Warning of right-to-die law 'row'

"Any new right-to-die legislation will be rigorously fought by MPs from across the House.

Continue reading the main storyRight-to-die cases

Diane Pretty was terminally ill with motor neurone disease. She wanted the courts to give her husband immunity from prosecution if he was to help her die. In November 2001 the House of Lords refused her application.

Ms B was left a tetraplegic by a brain condition. She went to court because doctors refused to stop her artificial ventilation. The High Court ruled in 2002 that her request was valid and treatment was stopped.

Mrs Z, who had an incurable degenerative disease, wanted to go to Switzerland to die and Mr Z arranged it. An injunction to prevent the travel was granted to the local authority. The order was overturned in 2004.

MS sufferer Debbie Purdy challenged the lack of clarity on the law on assisted suicide. She wanted to understand how prosecutors would make a decision on whether or not to prosecute her husband if he was to assist her to get to Switzerland to be helped to die. Ms Purdy won her case and guidance was issued.

"This is a slippery slope, which incrementally and over time, will reduce the 'right to life'."

BMA president Baroness Hollins also criticised moves to re-open the debate, and made it clear the medical profession did "not support a change in the law".

Speaking to Sky News, she said: "To change the law would be to change the boundary between life and death altogether. That's a journey I just don't want us to even start out on in this country."

The Department of Health said the views expressed by Ms Soubry were her own, and the Ministry of Justice said there were no plans for the government to change the law.

It was a matter for Parliament to decide, the justice ministry added.

Campaign group Dignity in Dying said it was currently consulting - along with the all-party parliamentary group on choice at the end of life - on a proposed draft bill.

In January, the Commission on Assisted Dying - led by Lord Falconer and set up and funded by campaigners who want to see a change in the law - said there was a "strong case" for allowing assisted suicide for people who are terminally ill in England and Wales.

But the report had a mixed response, with critics calling it biased.

Paul Tully, of campaign group SPUC Pro-Life, warned that if assisted dying was legalised people with disabilities would be faced with "the sickening prospect that if they struggle with suicidal feelings they will be given help to die instead of care and support".

"Such a move would allegedly save huge amounts of public funds in the costs of caring for disabled, elderly and supposedly unproductive people," he added.

"Disabled people must speak up now before the minister starts trying to legislate against their equal right to exist."

The debate over assisted suicide has resurfaced after Tony Nicklinson, a man with locked-in syndrome, died a week after losing a legal bid to end his life.

Diabetes cholesterol risk warning

The majority of people with diabetes are not controlling cholesterol levels effectively - putting them at increased risk of heart disease, a charity warns.

Diabetes UK says 90% of people with the disease are having annual checks which will show up problems.

But it says the most recent national diabetes audit found many are not then addressing high cholesterol.

Chief executive Barbara Young said it meant the health of thousands was being put at unnecessary risk.

'Easy to control'

About 3.7 million people in the UK have diabetes. The majority - about 90% - have Type 2 diabetes, where the body makes too little insulin or where it fails to make it properly. In those with Type 1 diabetes, the body cannot produce any insulin at all.

The audit includes data on 1.9 million people in England with diabetes.

Continue reading the main story
“
Start Quote
It is an issue that is putting the health of hundreds of thousands of people at risk. ”
End Quote
Barbara Young

Diabetes UK
People with both types of the condition have a higher risk of heart disease than the rest of the population.

Cardiovascular disease is linked to 44% of deaths in people with Type 1 and 52% with Type 2.

Diabetes UK says that because of the existence of statins - cholesterol-lowering drugs - it is relatively easy to control high cholesterol.

People with Type 2 diabetes also have twice the risk of stroke within the first five years of diagnosis compared with the general population.

Barbara Young said the findings were worrying, adding: "It is not clear why the high number of people having their annual cholesterol check is not translating into better cholesterol control, but it is an issue that is putting the health of hundreds of thousands of people at risk.

"It will often be appropriate to prescribe medication such as statins, but it is no good doing this without explaining the importance of taking the medication regularly and the potentially devastating consequences of not doing so.

"Other ways people can help improve their cholesterol levels include losing weight, exercising daily, reducing alcohol consumption, stopping smoking and eating a healthy diet, low in fat."

Pledge to Resist Fracking: Writer-Biologist Sandra Steingraber Issues a Call for Action and a Warning to the Gas Industry

By Sandra Steingraber
The following was a speech given by Sandra Steingraber for the Don't Frack New York Rally in Albany, August 27, 2012.

On this day, 53 years ago, a pregnant college student walked into a hospital in rural Illinois and gave birth to a child.

And then she walked out. By herself.

The baby she left behind became a ward of the state. Three months later a family was found for it.

That child was me.

This story carries three messages. The first is for Governor Cuomo. At the Democratic Committee Policy Conference last week, the governor affirmed his belief in the essential value of government, calling it "the vehicle for the community." I am Exhibit A for that noble idea.

Sometimes the vehicle for community means finding a home for an abandoned child.

Sometimes the vehicle for community means saying NO to a carcinogen-dependent industry that seeks to use our towns as their factory floor, offering temporary riches for a few and permanent pollution for all.

Governor Cuomo: The state of Illinois once protected me. Now I want you to protect my two children. Governor Cuomo, say NO. 

Warning over 'black market food'

Chinese arrests over milk scandal Economic strife, unemployment and the high cost of living could lead to a growth in black market food sales and food fraud. That was the warning at a London conference on global food risk.

Food is an essential for all of us, but in these straitened times, it's an expense as well.

As a result, people may go to great lengths to get it for less - while those who produce it may cut corners to boost their sometimes meagre profits.

The food we buy in supermarkets must meet rigorous standards to make sure it is safe to eat - but those standards increase the costs.

Stealing an animal from a farmer's field or buying goods out of the back of a van is certainly cheaper, and those in the know fear the temptation of those options could prove too strong for some.

Continue reading the main storyThreats to our food Unintentional contamination - accidental damage, for example, due to poor storage Deliberate - for personal, malicious or ideological reasons Indirect - for financial gain, for example, by watering down a product Looking ahead to the next 12 months, Fiona Lickorish, an expert in food trends, says: said: "I think black market food is still going to be around and probably getting worse if what's going on with the economy isn't improving.

"I think there will be a trickle down to people at the lowest level who will find it very difficult to afford their food bills."

She adds grimly: "If I was a farmer I would be locking up my sheep because we're already seeing a much higher incidence of rustling.

"If you were clever you could get yourself a mobile slaughterhouse, get rustling, and be selling into the black market."

Indirect risk

Ms Lickorish was one of several figures giving their views at a London conference on future food risks this week.

Another was Terry Donohoe, head of strategy and policy at the chemical safety division of the Food Standards Agency.

He describes three kinds of food threat - unintentional, deliberate and indirect - and it's the latter that's causing most concern at the moment.

Continue reading the main storyPolicing the problem The FSA investigated 1,505 incidents in 2010 and issued 70 food alerts Five countries - Iran, China, the US, Turkey and Spain - are responsible for 50% of the rogue products detected in Europe The three most active policemen of food quality are the UK, Germany and Italy As opposed to deliberate contamination - which may be done for malicious or ideological reasons by anybody from a disgruntled employee to a terrorist - indirect contamination is for financial gain, and while harming people might never be the intention, it could still be the end result.

Practically speaking, it means changing a product in some way to try to squeeze more value out of it - watering it down, using substandard ingredients, skipping a rule or regulation or two.

An extreme example was seen in China in 2008 when melamine was added to milk formula in an apparent effort to cheat checks on its protein levels - six babies died.

Alec Kyriakides, head of product quality at Sainsbury's, told the conference this type of food fraud was his biggest worry at present.

"If you look at motivation, what creates an environment where people undertake that activity, I think we are moving into that type of environment.

"We have to look at our control programmes, we have to be vigilant."

Being vigilant, everyone agreed, means trying to identify the weak points in the food supply chain - these are often the points at which the value of the goods undergoes a significant jump, between farmer and wholesaler, or wholesaler and retailer.

Those weak points could be an individual or company under financial pressure - with something to gain from creaming off a bit extra - or perhaps a part of the world where standards are not rigorously enforced.

Insects and GM

Ms Lickorish, a principal research fellow at Cranfield University, is into a brand of work called horizon scanning.

Rather than spotting the latest food fads, she tries to identify longer term and "megatrends" - ones driven by fundamental change - like urbanisation or an ageing population.

For example, mankind's consumption of meat has tripled in the past three decades and is forecast to double again by 2050 - horizon scanners are trying to envisage how we might cope with that huge demand.

Continue reading the main story“Start QuoteYou only need a food price spike to see how people's attitude to GMOs changes”

End QuoteFiona LickorishCranfield University One option will be to look to new countries to supply it, but not everyone has the same high food safety and animal welfare standards of the UK.

Future entrants to the EU might seem like a welcome option, but Turkey, for example, has a high number of incidents of foot and mouth disease, so we couldn't start immediately trading livestock with them, the conference was told.

People may also look to alternative sources for protein, namely insects, and more of us may take up DIY urban farming.

The growth of mobile slaughterhouses might have potential for illegal uses, but they could also be a way of satisfying a growing demand for locally-sourced meat, while reducing fears associated with animal movement.

Ms Lickorish also believes we're likely to see a resurgence in GMOs - genetically modified organisms - in food products, arguing that "you only need a food price spike to see how people's attitude to GMOs changes".

"The majority of people don't care where their food comes from as long as it's safe and cheap," she adds.

Dr Andrew Wadge, chief scientist at the FSA, thinks the success of GM will come down to what kind of benefits the public see from it.

He compares it with the microwave - people put aside any issues they might have with the technology because it's so useful - GM just has to become indispensable in the same way.

Ingenious labelling

Speaking of technology, horizon scanners have also spotted some exciting things in the food pipeline - things we might all see on our shelves in the next few years.

Intelligent packaging made with special paper that wards off bacteria and could help keep food fresh longer.

Ultra violet chopping boards which destroy 99.9% of bacteria.

And ingenious labels which use the ammonia given off by meat as it degrades. Ammonia alters the label's barcode to gradually render it unreadable and unsaleable when the product has fallen below a certain standard.

Innovations of these sorts could hopefully reduce food poisoning and food waste, thanks to more accurate use-by dates.

Like so many trends, though, new technology could be something of a double-edged sword.

Scientists are also creating micro-tools that, in theory at least, we could all use to test food and drink for pathogens and pesticides.

This might help keep us healthier, but it might, Ms Lickorish says, actually lead to more food scares, not less, if we're all able to scrutinise our restaurant meals or supermarket sandwiches before we eat them.

Warning of cancer cost 'crisis'

alue" of new treatments and technologies.

It says the number of cancer patients and the cost of treating each one is increasing.

It argues for reducing the use and analysing the cost of cancer services.

About 12 million people worldwide are diagnosed with cancer each year. That figure is expected to reach 27 million by 2030.

The cost of new cancer cases is already estimated to be about £185bn ($286bn) a year.

Rising costs
A group of 37 leading experts from around the world say the burden of cancer is growing and becoming a major financial issue.

Their report says most developed countries dedicate between 4% and 7% of their healthcare budgets to dealing with cancer.

"The issue that concerns economists and policymakers is not just the amount of money spent on healthcare, but also the rate of increase in healthcare spending or what has become known as the cost curve."

It says the UK's total spend on breast cancer has increased by about 10% in each of the past four years.

"In general, increases in the cost of healthcare are driven by innovation. We spend more because we can do more to help patients."

For example, the number of cancer drugs available in the UK has risen from 35 in the 1970s to nearly 100, but the report warns they can be "exceedingly expensive".

It adds: "Few treatments or tests are clear clinical winners, with many falling into the category of substantial cost for limited benefit."

The cost of drugs is not the only target for criticism.

Lead author Prof Richard Sullivan told the BBC: "It's not just pharmaceuticals. Biomarkers, imaging and surgery are all getting through with very low levels of evidence - the hurdles are set too low."

The report calls for a proper evaluation of the relative merits of conventional surgery and less invasive robotic surgery.

Too much

Another criticism is "overusing" treatments and technologies.

"It is often easier to order a scan than to reassure the patient or physician on the basis of a careful history and a physical examination," the report claims.

There is also criticism of "futile care" - providing expensive chemotherapy which gives no medical benefit in the last few weeks of a patient's life.

Prof Sullivan said: "We're on an unaffordable trajectory. We either need to manage and reduce the costs or the cost will increase and then inequality rises between rich and poor."

He said failure to manage costs could result in a "train crash".

The report says solutions fall into two categories: reducing the cost of services or reducing the number of people using them.

Young get sex health web warning

Young people account for more than half of all new sex infections Rise in UK sex infections Many young people worried about sexual health problems shun traditional health services for potentially untrustworthy websites, a poll suggests.

The Information Standard - a government-backed scheme to improve the reliability of health information - surveyed 1,200 18-24-year-olds.

The research showed eight in 10 relied on the internet for help without being aware of the authenticity of the sites.

Experts said it was essential the young sought help from official channels.

Nearly two-thirds of participants reported never having had a sexual health screening.

Their reluctance to use official NHS services was blamed on embarrassment and a lack of awareness about the seriousness of conditions.

Informed advice

Where young people do rely on the internet, the Information Standard said it was important to use reliable sites, such as those produced by the NHS, local authorities or leading charities.

Official and authenticated sites carry the Information Standard brand.

Ann Robinson, director of public awareness at the Information Standard, said: "We want all young people to understand how to spot a trustworthy site.

"Just because it ranks high in the search engine, for example, does not mean that it will provide informed advice."

Dominic Edwardes, of the Terrence Higgins Trust charity, said: "Sexually transmitted infection rates are worryingly high amongst young people, accounting for more than half of all new diagnoses in England in 2010.

"To reduce these figures we need to make sure that young people are equipped with trustworthy advice and understand how to have safe protected sex."

Health warning

Nye Bevan's NHS legacy is both cherished and fiercely fought over

The coalition wouldn't be the first government to come to grief trying to reform the health service. Jonathan Harvey, Political Producer for BBC Radio 4's PM, looks at the problems past governments have encountered.

Much may have changed since the NHS was first launched in 1948 and yet fast forward to today and what would its founder Nye Bevan make of the modern health service?

Lord Warner, who served as minister for health under Tony Blair, says his Labour predecessor would be surprised.

"I think Nye, who was a great reformer, would have actually wondered why we couldn't get on our bikes and reform it."

But he believes it is the public's attitude towards the NHS which is the real road block to reform.

"I think the people have got very attached to their local district general hospitals," he believes.

"People have got it into their heads that if we tamper with some of these local services they're somehow going to be disadvantaged and we've not done a very good job at explaining to them that the world does move on."

In Canada they had a very radical approach to combating public resistance to change.

When the Canadian government deemed Calgary General Hospital no longer financially viable they simply blew it up.

Political will

It's doubtful such an approach would be acceptable here. Which begs the question do politicians lack the nerve to reform the NHS?

Continue reading the main story“Start QuoteNigel Lawson famously said that the NHS is the closest thing we now have to an established church”

End QuoteStephen DorrellConservative MP NHS reforms may change - Lansley NHS overhaul: What next? Former Conservative Health Secretary Stephen Dorrell thinks it's easy for people to portray politicians as "spineless" but that's not really the point.

"Nigel Lawson famously said that the NHS is the closest thing we now have to an established church, and anyone who wants to change it has to take people with them. You can't simply ask them to believe you know what you're doing."

There's also the problem of imposing change on a workforce of more than a million.

Nick Seddon, from the think tank Reform, says staff have a very powerful vested interest in resisting change.

"Our GPs are the highest paid in the world, no wonder they don't want the system to change".

It's a claim hotly disputed by the doctors themselves, who insist the real problem is the politicians who try to change the NHS too much to often.

"Every time the new reforms come along it's taken about three of four years for the next government, or sometimes even the same government, to abolish that reform and start another one." Dr Mark Porter, from the British Medical Association, suggests.

Rhetoric

And then there's the rhetoric around the NHS.

Successive prime ministers have used the health service to gain political advantage.

Margaret Thatcher once said the NHS "is safe in our hands". In 1997 Tony Blair claimed that only by electing him would the public be able to "save the NHS" and recently David Cameron said "it is because I love the NHS so much that I want to change it".

Does the overblown rhetoric make the consensus required for reform almost impossible?

One former government minister thinks so.

"It certainly needs people in the different political parties not to turn the NHS into a political football." Lord Warner says.

All of which doesn't mean reform of the NHS is impossible - but it does rather suggest that despite Mr Lansley's immediate political problems - history too would not appear to be on his side.

Child 'slow development' warning

Children are expected to be able to concentrate and share by five Continue reading the main storyRelated StoriesPoorest 'die seven years earlier'Warning over health inequalitiesCall for health inequalities push Nearly half of children in England are not reaching what teachers consider a good level of development by the age of five, public health experts say.

Achieving a good level of development by five is considered to be a guide to future health prospects.

The Marmot Review team examined local authority data and found inequalities in life expectancy, how long people lived disability-free and unemployment.

The government said it wanted to improve the health of the vulnerable.

Regular bedtimes

The report's authors, who last year published a groundbreaking study of health inequalities in the UK, looked at five key indicators that are used to predict future health: life expectancy, disability-free life expectancy, child development at five, young people out of work and households on means-tested benefits.

The assessment of children's development at the age of five is based on their behaviour and understanding.

Children should be able to share, self-motivate, co-operate and concentrate by the time they start school.

But the research, led by British Medical Association president Sir Michael Marmot, found 44% of all five-year-olds in England are not considered by their teachers to have reached that level.

UK given 'heart epidemic' warning

Case studies The UK needs to prepare for an epidemic of valvular heart disease, caused by a rapidly ageing population, say experts.

With four million people set to be aged 75 to 84 within a few years, surgeons see a rise in the number of transplants to replace worn out valves.

Latest audit data shows a sharp increase in all types of valve surgery in the UK, with some surgeons say it is now taking up 40% of their workload.

Experts say the UK is poorly prepared for more cases.

European and US data indicate that more than 13% of people aged 75 and above have valvular heart disease (VHD).

To some extent, it is part of ageing: as people get older, their valves become less flexible, and more stretched or torn.

And experts are concerned that the UK is poorly prepared for what is certain to be a big increase in cases.

Continue reading the main story“Start QuoteVHD has been relatively neglected by politicians, health economists and even by cardiologists”

End QuoteThe journal paper authors Data from the latest National Adult Cardiac Surgery Database for Great Britain and Northern Ireland shows wide variation in treatment provision.

More than a third of those undergoing surgery to repair their defective heart valves had advanced disease, significantly increasing their likelihood of complications, death, and ineffective symptom relief, researchers told Heart journal.

"These observations suggest that both initial diagnoses and subsequent follow up are currently inadequate and that patients are routinely referred late in the natural history of the condition, beyond the window where surgery is of maximum benefit," they said.

The surgeons were based at Oxford's John Radcliffe Hospital, London's St Thomas' Hospital and the University Hospital of South Manchester.

Ageism and sexism also seem to be factors, with twice as many men undergoing aortic valve replacement as women, and patients over the age of 75 with moderate to severe disease half as likely to be treated surgically as their younger counterparts.

"Advancing age is often used to justify the decision to withhold surgery, but suitably selected patients may derive considerable improvement in symptomatic burden and overall quality of life, following successful intervention," they say.

Mr Ben Bridgewater, a heart surgeon from South Manchester University Hospital, and colleagues are calling for specialist centres to be set up, staffed by specialists with access to the right screening tests and equipment to treat patients with VHD.

Continue reading the main storyValvular heart disease symptoms

Some people may not experience any symptoms but common symptoms are:

being out of breath swelling of the ankles and feet being unusually tired "VHD has been relatively neglected by politicians, health economists and even by cardiologists," they say.

"National programmes already exist for heart failure and coronary disease. A similar coordinated approach to research, education, and clinical management is now needed to ensure improved outcomes for all patients with VHD."

Professor Peter Weissberg of the British Heart Foundation said: "The authors of this paper are right to point out that the NHS will need appropriately skilled health care professionals to identify and deal with patients of all ages - particularly the elderly - with valve disease.

"It is well established that patients with all types of heart disease have a better chance of survival and quality of life when managed by an expert cardiological team.

"It is essential that all hospitals maintain and indeed expand their expert cardiac services over the coming years to avoid the financial and health costs of not dealing with the changing pattern of heart disease in an expert and timely manner."

A Warning by Key Researcher On Risks of BPA Plastic Bottles and Cans in Our Lives

The chemical Bisphenol A, or BPA, has been much in the news lately. BPA is the building block for polycarbonate plastic - the sort of hard, clear plastic often used in water bottles - and it is found in everything from linings of metal cans, to the thermal paper used for cash register receipts, to the dental sealants applied to children's teeth. The chemical mimics estrogen, and in studies involving lab animals, exposure to BPA, even at very low doses, has been linked to a wide variety of health problems, from an increased risk of prostate cancer, to heart disease, to damage to the reproductive system.

Frederick vom Saal, a biologist at the University of Missouri's Endocrine Disruptors Group, is one of the world's leading researchers on the ill health effects of BPA in humans and animals. He is also one of the most outspoken critics of U.S. businesses and regulators for glossing over, or concealing, the major impact that BPA exposure is increasingly having on human health. Vom Staal is irate that even though BPA is quite similar to another synthetic hormone - DES, or Diethylstilbesterol - that caused myriad health problems in thousands of women in the 1940s and 1950s, federal regulators are only now beginning to take seriously the threat from BPA.

In an interview with Yale Environment 360 contributor Elizabeth Kolbert, vom Saal excoriated the U.S. chemical industry for attempting to quash research showing the dangers of BPA and for threatening him and other researchers. Vom Saal was equally critical of regulators from the U.S. Environmental Protection Agency (EPA) and other agencies, whom he says have relied on outdated studies, often funded by industry, to support claims that BPA is safe.

Vom Saal adamantly believes that BPA should be removed from all products as soon as possible, as was done a decade ago in Japan. Although the U.S. Food and Drug Administration (FDA) said earlier this year that the health effects of BPA represent "reason for some concern," the chemical still remains unregulated. Vom Saal maintains that the regulatory system has failed to protect U.S. consumers, adding, "It is a lie. It is a fraud. It is absolutely intolerable that this kind of thing is going on."

Fracture warning over bone drugs

Bisphosphonates slow down bone turnover US regulators are warning patients that drugs used to protect brittle bones may increase fracture risk in rare cases.

The Food and Drugs Administration (FDA) says all drugs in the bisphosphonate class must carry an alert on their label about this unusual side effect.

They say patients should keep taking the pills unless they are told by their doctor to stop.

In the UK, only one bisphosphonate drug - alendronate - carries the warning but regulators are reviewing this decision.

Continue reading the main storyRelated storiesBone drug linked to cancer risk Nearly three million people in the UK have osteoporosis, a condition that makes the bones brittle and causes about 230,000 fractures a year.

Bisphosphonates are given to more than half a million of these patients in a bid to strengthen their bones and reduce their risk of a fracture.

But experts are becoming increasingly concerned that the drugs may cause the very thing they are trying to prevent after finding a link between their use and an unusual type of leg fracture.

Continue reading the main story“Start QuoteAt present it is uncertain whether these fractures are directly related to treatment but an association has not been excluded”

End QuoteA spokesman for the National Osteoporosis Society The FDA says it is not clear whether bisphosphonates are the cause of these thigh bone breaks, but they are concerned enough to tell manufacturers to add warnings to medication packets.

FDA medical officer Theresa Kehoe said they would continue to monitor the safety of the drugs, adding: "In the interim, it's important for patients and health care professionals to have all the safety information available when determining the best course of treatment for osteoporosis."

The FDA says patients should keep taking their medication unless they are advised by their doctor to stop.

Under review

The UK's drug regulator, the Medicines and Healthcare Products Regulatory Agency (MHRA), said it had begun to look at the possible increased risk of fractures in patients taking bisphosphonates in case it was an effect common to all members of that drug family, not just alendronate.

A spokeswoman said: "The committee will now review all available data thoroughly, including published data, non-clinical and clinical data, and post-marketing reports, to clarify whether atypical stress fractures are a class effect of bisphosphonates, and will assess their impact on the balance of risks and benefits of these medicines."

A spokesman for the National Osteoporosis Society said: "At present it is uncertain whether these fractures are directly related to treatment but an association has not been excluded.

"Bisphosphonates slow down the rate at which bone is destroyed and replaced, by reducing the activity of osteoclast cells that break down bone.

"Although this is a useful process to prevent bone loss and fractures, there are concerns that over a prolonged period of time, this may result in bones becoming 'older' and more brittle."

He said it should be remembered that these unusual fractures are rare and that in the vast majority of patients the benefits of treatment will far outweigh the risks.

A recent study, published last month in the British Medical Journal, linked bisphosphonate use to cancer of the gullet.