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218 records
found from year 2006
| View London stories from other years: 2005 2004 |
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| Thursday, 08 June 2006 12:32 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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NHS trusts in England ran up deficits totalling £1.3 billion in the last financial year despite record growth in the health service budget, according to accounts published yesterday by Patricia Hewitt, the health secretary.
Ms Hewitt said she would not allow patient care to be compromised after the National Audit Office warned that the most troubled trusts would have to make severe financial cutbacks.
Surrey and Sussex Healthcare trust ran up the biggest deficit (£40.8m), while other big overspenders included St George's Healthcare trust in south-west London (£33.6m) and West Hertfordshire hospitals (£28.3m).
The government said the NHS’s net deficit was actually much lower after surpluses made by some trusts had been subtracted from the deficits. For the last financial year this net deficit came to £512m, compared with a forecast of £623m made by the Department of Health in December.
Acting NHS chief executive Sir Ian Caruthers said this amounted to just 0.8 per cent of the budget and was equivalent to a householder on an income of £20,000 overspending by £160 over the year.
He accepted that the deficit was a “serious blot on the landscape”, but denied that there was a financial crisis that would lead to thousands of job losses.
Ms Hewitt identified East Anglia, Bedfordshire and Hertfordshire, Surrey and Sussex and north-west London as the worst areas but refused to speculate on whether hospitals in these areas might have to close.
When asked if she would resign if she failed to eliminate the NHS’s financial deficit, she replied: "By the end of March next year, we will restore the NHS to financial balance and I will be held to account for that."
The NAO said the current deficit would have serious consequences for NHS spending this year, with trusts expected to make a double cut to pay back last year’s deficit as well as eliminating this year’s overspending.
Shadow health secretary Andrew Lansley said the figures "will deepen the crisis of confidence in the government's stewardship of the NHS ... The health secretary is living in a parallel universe, in which everything gets better and nothing is wrong. Hard-working NHS staff are in the real world, where they deliver in spite of the government's policy failures."
Liberal Democrat health spokesman Steve Webb said: "It takes a special sort of mismanagement to spend record billions on the NHS and still have hospitals cutting frontline staff in financial rescue packages."
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| Thursday, 08 June 2006 12:10 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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A leading medical ethics expert has today called on doctors to be allowed to end the lives of some terminally ill patients “swiftly, humanely and without guilt” – even if they have not given consent.
Len Doyal, emeritus professor of medical ethics at Queen Mary, University of London, says doctors should recognise that they are already killing patients when they remove feeding tubes from those whose lives are no longer judged to be worth living.
Some will suffer a “slow and distressing” death as a result, Professor Doyal writes in an article in Clinical Ethics, and it would be better if their lives were ended without this unnecessary delay.
Critics have labelled Prof Doyal’s views "very worst form of medical paternalism".
He was a supporter of Lord Joffe’s assisted dying bill that would have allowed terminally ill patients to request a cocktail of drugs to end their lives early. The bill was shelved after opponents voted for a postponement for further debate.
In the article, Prof Doyal says withdrawing life-saving treatment from severely incompetent patients - which may involve turning off a ventilator, ending antibiotics or withdrawing a feeding tube - is "believed to be morally appropriate because it constitutes doing nothing. It is disease that does the dirty work, not the clinician. Yet this argument cannot wash away the foreseeable suffering of severely incompetent patients sometimes forced to die avoidably slow and distressing deaths.
"Clinicians who starve severely incompetent patients to death are not deemed by law to have killed them actively, even if they begin the process by the removal of feeding tubes. The legal fiction that such starvation is not active killing is no more than clumsy judicial camouflage of the euthanasia that is actually occurring.
"The category of patients that concerns me most are the patients where we are not sure. There is still some brain function, but they will never have any brain awareness or cognitive function, but they seem to be suffering," he told the Guardian.
This could happen after an accident or a stroke. He does not believe that legalising non-voluntary euthanasia for such patients would lead to more or inappropriate deaths.
"We have a situation where these decisions are being made all the time and yet we have no coherent system of regulation for them. We really don't know what is going on out there, as they do in Holland where all this is legal or in Oregon where they have physician-assisted suicide.
"Where you have legalisation, you have the best data about what is going on because people are not afraid to report it," he added.
Peter Saunders, the campaign director of Care Not Killing, an alliance of healthcare professionals and others opposed to euthanasia and the Joffe bill, said the professor was confusing the withdrawal of treatment that was more burdensome than beneficial to the patient with actively ending life.
"Doyal is advocating the very worst form of medical paternalism whereby doctors can end the lives of patients after making a judgment that their lives are of no value and claim that they are simply acting in their patients' best interests," he said.
"The clear lesson from the Netherlands, where over 1,000 patients are killed by doctors every year without their consent and where babies with special needs are killed ... is that when voluntary euthanasia is legalised involuntary euthanasia inevitably follows."
The British Medical Association declined to comment on Prof Doyal's article. "We have a neutral position," said a spokeswoman. "We leave it to society to decide."
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| Thursday, 08 June 2006 10:37 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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A new form of hip replacement decreases the risk of patients being left with one leg longer than the other.
A third of hip patients risk having a 1cm or greater difference in leg length after surgery. But research on 102 hip replacement patients at the Royal London Hospital who had the new joint showed an average difference of only 1mm.
Seventy per cent had differences of 5mm or less, while one in four patients receiving the new joint had legs of identical lengths.
When people are born with legs of unequal length, the extra strain on the hip joint can eventually lead to arthritis, while the disease itself can result in a loss of leg length. A hip replacement can also leave a leg shorter than before, with around one in three patients ending up with an average difference of 1.5cm.
Minor differences, less than 1cm, are not usually a problem, but bigger gaps have been linked to low back pain, risk of dislocation, sciatic nerve pain and walking difficulties.
Different leg lengths may also put extra strain on the new artificial joint, with a risk that it may fail sooner than it should. Although shoe inserts and other strategies can be used to combat the problem, research shows many patients are still unhappy.
The thigh bone is made up of three parts: a head, which fits into the socket of the hip, a neck, and shaft. In normal hip replacement surgery, the ball and socket joint of the hip, including the neck of the thigh bone, is replaced by an artificial socket and ball.
The metal ball, or head, is attached to a stem implanted in the femur or thigh bone.
In the procedure used by surgeons at the Royal London Hospital, the 1cm to 2cm long neck of the thigh bone, which links the discarded head to the shaft, is not cut away, but retained. A slot is cut in the femur and the neck-retaining femoral implant is designed to fit over and around the neck.
Keeping the neck of the bone means that more of the natural anatomy is retained and this makes it more likely that the legs will be of equal length.
Retaining the neck also makes it easier to keep check on the alignment of the legs during surgery.
Surgeons at the Royal London have now analysed the results from 102 patients who have had the procedure, and found high rates of accuracy.
"Our results show the neck-retaining joint minimises leg-length inequality following total hip replacement," says Vikas Khanduja, one of the team involved in the research, which was led by consultant surgeon Gareth Scott.
"Minor discrepancies, of less than 1cm, are usually well tolerated," he added, "but inequalities of more than 1cm can be associated with a number of risks."
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| Monday, 05 June 2006 10:33 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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New evidence which appears to support the work of Andrew Wakefield, the scientist who first suggested that the MMR vaccine may be linked to some cases of autism, has emerged, reports the Daily Mail.
Dr Stephen Walker, of Wake Forest University Medical Centre in North Carolina, said the discovery of measles in the intestines of children with a form of autism suggested an association between measles and autistic children with bowel disease.
But he added: “We haven't done anything to demonstrate that the measles virus is causing autism or even causing bowel disease.
“Even if we showed association between measles virus and bowel disease and we published in a peer-reviewed journal, the conclusion will be simply that there is measles virus in the gut of a large number of children who have regressive autism and bowel disease. End of story.”
Richard Halvorsen, a London GP and childhood vaccination expert, claimed the results were “incredibly significant”.
He said: “This may not be proof of causation, but we have confirmation that there is a association between MMR and autistic children.
“The Government needs to have a little humility and accept there could be an issue and as a matter of urgency readdress their vaccination programme.”
Dr Walker presented the New York University School of Medicine study of 275 American children at the International Meeting for Autism Research in Montreal on Friday.
All of the children had bowel disease and regressive autism, and tissue biopsies found that 85 per cent showed signs of the vaccine strain of the measles virus.
Dr Walker, who hopes to finish the study this summer, added: “There are lots of viruses in the gut and any one of them could be causing inflammation.
“If it truly is from a vaccine and this virus causes inflammation and a chronic bowel condition in some susceptible children, then that's something that needs to be known.'
Dr Wakefield, who now works in Texas, welcomed the research yesterday. “The findings are immensely reassuring in as much as they confirm the validity of our original study,” he said.
“Everything that we reported in the original paper in 1998 has been supported by independent replications.
“In an effort to maintain vaccine uptake and protect susceptible children against autism I believe that the Government should, at the very least, make single vaccines available again.'
The controversy has scared some parents off the measles, mumps and rubella jab. Uptake is now as low as 70 per cent in some areas. Jackie Fletcher, founder of vaccination pressure group JABS, said yesterday: “This appears to be further compelling evidence linking the MMR vaccine to autism.
“It confirms the measles virus is present in the gut of these children when it shouldn't be.
“The Government should reinstate the single vaccines immediately.
“They have failed in their care of children.'
The Department of Health insisted the latest study had no validity because control groups were not used.
“The same investigation in Dr Wakefield's own laboratories showed no evidence of measles virus in bowel tissue from autistic children,” said a spokesman.
“Several properly conducted studies that include control groups, have failed to find measles virus persisting in the blood cells of autistic children.
“We believe there remains no convincing epidemiological or virological evidence for MMR playing a part in causing autism.
“MMR remains the best form of protection against measles, mumps and rubella and it is recognised by the World Health Organisation as having an outstanding safety record.”
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| Sunday, 04 June 2006 11:17 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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A new type of breast cancer drug has produced dramatic improvements in survival rates, researchers are set to report.
Scientists will tell the American Society of Clinical Oncology in Atlanta that exemestane produced a 15 per cent improvement in survival rates in breast cancer patients when they switched from tamoxifen.
Tamoxifen has been the ‘gold standard’ treatment for post-menopausal women who have undergone surgery for a first breast cancer and has produced a steady improvement in survival rates over the past 10 years.
But researchers have found that exemestane could make even greater improvements.
“These results show that switching to exemestane after two to three years of tamoxifen is safe and can improve the cure rate in post-menopausal women with breast cancer,” said Professor Raoul Coombes of Imperial College, London. “Both drugs can be an important part of therapy for these patients.”
Experts say aromatase inhibitors like exemestane will gradually replace tamoxifen. However, exemestane costs about £1,000 per patient per year, 10 times more than tamoxifen.
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| Saturday, 03 June 2006 11:15 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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A study has revealed that an extract of cannabis provides pain relief for patients after major surgery.
Imperial College London researchers tested Cannador on 65 patients after surgery such as knee replacements and found it helped reduce pain.
Lead researcher Dr Anita Holdcroft said: "Pain after surgery continues to be a problem because many of the commonly used drugs are either ineffective or have too many side effects.
"These results show that cannabinoids are effective and may lead to the development of a wider range of drugs to manage post-operative pain."
The team tested different doses of Cannador on 65 patients who had previously undergone surgery. All 11 who received the 5mg dose requested further pain relief, but only 15 of the 30 who received the 10mg dose and 6 of the 24 on the 15mg dose needed additional painkillers.
However, the increased doses also led to side effects such as nausea and increased heart rate.
Professor Mervyn Maze from Imperial College London, who also worked on the study, said: "We thought cannabis might be beneficial in helping manage pain following surgery, as previous research indicated cannabinoids help 'top up' the body's natural system for reducing pain sensation.
"This research proves it can be effective, with minimal side effects at low doses."
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| Thursday, 01 June 2006 10:38 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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Drug manufacturers have been urged to tamper-proof their products amid concern about drug abusers trading techniques on how to increase the effects of powerful painkiller, sedatives, tranquillisers and stimulants.
A study found that people were increasingly using the internet to find recipes on how to get around measures such as time-release capsules used to deliver powerful drugs. Users crush, dissolve or inject these drugs in order to release the active ingredient into their bloodstream in one dose.
Edward Cone, a toxicologist at ConeChem Research in Maryland and author of the study, told New Scientist: "Drug misusers are tampering with the drugs to get high, and you get high by getting the drug in faster or giving a bigger dose. All of these drugs are toxic or lethal at certain levels."
According to the magazine, websites have appeared that explain how to use legal drugs recreationally.
In 2003, the US National Survey of Drug Use and Health showed the number of people misusing legal drugs was 6.3 million – more than double the number using cocaine. John Hendry, a clinical toxicologist at Imperial College London, said: "People take things to get a bit of a buzz. But this [adulteration] is new. It is difficult to prevent."
"Now that the manufacturers are aware of it, they're very likely to take steps to prevent this [tampering] from happening," he added. "There's a constant battle between licit versus illicit."
A spokesperson for the Association of the British Pharmaceutical Industry said: "It's our first priority to ensure sufficient people get access to quality medicines as quickly as possible. You can't legislate for the actions of individuals who would tamper with or incorrectly use medicines."
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| Thursday, 01 June 2006 08:27 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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Researchers from the University of London claim that leaving babies to cry will only end in more tears, and parents are far better off comforting them, especially in the first weeks of life.
Prof Ian St James-Roberts recruited a group of parents from London and Copenhagen to conduct his study.
He also recruited a "control" group of British, American and Danish parents who rushed to their baby's side at the first hint of upset, held their babies for 16 hours a day and frequently shared a bed with their offspring.
The parents were asked to keep a diary of their baby's crying and night-waking and their own responses at 8-14 days, five to six weeks and 10-14 weeks.
London parents held their babies on average for eight hours, 30 minutes a day and those living in Copenhagen for just under 10 hours a day.
They found that babies in London fussed and cried 50 per cent more at two and five weeks and were still crying more at 12 weeks.
Prof St James-Roberts, whose research is being published in the journal Paediatrics this week, said comforting a baby on demand could minimise fussing and crying in the early weeks.
But he told New Scientist: "It makes no difference to unsoothable bouts of crying that are at the core of colic”.
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| Wednesday, 31 May 2006 11:56 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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A quarter of smokers wrongly believe that hand-rolled tobacco poses less risk to health than manufactured cigarettes, a study has revealed.
A survey of 1,000 smokers by the NHS Smoking Helpline found that 24 per cent of smokers use rolling tobacco, up from 11 per cent in 1990, and that many do not understand the risks.
Public health minister Caroline Flint said: "It's so important that we de-bunk the myths associated with rolling tobacco - it's not less harmful, it's not more natural and you're just as likely to develop smoking related illnesses."
Many respondents said they smoked roll-ups because they were cheaper and helped them smoke less, but experts said it was worrying that many also incorrectly cited health benefits.
Professor Martin Jarvis, an expert in tobacco dependence at University College London, said: "Smokers are attracted to own-rolled because they offer a cheaper nicotine fix.
"But they should not delude themselves that they are somehow more natural or less toxic."
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| Tuesday, 30 May 2006 11:46 | | BNN: British Nursing News Online · www.bnn-online.co.uk |
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A rare genetic disorder is the cause of some strokes in young people, research has suggested.
German scientists found 4 per cent of over 700 18 to 55-year-olds who had a stroke also had Fabry disease, and that strokes occurred about a decade earlier in people with the condition
Fabry disease is caused by a missing or faulty enzyme needed by the body to process oils, waxes, and fatty acids.
These substances build up to harmful levels in the eyes, kidneys, nervous system, and cardiovascular system, causing premature death in sufferers through renal, cardiac or cerebrovascular complications.
Researchers from the University of Rostock carried out genetic screening on 700 adults suffering from unexplained stroke to see if they had Fabry disease.
Five per cent of the male patients and just over 2 per cent of the female patients had the condition. This could mean that one per cent of all young people suffering from stroke may have Fabry disease, the researchers said.
The team also found that the average age for people with Fabry disease to have a stroke was 39, while for those without the condition the average age of stroke was 48.
Professor Arndt Rolfs, who led the study, said: "These data show that Fabry disease must be considered as a potential cause of a cryptogenic [unexplained] stroke in young people, and may be more common than previously thought.
"This is a new and important consideration for healthcare professionals managing young people with stroke, and may indicate a need for screening for Fabry disease in this patient population."
Dr Antony Rudd, a stroke specialist at King's College London, said: "This is interesting research, but Fabry disease is still only likely to be responsible for a small proportion of strokes even in young people.
"However, as a potentially treatable and preventable cause, it is one that all doctors involved in treating stroke patients should be aware of."
Dr Isabel Lee, of the UK's Stroke Association, said: "Stroke is the UK's third biggest killer and we recognise the importance of research into Fabry disease in the search for a reason for unexplained strokes in younger people.
"The results presented in this study show that the incidence of Fabry disease in younger stroke survivors is higher than first thought and further research must be carried out to determine whether preventative measures could be taken."
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