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Swine flu vaccine ‘months away’

July 15th, 2009 | No Comments

Head of World Health Organisation casts doubt on government’s claim that first stocks will arrive in August

Vaccines to protect millions of Britons from swine flu will not be available for several months, the head of the World Health Organisation warns today.

Her remarks, in an interview with the Guardian, cast serious doubt on ministerial claims in parliament that the first stocks would arrive in August.

Dr Margaret Chan, WHO director general, said: “There’s no vaccine. One should be available soon, in August. But having a vaccine available is not the same as having a vaccine that has been proven safe. Clinical trial data will not be available for another two to three months.”

One of the world’s most respected influenza scientists told the Guardian that health officials have been surprised by the rapid spread of swine flu in the UK. Dr Alan Hay, director of the WHO’s London-based World Influenza Centre, said the extensive summer outbreak in Britain had not followed expected patterns and warned that the health department needed to be prepared for a more deadly form of the disease.

“We have been a little surprised by the degree of spread of this virus. A few weeks ago we anticipated that this was going to be a short series of outbreaks that would probably peter out before reappearing in the autumn or winter and that has proved not to be the case,” he said.

He said Burnham had been “a bit optimistic” when he told the House of Commons that a flu vaccine would arrive in Britain next month.

Public anxiety about swine flu has risen since the death of six-year-old north-west London schoolgirl Chloe Buckley, who had contracted the virus but had previously apparently enjoyed good health. Sixteen people in the UK have now died after contracting swine flu – although a postmortem revealed yesterday that Bedfordshire GP Dr Michael Day, who was thought to have become the 17th victim, had died as a result of natural causes.

At least 335 people have been treated in hospital after contracting the virus, but tens of thousands are visiting GPs with flu-like symptoms every week, according to the Health Protection Agency.

Andy Burnham, the health secretary, urged people yesterday to keep the threat posed by swine flu “in perspective”, noting the vast majority of sufferers made a full recovery. Britain was “front of the queue” for vaccine stocks, he told GMTV.

But while it is known that the government asked two major drug companies in June to urgently develop a vaccine, trials of preliminary batches of what they hope will be an effective jab have only begun in the last fortnight. A Department of Health spokeswoman said: “We expect delivery of the vaccine in the coming months. Vaccine development can take some time. We hope to have enough vaccine by the end of the year to cover half of the population, but that’s a forecast and it could go up or it could decrease. We can’t be more precise about when it will be delivered and go into people’s arms.”

The government is basing its contingency planning on the UK workforce being reduced by 15-20% at the pandemic’s peak. That could rise to 35% in the unlikely event that every school closed.

The plans are based on the expectation of a 15-week-long wave of illness, but it is impossible to predict how many there will be.

Latest swine flu developments were discussed at cabinet level yesterday. Part of the government’s strategy will see the NHS cancel non-emergency operations, discharge patients early and care for people with swine flu miles away from their homes if hospitals become overwhelmed with people who are seriously ill with the virus.

The Department of Health has agreed the contingency measures with local NHS leaders during co-ordinated efforts intended to help them prepare to cope with a possible huge increase in the number of people who need what would in some cases be life-saving treatment.

Operations involving elective or non-urgent surgery for conditions such as a hernia or varicose veins would be halted and beds earmarked for these patients used instead for people whose health is at risk because they have swine flu as well as breathing conditions such as asthma, bronchitis or pneumonia.

Hospitals in swine flu hotspots such as London and the West Midlands that become overwhelmed by the sheer number of patients have also put in place plans to transfer some such cases to nearby hospitals, some of which could be 10 or 20 miles away.

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Health experts ‘surprised’ by UK spread of swine flu

July 14th, 2009 | No Comments

• Scientists were ‘caught napping’ by outbreak, says flu expert
• Under 30s at greatest risk from pandemic

One of the world’s most respected influenza scientists said today that health officials had been surprised by the spread of swine flu.

Dr Alan Hay, director of the London-based World Influenza Centre, said the extensive summer outbreak in Britain had not followed expected patterns and warned the Department of Health needed to be prepared for a more deadly form of the disease.

“We have been a little surprised by the degree of spread of this virus. A few weeks ago we anticipated that this was going to be a short series of outbreaks that would probably peter out before reappearing in the autumn or winter and that has proved not to be the case.”

Hay added:

• Some of the background health concerns noted against flu deaths would not have been fatal, noting an American case where the underlying cause was obesity

• The flu surveillance community had been “caught napping” by the emergence of the swine flu outbreak as most resources were concentrated on guarding against a bird flu pandemic

• He was concerned about the emergence since 2007 of drug-resistant flu, which could impact on the pandemic virus.

Seventeen people in the UK have died after contracting swine flu and 335 people have been treated in hospital after contracting the virus. But tens of thousands are visiting GPs with flu-like symptoms every week, according to the Health Protection Agency. The latest deaths were of a six-year-old girl from north-west London and a GP from Bedfordshire.

Hay, who advises the World Health Organisation on its flu policy, said it had become clear the flu pandemic was predominantly affecting children aged five to 14, with the majority of cases nationally and internationally affecting people under 30. Those born before the 1957 flu pandemic appeared to be particularly resistant to the outbreak, indicating they carried some residual immunity.

Hay said the current outbreak would probably continue for another “week or two” before re-emerging in the autumn and early winter. However, the high level of sufferers now could mean that an autumn outbreak would be less severe.

“We are already experiencing this extensive outbreak of the flu at the present time. The people who are being affected will have reasonable immunity against the virus if it reappears during the winter season, which we anticipate. That will lessen the impact subsequently [on health services],” he said.

“So forecasting what will happen is rather difficult but what the Department of Health has to be prepared for is for there to be significant demand on health services resources.”

Of particular concern was that the virus, which has caused only mild illness in most cases, could become more deadly.

“The concern is that the situation might change, the virus may become more virulent,” Hay said. “The proportion of severe infections might increase. And fatalities might increase. We have been monitoring this quite intensively in the labs all around the world and have been seeing some minor changes in the viruses.”

Hay said there had been a small number of cases of resistance to antiviral drugs but no sustained emergence of resistance.

“We’re not totally sure what to expect. Because on the one hand, prior to a year ago, really the anticipation was for very low levels of drug resistance, and then we had the experience in late 2007 with the emergence of drug resistance of seasonal H1N1. And those emerged to become the predominant seasonal virus that has circulated recently. That was really an unanticipated event. We don’t know what the implications of that are in the emergence of this novel virus. It is a concern.”

Hay concurred that most people who had died from the outbreak had underlying health problems, but said that those may not have been life-threatening.

“Would they have died anyway? I think the answer to that is probably no,” said Hay. “Those who have underlying conditions included one that was identified in the US was obesity. So these people were not going to die of obesity in the next month or two I suspect. Some people may have been in a more critical condition.”

Flu surveillance scientists, who had been concentrating resources on looking for a bird flu pandemic, had been surprised by the swine flu outbreak, he added.

“We were not anticipating a virus of this nature causing a pandemic. All our eyes were focusing on the H5N1 virus that had been circulating in wild and domestic poultry populations.

“We have been observing similar viruses to this pandemic in pigs in the past 10 years in the US. And because it was antigenically related to the viruses already circulating – it was the same H1N1 subtype – it was not perceived as being a major threat. Of course we were caught napping, you might say, but this is what has transpired.

“We don’t really know the way this virus might change as it adapts to the human population and what the consequences of such changes might be.”

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Six-year-old and GP die of swine flu

July 13th, 2009 | No Comments

Chloe Buckley, from north-west London, and Bedfordshire GP Michael Day take UK death toll to 17

A six-year-old girl and a GP have died from swine flu, taking the number of UK deaths linked to the virus to 17, it was announced today.

Chloe Buckley, from north-west London, died on Thursday at St Mary’s hospital in Paddington after contracting the virus in the UK. Bedfordshire GP Dr Michael Day died on Saturday in the Luton and Dunstable hospital.

A post-mortem examination will be carried out on Chloe to determine whether she had any underlying health conditions, said Dr Simon Tanner, from NHS London.

A swab test has shown that Day had swine flu but his death will be investigated by the local coroner to determine its exact cause, a statement from NHS East of England said.

It comes after the first British patient without underlying health problems died on Friday after contracting swine flu. The patient, from Essex, died in Basildon.

Earlier today, it was disclosed that the virus had reached Downing Street. It is understood that Gordon Brown’s adviser on climate change, Michael Jacobs, has been infected.

Nearly 10,000 Britons have been confirmed with swine flu after it spread to the UK from Mexico. However, hundreds of thousands more people in the UK are thought to have the virus.

The total number of cases in the country are now being estimated rather than counted individually.

The UK has the third highest case total in the world after Mexico, which has 10,262 cases, and the US, which has at least 33,902.

Speaking about Chloe’s death, Dr Tanner said: “We don’t know if she had underlying health issues.

“There is a post-mortem examination planned. At that point we hope to say if there were underlying health problems.”

Chloe’s death brings the number of swine flu-related deaths in the capital to six.

Tanner said it was difficult to say exactly how many people have caught the virus, now patients are no longer swabbed. He said most people who contracted the virus would experience mild symptoms and feel better within a few days.

The advice to regularly wash hands and throw away used tissues remains the same, he added.

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Swine flu death of ‘healthy’ person

July 11th, 2009 | No Comments

• Latest person to die was otherwise healthy – NHS
• Experts say virus has not necessarily mutated

The first death from swine flu of an otherwise healthy individual was announced last night by NHS authorities in Essex.

At the wishes of the family, no details were given of the patient who died at Basildon and Thurrock University hospital. But the case will cause widespread concern. Until now, every adult and child who has died has had serious underlying health problems that made them particularly vulnerable to infections.

But the chief medical officer, Sir Liam Donaldson, has warned that a few apparently healthy people have succumbed to swine flu and become seriously ill abroad. In one case last month, a healthy 15-year-old teenager called Matthew Davis from Buffalo in New York state, fell ill with swine flu and died, apparently because of co-infection with the superbug MRSA, which he may have contracted in the community rather than in hospital.

Speaking last night, Donaldson pointed to the sometimes apparently random behaviour of the infection: “This death underlines that, although the virus is proving generally mild in most people, it is more severe in some cases. As with all flu-like viruses, some people are at higher risk than others. Unfortunately, people who are otherwise healthy could also become seriously ill or, sadly, die.”

But the director of public health for NHS south-east Essex, Dr Andrea Atherton, said she wanted to reassure people that the risk of transmission still remains small.

“It is important to stress that the symptoms of swine flu are, relatively speaking, mild. Unless you have flu-like symptoms and are being tested for swine flu, there is absolutely no need to stop your normal everyday activities,” she said.

Another expert, Prof Robert Dingwall, director of the Institute for Science and Society at the University of Nottingham, also struck a reassuring note. “This is not at all unexpected – there have been a few deaths elsewhere in the world among people with no obvious underlying condition.

“However, it does not really affect the growing body of evidence that the first pandemic of the 21st century is a relatively mild one and that death rates are likely to be broadly comparable with the annual toll from seasonal flu. There certainly will be more deaths like this one – but most deaths will still occur among people who have some serious underlying condition, and are already likely to be under active medical management,” he said.

John Oxford, professor of virology at Queen Mary’s College of Medicine in London and scientific director of Retroscreen Virology Ltd, said the death was to be expected and did not give any extra cause for concern: “We’ve all been gritting our teeth, waiting for this to happen, and now it has. This doesn’t necessarily mean the virus has mutated. Whether more patients with no underlying health problems die … depends on what the virus does next.”

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Scheme to let new drugs bypass NHS watchdog

July 10th, 2009 | No Comments

• Drayson plans fast track for ‘innovative’ medicines
• Treasury fund would pay for high-cost treatments

Drug companies with “innovative” medicines would be able to bypass current safeguards and sell to the NHS at a high price under a fast-track procedure to be proposed next week by the Office for Life Sciences (OLS), run by science minister Lord Drayson.

The proposal, in a blueprint being prepared behind closed doors with input from the pharmaceutical industry, will effectively undermine the present system of approving medicines for the NHS. It will allow companies with medicines they claim are valuable and original to bypass the National Institute for Health and Clinical Excellence (Nice), which currently must assess every new drug to ensure it offers value for money before it can be used in the health service.

The pharmaceutical industry has been fiercely critical of Nice since its inception in 1999 because it blocks sales of expensive drugs to the NHS that are of only limited benefit. Its protests have been backed by an outcry from patient groups, often partly funded by the pharmaceutical industry, which want new drugs to treat their particular condition.

The proposal comes from OLS, run by Drayson, a former drug company boss. His remit is the promotion of the life sciences as potential big earners for Britain. Lord Mandelson, whose business department oversees the OLS, believes pharmaceuticals are key to the revival of the economy.

The blueprint will recommend that medicines thought suitable for fast-tracking should be allowed into the NHS for a period of time without Nice scrutiny.

Pharmaceutical companies are reluctant to launch new drugs in the UK at low cost because 25% of the global market is influenced by the UK price. Under the OLS proposal, Nice would appraise the drug after perhaps three years – but at that point the company may be willing to drop the price here. Critics will say the proposal threatens to undermine Nice by allowing into the NHS costly drugs that may offer no real health gain.

It comes at a time when other countries are actively considering setting up equivalents to Nice. First among them, and most important for the pharmaceutical industry, is the US. President Obama is known to be interested in some sort of cost-effectiveness scrutiny of medicines, which is bitterly opposed by the industry.

Joe Collier, emeritus professor of medicines policy at St George’s, University of London and an adviser to the select committee on health’s inquiry into the pharmaceutical industry, said there were already safeguards in Nice to propel medicines that are truly innovative and needed into the NHS rapidly, and a fast-track proposal was not needed. “It should not need to embarrass the current arrangements. If it either is designed to, or it does, then the system has got to be rethought,” he said.

“If it is an attempt to undermine the Nice process or throw the Nice process, then it is misguided and mischievous.”

While the scheme is the brainchild of Drayson’s office, the implications for the Department of Health have led to cross-departmental negotiations, which were still going on at a late stage this week.

Crucial to winning the support of health ministers and primary care trusts‚ which foot drugs bills locally‚ has been the Treasury, which agreed to fund a pot of money to pay for “innovative” drugs, so the NHS does not have to bear the cost.

Who decides which drugs are sufficiently innovative may be more difficult. It is likely that Nice itself will be invited to help select them. Those that are original and claim to offer better treatment or a longer life – but to small groups of patients – will be prime candidates. One of the arguments for this approach is the invention of “targeted” drugs such as Herceptin, which work on people with a certain genetic make-up but not others.

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Swine flu plan to ditch doctors’ notes

July 10th, 2009 | No Comments

Government says contingency plan to extend self-certification for limited period will only be implemented ‘if absolutely needed’

Anyone infected with swine flu could stay off work for 14 days without a doctor’s note, under government plans to deal with the pandemic.

Employees can currently be off for seven days, including weekends and bank holidays, without needing a sick note from their GP.

A spokesman for the Department for Work and Pensions said: “The government is rightly considering possible measures to minimise the risk of further spread of swine-flu and protect public health.

“We don’t want people to feel obliged to leave the home or return to work when they are still unwell or put an unnecessary burden on GPs in a pandemic. Contingency plans therefore include the possibility of extending self-certification to 14 days for a limited period.”

He said the measures would “only be implemented if absolutely needed”, and the decision would be taken by the government’s civil contingencies committee.

Professor Sayeed Khan, chief medical adviser at the manufacturers’ body EEF, said: “We are going to have GPs – quite rightly – dealing with more serious cases. The advice is not to visit your GP if you get swine flu.

“Being realistic, there will be some people who think ‘I’ve got a bit of a cold’ or ‘I’m not that bad’ and will stay off work. There’s nothing you can do to fix that. Employers can rely on the good morals of their employees and say ‘don’t abuse it’. They can say they will take tough measures against anyone found abusing it, but that’s about all they can do.”

The move follows the government’s chief medical officer announcement yesterday that the number of deaths from swine flu had risen to 14, with the infection reaching epidemic levels in the worst-hit parts of the country, such as London and the west Midlands.

The Health Protection Agency revealed a snapshot of the numbers going to hospital in a serious condition. Yesterday, 335 people were being treated, 43 of whom were in critical care. Sixty of those in hospital were under five years old, 47 were aged five to 15, 189 were 16-64 and only 39 were over 65.

Exact figures for the numbers of people diagnosed as having swine flu are no longer being given, because of the large numbers infected. Sir Liam Donaldson, the chief medical officer, said about 27,000 people had consulted a GP with symptoms in the last week, but the HPA said its sampling showed that only about 28% – 8,000 or so people – of those had a flu-like illness.

The government’s national framework for dealing with a flu pandemic estimates that up to 50% of the workforce may require time off at some stage, “with individuals absent for a period of seven to 10 working days”. Staff may also need time off to care for family members with swine flu and some may suffer “other psychosocial impacts, fear of infection and/or practical difficulties in getting to work,” the plan says.

Small firms, with five to 15 staff, or small teams within a larger organisation are likely to suffer more, with a higher proportion of staff absence. This could mean up to 35% of their workforce off over a two or three-week period at the peak of a pandemic.

Neil Carberry, head of employment policy at the CBI, said it was likely that temporary changes to sick leave policy would have to be taken.

“Employers need to be thinking through their business resilience plans in the face of threat of pandemic. The impact of a pandemic outbreak is going to be the significant threat to employers, not necessarily some of the temporary measures,” he said.

The plans were revealed as it emerged that some senior NHS managers had criticised the government’s pandemic flu strategy as muddled and contradictory. Health trust chiefs also claimed that the introduction of vouchers for Tamiflu would hamper the rapid distribution of antiviral drugs, according to the Times.

A memo obtained by the paper sent by an NHS trust executive responsible for emergency planning to other senior NHS staff described some measures to distribute drugs and relieve pressure on hospitals and GPs as “a complete waste of time”.

Ian Dalton, the government’s national director of flu resilience, said the NHS was “coping very well with the challenges” posed by swine flu.

“However, now that we have moved into the treatment phase, further clear guidance has been provided to the NHS on its roles and responsibilities,” he said. “Although this is being centrally led, the local NHS clearly must ensure that these plans are implemented in a way that meets local needs.”

The UK’s swine flu case total is the third highest in the world after Mexico, where the bug was first identified, and the US. There are 9,718 confirmed cases of swine flu in the UK. Mexico has 10,262 cases of the disease, with 33,902 in the US.

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Children dead as swine flu toll rises

July 6th, 2009 | No Comments

• Man and child from Yorkshire, child from London killed
• All victims had serious underlying health problems

Three more people, two of them children, have died of swine flu, it was announced today, taking the death toll in the UK to seven.

One of the children, a nine year-old from south London, died at the weekend. The family asked for their privacy to be respected and would not allow any information about the child’s health problems to be divulged.

The other two were a man and a child from the Kirklees area of West Yorkshire. All three victims had serious underlying health problems, according to local NHS officials.

Three children have now died. The first, Sameerah Ahmad in Birmingham, was six and suffered from a rare life-threatening disease which impaired her immune system and made her vulnerable to infections. Only one victim so far has been elderly – a 73-year-old man in Scotland. The others were a 19-year-old and a 38-year-old woman, who had recently given birth. All five had serious underlying health problems, according to NHS officials.

The virus is more likely to affect younger people than older. The chief medical officer, Sir Liam Donaldson, has said that the flu strain was part animal, part bird and part human and that the human element had been in circulation in the past, with the result that the immune systems of some of the older generation have some protective “memory” of it.

So far, more than 7,500 people have been diagnosed with swine flu in the UK, although the numbers are now rising so rapidly that the Health Protection Agency is no longer providing them on a daily basis. London, the West Midlands and Scotland have been worst hit so far.

The worldwide figures as of yesterday were 94,512 cases and 429 deaths, according to the World Health Organisation. Many more people will have been infected but will not be reported, because they have not seen a doctor.

The increased vulnerability of younger people could mean that they will be prioritised when the vaccine against swine flu becomes available, which should be by the end of August. Although the government has signed a contract for enough doses for the entire population, they will arrive in batches.

Most cases of swine flu have been and continue to be mild, except in those children and adults with existing serious health problems. However, there have been cases of severe illness involving hospitalisation and even death in some apparently previously healthy people in other countries. For that reason, everybody who falls ill and is diagnosed with swine flu in the UK will continue to be given antiviral drugs, the government said last week, rather than allowing the illness to take its course.

As of last week, however, when the government abandoned its containment strategy; people who fall ill are urged not to go to their doctor or to hospital accident and emergency departments. Instead, they are asked to check their symptoms online at www.nhs.uk or call the swine flu information line, on 0800 1 513 513. If they need drugs, a prescription will be issued for a healthy friend to collect.

Last week the health secretary, Andy Burnham, said contingency planners had estimated the number of new cases could hit 100,000 a day by the end of August. The public health strategy is now to treat those affected rather than attempt to stop the spread. Schools, for instance, will only be closed if too many teachers are off sick to keep classes going.

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Nine-year-old dies of swine flu

July 6th, 2009 | No Comments

• All victims had serious underlying health problems
• Virus more likely to affect younger people

A second child has died from swine flu, it was announced today, bringing the death toll so far to five.

The latest victim, from south London, was nine years old. The other child to die, Sameerah Ahmad in Birmingham, was reportedly six. Only one victim has been elderly so far – a 73-year-old man in Scotland. The others were a 19-year-old teenager and a 38-year-old woman. All five had serious underlying health problems, according to NHS officials.

The virus is more likely to affect younger people than older. Chief medical officer Sir Liam Donaldson has said that one element of the strain had been in circulation in the past, with the result that the immune systems of the older generation have some protective “memory” of it.

There are almost 2,000 cases of swine flu in London, the second most affected area in the UK after the West Midlands. Last week there were warnings that the number of cases of swine flu could soar to 100,000 a day by the end of next month. Health chiefs said the UK had moved past the stage of containing the outbreak and into the “treatment phase”.

A spokesman for NHS London said the latest fatality happened over the weekend, and said the family did not wish more details to be be released.

He added: “Once again we wish to take this opportunity to remind the public that for most people this is a minor illness and that they should start to feel better after a few days without needing to go to their GP or A&E.

“However, some people may be more susceptible to the virus. If you have flu-like symptoms it’s important that you talk to your doctor if you are pregnant, very young, over-65 or have long-term conditions such as asthma or diabetes.”

He said NHS London was running a series of newspaper and radio adverts to provide advice about swine flu.

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Pay squeeze for public sector workers

July 6th, 2009 | No Comments

A tight squeeze on the pay of 6 million public sector workers, and a further public sector efficiency drive this summer, was signalled today by Alistair Darling as he warned he was determined to tackle ballooning public sector debt.

The chancellor’s remarks indicate the government may be willing to take the controversial step of reopening multi-year deals with teachers and health workers. Darling’s comments also appeared to run counter to the broad strategy run by Gordon Brown that the electorate faces a choice next year between Labour investment and Tory cuts.

The chancellor, in an interview with Sky News, revealed he would be setting out his thoughts on public pay policy “over the next few weeks”. But he pointedly said: “Public sector pay has obviously got to reflect prevailing conditions and in particular inflation has come way down.” He added: “We have got to be fair with regard to people who work in the private sector,” a reference to the fact that its pay has been hit harder in the recession. Average earnings in the public sector for the three months to March 2009 (including bonuses) stood at +3.6%, compared to -1.2% in the private sector.

Darling was speaking against the backdrop of a call by the chairman of the Audit Commission, Steve Bundred, for a freeze in public sector pay. He wrote in the Observer that it could provide £5bn of the £50bn that would have to be found through tax rises or spending cuts.

Darling refused to be as specific, but pointedly declined to propose the kind of binary choice between Labour spending and Tory cuts proposed by Brown.

Brown’s strategy has been creating tensions within the cabinet, with some ministers blaming the increasingly influential Northern Ireland secretary Shaun Woodward for what they regard as daft political advice.

Darling put the emphasis on the pain ahead, saying overall public spending totals after 2010-11 will have to be much tighter. At present, year on year or current spending is due to rise by 0.7% per year from 2010-11, with total spending, including capital spending, due to fall.

Darling also said the slowdown in the economy has been deeper than he had predicted at the time of the spring budget. Over the summer he promised to “rigorously examine each budget”, and will give fresh public spending predictions in the pre-budget report in autumn.

Darling’s relative candour came as the former defence secretary, John Hutton, also urged the leadership to be straight on the size of the deficit. Hutton told the BBC: “I don’t think you can go on saying we can continue to spend as if nothing has happened in the last year or so. Politicians have got to …be clear with people about what’s happening.” Some of the government’s immediate options to rein in public sector pay look limited in that two of the biggest groups – health workers and teachers – are in the middle of three-year deals not due to end until 2011. They were negotiated when inflation was projected to be much higher than the current 1%.

Teachers’ employers have said they will decide in the next few weeks whether to ask the government to review the 2.3% offer due in September and in 2010.

Similarly in the autumn, the NHS pay review body will decide whether the final year of a three-year deal, covering 2008-09 to 2010-11 and worth 2.7% a year, will be honoured. Pay makes up more than 40% of the health budget, and the pay deal covers more than 1.3 million staff.

In local government, the unions are still seeking an improvement on a 0.5% offer that was due in April. Dave Prentis, general secretary of Unison, said: “Freezing public sector pay during a recession is not the way to steer people through it.”

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Public warned off web swine flu drugs

July 3rd, 2009 | No Comments

Fourth death in UK as chief medical officer says Britain has enough Tamiflu and online pills may be counterfeit

The government’s chief medical officer has warned the public against panic-buying swine flu drugs online after it was revealed that the number of new cases of the virus could reach 100,000 per day.

Professor Sir Liam Donaldson said Britain had a large stockpile of Tamiflu, the antiviral drug used to combat infection with the H1N1 virus, and there was no need for people to buy what were likely to be counterfeit medicines on the internet.

His comments came as a 19-year-old man was confirmed today as the fourth person with swine flu to die in the UK. The teenager from south London, who had other serious health problems, tested positive for the virus after his death on Wednesday.

The health secretary, Andy Burnham, yesterday told MPs the spread of swine flu in the UK could no longer be contained.

He said predictions showed the figure of up to 100,000 new cases diagnosed every day could be reached by the end of next month.

In a Commons statement yesterday, Burnham said the country had moved into the “treatment phase” of its response to the flu pandemic.

No more schools will be closed unless forced to by a lack of staff or if pupils are especially vulnerable.

Families and others in contact with infected people will not be given preventative antiviral drugs – a move some doctors predict could push people to go to internet pharmacies.

Donaldson told GMTV there was considerable concern that people might buy counterfeit drugs.

“People shouldn’t buy Tamiflu from the internet,” he said. “We have got a massive stockpile in this country, and everybody can have access to it through the National Health Service.”

The Royal Pharmaceutical Society’s director of policy, David Pruce, said most Tamiflu for sale online was probably fake because no legitimate online pharmacy would sell it.

“These sites could be based anywhere in the world,” he told BBC Radio 4′s Today programme. “They could be selling anything from sugar to rat poison.

“Counterfeiters are very good at producing goods that look like the genuine article. When it’s counterfeit medicines and you’ve got really no idea what’s in the tablet or the capsule, you’re taking your life in your hands.”

Pruce added that while people could get a private prescription for Tamiflu from their GP, there was no point in taking the drug unless they had symptoms.

There are now 7,447 diagnosed cases in the UK, but the number is doubling every week.

People who think they may have flu are advised to go online and check their symptoms on the NHS website or call the swine flu information line on 0800 1 513 513.

Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone.

If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.

The first doses of swine flu vaccine will arrive in the UK in August. Although the government has ordered enough for the entire population, it will arrive in batches.

At-risk groups – especially those vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma – would get it first.

The shift in the government’s swine flu strategy came as the World Health Organisation warned that the spread of swine flu was now “unstoppable”, with a total of 112 countries reporting nearly 77,201 infected people and 332 deaths since April.

Dr Margaret Chan, the WHO director general, told an international conference on swine flu in Mexico: “With well over 100 countries reporting cases, once a fully fit pandemic virus emerges its further international spread is unstoppable.”

Chan said there was “good reason to believe” the swine flu pandemic would be “of moderate severity, at least in its early days”.

But she said that while most deaths had so far occurred in people with serious underlying medical conditions, there were a few exceptions that raised alarm.

“For reasons that are poorly understood, some deaths are occurring in perfectly healthy young people,” she said.

“Moreover, some patients experience a very rapid clinical deterioration, leading to severe, life-threatening viral pneumonia that requires mechanical ventilation.”

So far, the fatality rate appears to be low. In the UK only four people have died. All had significant underlying health problems.

Jacqui Fleming, 38, of Glasgow, was the first person in the UK to die after contracting the virus. Fleming died last month, two weeks after her son, Jack, was born 11 weeks prematurely. The boy died later but had not contracted the virus.

The second victim was a 73-year-old man from the Inverclyde area of Scotland. Then a week ago today six-year-old Sameerah Ahmad, who was born with a rare life-threatening disease, became the youngest UK victim to date.

Health experts believe more people have caught swine flu but have shown no symptoms.

In the US the official figures show 27,725 Americans have contracted H1N1, with 127 deaths.

The Centres for Disease Control and Prevention, in Atlanta, estimate that one million Americans may have caught swine flu but not been to a doctor, suggesting fatality rates are as low as 0.012%, Burns said.

The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide only 328 people had died – a fatality rate of 0.47%.

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Swine flu ‘can no longer be contained’

July 2nd, 2009 | No Comments

More than 100,000 people could be diagnosed with swine flu every day by the end of August, the government said, announcing that the disease can no longer be contained in the UK.

A Commons statement by the health secretary, Andy Burnham, marks a watershed in the spread of the flu. No more schools will be closed, unless forced to by the lack of staff or if the pupils are especially vulnerable. Families and people in contact with those with flu will not be given preventative antiviral drugs.

The new policy of treatment for those with diagnosed illness, rather than containment, has already begun in the hotspots – chiefly London, Birmingham and Scotland.

The change of tactic is the predicted response to the swelling number of people infected. There are now 7,447 diagnosed cases in the UK, but the number is doubling every week. If they continue in this way, said Burnham in his statement, “we could see over 100,000 cases per day by the end of August”. He later stressed that the figure “is a projection. It is not a fact. This is how the disease could develop and we don’t know.”

Those sorts of numbers would put a heavy burden on the NHS, which is already feeling the strain in some areas. The new strategy will help keep those with possible symptoms out of GP surgeries.

People who think they may have flu are now being advised to go online and check their symptoms on the NHS website or call the swine flu information line, on 0800 1 513 513. Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone. If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.

But health officials in Scotland doubt the virus will spread dramatically across the UK, as it seems to have peaked in Scotland, which saw the first big outbreaks, and the first two deaths in Europe.

The rapid spread of the virus has slowed down in Paisley, which suffered the second largest outbreak, and it has disappeared in Dunoon, where a coachload of football fans were infected. In Glasgow, until recently the worst affected area of the UK, infection rates have stabilised. After infection rates peaked at 111 confirmed cases on 25 June, the rate in Scotland has remained steady at an average of about 60 new cases a day over the last week. There is no evidence that infection rates in Scotland, where the virus first arrived in late April, were doubling.

Dr Harry Burns, Scotland’s chief medical officer, said he was “now optimistic that sometime over the next few weeks, the rate of transmission will begin to slow down” [in Scotland].

It was entirely possible, he added, that the outbreaks elsewhere in the UK would also slow down in a matter of weeks.

The fatality rate also appears to be low. In the UK, only three people – all with significant underlying health problems – have died out of 7,447 confirmed cases. Health experts believe more people have caught swine flu but shown no symptoms.

In the United States, the official figures show 27,725 Americans have contracted H1N1, with 127 deaths. The Centres for Disease Control and Prevention, in Atlanta, estimates that a million Americans may have caught swine flu but not been to a doctor, suggesting that fatality rates are as low as 0.012%, Burns said.

The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide, only 328 people had died – a fatality rate of 0.47%.

However, Sir Liam Donaldson, the chief medical officer, said that it was not yet possible to work out the death rate from the virus, “given the unreliability of the data”, but that it would become clearer in the coming months.

The first batches of vaccine will arrive in August.

Although the UK has ordered enough for the entire population, it will arrive in batches. At-risk groups would get it first, said Donaldson: those especially vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma.

New flu strains cannot be eradicated. They simply become part of the seasonal flu mix. Donaldson said that swine flu could continue to cause extra deaths for five years. “We will need the vaccine in years to come,” he said.

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Swine flu ‘can no longer be contained’

July 2nd, 2009 | No Comments

More than 100,000 people could be diagnosed with swine flu every day by the end of August, the government said, announcing that the disease can no longer be contained in the UK.

A Commons statement by the health secretary, Andy Burnham, marks a watershed in the spread of the flu. No more schools will be closed, unless forced to by the lack of staff or if the pupils are especially vulnerable. Families and people in contact with those with flu will not be given preventative antiviral drugs.

The new policy of treatment for those with diagnosed illness, rather than containment, has already begun in the hotspots – chiefly London, Birmingham and Scotland.

The change of tactic is the predicted response to the swelling number of people infected. There are now 7,447 diagnosed cases in the UK, but the number is doubling every week. If they continue in this way, said Burnham in his statement, “we could see over 100,000 cases per day by the end of August”. He later stressed that the figure “is a projection. It is not a fact. This is how the disease could develop and we don’t know.”

Those sorts of numbers would put a heavy burden on the NHS, which is already feeling the strain in some areas. The new strategy will help keep those with possible symptoms out of GP surgeries.

People who think they may have flu are now being advised to go online and check their symptoms on the NHS website or call the swine flu information line, on 0800 1 513 513. Anyone still concerned after that should phone their GP, who can provide a diagnosis over the phone. If swine flu is confirmed, they will be issued with an authorisation voucher, which a “flu friend” can take to an antiviral drug collection point, which may be a pharmacy or a health centre.

But health officials in Scotland doubt the virus will spread dramatically across the UK, as it seems to have peaked in Scotland, which saw the first big outbreaks, and the first two deaths in Europe.

The rapid spread of the virus has slowed down in Paisley, which suffered the second largest outbreak, and it has disappeared in Dunoon, where a coachload of football fans were infected. In Glasgow, until recently the worst affected area of the UK, infection rates have stabilised. After infection rates peaked at 111 confirmed cases on 25 June, the rate in Scotland has remained steady at an average of about 60 new cases a day over the last week. There is no evidence that infection rates in Scotland, where the virus first arrived in late April, were doubling.

Dr Harry Burns, Scotland’s chief medical officer, said he was “now optimistic that sometime over the next few weeks, the rate of transmission will begin to slow down” [in Scotland].

It was entirely possible, he added, that the outbreaks elsewhere in the UK would also slow down in a matter of weeks.

The fatality rate also appears to be low. In the UK, only three people – all with significant underlying health problems – have died out of 7,447 confirmed cases. Health experts believe more people have caught swine flu but shown no symptoms.

In the United States, the official figures show 27,725 Americans have contracted H1N1, with 127 deaths. The Centres for Disease Control and Prevention, in Atlanta, estimates that a million Americans may have caught swine flu but not been to a doctor, suggesting that fatality rates are as low as 0.012%, Burns said.

The European Centre for Disease Prevention and Control reported on Thursday that of 69,177 cases which had been detected worldwide, only 328 people had died – a fatality rate of 0.47%.

However, Sir Liam Donaldson, the chief medical officer, said that it was not yet possible to work out the death rate from the virus, “given the unreliability of the data”, but that it would become clearer in the coming months.

The first batches of vaccine will arrive in August.

Although the UK has ordered enough for the entire population, it will arrive in batches. At-risk groups would get it first, said Donaldson: those especially vulnerable because of diseases which have compromised their immune systems or affect their breathing, such as asthma.

New flu strains cannot be eradicated. They simply become part of the seasonal flu mix. Donaldson said that swine flu could continue to cause extra deaths for five years. “We will need the vaccine in years to come,” he said.

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UK braced for heatwave’s stormy end

July 2nd, 2009 | No Comments

Thunder, downpours and flooding from Scotland to Cornwall as temperatures ease

The heatwave that has swept much of the country came to an abrupt end in some areas today, with torrential downpours in some places while the south-east continued to swelter in above-average temperatures.

There was a clear north-south divide as Londoners experienced one of the hottest day of the year so far, while other parts of the country saw torrential storms and experienced some local flooding.

After one of the hottest weeks in years, north-east England was hit by thunderstorms with the Environment Agency warning that south Wales and south-west England would also get wet weather.

A spokesman for the agency said though flash flooding had been expected in the south-west, the rainfall had been less heavy, and flood warnings were lifted across the UK. There was some flooding in Truro due to overflowing drains, but rivers had not burst their banks.

The Met Office continued to warn of high temperatures in other areas of the country today, but said they were beginning to fall today.

Nigel Bolton, a forecaster at the Met Office, said that temperatures would remain well above average in the south-east before dropping again at the weekend.

“The average temperature for this time of year is about 23C, though we are unlikely to see record temperatures, which reached 36C in both 1976 and 2003.” The country remained at heatwave level three.

The west of the country saw very different weather, however. There were scattered heavy thunderstorms in the south-west, Wales, parts of Ireland and central and western Scotland with some localised torrential downpours, with up to 25-30mm of rainfall in an hour and hail in some places, he said. Footage on YouTube revealed that Dublin had also had heavy downpours leading to flooding.

Wet weather affected the north-east; police closed the A68 after a storm near Consett, County Durham, caused the collapse of an old railway bridge in Rowley.

The heatwave was likely to continue tomorrowin the rest of the country, but temperatures would begin to drop to around 26-28C in the south-east.

“For most there will be a sense of relief from the heat and into the weekend, with temperatures down to more pleasant levels,” said Bolton.

The weekend would see a more typical mix of British weather, he added, with sunshine and showers, some heavy, and temperatures continuing to ease.

Central, southern and south-eastern areas are likely to see temperatures of around 24-25C, the south-west around 19-20C, while Wales and the north-west could expect temperatures of around 17-18C by Sunday.

This weather spell has been the hottest since July 2006, with yesterday being the hottest day of the year so far, reaching 31.8C.

The government heatwave plan alert has four stages, with green, or level one, signalling “summer preparedness and long-term planning”. Level two is amber and signals “alert and readiness”, while three is red for “heatwave action”, and four is classed as “red emergency”.

The London ambulance service, which fielded 4,754 calls yesterday , signalling a 23% increase on the same day last week, said it had treated a large number of patients for breathing problems, chest pains and loss of consciousness, and urged people to call for an ambulance only in a genuine emergency.

Despite the warnings, the heatwave has led to casualties. West Yorkshire police were called to Widdop reservoir, near Hebden Bridge, yesterday, after a teenager disappeared while swimming with friends. Police divers were called and a body was found after a four-hour search. The teenager has not been named but is understood to be from London.

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Burnham to alter swine flu approach

July 2nd, 2009 | No Comments

Health secretary Andy Burnham to make Commons statement on changes to way outbreaks are managed

The government is due to announce a major change in its handling of swine flu outbreaks today, with the daily recording and reporting of cases expected to be abandoned because of the increasingly rapid spread of the virus.

The health secretary, Andy Burnham, is due to make a statement on swine flu in the House of Commons just after midday. With the number of cases confirmed by laboratory tests set to exceed 7,000 today, it is likely that the policy of trying to contain the H1N1 virus may be abandoned in favour of “outbreak management”.

In swine flu hotspots such as London, the West Midlands and parts of Scotland, which have already moved to the outbreak management phase, diagnosis of the virus is now being done by doctors rather than laboratory testing and tracing the contacts of people with swine flu and the preventative use of anti-viral drugs has stopped. Anti-viral drugs are still being offered to all people with symptoms.

Collating daily figures is proving time consuming but the government and other agencies recognise they still need other ways of regularly informing the public.

Other countries already update their swine flu numbers less frequently, for instance, weekly or every other day. Among the options being considered by the government is weekly updates on the spread of the disease, with cases reported as a number per 100,000 of the UK population. This is how traditional flu cases are reported each winter, and with the NHS preparing for tens of thousands of swine flu cases a week by the end of this year, a similar system would be understood by public health experts.

The Health Protection Agency yesterday announced another 342 patients in England have been confirmed with swine flu, while the figure for the UK as a whole rose to 6,929.

The official statistics on the virus are likely to underestimate the true scale of infection in the UK because only a sample of patients in the hotspots now have a diagnosis of swine flu confirmed by lab tests. Furthermore many people are thought to have such mild symptoms they are not even bothering to contact their doctors and others are being treated in surgeries without being regarded as suspected swine flu cases.

Although a bout of swine flu is currently causing less serious illness than traditional seasonal flu, three people with other serious health conditions in the UK have died after catching the virus and there are concerns that it could mutate into a more virulent form.

The chief medical officer, Sir Liam Donaldson, has already warned that there may be tens of thousands of cases each week this autumn, because the virus is more likely to thrive in a colder climate.

Meanwhile, senior doctors have warned parents not to take their children to “swine flu parties” in the hope that they catch the disease now and build up immunity.

Although no firm evidence has emerged that these are taking place, the family website mumsnet.com has seen discussions between parents on whether they should deliberately expose their offspring to the virus in the same way that chickenpox parties are sometimes arranged to allow friends to have the once-only disease at a convenient time.

Richard Jarvis, of the British Medical Association’s public health committee, said: “I think parents would want to take into account that the flu – although this strain is relatively mild for the most part – is something that will knock people off their feet for a few days and we are seeing appreciable morbidity, severe side-effects and sadly the occasional death.”

Scientists have found the first case of the new H1N1 influenza strain showing resistance to Tamiflu, the main anti-viral flu drug, Danish officials and the manufacturer said yesterday. It was expected that the strain would at some point show resistance to Tamiflu, Denmark’s State Serum Institute said. The patient is now well and no further infection with the resistant virus had been detected.

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It’s official: the heatwave is on

July 1st, 2009 | No Comments

• Met Office triggers measures to help vulnerable and elderly
• Tomorrow could be hottest before weather cools at weekend

A heatwave has been declared in Britain, with temperatures in southern England expected to have hit a sweltering 32C (89.6F) – even hotter than yesterday.

The Met Office raised its heatwave plan to level three, or amber alert, in London and south-east England, triggering measures designed to help safeguard the welfare of thousands of elderly and other vulnerable people at risk from heat-related conditions.

Yesterday was the hottest day of the year to date, with temperatures reaching 31.8C (89.24F) in Wisley, Surrey, as June became the hottest month in three years.

The chief forecaster at the Met Office, Eddy Carroll, said: “Temperatures are likely to peak today and tomorrow, reaching 32C before becoming less hot by the weekend as noticeably fresher conditions with the risk of showers push east across the country.”

The Department of Health warned that temperatures could be higher tomorrow, touching 33C (91.4F), and advised people with respiratory problems to stay inside during the hottest parts of the day.

A heatwave is officially declared when the Met Office confirms that the threshold of an average temperature of 30C by day and 15C overnight for one or more regions has been met and there is a 90% risk that the daytime threshold temperature will be met the following day.

Parts of England have seen temperatures climb to highs of around 31C by day and in some areas they have not fallen below 18C at night.

The head of health forecasting at the Met Office, Wayne Elliott, said: “There are four key things to try to remember during a heatwave. If possible stay out of the heat during the middle part of the day; cool yourself down; keep your environment cool; and look out for others, especially older people, those living alone and babies and young children.”

Yvonne Doyle, the director of public health in south-east England, said: “Everyone’s health can be affected by the heat, with greater risks of dehydration, sunburn, heat exhaustion and heatstroke. Those most at risk are the very young and the very old, and people who already have health conditions, especially heart and respiratory problems – the heat can make their symptoms worse.”

Temperatures in the capital have been higher than in Bangkok this week, and Trafalgar Square’s fountains turned green as algae spread.

There is an 80% risk of heatwave conditions in the East and West Midlands and a 70% chance in eastern England. Temperatures are cooler in the north of England, where the chance of heatwave conditions is just 40%. The areas least at risk are Wales, where there is a 20% risk, and south-west England, where there is only a 10% chance of heatwave conditions.

Only extreme coastal areas, Northern Ireland and the west coast of Scotland, where temperatures were hitting a more moderate 20C (68F), escaped today’s heat, said a Met Office spokeswoman. Average temperatures for the time of year, which normally hit about 20C, were being surpassed, with most places recording more than 25C (77F), she said.

The weather has prompted the government to set up a heatwave advice page on its Directgov website, while the NHS Direct helpline has received hundreds of calls from patients suffering symptoms related to the heat.

The London ambulance service said it been treating large numbers of patients for breathing problems, chest pains, loss of consciousness and fainting. The service received 4,765 calls yesterday – an increase of 21% on the previous Tuesday – and urged people to call only in a genuine emergency.

Staff should be encouraged to wear shorts during the sweltering heat to make work more bearable and prevent them “collapsing” at their desks, the TUC urged. The weather has sent sales of electrical fans and ice cream soaring, according to Tesco and Sainsbury’s.

Keepers at London zoo have been feeding gorillas ice blocks, while tapirs at Port Lympne wild animal park near Ashford, Kent, were daubed with suncream by staff yesterday.

A London zoo spokeswoman said: “In this really hot weather we give the gorillas ice lollies which we make in buckets. We put fruit inside the ice lollies which they try to get out by standing on the blocks. Our gorilla group also have air conditioning inside their enclosure so they can go inside and outside into the heat as they please.”

The highest level of Britain’s heatwave plan is level 4, the red or emergency alert, which is declared when a heatwave is so severe or prolonged that the general population, and not just vulnerable groups, is at risk from heat-related conditions.

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Mercury to hit 33C as Britain bakes

June 30th, 2009 | No Comments

Social services and hospitals on alert for hot weather casualties, with no relief from heat expected until weekend

An official heatwave health warning will be issued tomorrow morning, meaning that schools, hospitals, local authorities and social services must take action to avoid casualties, unless temperatures plummet tonight.

London and much of the south-east has already sweltered through two days where temperatures topped 30C, and tonight temperatures in the low 20s are expected in many areas. The lowest temperature anywhere in the Greater London area on Monday night was 18C.

The temperature hit 31C today at Heathrow. The highest temperatures recorded so far this week were 31.4C at Wisley in Surrey, and 30.4C in St James’s Park, London, both on Monday.

The scorching end to the month made June the hottest, driest and sunniest month since July 2006. Ladbrokes has cut the odds on a record-breaking UK summer from 9-2 to 4-1.

According to climatologist Philip Eden, England and Wales had on average 222 hours of sunshine in June, 117% of the figure for 1971-2000, while rainfall was only 80% of the same period.

Already this week Tesco reports that sales of electrical fans are 20 times that of last week, and they expect to sell 100,000 before any relief from the heat is forecast at the weekend.

Tomorrow could be the hottest day of the year, with temperatures predicted to reach 33C.

The Met Office has issued a warning of heavy rain across most of Wales this evening, and advance warnings of thundery downpours in the west tomorrow which could cause localised flooding.

The hottest spell in three years is already leaving the elderly, very young, frail and those with breathing problems particularly vulnerable. Advice on health, travel, and how to manage the heat in homes, schools and workplaces is available on the government’s Directgov website, drawing together information from the Met Office, NHS, and the Highways Agency.

During record temperatures in 2003, an estimated 2,000 people died from heat-related conditions.

NHS Direct and the London ambulance service, which will bear the brunt of pressure in the capital, are gearing up for a major demand on their services.

The UK’s heatwave plan remains at level two, but the Met Office believes it will be raised to level three.

Official advice says anyone who can should stay indoors from noon to 3pm, draw curtains to shade rooms, drink plenty of water and wear sunscreen while outdoors.

Many schools are already keeping children out of playgrounds during breaktimes.

Care homes have been advised to monitor indoor temperatures four times a day, identify high-risk residents and prepare a cool room.

Officials are urging people to identify the coolest room in their home, stock up on essential supplies to cut down on shopping trips and check on neighbours, relatives and friends, especially those with mobility problems.

The Department of Health and the lifeboat service have warned people to be careful if going swimming.

A teenage boy, who has not yet been formally identified, drowned while swimming with three friends in the river Severn yesterday.

Search teams using a helicopter and boat recovered the boy’s body. He was confirmed dead on arrival at Worcestershire Royal hospital.

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NHS restrictions prompt fertility tourism boom

June 29th, 2009 | No Comments

Stringent NHS criteria for treatment force hundreds of women over the age of 40 to travel to clinics abroad, the first Europe-wide study of fertility tourism reveals

Hundreds of women over the age of 40 are travelling to fertility clinics in Europe to try to get pregnant because NHS clinics in the UK will not take them, the first-ever Europe-wide study of fertility tourism shows.

The research shows considerable movement across Europe, with women seeking out procedures that are banned in their own country. Italian women are crossing the border in droves following tough legal restrictions on IVF imposed in 2004, while large numbers of gay French women bypass a ban by seeking treatment in Belgium.

Francoise Shenfield from University College hospital in London, who co-ordinated the study, said at the European Society for Human Reproduction and Embryology (ESHRE) conference in Amsterdam that it appeared at least 20,000 to 25,000 cross-border fertility treatments were carried out each year. While one woman might have more than one treatment, there are still many thousands seeking help to get pregnancy abroad.

Hundreds are thought to be travelling from the UK every month. The most popular destinations for UK women are the Czech Republic and Spain, the top locations for obtaining donated eggs. As women get older, their eggs are fewer, and less likely to fertilise and implant in the womb. Donated eggs can be their only chance, but they are in short supply in the UK, where the rules say donors can only be given expenses up to £250. A further disincentive has been the rule change to help a child discover the identity of the donor when he or she is 18.

In Spain, by contrast, the ceiling on compensation is 900 euros and in the Czech Republic women receive 500 euros. Of the women in the study leaving the UK for treatment, 53% went to the Czech Republic and 28% went to Spain.

Dr Shenfield said that, although the UK had some of the most liberal fertility laws in Europe, there were “all kinds of barriers” to treatment on the NHS, including age and waiting lists. Private treatment is very expensive. “They might find it is cheaper to go somewhere else,” she said. “London is still one of the most expensive capitals in the whole of Europe.”

Infertility Network UK confirmed that many couples consider travelling because they cannot get help at home. An online survey of over 300 patients last year found that 76% would consider going abroad. The vast majority of those who went (88%) were happy with their treatment. Chief executive Clare Lewis-Jones said many patients could not get NHS care because they did not fit the “extremely tight access criteria applied by many of the PCTs”.

Couples are finding clinics in Europe on the internet and even in adverts in airline magazines, she said. “I don’t think it is stoppable. There is no ethical reason why it should be stopped, because it enhances the autonomy of patients. But we must concentrate on the information and make it even safer for our patients,” she said.

One of her concerns was that women would have several embryos transferred in a European clinic, where in the UK the move is to have just one. Multiple pregnancies are riskier, especially for the babies who may be premature and need intensive care. “We know that women will come back with problems,” she said.

The willingness of women to donate their eggs in countries with higher levels of compensation payments was a very important ethical issue, she added. “Young women may not be well enough counselled about what it means to donate eggs,” she said. “The risks are very little but there is the psychology of it all – realising 10 years later when one is a bit more mature what it means to give some of your genetic input, whether you are a man or a woman.”

The study was carried out in six countries during the course of one month – Belgium, the Czech Republic, Denmark, Slovenia, Spain and Switzerland – where foreign patients in fertility clinics were given questionnaires about their trip. A total of 1,230 forms were completed. The biggest proportions were from Italy (31.8%), Germany (14.4%), the Netherlands (12.1%) and France (8.7%).

Most travelled to bypass legal restrictions, but 34% of those from the UK said they went abroad because of difficulties of access to treatment. The average age was over 37 but 63.5% of the British patients were over 40.

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Public want NHS protected from funding cuts

June 29th, 2009 | No Comments

Sacrifice other departments instead of the NHS, say three out of four people in British Medical Association poll

More than three-quarters of the public – 77% – believe NHS funding should be protected in the face of future spending cuts, an opinion poll has found.

Other departments’ budgets should be sacrificed in order to preserve the health service, the British Medical Association survey heard. Four out of 10 people said they would be willing to pay higher taxes to sustain growth in NHS funding.

The poll questioned 1,071 people in five UK cities – London, Edinburgh, Belfast, Manchester and Cardiff – a week ago, and reflects fears that severe cutbacks are looming.

Nine out of 10 people suspect NHS services will be cut as a result of the recession, and almost as many believe waiting times for treatment will rise; 85% anticipate additional charges for NHS treatments.

The level of public support for the NHS at the expense of other departments is likely to be welcomed by the Conservative health spokesman, Andrew Lansley, who last month stirred controversy when he declared that a future Tory administration would protect the health service and target cuts elsewhere.

The poll, released on the eve of the BMA’s annual conference in Liverpool, gave conflicting evidence about privatisation. Nearly 60% said the private sector should be more involved in providing NHS services but almost half (47%) said there should be no further contracts for commercial companies.

The BMA chairman, Dr Hamish Meldrum, said: “These results show how anxious the public is about the effects of the recession on the health service, with a significant number saying taxes should increase to protect NHS funding. No one wants to see any cuts in the public sector but our poll reveals just how much society values their health service.

“Fear often goes hand in hand with economic slumps, with people worrying what will happen to them and their families in times of ill health. While we appreciate that the government needs to steer the country through this difficult economic period, we urge it not to do so at the expense of NHS funding.”

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Let doctors pray for patients, BMA to be urged

June 29th, 2009 | No Comments

British Medical Association conference to be told praying for patients should not be grounds for NHS disciplinary action

Doctors’ attempts to discuss spiritual affairs with patients or to offer prayers for them should not trigger NHS disciplinary action, the British Medical Association will be told this week.

The issue has been raised in a series of critical motions to be debated at the BMA’s conference in Liverpool during a session on medical ethics.

Concerns about what is professionally appropriate have been highlighted by the case of a nurse, Caroline Petrie from Weston-super-Mare, who was suspended after a patient complained she had offered to pray for her.

Her primary care trust later agreed she could continue to pray for patients as long as she asked them first if they had any spiritual needs.

Most of the BMA motions effectively support that position but insist spiritual discussions should not be grounds for disciplinary intervention by NHS managers.

The main motion, put forward by the BMA’s agenda committee, states that it “is concerned that … any discussion of spiritual matters with patients or colleagues could lead to disciplinary action”.

It adds: “Offering to pray for a patient should not be grounds for suspension.” Spiritual matters should be raised, it suggests, “with respect for the views and sensitivities of individuals”.

The area is currently subject to two distinct sets of guidelines, one set out by the General Medical Council (GMC) and the other by the Department of Health.

In Religion or Belief: A Practical Guide for the NHS, the department states: “Members of some religions … are expected to preach and to try to convert other people. In a workplace environment this can cause many problems, as non-religious people and those from other religions or beliefs could feel harassed and intimidated by this behaviour.

“To avoid misunderstandings and complaints, it should be made clear to everyone from the first day of training and/or employment, and regularly restated, that such behaviour, notwithstanding religious beliefs, could be construed as harassment under the disciplinary and grievance procedures.”

The GMC guidance is the one preferred in most of the motions before the BMA conference. It urges the department “to exercise some joined-up thinking so that while always respecting the views and sensitivities of others, there should be freedom of speech to have appropriate consensual discussions of spiritual matters within the NHS”.

Dr Hamish Meldrum, chairman of the BMA’s Council, said yesterday he was unaware of the issue intruding on the working lives of most doctors.

It was, he suggested, difficult to expand on the subject based on a few isolated cases. What was most important, he said, was good communication between patients and doctors.

Dr Vivienne Nathanson, director of professional activities at the BMA, said it was “hugely important that it’s done right and sensitively… [Doctors] want to know what they are allowed to do.”

A Department of Health spokesman yesterday said its document was a guide to encourage awareness for staff and patients.

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Warning of heatwave danger

June 27th, 2009 | No Comments

Met Office uses government warning system to put hospitals on standby for a rush of heatstroke cases

Hospitals were put on high alert today as the Met Office issued its first ever heatwave warning, designed to signal impending extreme weather events. Temperatures are forecast to reach 33C this week and it is thought that the UK could be placed on the highest level of the government’s Heatwave Plan by midweek, a category that denotes a state of “emergency”.

As temperatures peaked at 28C in London today the Health Protection Agency began monitoring for cases of “heat-related illness”, particularly among the elderly, and the NHS prepared for increased admissions.

The country was placed on amber level 2, the “alert and readiness” category in the Heatwave Plan, meaning there is a 60% risk of high temperatures being reached in at least one region on consecutive days and the intervening night.

Met Office experts expect level 3 to be reached early on Monday and level 4 possibly by midweek. Level 4 is the highest rung and in effect denotes a state of emergency. The government defines this as when a “heatwave is so severe and/or prolonged that its effects extend outside health and social care, such as power or water shortages, and/or where the integrity of health and social care systems is threatened”.

Met Office forecaster Tim Thorne said: “This is the first time we have released a heat warning since we introduced the system a couple of years ago. It is designed to allow the NHS to plan for increased admissions and ensure it does not buckle under the strain. They can get their plans in place and ensure they have the space and manning to deal with an increase and notify other organisations such as the military.”

Heatstroke, exhaustion and dizziness are among the risks associated with the heatwave, which will bring the hottest spell of the summer so far, say health experts.

At Wimbledon today the sunshine guaranteed brisk business as officials said the weather had helped it to record one of the busiest Saturdays most could recall. Steward Peter Wagstaffe said: “It’s not only the hottest Saturday, it’s the busiest I can remember. We had 2,200 camping here overnight. I honestly can’t recall a day like it so far.”

More than 500 people have succumbed to the hot weather at SW19 and needed treatment from the St John Ambulance in the first week of the tournament, but paramedics said the majority of today’s visitors had heeded weather advice. Darron Hazleby, silver commander with the St John Ambulance inside Wimbledon, said: “Most people are sensible enough: drink fluids, use sunscreen. I don’t think the heat will be a problem.”

However, the soaring temperatures claimed a number of victims en route to the All England Club, with reports of several passengers fainting on crowded underground trains.

For the 180,000 people at Glastonbury festival, there was continued respite from the heavy downpours on Thursday night as sunny intervals dried out the traditional mudbaths. Paul Mott, of forecaster Meteogroup, said temperatures at the festival reached 24C yesterday and said today would be “very dry and warm with some chance of showers”.

London, eastern England, the south west, the south east and the Midlands are the most likely areas to be affected, with temperatures expected to reach 30C on Monday and climbing as high as 32C by Wednesday.

Night-time temperatures could remain as high as 18C in some areas and in London fall no lower than 20C. The record for the hottest day in Britain is unlikely to be beaten, however. The temperature rose to 38.1C in Gravesend, Kent, during the summer of 2003, which inspired the introduction of the government’s Heatwave Plan.

Medical experts noted that deaths among people over 75 rose 60% during that period, with around 2,000 people dying from heat-related conditions. In the plan’s foreword, chief medical officer Sir Liam Donaldson says that the future is likely to be characterised by frequent heatwaves of similar intensity. “By the 2080s, it is predicted that an event similar to that experienced in England in 2003 will happen every year.”

The Department of Health warned that the elderly and young children are most at risk from heatstroke. “Keeping the home as cool as possible and remembering the needs of friends, relatives and neighbours who could be at risk is essential,” a statement said.

The hottest day of the year so far was recorded last Thursday at Heathrow, when the mercury reached 28C, a far cry from last year. Thorne said: “This time last year I remember going to Wales and lighting a fire.”

However, the Met Office forecasters do not envisage anything as severe as the heatwave that is causing havoc in India, where hot weather has claimed the lives of nearly 100 people and schools in Delhi are to remain shut.

Extreme conditions

August 2003
The highest temperatures ever recorded in the UK culminated in a British record of 38.1C at Gravesend, Kent. There were thousands of deaths as Europe had its hottest summer in at least 500 years.

Great storm of 1987
On the night of 15 October parts of the UK were rocked by winds of up to 115mph. The storm caused widespread devastation and killed 18 people.

Summer 1976
Otherwise known as the great drought, the heatwave began on 23 June and for the next fortnight temperatures reached 32C in southern England.

Summer 1903
The wettest summer on record. In mid-June it rained without interruption for more than 58 hours. Fields were flooded, hay and fruit rotted, and cattle and sheep drowned.

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