ILL-trained doctors pose risk to patients
Patients are being put at risk by a generation of inadequate doctors, a leading professional body has warned. Research has found that young doctors are being forced to neglect training to “plug gaps” in understaffed wards.
A scathing report by The Royal College of Physicians of Edinburgh (RCPE) has called for an urgent overhaul of the way junior doctors are trained, claiming the current generation could “seriously undermine patient safety”. It says that there are not enough doctors to safely staff rotas, leading to “near misses” as inexperienced doctors work unsupervised.
The RCPE also claims that consultants are struggling to properly supervise junior doctors because of their huge workloads, while EU working time regulations have cut down on the hours they are allowed to spend on training. It recommends a series of measures including guaranteeing protected training time for trainee doctors and supervising consultants.
Dr Kerri Baker, Chair of the RCPE Trainees and Members' Committee, said: “Trainee doctors report feeling disillusioned and let down by their training experience in the NHS. Many believe they are gaining insufficient training to enable them to function safely and efficiently as the consultants of the future.”
Dr Robert Cumming, chairman of the Scottish Health Campaigns Network, himself a former consultant, said: “I think there's no question about the fact that the training of junior staff in particular has worsened from the days I was a consultant. “I think nowadays there is a loss of the team system that used to exist. They don't have the same loyalty and a sense of belonging.
“I feel very sorry for the trainees. It's not their fault. “It's the system that requires a real revolution to look at it again.”
A recent Academy of Medical Royal Colleges survey found that only 42 per cent of trainees believed they would be adequately trained to become consultants by the end of the process. Whilst training remains a reserved issue under the control of the UK Government, the four Departments of Health in Scotland , England , Northern Ireland and Wales are responsible for overseeing training programmes.
An SNP spokeswoman said that the over the past four years, the number of consultants employed by NHS Scotland had risen by 21 per cent.
She added: “The SNP is determined to protect investment in the NHS with real terms increases in NHS resources of £1billion in the next Parliament and to ensure that we continue investing in staff training to the highest standards.” 30.3.11
NHS trusts ''fail to get value for money''
Value for money is not being achieved by NHS trusts in England in the planning, procurement and use of 'high value equipment', such as CT, MRI scanners and linear accelerator machines, the National Audit Office (NAO) has said. The NHS simply does not have the information it needs to achieve cost-effective procurement and sustainable maintenance of this equipment.
Also, there are "significant variations" across the country in levels of activity and a lack of comparable information about performance and cost of machine use.
Around half of this equipment is due to be replaced in the next three years and this could cost around £460m. But the NAO said that trusts were not collaborating when they buy machines and would be unlikely to get the best prices. About 25 per cent of purchases in 2009/10 were made outside existing framework agreements and opportunities were missed to secure lower prices by grouping together requirements for new machines.
NAO head Amyas Morse said: "This is a challenge requiring planning by individual trusts since there is no longer a centrally funded programme. Turning to efficient management of this equipment, trusts across the NHS lack the information and benchmarking data required to secure cost efficient procurement and sustainable maintenance of these key elements in modern diagnosis and treatment." 30.3.11
NHS accused of bias against private care
Evidence is emerging that nearly half of health managers are rebelling against plans to create greater competition in the NHS. The BBC has learnt that many English trusts are introducing steps that make it harder for patients to opt to have NHS care done by private hospitals.
Health firms said it was a sign of bias, while ministers said there was no justification for the restrictions. The behaviour of nearly half of local NHS management bodies is now being looked at by a government inquiry.
NHS patients needing non-emergency operations, such as hip and knee replacements, are already able to be treated by private hospitals that have agreements in place to carry out the care at NHS cost. But at the moment, only 3.5% of operations are done this way, but under the government's shake-up of the health service the number is set to increase.
However, in recent months managers working for primary care trusts have started trying to impose restrictions that channel patients away from private hospitals. These include reductions in the range of treatments that private hospitals can offer NHS patients, caps on the number of people they can treat and promising NHS hospitals set numbers of patients.
Another tactic is to introduce minimum waiting times, which has the effect of slowing the flow of patients and cancels out one of the key benefits of being seen by the private sector - quicker treatment.
The issue is being looked into by the Co-operation and Competition Panel on behalf of the Department of Health. Its interim findings suggested as many as 70 of the 151 PCTs are employing such tactics.
Block contracts - PCTs promise NHS hospitals a certain number of patients, leaving the private sector only what is left over
Minimum waiting times - Insisting patients wait a certain length of time before treatment. Health firms say this is about lowering the bar so that they cannot use the pulling power of quicker care
Activity caps - Limits on the number of patients that can be referred on to private hospitals
Fewer options - Reducing the range of treatments the private sector can offer to NHS patient
They refused to give the BBC the details of the complaints, but a source close to the inquiry said trusts seemed to be motivated by a desire to protect their local hospitals in the tight financial situation - in some cases specialist regional NHS centres outside trust areas were being hit by the restrictions - and a desire to curb competition in the health service.
Circle is one of the health firms that has complained. It has highlighted the behaviour of two PCTs - Wiltshire and Bath and North East Somerset, which cover the areas surrounding its Bath hospital. Documents seen by the BBC show that the PCTs have proposed introducing a range of restrictions, including cutting the number of areas of treatment Circle - and any other private sector provider - can offer to NHS patients from 11 to five. Part of the reasoning is that it is needed to protect the local NHS hospitals.
The PCTs refused to comment about the plans, which were to be introduced in April but have now been postponed while the government inquiry is carried out. Ali Parsa, head of Circle, said there needed to be a "change in mindset" in the NHS. "There is too much focus on who is delivering the care. It is quality that matters."
David Worskett, director of the NHS Partners Network, which represents those private firms which see NHS patients, said the tendency within the NHS at the moment was one of "retreat" away from choice and competition. "It is absolutely the case that in this period of transition that independent sectors are facing significant difficulties. The practices seem to be bias against the independent sector."
Health minister Lord Howe said: "There is no justification, either financial or clinical, for PCTs to restrict patient choice and think that they know better than patients or their doctors where patients should be treated. "Any barriers to patient choice must be removed. In the future, Monitor [the regulator] will have legal powers to address restrictions on patient choice."
But David Stout, of the PCT Network, rejected the suggestion there was an anti-private sector culture in the NHS. "It is not necessarily against the rules. These things can be justified because of the financial situation or because of valid clinical reasons. For example, it may be right to protect the local hospital to keep essential services going. "I am sure many members of the public would be sympathetic to that. The important things is that it must be done in a transparent way and be able to be justified'. But critics said this is not in line with patients getting the best treatment, if that treatment is provided by the private sector. 29.3.11
NHS patients promised more choice by new regulator
Patients have been promised more choice in where they are treated as a result of plans for more competition in healthcare. Dr David Bennett, head of the economic regulator Monitor, has told the BBC he expects to see many more private companies and charities treating NHS patients. If NHS services cannot attract patients they will be allowed to close.
The British Medical Association is opposing the plans to increase competition in healthcare in England as part of the coalition government's health bill. Under the government's plans an organisation called Monitor will regulate a healthcare market in which NHS , private sector companies and charities will compete to treat NHS patients.
Failing NHS services allowed to fail
Monitor will have a legal duty to promote competition, while making sure no community loses access to essential health services. Its role will have some similarities to similar regulators for power and telecommunications.
In an interview with the BBC, Dr Bennett said he expected to see more private companies and charities venturing into healthcare. He expects more competition to mean better value for taxpayers and pressure to innovate.
"Anyone who can provide high quality care, think of new ways of doing things, give benefit to patients should be able to participate. Over time I think you'd expect to see more players emerging - new types of public sector providers, voluntary sector providers, private sector providers."
Dr Bennett said that NHS hospitals providing essential services, such as those in rural areas, would be protected from the full force of competition. But hospitals in areas where there are alternatives would not be guaranteed public money if they fail to attract patients. "If an NHS hospital is providing a service that people don't want to use, which GPs don't want to send them to, then those services may get into financial difficulty and ultimately close."
Level playing field
The government has said it wants to see a level playing field between the NHS and anyone else bidding to treat patients. A newly created private hospitals alliance called H5 will be lobbying Monitor to take into account what they argue are disadvantages.
Matt James, the chief executive of H5, said the plans build on changes introduced under Labour but which languished during Gordon Brown's time as prime minister. He described the coalition as having the energy and commitment to make sure that patients are offered a greater choice between NHS and private hospitals.
Private companies feel they have been at a disadvantage he said, "If you look at pensions - NHS providers have access to the NHS pension scheme but do not bear the full cost. That can make a very real difference if you have two hospitals competing to offer the same care to patients."
The private sector hopes of any immediate change in their favour may be disappointed. Monitor has told the BBC it could take some years to work out whether the NHS or the private sector had greater costs to take into account.
The creation of an economic regulator, and the plans to expose the NHS to greater competition for the NHS has been at the heart of the BMA's objections to large parts of the government's plans. BMA chairman Hamish Meldrum said the full implications had been poorly understood. "They're going to be encouraging competition, almost like was done in the gas and electricity industries, even the railways in terms of breaking up the NHS into a lot of private providers."
The government has argued that its reforms are designed to secure the future of the NHS, not undermine it. It argues that the market in healthcare will be highly regulated to protect crucial services while allowing patients to fully exercise the choice they were promised under Labour. 29.3.11
Half of doctors prescribe placebos, study finds
Doctors often prescribe placebos to patients, according to a new study from the German Medical Association released this week. But that's not a bad thing, they said, recommending that placebos be used even more often.
“Placebos have much stronger and more complex effects than we used to think. Their use is extremely important in medicine,” said Christoph Fuchs, managing director of the association, adding that pills and injections without active ingredients can be enormously beneficial to patients.
The author of the study, Robert Jütte, said about one in two doctors in Germany prescribes placebos on occasion. In Bavaria, a study found that 88 percent of general practitioners prescribe inactive drugs.
Often, doctors prescribe vitamin pills or homeopathic remedies that contain none of the medicine generally used to treat a specific illness. Some physicians even have agreements with nearby pharmacies who give patients sugar pills when filling prescriptions.
While it is still not completely understood how placebos function, researchers hypothesize that they work by activating the brain's frontal lobe.
According to Jütte, what might appear as ethically dubious is actually often in the best interest of the patient. One study in Germany found that placebos helped 59 percent of patients with stomach ailments. With depression, placebos have the same effect as anti-depressants in about one-third of cases. In addition, placebos also carry none of the side-effects that genuine medicines often do.
“Using placebos often maximizes the desired medicinal effect, reduces unwelcome side-effects and cuts health care costs,” Jütte said.
The medical association added that doctors should only prescribe placebos under certain conditions, for example if there is no approved pharmaceutical therapy available, if the patient only has a minor illness or condition and if it appears likely that a placebo treatment will be successful. 3.3.11
Placebo Use - Practical medicine or unethical?
A report out last week revealed that half of all German doctors are happily dishing out placebos to their patients for ailments such as stomach upset and low mood. The study, published by the German Medical Association, said that placebos - defined as sham treatments without any active constituents and even surgery, can prove effective as treatments for minor problems and are completely without side effects.
The power of the placebo first came to light during the Second World War. Morphine was in short supply in military field hospitals and an American anaesthetist called Henry Beecher, who was preparing to treat a soldier with terrible injuries, feared that without the drug the operation could induce a fatal heart attack.
In desperation, one of the nurses injected the man with a harmless solution of saline. To Beecher's surprise, the patient settled down as if he had been given morphine and felt little pain during the operation. Dr Beecher had witnessed the placebo effect.
Wind forward 70-odd years and the story of the placebo continues to fascinate, even though in the UK placebo treatments are usually confined to clinical trials, as a comparison with ''real'' treatments. Recent research suggests the placebo effect is not confined to subjective areas such as pain but may bring about physical changes.
In one (albeit small) trial, published in the journal Science , people with Parkinson's disease given placebo injections showed significantly higher dopamine levels in the brain, similar to the effects of medication. Interestingly, the German study found that the efficacy of a placebo can depend on the size and colour of a pill and on its cost (with more expensive placebos being more effective) and that injections work better as placebos than tablets.
What causes the placebo effect? No one really knows; but the idea of the healing power of the mind is nothing new. The discovery in the 1980s of the rich supply of nerves linking the brain with the immune system, which led to a new branch of medical research known as psychoneuroimmunology, clearly goes some way to explain it.
Nor does the placebo have to be a pill or injection: just seeing your doctor can work wonders. Edzard Ernst, professor of complementary medicine at the University of Exeter, believes that the key is the relationship between the patient and the doctor or therapist.
''Trust can generate a placebo response. People are already anticipating getting better when they come to the surgery. If the doctor then gives that patient an aspirin for a headache and does it in an empathic manner, the aspirin will have a pharmacological effect and the therapeutic relationship will generate the placebo effect,'' explains Prof Ernst.
One widely publicised analysis of clinical trial data on modern antidepressants from the University of Hull found that leading brands of antidepressants worked little better than placebos.
Subsequent reporting by the press concluded that antidepressants were useless. However, this failed to mention that the patients' response to placebos was ''exceptionally large''. In other words, it wasn't that antidepressants didn't work - but that placebos worked very well.
''If the drugs are no better than a placebo, then why not give a placebo which has none of the nasty side-effects?'' argues Irving Kirsch, professor of psychology at Hull and lead researcher.
But others say using placebo treatments other than in clinical trials poses an ethical dilemma. While it is not illegal in Britain for a doctor to prescribe a placebo if they believe it is in the best interests of the patient, Dr Tony Calland, chairman of the British Medical Association's Medical Ethics Committee, says: ''Long ago, doctors would give people medication that was scientifically of no value. These days, we believe patients should have an informed choice. Giving a patient a placebo without telling them is regarded as unethical and deceptive.''
But if deception is the problem, could patients be informed they were getting a placebo? A recent study of 80 patients with irritable bowel syndrome at Harvard Medical School in Boston showed that, even though patients were told, their symptoms still improved, compared to those who had no treatment.
Dr Calland points out there is a bigger problem with the placebo response. ''In one patient it may be very strong, while in another it may be virtually non-existent,'' he says. And placebos do not work for everything: they cannot alter blood sugar levels in diabetics, mend a broken leg or cure cancer.
''To hope you will get a placebo effect would simply be not very good medicine,'' Dr Calland argues. ''Why not just give a treatment that actually works?'' 29.3.11
Taxpayers anger as NHS bosses' pay soars 50% while front line staff face axe
NHS bosses in charge of hospitals being forced to sack thousands of staff have seen their pay soar by up to 50 per cent in the past five years, it has emerged. The chief executives at trusts facing the worst cutbacks are now on lucrative salaries far higher than the Prime Minister's, with some earning more than £200,000.
And most handed themselves comfortable pay rises last year even though hundreds of their own staff were being made redundant to reduce costs. The NHS has been ordered to make up to £20billion of efficiency savings by 2014 and hospitals have resorted to axing hundreds of posts to meet the targets.
Figures released yesterday show more than 50,000 jobs have been earmarked to go over the next three years, including frontline doctors, nurses and midwives.
Many NHS workers lucky to keep their jobs are facing a two-year pay freeze, which effectively amounts to a pay cut once inflation is taken into account. But it has emerged that over the past five years the hospital chief executives laying off the most staff have seen their salaries soar by as much as £70,000.
The same hospitals have also squandered inappropriate sums of money redesigning their logos, on expensive restaurant meals for managers and pornographic magazines for IVF clinics. Unions attacked the payouts as ‘poor judgment' claiming they sent out ‘completely the wrong message' to patients and front-line workers.
Figures show the chief executive of Central Manchester University Hospitals Trust, where 1,400 jobs are to go in the next four years, has enjoyed a pay rise of 48 per cent since 2008. He is currently on a salary of between £210,000 and £215,000, an increase of £70,000 compared to five years ago.
Meanwhile the pay of the chief executive at Devon and Exeter NHS Trust – which is to lose more than 1,000 full time posts by 2012 – has gone up by more than 30 per cent in the past five years.
Her salary has overtaken that of David Cameron, who earns £142,000 a year, and she now takes home between £165,000 and £170,000. The boss of Heart of England NHS Trust takes home around £240,000 a year, a rise of almost 30 per cent since 2006. But the trust is set to lose 1,600 posts over the next four years, although bosses insist most will be managerial and administrative roles.
At East Lancashire Hospitals NHS Trust, which is set to shed more than 1,000 staff, the chief executive's pay has also soared by 32 per cent to between £165,000 and £170,000. The most up-to-date figures uncovered by the TUC show at least 53,150 posts in hospitals, health trusts and ambulance services will be lost by 2014.
Campaigners have repeatedly warned staff are already stretched to breaking point and further cuts will lead to longer waiting times, poorer care and deaths. Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: ‘These pay rises reveal poor judgment and leadership at a time when the NHS is facing serious financial challenges.
‘It also sends completely the wrong message to frontline staff, who are not only concerned about losing their jobs, but are facing a pay freeze. It is the collective hard work of all NHS staff that ensures high quality healthcare services are delivered on a daily basis. ‘Managers play a very important role in the NHS, but nothing should come ahead of delivering patient care.'
Charlotte Linacre, campaign manager at the TaxPayers' Alliance, said: ‘It's unbelievable that some NHS bosses have taken massive salary increases just as the NHS has to be careful with spending including on staff costs. ‘Taxpayers who fund these eye-watering increases will not be impressed. ‘Bosses knew budgets would be tighter in the following years but they've helped themselves to more money, it's time these high salaries were brought under control. ‘Taxpayers will feel cheated if top earner salary hikes have been prioritised over core frontline health services.' 28.3.11
Understanding the roots of medical dysfunction
Aside from the obvious fact that modern medicine has devolved into an industry that markets products to medical "consumers," there are a number of more basic problems that must be addressed if the system is ever to be improved. Since those medical products tend to create more sickness than health, it virtually guarantees an endless revolving door of sick consumers in need of more care and drugs. The impetus for meaningful medical change must ultimately come from a general public that has become increasingly aware of the dysfunctional nature of health care. The medical system itself cannot be expected to initiate such changes without external pressure from so-called consumers.
Even if we could mitigate the profit motive in medicine, it remains constrained by a number of false assumptions regarding health and healing that must change if it is ever to transcend its limited worldview. But effective change will not be possible unless we first identify some of the shortcomings that prevent Western medicine from attaining a truly holistic perspective. The following broadly constructed categories describe some of the most prominent flaws in Western medical philosophy that, in turn, lead to inappropriate and often dangerous strategies in the actual practice of medicine.
The parts versus the whole:
Of necessity, medical science has historically taken a reductionist approach to investigating issues of human health. It breaks the physical body down into its component parts - including a vast universe of microscopic parts that can't be seen by the naked eye - in an attempt to understand the way things work. Much valuable information has been learned in the process. However, when taken as the only approach, the end result is a fragmented array of body parts, bits and pieces of scientific data, and specialized fields of medicine all of which are increasingly dissociated from one another.
As a consequence, each medical event in the history of a patient is seen as discrete and unrelated to all other events in that patient's history. This accounts for the legions of walking wounded who take, for example, one pill for headaches, another for arthritic pain, a third pill for insomnia, and another for depression. The system is in desperate need of a more holistic perspective that can put all of the pieces back together again.
Fortunately, that is precisely what most alternative practitioners are trained to do. Naturopaths, homeopaths, acupuncturists, and many others are busy connecting the dots where conventional medicine has failed to do so. More often than not, most holistic practitioners are generalists that view human health in its totality. They see the big picture that medical science fails to take into account.
Rational analysis versus experience:
Modern medicine relies heavily upon the rational faculty of the mind. This is essentially a left-brain trait that places a premium upon a quantitative approach to human health. It places excessive value upon lab results and the statistical abstractions of research studies while it downplays the reality of patient's first-hand experiences. It is the lopsided overly analytical legacy of 2000 plus years of patriarchy. While this may be a useful approach when applied to some of the hard physical sciences such as geology or mechanical engineering, it is woefully inadequate when it is the dominant or exclusive approach to healing.
This predominantly rational worldview is a breeding ground for a mentality that, for example, can so casually excuse "X" number of deaths caused by drug "A" as the necessary "risks that come with the benefits." Such a mindset allows medical professionals to actually believe their own rhetoric when they proclaim that it does not constitute "conclusive evidence" when a parent reports that their normal child decompensated into an autistic state within days after having been vaccinated. It amounts to an eggheaded form of logic that has no grounding in the reality of patients and their actual problems.
It is the same mindset that dismisses a patient's report of his or her own symptoms and experiences as "merely anecdotal." Objectivity is worshipped while subjectivity has become a bad word - as if to say that one's own self-assessment is inferior to what the medical literature and lab numbers tell us. This is why patients frequently come away from a visit to the doctor feeling unseen and unheard. This overvaluation of rational thinking results in what can most accurately be called rationalizations - like the ones described above.
Another erroneous rationalization is that one size should fit all. The very foundation of most medical research, therefore, is grounded in the notion that it is possible to develop a synthetic drug that can be applied across the board to many people with the same condition. This tendency to generalize runs contrary to a holistic understanding of the need to individualize treatment for each and every person. All cases of arthritis, so the logic goes, are considered the same and should respond to the same drug. This fails, however, to take into account the experiential reality that each and every case of illness is unique and while some will respond to one particular therapy, others will respond best to a different approach, and still others will benefit from another.
Real and lasting healing must also make use of the right brain. Many green healing methods value a more direct, empirical, experiential orientation to the patient. It is a qualitative approach that also involves intangibles like intuition, feeling, meaning and subjective assessment. These tools form the missing complement to the analytical mode of scientific medicine. This is not just a call for doctors to be more compassionate. It is a practical matter that often has a very real impact upon patient outcomes.
Mechanism versus bioenergetics:
Western medicine's mechanistic bias is another of its notable shortcomings. The human body tends to be seen as an automobile that periodically needs its parts repaired, removed or replaced. This mechanical bias predisposes medical scientists to believe that technological solutions are superior to the innate and natural healing power of Mother Nature. Mechanistic thinking is closely allied with the cause-and-effect mode of perception that tends to dominate conventional medical thought.
When a person taking a pharmaceutical prescription for migraines subsequently develops an arthritic knee, the two phenomena are considered to be unrelated because there is no anatomical or logical connection between the two - according to the conventional medical worldview. Events, therefore, must have a clear and logically explainable connection in order to be taken seriously. "Coincidences" are easily dismissed as such because they cannot be assigned any logical reason for their existence. A greener perspective, on the other hand, takes it as a given that the migraines and knee pain are almost always related.
A mechanistic view holds that our thoughts and emotions are by-products of the physical brain with its neurons, synapses, and neurotransmitters. A more enlightened bioenergetic model views the human body, brain and nervous system as the most complex receiver, transducer, and transmitter of energies in the known universe. Many green healing practices are grounded in the notion of the universe as a vast interconnected sea of particle-waves and energy fields. Just because the physical senses can only detect a narrow spectrum of visible light and a small band of sound waves does not mean that the comparatively vast remainder of energies along the electromagnetic spectrum do not have an impact upon human health and behavior. A variety of known and unknown energetic influences are continuously affecting the health of individuals, groups, societies and the ecosystem. Such a vast unexplored field of "invisible" energetic interconnections constitutes a potential goldmine that stands ready for serious scientific inquiry.
Materialism versus non-physical reality:
Perhaps the most problematic aspect of Western medicine is its inability to come to terms with issues of non-physical reality. It tries to force the multidimensional nature of human health experiences into a strictly materialistic framework. Those who subscribe to this worldview "believe" that the physical is the only reality of relevance, or that even exists. The related illusion that science is an amoral endeavor is a serious error in judgment that has far-reaching practical implications for health care. Medicine is so uncomfortable with the non-physical dimension that it artificially excludes it from the medical equation with the justification that it is unscientific and unworthy of investigation - yet another unfounded rationalization.
Most green therapeutic modalities accept the energetic, psychic, and spiritual dimensions of human existence as fundamental realities. They do not dismiss them because they cannot be measured by scientific instruments or verified by rationalist standards of proof. One cannot dissociate one's personal spiritual principles from one's quest for health and healing and, at the same time, expect beneficial and lasting results. The spiritual dimension is an experientially confirmed reality "known" by millions, and "believed" to be the case by many millions more. This constitutes a form of knowing very different from, but equally valuable to, a rationally constructed logic of knowing. My personal spiritual experience is something that I may "know," or it may be something that I "believe," but it can never be proven to the scientific skeptic. This does not render it unimportant to issues of health and healing. In fact, it is a vital component without which genuine healing often falls short.
Suppression versus healing:
When we indiscriminately combat symptoms we run the risk of suppression. The body in its wisdom often causes a symptom to recur in spite of our attempts to eradicate it. Each dose of migraine medication, for instance, dulls the pain temporarily until the next one occurs. However, when the migraines fail to recur, that is when we may be in for trouble. There is no free medical lunch. When a symptom or condition is successfully squelched, the bioenergetic source of the original disturbance simply seeks the next best avenue for expression. Thus, the migraines may "mutate," for example, into fatigue, arthritis or colitis. Furthermore, the consequences of such inappropriate treatment are not limited to physical maladies. The same migraines can just as easily mutate into insomnia, depression, or an anxiety disorder. This is not mere speculation; it is a phenomenon repeatedly observed by thousands of green healing practitioners. The possibilities are endless and depend upon each individual case.
And when symptoms do mutate, regular medicine usually fails to connect the dots. Medicine pursues its ill-advised strategy of symptom suppression largely without realizing what it is doing. The sequelae of suppression are just considered random occurrences that have no connection to the previous history of the patient. When we consider that almost all conventional medical treatments are essentially suppressive, the implications are staggering. Thus, an endless cycle of chronic disease is generated. It is no coincidence, and no wonder then, that we are seeing such dramatic rises in the incidence of many chronic diseases, autoimmune disorders, and psychiatric illness.
Treatment focused on symptoms has no larger purpose or conscious goal that leads toward greater health. This strategy is emblematic of a war against disease mentality that views symptoms as the enemy rather than as the manifestations of the body's innate healing mechanism. Green healing is not congruent with such a misreading of the nature and intent of symptoms. True healing recognizes the self-healing capacity of the bioenergetic life force and seeks to work with it rather than against it. Green medicine takes into account the whole person and the connections between symptoms even when they occur in seemingly unrelated parts of the body and even when they are separated by time. Real healing leads to greater health, vitality, maturity and self-awareness.
Each of the aforementioned opposing viewpoints does not have to be at odds with each other. An appreciation for the whole is complementary to an understanding of the parts. Empirical observation and rational analysis are most effective when they work together hand in hand. A thorough knowledge of mechanics is necessary to set a bone, plug a leaky vessel, and remove a diseased appendix, just as an understanding of human bioenergetics can lead to the resolution of chronic disease. It should go without saying that body, heart, mind, and soul are inextricable aspects of the one whole. And even suppression may come in handy in a pinch when faced with life-threatening illness. Once things are stabilized, more enduring methods of genuine healing can then be employed. Real green healing utilizes the best of all medical worlds. Natural News 25.3.11
B. Alan Wallace and Brian Hodel, Embracing Mind: The Common Ground of Science and Spirituality. Boston: Shambhala , 2008.
Edward C. Whitmont, MD, The Alchemy of Healing: Psyche and Soma . Berkeley, CA: North Atlantic Books, 1993.
Respected senior consultant brands NHS management 'a cancer within the health service'
A respected senior consultant has hit out against NHS managers in an astonishing speech branding them 'a cancer' and claiming the health service is 'on its way out'.
John Riddington Young, 63, who has been a ear, nose and throat surgeon at the North Devon District Hospital since 1981, called for all hospital management to be sacked during his speech at the historic Manor Court ceremony in Bideford, North Devon last weekend.
But the hospital has hit back calling his remarks 'wholly offensive' and said he would face formal action. Mr Riddington Young, who began his NHS career as a hospital porter 40 years ago, told the audience: 'There is a great impression the NHS is on its last legs. But it is not just sick - it's on its way out. 'Personally I think there is a cancer in the health service and it grows at the expense of the healthy tissues. 'It is killing the lifeblood of our NHS.
'Doctors and nurses are resigning at an unprecendented rate and that cancer is management. 'I believe if all management were got rid of there would by a massive improvement in morale and that things would get better. 'From our lowest porter to a senior consultant, we all feel totally undervalued. The reason we are still there is not because we work for NHS but for our patients. 'They are the ones who appreciate us, respect us and value us.'
The Manor Court is an annual custom dating back to the Elizabethan age where local civic dignitaries listen to the 'presentments' made by the people of Bideford. In his speech Riddington Young also compared NHS managers to The Stasi - the former East German secret police.
He also showed off an armband he had designed with a new NHS logo which resembled a swastika. He added: 'In these days, despite the burden of obvious human misery, hospitals were happy places to work - doctors felt respected, trusted and valued.
'We don't hear these stories in the media because the NHS doesn't allow us to have freedom of speech.'
Mr Riddington Young is President of the South West ENT Surgeon's Society but said he was contractually obliged not to talk to the media.
The Northern Devon Healthcare Trust have now issued a statement saying: 'These are extraordinary claims. 'We are perplexed by Mr Riddington Young's motives for attempting to bring the NHS services into such disrepute.
'Although Mr Riddington Young makes clear that these are his personal views, these comments will be wholly offensive to many of his colleagues, the wider NHS and the wider public.
'As a responsible employer we absolutely condemn and distance ourselves from these remarks which we will be taking up with him formally.
'We are treating this incident very seriously due to the potential damage in reputation to the Trust and loss of confidence of local people in the NHS services we provide.'
In 2008 the consultant made similar claims about NHS managers in a book he co-authored called The Hospital Revolution. A year earlier he was temporarily suspended after allegations he made a racist remark. He then turned up at an internal hearing wearing African dress over his pinstripe suit.
Mr Riddington Young said he was unable to comment on the row when he was contacted yesterday because of a ban on him speaking directly to the media. In his book he said the 'large cancerous growth and malignant mass in the NHS was its management system'.
Sources close to the controversial consultant, who was at a clinic yesterday, said he had no intention of retiring and claimed the NHS had been 'harassing him for years'. The source said: 'Because free speech is denied him under the Human Right Act, he takes the opportunity of making his feelings known when speaking publicly or when he wrote his book'. 25.3.11
NHS manager numbers falling after 66% rise under Labour
The number of managers in the NHS is finally falling after rising by two-thirds under Labour. Official figures also show that the number of frontline workers continued to rise last year. Over the past year the number of managers has fallen by 2,770 while the number of clinical staff rose by 2,707. However unions fear that hospitals are starting to cut jobs to save money and that the number of nurses and doctors will now start to fall.
The Health Minister, Simon Burns, said: “Under Labour, tiers of management took resources away from improving frontline patient care. “On their watch, doctors and nurses were overwhelmed with red tape whilst management costs soared and productivity fell through the floor. “We're changing all that by reducing bureaucracy and ploughing this money straight back into patient care.”
The annual workforce census published by the NHS Information Centre on Tuesday showed that in total the health service employs 1,431,557 staff, a rise of 312,599 (27.9 per cent) over the past decade.
There were 41,962 managers and senior health service managers in England on 30 September 2010, a fall of 6.2 per cent on the same month in the previous year but an increase of 66.1 per cent since 2000 as Labour began its tripling of health spending. Between September and December last year the number of bureaucrats fell still further, by 2.7 per cent to 40,819.
More redundancies are on the way as the Government's controversial Health and Social Care Bill will result in the removal of two tiers of management – the 10 Strategic Health Authorities and the 152 Primary Care Trusts. The NHS is also under orders to make £20billion of efficiency savings over the next three years.
New data also show that there were 721,717 “professionally qualified clinical staff” in September, a rise of 0.4 per cent on the previous year and an increase of 167,664 (30.3 per cent) on the figure for 2000. There have been particularly large rises in the number of hospital consultants (54.7 per cent), GPs (25.6 per cent) and nurses (21.7 per cent) over the past decade.
However when temps known as “bank staff” are included, the number of nurses has fallen by 3,678 (0.9 per cent) in the past year. This could be because hospitals are less reliant on agency workers now they have more staff, or because they are cutting back to save money.
Despite ministers pledging to maintain the NHS budget at a time of austerity in public services, several hospitals have already announced they are cutting hundreds of posts to save money, including some frontline jobs.
Dr Peter Carter, Chief Executive & General Secretary of the Royal College of Nursing, said: “These figures mask the reality of what is happening on the ground. Despite the rhetoric of protecting healthcare services, we know that tens of thousands of NHS posts are earmarked to be cut and that nurses and healthcare assistants are being stretched to breaking point." 23.3.11
'Quick fix' GPs blamed as number of people using diet pills balloons
Record numbers of overweight men and women are resorting to diet pills instead of a healthy diet and exercise statistics reveal.
Doctors are to willing to writing almost 1.5million prescriptions a year for the drugs – 11 times more than a decade ago due to incentives from drug companies to sell more drugs. The figures come as obesity is spiralling, from 7 per cent of adults in 1980 to 23 per cent in 2009.
However, it is feared that many GPs are using the pills as a quick fix instead of encouraging patients to focus on healthy eating and exercise.
Just 127,000 prescriptions for obesity pills were handed out in England in 1999 against 1.45million in 2009, according to latest figures from the NHS Information Centre. The cost to the Health Service has rocketed to almost £47million a year as a result.
Orlistat – which is marketed under the trade name Xenical – is the only anti-obesity pill currently available for GPs to prescribe to seriously overweight patients. Rimonabant – also known as Acomplia – was withdrawn from the market in 2009 due to the risk of serious psychiatric problems, and use of sibutramine – also known as Reductil – was suspended last year amid fears it increased the risk of heart attacks and strokes.
Orlistat, which came on to the market in 1998, disrupts the absorption of fat in the intestine so that the body excretes it instead. Users must stick to a low-fat diet or face unpleasant side effects, including bowel problems.
Although doctors argue that issuing pills is only a last resort after obese patients have failed to lose weight by changing their diet and lifestyle, health experts have criticised the findings, arguing that GPs are still turning too quickly to the prescription pad.
Dr Tam Fry, of the National Obesity Forum, said: ‘NICE (the National Institute for Health and Clinical Excellence), which should be used as a gold standard, says pills should be second on the list of anti-obesity actions and that exercise and healthy eating should be the first. ‘The problem with that, however, is that it takes such a long time to see the effects that many doctors are reverting to pills as a first course of action followed up rapidly by bariatric surgery (gastric banding or a gastric bypass).
‘The only problem with any pill is what happens when the weight comes off and you finish treatment. Are they able to maintain the weight which they have attained or do they just put it all back on again?'
Bridget Benelam, nutritional scientist at the British Nutrition Foundation, insisted that obesity pills were not a ‘magic bullet'. She said: ‘Obesity drugs alone are not going to help us solve the obesity problem. ‘If that's being used instead of longer term changes to diet and lifestyle, it will be a problem and people won't get the results that they need to improve their health.'
Dr Clare Gerada, chairman of the Royal College of General Practitioners, said obesity was a ‘ticking time bomb', leading to serious complications including diabetes and heart disease. She added: ‘Of course GPs always advocate healthy eating and regular exercise to maintain a healthy weight, but some patients need additional help. ‘It is better that GPs work with their patients to monitor the efficacy of weight-loss drugs in the long term than patients buying them over the counter without any clinical support, and without knowing the full risks involved.'
Meanwhile, the latest data on global trends in obesity has revealed that weight levels rose rapidly in Britain between 1980 and 2008. British women are now the most overweight in the whole of Western Europe, according to research recently published in The Lancet medical journal. 28.3.11
NHS told to end culture of overprescribing
NHS patients are being prescribed too many drugs with detrimental effects on their health and the loss of millions of pounds from the health budget, the head of Britain's drug safety regulator has said.
Amount of drugs prescribed by GPs triples over 15 years
Pharmaceutical drugs causing spike in diseases they supposedly treat
Back in 1998, treatment centers reported relatively modest numbers of 19,870 admissions for prescription-drug abuse; by 2008, these had escalated to 111,251 - a 560% increase in just 10 years however the NHS has no specialist treatment to help these people stop their drug use, they are force to go 'cold-turkey'.
The average 80-year-old patient is taking seven or eight drugs but many were not needed, Professor Sir Alasdair Breckenridge, chairman of the Medicines and Healthcare Products Regulatory Agency (MHRA) which licenses drugs for use in the UK, said.
Wastage caused by excessive prescribing was compounded by patients who took too few of the drugs they were given, with further losses to the NHS and additional risks to their health. Huge savings for the NHS and big gains for public health could be made by tightening controls on the £10bn NHS medicines bill, he added.
Speaking to The Independent, Professor Breckenridge, who has led the MHRA since it was formed in 2003, said an investigation had been launched into concerns about the lack of training of doctors in pharmacology. He called on the pharmaceutical industry, the medical profession and NHS regulators to reduce multiple prescribing and improve patient compliance, responsibility for which was "falling through the slots" between them.
A study of GPs in a healthcare centre who hired a pharmacist to sit in on their consultations and check the prescriptions they wrote revealed the scale of over-prescribing.
"In most instances the pharmacist was able to prune 30 to 40 per cent of the drugs from the prescription, saving the NHS money and improving the patient's health. Some drugs are continued for long periods beyond the point when they are needed. They were justified in the short term but not in the long term. Pharmacists should be able to question prescriptions that doctors write and ask 'Is this really necessary?' We have more powerful drugs with more possible adverse effects than in the past," he said.
Worries about the lack of training for doctors in clinical pharmacology increased the need for pharmacists to monitor GPs. "We are very concerned about this. Training in pharmacology for doctors has been squeezed. We have set up a working party to look at it."
Sir Alasdair, former professor of clinical pharmacology at the University of Liverpool, said his experience in hospital medicine had shown him that what patients told their doctors and what they did were often not the same. "Adherence is a hobby horse of mine – it is one of the biggest problems we face today. Around 30 per cent of medicines are not taken by patients – either because the prescription is not dispensed or because patients don't take the medicines prescribed, to the detriment of public health and [causing] huge losses to the NHS, around £3billion every year.
Whose responsibility is it? No one's. It is not a prime concern of the regulator. It is not a prime concern of the drug industry – once the drug is sold they are happy about that. We as regulators have got to get more interested. But so has the industry, doctors and pharmacists. The message has got to go out to patients, as well, about the importance of taking their drugs."
Professor Breckenridge said too much emphasis was placed on safety in the debate about drugs when it would be better to talk of risks and benefits.
He said he was impressed by recent research showing a low-dose aspirin taken daily cut the risk of a range of cancers by 21 per cent over five years – and by earlier research showing a protective effect against heart attacks and strokes in patients who had already had a heart attack.
But he cited his own study in two hospitals in Liverpool published in the British Medical Journal in 2004 which showed 6.5 per cent of admissions were due to adverse reactions to drugs. Internal bleeding caused by low-dose aspirin was one of the two commonest causes (the blood-thinning drug warfarin was the other).
"On the benefit-risk ratio, people have got to realise it is not all on the benefit side. There is no such thing as a free lunch with drugs."
Keep taking the tablets?
67% The rise in the number of drugs prescribed by GPs in England in the decade to 2009, to 886 million items.
17.1 Average number of prescription items dispensed to every man, woman and child in England in 2009, compared with 10.8 in 1999.
£9.64 Average cost of each prescription item, implying an average spend by the NHS of £165 on drugs per person per year.
42.4 The number of prescription items received each year by the over-60s in 2007, nearly 50 per cent more than in 1997 (22.3 items), at an average cost of over £400 per person per year
£8.54bn The cost of all prescriptions dispensed by the NHS in 2009 - £10bn in 2010 - 4.1.11
Misery of the tranquilliser addicts forced to go cold turkey by GPs
Helen lay shaking and sobbing in the drug addiction detox unit. The 61-year-old businesswoman was racked with such excruciating pain she wasn't sure she could survive it.
What's so shocking is that unlike the other patients at the unit, who were struggling with heroin or cocaine addictions, the only drugs Helen had ever taken were the tranquillisers prescribed by her GP for depression and anxiety. ‘Seven years ago, my doctor gave me Valium, which I thought would just get me through a rough patch,' recalls Helen, who is married with a daughter. ‘I had no idea they were addictive.'
Two years ago, she began to suffer from chronic dizziness — her GP sent her for brain scans and heart tests but these proved inconclusive, so Helen did her own research, and discovered that her symptoms matched the symptoms of the long-term side-effects of common tranquillisers. ‘When I went back to my GP, he said my symptoms had nothing to do with drugs and asked me why I wanted to come off them,' says Helen.
Even when she did finally get herself into a detox unit, the drugs were withdrawn at a much faster rate than officially recommended, causing her such terrible side-effects she's had to go back on to the drugs. Helen is one of an estimated 1.3 million Britons addicted to prescription tranquillisers, also known as benzodiazepines.
These drugs include diazepam (known previously as Valium), Xanax, Ativan, Serax and Librium. They are commonly prescribed as a treatment for severe anxiety and insomnia — last year ten million prescriptions for benzodiazepines were issued in England alone.
They work by boosting the action of a naturally occurring brain chemical called GABA (gamma-aminobutyric acid). GABA tells brain cells to slow down and stop firing, and has a calming effect on the brain, muscles and heart rate, helping to ease the insomnia that often accompanies anxiety.
But the drugs use the same addictive pathways in the brain as illegal drugs such as heroin. Patients often need progressively higher doses as the body becomes accustomed to the drug — these higher doses can cause side-effects including paranoia, fatigue, dizziness, memory problems and dulled emotions.
Because of the high risk of addiction, the UK's Committee for Safety of Medicines issued guidelines back in 1988 advising GPs that the drugs should be prescribed for no more than two to four weeks. Despite this, there are huge numbers of patients who've been left on the pills long term, even for decades, say campaigners.
The concern now, however, is that over the past year GPs have performed a drastic U-turn and, without warning, are rapidly reducing patients' drug doses in a short space of time to get them off the drugs.
Campaigners believe this has been prompted by a Department of Health review looking into the number of prescriptions GPs are issuing for benzodiazepines. But going ‘cold turkey' in this way can cause severe withdrawal effects, including excruciating pain in the muscles and joints, insomnia, and even suicidal thoughts.
Barry Haslam, the chairman of Oldham TRANX, a support group for patients addicted to benzodiazepines, says the charity is taking calls from people all over the country about being suddenly and abruptly withdrawn from their tranquillisers.
Apart from the crippling side-effects, he points out that, ‘most patients are just left to go on with it on their own. ‘And even if they are offered help it's usually a referral to a detox unit for illegal drug users, and that is just not appropriate because they bring patients off the drugs in too short a space of time.'
Official advice for health professionals (NHS Clinical Knowledge Summaries) suggests reducing a patient's dose of benzodiazepines by five to ten per cent every one to two weeks. Once a lower dose is reached, the reduction should be slowed. It acknowledges that it may take a year or longer for patients to come off the drugs and stresses a patient must be stable, and willing to come off their tablets — and that the withdrawal plan should be tailored to their individual needs.
Campaigners say it's the latter point that is crucial; patients should be allowed to proceed at their own pace and have their personal situations taken into account.
Dr Trevor Turner, a consultant psychiatrist at the East London Foundation Trust, says: ‘GPs are caught in the middle between trying to be humane prescribers — after all, some of these patients really do need this medication to function — and following clinical guidelines.
If patients do want to come off their medication they should be offered alternative therapies such as cognitive behavioural therapy, relaxation classes and maybe alternative medication such as anti-depressants.'
One of those affected by the new change of heart about benzodiazepines is Steven James. The 26-year-old writer was shocked when he received a terse phone call from his GP practice six months ago telling him he must quit his prescription tranquillisers. ‘My old doctor retired and a new doctor rang out of the blue last summer and said my pills were addictive and were only a short-term treatment,' recalls Steven, who lives in Cardiff. ‘I was horrified as this had never been mentioned to me before'.
Steven was 14 when he was first prescribed diazepam for panic attacks. ‘I was on a repeat prescription, and if I felt stressed or anxious my GP would put it up a bit more each time. No one ever mentioned I shouldn't be on them long term.'
But Steven's new doctor was adamant he must come off the drugs, and reduced his prescription by 2mg a fortnight from his daily 45mg a day. He is now taking 20mg, but although this reduction rate was in line with official advice, Steven has found it hard to function and he suffers from headaches, lack of concentration and panic attacks. ‘The effects are horrendous,' he says.
In some ways, however, he's been more fortunate than patients such as Helen, whose prescription was reduced at a much more brutal rate.
Initially undeterred by her GP's reluctance to take her off the drugs, Helen had started to follow The Ashton Manual, an online guide to coming off benzos written by Professor Heather Ashton, an expert in benzodiazepines.
‘I gradually reduced my dosage down from 15mg a day to 1.5mg over ten months, but I was in excruciating pain,' she says. ‘In desperation, I called my GP who said I would have to have my dosage increased to 20mg a day to stabilise my condition — which was higher than when I started out.'
So Helen rang her local drug and alcohol misuse service, who suggested she go to a residential NHS Detox Unit, and made a referral. ‘The problem is that the staff reduced my dosage far too rapidly — from 16.5mg to 8mg in two weeks, which is the speed used for illegal drugs. I was in a terrible state, crying and shaking. After a four week break, I was re-admitted and my dosage was reduced to zero.'
Eight weeks later, the pain was so bad that Helen had to go back on diazepam and is back up to 15mg. ‘I don't want to stay on the pills — they suppress all your emotions and make you feel like you're in a parallel universe,' she says. ‘I will come off them eventually, but it has to be at my own pace and I need support to be able to do this.'
The solution, ultimately, is for psychiatrists, GPs and patient groups to sit down ‘and thrash out a good set of guidelines on monitoring and assessing patients', says Dr Martin Johnson, a GP and trustee of the Patients' Association.
A Department of Health spokesman says: ‘GPs should be prescribing benzodiazepines and managing withdrawal from these drugs based on their clinical judgment of their patients' needs and in line with the guidance available to them.'
However, patients such as Steven and Helen say they can't come off these drugs alone. ‘All I'm asking for is a GP or psychiatrist to be willing to help me,' says Steven. ‘And that means more than just stopping the prescription.' 22.3.11
Actos is 'alternative' to banned diabetes drug Avandia
A drug to treat diabetes, Actos, would be a "sensible alternative" to one which was banned last year, researchers have said. Avandia, also known as rosiglitazone, was suspended by authorities in Europe, but is still available in the United States and Canada.
The study published on the BMJ website said patients taking Actos had fewer heart problems. Diabetes UK said Actos was a very effective treatment.
Rosiglitazone and pioglitazone, which has the trade name Actos, are used to control blood sugar levels in patients with type-2 diabetes and both are known to increase the risk of heart failure. The research team at the University of East Anglia compared the risks associated with each drug by analysing 16 studies of more 800,000 patients.
Rosiglitazone increased the risk of heart attack by 16%, heart failure by 23%, and death by 14% compared with pioglitazone.
The report says: "For patients who need thiazolidinedione treatment, continued use of rosiglitazone may lead to excess heart attacks, heart failure and mortality, compared with pioglitazone, the effect on public health may be considerable."
Dr Yoon Loke, from the Univeristy of East Anglia, told the BBC : "For patients who have come off rosiglitazone, pioglitazone would be a sensible alternative." "Although it's like jumping out of the frying pan and into the fire in some ways, pioglitazone can lead to fractures in women, is being evaluated for risk in bladder cancer and increases the risk of heart failure."
Deepa Khatri, clinical advisor at Diabetes UK, said people with diabetes should have as much choice as possible. "Actos (pioglitazone) is still available on the European market for people with diabetes.
"For many people, Actos is a very effective treatment to help control blood glucose levels and Diabetes UK believes this drug should continue to be made available to ensure people with diabetes have as much choice as possible.
"Alternatives to Actos are available, however is it very important that people discuss treatment options with their healthcare team to assess the most appropriate form of medication to suit their individual needs." 18.3.11
Europe regulators starts safety probe into Actos
European regulators have launched an investigation into the safety of Takeda's diabetes drug Actos, following a possible link to increased bladder cancer risk.
The European Medicines Agency said on Friday its experts would examine the benefit-risk balance of the drug, known generically as pioglitazone.
The bladder cancer risk has been under close review ever since Actos was approved in 2000 and Takeda is conducting a 10-year study looking at cancer rates
in diabetic patients on the medicine.
Three interim study reports have so far have not confirmed a clear association between Actos and bladder cancer -- but the European agency said an increased number of spontaneous reports had prompted it to start the latest review.
Actos belongs to the same drug class as GlaxoSmithKline's Avandia, which was pulled from the market in Europe last year and faces stringent restrictions in the United States after being linked to heart risks. 18.3.11
NHS bodies faced to break 'cartel' agreements
Hospitals and doctors could be accused of running “cartels” and fined millions of pounds under controversial reforms that will turn the NHS into an equal market, Labour has said.
The party's shadow health team believes that the Government's radical legislation could lead to delays in care for patients as GPs and surgeons become tied up in legal red tape, as well as exposing them to the allegations of anti-competitive practice which already exists. They say it is wrong to turn an essential public service such as health into a deregulated market such as electricity, gas or telecommunications.
Labour's concerns about the Health and Social Care Bill, which forces doctors to consider private providers when purchasing treatment for their patients, are likely to be echoed by backbench Liberal Democrat MPs in an Opposition Day debate in the Commons on Wednesday.
The shadow health secretary, John Healey, told a press briefing on Tuesday: “The operation of competition law means that if there are grounds for a legal challenge to providers or commissioners, the GPs and hospitals talking to each other about the planning of services, how they should be provided, including inevitably aspects of the cost of that, as part of their necessary discussions, that could clearly be regarded as anti-competitive, collusive possibly even cartel practices that a court-happy private health company could use lawyers to challenge.”
Under the bill, GPs will be responsible for commissioning services and will have to choose from “any willing provider” rather than just their nearest state-run hospital as they do at present.
The current regulator for independent Foundation Trust hospitals, Monitor, will become the economic watchdog for the NHS with similar powers to the Office of Fair Trading and will enforce English and EU competition law in the health service for the first time. This will mean that any NHS body found to have breached competition law, by unfairly favouring one provider over others, could be fined 10 per cent of their annual turnover – amounting to tens of millions of pounds.
It is feared that GPs and hospitals will be forced to take out insurance policies and hire lawyers, diverting money away from patient care and slowing down the treatment process, to ensure their contracts are fair and no open to legal challenge as they are unfair at present.
Labour has tabled amendments to the Bill that seek to block the introduction of a competitive market throughout the NHS to improve care.
Mr Healey claimed that Andrew Lansley, the Health Secretary, has kept quiet about these consequences of the legislation, by concentrating on improved choice for patients and a reduction in tiers of management. “The more that people see of the changes and look at the risks, the more concerned they become,” said Mr Healey.
A Department of Health spokesman said: "The Bill does not introduce any new competition law or extend current UK or EU competition legislation." 18.3.11
NHS been in 'almost continuous decline'
Although spending on the NHS went up by over £40bn in the last decade, productivity in hospitals was in 'almost continuous decline' during the period which also contributed to an appalling level of waste because they focused too much on meeting targets, according to a report by the Public Accounts Committee. Also, while pay for consultants increased their productivity fell.
Between 2000/01 and 2010/11, spending on the NHS increased by 70 per cent and 40 per cent of this extra money went on services provided by acute and foundation hospitals. This substantial increase in funding enabled hospitals to invest in more, better paid staff and improve their buildings and equipment. And there were "significant" improvements in performance, especially in hospital waiting times and outcomes for patients with cancer and coronary heart disease. But the level of hospital activity didn't keep pace with these increased resources because hospitals focused on meeting national targets and not on improving productivity, the committee found.
The previous government had promised that productivity in the NHS overall would increase every year by between 1 per cent and 2 per cent. But the Office for National Statistics reckoned that since 2000 NHS productivity fell by an average of 0.2 per cent a year, and by an average of 1.4 per cent a year in hospitals.
The committee said that this trend of falling productivity will have to be reversed if the NHS is to deliver £20bn of efficiency savings a year by 2014/15 without cutting services.
Committee chair Margaret Hodge said: "Over the last 10 years, the productivity of NHS hospitals has been in almost continuous decline. Over the same period, the amount spent on the NHS increased from £60bn to £102bn a year. The quality of the health service has improved as a result of this increase in spending. But the taxpayer has been getting less for each pound spent."
She added: "A key problem is that national pay contracts have not so far been used to manage the performance of staff effectively. It is indicative of this that consultants' productivity has fallen at the same time as they have had significant pay rises." 15.3.11
NHS needs to treat productivity issues
Parliamentary watchdog says that NHS productivity has been declining for years. Despite increased resources, NHS productivity has fallen over the past 10 years, according to a report by parliament's public accounts committee.
Since 2000 total NHS productivity fell by an average of 0.2% a year, and by an average of 1.4% a year in hospitals, according to the Office for National Statistics. Government spending on the NHS increased by 70%, from £60bn in 2000-01 to £102bn in 2010-11, with some 40% spent on services provided by acute and foundation hospitals.
This investment has resulted in improvements, as hospitals have focused on areas targeted by the Department of Health (DH), such as hospital waiting times and treatments for cancer and heart disease. Margaret Hodge MP, chair of the committee, said: "The quality of the health service has improved as a result of this increase in spending. But the taxpayer has been getting less for each pound spent."
The DH uses national pay contracts, and the fixed price Payment by Results scheme to drive efficiency and productivity. According to the report, although Payments by Results appears to have driven some improvements, the system only covers 60% of hospitals' activities.
National pay contracts have not been used to manage staff performance effectively, and consultants' productivity has fallen at the same time as they received significant pay rises. "In general, the national focus on quality of care has meant that clinical staff have not been performance-managed with regard to the cost or efficiency of their activities," the report says. "Few hospitals have used staff appraisal systems to demonstrably improve productivity."
The report, Managing NHS Hospital Productivity, highlights the DH's failure to focus on the reasons for differing costs between hospitals for providing similar services, either to identify good practice or efficiencies.
Examples of differences are the variation in the cost of a first-time elective coronary artery bypass graft from £5,000 to £12,000, and number of staff per bed ranging between hospitals from about four to 13.
The committee calls on the DH to explain what more it will be doing to support hospitals and commissioners to use national pay contracts to deliver better productivity. "The Department of Health will now have to work to reverse the trend of falling productivity if it is to meet its ambitious revised target of achieving, by the end of 2014-15, savings of up to £20bn each year," Hodge warned. Her committee intends to re-examine issues of NHS efficiency savings and productivity in future reports.15.3.11
Hospital consultants' productivity falls despite pay increases
Hospital consultants' productivity has fallen over the last 10 years while their pay has risen significantly, according to an influential committee of MPs. Taxpayers are also getting "less for each pound spent" from the NHS as a whole than they were a decade ago, the Public Accounts Committee warns in a report published today (TUES), called Management of Hospital Productivity.
The committee's remarks about productivity - the measure of output per pound spent - are perhaps surprising given that it is chaired by Margaret Hodge, a Labour MP. She said: "Over the last 10 years, the productivity of NHS hospitals has been in almost 'continuous decline'. Over the same period, the amount spent on the NHS increased from £60 billion to £102 billion a year.
"The quality of the health service has improved as a result of this increase in spending. But the taxpayer has been getting less for each pound spent." She went on: "A key problem is that national pay contracts have not so far been used to manage the performance of staff effectively. "It is indicative of this that consultants' productivity has fallen at the same time as they have had significant pay rises."
In December the National Audit Office published a report that found hospital consultants on average earned £120,000 - up from £70,000 a decade ago - but that their workload had fallen.
Mrs Hodge said staff contracts would have to be managed more effectively to improve productivity. She also warned: "The Department of Health will now have to work to reverse the trend of falling productivity if it is to meet its ambitious revised target of achieving, by the end of 2014-15, savings of up to £20 billion each year."
The Office for National Statistics (ONS) has estimated that total NHS productivity has fallen by an average of 0.2 per cent per year since 2000.
In 2002 the Department of Health pledged to increase NHS productivity by between one and two per cent a year, but that failed to happen.
Dr Paul Flynn, deputy chairman of the British Medical Association's consultants' committee, warned against "knee-jerk responses", saying: "Although this report talks about “significant pay rises”, consultants' salaries have been frozen for two years."
Simon Burns, the Health Minister, said: “This report is yet another sign that 13 years of Labour failed to deliver value for money in the NHS. "We are committed to the NHS, which is why we are modernising it and making sure that money currently spent on bureaucracy, will be spent on making sure patients get the best care possible". 14.3.11
Pharma industry wary of UK drug pricing changes
As most drugs don't live up to their hype or benefits and don't work for most people, the government is changing the way the DoH pays for its medications – by results.
Understandably this has caused major concern for the pharmaceutical industry that is fast running out of cash cows as 15 of their leading drug patents expire this year. The ABPI wants the current drug pricing system to remain, but has welcomed government proposals to take a broader view of the benefits medicines provide.
The UK pharma association was responding to the government consultation on plans to introduce a value-based pricing system, under which a drug's price will be set according to the value it provides meaning they will no longer be paying for useless drugs. The reforms will see the current Pharmaceutical Price Regulation Scheme (PPRS) scrapped by 2014, a move ABPI said would be premature given the thousands of existing drugs that would need to be re-priced.
Instead it wants value-based pricing (VPB) to be integrated with an evolved PPRS for existing products, and to “co-create” a new pricing system.
Speaking at the ABPI headquarters in London, president Simon Jose said he also wanted the role of R&D to be “fully reflected in the future system” and recognise medical breakthroughs are ‘rare' and often the result of ‘step-by-step' innovation. He said this ‘progressive innovation' could dramatically improve the lives of patients, but its “cumulative value only becomes apparent after some time”.
Critics say ‘If you listen purely to the industry side of the story, you might think that drug companies are more than vindicated in selling brand-name drugs for sometimes thousands of times more than they cost to produce, and raking in billions of dollars in profits every year. After all, much of that profit covers research and development (R&D) costs, right? Wrong. According to a new study by Prof. Donald W. Light from the University of Medicine and Dentistry of New Jersey, and Rebecca Warburton from the School of Public Administration at the University of Victoria the average R&D costs to bring a new drug to market are a mere four percent (4%) of what Big Pharma claims they are -- and that is a generous estimate.
The ABPI says the NHS has a key role to play if access to medicines is to improve, and that the health service should help ensure “value-proven medicines” are used by clinicians for their patients.
The ABPI added that the National Commissioning Board, responsible for the new GP consortia, should be greatly involved in the development of VBP in order to secure medicines access and uptake across the NHS.
But Jose warned that VBP alone would not solve “broader issues of access and uptake” – this would need to be a collective effort by government and pharma. The PPRS has operated since 1957 as a voluntary scheme between pharma and the government. It is negotiated every five years and regulates the overall profit pharma can make from their drugs, capping the maximum at just under 30%.
The industry is keen any future pricing system would follow this voluntary model, with room to re-negotiate terms every five years.
Also speaking at the ABPI headquarters was the head of patient group National Voices Jeremy Taylor, who voiced his concerns about how the new system would work in practice and whether lay voices would be heard in the decision-making process. “We need more clarity and are keen to work with the government and industry to ensure the future system does not have unintended side effects,” he said.
Today is the final day of the three-month consultation process on VBP with a formal governmental response expected next month. 18.3.11
Big Pharma lies about R&D costs to justify huge profits
If you listen purely to the industry side of the story, you might think that drug companies are more than vindicated in selling brand-name drugs for sometimes thousands of times more than they cost to produce, and raking in billions of dollars in profits every year. After all, much of that profit covers research and development (R&D) costs, right? Wrong. According to a new study by Prof. Donald W. Light from the University of Medicine and Dentistry of New Jersey, and Rebecca Warburton from the School of Public Administration at the University of Victoria the average R&D costs to bring a new drug to market are a mere four percent (4%) of what Big Pharma claims they are -- and that is a generous estimate.
Drug companies constantly whine in their defense that the cost of producing a new drug tops $1 billion. They derive this lofty figure from a 2003 study by Joseph DiMasi from Tufts University, Ronald W. Hansen from the University of Rochester, and Henry Grabowski from Duke University. The study, which was published in the Journal of Health Economics , was conducted out of the Tufts Center for the Study of Drug Development (TCSDD), a drug industry-funded group that "advocate[s] on behalf of initiatives and issues that further the cause of pharmaceutical innovation'.
Let's face it. Any study out of TCSDD is about as unbiased and credible as a court decision reached with the defendant sitting on the jury. The TCSDD study used by the drug industry to defend its billion-dollar drug production claims is based on an arbitrary sampling of drugs produced by ten pharmaceutical companies. These drugs are confidential, of course, and the 12 other firms that were invited to participate in the survey did not participate, according to reports.
So TCSDD basically produced a drug industry-funded study that contains drug industry-favored results. It includes a small and random sampling of unnamed drugs, and claims that such drugs cost an average of $802 million a piece to produce in 2000, or $1 billion in 2011 dollars when accounting for inflation. But the precise numbers and details are all but missing from the report. So how anyone in the scientific or regulatory community can willfully accept the report as anything other than hearsay is anyone's guess [just like the peer review process].
According to a recent piece in Slate, the Pharmaceutical Manufacturers Association ( PhRMA), a pharmaceutical and biotechnology industry trade group, says that average drug development costs are even higher, having allegedly topped $1.32 billion in 2006. Based on this number, PhRMA is claiming that such costs increased by a whopping 64 percent in just six years, which is more than double the normal medical inflation rate.
The Light and Warburton study, which has been published in the journal BioSocieties, says that these figures are greatly overblown, and are simply not based in reality. The Slate piece cites additional research noting that 84 percent of the costs associated with the first research phase of drug development is covered by taxpayers via government grants. Add to this the report's estimate that the drug industry uses a little more than one percent of its sales revenue on basic research, and the costs in this department are very minimal.
Another little-known fact is that drug company R&D costs are tax exempt. They do not depreciate like normal investments do, either. When accounting for the many other tax breaks that drug companies receive, their actual net costs are cut by at least half of what they claim, according to the report. And when adjusting for "cost of capital," that amount should be cut in half again if it is to even approach an accurate estimate for R&D costs. After all, if drug companies are not willing to take a risk in the R&D department -- which is part of what running a business is all about -- then they should not be in business at all, right?
Apparently drug companies feel as though they are entitled to massive profits, even if they fail to produce a valuable product. No other industry receives the benefits that Big Pharma does in the name of public health, and yet the industry is constantly whining and threatening that unless it can keep riding the gravy train and receiving special treatment, the production of drugs will cease. This, of course, takes place as the industry marks up its drugs as much as 569,000 percent over cost, bilking insurance companies and the government out of billions. Natural News 10.3.11
Conflicting Medical Advice – Another Medical U-turn on ‘apple-shape' warnings: It isn't especially dangerous to the heart
A medical U-turn has cast doubt on warnings that being overweight and 'apple-shaped' is especially dangerous to the heart. Researchers who studied 220,000 adults found that fat concentrated around the waist did not increase the risk of heart attacks and strokes any more than general obesity.
Their findings contradict previous evidence that obese individuals with 'apple-shaped' bodies are three times more likely to suffer a heart attack than those with other kinds of fat distribution.
The authors of the new research argue that earlier studies had delivered a misleading message because of study design flaws. Experts said the results should help end confusion over different international guidelines.
Obesity as measured by a person's Body Mass Index, which relates weight and height, and is a known risk factor for heart disease. But recent research has suggested that being fat around the middle is especially bad, increasing the risk over and above that resulting from having a high BMI.
Some experts have even challenged the usefulness of BMI as an assessment tool, arguing in favour of the tape measure instead. The new investigation involved examining data from 58 studies which collectively monitored more than 220,000 adults for almost a decade.
During this period, more than 14,000 participants suffered a heart attack or stroke.
Analysis confirmed that obesity was a major risk factor for heart disease. But the risk remained the same whether worked out from BMI scores - calculated by dividing a person's weight in kilograms by their height in metres squared - waist circumference, or waist-to-hip ratio.
Waist-to-hip ratio compares the distance around the hips and waist to assess levels of 'central obesity'. It shows if a person is 'apple-shaped' with a bulging middle or 'pear-shaped' with a narrower waist and fatter hips and bottom.
A consortium of 200 scientists from 17 countries carried out the study, funded by the Medical Research Council (MRC) and British Heart Foundation (BHF). The findings are published today in The Lancet medical journal online.
The authors, led by Professor John Danesh, from Cambridge University, wrote: 'Whether assessed singly or in combination, body-mass index, waist circumference, and waist-to-hip ratio do not improve prediction of first-onset cardiovascular disease when additional information exists on blood pressure, history of diabetes, and cholesterol measures. This finding applies to a wide range of circumstances and clinically relevant subgroups.'
Dr Mike Knapton, associate medical director at the BHF, said: 'Regardless of how you measure it, being obese is bad for your heart. This study suggests that measuring your waist is no better than calculating your BMI but it's not time to throw away the tape measure just yet. 'We tend to underestimate our body shape and size, so measuring our waist or checking our BMI are both quick and easy ways we can check our health at home.
'We should also remember there are other heart risk factors we need to think about too, such as blood pressure, cholesterol, diabetes and smoking.' 11.3.11
Leading NHS hospitals, family doctors and consultants face Office of Fair Trading probe
Leading NHS hospitals, family doctors and consultants face investigation over allegedly unfair practices by the Office of Fair Trading. Britain's consumer watchdog is looking at whether or not the private healthcare market is “fully competitive” but the increasing liberalisation of the state-run service means it will also come under scrutiny.
It is claimed by some independent firms that NHS hospitals which treat private patients are not competing on a level playing field, as their buildings and services are paid for by the taxpayer. In addition, some GPs are said to only refer patients to particular consultant surgeons or services, making it difficult for others to get business.
The OFT probe could prove embarrassing to the Government as its health service reforms will see more hospitals encouraged to take on private patients, and family doctors given power to choose any provider for treatment.
James Gubb, director of the health unit at the think-tank Civitas, said: “If they do uncover a cosy relationship between GPs and consultants, that does have implications for the role they are going to be taking in leading commissioning. “If they operate like that, the market isn't going to be very competitive and not the best deal for patients.” Civitas has already uncovered a protective 'closed-shop' policy within the NHS.
The private healthcare market in Britain is estimated to be worth at least £5.8billion a year as more people take out private medical insurance or pay for procedures themselves, particularly services such as infertility treatment that are rationed on the NHS.
But over the past decade successful NHS hospitals known as Foundation Trusts have also been allowed to treat privately-paying patients, such as wealthy foreigners or those with insurance policies, in special Private Patient Units. Up until now there has been a cap on the proportion of their income - which must be ploughed back into health services - they can make from private patients but this is set to be removed.
In addition, many leading consultants carry out private surgery when they are not on the rota at their state-run operating theatres.
They can receive referrals from GPs, who under the controversial Health and Social Care Bill will be given control of £80billion of the NHS budget to purchase treatment from “any willing provider” including private firms as well as state-run hospitals.
Last year a new private firm that is to take over an NHS hospital, Circle, complained to the OFT that the healthcare market was “anti-competitive” because it said leading insurance firms would only cover customers if they were treated by established firms.
But on Thursday the OFT published a document setting out the final scope of its investigation, which confirmed that it would also look at the position of Private Patient Units in the NHS and the role of consultants.
The document says that respondents to its consultation complained that: “Private Patient Units appear to enjoy several unfair competitive advantages including access to state funded pensions, corporation and VAT exemptions, no regulatory fees and access to facilities such as NHS intensive care units, and that the NHS is cross-subsidising Private Patient Units to create an unlevel playing field with private healthcare providers.”
The OFT will also examine “the role of GPs, consultants and private medical insurance providers in advising consumers of their healthcare choices”, and whether or not patients “are given choices as to which consultants or services to use”.
Jocelyn Ormond, a corporate partner at the legal firm Beachcroft, said: “The focus on the NHS's role as a provider of privately-funded healthcare is likely to shine a light on the way in which Private Patient Units are operated and the way in which they are arguably cross-subsidised by the taxpayer-funded part of the NHS bodies, and whether that raises competition and state aid issues.”
General Healthcare Group, the UK's largest independent provider of private healthcare, said: “We welcome the OFT's final statement of scope and, in particular, its support for our view that private healthcare provision is now very much a mixed market including traditional private providers as well as the NHS. We are pleased that the more extended scope announced by the OFT reflects how many others in this mixed market, such as insurers, GPs and consultants, impact on its operation and on the service and information received by patients.”
Ali Parsa, the chief executive of Circle, said: “As the Government push the boundaries of patient choice in the public healthcare market, it's encouraging to see the OFT applying the same standards in their scrutiny of the private healthcare market. “The NHS has opened its doors to competition from the private sector, but the private sector is protected from competition from new entrants and NHS providers by closed networks that some private providers are keen to maintain.”
Sue Slipman, the director of the Foundation Trust Network, said it was unlikely that use of Private Patient Units would increase greatly now that waiting times are much shorter than in previous years. “It seems to me that a lot of the reason for going private has been taken away, except where you can see Primary Care Trusts rationing services like in infertility.”
The OFT, which says it has identified “significant issues” in the private healthcare market, expects to publish a final study by the end of 2011. It could lead to recommendations being made for the industry or even “enforcement action” being taken against businesses suspected of breaching consumer or competition laws. 11.3.11
Doctors gunning for Health Secretary Andrew Lansley over NHS reforms as they will be worse off
Doctors are set to deliver another blow to Andrew Lansley's NHS reforms today – by lambasting them at a specially convened conference.
Some 350 delegates have been summoned to London for an emergency meeting of the British Medical Association to discuss dozens of motions highly critical of the Health Secretary's policies. And the medical profession may even declare at the meeting that it has no confidence in Mr Lansley.
The meeting is expected to confirm that most doctors are firmly opposed to the controversial proposals to hand £80billion of the Health Service budget to GPs. Doctors are expected to claim his changes will worsen patient care, squander billions of pounds and threaten the principles of the NHS but in reality two thirds of GPs fear they will be worse off.
Their motions will allege a nightmare scenario under which services could be cut, waiting times could lengthen and hospital departments could close – as a direct result of the reforms. It tops an awful few days for the embattled Health Secretary, whose radical NHS reforms which are desperately needed are coming in for mounting criticism.
Critics say his wholesale changes – the biggest since the NHS was formed in 1948 – are being rushed through with little consultation and despite not having appeared in either of the Coalition parties' manifestos. It has also emerged that former Labour Health Secretary Alan Milburn has snubbed Mr Lansley's offer to head up the powerful quango which will run the Health Service. The Blairite MP indicated that he had no confidence that the Coalition's policies would improve the NHS.
And on Saturday, LibDem activists voted to oppose the broad thrust of his NHS policy, in particular opening it up further to private providers to improve care and outcomes. Critics said ‘it's strange how some people are opposed to breaking up the current NHS monopoly, getting better care and treatments for patients while getting better value for the tax-payer'.
Critics say the Health Secretary has failed to explain why there is such an urgent need for an expensive top-down reorganisation of the NHS. Now the BMA has called a ‘special representative meeting' to discuss the historic changes. The 205 motions, which are largely critical, attack the pace and scale of the reforms, the role of the market and worries over patient confidentiality. 14.3.11
Real reason why GP's are fighting healthcare reforms - 66% of GPs say THEY will be worse off under commissioning
Nearly two-thirds of GPs believe their lives will be worse off and their jobs under threat because of the Government's plans for GP commissioning, according to Pulse analysis of a major BMA poll.
Of GPs who took part in the Ipsos MORI survey, 43% believe the reforms will have a ‘major negative impact' on their role, with a further 20% thinking it will have a ‘minor negative impact'. The breakdown also shows widespread fears over GP job security, with two thirds of GPs saying they feel job security will be worsened under the changes hence their opposition to the reforms are based upon 'self-interest' and not patient care as claimed.
In a further blow to the Government, the survey also shows a huge majority of GPs fear the proposals will damage the relationships GPs have with their patients as their patients will be able to demand treatments not supplied by the NHS and therefore they will lose out on their bonuses.
Of the GPs who responded, nearly a third strongly agreed with the statement, while a further 41% said they tended to agree, whereas just one per cent of GPs felt GP commissioning would improve the GP-patient relationship.
The overall findings from all doctors who responded to the poll of BMA members showed most believing it will harm patient care, with huge concerns raised about the impact of increased competition in the NHS and ramping up the role of private providers or competition to their services were they enjoy a monopoly position at present.
The vast majority of GPs (84%) have taken at least one step to prepare for the reforms, the survey found, with 25% having been signed up as pathfinders.
The Department of Health claimed this and the fact that pathfinders now cover two thirds of the country, showed there was appetite for the reforms and more choice. A spokesperson said: ‘We're glad to see the vast majority of doctors do want to take on more control and work across the primary and acute sector. Our plans take power from bureaucrats and hand it directly to GPs.'
However, the survey shows nearly 80% of GPs think the plans will mean spending less time with patients, while a similar proportion do not believe it will lead to more professional autonomy, while more than half do not believe the plans will lead to closer working with secondary care.
GPC negotiator, Dr Beth McCarron-Nash, told Pulse: ‘The vast majority of GPs that are getting involved because they feel that they have no choice but to get involved, which is a real disaster. We could have had clinical commissioning without all of the damaging stuff.'
The survey shows 94% of GPs believe the reforms will see an increased role for private providers offering patients more choice other than the limited choice currently available on the NHS, with 56% of GPs believing increased competition will damage NHS care but others said having more choice will facilitate better outcomes.
The DH spokeperson added: 'it is clear from this survey, that there are a few misconceptions about competition. We are not introducing price competition and we will never privatise the NHS. We are investing an extra £10.7bn and services will remain free at the point of use, based on need and not on ability to pay.' 6.3.11
Incompetent doctors 'protected by silence' of colleagues who fear retribution
One in four doctors who believes a colleague to be behaving incompetently fails to sound the alarm, a survey has found. They keep quiet because of fears of retribution, or because they think nothing will happen, or that someone else will take care of the problem. The survey comes as complaints against doctors have hit record levels and MPs are holding an inquiry into the medical complaints system.
Almost 3,000 doctors were surveyed from the U.S. and UK, including 1,078 Britons. Some 19 per cent of the British doctors said they had had experience of an incompetent colleague in the last three years, compared with 16.5 per cent of U.S. doctors. Nearly three out of four British doctors said they had alerted individuals or bodies responsible for investigating such behaviour. Of those who did not, a third said they feared retribution, while a quarter thought someone else was taking care of the problem.
One in seven UK doctors said they thought nothing would happen if they did, according to the survey published online in BMJ Quality and Safety. Where doctors had not reported a colleague, the most common reason in Britain was that they were afraid of retribution, reflecting the unsympathetic treatment of whistleblowers .
Katherine Murphy, of the Patients Association, said: ‘It's appalling that some doctors seem still to be operating a cosy club from a misguided sense of loyalty to colleagues rather than protecting their patients.' Peter Walsh, of the patient safety charity Action against Medical Accidents, said there was not enough protection for ‘whistle-blowers' who could see their careers vanish because they had done ‘the right thing'.
The survey also found only six out of ten felt they should disclose any financial ties they had with pharmaceutical companies to their patients.
And not all doctors agreed it was ‘never appropriate' to have a sexual relationship with a patient, according to the survey responded to by four out of ten UK doctors.
Doctors' leaders last night moved to reassure patients. Dr Mark Porter, chairman of the British Medical Association's consultants committee, said: ‘Our primary responsibility as doctors is to our patients.' Niall Dickson, of the General Medical Council, the regulatory body for the profession, said: ‘Doctors have a clear duty to put patients' interests first and act to protect them. This includes raising concerns about colleagues when necessary.' 8.3.11
Ministry of Defence pays £22 for a 65p light bulb
DEFENCE chiefs pay £22 EACH for 65p lightbulbs, Army documents seen by The Sun have revealed. Dim MoD bosses incredibly also pay £103 each for screws that cost £2.60 each. The shocking waste is revealed as 11,000 of Our Boys and Girls face the sack, and ships and planes are scrapped, to plug a £38billion deficit.
The public money spent on lightbulbs represents a mark-up of more than 3,000 PER CENT on their true retail value. Angry Defence Secretary Dr Liam Fox said last night the inflated prices paid showed a "lack of common sense".
Invoices for the 100-watt fittings - known as lamp filaments in Army inventories - were shown to The Sun by a soldier sickened at the pen-pushers' incompetence. Other paperwork revealed the MoD buys simple inch-long steel screws for the Army's Land Rovers for £103 each. Exactly the same screw can be ordered online for £2.60.
The soldier, who works in the stores at a UK base, said: "I can't ignore this any more. The waste I see every day is criminal. "I've seen the cuts they're making - sackings, getting rid of planes, cancelling contracts when it costs more than going ahead with them. And I see the forms - £22.51 for a lightbulb, £103 for a screw. It's like Monopoly money.
"You're talking about a fortune for these bulbs. If I order 100, that's over two grand. But you can pick them up for 65p each, the exact same ones. "There must be thousands of lightbulbs across the MoD. If people paid attention to simple things like this, they could save a lot of money - and maybe jobs. "The question isn't how many defence chiefs does it take to change a lightbulb - but how many soldiers' paychecks does it take to pay for them all."
Frontline troops in Afghanistan learned this week they are among those facing the chop to save cash. Royal Navy warships and RAF jets have also been scrapped.
The Sun launched a War On Waste campaign last year, calling on readers to report bunglers who throw around public money. Our soldier source said huge MoD savings could be made by bulk buying. But single items or tiny amounts were often ordered. He added: "Families know it's much cheaper to buy in bulk. Why doesn't the MoD?"
The soldier explained that specialist contractors source items for the military and add their costs on to the price. The lightbulb supplier is named as FEL Avionics on an invoice from ten days ago.
Their astonishing contract was set up by the previous Labour government. Dr Fox told The Sun: "We are already tackling the procurement problems we inherited head-on. "When money is tight and we need to protect the front line, waste is inexcusable.
"This is classic evidence of how Labour wasted taxpayers' money and shows a complete lack of common sense. No wonder the last government left the MoD with a budget deficit of £38billion."
An MoD spokesman said: "Given the current financial situation, we are looking at existing contracts to ensure value for money and taking steps to make efficiency savings." If you want to know where the armed forces jobs are going take a look at Labour's unbelievable waste in their tenure in power.4.3.11
Drug research fraud scandal - Millions of surgery patients at risk
Millions of NHS patients have been treated with controversial drugs on the basis of "fraudulent research" by one of the world's leading anaesthetists, The Daily Telegraph can disclose.
Joachim Boldt is at the centre of a criminal investigation amid allegations that he may have forged up to 90 crucial studies on the treatment. He has been stripped of his professorship and sacked from a German hospital following allegations about his research into drugs known as colloids.
Experts described Mr Boldt's alleged forgeries as possibly the biggest medical research scandal since Dr Scott Reuben a former member of Pfizer's speakers' bureau, plead guilty to faking dozens of research studies that were published in medical journals. Dr. Reuben had made a career out of faking studies.
Guidelines for British anaesthetists regarding colloids – used to boost blood volume in patients undergoing surgery – are being revised after it emerged that four of the key studies on which they were based are to be formally retracted. Mr Boldt, 57, was regarded as a leading specialist in intravenous fluid management, and his work was published widely in British medical journals.
He claimed to have proved that colloids were as safe as other, similar treatments despite earlier studies showing them to be more dangerous. Mr Boldt's alleged forgeries date back up to a decade.
The Consensus Guidelines on Intravenous Fluid Therapy, published by six British medical groups including the Association of Surgeons and the Intensive Care Society, were being withdrawn last night. Prof John MacFie, president of the Association of Surgeons, suggested that some British patients could have been put in danger. He said he would urge other medics to abandon colloids.
"We have withdrawn the guidelines from our website and we will need to rewrite the article," he added. "The profession I represent does not want to be to be associated with potentially fraudulent research. As chief anaesthetist at Ludwigshafen Hospital in the Rhineland , Mr Boldt was the leading advocate of colloids, which are now commonly used across Europe.
He published dozens of papers "proving" their benefits and contradicting studies which suggested they could increase the risk of death in surgery and cause kidney failure, severe blood loss and heart failure.
German medical authorities are scrutinising 92 of his key publications and a criminal investigation is under way into allegations that he forged documents, tested drugs on patients without their consent and fraudulently claimed payments for operations he had never performed.
Mr Boldt received funding from manufacturers of hydroxyethyl starch (HES) – the colloid he most strongly advocated – including B. Braun, Baxter and Fresenius Kabi.
He was frequently paid to speak at international medical conferences where he hailed HES as "the holy grail" of fluid drugs.
HES and other colloids are up to 10 times more expensive than the alternative fluid management drugs, crystalloids, which some experts believe are safer as they contain smaller molecules and are more easily absorbed. Mr Boldt was sacked from Ludwigshafen Hospital last November. It has established an investigating commission to review 29 of the 92 papers which have been identified as "highly suspected" of containing forged or distorted data. The others will be examined if serious evidence of forgery is found.
Prof Eike Martin, head of the investigating commission, told The Telegraph : "At first we thought that all the studies were 100 per cent invented, but now we have found a huge amount of clinical data from trials that were conducted.
"Our suspicion is that the trials are not reported accurately in the papers. Prof Boldt was an advocate for colloids and that was the conclusion of his studies, but the data he published is different from the original data we have seen.”
Prof Martin said investigators examining one study, which purported to show that HES caused less inflammation than another fluid management drug, had found that the original data contradicted the conclusion.
The editors in chief of a consortium of medical journals which published Mr Boldt's work are also reviewing the 92 publications. Sources close to the investigation said that the editors would announce the formal retraction of 89 papers next month.
Rhineland state prosecutors are investigating Mr Boldt over allegations that he forged the signatures of his alleged “co-authors” on his studies, but editors of publishing journals are meant to check such details which highlights a worrying trend of publishing what they are told to, he also conducted drugs trials without official approval and claimed money for operations that he never performed. Police raided his home and his offices at the hospital in December and seized paperwork and computers.
Lothar Liebig, the state's director of public prosecutions, said: “Boldt published certain studies about medical drugs in order to get them accepted. “There there is a strong suspicion that he deliberately failed to obtain the approval of the institutional review board in Ludwigshafen , which is a criminal offence.”
Other medical research has contradicted Mr Boldt's findings.
Research by Dr Gill Schierhout and Dr Ian Roberts of University College London found in 1998 that the use of colloids during surgery increased the risk of death by four percentage points – equivalent to four extra deaths in every 100 patients.
A review published 10 years later by Konrad Reinhart and Christiane Hartog of Friedrich Schiller University in Jena, Germany cited two large-scale clinical trials which found that HES could prevent the blood from clotting, which can cause heavy bleeding. Other studies have shown that some colloids can result in complications including heart and kidney failure, fluid entering the lungs and anaphylactic shock.
Suspicion first fell on Mr Boldt in October when readers of an article that he had published in the US journal Anesthesia and Analgesia, about the benefits of HES in bypass surgery, noticed that the pattern shown by his data was “too perfect to be believed”.
Dr Rupert Pearse, a senior lecturer in intensive care medicine at Barts and the London School of Medicine, and co-author of the British guidelines on fluid drugs, said last night: “I specifically remember looking at a paper of his last year and being surprised at how lucky he had been with his results. “For me, it shakes the world I work in and makes me feel less confident in it, and if I were a member of the public I would feel the same.”
Mr Boldt was unavailable for comment. 4.3.11
Joachim Boldt profile: a glittering fake career built on charisma and charm
Joachim Boldt was a leading anaesthetist, internationally respected for his prolific research and renowned in medical circles for his charm and charisma.
His studies of obscure fluid drugs helped him carve out a niche in a little-known area of medicine and attract funding from pharmaceutical companies. But his glittering career came to a sudden end in November when medical authorities began an investigation into more than 90 of his studies.
Mr Boldt gained the title "professor extraordinary", now retracted, from the University Hospital of Giessen in 1993, where he quickly rose to prominence as a promising young medic.
During his tenure at the Ludwigshafen hospital, he built up an international reputation. Colleagues who saw him speak recall his presence and persuasiveness.
Dr Bob Winter, president of the Intensive Care Society, said: "I saw him address a number of conferences and he was entirely plausible. He was a charismatic man. The allegations against him are a surprise."
Mr Boldt's peers marvelled at the consistency and clarity of his findings – especially as many of the trials were performed on patient groups of fewer than 16 – but some began to comment privately that the data seemed "a little too good to be true".
When a reader of Anesthesia and Analgesia pointed out that data in a study of HES during heart surgery showed an implausibly perfect pattern the journal's editor contacted the Rhineland State Medical Association.
The allegations of academic forgery which followed have left the medical community in Ludwigshafen reeling.
Prof Howard Martin, who is leading the hospital's internal investigation, said: "I don't understand. "He had a good position and a good job. Why has he done this? My feeling is that it is unbelievable that someone would be publishing studies without proper regulation. It's crazy. This is very bad for our discipline. "There is also a serious abuse of power."
If a criminal investigation ends with a conviction he could face a sentence of more than 10 years, or a fine of up to €100,000 (£85,000). 4.3.11
Labour cover-up: Reports kept secret by Labour
Reports show mass immigration cut wages, raised tensions and that too many stayed too long. Labour is today accused of a ‘shocking' cover-up over the impact of years of mass immigration as damning official research buried by the last government is revealed.
Ministers will publish three reports commissioned at the taxpayers' expense by Labour politicians – but then apparently ‘sat on' because of their inconvenient conclusions. Critics say other reports detailing the failings of the NHS and its monumental waste were also ‘sat on'.
Government advisers concluded immigration had depressed wages, threatened to increase community tensions and seen many incomers stay longer than intended. The Coalition claims the unpublished reports, which cost more than £100,000 to produce, are extraordinary evidence of how Labour lost control of Britain's borders and then tried to cover it up.
The revelations come as Labour leader Ed Miliband admitted his party got it ‘wrong' on immigration while they were in power – with millions of families having their incomes squeezed as a result. The last government was widely criticised for failing to impose any controls when ten countries joined the EU, underestimating the number of migrant workers coming to the UK as a result of the changes by a factor of ten.
Local government minister Grant Shapps, who will release research commissioned by the Department for Communities and Local Government before last year's election, said: ‘This is a shocking cover-up by Labour. Labour ministers spent over £100,000 of taxpayers' money on research reports into immigration, and when they didn't like the results they tried to brush it all under the carpet.
‘The new Government is being more honest with the public and so we will be making these reports public. We are introducing a series of measures to get immigration under control. Labour's uncontrolled immigration put unacceptable pressures on public services and harmed community relations.'
The first report, a DCLG ‘economics paper', was commissioned in 2009 at a cost of £24,275, and looked into immigration and rural economies. Government advisers concluded that immigration had had a negative effect on the wages of British workers, particularly at the lower end of the income scale. They also warned of a big increase in the number of National Insurance numbers being issued, with hundreds of thousands handed to illegal workers as there was no requirement for JobCentre staff to check whether a person was in the country legally.
In rural areas, migrants make up a third of food manufacturing workers, a quarter of farm workers and a fifth of hotel and restaurant workers, the report added. ‘There are challenges posed by language barriers, which can make access to services and integration within local communities more difficult,' it said.
‘Housing, healthcare and education could also be affected by an increase in local population, when some existing local services may already be under pressure.' The largest clusters of migrant workers, the report said, were around Herefordshire, Lincolnshire and Cambridgeshire and, to an extent, Somerset and Devon. ‘Far from being an urban phenomenon, recent migrants have increasingly chosen to settle in the countryside, in many cases in areas without a history of migration,' the report added.
The second report, prepared by the Government's regeneration and economic development analysis expert panel, looked at the impact of the economic downturn on migration. It was commissioned in 2008 at a cost of £3,400. The report showed that the number of migrants entering the country with dependants increased dramatically from 2007 to 2008. Ministers were also warned that community tensions were likely to increase in the event of an economic downturn.
The third report, commissioned last year at a cost of £78,500, was designed to measure international and internal migration using information from a national database of school pupils. It found that one in eleven pupils spoke English as a second language.
Yesterday, Ed Miliband admitted the Labour government's open door policy towards immigration from Eastern Europe had put ‘pressure on people's wages' by bringing about an influx of cheap migrant labour. He also conceded that Labour ministers had been ‘wrong' to say that a maximum of 13,000 migrants a year would come to the UK from Eastern Europe following EU enlargement in 2004. In the event, more than 600,000 arrived in the following two years.
And he warned that immigration had helped widen the gap between rich and poor by piling pressure on those in lower skilled jobs. Labour's former immigration minister Phil Woolas claimed last year that even at party gatherings, senior figures were reluctant to talk about one of voters' chief concerns.
‘We had imposed a gag on ourselves,' he said. And by the 2010 election, when the party did finally discuss the issue, ‘the public thought we were shutting the stable door after the horse had bolted and even worse that we were doing it for electoral gain'. 1.3.11
NHS bosses' pay soars 50% as thousands of doctors and nurses face axe
NHS bosses in charge of hospitals being forced to sack thousands of staff have seen their pay soar by up to 50 per cent in the past five years, it has emerged. The chief executives at trusts facing the worst cutbacks are now on lucrative salaries far higher than the Prime Minister’s, with some earning more than £200,000.
And most handed themselves comfortable pay rises last year even though hundreds of their own staff were being made redundant to reduce costs. The NHS has been ordered to make up to £20billion of efficiency savings by 2014 and hospitals have resorted to axing hundreds of posts to meet the targets.
Figures released yesterday show more than 50,000 jobs have been earmarked to go over the next three years, including frontline doctors, nurses and midwives. Many NHS workers lucky to keep their jobs are facing a two-year pay freeze, which effectively amounts to a pay cut once inflation is taken into account.
But it has emerged that over the past five years the hospital chief executives laying off the most staff have seen their salaries soar by as much as £70,000.
The same hospitals have also squandered inappropriate sums of money redesigning their logos, on expensive restaurant meals for managers and pornographic magazines for IVF clinics. Unions attacked the payouts as ‘poor judgment’ claiming they sent out ‘completely the wrong message’ to patients and front-line workers.
Figures show the chief executive of Central Manchester University Hospitals Trust, where 1,400 jobs are to go in the next four years, has enjoyed a pay rise of 48 per cent since 2008. He is currently on a salary of between £210,000 and £215,000, an increase of £70,000 compared to five years ago.
Meanwhile the pay of the chief executive at Devon and Exeter NHS Trust – which is to lose more than 1,000 full time posts by 2012 – has gone up by more than 30 per cent in the past five years. Her salary has overtaken that of David Cameron, who earns £142,000 a year, and she now takes home between £165,000 and £170,000. The boss of Heart of England NHS Trust takes home around £240,000 a year, a rise of almost 30 per cent since 2006.
But the trust is set to lose 1,600 posts over the next four years, although bosses insist most will be managerial and administrative roles. At East Lancashire Hospitals NHS Trust, which is set to shed more than 1,000 staff, the chief executive’s pay has also soared by 32 per cent to between £165,000 and £170,000.
The most up-to-date figures uncovered by the TUC show at least 53,150 posts in hospitals, health trusts and ambulance services will be lost by 2014. Campaigners have repeatedly warned staff are already stretched to breaking point and further cuts will lead to longer waiting times, poorer care and deaths.
Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: ‘These pay rises reveal poor judgment and leadership at a time when the NHS is facing serious financial challenges. ‘It also sends completely the wrong message to frontline staff, who are not only concerned about losing their jobs, but are facing a pay freeze. It is the collective hard work of all NHS staff that ensures high quality healthcare services are delivered on a daily basis. ‘Managers play a very important role in the NHS, but nothing should come ahead of delivering patient care.’
Charlotte Linacre, campaign manager at the TaxPayers’ Alliance, said: ‘It’s unbelievable that some NHS bosses have taken massive salary increases just as the NHS has to be careful with spending including on staff costs. ‘Taxpayers who fund these eye-watering increases will not be impressed. ‘Bosses knew budgets would be tighter in the following years but they’ve helped themselves to more money, it’s time these high salaries were brought under control.
‘Taxpayers will feel cheated if top earner salary hikes have been prioritised over core frontline health services.’
Rude, arrogant, lazy: Patients' verdict on NHS staff as two in three tell of poor care
Up to two in three patients are unhappy with the care they are given on the NHS, an alarming report has found.
Many of those treated by the Health Service complain that they were dehumanised, humiliated and embarrassed by the doctors and nurses who were supposed to be looking after them. The survey of almost 12,000 patients found that staff were criticised for being rude, arrogant and lazy – too often refusing to treat their patients with dignity or compassion.
And only a third of those polled said they were content with the standard of care that they had received on an NHS ward or at a surgery.
The remainder were unhappy with at least one aspect of their treatment, citing impolite staff, a lack of compassion, poor standards of hygiene and waiting times. The report comes just a week after an official accused the NHS of an ‘ignominious failure' to care for the elderly.
A scathing study by the health service ombudsman highlighted examples of inhumane treatment, including patients being left unfed and unwashed, and sent home in urine-soaked clothes. The latest research comes from Patient Opinion, a website set up for patients to detail their experiences of the NHS. It found that staff attitude was the biggest source of complaint.
One new mother, who has withheld her name, described how she was ‘treated like an animal' when she recently gave birth at St Thomas' Hospital, London. She claimed that despite her pleas for pain relief she waited six hours before a member of staff gave her some paracetamol.
The woman, a lawyer who works in the City, added: ‘When I asked for help breastfeeding, the midwife shrugged and said, “Try whatever you like”.' Another told of being forced to stay on a mixed ward despite ‘promises' from staff this would not happen.
Meanwhile, one patient admitted to Derby City Hospital claimed that the standard of food was so appalling, all they ate over the course of four days were two slices of toast and a sandwich.
Others complained about a lack of communication, saying that staff refused to give them enough information about their treatment and made decisions behind their backs. One said: ‘You're made to feel that you're not allowed to ask the doctors any questions to do with yourself.' Another said: ‘No one is telling my daughter what the problem is and who to talk to.'
Patient Opinion, which was set up in 2005, has collated almost 13,600 patients' experiences of the NHS.
But since many of its contributors are likely to log on because they are unhappy with their care, it is difficult to quantify exactly what proportion of all NHS patients are similarly disgruntled.
Paul Hodgkin, who is chief executive of Patient Opinion, said: ‘This report shows that patients' main concerns about their care happen at a staff-to-patient level, and these concerns can all be remedied quickly and cheaply. ‘My hope is that this report empowers and inspires staff.
‘Irrespective of political, financial or managerial changes, every NHS staff member has it in their power to improve the experience of their patients – at no extra cost to the NHS.' 23.2.11
Reforming the NHS: Accountability
Last week, Reform published its 2011 public service reform scorecard. It judged each major government department against the three criteria set out by David Cameron: accountability, flexibility and value for money. The report finds the Home Office's policing reforms succeeding on all three fronts, but inconsistency across other government departments. The Government's health reforms are awarded grade D overall, with an E for accountability, a D for flexibility and a D for value for money. Here's how the coalition can get its NHS reforms back on track.
The government has recognised the need for fundamental reform of the NHS. The proposals announced in the July 2010 White Paper are substantial. However, the government's plans leave accountability divided between patients, doctors and local authorities. Healthcare delivery continues to be centralised: Andrew Lansley has placed a moratorium on hospital closures, and the government will maintain national direction of the workforce. The decision to ring-fence health spending means that health policy is based on increasing inputs and not value for money; significant waste has been identified, but it should still be protected.
The government is reorganising the NHS' commissioning structure. Clinicians will have to commission healthcare services from a plurality of providers and put patients at the heart of the NHS. However, rather than consumer choice, the NHS White Paper sees professional empowerment and localisation as the key drivers of change. This has divided accountability: the reforms make GPs responsible for commissioning medical services on behalf of patients; consortia are accountable to the Commissioning Board; local authorities will be responsible for public health, joining up commissioned services and leading strategic needs assessment. Moreover, the Health Bill gives the Commissioning Board significant powers over consortia. But it also gives the Secretary of State power to direct the Commissioning Board not only in what it does but in how it does it. Consequently, accountability runs to the centre with “the Secretary of State…holding the NHS to account for improving healthcare outcomes.”
Sitting before the House of Commons Health Select Committee, Sir David Nicholson stated that “we'll have to centralise more power in the very short term to deliver benefits”. The Commissioning Board, which Sir David has been chosen to chair, will be able to wrest funds from allocations to commissioners for the purpose of creating risk-sharing arrangements and to bail overspending consortia out – implying that surplus generating consortia might not have their full underspends returned to them each year. This disincentivises success and indicates that the desired healthcare market may advance no further than it did under the Primary Care Trust structure, which was subject to such top-slicing under the previous Government. In addition, having abolished targets, the Department of Health's technical guidance for the 2011-12 Operating Framework runs to 261 pages and contains more than 100 indicators “against which the NHS will be held accountable”.
Existing proposals would see a new national workforce strategy for NHS employment. Despite a stated desire “to empower healthcare providers, with clinical and professional leadership, to plan and develop their own workforce”, the proposed strategy calls for “sector-wide oversight of key aspects of workforce planning, education and training” and “mechanisms that allow the NHS Commissioning Board to have strategic influence on the national picture for education and training.”
Broadly speaking, the reforms aim to liberate the NHS from central control and create “the largest social market in the world”. However, providers' freedoms continue to be curtailed. The Secretary of State has imposed a penalty upon hospitals that continue to house patients in mixed sex wards. The government also acted immediately to stop NHS London's proposed reorganisation of its healthcare services and introduced new tests for redesigning hospital services.
If the government really wants to deliver a revolution in healthcare, it must make doctors and hospitals accountable to patients, not to multiple points within government. Doing so would create a real market for health and the government must remove regulatory barriers to ease access for new entrants, while restrictions on how providers deliver their services must be lifted. Above all, the ring-fenced budget must be scrapped to incentivise a real focus on value for money. 22.2.11
David Cameron: End state monopoly over public services
David Cameron has said the government will set out plans to allow private and voluntary groups to run almost every kind of public service. He told the Daily Telegraph there would be a new "presumption" that private companies, charities and voluntary groups could run public services. A "complete change" was needed to boost standards and end the "state's monopoly" over public services.
But unions accused him of trying to "privatise everything". Ministers are due to publish a White Paper outlining the changes in the next fortnight.
In his interview, Mr Cameron promised to release public services from the "grip of state control" as part of his Big Society agenda. The prime minister said he wanted an automatic right for private sector bodies, charities and voluntary groups to bid for public work. He also said decision-making power would be given back to professionals and people would have more control over the budget for the service they receive.
Mr Cameron wrote: "We will create a new presumption - backed up by new rights for public service users and a new system of independent adjudication - that public services should be open to a range of providers competing to offer a better service. "Of course, there are some areas - like national security services or the judiciary - where this wouldn't make sense. But everywhere else should be open to real diversity."
Mr Cameron promised to end the "old-fashioned, top-down, take-what-you're-given" model of public services. He insisted the state still had a crucial role to play in ensuring fair funding and access.
But General Secretary of the Trades Union Congress Brendan Barber accused Mr Cameron of pursuing a "naked right-wing agenda" that would take the country back to the most divisive years of the 1980s. "The prime minister has been telling us that the cuts are sadly necessary, not a secret political project to destroy public services. Yet today's proposal to privatise everything that moves is exactly the kind of proposal that voters would reject if put at an election. "What is particularly laughable is the idea that this will reduce bureaucracy. Privatisation replaces democratic oversight and accountability with a contract culture that is a job creation scheme for lawyers.
"Voters and service users lose their say in what will be a get even richer quicker scheme for the companies that win contracts." And Rail, Maritime and Transport union leader Bob Crow said the government would "privatise the air that we breathe if they thought they could away with it".
Anticipating criticism in his article, Mr Cameron said: "This is not about destabilising the public services that people rely on; it is about ensuring they are as good as they can be. "These are practical reforms, driven by a clear rationale that the best way to raise quality and value for money is to allow different providers to offer services in an open and accountable way."
The prime minister is clear how he wants to transform public services - by opening them up to the private and voluntary sector - but he is a good deal less clear about how he is going to make this happen. Merely urging public sector bosses to put services out to tender is unlikely to be sufficient.
Firstly, many local councils and education authorities are certain to resist handing over vast chunks of their services to outside contractors.
Secondly, public sector workers are likely to be distinctly unenthusiastic about being replaced or having to re-apply to provide the same services but as "a mutual".
And the trade unions are unlikely to simply walk away over what they will see as a threat to their power base and members conditions.
Mr Cameron has willed the ends. But so far he has not willed the means. 21.2.11
NHS bosses blocked hospital food revamp
Lloyd Grossman last night accused NHS bosses of thwarting his attempts to reform hospital meals. The TV chef headed a £40million revamp of NHS menus amid great fanfare in 2000, pledging to replace soggy sprouts and lumpy custard with healthy and tasty dishes.
But the initiative was scrapped just five years later, after Mr Grossman left in frustration at the lack of progress. In a programme to be screened tonight, the former presenter of the BBC’s Masterchef delivers a searing critique of NHS bosses for failing to push through the proposed changes, and laid bare the chronic ‘lack of common sense’ which compelled him to walk out.
He told Channel 4’s Dispatches: ‘Someone at the top has got to take the issue of food seriously or else patients will continue to suffer unnecessarily. ‘It seemed so obvious and it still seems so obvious that if you give patients better food they will be happier, they will heal more quickly.’ Grossman, who was not paid for his involvement in the initiative, added: ‘There was kind of a prejudice against common sense, the kind of common sense that’s been part of patient care since Hippocrates. ‘I don’t think anything made me snap. It was really just an accumulation of five years of frustration, knowing that it should be done, knowing that it could be done, yet, looking all around me and finding all sorts of impediments.’
The NHS spends around half a billion pounds on catering every year, but has been hit by a welter of complaints about poor quality food and malnutrition, especially among the elderly. Grossman’s revolution was intended to replace unappetising fare with restaurant-quality meals.
Some of the recipes he devised – which were trialled at London’s St Bartholomew’s Hospital – included braised lamb with parsley dumplings and smoked haddock macaroni. But ten years on, the Dispatches programme, The Truth About Hospital Food, reveals shocking examples of poor quality.
Reporter Mark Sparrow, who spent ten weeks in hospital, found young cystic fibrosis sufferers who said their survival was being jeopardised by a poor diet. He also met elderly patients being given revolting food and no help to eat it, an issue repeatedly highlighted by the Daily Mail’s Dignity for the Elderly campaign.
Health Minister Anne Milton said: ‘There is no excuse for any hospital offering patients poor quality food. ‘Progress is being made, but more needs to be done. We are making the NHS more transparent and accountable to patients, including a national roll-out of spot inspections to check specifically for malnutrition.’ In The Truth About Hospital Food is on Channel 4 tonight at 8pm. 21.2.11
Laser light treatment for cancer
Yale boffins have built a laser light cancelling device roughly analogous to noise-cancelling headphones.
Laser (Light Amplification by Stimulated Emission of Radiation) beams are made by pumping electricity or light into a device composed of two opposing mirrors and a so-called gain medium, such as gallium arsenide, between them. One of the mirrors is partially transparent. The gain medium, excited by the applied electricity or light, emits photons which bounce back and forth between the mirrors and the amount of light involved is amplified as more photons are emitted.
The device is a resonant optical cavity and the emitted photons oscillate between the two mirrors, with some escaping as an intense beam of coherent light through the partially transparent mirror, as the number of photons in the device continually increases.
"Coherence" means the laser beam is made of light waves with a single frequency and amplitude.
So we have light waves oscillating back and forth within the device. According to the El Reg science 101 manual, if a light wave travelling one way meets a light wave travelling the other way that has the same wavelength but is an inverse of itself, the two waves should cancel each other out. Put another way, if the incoming light enters what is effectively a loss medium instead of a gain medium it should disappear.
Laser killer chase
The laser killer chase was started last year when a team, led by Yale University physicist A Douglas Stone, published a paper theorising that a laser-killing device could be built using common or garden silicon. He then worked with another team of boffins led by Hui Cao at Yale, and they built and demonstrated a 1cm device, a Coherent Perfect Absorber (CPA) that worked almost perfectly, absorbing 99.4 per cent of the near-infrared laser light shone into it.
The concept is that laser beams of the same wavelength from two laser sources are shone directly at each other, meeting inside a cavity containing a silicon wafer, the loss medium, where the wavelengths bounce back and forth inside the wafer, cancelling each other out.
The Yale release says: "The wafer aligned the light waves in such a way that they became perfectly trapped, bouncing back and forth indefinitely until they were eventually absorbed and transformed into heat."
The boffins think they can build a device absorbing 99.999 per cent of incoming light, which measures only six microns across. They also expect to be able to absorb light at wavelengths visible to the human eye by altering the cavity dimensions and the loss medium.
The scientists say possible uses of the technology include an optical computer and radiological imaging or treatment of the human body for diseases such as cancer.
The device isn't exactly analogous to noise-cancelling headphones, as it doesn't generate the sound needed to cancel out incoming sound at certain wavelengths. However this is only a first step. It also can't function well as a defensive shield against laser light beams as, a) you need to generate an exactly identical opposing beam, and b) the absorbed light becomes heat, which would fry the shield. 18.2.11
CBT and exercise challenge 'no cure' for ME in flawed study
Counselling and exercise could help reverse some effects of ME, a new study has suggested but the results where ‘exaggerated' and only those well enough to travel took part in the study, which immediately undermines it's results.
Experts have identified two types of treatment for chronic fatigue syndrome, potentially helping thousands of sufferers. It is a widely accepted belief that ME cannot be cured, but the landmark study - which is the most comprehensive to date - questions this.
Scientists involved in the research spent eight years working on it, and believe that it could spark a new era of ME treatment. They hope the result will change the belief that nothing can be done for the quarter of a million sufferers who are living with the condition in the UK.
Researchers found six in 10 patients reported significant improvements after undergoing either cognitive behavioural therapy (CBT), while encouraging them to increase their activity - or graded exercise therapy, which is based on gradually increasing exercise.
Half of these people reported a return to “normal” energy levels.
However, the study showed one of the most common CFS treatments has no definitive medical benefit. Adaptive pacing therapy, which teaches patients to match their activity level to the amount of energy they have, does little more than help sufferers manage their illness, the study showed.
Though it has been widely advocated, the therapy has never before been scientifically tested.
Michael Sharpe, professor of psychological medicine at the University of Edinburgh and co-author of the report, said scientists had achieved a significant “milestone” by proving exercise therapy and CBT were both effective and safe.
Pacing, graded Activity and Cognitive behaviour therapy: a randomised Evaluation is published in The Lancet.
Action for ME said it was “surprised and disappointed” by the results of the study, insisting its claims were “exaggerated”.
Chief executive Sir Peter Spencer said the findings contradicted evidence from the charity's own surveys and those of other patient groups.
“The pace trial was limited to patients who were well enough to travel to hospital for therapy and those who had fatigue as a primary symptom,” he said.18.2.11
Medical hypocracy alive and well as regulation of herbal medicines gets go-ahead
The Government will proceed with the statutory regulation of herbalists and acupuncturists, side-stepping some concerns that it may put patients at risk. EU laws – due to be brought in this April – would have made it illegal for practitioners to provide unlicensed herbal medicines.
However, in a controversial move, the Government has decided to side-step this legislation by offering statutory registration for all practitioners of acupuncture, herbal medicine and traditional Chinese medicine.
The Government has decided to plough ahead with regulation, despite concerns from doctors that it will mislead patients, as that is their job.
In a consulation in 2009, the Royal College of Physicians issued a strongly worded response against statutory regulation, saying it was ‘completely inappropriate' and arguing it would lend credibility to therapies that had ‘the potential to increase the possibility of harm' but critics pointed out pharmaceutical drugs (ADR) 'harm' and kill more people than any other cause in the country and iatrogenic deaths are also on the increase.
Today, RCP president Sir Richard Thompson said he was 'disappointed' with the changes announced by the Government. 'The proposed statutory regulation will imply herbal therapies have the same legitimacy as medicine, nursing and dentistry, despite offering patients no proven benefit,' he said. Critics then pointed out most pharmaceutical drug are just synthetic copies of 'herbal substances' already found in nature, the only reason the natural compounds aren't used, is because they cannot be patented or exploited by drug manufactures.
Health secretary Andrew Lansley said he had already asked the Health Professions Council to establish a statutory register for practitioners supplying unlicensed herbal medicines. ‘This approach will give practitioners and consumers continuing access to herbal medicines.
‘It will do this by allowing us to use a derogation in the European legislation to set up a UK scheme to permit and regulate the supply, via practitioners, of unlicensed manufactured herbal medicines to meet individual patient needs.'
Alternative medicine practitioners are currently only subject to voluntary regulation by the Complementary and Natural Healthcare Council. 18.2.11
Herbal medicines will survive after ministers approve plan that bypasses EU directive
Herbal and Chinese medicines that faced an EU ban are to stay on sale under plans to register UK practitioners for the first time. The Government moved yesterday to protect consumers wanting herbal products that will disappear from many health food shops after April 30.
Mr Lansley has approved a plan for the Health Professions Council to establish a register of practitioners supplying unlicensed herbal medicines, who will be required to sign up by law.
But from May 1 consumers will be unable personally to buy many traditional herbal products under an EU directive passed in 2004, taking effect this year. Only those which have been licensed in a process costing £80,000 to £120,000 will remain on sale.
At least 50 herbs, including horny goat weed (so-called natural Viagra), hawthorn berry, used for angina pain, and wild yam will no longer be stocked in health food shops, says the British Herbal Medicine Association.
The EU directive demands that a traditional herbal medicinal product must be shown to have been in use for 30 years in the EU – or at 15 years in the EU and 15 years elsewhere – for it to be licensed.
The UK drug safety watchdog, the Medicines and Healthcare Products Agency, has issued more than a dozen alerts in the past two years, including a warning last month over a contaminated weight loss pill called Herbal Flos Lonicerae (Herbal Xenicol) due to concerns over possible side-effects.
Mr Lansley, in a written statement, said the Government wanted to ensure continuing access to unlicensed herbal medicines via a statutory register for practitioners ‘to meet individual patient needs'. All UK health departments will consult on the legislation, and the aim is to have it in place in 2012.
Acupuncture falls outside the EU directive and so remains unaffected.
Prince Charles, a long-standing supporter of complementary therapies, has voiced his support for formal regulation of herbal practitioners.
Michael McIntyre, chairman of the The European Herbal and Traditional Medicine Practitioners Association, said: ‘The Government is to be congratulated on making the right decision to bring in statutory regulation for all those prescribing herbal medicines. ‘Ministers have clearly recognised that this legislation is for patients' benefit and we look forward to working with the Department of Health and Health Professions Council to implement this as soon as possible.'
Professor George Lewith, professor of health research at Southampton University, said: ‘Evidence for the efficacy of herbal medicines is growing; they may offer cheap, safe and effective approaches for many common complaints.'
Kaye McIntosh, of the College of Medicine, said: ‘Without statutory regulation, many herbal practitioners in the UK would have been unable to continue practising and thousands of patients would be unable to make the choice to use herbal treatments.' At least six million Britons have consulted a herbal practitioner in the past two years, according to Ipsos Mori research. 17.2.11
Think positively: Placebos really do make you feel better
Having faith in your medication increases the chance of it working, researchers have found. They say a patient's attitude can directly affect how well a drug works – or whether it works at all.
Though often dismissed as mere wishful thinking, the so-called ‘placebo effect', where patients derive benefits from dummy drugs, is very real.
But a sceptical outlook can cause an ailment to linger.
The Oxford and Cambridge university researchers looked at how people's attitudes affected a drug's effects. Twenty-two young men were hooked up to a drip of remifentinal, a powerful morphine-like drug, while a heated rod was attached to their calf. The temperature was adjusted so the men rated the pain equally and, without telling the participants, the drip was started.
This lead to the average initial pain rating of 66 going down to 55, the journal Science Translational Medicine reports. When the men were then told the drip was being started, despite the dose being the same, their perception of the pain fell to an average of 39.
The volunteers were then told the drug had been stopped – when it hadn't – and were warned this could lead to increased pain. The amount of pain they felt shot up to 64. Lead researcher Professor Irene Tracey said: ‘Doctors shouldn't underestimate the significant influence that patients' negative expectations can have on outcome.
The placebo effect therefore relies on the positive 'belief' or the 'expectation' that the treatment will work and herein lies the problem when applying the placebo effect argument to most non-pharmaceutical treatments. When a patient takes a pill, they 'expect' and 'believe' they will get better [placebo effect] but often they don't. When a patient tries a non-pharmaceutical treatment they are usually 'highly sceptical' [no placebo effect] but often do get better, therefore the placebo effect applies more to' drugs' than to complementary treatments. 17.2.11
Nearly all drug trials scientifically invalid due to influence of the mind; Big Pharma science dissolves into wishful thinking
A new study in Science Translational Medicine has cast doubt over the scientific validity of nearly all randomized, double-blind placebo controlled studies involving pharmaceuticals used on human beings. It turns out that many pharmaceuticals only work because people expect them to, not because they have any "real" chemical effect on the body. As you'll see here, when test subjects were told that they were not receiving painkiller medications -- even though they were -- the medication proved to be completely worthless.
This particular experiment involved applying heat to the legs of test subjects in order to cause pain, then adding a painkiller medication to an IV drip while assessing the subjects' pain levels. When the painkiller drug was present, the test subjects were told about it, and just as expected their pain scores significantly dropped. But when test subjects were told the pain medication had been stopped, their pain levels returned back to the original, non-medicated levels even though the pain medication was still being dripped into their IVs.
The mind of the patient, in other words, is what actually determines the "effectiveness" of the pain drug, not the chemical effect of the drug itself.
Talking to the BBC, Professor Irene Tracey from Oxford University said, "It's phenomenal, it's really cool. It's one of the best analgesics we have and the brain's influence can either vastly increase its effect, or completely remove it."
As pointed out by George Lewith, a professor of health research at the University of Southampton, these findings call into question the scientific validity of many randomized clinical trials . He said, "It completely blows cold randomized clinical trials, which don't take into account expectation."
Many pharmaceuticals only work if you believe they do.
What the research really means, you see, is that the mind is the main determiner of the effectiveness of many drugs, not the so-called chemical profile of the drugs themselves. This has been proven out again and again with not just painkiller drugs, but also with antidepressant drugs which have consistently failed to out-perform placebo.
But it all brings up a question: If many pharmaceuticals only work because the mind makes them real, then why do some drugs appear to out-perform placebo in clinical trials?
The answer to that will probably surprise you: It's because when people are in randomized, placebo-controlled studies, they're usually hoping to get the real drugs, not the placebo . And how do they determine whether they're getting the "real" drugs? By the presence of negative side effects due to placebo fraud. As those side effects begin to appear -- constipation, sexual disorders, nausea, headaches, etc -- then those participants convince themselves that they received the "real" drugs! And from that point, their mind makes it real! So the blood pressure actually then starts to go down, or their cholesterol numbers drop, and so on.
The patients make real whatever expectation they were given when they were recruited for the drug trial in the first place. Even the act of recruiting people for drug trials sets an expectation in their minds. Patients, after all, are recruited for a " cancer drug trial" or a " blood pressure drug trial" or some other trial in which the expected outcome is made evident during the recruitment phase.
This is all really important to understand so I'm going to break it down step by step:
Why pharmaceutical "positive" effects are actually generated by the minds of the clinical trial participants:
Step 1: Clinical trial participants are recruited through a trial that is advertised as testing a drug for a particular outcome such as lowering blood pressure, halting cancer, normalizing blood sugar, etc. This sets the 'expectation' of the drug effects in the minds of the patients even before the trial begins.
Step 2: When the trial begins, the clinical trial participants are told that half will be given the "real" drug, and the other half will be given a placebo, but it's a blind study, so no one knows whether they're receiving the drug or the placebo.
Step 3: Study participants begin to take the pills, but they don't know whether they're getting drugs or placebo.
Step 4: Those participants who are receiving the real drugs begin to show toxic side effects (because most pharmaceuticals are toxic to the body). This excites them because they conclude that they are on the "real" drugs!
Step 5: Those participants who conclude they are on the "real" drugs then, through the power of their minds, cause their bodies to make real the physiological effects that were imprinted in their minds in step one! Whatever drug expectation was explained to them before the trial, in other words, is suddenly made real by the patient's mind.
Step 6: Meanwhile, those patients receiving the placebo pills and having no side effects convince themselves that they aren't receiving the "real" drugs and therefore they should experience no positive physiological effects. So their mind makes that real, too, and they get no benefit from the whole experience.
Step 7: After the end of the clinical trial, the researchers compare the results of the placebo group against the results of the drug group, and guess what? The drug looks like it performed better! But was the drug the actual cause of that? Not at all: It was the expectations of the study subjects that made the effects real. The drugs, in other words, only look good as a result of wishful thinking.
As you can see here, this calls into question the scientific validity of every randomized, double-blind placebo-controlled drug study that has ever been conducted. The critical scientific failure they all share, you see, is that as part of the clinical trial, the researchers set the expectations of the drug's results in the minds of the patients. It is those minds that then made the effects real, not necessarily the drugs.
This leads to the fascinating conclusion that in today's medical system, many drugs may only work when patients expect them to because it is the patient's mind creating the physiological effects, not the drug itself.
So how do you get around this and design a truly scientific trial that eliminates the effect of the mind?
How to design a truly scientific clinical trial using drugs
The answer to that is simpler than you think: In humans, you must eliminate the trial subjects from learning of any expectation of the drug's effects. In other words, you can't sign patients up for a "blood pressure drug trial" because right there you've set the expectation that the drug will lower blood pressure.
You essentially have to sign people up for a trial of a "mystery drug" with no expectation of any effects whatsoever. That way, the mind of the study participants is no longer a variable in the outcome of the drug trial. From there, all the various physiological effects of the patients must be tracked. With the patients' minds now out of the picture, you can get an honest assessment of the genuine chemical action of the drug itself.
Why most clinical trials are scientifically invalid
It is fascinating, of course, that virtually no clinical trials are ever conducted in this way. Today's drug trials are almost universally described to patients along with the expectations of the outcome. This has been done for decades under the false belief that the mind somehow played no role whatsoever in the physiology of the body. Conventional medical researchers and scientists incorrectly believed that chemistry alone would dictate the outcome of the trial. The mind had nothing to do with it, they claimed.
They were wrong. The mind has everything to do with it. In fact, the mind can make a placebo "real" and render a drug useless . The mind has near total control over the outcome of the trial. Because this has almost never been taken into account, all those clinical trials that ignored the influence variable of intention are, technically speaking, scientifically invalid . There's no way to know whether the outcome of the trial was due to the drug or the mind.
And that makes the mind a variable in the scientific question of what is at work in a clinical trial. When the mind is at work, you cannot scientifically claim the achieved results were simply due to the drug itself. Unless, of course, you disavow the influence of the mind. And that is precisely the mistake that has been made since the dawn of modern medical science .
The pharmaceutical industry's "science" falls apart in the presence of the mind.
Once you understand the power of the mind to either create real physiological effects in the body or nullify the chemicals being administered to the body, you immediately grasp the stunning conclusion: Big Pharma's "science" is not scientific!
Virtually all the results from the tens of thousands of clinical trials that have been conducted over the last several decades must now be called into question. In which trials did patients produce their own positive results simply through the power of their minds after believing that negative side effects meant they were taking the "real" drugs?
It is not a question to be taken lightly. This question, in fact, will demolish modern pharmaceutical "science" once it is fully understood. The pharmaceutical industry, you see, needs the power of the mind to make its drugs appear to work! Without the "wishful thinking" factor engaged, it is altogether likely that most pharmaceuticals simply don't work at all .
The truth is that virtually all the effects of the most commonly prescribed pharmaceuticals -- diabetes drugs, blood pressure drugs, painkillers, statin drugs and so on -- can be achieved without using any drugs whatsoever. The only cause required to produce the positive effects is the expectation of positive results in the minds of the patients.
There are certainly exceptions to this, of course. Anesthesia drugs do not appear to require the active mental participation of patients in order to function as expected. Likewise, there are certainly nutrients such as vitamin D that function in a certain way in the human body regardless of whether a person "believes" in vitamin D.
The real question, you see, is what happens at the intersection of molecular biology and the expectation of the mind? Modern medical science has near-zero knowledge on that subject because it has denied the existence of the mind. Most so-called "skeptics," for example, do not believe there is such a thing as the mind. Humans are merely biological robots, they say, and brains are mere molecular machines that carry out deterministic actions based purely on the laws of chemistry and physics. The mind, they insist, does not exist.
No wonder their clinical trials fail to take the mind into account. And that is why their clinical trials are now revealed as medical self delusion. They thought their drugs were working, but it turns out it was the patients' minds that delivered the results. Natural News 22.2.11
Traditional drug-discovery model has run dry
With drug pipelines running dry and a slew of blockbuster medicines about to lose patent protection, the voices arguing that the traditional drug-development process is too expensive and inefficient to survive are getting louder.
Employing thousands of in-house scientists to develop drug candidates from scratch has turned into a billion-dollar gamble that simply isn't delivering enough profitable products to market. Bernard Munos, founder of the InnoThink pharmaceutical policy research group in Indianapolis, Indiana, is not alone in believing that the next three years "will probably see an implosion of the old model" of drug discovery.
So what comes next? Cutbacks, certainly: witness Pfizer's dramatic announcement early last month that it will soon close its research site at Sandwich, UK, and slice roughly US$1.5 billion from its proposed 2012 research and development spend. But beyond that, perhaps, a rethink of the old divisions of labour is needed.
Canny drug-makers are listening to those who propose that they should increasingly outsource early-stage drug development, including phase I safety trials, to academia or to small, specialist companies. This would leave pharmaceutical companies to focus on their strengths: running large clinical trials and marketing medicines. Basically they want to pass the risk and the hard work to someone else but cream off the profits.
One such model was the focus of a meeting in Toronto, Canada, on 16 February, involving some 40 leading lights from industry, academia and funding agencies. The meeting was co-convened by Chas Bountra, head of the Structural Genomics Consortium at the University of Oxford, UK, who argues that a key problem with the current system is that companies tend to work in parallel, identifying similar or identical target molecules while remaining unaware that the compounds may have already been tested and discarded by rivals. "What we're trying to do is reduce that duplication," he says.
His scheme adopts the highly collaborative approach pioneered by those working on cures for neglected diseases, in which intellectual property (IP) restrictions are lifted. Companies would begin to compete only after early clinical trials had shown a drug to be safe and potentially effective. Up to that point, all data on prospective drug candidates would be published openly. This would allow targets to be validated much more quickly, says Bountra, potentially giving enormous savings in cost. It would also prevent companies "exposing patients to molecules that other organizations already know are going to be ineffective".
The model would rely heavily on academic scientists supported by a global initiative costing about $325 million a year, with half coming from the pharmaceutical industry and half from public and charitable sources. Successful drug candidates would be made available for the initiative's commercial sponsors to buy and bring to market.
Industry already believes that this is a fine solution for programmes in areas without major commercial interest, such as neglected diseases, says Stephen Friend, an organizer of the meeting and president of non-profit research organization Sage Bionetworks, based in Seattle , Washington . The key difference in the Toronto proposal is that it may also be a "viable way to improve return on investment in commercially important areas", he says.
Bountra is confident that within the next two months he will complete negotiations to sign up two industry partners, two public funding partners and two academic partners. The response at the meeting, to which all the large drug companies sent representatives, was very positive from all involved, say attendees. "The more we discussed it, the more convinced we were that this is the only way forward," says Bountra. A follow-up meeting in San Francisco in April will flesh out the plans.
Meanwhile, government funders of research are trying out similar initiatives. The UK Medical Research Council has established the Developmental Pathway Funding Scheme to support the development of basic science into drugs and medical devices. And Francis Collins, head of the US National Institutes of Health, is proposing a National Center for Advancing Translational Sciences to push more basic science towards the medical market.
Ted Bianco, director of technology transfer for the Wellcome Trust, a UK biomedical research funder, agrees that shifting early-stage drug discovery work to academia could fix some of pharma's problems. The trust's Seeding Drug Discovery initiative already funds researchers to optimize drug candidates and take them through to clinical trials. But Bianco points out that commercial partners in Bountra's initiative would expect to see a financial return: "The dilemma is that heavy investment is required, and it has to be carried by somebody's money."
Bountra's IP-free model could also deprive collaborating universities of the opportunity to profit from spin-out companies, says Melanie Lee, chief executive of Syntaxin, a biotech company based in Oxford , UK , who attended the Toronto meeting. Bountra says he doubts that will discourage academics, who get into drug discovery to develop medicines, not to acquire intellectual property.
But Patrick Vallance, senior vice-president for medicines development and discovery at London-based drug-makers GlaxoSmithKline (GSK), also believes that IP will be the most contentious part of Bountra's model. "I'm completely on board with the idea you don't really know if you're on track until you've done an experiment in the clinic, and that you should publish that early," he says. But "it's much more complex to determine where you need to secure the IP along that chain, and I think it will differ from molecule to molecule".
Nevertheless, his company is experimenting with open innovation, having last year put more than 13,000 potential anti-malarial drug structures into the public domain to encourage academics to identify promising leads. "One of the reasons I want to push that model very hard is that if it works in malaria — and we've yet to see what the uptake from academics and others is — I don't see how you could do anything but pursue it in other areas," says Vallance.
Vallance notes that industry is also developing new models of academic collaboration. GSK announced this month that it will collaborate with Mark Pepys, head of medicine at the Royal Free and University College Medical School in London , to develop a candidate drug for amyloidosis, a protein disorder. The idea, says Vallance, is not just to buy up promising molecules, but to form long-term partnerships that last all the way through drug development.
All these models put academic researchers at the heart of drug discovery. But they will fail unless more money flows from governments, charities and industry into academic labs, says Cathy Tralau-Stewart, who heads Imperial College London's drug discovery research unit. "Academic drug discovery is growing and is becoming much more important," she says, "but if we don't solve the funding issues, then the pharma companies will not have a pipeline of innovative drugs in ten years' time." 2.3.11
NHS to meet local health dragons in challenge to improve care
Teams of clinicians in the South-East Coast region will go head to head today in pitching their innovative ideas to a Dragon's Den style panel as part of the Transforming Community Services Multi Professional Leadership Challenge. The challenges are open to all clinicians within the NHS who have a 'local idea' which could improve primary or community care services within their area.
Each event brings together the skills of clinicians in how best to design and deliver high quality, seamless care, including child and family centred public health from the beginning of life to end of life care. Up to 13 different teams from each Strategic Health Authority, made up of GPs, allied health professionals and nurses, will compete for a regional prize of £50,000 to implement their idea.
Teams will present their business case to a panel of experts in the style of Dragon's Den who will assess the teams on their leadership skills and the validity of their idea. The panels will be made up of credible local professionals from the NHS such as directors for finance, innovation, nursing and quality as well as patient representatives. Regional winners will also be invited to a final event to share their learning and best practice ideas.
Public Health Minister, Anne Milton said: “These challenges are a great way to show off and bring out the new ideas and improvements that I know the NHS has. If we want to improve patient outcomes then community services need to be designed, developed and provided by the people who know the needs of patients best - the nurses, doctors and other health professionals.
“Good community services are vital in helping patients recover or providing them with essential care, from health promotion to managing long term conditions. I look forward to hearing about their ideas to improve services in their area and raise the standards of patient care.”
The teams have come together from acute trusts, mental health, social care and community organisations and will present their idea on how to improve a service.
For example, at the South East Coast event today, ideas range from improving clinical care for patients with heart failure to developing services to support young people who are morbidly obese.
All ideas have come from talking to patients or other professionals about care in their local communities. On the day itself the ideas will be turned into a robust business case that take into account local priorities and the best use of resources.
Each regional winner will be supported for a year to develop, implement and deliver their idea by the local region. All the teams who take part in the day will have the benefit of working with other clinical leads including local GPs and will have benefited from translating their idea into a viable business case. All these ideas can then be used by the new local GP consortia to inform service improvement and enhance the patient experience.
Dame Christine Beasley, Chief Nursing Officer said: “Patients and communities view and judge their overall experience by the quality of nursing care they receive and I am pleased to see the high level of involvement from nurses in these regional events.
“Strong nursing leadership in any part of the NHS is highly valuable and I encourage nurses to get involved in events like these so that they can work with other professionals in the community and improve outcomes for patients.” 14.2.11
Hospital chaplains who cost £29m a year have no clinical benefit, says controversial study
Church leaders said the study was guilty of a 'laughable misuse of statistical information'. The NHS spends £29million on hospital chaplains which provide 'no clinical benefit', critics claimed today.
Data obtained by the National Secular Society (NSS) from 227 trusts in England found savings of £18.5million a year could be made if all trusts brought their spending into line with those who spent the least.
The society argues this cash could be better spent on 1,000 nursing assistants or a new community hospital every year. Using the Freedom of Information Act, analysts compared the amount spent on chaplains in 2009/10 with how well trusts performed on some quality indicators, including death rates.
They reported that those with the lowest spend on chaplaincy services were some of the best-performing hospitals. The NSS concluded the NHS 'wastes millions every year' on services that have no clinical benefit.
NSS executive director Keith Porteous Wood said: 'Taxpayers will be shocked to learn how much healthcare money is diverted into paying for chaplaincy services. 'The cash-strapped NHS should spend its money on frontline services.
'The National Secular Society is not seeking to oust chaplains from hospitals, but their cost should not be borne by public funds, especially when clinical services for patients are being cut.
'We have proposed that chaplaincy services should be paid for through charitable trusts, supported by churches and their parishioners. 'If churches really support 'the big society', then they will stop siphoning off NHS cash to fund chaplains' salaries.'
The Rev Dr Malcolm Brown, director of mission and public affairs for the Archbishops' Council of the Church of England, said the NSS was 'guilty of a laughable misuse of statistical information'. He added: 'It is widely accepted within the medical profession that healthcare involves looking after the whole person, not just the body. 'It is equally obvious that national quality ratings can only be used to measure the discrete criteria which they have been designed to measure.
'The role of hospital chaplains in a regime of holistic care is not in doubt among serious practitioners.
'Chaplains are greatly appreciated by patients and staff alike and it is unfortunate that the NSS continues to try to pressurise experienced healthcare professionals, including those with responsibility for budgets, to allocate resources according to the NSS's minority ideology rather than affirming the NHS's long tradition of caring for the whole person.'
Father Peter Scott, advisor for healthcare chaplaincy to the Roman Catholic Archbishop of Westminster, Vincent Nichols, said that, according to the NSS calculations, 0.000029% of the NHS 2009/10 budget was spent on employing 500 whole time and 800 part-time chaplains 'to meet the spiritual and religious needs of 1.7 million NHS staff and to serve a patient turnover of one million patients every 36 hours'.
He said the Department of Health website makes clear it is 'impossible to say exactly how much the nation's health improves for each pound spent by the NHS'. He added: 'The 'National Quality Ratings' that the National Secular Society quotes are not designed or narrow enough to measure whether the spiritual needs of a patient have been met.
'The National Quality Ratings are about general performance issues regarding each healthcare trust. 'Therefore the conclusions drawn by the NSS are irrelevant.' 28.2.11
Mothers-to-be will be taught to hypnotise themselves before giving birth in NHS trial
Expectant mothers will be taught to hypnotise themselves before giving birth as an alternative to painkillers. They will learn to put themselves in a trance-like state during labour in the hope that they will not need costly drug treatments such as epidurals, laughing gas or morphine.
More than 800 first-time mothers will take part in the 18-month NHS trial study on the effectiveness of hypnobirthing.
Teaching women to control their pain might also reduce the need for supervision from midwives, which would help ease the pressure on overstretched maternity wards. In some hospitals as many as 60 per cent of mothers have epidurals – anaesthetics injected into their spine – while many others are given injections of diamorphine, a form of morphine, pethidine or inhale laughing gas.
The drugs are expensive and there have been claims they could be harmful to mother and baby. Epidurals have been found to increase the length of childbirth, making it more likely that a woman will need a caesarean.
It has been suggested that having an epidural may hinder a mother's ability to breastfeed – although this has never been substantiated – and there are also fears it is linked to post-natal depression.
Natural childbirth advocates also say the drowsiness brought on by painkillers prevent a woman fully appreciating the joy of childbirth. The trial is being led by Professor Soo Downe, a specialist in midwifery at Central Lancashire University , and will run at hospitals in Blackburn and Burnley.
Professor Downe said: ‘There is good evidence that hypnosis works well in other areas of health management. ‘The idea is to give women the capacity to manage their labour themselves. If the results are promising we will do further trials. ‘The intention would then be to provide free hypnobirthing training on the NHS.' Hypnobirthing has become increasingly popular and Britain has around 250 qualified therapists.
Courses tend to last several hours and teach women to put themselves into a state of deep relaxation. Words such as ‘pain' and ‘contraction' are replaced in training manuals with neutral terms such as ‘pressure' and ‘tightening'.
The sessions, which can cost up to £800 on a one-to-one basis, also teach women massage techniques which enable them to stimulate the release of endorphins, the body's natural painkillers. Critics claim such methods work for only one in four women. There are also concerns that if mothers are left to cope on their own during labour their babies may be at risk.
Maureen Treadwell, a co-founder of the Birth Trauma Association, said: ‘It is nonsense to say childbirth is a natural event so you don't need drugs. ‘Death is also a natural event but nobody would suggest you don't need drugs to ease the pain.' 14.2.11
Nobel Prize Winner Luc Montagnier Supports Science of Homeopathy
Dr. Luc Montagnier, the French virologist who won the Nobel Prize in 2008 for discovering the AIDS virus, has surprised the scientific community with his strong support for homeopathic medicine.
In a remarkable interview published in Science magazine of December 24, 2010, Professor Luc Montagnier, has expressed support for the often maligned and misunderstood medical specialty of homeopathic medicine. Although homeopathy has persisted for 200+ years throughout the world and has been the leading alternative treatment method used by physicians in Europe, most conventional physicians and scientists have expressed skepticism about its efficacy due to the extremely small doses of medicines used.
Most clinical research conducted on homeopathic medicines that has been published in peer-review journals have shown positive clinical results especially in the treatment of respiratory allergies influenza, fibromyalgia, rheumatoid arthritis, childhood diarrhea, post-surgical abdominal surgery recovery, attention deficit disorder, and reduction in the side effects of conventional cancer treatments. In addition to clinical trials, several hundred basic science studies have confirmed the biological activity of homeopathic medicines. One type of basic science trials, called in vitro studies, found 67 experiments (1/3 of them replications) and nearly 3/4 of all replications were positive.
In addition to the wide variety of basic science evidence and clinical research, further evidence for homeopathy resides in the fact that they gained widespread popularity in the U.S. and Europe during the 19th century due to the impressive results people experienced in the treatment of epidemics that raged during that time, including cholera, typhoid, yellow fever, scarlet fever, and influenza.
Montagnier, who is also founder and president of the World Foundation for AIDS Research and Prevention, asserted, "I can't say that homeopathy is right in everything. What I can say now is that the high dilutions (used in homeopathy) are right. High dilutions of something are not nothing. They are water structures which mimic the original molecules."
Here, Montagnier is making reference to his experimental research that confirms one of the controversial features of homeopathic medicine that uses doses of substances that undergo sequential dilution with vigorous shaking in-between each dilution. Although it is common for modern-day scientists to assume that none of the original molecules remain in solution, Montagnier's research (and other of many of his colleagues) has verified that electromagnetic signals of the original medicine remains in the water and has dramatic biological effects.
Montagnier has just taken a new position at Jiaotong University in Shanghai , China (this university is often referred to as " China 's MIT"), where he will work in a new institute bearing his name. This work focuses on a new scientific movement at the crossroads of physics, biology, and medicine: the phenomenon of electromagnetic waves produced by DNA in water. He and his team will study both the theoretical basis and the possible applications in medicine.
Montagnier's new research is investigating the electromagnetic waves that he says emanate from the highly diluted DNA of various pathogens. Montagnier asserts, "What we have found is that DNA produces structural changes in water, which persist at very high dilutions, and which lead to resonant electromagnetic signals that we can measure. Not all DNA produces signals that we can detect with our device. The high-intensity signals come from bacterial and viral DNA."
Montagnier affirms that these new observations will lead to novel treatments for many common chronic diseases, including but not limited to autism, Alzheimer's disease, Parkinson's disease, and multiple sclerosis.
Montagnier first wrote about his findings in 2009 and then, in mid-2010, he spoke at a prestigious meeting of fellow Nobelists where he expressed interest in homeopathy and the implications of this system of medicine.
French retirement laws do not allow Montagnier, who is 78 years of age, to work at a public institute, thereby limiting access to research funding. Montagnier acknowledges that getting research funds from Big Pharma and certain other conventional research funding agencies is unlikely due to the atmosphere of antagonism to homeopathy and natural treatment options.
Support from Another Nobel Prize winner
Montagnier's new research evokes memories one of the most sensational stories in French science, often referred to as the 'Benveniste affair.' A highly respected immunologist Dr. Jacques Benveniste, who died in 2004, conducted a study which was replicated in three other university laboratories and that was published in Nature. Benveniste and other researchers used extremely diluted doses of substances that created an effect on a type of white blood cell called basophils.
Although Benveniste's work was supposedly debunked, Montagnier considers Benveniste a "modern Galileo" who was far ahead of his day and time and who was attacked for investigating a medical and scientific subject that orthodoxy had mistakenly overlooked and even demonized.
In addition to Benveniste and Montagnier is the weighty opinion of Brian Josephson, Ph.D., who, like Montagnier, is a Nobel Prize-winning scientist.
Responding to an article on homeopathy in New Scientist , Josephson wrote:
Regarding your comments on claims made for homeopathy: criticisms centered around the vanishingly small number of solute molecules present in a solution after it has been repeatedly diluted are beside the point, since advocates of homeopathic remedies attribute their effects not to molecules present in the water, but to modifications of the water's structure.
Simple-minded analysis may suggest that water, being a fluid, cannot have a structure of the kind that such a picture would demand. But cases such as that of liquid crystals, which while flowing like an ordinary fluid can maintain an ordered structure over macroscopic distances, show the limitations of such ways of thinking. There have not, to the best of my knowledge, been any refutations of homeopathy that remain valid after this particular point is taken into account.
A related topic is the phenomenon, claimed by Jacques Benveniste's colleague Yolene Thomas and by others to be well established experimentally, known as "memory of water". If valid, this would be of greater significance than homeopathy itself, and it attests to the limited vision of the modern scientific community that, far from hastening to test such claims, the only response has been to dismiss them out of hand.
Following his comments Josephson, who is an emeritus professor of Cambridge University in England , was asked by New Scientist editors how he became an advocate of unconventional ideas. He responded:
I went to a conference where the French immunologist Jacques Benveniste was talking for the first time about his discovery that water has a 'memory' of compounds that were once dissolved in it -- which might explain how homeopathy works. His findings provoked irrationally strong reactions from scientists, and I was struck by how badly he was treated.
Josephson went on to describe how many scientists today suffer from "pathological disbelief;" that is, they maintain an 'unscientific attitude' that is embodied by the statement "even if it were true I wouldn't believe it."
Even more recently, Josephson wryly responded to the chronic ignorance of homeopathy by its skeptics saying, "The idea that water can have a memory can be readily refuted by any one of a number of easily understood, invalid arguments."
In the new interview in Science , Montagnier also expressed real concern about the unscientific atmosphere that presently exists on certain unconventional subjects such as homeopathy, "I am told that some people have reproduced Benveniste's results, but they are afraid to publish it because of the intellectual terror from people who don't understand it."
Montagnier concluded the interview when asked if he is concerned that he is drifting into pseudoscience, he replied adamantly: "No, because it's not pseudoscience. It's not quackery. These are real phenomena which deserve further study."
The Misinformation That Skeptics Spread
It is remarkable enough that many skeptics of homeopathy actually say that there is "no research" that has shows that homeopathic medicines work. Such statements are clearly false, and yet, such assertions are common on the Internet and even in some peer-review articles. Just a little bit of searching can uncover many high quality studies that have been published in highly respected medical and scientific journals, including the Lancet , BMJ , Pediatrics , Pediatric Infectious Disease Journal , Chest and many others. Although some of these same journals have also published research with negative results to homeopathy, there is simply much more research that shows a positive rather than negative effect.
Misstatements and misinformation on homeopathy are predictable because this system of medicine provides a viable and significant threat to economic interests in medicine, let alone to the very philosophy and worldview of biomedicine. It is therefore not surprising that the British Medical Association had the sheer audacity to refer to homeopathy as "witchcraft." It is quite predictable that when one goes on a witch hunt, one inevitable finds "witches," especially when there are certain benefits to demonizing a potential competitor (homeopathy plays a much larger and more competitive role in Europe than it does in the USA ).
Skeptics of homeopathy also have long asserted that homeopathic medicines have "nothing" in them because they are diluted too much. However, new research conducted at the respected Indian Institutes of Technology has confirmed the presence of " nanoparticles " of the starting materials even at extremely high dilutions. Researchers have demonstrated by Transmission Electron Microscopy (TEM), electron diffraction and chemical analysis by Inductively Coupled Plasma-Atomic Emission Spectroscopy (ICP- AES ), the presence of physical entities in these extreme dilutions. In the light of this research, it can now be asserted that anyone who says or suggests that there is "nothing" in homeopathic medicines is either simply uninformed or is not being honest.
Because the researchers received confirmation of the existence of nanoparticles at two different homeopathic high potencies (30C and 200C) and because they tested four different medicines (Zincum met./zinc; Aurum met. /gold; Stannum met./tin; and Cuprum met./copper), the researchers concluded that this study provides "concrete evidence ."
Although skeptics of homeopathy may assume that homeopathic doses are still too small to have any biological action, such assumptions have also been proven wrong. The multi-disciplinary field of small dose effects is called "hormesis," and approximately 1,000 studies from a wide variety of scientific specialties have confirmed significant and sometimes substantial biological effects from extremely small doses of certain substances on certain biological systems.
A special issue of the peer-review journal, Human and Experimental Toxicology (July 2010 ), devoted itself to the interface between hormesis and homeopathy. The articles in this issue verify the power of homeopathic doses of various substances.
In closing, it should be noted that skepticism of any subject is important to the evolution of science and medicine. However, as noted above by Nobelist Brian Josephson, many scientists have a "pathological disbelief" in certain subjects that ultimately create an unhealthy and unscientific attitude 'blocks real truth and real science'.
Skepticism is at its best when its advocates do not try to cut off research or close down conversation of a subject but instead explore possible new (or old) ways to understand and verify strange but compelling phenomena. We all have this challenge as we explore and evaluate the biological and clinical effects of homeopathic medicines. Natural News. 11.2.11
You can't overdose on homeopathic remedies; But why won't homeopathy skeptics drink their own medicine?
It's really quite hilarious to see this unfold: Homeopathy skeptics and vicious Big Pharma attack dogs are running around the globe in ludicrous demonstrations where they consume huge doses of homeopathic remedies in public and then claim that because they don't die of an "overdose," these medicines therefore don't work.
Notice that they never consume their own medicines in large doses? Chemotherapy? Statin drugs? Blood thinners? They wouldn't dare drink those. In fact, today I'm challenging the homeopathic skeptics and other medical fundamentalists to a "drink-a-thon" test to see which medicines will kill you faster. But we'll get to that in a minute...
First, let's get to the understanding of why the idea that you could "overdose" on homeopathic remedies is ridiculous to begin with.
It requires an elevated worldview
Teaching the so-called 'skeptics' about how homeopathic medicine really works is a bit like trying to convince flat Earthers that the planet is really spherical. Although they fully understand the principles involved, they choose to ignore them or pretend to. These skeptics, you see, approach homeopathy as if it were a drug (because that's all they really know). And in their world, all drugs are dangerous if you overdose on them, which makes sense from their point of view because they're educated solely in dangerous, synthetically-derived chemicals that are incompatible with the human body.
So it may be understandable at some level that since this is all the 'medical fundamentalists' (skeptics) know, they have probably not attained the level of sophistication required to understand the far more advanced mechanisms of homeopathy. It's a bit like trying to teach a five-year-old child how to play Mozart. And while that may have worked if your child was Mozart, it probably doesn't work for anyone else.
Homeopathy isn't a drug
Homeopathy, you see, isn't a drug. It's not a chemical. So you can drink all you want and you won't overdose on it. That's not a defect in homeopathy -- it's a remarkable advantage! It means that while 200,000+ Americans are killed each year by toxic pharmaceutical drugs, no one is harmed by homeopathy. Not even those who are desperately trying to be harmed by it!
It seems these skeptics really want everything to be more dangerous because the world of toxicity is so much more familiar to them. What these not-so-amazing skeptics would like to see, it seems, is more people dropping dead from dangerous side effects. Then they would believe homeopathy was real.
That's the way ignorant conventional medicine operates today: You know the drugs are kicking in when you start getting worse . Toxicity and conventional medicine go hand in hand.
But homeopathy isn't based upon a chemical. It's different, it's a resonance or vibration.
Measuring the Wrong Thing
The skeptics tell everyone homeopathy can't work because there isn't enough of the original compound left to have any effect and they are right about the compound. However they are looking for or measuring the wrong thing.
Although it is common for modern-day scientists to assume that none of the original molecules remain in solution, independent research has verified that the 'electromagnetic signals' of the original medicine remains in the water and they have 'dramatic biological effects'.
Homeopathy involves the restructuring of water to resonate with the particular energy of a plant or substance. We can get into the physics of it in a subsequent article, but for now it's easy to recognize that even from a conventional physics point of view, liquid water has tremendous energy, and it's constantly in motion, not just at the molecular level but also at the level of its subatomic particles and so-called "orbiting electrons" which aren't even orbiting in the first place. Electrons are vibrations and not physical objects.
But, oh yeah, I forgot. The skeptics don't know that yet. That won't be taught that in university physics classes until probably 2020, at which point most of them will probably be dead from taking pharmaceuticals to treat their own diseases. For now, they've all convinced themselves that electrons are -- get this -- tiny "particles" flying around atomic nuclei and tremendous speeds which just happen to stay in their little orbits like little perpetual motion machines (which they say are impossible), until all of a sudden, these electron "particles" inexplicably leap to a higher or lower orbit without occupying the space in-between those orbits at any moment . Yep, magic teleporting particles! That's the "scientific" explanation of these folks. No wonder so many of them are magicians: Believing their explanations requires that you believe in particle magic!
But getting back to water and vibrations, which isn't magic but rather vibrational physics , you can't overdose on a harmony. If you have one violin playing a note in your room, and you add ten more violins -- or a hundred more -- it's all still the same harmony (with all its complex higher frequencies, too). There's no toxicity to it.
Homeopathy works much the same way: You can drink a few drops or a few gallons. It's the same harmony being introduced into your body's living cells, regardless of the quantity. And drinking a few gallons of it will only make you urinate a whole lot, which I suppose the skeptics have been doing a lot these days, staring down into the toilet bowl with their pants unzipped, declaring, "I was right! I can't overdose on it!" Talk about expensive urine, eh?
It's hilarious, in fact, that those who would try to disparage homeopathy would even think that attempting to "overdose" on it proves anything at all. What it really shows is that they utterly lack any understanding of the underlying theories of how homeopathy works -- theories that Nobel Prize winner Luc Montagnier -- the discovered of the AIDS virus -- now publicly supports, by the way.
Montagnier has just taken a new position at Jiaotong University in Shanghai , China (this university is often referred to as " China 's MIT"), where he will work in a new institute bearing his name. This work focuses on a new scientific movement at the crossroads of physics, biology, and medicine: the phenomenon of electromagnetic waves produced by DNA in water. He and his team will study both the theoretical basis and the possible applications in medicine.
Bent on their own destruction
What really drives the skeptics crazy is that no matter how hard they try, they just can't seem to kill themselves . To be so out of touch with the beautiful, loving and holographic nature of the universe around us is to retreat to a self-loathing worldview that can only be resolved through self destruction. These skeptics just want to kill themselves... and they wouldn't mind taking a few of you along with them, too. Hence their promotion of vaccines, pharmaceuticals, chemotherapy and water fluoridation.
These public demonstrations of chugging what they call "drugs" can only be called psychopathic "public suicide attempts" -- and they can't even get that right, either. (They're drinking the wrong stuff...)
I would suggest they try a few fluid ounces of their own medicines if they want to achieve the overdoses they're looking for. A few ounces of chemotherapy would do the trick nicely. Let me know if one of them tries that, and we'll carry the news: "Skeptic dies after drinking his own medicine. Story at eleven..."
In fact, if these skeptics are looking to kill themselves, they need look no further than the tens of thousands of toxic drugs, vaccines, chemotherapy agents, radiation procedures and barbaric surgical procedures that they claim will heal you! Yep, the stuff they say is good for you is the stuff they won't drink .
And therein lies my challenge...
Why I'm challenging skeptics to drink a gallon of chemotherapy
I am hereby challenging the skeptics to a public drink-a-thon, each drinking the medicines we advocate. I'll meet them in a public place, and we'll each drink the medicines we believe in the most.
I'll bring a gallon of homeopathic remedies and healing raw juices, and the medical fundamentalists and their supporters (the more, the merrier) can each bring a gallon of the liquid forms of chemotherapy, blood pressure medications, coumadin, or statin drugs. We'll chug them in public and see who's left standing. The results get posted on YouTube for the whole world to see. We'll title the video, "SKEPTICS COMMIT MASS SUICIDE BY DRINKING PHARMACEUTICALS AS IF THEY WERE KOOL -AID." Jonestown, anyone?
Do you have any doubt which of us will be left standing? Sure, I may need to pee a whole lot, but the restrooms won't be crowded, because all the skeptics won't be needing them anymore.
That outcome, my friends, would be sad, but newsworthy. More importantly, it would prove an important point: Medicine should be safe for people to consume, not so deadly that you drop dead after consuming it, which is what often happens with pharmaceuticals.
But, alas, my challenge will certainly never be accepted. None of the magicians, skeptics of medical fundamentalists will be publicly chugging chemotherapy any time soon, nor any other large doses of liquid pharmaceuticals. Why? Because they know how toxic those chemicals are.
Do you notice the irony here? The only medicines they're willing to consume in large doses in public are homeopathic remedies! They won't dare consume large quantities of the medicines they all say YOU should be taking! (The pharma drugs.)
And therein rests the truth in all this: Even the skeptics know that homeopathy is inherently safer than their own medicines.
No wonder they keep attacking it: If people found out about safe medicine, where would all of Big Pharma's repeat business come from? After all, the best thing about chemotherapy (from Big Pharma's point of view) is that it creates repeat business from liver damage, kidney damage and brain damage.
All these pharmaceutical poisons are so damaging to the human body -- and brain -- that these is probably one of the main reasons why the skeptics who take all these drugs are incapable of understanding high-vibration advanced medicine. A vaccine shot every year does wonders for lowering the IQ and killing off the creative thinking portions of the brain, after all.
So if you're looking for safe medicine, definitely take a look at homeopathic remedies. They so safe that even the critics can't overdose on them... but you have to admit the attempt makes for great entertainment. Natural News 11.2.11
Pharmacogenomics, the next frontier in medicine?
A senior executive with GlaxoSmithKline (GSK) in the U.K. stunned the medical world on December 8, 2003 when he publicly stated that most prescription medicines do not work on most people who take them. Those of us who have studied drug side effects for decades know that they can often be ineffective as well as dangerous. But for Dr. Allen Roses, worldwide vice - president of genetics at GlaxoSmithKline (GSK), to admit that less than half of the patients taking blockbuster drugs actually benefit from them sounded, at first, like mutiny.
The U.K. has the same problem with its health care system as North America . Only days before Dr. Roses spoke at a scientific meeting in London the National Health Service reported that the total cost of drugs had soared by 50 percent in the previous three years, from $2.3 billion a year to an annual cost to the taxpayer of $7.2 billion.
An announcement by GSK the previous week promoted a line up of 20 or more new drugs under development that boasted potential earnings of up to $1 Billion (£600m) a year.
Dr. Roses is an academic geneticist originally from Duke University in North Carolina. In his talk he cited figures on how well different classes of drugs work in 'real patients'. And he probably knew just what he was doing - heralding the "brave new world" of genetic engineering and genomics. When you want to promote a new therapy, you have to prove that the previous one is not doing the job or that the new modality at least improves on existing technology.
Roses was doing just that when he talked about drugs for Alzheimer's disease working in less than one third of patients, and cancer chemotherapy being effective in less than one in four. Drugs for migraines, osteoporosis, and arthritis do somewhat better and work in about half the patients. His final analysis was that more than 90 percent of drugs work in only 30 to 50 percent of people. That's way less than the placebo effect!
The reason that drugs work effectively, on average, in less than one half of patients according to Dr. Roses, is because their genetic makeup interferes with the medicine in some unknown way. Some people thought it was a gaffe but others admitted that: "Roses is a smart guy and what he is saying will surprise the public but not his colleagues. He is a pioneer of a new culture within the drugs business based on using genes to test for who can benefit from a particular drug ."
Roses is on a mission to promote his field of "pharmacogenomics", which applies human genetics to drug development by "identifying "responders", or people who benefit from the drug, with a simple and cheap genetic test that can be used to eliminate those non - responders who might benefit from another drug. It may be the trend in medicine but it does fly in the face of an industry that markets drugs to the masses, not a select few.
Are we ready to leap into pharmacogenomics when we haven't even mastered nutrition ? The late Dr. David Horrobin, a psychopharmacologist and a pioneer in the field of essential fatty acids, asked the quintessential question in his article, "Why do we not make more medical use of nutritional knowledge? How an inadvertent alliance between reductionist scientists, holistic dietitians and drug-oriented regulators and governments has blocked progress." He was probably frustrated with being misquoted so often over the years, thus he made his point perfectly clear in the unwieldy title of his paper.
Dr. Horrobin, a brilliant researcher, questioned whether there was "Something Rotten at the Core of Science?" in a 2001 issue of Trends in Pharmacological Sciences . Commenting on an analysis of the medical journal peer review system and a U.S. Supreme Court decision which questioned the authority of peer review, Dr. Horrobin concluded that, "Far from filtering out junk science, peer review [paid review] may be blocking the flow of innovation and corrupting public support of science."
Horrobin and a handful of scientists have complained about the peer review process for decades, to no avail. A crack in the armor began in earnest when two researchers, Rothwell and Martyn, laboriously evaluated reviews of papers submitted to two neuroscience journals. They performed a statistical analysis on the correlations among reviewers' recommendations. They concluded that none of the reviewers seemed to agree on anything! Horrobin lamented that, "The core system by which the scientific community allots prestige (in terms of oral presentations at major meetings and publication in major journals) and funding is a non - validated charade whose processes generate results little better than does chance. Given the fact that most reviewers are likely to be mainstream and broadly supportive of the existing organization of the scientific enterprise, it would not be surprising if the likelihood of support for truly innovative research was considerably less than that provided by chance."
Horrobin noted that scientists often become angry because the public rejects the results of the scientific process. However, the Rothwell and Martyn report indicates that the public may be on the right track and is waiting for science to do more than just state its superiority but actually put itself to objective evaluation. Dr. Horrobin found that in the midst of the rejection of science by the public there is also the fact that pharmaceutical research is failing. The annual number of new chemical entities submitted for approval is steadily declining. Horrobin concluded that drug companies are merging because of failure; it is not a measure of success.
In his field of psychopharmacology, Dr. Horrobin said he was able to find no improvement in the treatment of depression and schizophrenia in the past forty years. "Is it really a success that 27 of every 100 patients taking the selective 5 - HT reuptake inhibitors stop treatment within six weeks compared with the 30 of every 100 who take a 1950's tricyclic antidepressant compound?"
Of course, I say my Future Health Now! online lifestyle and wellness program is the future of medicine, not genetic engineering. William Leiss is past President of the Royal Society of Canada and a widely sought after advisor on the social and ethical implications of "risk controversies and public policy." In an interview available online, Leiss attempts to warn government and the public about galloping technology. Dr. Leiss says there is an unresolved tension between two competing aspects of the scientific revolution in the modern world.
There is a battle between inventive science, the creation of products, and transformative science, which results in cultural change. Inventive science goes from triumph to triumph virtually uncontested and is bolstered by unlimited funding. Even though Francis Bacon in the 1600s championed inventions as a way of improving the human race, it was not until the end of the 1800s that Bacon's dream was realized. The first inventions were in the field of chemistry.
Transformative science was championed in the 1700s as a way of not just understanding and overcoming nature but as an important new way of organizing the basis of social institutions, promoting universal education and rendering social policies and institutes more humane and just.
Dr. Leiss reminds us of the many risks we have overcome through advancement in invention and transformative science. Where would we be if it were not for the many products that have advanced the world through childbirth morality, infant and childhood mortality, infectious diseases, malnutrition, personal security, accidents, birth control, and the treatment of mental disorders reflected in an increase in average lifespan? Bacon would be happy that we have achieved results far beyond what he had expected, however, Leiss is afraid we don't know when to put the brakes on technology. He also asks why have we accepted without challenge most new inventions that have darkened our door?
When it comes to genetic engineering, affecting our very DNA, proponents envision programming perfection in humans, doubling the human lifespan, and developing entirely new life forms once scientists have mastered the necessary genome that will sustain human life.
Leiss thinks that by the late 19th century, the products of science began to be more important than improvement of society through transformative science. He reminds us that World War II brought us extremely close to nuclear war and changed the world immeasurably. But Leiss feels the final frontier is biotechnology that is capable of "modifying" genes at the embryo stage. For neurodegenerative diseases like Huntington's Chorea, this treatment could be a miracle. But what is to stop scientists from enhancing normal performance and creating super geniuses, super athletes, super entertainers, or super politicians. Many questions are yet to be asked. How will these changes affect the gene pool? What about the notion of extending human life? Leiss, with tongue firmly in - cheek, speculates about a 200 - year life span and spending the last 100 years of life on cruise ships!
Dr. Epstein, a professor of environmental and occupational medicine at The School of Public Health, University of Chicago , spoke at The Lighthouse in New York on November 11, 2001 . He said that this century has seen the emergence of new technologies: petrochemicals developed around 1940 with new methods of fractional distillation creating 1 billion pounds in 1940, 50 billion by 1950 and now an annual production of 900 billion pounds; a second concern is nuclear technology and fuel; a third is genetic engineering, an emerging technology with the potential for irreversible health effects.
Epstein says these technologies outstrip any social mechanism that would try to control them. Therefore, we have a complex set of factors, which add up to seeing the actual abolition and desecration of democratic structure by corporate influences on national and government levels. Most journalists in a knee - jerk reaction cheer on the technologies, says Dr. Epstein, and furthermore, they never see a carcinogen they don't like.
Less than six months after Dr. Roses made his startling announcement that 90 percent of drugs only work on 30 - 50 percent of the population, GlaxoSmithKline sponsored a special edition of the well - known scientific journal, Nature . It was called "Nature: Insight on Human Genomics and Medicine" and GSK defined the parameters of the journal as follows:
1. Pharmacogenetics - exploring the genetic basis for drug response to find the right medicine for the right patient.
2. Disease Genetics - studying patient populations with common disease: asthma, depression, COPD, osteoarthritis, early onset heart disease, and migraine in order to identify disease susceptibility genes.
3. Genomics/Proteomics - understanding the functions of genes, proteins, and their complex interactions to discover and validate new drug targets and biomarkers.
4. Bioinformatics - combining biology, genetics, statistics, and computer.
Exerpted and edited from Death by Modern Medicine: Seeking Safe Solutions , eBook. Dr. Carolyn Dean. 11.2.11
Report: "Limited evidence" that Botox injections help migraines
The BBC is reporting that the wrinkle-fighter Botox, which costs roughly £276 (about $443) per injection, may not be appropriate for chronic migraine sufferers. A trial of more than 1,300 patients had shown the drug was helpful in reducing the frequency of headaches. But experts from the Drug and Therapeutics Bulletin , which reviews UK medical treatments, have questions about patient selection in the trial, adding that the diagnosis of chronic migraine was incorrect in some.
Furthermore, the experts say, the product led to a worsening of headache symptoms for roughly one in 10 people, and a similar number developed other adverse reactions, including itching, rash, pain, stiffness and muscle spasms.
Not everyone is agreeing with this assessment, however. "Anyone who suffers from chronic migraine knows that there is no cure, but for these patients, who are often quite disabled by their unremitting and remorseless pattern of headaches and migraines, any new treatment that helps them to get their lives back in control and to proactively manage their condition like Botox, gives them hope for a better future," Migraine Action director Lee Tomkins says, according to the BBC.
When Allergan obtained FDA approval last fall for the migraine indication, analysts saw it as a win, saying it could add $1 billion to its current annual sales of $1.3 billion. "This is the most meaningful market expansion that the product has had since it was approved for cosmetic use," Piper Jaffray's David Amsellem told Bloomberg .
Allergan had a lot of hope for Botox; it has been looking at more medical uses for the drug, EVP Scott Whitcup said last year. "We call it our pipeline in a vial," Whitcup explained. "People still think about it as a cosmetic product, but the therapeutic indications in the next five years will far surpass its cosmetic use." In fact, one the indications Allergan is studying for Botox is overactive bladder'. 11.2.11
Growing numbers are backing my NHS reforms
With every new day, more of the people who matter are embracing the opportunities presented by our plans, says Andrew Lansley. There is mounting support within the NHS towards the government's plans to modernise the service. The NHS is full of highly skilled, dedicated people. Parts of it provide world-leading levels of care. But too often, the system itself can act as a barrier to the kind of progress that doctors and nurses want for patients.
Last week, Denis Campbell said in this paper that few in the medical profession seem convinced of government plans. And yet 141 "shadow" GP consortia, covering 28 million people have already stepped forward to voluntarily wrest responsibility for local health services away from primary care trusts.
With every new day, more of the people who matter – local GPs, hospital doctors, community nurses – are embracing the opportunities presented by our plans. Howard Stoate, GP, former Labour MP and elected chair of Bexley's shadow GP consortia, said recently that, in his experience, GPs "reveal overwhelming enthusiasm for the chance to help shape services for the patients they see daily".
Campbell 's other claim was that our plans will create a "democratic deficit". He quoted the London Health Emergency campaign, which said that our plans would be a "disaster for local accountability". If our plans were remotely similar to what it claims, it might have a point. But they are not.
The NHS will be legally obliged to involve patients, the public and local authorities when planning and implementing significant changes to local services. Foundation trusts will become more accountable to their governors and members. Who are these people? If you want, they can be you.
We will significantly extend local authority powers. For the first time, they will be able to scrutinise any NHS funded services, whoever provides them. We are already working with 25 councils to help them design their new health and wellbeing boards, which will bring unprecedented levels of local democratic accountability to the NHS. By April, we expect to be working with up to half of all local authorities.
The new consumer champion, HealthWatch England, part of the Care Quality Commission health regulator, will be able to quickly deal with any concerns about the quality of health and care services. But beyond institutional accountability, genuine patient choice will bring a dramatic level of direct accountability to NHS providers.
A range of new quality standards will show just what excellent care for cancer, diabetes and over a hundred other conditions should look like. We will then publish just how good NHS services really are. If a hospital is not up to scratch, then patients can vote with their feet and go elsewhere. "No decision about me, without me" is not empty rhetoric, it will be the normal experience in a renewed NHS. Where this sort of openness has already happened, its impact has been dramatic – death rates for cardiac surgery have halved in just five years.
As an ex-US supreme court judge once said: "Sunlight is the best disinfectant." We will shine this light more widely and brightly throughout the NHS. 8.2.11
Drug companies panic as thirteen 'blockbuster' drugs about to lose patent protection
Reports indicate that the drug industry is in a panic over the patent losses of 13 big-money drugs, and many others, within the next few years. Everyone knows that the drug industry thrives on developing "blockbuster" drugs that reap huge profits during their initial patent period, after which generic competitors can come in and begin producing the same drugs for less. But Big Pharma is having trouble developing new blockbusters to take the places the old blockbusters, which could hit industry profits hard in the very near future.
According to data compiled by EvaluatePharma, a pharmaceutical and biotechnology industry analysis group, more than $15 billion worth of drug patents are set to expire in 2011, and another $133 billion worth of drugs in the next six years. One of the biggest blockbuster drugs, Pfizer's $11 billion heart drug Lipitor, is also set to expire late in 2011.
Other patent expirations to occur in 2011 include Eli Lilly's Zyprexa and Johnson & Johnson's Levaquin. And in 2012, Bristol-Myers Squibb's Plavix, AstraZeneca's Seroquel, Merck & Co.'s Singulair, Takeda's Actos, and Amgen's Enbrel, all face patent expirations. To put the patent losses into perspective, more than double the value of drugs are expected to lose their patents in 2012 compared to in 2011.
While some sources are bemoaning these losses as a big hit to the drug industry, which they naively view as the medical saviors of mankind, the patent losses are a big win for the public. Not only do they demonopolize drug industry control over FDA-approved medical treatments, thus reducing costs for patients, but they also stop the industry from endlessly raking in billions of dollars in profits for products that cause millions of serious injuries and deaths every year.
The drug industry is not giving up, though, as it scrambles to concoct new blockbuster drugs to keep the cash cow flowing. But sources say many drug companies are having difficulty coming up with new ones. And they face additional problems from the growing awareness that many natural remedies are superior to drugs because they provide increased benefits and real improvements, without the harmful side effects. Natural News 7.2.11
Another failure for AstraZeneca
AstraZeneca's run of disappointing drug development results has continued with the early end to a trial of prostate cancer treatment zibotentan.
The advanced trial on the drug's impact on men with non-metastatic, castrate resistant prostate cancer has been scrapped after the early results showed it had no benefit to the patient.
The decision follows the failure of zibotentan in a trial of men with metatastic prostate cancer last September. Metatastic cancers can spread to other parts of the body.
A trial is still underway evaluating zibotentan's effectiveness with chemotherapy in more advanced cases. This trial will continue and full results are expected in the second half of 2011, Astra said.
The pharmaceutical giant has suffered a number of setbacks to its drug development programme in recent months due to new drugs being unable to beat the effects of the placebo control group.
It stopped all development work on its fledgling respiratory drug motavizumab in December, resulting in a $445m impairment charge.
It is also still trying to get the US authorities to approve potential blockbuster blood thinning drug Brilinta, after an unexpected delay following concerns over disparities in test results on US patients compared to elsewhere. The drug industry is in trouble as existing blockbuster drug patents expire and no new drugs in the pipeline, the industry is worried for its future. 7.2.11
NHS needs to take responsible approach to enormous waste in this financial crisis
With MPs discussing fundamental NHS reform at the same time as jobs, pay and pensions are under threat; I am disturbed as to how little attention is being paid to making the NHS itself a more efficient organisation.
At a time when the NHS in England needs to make £20 billion of savings, getting the most out of every pound spent has never been more important. There are two opinions on how the NHS can play its part. The first is a simple one: drastically cut back on staff costs, ignoring the long term impact this has on patient care. Then there is the second approach: consider the long-term solutions to the savings challenge.
It will come as no surprise that I do not favour the first approach. Tackling this waste properly is the solution favoured by the second approach.
It is remarkable that in today's networked world, different wards in the same Trust can spend hugely varying amounts ordering equipment and supplies. This inefficiency costs the service more than £1 billion a year. Just this week, the National Audit Office highlighted that hospitals are overpaying for basic supplies to the tune of £500 million a year.
Financial waste exists in every corner of the NHS. Nurses often find thousands of pounds worth of unused medication in patient's homes, no longer needed but delivered on repeat prescription. Just in England , it has been estimated wasteful prescriptions costs £300 million a year.
Professor Steve Boorman's review of NHS health and wellbeing proved that £555 million could be saved each year by properly supporting staff. Saving money and improving health can go hand in hand. Similarly, pressure ulcers cost the NHS up to £2billion a year, yet most are preventable with the right levels of skilled staff, training and equipment.
The RCN's own research shows that at least £350 million is spent by NHS organisations on management consultants each year; enough to pay for 330 fully staffed medical wards with 28 beds, 9,160 staff nurses, 3.1 million community midwife visits or 267,647 bed days in a neonatal intensive care unit. This figure is likely to be much higher as the Department of Health has said that consultancy spend by just Primary Care Trusts and Strategic Health Authorities was some £313 million over a year long period. This is in addition to almost £500 million that the Department of Health is said to have spent directly on management consultancy contracts. This comes to around a billion pounds in total.
Where is the value for the taxpayer in this management spend?
The cost of NHS reorganisation set out in the Health and Social Care Bill has been estimated at between £2 - £3 billion. We have many concerns around the detail of the Bill. However, we have to fundamentally question the timing as employers make a concerted effort to reduce their pay bill. To make these reforms when the purse is full would be hard, to do so now represents an unprecedented challenge.
In light of this scandalous financial waste, staff cutbacks should be the last thing that NHS employers look at when addressing their financial challenges. Piling pressure on staff without addressing these inefficiencies will not help the government's NHS reform programme in the long-term. We need an intelligent solution to fix complex problems. 7.2.11
Gordon Brown to crack down on 'vested interest' GP leaders
Gordon Brown will crack down on ‘vested interests' including GP leaders who he sees as blocking Government reforms, it has been reported.
According to cabinet sources quoted in The Guardian at the weekend, the Prime Minister has decided to take a tougher stance to defend against GP's self interests and Conservative attacks that Labour is complacent about public sector performance. As part of it patients will be offered private sector help if local primary care or hospital services are inadequate, it is reported.
The new strategy seems to fly in the face of recent moves by the Government to backtrack on its pro-private sector strategy.
Just last week NHS chief executive David Nicholson wrote to trusts stressing that the NHS was the preferred provider of services adding: ‘Our aim is to ensure that NHS staff are treated fairly and engaged in decisions'.
But critics said 'GP's are opposed to NHS reform because it will be bad for them and break-up their monopoly not because it will be bad for their patients as claimed. NHS and private treatments equals a better standard of care for patients. Blocking private treatments just to protect GP's pay and bonuses while safeguarding NHS services is clearly wrong'. 19.9.09
Beware doom merchants with a ‘vested interest'
The Health Secretary has promised a structure in which those who commission services and use NHS budgets to purchase services on behalf of patients, are separate from those who provide hospital and community health services. “This means the NHS isn't controlled by vested interests'.
Health Minister Simon Burns said: "We expected resistance from the BMA over our proposals to create a fair playing field to give patients more choice of provider. They have previously opposed this under successive governments."
They protest: "Hospitals will have to close, patient care could be hit and treatment rationed by GPs because of the government's controversial shake-up of the NHS, health bosses and medical leaders have warned." 'The biggest restructuring of the service since its creation in 1948 is described as "extraordinarily risky" by NHS leaders and medical groups in a new report'.
The analysis by the NHS Confederation – comprising the British Medical Association, the Faculty of Public Health and the royal colleges representing GPs, surgeons and hospital doctors – comes ahead of publication of the government's flagship Health and Social Care Bill.
Let's just stop for a minute and consider why the BMA, faculty of Public Health and various surgeon's colleges are saying this. Is it because they look after the interests of the patient? Hardly. Don't be fooled. To put it politely, they are collectively the TUC of the National health service looking after the interests of their members.
So what are they worried about? Is the government threatening to shut vast swathes of the NHS and put them out of work. Hardly. The government intends to commission the same work and more as the population ages, so why are they making a fuss?
The simple answer is that many of the changes to be proposed will get rid of a lot of unnecessary practices in the NHS, moving some care from secondary care (hospitals) to primary care (day clinics) where the cost of patient care is far lower.
For example: Gone will be the easy life of the consultant surgeon who wants a fully staffed operating theatre for even the most routine operations (and the cancelled operations because X or Y wasn't available). With it goes the overgenerous overtime that only came about because of "inefficient administration" (for that read the difficulty of getting so many ducks in a row so the operations had to be performed outside normal working hours at inflated rate).
In comes competitive working as GP's commission services from the most efficient hospitals or treatment providers.
But in the meantime expect more squeals and threats from the ‘vested interests' whose fingers are firmly stuck into an NHS pie that costs more than the country raises in income tax. Doctors will consider striking against the Government's NHS reforms as opposition to the changes within the medical profession hardens. The British Medical Association is to hold an emergency meeting next month after its council bowed to grassroots pressure from members angry at its policy of "critical engagement" with the Government over the reforms.
Health Minister Simon Burns said: "We expected resistance from the BMA over our proposals to create a fair playing field to give patients more choice of provider. They have previously opposed this under successive governments."
Doctors' fears for the NHS:
Pace and scale of the reforms
The reforms have not been piloted or tested, and implementing them as the NHS is seeking £20bn of savings is "exceptionally crazy", doctors say but others say they are necessary for the health service to survice.
Privatisation and expansion of the market
Doctors fear allowing private organisations to compete to run services will lead to fragmentation and break-up of the NHS but private companies will bring competition, lower prices and drive up standards.
NHS hospitals will be able to cut prices to attract business in what critics have warned will be a "race to the bottom" but as patients will have a choice about who provides their treatment, those who do not perform well will loose out of they do not maintain standards.
David Cameron has defended the coalition's radical NHS reforms, insisting that "fundamental changes" are needed to raise standards. The Prime Minister said the health service's performance had fallen behind other systems in Europe , even though spending was at similar levels. He urged those warning of NHS privatisation to grow up, and recognise that the public did not care about whether an NHS provider was public, private or charitable so long as the NHS was free at the point of care.
Dr. Michael Dixon, chairman of the N.H.S. Alliance , which supports clinicians' ability to commission health care, said it was inevitable that the proposals would provoke opposition. “Giving power to frontline clinicians and their patients is bound to upset those with vested interests, such as some of the more centralist senior N.H.S. managers who are used to ruling the roost,” Dr. Dixon said.
The NHS is in a dire state with stories hitting the press almost every day about patient neglect and poorly delivered services and as the UK's financial situation gets worse it is time for the Government to have the courage of their convictions to push through the reforms that are necessary.
We are already seeing 'vested interest groups' such as the NHS Confederation and the Unions condemning the reforms . Overall, these reforms are necessary so that healthcare is pushed through the beneficial reforms that we now enjoy in so many other areas of our daily lives. 3.2.11
NHS hospitals wasting £500m a year on 652 different types of gloves and 21 types of A4 paper
The NHS is throwing half a billion pounds down the drain every single year by paying over the odds for hospital equipment. Some trusts are paying half as much again as others for the same medical supplies - leading to massive waste at a time when nurses' jobs are under threat and some operations are being rationed.
A scathing report by the National Audit Office found that even in the same hospital, different departments are needlessly buying lots of different types of the same product - at massively varying prices.
Across the NHS, trusts bought 21 different types of A4 paper, 652 types of medical gloves and an astounding 1,751 'cannulas', instruments which are used for withdrawing or inserting fluid from a patient.
There were wide variations in prices paid - with a 180 per cent difference in price between the highest and lowest for one item. The NAO found that if hospitals worked together on purchasing, millions could be saved. Even within trusts, there are huge variations. One hospital bought 13 types of glove while - amazingly - another bought 177 types, the study found.
And hospitals were not good enough at saving money by ordering in bulk. Overall, 61 trusts analysed by the NAO issued more than 1,000 orders each per year for A4 paper alone. More than three-quarters of orders are for less than £50 - less than the cost of administrating them.
The NAO predicts that, for just four common healthcare products, around £7million in administration costs could be saved every year if the number of orders was reduced to the level achieved by the best 25 per cent of trusts.
Most NHS trusts are now 'foundation trusts', falling outside of the Government's control - and this will soon become all under new NHS reforms.
The report said: 'There is therefore no mechanism to secure commitment by 165 separate hospital trusts to purchase a single item or class of supplies, much less the hundreds of thousands of separate consumable products which the NHS uses. 'Many trusts take part in collaborative purchasing arrangements to some extent, but nevertheless, trusts are often paying more than they need to, for basic supplies.'
Of 66,000 products which could be compared on a like-for-like basis, there was wide variation in how much trusts paid. The average variation between the highest and lowest unit price paid was around 10 per cent but was more than 50 per cent for over 5,000 products.
The study said: 'We estimate that £150million or an average of £900,000 per trust could be saved if trusts had bought the same volume and type of products, but paid the lowest available price at the point of purchase.' For some trusts, as much as £2million a year could be saved in this way.
Trusts are also unable to identify easily how what they pay compares with what their peers pay. And more importantly, they do not know 'whether better prices might be available if they were to engage with the market more effectively'.
The total NHS expenditure on 'consumables' is £4.6 billion, meaning the health service could save at least 10 per cent of this if it worked more efficiently, the research suggests. Hospital trusts have complete freedom to decide what they buy and how they buy it. They can use regional procurement hubs or the central NHS Supply Chain, or they can buy direct from suppliers.
The NAO pointed to evidence which suggests new contracts are frequently established that overlap and duplicate one other, incurring unnecessary administrative costs.
Margaret Hodge, chairwoman of the Commons Public Accounts Committee, said: 'It is simply unacceptable that so many hospital trusts are currently paying more than they need for basic supplies. Even for some of the commonest items, the price hospitals pay varies by more than 100 per cent. 'The range of similar products that trusts buy is sometimes so wide as to appear ridiculous: how can it be, for instance, that while one trust does its work with just 13 different types of surgical glove, another requires 177?'
Critics said 'this is just the tip of the iceberg, trusts are buying in NHS services which can be bought cheaper elsewhere without a thought to costs as no one cares'. 2.2.11
Labours failure: Sleaze probe into 'misuse of millions' at Network Rail as it is claimed 'hush money bought off ex-staff'
Labours ineptitude bankrupted the country, every year they borrowed more money to pay for their policies which were ill conceived by ministers who were out of their depth and poorly executed by officials who raided the system. No where typifies this more than Network Rail.
- Probe over claims of 'serious financial impropriety'
- Chief exec Iain Coucher received £7m in bonuses
- Bought Aston Martin and London flat with allowances
- Network Rail costs taxpayer £4bn a year
- Taxpayer faces taking on £23bn debt burden
A leading QC has begun an inquiry into ‘sleaze' allegations that have plagued Britain 's rail operator. Network Rail – the private company that receives billions of pounds in taxpayers' money to maintain the country's railways, has been dogged by a string of allegations of illicit payments and sexual harassment.
Its controversial former chief executive Iain Coucher is accused of enjoying a ‘James Bond lifestyle' funded by lavish allowances. The boss of Britain 's railways and his business partner, Victoria Pender, also faced claims they received £180,000 every three months for ‘unspecified services' on top of salaries, pensions and bonuses.
Bosses were also accused of using millions of pounds of public funds as hush money to ‘buy off' disgruntled former staff over allegations of sex and race discrimination.
An internal inquiry found no evidence of wrongdoing but now leading barrister Antony White confirmed yesterday he is ‘conducting an inquiry into allegations of misuse of public funds and serious financial impropriety'. Mr Coucher, who left the firm in October after three years as its chief executive and five as deputy, was the country's highest paid public official.
He received £7 million in salary and bonuses over eight years. He also enjoyed a car allowance which he used to fund an Aston Martin, and a £20,000 housing allowance for a flat overlooking Regent's Park. During his time at Network Rail he also purchased a £1million Highlands estate, named Iainland.
Mr Coucher, 49, joined Network Rail when it took over its failed predecessor Railtrack in 2002 with 45-year-old Miss Pender. She was made head of government affairs at NR but no longer works for the firm. Mr Coucher's brother, Tim, was appointed last year to oversee its new £30million national centre in Milton Keynes.
From 2007 to 2009 about 150 employees left with pay-offs totalling £9million of taxpayers' money after signing secrecy agreements. Allegations surfaced last year of deals of between £300,000 and £500,000 paid to ‘buy off' staff before any complaints could be heard before an employment tribunal.
The firm's own inquiry confirmed that one in five claims were for more than six figures but the average settlement was £60,000. The inquiry by Mr White, a specialist in asset tracing and employment law, was agreed by the TSSA white-collar union and Network Rail, which denies the allegations.
Last year the union said it hoped Mr Coucher's departure ‘brings to an end the exhorbitant bonus culture that allowed him to live a pop-star lifestyle off the back of taxpayers'. The barrister's inquiry, paid for by Network Rail, comes as the Government begins a review of the company, which receives £4billion a year from Whitehall to maintain tracks, stations and signals.
Ministers are expected to order a ‘root and branch' reform of Network Rail following the review.
The Coalition is said to be considering taking its £23billion debt burden back on to the public books and opening it up to public scrutiny for the first time under the Freedom of Information Act. The Network Rail board hopes that the recent appointment of new chief executive David Higgins, coupled with the independent investigation, will bring an end to claims of financial impropriety.
Network Rail was set up without shareholders and is free from direct interference from ministers even though most of its funds come from the public purse. At the end of his two-month inquiry, Mr White could either issue a full exoneration of the company and its staff, or call for disciplinary, civil or criminal proceedings. 29.1.11
Financial meltdown in 2008 down to greed and government incompetence (U.S. & U.K.)
The government-appointed panel investigating the roots of the financial crisis has said the meltdown occurred because government officials and Wall Street executives ignored warning signs and failed to manage risks.
The crisis could have been avoided, the Financial Crisis Inquiry Commission determined in a final report released today, which was only supported by Democrats on the panel. Instead, the U.S. fell into the deepest recession since the 1930s and millions of Americans lost their jobs, the congressionally appointed panel concluded.
The Bush and Clinton administrations, the current and previous Federal Reserve chairmen, and Treasury Secretary Timothy Geithner all bear some responsibility for allowing the crisis to happen, the panel said.
It also criticised bankers who got rich by creating trillions of dollars in risky investments. The deals grew so complex that bank executives and regulators did not understand them, the report found, and banks discouraged aggressive oversight of their activities, saying the government's interference would stifle financial innovation.
The commission's findings have been criticised as being tainted by partisan politics.
Six Democrats on the panel supported the conclusions; the four Republicans dissented. The inquiry commission was created by Congress in 2009 to delve into the causes of the financial crisis.
The conclusions contradict a parade of witnesses in the panel's hearings who said the crisis couldn't have been avoided or prevented. Federal Reserve Chairman Ben Bernanke and Goldman Sachs Group Inc. CEO Lloyd Blankfein were among those asserting that defence.
'The greatest tragedy would be to accept the refrain that no one could have seen this coming and thus nothing could have been done,' the report said. 'If we accept this notion, it will happen again.'
The report details numerous warning signs that were ignored, among them:
- an explosion in risky subprime mortgage lending
- an unsustainable rise in housing prices
- widespread reports of unscrupulous lending practices
- steep increases in homeowners' mortgage debt and a spike in Wall Street firms' trading activities, especially in high-risk financial products
- a combination of excessive borrowing, risky investments and lack of transparency
put the financial system on a collision course with crisis,' the report said.
The commission also singles out decisions by regulators who believed the industry could police itself, the report says. 27.1.11
Can it really be true that statins are a waste of time and won't stop heart attacks?
Confused about statins? Hardly surprising, due to all the confilicting medical advice as the experts disagree.
Last week, a major report suggested that if you hadn't had a heart attack or a stroke, taking one of the cholesterol- lowering drugs was probably a waste of time. That's because the chance of them preventing a heart attack was very small.
But other experts rejected the report by the respected Cochrane Library, saying it hadn't included the latest studies. ‘The quality of the data showing the effectiveness and safety of statins is remarkably high,' argued Dr Colin Baigent of the Cholesterol Treatment Trialists' Collaboration in Oxford who are funded by the pharmaceutical industry. ‘We now have a very large database of patients that show clear benefits.'
There are just over two and a half million people living with heart disease in the UK and there's no doubt some will be benefiting from statins.
However, seven million Britons take them and the number is rising. While some of these people are at high risk of heart disease and may be helped by the drugs, several million others are taking them when the evidence for their benefits is conflicting and can be dangerous.
And now to add to the confusion, an influential cardiology organisation known as The Joint British Societies is expected to announce even more people should be put on the drugs and given them earlier, again they are funded by the drug industry.
So who is right, why has it taken so long for these doubts to appear, and what else could you be doing? Good Health asks the experts.
I've never had a heart attack, do I need statins?
That depends on your age and how healthy you are. The latest report found little evidence that taking a statin would protect people from having a first heart attack unless their risk was high. This risk is calculated by your doctor according to a number of factors including your cholesterol levels.
But if you are female or over 65 and at low risk, the Cochrane review says it's even less clear. That's because most trials involve white, middle-aged males so the results don't necessarily apply to anyone else.
But some experts say that I should take them . . .
These experts were probably relying on studies that some people now say were flawed. This is because they included patients who already had heart problems — there's little doubt that statins help these patients, so their inclusion skews the results. Critics say you can't use this evidence to justify treating healthy people with statins.
The evidence for statins can also be made to seem more favourable that it really is. One technique used by drug companies is ‘simply to not say very much about negative findings', says Dr Shah Ebrahim, senior author of the latest review.
The Cochrane review, carried out by researchers from the London School of Hygiene & Tropical Medicine and the University of Bristol , closely analysed 14 controlled trials that involved 34,272 primary prevention patients — that is, people who'd never had a heart attack.
It found ‘only limited evidence that primary prevention with statins may be cost-effective and improve patient quality of life'. The small size of the benefit is vividly illustrated by this fact: out of 1,000 primary patients taking a statin, only one death from heart disease would be avoided.
If benefits are that small then it becomes more important to balance them against the side-effects.
So what are the side-effects?
On the positive side, the review didn't find any evidence that the drugs cause some of the adverse reactions that people have worried about in the past, such as cancer, low mood or anger or increased deaths from violence or suicide.
But that still leaves quite a number that you have to weigh against a small benefit. Statins are well known to cause muscle problems, including muscle pain, fatigue and weakness. Estimates of how common they are vary widely — from 1 per cent to 20 per cent.
Other potential reactions include cataracts, acute kidney failure, and moderate or severe liver dysfunction, said to be rare. Recently the Medicines and Healthcare products Regulatory Agency warned about some additional risks — sleep disturbances, memory loss, sexual dysfunction, depression, and (very rarely) interstitial lung disease.
However the review points out that the trials don't give nearly enough information about side-effects. Over half the trials didn't report on adverse effects, and there has been no attempt to assess the risk of some potentially serious side-effects such as cognitive impairment or the risk of diabetes when cholesterol is lowered too much.
What if I'm only ‘at risk' of a heart attack?
The Nice guidelines say that if you have some of the familiar risk factors for heart disease — are male and over 55 (65 for a woman), have high cholesterol, smoke or are overweight — which gives you a 20 per cent or more chance of a heart attack in the next ten years, you should be prescribed statins.
The Cochrane report doesn't change that advice. It says ‘it is likely the benefits of statins with a raised risk of heart disease are greater than potential short-term harms', but warns: ‘Long-term effects (over decades) remain unknown'.
Dr David Tovey, head of the Cochrane Editorial Unit, says: ‘This report is a warning against expanding statin use further to people below that level of risk. [This expanded use] is not supported by existing evidence.'
So will GPs stop giving out so many statins?
Despite the latest research, your GP may well start prescribing more. That's because in a few months' time the Joint British Societies will issue new guidelines under pressure from the drug industry to sell more product.
This will mean that instead of calculating your risk of heart attack within ten years, your GP will calculate it for your lifetime and start treating you as soon as possible. But as the doctors' magazine Pulse recently warned, this means GPs faced with younger patients will inevitably reach for the statins. An editorial decries this ‘latest step on the road to mass medicalisation'.
Are there other ways to protect my heart?
Last year Kausik Ray, professor of cardiovascular disease prevention at St George's , University of London , published a review that, like the Cochrane Review, also found virtually no benefit from statins in primary prevention. He encourages patients to look at alternatives.
‘The data is very clear that statins can save some lives,' he says. ‘But we need to get better at predicting who is going to benefit. ‘GPs have been pushed into a tick-box culture that means you get statins if you have certain risk factors,' says Professor Ray.
‘But ideally you should discuss concerns, like how to handle long-term issues such as side-effects. Statins are unlikely to kill you but they can affect your quality of life. ‘You may want to try other treatments such as the B vitamin niacin, which has proved effective in trials recently. There are lots of options.'
Several trials have shown that niacin can bring down the ‘bad' LDL cholesterol and raise the ‘good' HDL . It does have a brief flushing effect on the skin, which some people find unpleasant. Omega 3 may help prevent coronary heart disease, according to a World Health Organisation report Both are available on the NHS. 27.1.11
Psychiatric diagnostic manual editor reveals its all bull***t - the emperor has no clothes
"There is no definition of a mental disorder. It's bull***t. I mean, you just can't define it," states Allen Frances, MD, lead editor for the Diagnostic Statistical Manual (DSM-IV). As DSM-IV is the imperial doctrine used by psychiatrists in diagnosing mental disorders, prescribing powerful psychotropics to the masses, and commanding health care dollars, this is quite a confession. "We made mistakes that had terrible consequences," Frances concedes.
Gary Greenberg who interviewed Frances and wrote an in-depth article for Wired Magazine, describes how Frances ' conscience has been hitting him in the gut. "Diagnoses of autism, attention-deficit hyperactivity disorder, and bipolar disorder sky-rocketed, and Frances thinks his manual inadvertently facilitated these epidemics -- and, in the bargain, fostered an increasing tendency to chalk up life's difficulties to mental illness and then treat them with psychiatric drugs," writes Greenberg.
DSM-IV led to a 40X increase in child bipolar diagnoses and an epidemic of dangerous antipsychotic prescriptions for children, even as young as 3.
Senior editor of DSM-III (the prior version), Robert Spitzer MD, had his own rude awakening. He is the one who spurred Frances to join him in battling against the creators of DSM-5 -- the next edition in progress. Spitzer publicly censured the APA for mandating that psychiatrists involved in DSM-5 sign a written promise to never talk about what they were doing, except when necessary for their jobs. "The intent seemed to be not to let anyone know what...was going on," says Spitzer.
Spitzer and Frances warn that including a proposed "pre-psychotic" disorder could lead to a new diagnosis explosion and drug company marketing onslaught. Frances says an emphasis on early intervention would encourage the "wholesale imperial medicalization of normality," producing "a bonanza for the pharmaceutical industry "while imposing on patients the "high price [of] adverse effects, dollars, and stigma".
There are many other dissenters in the field. Greenberg says "they are becoming increasingly restive, and some are beginning to agree with Frances that public pressure may be the only way to derail a train that he fears will 'take psychiatry off a cliff.'"
Greenberg, himself a psychotherapist, points out that scientific certainty eludes psychiatry. He reports, "every fight over nomenclature threatens to undermine the legitimacy of the profession by revealing its dirty secret: that for all their confident pronouncements, psychiatrists can't rigorously differentiate illness from everyday suffering."
With 25% more mental disorders than DSM-III, DSM-IV has been a goldmine for drug companies. According to a 2006 study by Tufts University , more than half of the DSM-IV authors had financial links to the pharmaceutical industry.
Lacking medical research, the DSM-5 website is riddled with "deliberating", "discussing", and "heavy discussions" to describe how these professed experts attempt to decree new disorders. New proposals for DSM-5 include "Hoarding Disorder", "Skin Picking Disorder" and worse, new labels for babies: "Temper Dysregulation Disorder" and "Feeding Disorder". This would open the door to an infant drugging marketing campaign!
Like the tale of the pompous emperor who pretends his clothes are so magnificent they can only be seen by wise people, the psychiatric and drug industries peddle their fabricated labels and drug remedies to the world. And like the little boy who shouts the obvious "the emperor has no clothes", it's up to public pressure to stop this. 27.12.10
Common garden weed 'cures skin cancer', say scientists
A common weed could help cure skin cancers, claim researchers. The sap from a plant known as petty spurge or milkweed - found by roadsides and in woodland - can 'kill' certain types of cancer cells when applied to the skin. It works on non-melanoma skin cancers, which affect hundreds of thousands of Britons each year.
They are triggered by sun damage and, although not usually fatal, can be disfiguring without treatment. The plant has been used for centuries as a traditional folk medicine to treat conditions such as warts, asthma and several types of cancer.
But for the first time a team of scientists in Australia has carried out a clinical study of sap from Euphorbia peplus, which is related to Euphorbia plants grown in gardens in the UK. The study of 36 patients with a total of 48 non-melanoma lesions included basal cell carcinomas (BCC), squamous cell carcinomas (SCC) and intraepidermal carcinomas (IEC), a growth of cancerous cells confined to the outer layer of the skin.
Patients had failed to respond to conventional treatment including surgery, or they refused or were unsuitable for surgery because of their age.
The patients were treated once a day for three consecutive days by an oncologist using a cotton bud to apply enough of the E.peplus sap to cover the surface of each lesion. The initial results were impressive, says findings to be released this week in the British Journal of Dermatology.
After only one month 41 of the 48 cancers had completely gone.
Patients who had some of the lesions remaining were offered a second course of treatment. After an average of 15 months following treatment, two thirds of the 48 skin cancer lesions were still showing a complete response. Of the three types of skin cancer tested, the final outcome was a 75 per cent complete response for IEC lesions, 57 per cent for BCC and 50 per cent for SCC lesions.
Side-effects were low, with 43 per cent of patients in no pain as a result of the treatment and only 14 per cent reporting moderate pain, and only one patient encountered severe short-term pain.
In all cases of successful treatment the skin was left with a good cosmetic appearance.
The researchers, from a number of medical institutions in Brisbane, attribute the benefit to the active ingredient ingenol mebutate which has been shown to destroy tumour cells. British experts said further studies were needed and people should not try this at home as the weed sap can be harmful to the eyes and should not be eaten.
More than 76,500 people are diagnosed with non-melanoma skin cancer in the UK each year, with 90 per cent caused by ultraviolet light exposure. Lesions usually appear on the areas most exposed to the sun, such as the head, neck, ears, and back of the hands.
Kimberley Carter of the British Association of Dermatologists said: 'This is a very small test group so it will be interesting to see what larger studies and the development of the active ingredient in E. peplus sap will reveal. 'Whilst it would not provide an alternative to surgery for the more invasive skin cancers or melanoma, in the future it might become a useful addition to the treatments available to patients for superficial, non-melanoma skin cancers.
'Any advances that could lead to new therapies for patients where surgery is not an option are definitely worth investigating. 'It is also very important to note that this is definitely not a treatment people should be trying out at home. 'Exposure of the sap to mucous producing surfaces, such as the eyes, results in extreme inflammation and can lead to hospitalisation.
'The concentration of the active ingredients in the sap also varies between different plants, with high doses able to cause very severe and excessive inflammatory responses.' 26.1.11
NHS 'wasting billions with no benefits for patients' on cash incentives for GPs
Paying GPs cash incentives to improve healthcare often fails to produce the desired results, a damning report says today. It accuses the NHS of wasting billions on ‘pay-for-performance targets', which allow family doctors to supplement their incomes. But how much do we know about the effectiveness and value for money offered by doctors in General Practice? You can listen to a Radio 4 podcast here.
The study's conclusions are based on a multi-billion pound plan to lower patients' blood pressure, which had ‘no impact' on cutting heart attacks and strokes. Pay-for-performance targets were introduced by Labour in 2004 at a cost of £1.8billion a year as part of a new contract for GPs. Around one-third of their average income – currently £105,000 a year – is linked to achieving these targets.
But the study found they did not help patients with high blood pressure and provides the strongest evidence yet that pay-for-performance offers little benefit. The Government has pledged to reform the way GPs are paid for this type of work in the face of increasing criticism. They are to receive sweeping new spending powers under Health Secretary Andrew Lansley's controversial reforms and will form consortia to replace the soon to be abolished Primary Care Trusts.
Dr Brian Serumaga, a Harvard Medical School fellow working at Nottingham University , and a team of experts investigated 470,000 patients with hypertension (high blood pressure) at 358 UK general practices. They looked at various blood pressure measures between January 2000 and August 2007, before and after the Quality and Outcomes Framework (QOF) incentive scheme was introduced.
The study found no change in the amount of blood pressure monitoring or in success in getting readings down. There was a rise in the number of patients receiving medication, but this was not because of the scheme.
The targets had no ‘identifiable impact' on strokes, heart attacks, kidney failure, heart failure or deaths among patients starting treatment before 2001 and another sub-group of patients whose treatment started after the QOF. The study findings are published in the online journal bmj.com.
Around half of people aged over 50 have hypertension, which is one of the most treatable, but under-treated risk factors for heart disease and strokes. Meeting blood pressure targets contributes around 8 per cent of QOF income.
Other QOF areas include management of conditions such as heart disease, kidney disease, and epilepsy, as well as monitoring drinkers, smokers and obese patients.
Dr Serumaga said: ‘No matter how we looked at the numbers the evidence was unmistakable. To date, there is little evidence of the effectiveness of pay-for-performance targets.' Rachel Elliott, of Nottingham University , said: ‘These results show clearly the QOF programme hasn't helped people with hypertension, despite increased prescribing of medicines. In a time of constrained budgets, policymakers need to consult evidence so they don't introduce new initiatives that cost huge amounts of public money and don't work.'
But Dr Laurence Buckman, chairman of the GPs committee of the British Medical Association, said the QOF wasn't ‘simply an incentive scheme'. It was also designed to pay work by GPs that previously wasn't funded, to help reduce inequalities in health care between areas and to improve public health over the long-term.
‘The QOF is still relatively new,' he said. ‘Other studies have shown that it has improved care and treatment for people with diabetes and reduced the number of heart attacks and deaths, particularly in deprived areas. We expect the true gains will be seen in the long-term.'
The Department of Health said: ‘The QOF and other incentives for GPs are insufficiently focused on outcomes, including patient experience. ‘We therefore intend to reform the payment system so that GPs are rewarded appropriately for improving patient outcomes.' 26.1.11
Ripping off the NHS - Now the NHS pays £1,000 for a bottle of salt water!
It seems the only people who don't want change in the NHS as those who are ripping it off.
Last week, we revealed the NHS is being charged £175 for paracetamol. But as this investigation shows, that's just the tip of the iceberg . Thousands of patients who have difficulty swallowing pills find taking their medicine in this form difficult — if not impossible. As a result, these patients are prescribed their medication in a liquid state. But few of them would realise medicine suppliers are profiteering from their frailty.
Last week, Henrietta Spink wrote in the Mail about her shock on discovering that the liquid paracetamol prescribed to her son cost the NHS a staggering £175 for just 500ml. As Henrietta said: ‘If I'd crushed up painkillers in a spoonful of jam, for example, as I normally do, it would have cost less than £1.'
But her experience is just the tip of the iceberg, as this Good Health investigation reveals.
We've discovered that suppliers are charging exorbitant rates for a range of drugs — and some chemists are colluding with them and getting kickbacks in return. This means that the NHS is being ripped off for millions of pounds at a time when it needs to watch every penny.
The drugs in question are called specials — medicines not routinely produced by manufacturers. Examples of specials include child versions of adult medicines that contain smaller quantities of active drugs or — the most common form of special — liquid states of medicines needed for patients who cannot swallow tablets.
It was not that long ago that specials were made up by pharmacists. But now — partly as a result of EU safety regulations — they are put together by drug suppliers. The average difference in cost between a standard pill version and a specials order is £188, according to an NHS report. But the difference can sometimes be up to thousands of pounds.
One of the most popular specials is a liquid form of simvastatin, a drug to lower cholesterol. The NHS spent more than £3 million on around 14,000 liquid formulations of this in 2009, at a cost of £208 each (the equivalent amount in pill form costs £1.12).
But there are other, more shocking, price differences. ‘I couldn't believe an invoice I recently received,' one London-based pharmacist told us, on condition on anonymity. ‘It was for a supply of sodium chloride solution — salt water, basically, to treat a child with hormone problems. The charge was £570. I've been told it soon will be £1,000. The ingredients would have cost just pennies.'
There is also great variation in charges among specials suppliers, he told us: ‘Another prescription I received recently was for some clonidine (high blood pressure) patches. ‘I phoned different suppliers and got quotes ranging from £32 for a month's supply to £3,000 — for the same product. There was nothing to stop me ordering the £3,000 patches as the NHS would pay. It's being ripped off.'
Another pharmacist told us he'd received two charges for the same quantity of the antidepressant amitriptyline — £14 and £400 (a standard pill costs around £1). Since the NHS reimburses pharmacists for any specials they order — at whatever cost — business is booming. Latest figures show that NHS spending on specials rose from £58 million in 2006/7 to £164 million in 2009/10.
Suppliers argue that one reason demand for specials is rising is the ageing population. But over the past two years, pharmacists have reported prices have soared.
A major problem is that the NHS doesn't set a limit on the price of specials — as it does for other drugs — so suppliers are free to set prices. The issue is complicated by a number of third-party suppliers who act as agents between pharmacist and specialist supplier. Their charges, too, are unregulated.
The problem is industry-wide. Because the trade in specials is unregulated — making over-charging effectively legitimate — it's not easy to identity where the fault for price inflation lies. Certainly, many pharmacists and manufacturers blame middle-man wholesalers as responsible for price inflation.
An investigation into this by the NHS Counter Fraud and Security Management Service concluded no one was breaking the law by charging such high mark-ups.
Last year, the MHRA, the Government's medicines and healthcare products regulating agency, allowed suppliers to publish price lists (something they were not allowed to do before) so pharmacists could see the original price of each item before any added a mark-up. But suppliers don't have to do this.
By ordering from specialists, pharmacists avoid having to comply with UK and EU regulations that demand strict quality-control processing. It also means that if the drugs turn out to be faulty the manufacturer carries the risk.
There are also financial reasons pharmacists don't make specials — the fees they can charge for doing so are set between 85p and £3.10 for work that can take up to an hour. But Mark Burdon, a pharmacist in Durham , says the main reason to order specials is time. ‘Our first concern is that patients get their medicines quickly and of the appropriate standard. I'm not sure patients would put up with waiting weeks for their medication,' he says. 'They expect their medicines in new packs, with an expiry date and batch numbers, not something they'd see as “knocked up” in a pharmacy.'
Several pharmacists told us of a more reprehensible practice behind the rise in specials orders — some companies offer special discounts and fees to pharmacists. ‘Because the NHS always pays the full quoted rate, this is effectively a kickback,' said one. Pharmacists are deeply concerned. Last year, the Royal Pharmaceutical Society issued guidance asking pharmacists to choose manufacturers wisely.
‘Regularly check that your chosen supplier is offering the best all-round service, taking into account quality, promptness of supply and value for money,' it advised. Yet while most pharmacists are behaving correctly, some aren't — and, as there is no requirement for pharmacists to seek out the best deals, many simply don't bother.
Furthermore, as Noel Wardle, a lawyer specialising in pharmacy practice at Charles Russell, told the Mail: ‘Some primary care trusts have contacted pharmacists to say: “We think you should get your specials from this manufacturer,” but that is probably illegal, because it's anti-competitive.'
The Pharmaceutical Services Negotiating Committee, which negotiates directly with ministers on behalf of pharmacists, is lobbying for change to the pricing structure. Sue Sharpe, its chief executive, said: ‘We'd like to see a tariff system introduced so that the most commonly prescribed specials have a standard price.' With the amount of money involved, this change cannot come too soon.
As Katherine Murphy, of the Patients' Association, says: ‘At a time when the NHS is being asked to make £20 billion of savings, it's outrageous pharmacists are being asked to pay out such huge sums. These charges take money away from front-line services.'
A Department of Health spokesman said: ‘The Department is aware of the cost to the NHS of specially prepared medicines for a small number of patients. ‘We recognise the system needs to be reformed. The current reimbursement arrangements for specials do not give an incentive for competition between manufacturers. We want to encourage pharmacists to get best value while also ensuring patients receive the medicine they need, when they need it.'
A spokesperson for the Association of Commercial Specials Manufacturers says: ‘There is a need for greater transparency and consistency and [now that price lists can be published] anyone purchasing a special can now have some benchmark and then make a decision about where to purchase.' 25.1.11