the government to increase health spending by £10bn a year to bring funding into line with other leading European economies and shore up the NHS.

The union for doctors said increasing health spending to a proportion of GDP that matched that of the 10 leading economies across Europe could pay for at least 35,000 extra beds a day and several thousand more GPs.

In a letter to the chancellor, Philip Hammond, before Wednesday’s budget, the BMA council chair, Dr Mark Porter, wrote: “Our members report that services are truly at breaking point, with unprecedented rising patient demand met only with financial restraint and directives for the NHS and social care to make huge, unachievable savings through sustainability and transformation plans (STPs) across England.

“We are not calling for more than other comparable nations, we are simply calling for you to match the average spending of other leading European economies. Based on our analysis of the figures available, this would, in 2015, have equated to an increase of £10.3bn for NHS funding; an increase which is desperately needed.”

The BMA’s call for substantial extra investment comes at a time when the NHS is feeling the strain amid rising demand, staff shortages and pressures on its finances. The service is supposed to be seeking to achieve £22bn in efficiency savings by 2020, which NHS England chief Simon Stevens said would still leave the service with an £8bn funding gap.

However, the health service in England is on course to overspend by £1bn by the end of the current financial year after running up a deficit of £2.45bn in the previous 12 months.

The BMA has been a vocal critic of the STPs, claiming they are unworkable and will not secure the sustainability of the NHS as they are intended to do but threaten it by reducing services on a drastic scale.

The reference in the letter to Hammond to the number of beds that could be funded is particularly emotive as several thousand beds in acute district general hospitals face being axed under STPs submitted by 44 areas.

Additionally, lost bed days due to patients being unable to be discharged because of constraints on community or social care, have hit record levels in recent months.

They were also partially blamed for a deterioration in NHS finances in England in the last three months of last year as providers lost income from elective operations because of a lack of capacity.

The BMA’s analysis suggests that the 10 leading economies across Europe spend an average of 10.4% of their GDP on health in comparison with the UK’s 9.8%, using the current definition from the Organisation for Economic Co-operation and Development. According to this, the UK’s spending on health in 2015 should have been £10.3bn higher than it was.

Porter said if the government matched its peer group it could recruit an extra 10,000 GPs, along with other healthcare professionals, and improve surgeries so that practices could host more staff and deliver additional appointments to patients.

It could also reverse cuts already made to the public health budget rather than introduce further reductions of almost 4% up until 2020, he added.

“The crisis currently facing the NHS and social care is well known and becoming increasingly severe – the government cannot remain a bystander any longer,” Porter wrote.

“An entire system under such strain is not due to frontline financial mismanagement, or individual chief executives’ poor decision making, it is due to the conscious underinvestment in our health service.”

A Department of Health spokeswoman said: “We are committed to the NHS, which is why total health spending is above the OECD average as a percentage of GDP, and why we are investing £10bn in the NHS’s own plan for the future, including almost £4bn this year.

“What’s more, the NHS was ranked the best and most efficient healthcare system in the world by the independent Commonwealth Fund, showing that we make every bit of spending count.”

BMA calls for extra £10bn a year for NHS in Hammond"s budget

Dutch minister calls on UK to join safe abortion fund after Trump ban

The Dutch government has voiced hope that the UK will join 20 countries to set up a safe abortion fund to fill the gap left by Donald Trump’s “global gag rule”.

Lilianne Ploumen, the Dutch international development minister, is leading an international campaign to raise $ 600m (£480m) to compensate for the Trump administration’s ban on funding for NGOs that provide abortion or information on the procedure to women in developing countries.

Belgium, Denmark and Norway have joined the Netherlands in pledging $ 10m each, while at least 15 other countries are preparing to join the scheme, including Canada, Cape Verde, Estonia, Finland and Luxembourg.

The British government has yet to declare whether it will sign up to the initiative, prompting concerns from British Labour MPs that Trump’s ban could undermine the Department for International Development’s work in promoting the health and education of poor women around the world.

Ploumen said she had contacted the international development secretary, Priti Patel, and her DfID predecessor, Justine Greening, who serves as minister for women and equalities.

The British government and the Netherlands were working closely on international family planning topics, Ploumen said, voicing hope that the UK would join the latest initiative. “It is up to them to voice their support. They are a strong partner in all of this so I do hope they will be able to join.”

“The UK has been a great champion of international cooperation and not only when there were Labour leaders in charge,” she said, praising David Cameron and Theresa May.

The Dutch government wants donors to step in to support family planning programmes.

Campaigners fear the ban will choke off funding for maternal health services and work to combat Aids, malaria and the Zika virus.

Already, 3m unsafe abortions for 15- to 19-year-old girls are carried out each year, the World Health Organisation estimates, leading to lasting health problems and, in some cases, the mother’s death.

The Dutch minister voiced optimism that a coalition of international donors – governments, foundations, companies and individuals – could raise the money, despite tepid responses to international fundraising drives for humanitarian emergencies in Syria and Yemen.

The $ 600m goal was a “very ambitious target” that “signalled the US has been a great partner in the last years”. But she acknowledged that countries were struggling to “make ends meet and it is really unfortunate that the US has now given us another challenge”.

The Dutch government has also approached US foundations. A few individuals have handed over money in envelopes to the Dutch embassies in Washington and London, prompting the creation of the fundraising page at SheDecides.com

NGOs have praised the Dutch government and other countries, but fear the plan may not go far enough..

We are counting on the UK government to continue supporting the family planning cause

Irene Donadio, IPPF

“We are witnessing a new version of the global gag rule,” said Irene Donadio, an expert at the International Planned Parenthood Federation (IPPF). “It has been enormously expanded and that will affect expenditure on all global health programmes. We know that at a minimum it could be $ 600m a year, but it could be much more.

“We admire and support those governments who want to stand up for women and their dignity, but we are not sure this will fill the gap or how quickly it will fill the gap.”

The IPPF had “always admired the UK’s commitment to family planning”, but “could not help noticing that the UK has not been very vocal [on the global gag],” Donadio added. “We are counting on the UK government to continue supporting the family planning cause.”

A DfID spokeswoman did not address a question about whether the UK would contribute to the international fund, saying: “The UK is a global leader on family planning, sexual and reproductive health and rights. We are continuing to work closely with partners, including governments and civil society, to deliver this, and are stepping up our leadership even further by hosting a major international summit this summer to secure commitments that increase access to family planning services for women and girls in the world’s poorest and most fragile countries.”

Aid experts have voiced concern that Brexit will damage Britain’s international development role, by eroding budgets and prompting an isolationist turn.

But Ploumen voiced optimism that the UK would not shrink from its promises. “Listening to your prime minister, she has voiced the importance of Britain in the world on several occasions, and international solidarity is part and parcel, I would assume, of that relationship with the rest of the world.

“If you are a trading nation, if you are an open economy like the UK and the Netherlands, there is a deep interest in a stable world.”

Dutch minister calls on UK to join safe abortion fund after Trump ban

Charity calls on Jeremy Hunt to intervene over blood cancer treatment

A charity has urged the health secretary, Jeremy Hunt, to press the NHS to fund potentially life-saving treatment for blood cancer patients who it claims have been abandoned.

The blood cancer charity Anthony Nolan said the health service should fund second stem cell transplants for people with diseases such as leukaemia who relapsed after their first transfusion of cells. About 16 people a year relapse, and the charity says a second transplant provides a cure for one in three cases.

However, NHS England has said a second transplant is too expensive and provides low clinical benefit when compared with other treatments. The decision not to fund a second round is set to be reviewed in May, and the charity wants Hunt to put pressure on NHS England to change its stance.

Anthony Nolan’s chief executive, Henny Braund, said the refusal to fund a second transplant was unacceptable. “The health secretary must take action for people with blood cancer and blood disorders by raising this issue with NHS England,” she said. “We ask that Mr Hunt meets patients and families affected and take this issue up on their behalf with decision-makers at NHS England. Families are losing loved ones because the NHS is under pressure to make savings.”

In a poll of 1,700 people carried out by Populus on behalf of the charity, 66% of respondents said patients who relapsed after their first treatment should be given a second round, and almost half said it was unacceptable for friends or family to have to foot the bill. Almost six in 10 said the government was not doing a good enough job of making sure the NHS had the money to fund the treatments people needed.

Lisa Hepburn, whose husband Gavin died last year after two attempts to get an individual request for a second stem cell treatment were rejected, said: “There’s no explanation from the NHS; nothing from the heart. I feel for people who are in the situation of having to raise the money themselves. I can’t believe the government can put a price on a person’s life – that’s what they are doing.”

Last week a group of charities wrote to Theresa May urging her to stop the NHS rationing treatment for people with serious illnesses and to find more money for care in next month’s budget.

NHS England had not responded to a request for comment at the time of publication.

Charity calls on Jeremy Hunt to intervene over blood cancer treatment

Rise in calls to Childline for mental health issues prompts call for action

Charities are calling for improved mental health provision in schools as new figures reveal more than 50,000 children and young people contacted Childline last year seeking help for serious mental health problems.

The helpline has seen a 36% rise over four years in youngsters needing help for depression and other disorders, while there was also a rise in the number of youngsters feeling suicidal.

Figures from the National Society for the Prevention of Cruelty to Children (NSPCC) reveal 50,819 children and young people in 2015/16 received counselling for a serious mental health issue – a rise of 8% over four years.

Those aged 12 to 15 made up a third of the sessions, with girls almost seven times more likely to seek help than boys.

Peter Wanless, chief executive of the NSPCC, said the figures, released at the start of Children’s Mental Health Week, were deeply concerning.

He said: “To ensure the next generation aren’t left to deal with a mental health epidemic, there has to be a much more comprehensive network of professional support and treatment in place that is easily accessible for young people who are desperate for help to get their lives back on track.”

Sam Royston, director of policy and research at the Children’s Society, said it was desperately worrying that so many young people were experiencing problems.

She said: “Whilst such issues may affect any child, in our own research, we have found there is a widening gap between the wellbeing of adolescent girls and boys.

“Many factors may contribute to this – for example we have found that adolescent girls are particularly likely to experience emotional bullying such as name-calling.”

She added: “Failing to address mental health problems early on can severely damage the lives of young people. As a first step all children should be able to access mental health and wellbeing support such as counselling in schools so they get support early to prevent a problem becoming a crisis.”

Childline said early signs of a serious mental health problem in children and young people include becoming withdrawn from friends and family, being tearful or irritable, sudden outbursts, and problems eating or sleeping.

One 16-year-old girl told Childline: “I want to know what’s wrong with me. I have been seeing a counsellor about my mental health issues recently but they just told me to eat and sleep better and forget about the past, which didn’t help me at all.

She added: “I wish I could speak to someone who actually cared about me and I felt comfortable talking to.”

Another young person said: “I’m struggling to cope with bipolar. One minute, I feel so low, like I’m trapped, and all I want to do is disappear. Then suddenly, I feel the complete opposite, and I’m really happy and I start thinking about everything in a really positive light. I feel like I push away everyone that tries to help, I tell them I hate them and blame them for everything. I just feel like I’ve turned into a monster.”

Childline founder Dame Esther Rantzen said: “It’s striking how many more children seem to be suffering serious mental health problems today than when we launched Childline 30 years ago.

“So many desperately unhappy children seem to be suffering suicidal thoughts, self-harming, becoming anxious and depressed, with many of them turning to Childline because no other support is available.”

Rantzen said children’s mental health services are already “terribly overstretched” with young people unable to access the professional help they need.

She said: “We believe there needs to be far more emphasis on providing help for these children as they struggle to deal with what are very serious illnesses.”

Sarah Brennan, chief executive at the charity YoungMinds, agreed more support for young people was vital, especially from schools.

She said: “Young people face a huge range of pressures including stress at school, college, university, body image issues, bullying on and offline, around-the-clock social media and uncertain job prospects.

“Difficult experiences in childhood including bereavement, domestic violence or neglect can also have a serious impact on mental health.”

Brennan added: “As a society we need to do far more to prevent mental health problems from developing in the first place. To start with, we urgently need to rebalance our education system, so that schools are encouraged to prioritise well-being and not just exam results.”

Rise in calls to Childline for mental health issues prompts call for action

Private ambulances increasingly used to respond to 999 calls

Ambulance services are increasingly calling in private firms to respond to 999 calls in the latest sign that NHS care providers are struggling to cope with the sharply rising number of patients who need urgent medical attention.

The London ambulance service (LAS) has had the biggest increase among England’s 10 regional ambulance trusts. The amount it spent on private ambulance providers soared from £700,000 in 2011 to £10.1m last year, a thirteen-fold increase.

Cost of private ambulances

Many other NHS ambulance services are also spending more of their budgets on private firms because of their growing reliance on them to meet demand.

For example, the amount paid out by South East Coast ambulance service (Secamb), which covers Kent, Sussex and Surrey, rose from £5.8m in 2012 to £11.6m last year, though it spent even more than that, £14.5m, in 2014.

Similarly, Yorkshire ambulance service paid private services £1.85m in 2014-15 to respond to 10,862 incidents. Last year that jumped to to £7m for attending 38,821 incidents.

The number of calls for assistance in London to which private ambulances have responded rose from 5,024 in 2011 to 59,749 last year. The figure includes both 999 calls and non-urgent journeys to hospital or other medical appointments.

Number of private ambulance responses

The trend has sparked serious concern about the NHS’s chronic shortage of paramedics, which has coincided with big annual rises in emergency calls to all 10 ambulance services in England.

“Ambulance services are not something that should be flung out to the private sector,” said Tim Farron, the Liberal Democrats leader, who obtained the figures for London under a freedom of information request.

“We should not be offering this out to the lowest bidder. It’s not what people want or expect, and the NHS needs more paramedics.”

He said increasing demand was forcing NHS services to draft in private operators to ensure calls were answered on time. “Without the private providers we would currently not have enough resources to get to all the patients who need an ambulance.”

East Midlands ambulance service’s spending on private firms has also risen, up 15% from £4.47m in 2013-14 to £5.15m in 2015-16.

North West ambulance service used to pay only St John Ambulance and the British Red Cross to supplement its own services. But in 2014-15 it began using private providers for the first time, spending £998,741 on seven firms during that year, including QAS Ambulance (£244,365) and Trust Medical (£206,744).

Paul Woodrow, the director of operations at LAS, said: “We have seen a 45% increase in the number of life-threatening incidents in the last five years, responding to 504,685 category A incidents in 2015-16 compared with 347,659 in 2010-11. To continue providing a safe service to Londoners, we use three carefully selected providers in a similar way to hospitals employing agency nurses.”

Crews employed by all three providers “are appropriately trained at either paramedic or emergency medical technician level and carry the same equipment as our crews”, he said.

However, some NHS paramedics claim that private ambulance personnel are not always as well trained as them.

One Secamb paramedic said: “We as crews think they are not as well trained as us and we regularly have to travel with them and the patient to hospital because they cannot cope.

“They are good people but don’t have the same level of training as Secamb staff. This is not good for the patient as their skill set is well below ours. Often they call up asking for para backup, meaning they can’t manage that patient.”

LAS spending on private firms increased almost seven-fold inside one year, from £700,000 in 2011 to £4.8m in 2012, and then more than doubled inside the next 12 months to just under £10m in 2013. It fell slightly in 2014 to £9.2m but then rose to £12.2m in 2015, before falling to £10.1m last year.

Paul Evans, the director of the NHS Support Federation, a research group, said: “Ambulance services sit at the epicentre of the crisis in health and social care services and it’s not surprising they are struggling to cope with demand, but even so this is a shocking escalation in privatisation.

“Resorting to private providers is not the answer if we want to secure safe and effective emergency services. The evidence shows that they use fewer paramedics than NHS crews, which impacts upon patient safety as they will inevitably be sent to treat patients that they are not qualified for and leads to more situations where more experienced staff have to be sent to take over.”

Late last year Coperforma, a private transport firm, had to hand back the £63.5m contract it had held only since April for taking patients in Sussex to non-urgent hospital appointments after a series of blunders. Some of those involved cancer patients, and led MPs and others to describe its service as “a shambles”.

Evans said: “That shows that there are serious flaws in outsourcing theses vital services.”

Christina McAnea, the head of health at the Unison union, said: “Strained NHS finances have led to staffing shortages where shifts aren’t covered and ambulance services have no option but to call on private companies to fill the gaps.

“But the millions of pounds used hiring private ambulances would be better spent filling vacancies and holding on to those highly skilled staff who are leaving in droves.

“Ministers must accept that by continually slashing budgets they are forcing ambulance services into short-term solutions for urgent long-term problems. This helps no one.”

Private ambulances increasingly used to respond to 999 calls

John McDonnell calls for NHS funding audit as winter crisis deepens

NHS funding levels should be checked by the government’s budget watchdog amid public distrust of the figures and a worsening winter crisis in hospitals, John McDonnell has said.

The shadow chancellor wrote to Robert Chote, head of the Office for Budget Responsibility (OBR), asking him to look at NHS funding levels, as doctors warned that the shortage of resources in health and social care has created a crisis.

There have been a number of calls from Labour and the Liberal Democrats for an
independent auditor for the NHS. But McDonnell called on the existing OBR to see if it could establish the truth about public spending on the NHS.

The level of NHS funding has become hotly contested amid claims that cuts to social care have been causing unprecedented pressure on hospitals and further controversy over the government’s claims to be putting in another £10bn a year into the health service by the end of this parliament.

“It has become clear that Labour’s warnings of a looming winter crisis in the NHS were not heeded,” McDonnell wrote to Chote. “And we have seen in recent days that the British Red Cross has now had to describe the ongoing situation as a humanitarian crisis. The response from the prime minister at the weekend was to play down this situation despite the volume of continued complaints from frontline NHS staff.

“I strongly believe that this is leading to widespread public distrust in the government’s presentation of the level of funding and support for the NHS and social care. Therefore, it seems that now is the time to assess further enhancing the role of the OBR, and add additional responsibilities to your organisation.”

John McDonnell Photograph: Danny Lawson/PA

He suggested there should be an “annual standalone report that assesses short-medium term policy decisions made on health spending by the government, that takes into account the analysis you already do on the long-term trends and drivers of health spending.”

On Monday night, frontline doctors issued an unprecedented warning that patient safety was at risk at many A&E units across the NHS because hospitals are overwhelmed.

The health secretary, Jeremy Hunt, ­told the Commons in an emergency statement that hospitals may have to cancel operations and outpatient appointments so that staff can concentrate on the sickest patients.

GPs may also be drafted in to help hospitals cope with record demand for medical care. He also provoked controversy by suggesting the four-hour treatment target should exclude people who waste time by presenting with minor ailments.

The Royal College of Emergency Medicine said a substantial number of A&E departments were falling significantly short of the four-hour standard – but Hunt said that as many as 30% of those turning up were neither an urgent case nor a genuine emergency.

The college, which represents doctors in emergency care, warned: “In our expert opinion, when an emergency department falls below 75% against the four-hour standard, it shows a significant level of overcrowding and begins to put safety at risk. Present figures suggest a substantial number of departments are falling below this level.”

The college believes that one in four A&E units are at risk of offering poor care, citing delays in assessing patients and administering pain relief.

In an emergency statement prompted by reports of intense pressure at A&E units around the NHS in England, Hunt said that the four-hour waiting time had to be revised to remove non-urgent cases.

“This government is committed to maintaining and delivering that vital four-hour commitment to patients,” Hunt said. “But since it was announced in 2000 there are nearly 9m more visits to our A&Es, up to 30% of whom NHS England estimate do not need to be there. And the tide is continuing to rise.

“So, if we are to protect our four-hour standard, we need to be clear it is a promise to sort out all urgent health problems within four hours, but not all health problems, however minor.”

NHS Providers, which represents hospital bosses, welcomed the change as “potentially helpful” in relieving the strain on A&Es.

But Jonathan Ashworth, the shadow health secretary, said: “Is he now really telling patients that rather than trying to hit the four-hour target, the government is now rewriting and downgrading it?”

John McDonnell calls for NHS funding audit as winter crisis deepens

London ambulance staff log calls with pen and paper after IT failure

Staff at one of the country’s biggest ambulance services had to log emergency calls manually overnight because of technical issues in the control room, delaying response times.

It is understood London ambulance service’s computer system crashed, forcing staff to record details of calls by pen and paper for nearly five hours on one of the busiest nights of the year.

A spokeswoman said staff were trained to deal with such situations and were able to prioritise responses to those in greatest need.

The deputy director of operations Peter McKenna said: “Due to technical difficulties, our control room was logging emergency calls by pen and paper from 12.30am to 5.15am.

“Our control room staff are trained to operate in this way and continue to prioritise our response to patients with life-threatening conditions, using the same triage system as usual.

“We also have additional clinicians on duty to offer control room staff clinical advice if it is needed.”

London ambulance staff log calls with pen and paper after IT failure

Jeremy Hunt says calls for more NHS money are a "misjudgment"

Jeremy Hunt has said calls for more money for the NHS are a “misjudgment” less than a year after the health service received a “good settlement” from the government.

The health secretary was reacting to comments from Chris Hopson, the head of NHS Providers, the body that represents hospitals across England, who said on Tuesday that NHS trusts “simply cannot deliver all that they are being asked to deliver on the funding available”.

There have been repeated calls for more money, with charities, thinktanks and royal colleges all saying the NHS requires extra funding.

The chancellor, Philip Hammond, offered no extra cash for the NHS or social care in his autumn statement. He repeated the government’s claim that the NHS will receive an extra £10bn in funding to 2020-21 – a figure that has been challenged by MPs on the Commons health committee and health experts.

MPs have said the government is misleading the public over the “incorrect” figure, saying it is only being achieved through reductions in other areas of health spending outside of NHS England’s budget, such as public health and investment in training.

They said the real increase was £4.5bn while the King’s Fund thinktank has put the figure at £4.2bn.

According to the Health Service Journal (HSJ), Hunt, who is attending the NHS Providers conference in Birmingham, said of Hopson’s speech: “I read Chris’s speech, and I thought it was a very thoughtful speech, and indeed I think he’s a very thoughtful person when it comes to the challenges facing the NHS.

“But I did think it was a misjudgment for NHS Providers, less than a year after they had a settlement for the NHS which they themselves described as a good settlement, to say that there isn’t enough money.

“And the reason is that when we’re negotiating with the Treasury for extra support for the NHS, if less than a year ago you’ve got the biggest settlement that any government department got, in a period when most government departments have seen their budget cut, and less than 12 months later you’re saying, ‘there isn’t enough money, please sir can I have some more’, then you devalue the currency.

“What you do is you risk the NHS not being at the table in these discussions going forward because people will say, ‘whatever we do it’s not enough’.”

Jeremy Hunt says calls for more NHS money are a "misjudgment"

UN calls for urgent action to protect young women from HIV/Aids in Africa

Urgent action is needed to help and protect girls and young women from Aids in sub-Saharan Africa, thousands of whom are still being infected with HIV every week, the UN says.

Many adolescent girls do not know they have the virus and do not seek help or get treatment because they cannot tell their families they have had a sexual relationship with an older man. The death rates among adolescents are high.

In 2015, 7,500 girls and young women aged 15 to 24 were infected with HIV every week. More than 90% of the adolescents infected in sub-Saharan Africa are girls. Between 2010 and 2015, the total annual number of new infections among 15- to 24-year-old women fell just 6%, from 420,000 to 390,000. The UN target to reduce that number to fewer than 100,000 a year by 2020 is way off track, says the latest report from UNAids.

Too little has been done to help girls protect themselves and stay well, according to Michel Sidibé, the executive director of UNAids. “Young women are facing a triple threat,” he said. “They are at high risk of HIV infection, have low rates of HIV testing, and have poor adherence to treatment. The world is failing young women and we urgently need to do more.”

A woman looks at posters displaying information about HIV and Aids at a hospital in Liberia. Photograph: Ahmed Jallanzo/EPA

Girls are particularly vulnerable in southern Africa because of their low status in a strongly patriarchal society. “Women’s and girls’ heightened vulnerability to HIV goes far beyond physiology: it is intricately linked to entrenched gender inequalities, harmful gender norms, and structures of patriarchy that limit women and girls from reaching their full potential and leave them vulnerable to HIV,” says the report.

Helping girls avoid HIV is hard because efforts must address the issues of gender imbalance and violence in societies, as well as poverty, which causes some girls to have relationships with men for money, says the report. Education is also important. Studies have shown that girls who stay in school longer are less likely to become infected.

The report says that a cycle of infection is taking place, which must be broken. Girls and young women are infected with HIV by older men. Men tend to acquire HIV later in life, from women who were infected when they were younger.

The good news from the report is that the numbers of people with HIV being put on drug treatment to keep them well has now reached 18.2 million, which is 3 million more than two years ago. UNAids says it is on track to meet the treatment target of 30 million people by 2020.

But preventing infection is proving more difficult. There were 2.1m new infections in 2015 – the same number as in each of the last three years and only slightly down from 2.2m in 2010.

Global HIV numbers

It was hoped that widespread drug treatment would make a difference to the numbers becoming infected. People who are on the drugs have a low level of the virus in their blood and are unlikely to transmit it to their sexual partners.

But many men are reluctant to go to health clinics and do not get tested, or if they do, they will not go on drug treatment until they actually fall ill, which could be months or years later. “Studies are showing that almost 61% of infections are caused by people who know they are HIV positive but they are not on treatment,” said Sidibé. While that is happening, he said, “how do we control the epidemic?”

Drug resistance is another issue highlighted in the report, which is published ahead of World Aids Day on 1 December. The basic drug combination – “first line” treatment – has become cheap, but the virus is adept at mutating. When people develop or pick up resistant strains of HIV, they need second- or third-line drugs, which are much more expensive. If resistance spreads, said Sidibé, the cost of treating millions of people with newer drugs will be prohibitive and make it impossible to end Aids.

“We need really to protect the drugs that we have. If not, we will have failed,” he said.

UN calls for urgent action to protect young women from HIV/Aids in Africa

New GP leader calls for end to ‘expensive’ five-a-day goal

The new leader of Britain’s 50,000 family doctors says the “five-a-day” target for fruit and vegetable consumption should be revised because it is unaffordable for many Britons.

In her first interview since becoming the chair of the Royal College of GPs, Dr Helen Stokes-Lampard told the Observer: “For people that have got a low income five-a-day is really, really hard. It’s expensive to have five-a-day. I get my five-a-day, no problem, but for many people they can’t afford that five-a-day.” Fruit and vegetables should be reduced in price to encourage greater uptake, she said.

In general, consumption targets that people find unachievable or unrealistic should be rethought because they demoralise those who do not achieve them, Stokes-Lampard said.

Dr Helen Stokes-Lampard, the new Chair of the Royal College of General Practitioners, says alcohol guidelines also need to be adapted. Photograph: Andy Hall for the Observer

She also doubted the wisdom of always trying to persuade smokers to give up. “Many people love to smoke still. Any reduction they can make is a good thing.Encourage them to reduce. If you only say to them ‘the only positive outcome is quitting’, then you’re going to turn them off, you’re not going to be able to have an ongoing conversation.”

Stokes-Lampard speculated that the alcohol guidelines introduced in January, which state that men should drink the same maximum 14 units a week that women have been advised to stick to for years, risked being seen as too strict. “It’s realistic, because a lot of people don’t drink that much. But, for those who do, that seems like a hard task to achieve,” she said.

New GP leader calls for end to ‘expensive’ five-a-day goal

Childline anxiety calls spike as children express fears over global events

The number of children seeking help for anxiety has risen sharply in the last year, a leading charity has said, with increased exposure to global affairs on social media suggested as a possible cause.

The NSPCC’s Childline service handled 11,706 counselling sessions for anxiety over the past year, a 35% increase on 2014-15. The charity said: “Worryingly the problem appears to be getting worse.” It dealt with 6,500 contacts in the last six months where anxiety was cited the main issue – an average of 1,000 a month or 36 a day.

Research showed an increasing number of children and young people were concerned about world affairs such as the EU referendum, the US election and the conflict in Syria.

Childline figures

The rise is said to be down to a combination of personal and political issues, with some young people talking to counsellors about problems in their day-to-day life, while others cited disturbing events seen in the media and on social media as being the source of their worries, the charity said.

As Childline marks its 30th anniversary, it has created a webpage, launched in September, called Worries about the world, which has already received almost 5,000 visits.

Childline’s president, Esther Rantzen, said: “Seeing pictures of crying and bewildered toddlers being pulled from bomb-damaged homes upsets all of us. Often we fail to notice the impact these stories are having on young people.”

She said the fact they turned to Childline enabled them to express their anxiety. “Sometimes these stories also reveal related concerns in their own lives, such as being subjected to racist bullying.”

Being listened to and reassured, she said, meant if they suffer from other problems, “such as abuse or neglect, self-harm or cyberbullying, they will also turn to us for help”.

Esther Rantzen meeting volunteers at the NSPCC’s Glasgow office. Photograph: Julie Howden/PA

Peter Wanless, the chief executive of the NSPCC, said: “The world can be a worrying place but we need to ensure our children are reassured rather than left overwhelmed and frightened.

“It’s only natural for children and young people to feel worried sometimes, but when they are plagued by constant fears that are resulting in panic attacks and making them not want to leave the house then they need support.”

Children as young as eight have contacted Childline to talk about their fears, with girls seven times more likely to get in touch for help with anxiety than boys.

There has been a marked shift in how the service is used. More than two-thirds of users now communicate with counsellors online.

Children and young people can contact Childline for free, confidential support and advice, 24 hours a day on 0800 1111 or at childline.org.uk.

Childline anxiety calls spike as children express fears over global events

UN"s own expert calls its actions over Haiti cholera outbreak "a disgrace"

The United Nations’ refusal to accept responsibility for the devastating cholera outbreak that has claimed more than 9,000 lives in Haiti has been branded a “disgrace” by the organisation’s own human rights special rapporteur.

Human rights groups working with victims had reacted with jubilation earlier this year following the UN’s first tacit admission that it was to blame for the outbreak after doggedly refusing to address how its peacekeepers brought the disease to Haiti in 2010.

However, in a scathing report (pdf) to the UN general assembly, the organisation’s special rapporteur on extreme poverty and human rights, Philip Alston, said that flawed and unfounded legal advice provided by the UN lawyers was preventing it from accepting responsibility for the outbreak.

“The UN’s explicit and unqualified denial of anything other than a moral responsibility is a disgrace,” Alston said. “If the United Nations bluntly refuses to hold itself accountable for human rights violations, it makes a mockery of its efforts to hold governments and others to account.”

Alston accused the UN’s Office of Legal Affairs (OLA) for coming up with a “patently artificial and wholly unfounded legal pretence for insisting that the organisation must not take legal responsibility for what it has done”.

The criticism comes as the administration of the outgoing UN secretary general, Ban Ki-moon, is moving to provide compensation for the first time to victims of the outbreak. The UN plans to make cash payments from a proposed $ 400m (£328m) cholera response package, the New York Times reported.

Alston added that the OLA’s approach “has been cloaked in secrecy: there has been no satisfactory official explanation of the policy, no public attempt to justify it, and no known assessment of its consequences for future cases. This goes directly against the principles of accountability, transparency and the rule of law that the UN itself promotes globally.”

Peacekeepers who were relocated from Nepal to Haiti in 2010 in the wake of a major earthquake imported the deadly cholera bacterium with them. Studies have found that the UN troops could have been screened for the illness, and the disaster averted, for as little as $ 2,000.

Alston said the UN’s legal position appears to be largely explained by the approach of the US, the main contributor to the UN’s peacekeeping budget.
“Despite numerous requests to do so, the United States itself has never publicly stated its legal position on the responsibility of the UN for causing cholera in Haiti,” he added.

“Instead, it seems to have pressed the UN to adopt the position frequently taken by lawyers in the US that responsibility should never be accepted voluntarily, since it could complicate future litigation. But this rationale is completely inapplicable to the UN, which enjoys absolute immunity from suit in national courts and whose reputation depends almost entirely on being seen to act with integrity.”

The special rapporteur said that the current stance of the UN’s lawyers ensures that it would never admit its responsibility for introducing cholera. “And avoiding legal responsibility hinders the UN from learning lessons and making sure that the fatal mistakes made in Haiti are not repeated elsewhere.”

Ban’s office said in a statement earlier this year that the organisation had decided to step up its efforts to fight cholera in one of the world’s poorest countries. A reference to the UN’s “involvement in the initial outbreak” was greeted as a breakthrough by groups working with cholera victims.

Ban appeared to have been bounced into making a clearer recognition of responsibility than ever before by the advent of a draft report by Alston into how the UN handled the crisis. Alston had also been one of five experts working for the UN who earlier this year wrote a heavily critical letter to Ban in which the secretary general’s resistance to accepting any responsibility was torn apart.

UN"s own expert calls its actions over Haiti cholera outbreak "a disgrace"

BMA calls for helpline for people addicted to prescription drugs

The British Medical Association (BMA) has called for a 24-hour helpline to be introduced for patients who are addicted to prescription drugs.

The group believes it could help to tackle problems created when strong tranquillisers prescribed for short-term use, to treat issues such as anxiety and insomnia, are issued for longer periods.

Dr Andrew Green, the BMA’s GP clinical and prescribing policy lead, described dependence on the powerful prescription drugs as a widespread problem that sometimes involves patients who are upset at having been harmed by treatments they hoped would help them.

Dr Green said services need to be specifically designed for this group of people as they may feel out of place if they are referred to existing services, which are aimed at cocaine or methadone users.

He told BBC Breakfast: “The situation has been made worse because they have come to the NHS for help and they have found that the services are not available for them.

“We have even had some patients say they feel they are being blamed for the situation that they find themselves in.”

Benzodiazepines – taken for severe anxiety, insomnia and sometimes pain relief – are a particular concern. Disturbed sleep, personality changes, blunted emotions and people feeling they are struggling to manage their lives are among the potential side-effects of the drugs.

BMA calls for helpline for people addicted to prescription drugs

All-party group calls for legalisation of cannabis for medicinal uses

Cannabis should be made legal in Britain for medicinal uses, according to a cross-party group of MPs and peers who led an inquiry into the drug’s potential to help patients.

The recommendation from the group chaired by Lady Meacher would put the UK in line with at least 11 other European countries and 24 US states where laws already allow people to use the drug to alleviate chronic pain and other symptoms.

In a report published on Tuesday, the group calls on the government to introduce a system that grants people access to cannabis for medical reasons, and to decriminalise the growing of small amounts at home for the same purposes.

The group took evidence from more than 600 patients and medical professionals on the use of cannabis as a medicine and commissioned a consultant neurologist, Prof Mike Barnes, to review published research on the drug’s potential to alleviate medical problems.

His review found “good evidence” that cannabis can help with chronic pain, muscle spasms often associated with multiple sclerosis, the management of anxiety, and nausea and vomiting, particularly when caused as a side-effect of chemotherapy.

The inquiry heard that scores of patients had sought out cannabis to relieve their symptoms even though it was illegal, and that users often found it impossible to get expert medical guidance or supervision as to how they should take the drug. The report claims 30,000 people in the UK use cannabis as a medicine, but adds that the figure could be as high as 1 million, according to the campaign group End Our Pain.

“In Professor Barnes’s report we now have irrefutable evidence that cannabis is an effective medicine for very large numbers of people,” Meacher told the Guardian. “These are people who are suffering the most appalling chronic illness involving severe neuropathic pain, interminable nausea, and anxiety, and all these conditions can be helped, not in every case, but in many cases where prescribed medicines do not work or because there are such appalling side-effects that the person is worse off with prescribed medicine than without.

“About 30,000 patients in the UK currently risk arrest and in some cases are being arrested for buying their medicine from illegal drug dealers, and that is an appalling state of affairs,” Meacher added. “This money goes to drug dealers and terrorists, and we could avoid putting this money into the hands of these people by legalising cannabis for medicinal uses.”

The report, Access to Medicinal Cannabis: Meeting Patient Needs, from the all-party parliamentary group for drug policy reform, challenges the government’s classification of cannabis under schedule 1, which is reserved for drugs that have no recognised medicinal uses. Under the scheme, the production, possession and supply of cannabis, along with LSD and mescaline, is allowed only for research and other special purposes.

Caroline Lucas, the co-leader of the Green party and an author of the report, said: “The case for legalising the production and use of medicinal cannabis is overwhelming. Doing so would give immediate relief to people in pain, and the evidence from around the world shows that it can be done without increasing drug-related harms.”

David Nutt, formerly the government’s chief drugs adviser and now a professor of neuropsychopharmacology at Imperial College London, said it was “outrageous” that the government had “dragged its heels” over legalising cannabis for medicinal uses. The pursuit of patients who used the drug to alleviate pain and other symptoms caused harm and wasted vast amounts of taxpayers’ money in police and court time, he added.

“Cannabis has been a medicine for more than 4,000 years, and in the UK was in the pharmacopoeia until 1971 when the USA forced us to remove it as part of the war on drugs. Now, over 200 million Americans have access to medicinal cannabis whereas we do not,” Nutt said.

Mark Ware, a medical cannabis researcher at McGill University in Montreal, said that if the UK was serious about legalising medicinal cannabis, it would do well to learn from the Canadian legal framework.

“We have encountered many of the issues that the UK will inevitably face,” he said, citing the supply of quality-controlled cannabis with a choice of varieties and routes of administration, education on using the drug, and health risks. “Medical cannabis access is an issue that should be faced head-on, openly and collaboratively,” he said. “It is not an issue that patients or health professionals can afford to ignore.”

All-party group calls for legalisation of cannabis for medicinal uses

"Moonshot" cancer panel calls for US to create national research database

Top US cancer scientists have urged the Obama administration to create a national cancer database for clinicians and patients as part of a slew of recommendations presented on Wednesday by the White House-supported cancer “moonshot” panel.

Vice-president Joe Biden assembled the scientists as part of the administration’s effort to make the US the country that cures cancer “once and for all”.

The Cancer Moonshot Blue Ribbon Panel report said the recommendations, if implemented, “will transform our understanding of cancer and result in new opportunities to more effectively prevent and treat the disease”.

The ten recommendations include existing programs that need more funding – such as research to update guidelines for patient symptom control – and brand new initiatives including a human tumor database to monitor and analyze multi-dimensional cell behavior.

The panel also called for the creation of a network of databases for patients to profile their cancers and pre-register for clinical trials; the organization of a cancer immunotherapy clinical trial network; and the study and development of therapies that prevent or overcome drug resistance.

The panel also recommended initiatives to improve the understanding of a protein tied to pediatric cancers; increase monitoring and management of symptom care and treatment; support development of new testing and treatment technologies; and improve prevention and early detection.

But the funding necessary to fulfill these recommendations has not been approved by Congress despite lobbying by the Obama administration, which said it hoped to spend $ 1bn on the program.

“Congress should seize this historic opportunity – when researchers are on the brink of so many new and potentially life-saving developments in diagnostic tests and treatments – to boost funding for the NIH [National Institutes of Health] and NCI [National Cancer Institute],” said Gary Reedy, CEO of the American Cancer Society (ACS) and the not-for-profit organization’s action network, ACS CAN, in a statement.

The ACS said in January that it expects 1.6m new cancer cases to be diagnosed in 2016, the equivalent of about 4,600 new diagnoses each day.

Barack Obama announced that he had tasked Biden with leading the moonshot program in his final State of the Union address in January. The program aims to accomplish “a decade’s worth of cancer research progress in five years”.

It is a personal effort for Biden, whose son, Joseph “Beau” Biden III, died from brain cancer in 2015 at the age of 46. Last year, Biden helped secure a $ 264m increase in federal funding to the National Cancer Institute in the spending bill.

The panel report is a major step in that direction, and will be presented to the National Cancer Advisory Board on Wednesday, where it is expected to be formally accepted.

To determine the recommendations, the country’s top cancer scientists were divided into seven working groups to focus on elements like immunology and clinical trials. More than 1,600 ideas and comments were also submitted by the public.

Along with the recommendations, the panel also listed policy issues that needed to be addressed so that the recommendations could be efficiently implemented, including laws around patient privacy, the clinical trial system and insurance coverage.

Biden and Obama have acknowledged that it is unlikely cancer will be cured in the next five years, but they have said the moonshot program could create unprecedented strides in the fight against the disease.

“The key for us now is to put a lot more money into research,” Obama said in January. “If we do, I think we’re going to see some really big breakthroughs soon.”

"Moonshot" cancer panel calls for US to create national research database

Largest active veterans group calls for legalizing marijuana to treat PTSD

Faced with stark numbers of brain trauma and psychological distress cases among combat veterans, the nation’s largest active veteran’s organization has thrown its weight behind the growing movement to push for relaxing federal restrictions on marijuana.

The American Legion, the nation’s largest wartime veterans organization, took a position on medical marijuana for the first time last week. At its national convention, it passed a resolution calling on Congress to amend its laws to “at a minimum … recognize cannabis as a drug with potential medical value”.

Marijuana is currently classified by the Drug Enforcement Administration (DEA) as a Schedule 1 drug, putting it alongside drugs such as heroin and cocaine. The designation, which the DEA reaffirmed last month, means that the federal government officially believes there is no “accepted medical use” for the drug.

“It’s a tool in a toolbox,” said William Detweiler, who serves as the chairman of the American Legion’s traumatic brain injuries (TBI) and post-traumatic stress disorder (PTSD) committee and who is a past national commander of the organization. “We’re not advocating the use of marijuana or any other drugs,” but he said veterans “have a right to anything that may help them”.

The American Legion’s new policy platform comes amid greater medical understanding and scientific research in recent years on the causes and consequences of TBI and PTSD.

In the aftermath of the wars in Iraq and Afghanistan, the incidence of PTSD and TBI among veterans has rapidly increased, leading to a national crisis that has also coincided with alarming rates of depression and suicide.

The Department of Veterans Affairs estimates that 22% of combat casualties from the post-9/11 conflicts are brain injuries, compared to 12% for Vietnam veterans. It also estimates that between 60% and 80% of combat vets who have blast injuries may also have brain trauma.

A large and growing body of literature suggests that cannabis can be an effective medical treatment to alleviate the worst effects of PTSD. About two decades ago, scientists discovered the presence of an endocannabinoid system in the brain which responds to some 60 chemicals that are found in marijuana.

Detweiler said he and the organization as a whole were convinced of the case for allowing more study into the possible effects of treating PTSD and TBI with marijuana after coming into contact with the work or Dr Sue Sisley, a medical researcher who has pushed to reform cannabis laws so she can study the potential of cannabis for treating PTSD.

Detweiler admitted that he was initially concerned about how the push into the terrain of medical marijuana would be received, but he said those concerns were quickly allayed once people heard the case on its merits. “I’ve heard nothing but good things” from fellow Legion members and combat vets who urged the organization to consider taking a position on medical cannabis, he said.

In April, after seven years of trying to get the necessary federal approval, Sisley and other researchers were given a DEA license to begin a private study into the correlation between cannabis and PTSD, although the DEA’s official position remains that there is no medical value for the drug. The study is the first of its kind, involving a randomized, controlled study that uses actual marijuana plants, rather than oils or synthetic forms of the drug.

To that end, the American Legion’s resolution also calls on the DEA to “license privately-funded medical marijuana production operations in the United States to enable safe and efficient cannabis drug development research”.

“I consider this a major breakthrough for such a conservative veterans organization,” Sisley said after the vote. “Suddenly the American Legion has a tangible policy statement on cannabis that will allow them to lobby and add this to their core legislative agenda. The organization has a massive amount of influence at all levels.”

According to a major survey released in July by Iraq and Afghanistan Veterans of America, one of the nation’s largest veterans empowerment groups, some 68% of combat veterans support medical marijuana legalization in their states, while a further 75% said that the Department of Veterans Affairs ought to allow medical cannabis as a treatment option.

Marijuana reform groups have hailed the American Legion’s decision.

“Medical marijuana has been found to be a safe and effective treatment for PTSD, chronic pain, and other conditions that often affect veterans,” said Mason Tvert, director of communications at the Marijuana Policy Project. “Those who serve in our nation’s armed forces deserve access to every medical treatment option that could help them live a healthier and more productive life.”

Largest active veterans group calls for legalizing marijuana to treat PTSD