Anger at ‘missed TB opportunity’

Anger at ‘missed TB opportunity’

London has become Europe’s TB capital because primary care trusts are failing to adopt measures drawn up four years ago, MPs and health campaigners say.

Just 55% of PCTs in England routinely screen new immigrants, according to a poll by the All-Party Parliamentary Group on Global Tuberculosis.

One PCT with a very high TB rate had even scrapped its screening programme.

PCT representatives argued resources were finite and that decisions were taken on the basis of local needs.

TB is continuing to rise in the UK, and last week the first case of a form resistant to many drugs was diagnosed.

Globally, drug resistant TB is becoming a major problem.

Some 101 PCTs out of 152 responded to the survey sent out by the All-Party Parliamentary Group on Global Tuberculosis (APPG) and British Thoracic Society, the body which represents specialists in respiratory disease.

Only half had appointed an individual to be responsible for leading action on TB, while 41% said they were not actively raising awareness of the disease.

Both measures are laid out in the “TB Toolkit”, which was drawn up by the Department of Health.

The picture of the disease varies across the country, with cities with large immigrant populations much more likely to see a multitude of cases.

London, now Europe’s TB capital, accounts for half of the cases nationwide.

Rising numbers

Levels of TB have been increasing year-on-year in the UK since the late 1980s and the latest available figures from 2006 showed the number of cases increased 17% from three years previously.

KEY POINTS OF 2004 ACTION PLAN

• Better screening programmes
• Multi-lingual and culturally sensitive information
• Higher vaccination coverage of babies in high-risk groups
• Stronger TB surveillance in prisons
• DNA bacterial screening to track the disease
• More research into drugs and vaccines

Last week, doctors in Glasgow confirmed they were treating Scotland’s first diagnosed case of the drug-resistant XDR strain in an man who had come to the UK from Somalia.

The majority of PCTs predict that the number of TB cases in their region is set to rise.

Julie Morgan, chairman of the AAPG, said: “Our findings are deeply worrying.

“The Action Plan was published almost four years ago, and yet clearly very little has been achieved.”

She added: “TB is clearly not getting the attention it deserves. There should therefore be a properly-funded national TB awareness campaign, tailored to local circumstances, aimed at healthcare professionals as well as the general public.”

Professor John Macfarlane, chairman of the British Thoracic Society, said: “This report confirms the experience of our members trying to tackle TB in hospitals, who are not being provided with the tools and resources they need to effectively manage TB.”

“It clearly shows that PCTs must as a matter of urgency identify and commission TB services. Action one needs to be the appointment of a TB lead in every PCT.”

David Stout, director of the PCT Network, which is part of the NHS Confederation, said:”PCTs have the difficult job with finite resources of making decisions on local priorities.

“All PCTs are currently undertaking local needs assessments which will include an assessment of local rates of TB and will prioritise action accordingly.”

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Source: news.bbc.co.uk

School-gate junk food ban urged

School-gate junk food ban urged
Schools and councils are being urged to make it harder for children to swap their school meal for a takeaway.

Rising levels of obesity are being fuelled by the ready availability of junk food, said the School Food Trust.

It wants schools to close their gates at lunchtime and councils to stop new fast food outlets opening nearby.

But the Local Government Association said it could not force schools to shut their gates and that food retailers could challenge licence refusals.

Dinner money

The trust has issued a “league table” of the local education authority areas with the most takeaway and sweet shops per secondary school.

"At the moment school canteens have to compete with a myriad of take-aways, chippies, and sweet shops for pupils’ dinner money"
Judy Hargaddon
School Food Trust

Seaside towns – with dozens of outlets aimed at tourists – and inner city areas, fare the worst.

Topping the list is Brighton and Hove, with 46 per school, closely followed by Blackpool and Hull.

School Food Trust chief executive Judy Hargaddon said: “At the moment school canteens have to compete with a myriad of take-aways, chippies, and sweet shops for pupils’ dinner money.

“We all know that some children will go for chips five times a week if they are allowed to.

“The problem is that this is damaging their long-term health, and is also threatening the viability of school lunch services.”

Burger ban

She is backed by a dietician from London’s Great Ormond Street Hospital.

10 WORST LEA AREAS

• 1 Brighton and Hove 46.11 outlets per secondary school
• 2 Blackpool 40.63
• 3 Kingston upon Hull 40.00
• 4 Reading 39.17
• 5 Middlesbrough 38.33
• 6 Manchester 36.95
• 7 City of Bristol 36.94
• 8 Inner London 36.66
• 9 Newcastle upon Tyne 36.21
• 10 Gateshead 35.00

Source: School Food Trust

Paul Sacher said: “Children face daily temptation from junk foods and many find them hard to resist.

“These foods play a big part in weight gain, have little nutritional value and contribute to health problems later in life.”

Some councils and schools are taking steps to try to restrict the ability of children to buy fast food during school hours.

Leicester City Council is drawing up plans to ban mobile burger vans from areas around schools, and some schools already operate policies which stop children from leaving at lunchtime.

Licence fight

Dr Sacher encouraged other local authorities and schools to take steps to protect child health by restricting the number of new licences issued for fast food outlets in the areas around schools.

However, the Local Government Association said this could be hard to enforce, and any refusal to grant a licence could be challenged.

A spokesman said: “Councils are up for using all the powers at their disposal, including planning, to play their important part in tackling this weighty issue.

“It is wrong to imply that planning laws that ban junk food outlets around parks and schools are a potential ’silver bullet’.

“Local authorities have to base their decisions on good evidence of potential harmful impacts, and the matters they are allowed to take into account by law.”

She said that while education authorities could encourage schools to adopt “stay in” policies, they could not be compelled to do so.
Source: news.bbc.co.uk

Gay men risk of HIV ’still high’

Gay men risk of HIV ’still high’
Gay men are being urged to get HIV tests more regularly and practise safe sex in a bid to halt the high numbers of new cases in the UK.

The Health Protection Agency made the warning after new diagnoses among gay men topped 2,600 for the third year.

But the figures do seem to have begun to plateau after a surge at the turn of the century.

Overall, the number of new cases hit an estimated 6,840 in 2007 – a fall of 1,400 from the previous year.

"Gay men continue to be the group most at risk of acquiring HIV within the UK"
Dr Valerie Delpech

The HPA said this was mostly due to a decline in cases among those infected heterosexually in Africa.

But experts said the new cases among gay men was still at worrying levels.

There were 2,630 diagnoses – a slight fall on previous years, but much higher than the annual figures in the 1990s which tended to hover around 1,500.

HPA head of HIV surveillance Dr Valerie Delpech said: “Gay men continue to be the group most at risk of acquiring HIV within the UK.

“We need to reinforce the safe sex message for gay men that the best way to protect yourself from contracting HIV is practising safe sex by using a condom with all new and casual partners.”

She also urged more regular testing so treatment could be started earlier and to reduce the risk of transmission to partners.

The figures are only provisional as they also take into account the expected delays in diagnosis.

Genevieve Clark, of the Terrence Higgins Trust, said it was “good news” that the figures for gay men seemed to be levelling off.

But she warned the number of cases was still too high and called for easier access to testing as some places had long waits for access to sexual health clinics.<P
Source: news.bbc.co.uk

Caution call on pharmacist drugs

Caution call on pharmacist drugs
Raising the number of drugs that can be bought at pharmacies may affect safety and cut effectiveness, specialists say.

Writing in the British Medical Journal, two doctors say drugs such as statins could be less effective because over-the-counter doses are lower.

They warn some powerful painkillers available without prescription have potentially harmful side-effects.

But the National Pharmacy Association said its members treated newly classified medicines with caution.

Inquests

The government is keen to see some widely used drugs more easily available, to improve the health of people with long-term conditions and potentially cut the bill to the NHS.

"Given the concerns, it would be wise to avoid any wholesale rush to reclassify medicines"
Dr Robin Ferner
West Midlands Centre for Adverse Drug Reactions

However, West Midlands Centre for Adverse Drug Reactions director Robin Ferner and Keith Beard, from the Victoria Infirmary Glasgow, believe that the benefits need to be closely measured against the risks.

They highlighted two recent deaths in which codeine-based painkillers were implicated at inquests.

They said it was far more difficult for the potential side-effects to be explained to patients in their local pharmacy.

“Certainly, pharmacists can provide clinical advice to minimise the risk of misuse of pharmacy only drugs, but supervision by a busy community pharmacist in the UK may be perfunctory,” they wrote.

Patients who misdiagnose their symptoms then try to treat themselves using over-the-counter drugs could delay a vital trip to their GP surgery, they added.

‘Trusted profession’

The medicines safety watchdog – the Medicines and Healthcare Products Regulatory Authority (MHRA) relies on reports of side-effects, primarily from doctors, to alert them to any new concerns.

It recently extended its reporting scheme to make it easier for patients to contact them.

However, Dr Ferner and Dr Beard are not convinced that this is enough to ensure their safety.

“Given the concerns, it would be wise to avoid any wholesale rush to reclassify medicines,” they said.

“Whole communities might lose out in the long run if indiscriminate overuse of widely available medicines were to lead to large numbers of avoidable but irreversible adverse effects.”

A National Pharmacy Association spokesman, which represents community pharmacists, said that its members tended to err on the side of caution when handling newly reclassified medicines.

“When a medicine is available over the counter for the first time, it is generally only dispensed by the pharmacist themselves.

“In fact, when people were surveyed about sources of good quality health advise, as many said they would go to a pharmacist as said they would visit their GP.
Source: news.bbc.co.uk