Thursday 30th June 2016- The Guardian: Couple win legal battle against ruling on dead daughter’s eggs

‘A 60-year-old woman who wants to use her dead daughter’s frozen eggs to give birth to a grandchild has won a legal battle over what constitutes medical consent.

The court of appeal has ordered the Human Fertilisation and Embryology Authority (HFEA) to reconsider the application, opening the way for fertility treatment in the United States.

The woman, whose daughter died of bowel cancer in 2011, had asked three judges to allow her to carry out the dying wishes of her “much-loved and only child”. The family have remained anonymous; the court identified the mother as Mrs M.

Her daughter, who was 28 when she died, spent most of the last five years of her life in hospital. She wanted to have IVF treatment but became too ill. At one stage, she suggested having her ovaries transplanted into her mother. Three eggs were eventually removed and stored.

The legal problem the HFEA confronted, the judgment explained, “was that while [the daughter] consented to treatment for egg removal and storage (including storage after her death) and also to the use (other than for research purposes) of her eggs after her death, she never completed any form giving details of the precise use that is now proposed”.

Lawyers for the mother and her husband, referred to only as Mr M, said that if they did not overturn the refusal for treatment, the eggs would be allowed to perish.

Giving judgment, Sir James Munby, who is president of the family division of the high court, Lady Justice Arden and Lord Justice Burnett granted the parents’ appeal. Neither Mr or Mrs M were in court for the ruling.’

‘The judges heard that the daughter, referred to only as A, was desperate to have children and asked her mother to “carry my babies”. Her parents launched legal action against the HFEA’s refusal in September 2014 to allow them to take their daughter’s eggs to a US fertility treatment clinic to be used with donor sperm.’

‘The court’s role, however, was not to decide whether it would have permitted the mother to undergo fertility treatment using her deceased daughter’s eggs and donated sperm.

Its task was to determine whether Mr Justice Ouseley erred in concluding that the HFEA’s statutory approvals committee acted lawfully and rationally in exercising its broad discretion to refuse to authorise export of the frozen eggs.

Giving the court’s ruling, Lady Justice Arden said the challenge succeeded at three levels: “First, there was on the face of it the misstatement of certain of the evidence about [the daughter’s] consent by the [HFEA] committee.

“Second, even if what the committee meant was that there was a lack of effective consent because the appellants could not show that [the daughter] received information on certain matters, the decision was flawed because the committee pointed to the lack of certain evidence without explaining why [she] needed to receive that information and give that consent.

“The third level is that the committee did not ask the prior question of what information the Human Fertilisation and Embryology Act required to be given to [the daughter] in the circumstances of her case.”

The judge said the decision must be set aside and remitted to the statutory approvals committee of the HFEA for further consideration of the export application.’

Related Articles:

Couple win legal battle against ruling on dead daughter’s eggs- The Guardian

Woman wins appeal to use dead daughter’s eggs- BBC News

 

Monday 9th May 2016- The Independent: Hundreds of passengers on UK cruise ship fall ill with norovirus

‘Hundreds of passengers on board a British cruise ship have fallen in with norovirus, health officials have confirmed.

At least 252 [of 919] passengers and eight [out of 502] members of staff on board the Balmoral’s “Old England to New England” cruise have fallen ill with the stomach virus since leaving Southampton last month.

Now on its way to the Canadian province of New Brunswick, the ship has undergone inspections by the US Centres for Disease Control and Prevention (CDC), according to the ship’s owners, Fred. Olsen Cruise Lines.

The company said in a statement: “Balmoral has now left the US and is due to arrive in Saint John, New Brunswick later today [9th May 2016]. At no point has Balmoral been quarantined in any port on this cruise, and is continuing as planned.”

“Fred. Olsen has been undertaking extensive sanitisation measures and cleaning of the ship, following the company’s strict illness containment and prevention plan.”’

‘Evidence of the norovirus was confirmed on board while the ship was docked in Baltimore last week, where experts from the CDC carried out an environmental health assessment to evaluate the outbreak.

Despite the CDC proposing action including increased cleaning and disinfection procedures, the number of incidences later soared to more than a quarter of those on board.’

 

‘On Monday [May 9], a Fred Olsen spokesperson said the number of guests who have been confined to their cabins with the virus had reduced to just 15 out of a total of 1,434 guests and crew members on board, but the figure is yet to be confirmed by health experts.’

‘In 2010, at least 310 people on board the Balmoral were reported to be suffering from a vomiting virus when the ship docked in Los Angeles.

A confirmed outbreak of the winter vomiting virus hit more than 100 people on the same ship during a cruise of Scotland in 2009.

The..[CDC]… has reported 10 outbreaks on ships docked in the US so far this year, compared with 12 for the entirety of 2015.

Fred. Olsen said it was “co-operating fully with all the necessary maritime agencies and authorities, and will continue to make every effort possible to ensure the safety and well-being of all its guests and crew on board, which is of paramount ‎importance”.’

Related Articles:

Hundreds of passengers on UK cruise ship fall ill with norovirus

Balmoral cruise ship: Hundreds on board come down with norovirus- BBC News

Hundreds of UK cruise passengers fall ill in possible norovirus outbreak- The Guardian

Monday 9th May 2016- The Guardian: London HIV clinic fined £180,000 for revealing service users’ names

‘An NHS clinic in London has been fined £180,000 for a serious breach of the privacy of more than 700 users of an HIV service.

Patients and service users who were on the HIV clinic email list of 56 Dean Street, a Soho-based sexual health clinic, said at the time of the breach they were terrified it could leave them open to blackmail or public outing.

A staff error meant anyone receiving the September newsletter from the service could see the email addresses of all the other recipients.

Addresses had been wrongly entered into the “to” field instead of the “bcc” field, and 730 of the 781 email addresses contained recipients’ full names. Most of the recipients were HIV positive though a small number were not.

Chelsea and Westminster hospital NHS foundation trust, which runs the clinic, has been fined £180,000 after the Information Commissioner’s Office (ICO) found there had been a serious breach of the Data Protection Act, likely to have caused substantial distress.

The information commissioner, Christopher Graham, said it was “clear that this breach caused a great deal of upset to the people affected”.

Graham said the investigation revealed many people recognised other names on the list of recipients, because the clinic served a small area of London, and feared their own name would be recognised too.

The ICO investigation found the trust had previously made a similar error in March 2010, when a member of staff in the pharmacy department sent a questionnaire to 17 patients in relation to their HIV treatment. After the mistake, extra measures were put in place but no specialist training was implemented, the ICO found.

“The trust was quick to apologise for their mistake, and has undertaken substantial remedial work since the breach,” Graham said. “Nevertheless, it is crucial that the senior managers at NHS trusts understand the requirements of data protection law, and the serious consequences that follow when that law is broken.”’

Related Articles:

London HIV clinic fined £180,000 for revealing service users’ names

NHS trust fined for 56 Dean Street HIV status leak- BBC News

Monday 9th May 2016- The British Medical Association: BMA re-enters contract talks

‘The BMA will today re-enter talks with the Government over the junior doctors’ contract.

It comes after the Academy of Medical Royal Colleges called on both sides in the dispute to return to the table — with negotiations chaired by a third party.

Five days of ‘intensive talks’ from Monday to Friday are planned and ACAS chair Sir Brendan Barber will lead the negotiations.

BMA junior doctors committee chair Johann Malawana… said he hoped ‘real progress can be made’.

He said: ‘The BMA has agreed to re-enter talks with the Government on outstanding issues in this dispute, which include, but are not limited to, unsocial hours.

‘Junior doctors’ concerns extend far beyond pay, and our principle in talks will be to deliver a fair contract that does not discriminate against women or any other group, one which addresses the recruitment and retention crisis in the NHS and which provides the basis for delivering a world-class health service.

‘The BMA will also call for any contract offer — agreed or not — to be put to a referendum of junior doctors, as is usual following a contract negotiation.

‘We hope that with both parties back around the negotiating table, real progress can be made to end this dispute through talks.’’

The Telegraph:

‘Doctors are due to be moved onto the new contract over an 18-month period starting in August.

As it currently stands the new contract offers an average basic salary increase of 13.5 per cent and a 19% increase in the basic starting salary.

Those who work one in four Saturdays or more will receive a pay premium of 30 percent for all Saturday hours, however the BMA has demanded that any Saturday working, regardless of minimum number of days, attracts the premium rate.

Four strikes took place between January and early April, but they only affected routine and non-urgent care.

Last week’s two-day strike, however, was the first in the history of the NHS to affect all forms of care, including Accident & Emergency departments, intensive care and maternity units.’

Related Articles:

BMA re-enters contract talks

Junior doctors prepare for fresh talks over contracts- The Guardian

BMA agrees to re-enter talks over disputed junior doctor contracts- The Telegraph

British Medical Association to reopen contract talks with Jeremy Hunt- The Guardian

Junior doctors’ contracts: Fresh talks under way- BBC News

Sunday 28th February 2016- BBC News: Ebola nurse Pauline Cafferkey discharged from hospital

‘Scots nurse Pauline Cafferkey has been discharged from a London hospital after being treated there for a third time since contracting Ebola.

The 40-year-old from South Lanarkshire was flown to the Royal Free Hospital on Tuesday after being admitted to Glasgow’s Queen Elizabeth Hospital.

The Royal Free said she had been discharged and was “not infectious”.

Ms Cafferkey was treated there twice in 2015 after contracting Ebola in Sierra Leone the previous year.

A spokesman for the Royal Free Hospital said: “Pauline Cafferkey has today been discharged from the care of the Royal Free Hospital following her admission due to a complication related to her previous infection by the Ebola virus.

“We can confirm that Pauline is not infectious. The Ebola virus can only be transmitted by direct contact with the blood or bodily fluids of an infected person while they are symptomatic.”

Health Secretary Jeremy Hunt later tweeted: “It’s fantastic news that Pauline Cafferkey has been discharged from hospital. Outstanding care again from @RoyalFreeNHS #NHSheroes.”

The nurse, from Halfway, Cambuslang, contracted the virus while working as part of a British team at the Kerry Town Ebola treatment centre.

She spent almost a month in isolation at the Royal Free at the beginning of 2015 after the virus was detected when she arrived back in the UK.

Ms Cafferkey was later discharged after apparently making a full recovery, and in March 2015 returned to work as a public health nurse at Blantyre Health Centre in South Lanarkshire.

In October last year it was discovered that Ebola was still present in her body, with health officials later confirming she had been diagnosed with meningitis caused by the virus.’

Related Articles:

Ebola nurse Pauline Cafferkey discharged from hospital

Ebola nurse Pauline Cafferkey discharged from hospital- The Telegraph

Ebola nurse Pauline Cafferkey discharged from hospital- The Guardian

Saturday 27th February 2016- The Guardian: Decayed teeth removed from 128,000 children in England since 2011

‘Tens of thousands of children have had decaying teeth removed in hospitals in England, according to the latest figures, which show an increase for the fourth year in a row.

There has been a rise of almost 10% in child hospital admissions for severe tooth decay in England over a four-year period, with the report’s authors pointing out “a strong correlation between area deprivation and the rate of tooth extraction”.

More than 128,000 children aged 10 and under have needed at least one removed since 2011, often in cases where the decay may have been preventable.

There were 14,445 admissions of children aged five and under between April 2014 and March the following year, and a further 19,336 cases of six- to10-year-olds having teeth taken out in hospital in the same period. More boys than girls were likely to have suffered from severe tooth decay.

The rate of tooth extraction among the most deprived children is almost five times that for those from the least deprived decile, according to the statistics analysed by the Health and Social Care Information Centre.

In Yorkshire and the Humber, the tooth extraction rate was more than five times that for the east of England. London had the most children who needed to be admitted to hospital for severe tooth decay, with 8,362 having teeth removed.

Prof Nigel Hunt, the dean of the dental surgery faculty at the Royal College of Surgeons, said the 9.81% increase was unacceptable.

“Not only is tooth decay distressing to children and parents, it has serious social and financial implications,” he said. “The need for tooth extraction continues to be the number one reason why five- to nine-year-old children are admitted to hospital. This issue urgently needs to be addressed, especially since 90% of tooth decay is preventable.”

Related Articles:

Decayed teeth removed from 128,000 children in England since 2011

Tooth decay still on the rise among English children- BBC News

Friday 26th February 2016- The Independent: Asthma: Half of children diagnosed with the respiratory disease may not have it, study suggests

‘More than half of the children being treated for asthma might not actually have the condition, new research suggests.

A study, published in the British Journal of General Practice, found 53 per cent of children had no clinical signs of asthma despite being diagnosed at one of four medical centres in the Netherlands, whose healthcare system is widely regarded as one of the best in Europe.

In the UK last year, researchers found that a third of adults diagnosed with asthma did not actually have it.

Dr Ingrid Looijmans-van den Akker, one of the scientists behind the Dutch research, told The Daily Telegraph: “Over-diagnosis of asthma was found in more than half of the children, leading to unnecessary treatment, disease burden, and impact on their quality of life.

“Previous studies have indicated that asthma is over-diagnosed in children. However, the scale of the over-diagnosis has not been quantified.

“Only in a few children was the diagnosis of asthma confirmed using lung function tests, despite this being recommended in international guidelines. Over-diagnosis gives rise to over-prescription and incorrect use of medication, and to anxiety in parents and children.”

The UK’s National Institute of Clinical Excellence (Nice) has warned that doctors have too often tended to diagnose asthma based on a history of wheezing, coughs and other breathing problems, rather than clinical tests.

Professor Mark Baker, director of clinical practice at Nice, said it was developing new advice on how to properly diagnose the condition.

“As part of this work, Nice is inviting GP practices to take part in a project to check the feasibility of some diagnostic tests that Nice proposes to recommend,” he said.’

Related Articles:

Asthma: Half of children diagnosed with the respiratory disease may not have it, study suggests

Half a million children with asthma may not actually have condition- The Telegraph

Thursday 4th February 2016- The Telegraph: Team GB athlete dies from meningitis after being told by A&E doctor she had stomach bug

‘A young Great Britain athlete died from meningitis just hours after a junior doctor on his first week in A&E wrongly diagnosed a stomach bug, an inquest heard.

Ellie Penrose, a promising 18-year-old triathlete, was taken to hospital by her family after complaining of a headache and sensitivity to light.

She was seen by newly-qualified Dr Don Hettiarachchi who diagnosed gastroenteritis and dehydration and sent her home with paracetamol and ibuprofen.

But an inquest heard she was “inappropriately discharged” from Hull Royal Infirmary, in East Yorkshire, after the “failure in care”.’

‘Hours later, her parents Tom and Pauline dialled 999 after finding her critically ill on her bed at their home. She was taken to hospital, but died later the same day from “overwhelming sepsis” caused by meningococcal septicaemia.

Hours before she died last August, Miss Penrose discovered she had excelled in her A-levels and was destined for university.

Dr Hettiarachchi admitted to the Hull inquest he was “not 100 per cent sure” of the root cause of Miss Penrose’s illness when he saw her in the hospital at 3am on August 12 last year.

With no consultant available, he consulted with fellow trainee Dr Ayman Ghoneim in a corridor before discharging her.

Coroner Professor Paul Marks asked if he had considered meningitis and Dr Hettiarachchi replied: “I did. When I examined her there was no rash. There was blotching on her face. I felt it was more viral.’

‘Questioned by the Penrose family’s lawyer, Dr Hettiarachchi added: “I did not treat it as meningitis because I felt it didn’t fit with the general picture.”

Asked if he would have done anything differently, he replied: “Lots of things. I would have consulted with a registrar or above.”

Dr Hettiarachchi accepted he did not highlight key observations – crucially, Miss Penrose’s high blood pressure, low pulse rate and skin blotching – to Dr Ghoneim, but denied a claim that he had already reached a diagnosis.’

Related Articles:

Team GB athlete dies from meningitis after being told by A&E doctor she had stomach bug

Team GB triathlete Ellie Penrose died after her meningitis was misdiagnosed as stomach pains, inquest hears- The Independent

Triathlete died after doctor failed to diagnose meningitis- The Guardian

Thursday 4th February 2016- The Independent: World Cancer Day: Deaths caused by disease fall but number of cases rise

‘Cancer death rates in the UK have fallen by almost 10 per cent in the last decade, although the number of cases is still going up, new figures show.

Analysis by Cancer Research UK found that 284 out of every 100,000 people in the UK died from cancer in 2013 (around 162,000 people), down from 312 in every 100,000 a decade ago.

The slump is largely due to improvements in the detection, diagnosis and treatment of cancer.

A breakdown of the sexes shows men’s death rates have fallen by 12 per cent over the period, while the drop among women is 8 per cent.

This equates to around 85,000 men and 77,000 women dying from cancer each year in the UK.’

‘Cancers of the lung, bowel, breast and prostate account for almost half of all cancer deaths in the UK. These four cancers saw an 11 per cent drop in death rates for the period studied.

But some cancers – such as liver and pancreatic – have seen a rise in the rates of people dying, by 60 per cent over the last 10 years for liver cancer and by 8 per cent for pancreatic cancer.

Experts have predicted that, mostly due to the fact people are living longer, one in two people in the UK will be diagnosed with cancer at some point in their lives.

However, some cases could be prevented, with at least a third of cancer cases each year in the UK linked to unhealthy lifestyles, obesity, smoking and diet.’

‘Figures from Cancer Research UK also show the total number of cancer cases is still going up.

Almost 346,000 people were diagnosed with cancer in the UK in 2012, up from 282,000 in 2002 and 249,000 in 1992.

Around 162,000 people died from cancer in the UK in 2012, up from just over 155,000 in 2002, but a very similar figure to 1992.

Around 80 per cent of cancer deaths occur in people aged 65 and over, and more than half occur in those aged 75 and older.’

Related Articles:

World Cancer Day: Deaths caused by disease fall but number of cases rise

Cancer death rates down by 10% in 10 years- BBC News

UK cancer death rates after diagnosis drop 10% in ten years- The Guardian

 

Monday 1st February 2016- The British Medical Association: Junior doctors press ahead with industrial action

‘Junior doctors in England will take a second day of action after contract talks ended without agreement.

Action will take place from 8am on Wednesday 10 February to 8am on Thursday 11 February, with junior doctors providing only emergency care during this period.

Trusts across England have been informed of this change to the originally planned action, which would have seen the first-ever full walkout with no care provided by junior doctors.

The decision comes after talks between the BMA, NHS Employers and the Department of Health were unable to reach an agreement on the issue of unsocial hours.

Originally planned as a full walk-out, action on 10 February will instead mirror that taken on 12 January with junior doctors providing emergency care only until 8am on 11 February.’

‘BMA junior doctors committee chair Johann Malawana said: ‘Over the past few weeks, we have welcomed the involvement of Sir David Dalton in talks about a new junior doctor contract, which recognises the need to protect patient care and doctors’ working lives.

‘His understanding of the realities of a health service buckling under mounting pressures and commitment to reaching a fair agreement has resulted in good progress on a number of issues.

‘It is, therefore, particularly frustrating that the Government is still digging in its heels.’

He added: ‘The Government’s entrenched position in refusing to recognise Saturday working as unsocial hours, together with its continued threat to impose a contract so fiercely resisted by junior doctors across England, leaves us with no alternative but to continue with industrial action.”

Related Articles:

Junior doctors press ahead with industrial action

Next week’s junior doctor strike on- BBC News

Jeremy Hunt digs in as junior doctors announce new strike- The Guardian

Junior doctors’ strike to go ahead on February 10 after negotiations fail, BMA says- The Independent

Junior doctors’ 24-hour strike to go ahead from next Wednesday- The Telegraph