History > 2007 > UK > Health (IV)

Child suicide bids

rise to more than 4,000

Children's Secretary calls for greater vigilance
to spot those at risk

Sunday December 16 2007
The Observer
Jo Revill and John Lawless

More than 4,000 children under 14 have attempted to take their own lives in the past year, according to NHS figures that show the scale of distress and mental suffering in the young.

Statistics being released this week will paint a terrible picture of how children have tried to commit suicide. They reveal that 69 attempted to hang or suffocate themselves and two tried to drown themselves. Most took overdoses of medicines, drugs or solvents in an effort to end their lives, but some resorted to more extreme measures. Thirteen children leapt from a great height, while four lay or jumped in front of a moving vehicle. One child attempted suicide by deliberately crashing a car.

The records show that 4,241 children under 14 were admitted to hospitals in England in the 12 months to March 2007 after attempting to kill themselves. The figures are in a report by the Information Centre for Health and Social Care, a body set up by the government to analyse the details behind nearly a million adult and child admissions to accident and emergency departments each year.

The number of suicide attempts, which has risen slightly in the past five years, will worry ministers, who are aware that secondary school teachers and family doctors are increasingly seeing children, particularly young boys, in states of distress without being able to offer a specialised support service.

Ed Balls, the Children's Secretary, has set up a review of children's and teenagers' mental health services with the aim of finding ways to stop problems arising. He called last week for more vigilance in spotting 'distress signals' in young boys.

There is a growing debate about whether mental health disorders are rising in the young, but there are signs that health professionals are seeing more young patients. The number of prescriptions handed out to children under 16 for depression and mental health disorders has quadrupled in a decade.

Isla Dowd, of the charity Rethink, said: 'To have this number of children attempting to commit suicide in a country where we are claim to have a culture where every child matters is profoundly shocking. Children often attempt suicide when they feel that such drastic action is the only solution to their problems. There is still not adequate and appropriate access for children experiencing emotional and mental distress.'

About one in 10 children and young people will suffer behavioural, emotional or mental health problems before the age of 18, with twice as many young boys under 10 as girls diagnosed with a mental health disorder.

Balls said: 'We know that girls are better than boys at asking for help when they need it. That is why we are calling on professionals working with children to keep a close eye on boys in particular and spot when they are distressed.'

Health Secretary Alan Johnson added: 'Having good mental health enables young people to make the most of their opportunities. However, we know that a minority of children and young people are at increased risk of developing mental health problems than their peers.'

Child suicide bids rise to more than 4,000, O, 16.12.2007, https://www.theguardian.com/society/2007/dec/16/
children.socialexclusion

Gene test to screen embryos

at risk of developing heart illness

Saturday December 15 2007
The Guardian
Alexandra Topping

Doctors may be allowed to screen human embryos for a gene that causes a rare disease that prompts high cholesterol and an increased risk of heart attacks, it emerged yesterday.

Britain's fertility watchdog, the Human Fertilisation and Embryology Authority (HFEA), is considering granting a licence for an application to carry out tests to detect familial hypercholesterolaemia (FH), which can kill children before puberty.

A couple who have a milder form of the disorder are seeking permission to have their embryos screened by Paul Serhal, of University College hospital, London, according to the Times.

They have a five-year-old daughter, who was born with the serious homozygous form of FH and fear any other children they have could also be affected.

The decision may reignite controversy over parents' rights to create "designer babies", as the procedure may also identify a milder form of the disease that is affected by lifestyle and can be treated with drugs.

"This obnoxious disease can cause cardiovascular accidents at a very early age," Serhal said. "Some people would think twice about using embryos that they know have a risky gene, and others would say you shouldn't screen out a condition that can be managed..."

There are two forms of FH. The mild - or heterozygous - form affects about one in 400 people but can be controlled with cholesterol-lowering drugs. About one in 250,000 people inherits two defective copies of the gene and develops the more serious of homozygous FH. Sufferers can experience angina by the age of six.

An HFEA spokeswoman indicated it may only permit screening for the more serious form of the disease.

    Gene test to screen embryos at risk of developing heart illness, G, 15.12.2007, http://www.guardian.co.uk/science/2007/dec/15/genetics.health

UK fertility rate at its highest since 1980

Wednesday December 12 2007
The Guardian
Fay Schlesinger

Fertility rates are at their highest in 25 years due to increases in childbirth among both UK and foreign-born women, according to government figures.

More than 150,000 foreign-born women gave birth in the UK in 2006, making up almost 21% of the total number of births, according to the first in a new series of annual reports on the demography of the UK, published by the Office for National Statistics yesterday.

The current UK fertility rate of 1.84 is at its highest since 1980 - up from a record low of 1.63 in 2001 - after the fertility rate for women born overseas and British-born women increased.

Increasing fertility rates, notably in the 25- to 29-year-old age group, are due to several factors including changes in maternity leave, tax and benefits for parents and the impact of recent high levels of international immigration to the UK, the report suggests.

An unexpected slight rise in the fertility rate of those in their early 20s, which appears to have been driven by UK-born women, bucks the trend of delaying childbirth until later.

National statistician Karen Dunnell said: "Although international migration is certainly having an impact on UK births, the relationship between international migration and fertility is not at all straightforward. International immigration ... can affect both the size and structure of the female population of childbearing age, and thus the number of women who can potentially have children."

While the population continues to age so that a higher proportion of women are beyond childbearing age, it may be the lower average age of migrants from outside the UK that is contributing to the increased fertility rate.

The aspirations of women born outside the UK to have larger families also play a part, the study shows, with 18% of women born overseas aged 30-34 saying they want four or more children, compared with just 11% of UK-born women of the same age.

Mothers born in Pakistan, India and Bangladesh contributed 5% of the total UK births, while births to women born in EU countries other than the UK and Ireland increased by 87% between 2001 and 2006 to 4% of the total, reflecting the impact of the expansion of the EU on the UK's population.

The shadow home secretary, David Davis, said: "This shows all too clearly the impact immigration can have on the public sector infrastructure, including schools and hospitals, and why the government must answer our calls to take these factors into account. Immigration can be of real benefit to the country, but not all or any immigration."

Rhian Beynon, of the Joint Council for the Welfare of Immigrants, called for caution in drawing conclusions from the figures: "Why do ONS think it is useful to distinguish between women born overseas and women born here in terms of fertility, particularly given that women born overseas may include many women who are UK nationals, and women who have spent their formative years in the UK?"

The study projects that the UK population will rise to 65 million by 2016 and exceed 71 million by 2031.

    UK fertility rate at its highest since 1980, G, 12.12.2007, http://www.guardian.co.uk/society/2007/dec/12/immigrationandpublicservices/print

Bianca Jagger:

The unacceptable face

of our Aids policy at home

Published: 28 November 2007
The Independent

Gordon Brown, in his first message to the Labour Party conference as Prime Minister, went to great lengths to affirm the universality of human rights. "No injustice can last forever," he said. But while our attention is often drawn to human rights abuses in Burma, injustices in Darfur and HIV in Africa, it is easy to overlook our responsibility to end human rights abuses in our own country. And in the case of many migrants living with HIV in the UK, the Government seems to have forgotten to practice what it preaches.

Julia is pregnant and living with HIV. Drugs exist today that can prevent Julia passing the virus onto her unborn child. But Julia is unable to access these drugs, not because she is living in a developing country where HIV drugs are unavailable, but because she is one of many in a group ignored by the UK Government and by society; an asylum seeker whose request for sanctuary in the UK was refused, and who is now living in residency limbo.

Following an antenatal screen, Julia received a letter informing her that her residency status means she will not be provided free treatment for HIV and would have to pay thousands of pounds for the drugs needed. Julia disappeared from care, unable to afford the charges.

Julia's fate, and the fate of her child, was sealed not by outdated policy or a loophole in the system. Julia, and others like her, are denied treatment thanks to a new policy introduced by this Government in 2004, just one year before the UK's pledge of universal access to treatment for all by 2010.

Prior to 2004, NHS treatment of all kinds was available free of charge to anyone who could show that they had been in the UK for more than 12 months. Today, the new regulations mean some of the most vulnerable people living with HIV – refused asylum seekers and other undocumented migrants – cannot access free HIV treatment. These individuals legally are prohibited from working. As a result, they are often destitute – certainly unable to pay any bill for hospital care.

The tabloid press protests loudly about so-called "treatment tourism", but there is no evidence to show that this actually occurs. The evidence that does exist suggests that the majority of people who have claimed asylum and, are subsequently diagnosed with HIV, only receive their diagnosis after they have entered the UK and become ill, usually many months – if not years – later. People seek asylum because they face persecution in their own country, not to gain free treatment.

Every month HIV organisations including the National Aids Trust hear stories like Julia's, stories of pregnant mothers denied maternity care; of people co-infected with HIV and TB who discontinue their TB treatment so they can pay their HIV-related bills; of people either without legal residency or whose status is unclear being billed for thousands of pounds. Often destitute, those unable to pay such bills have had their treatment delayed, denied, interrupted or withdrawn. Many have been pursued aggressively by debt collectors. Furthermore, others have been mistakenly denied free treatment by NHS officials confused over their own regulations.

Unaffordable treatment is not accessible treatment – not only is the UK Government breaking its G8 promise, it is breaching basic human rights to life and healthcare.

And the consequences spread further than individuals' health. Without the prospect of access to treatment, people are deterred from having an HIV test. Undiagnosed infection is now fuelling the epidemic. Those untreated are significantly more infectious than those on treatment and, being unaware of their infection, will unwittingly put sexual partners at risk. Those sexual partners are likely to include others without residency; thus the cycle continues.

Eventually, of course, someone infected with HIV but undiagnosed will become seriously ill and arrive in Accident & Emergency departments, who pick up the bill. And a week in intensive care will wipe out the savings on a whole year's HIV treatment. Denying free treatment is a foolish and deadly false economy.

Gordon Brown must make good on the promises he has made with clear and unambiguous new legislation. He must set an example to other governments. He must not use "residency status" to get out of international obligations and human rights commitments. If the Government is serious about supporting global access to HIV drugs, it needs to begin by reassessing access to drugs in the UK.

I have signed the National Aids Trust campaign for free HIV treatment for all in the UK. I urge Gordon Brown to begin by doing the same.

The writer is chair of The World Future Council and founder of the Bianca Jagger Human Rights Foundation

    Bianca Jagger: The unacceptable face of our Aids policy at home, I, 28.11.2007, http://comment.independent.co.uk/commentators/article3201537.ece

3pm GMT update

Health watchdog

warns of UK sexual health crisis

Friday November 23, 2007
Guardian Unlimited
David Batty

The UK has one of the highest rates of HIV infection in Europe largely due to a growing epidemic of the disease in the black African community and among gay men, the Health Protection Agency (HPA) warned today.

The sexual health crisis is also worsening due to rising rates of other sexually transmitted infections (STIs) among young adults, the government health watchdog also warned.

There were 376,508 diagnoses of new STIs in 2006 - up from 368,341 in the previous year, said the HPA, which monitors infectious diseases in the UK.

Young people aged 16-24 accounted for the majority of new cases of some of the most common sexually transmitted infections, despite concerted efforts to encourage them to practise safer sex.

Last year, young adults accounted for 65% of all new cases of chlamydia, 55% of all genital warts cases and 48% of cases of gonorrhea. One in 10 of the 14,939 young adults tested in the national chlamydia screening programme in England tested positive for the disease, which is linked to infertility.

The findings came as a separate report found that the UK had one of the highest rates of new HIV infections in Europe last year.

The report by the European Centre for Disease Prevention and Control (ECDC) found the UK HIV infection rate was more than double the European Union average - almost 149 cases per million inhabitants compared with an EU average of 67 cases per million.

The ECDC found that HIV/Aids cases in Europe have doubled in six years, bucking the trend elsewhere in the world where infection rates have fallen.

Three-fifths of new HIV infections diagnosed in the UK last year were acquired abroad, according to the HPA. Black Africans accounted for half the total number of new HIV infections last year. More than four-fifths (84%) of them contracted HIV in Africa.

There has been a fivefold increase in HIV infections in black Africans since 1997.

The HPA, which monitors infectious diseases in the UK, also raised concern about the "disturbing" rise in HIV among gay men.

There were 2,700 new cases of HIV in this group last year, breaking the previous record high of 2,650 set in 2005. There were 31,100 gay men living with HIV in the UK last year - more than 40% of the total number of people infected, which is 73,000.

Rates of other STIs in gay men have also risen dramatically in recent years, which the HPA blamed on a growing failure among this group to practise safer sex.

Between 2002 and 2006, rates of newly diagnosed gonorrhoea rose by 25% in gay men, syphilis by 117%, chlamydia by 97%, non-specific urethritis by 24% and genital warts by 21%.

Dr Valerie Delpech, the head of HIV surveillance at the HPA, said: "In recent years we have seen steady increases in all sexually transmitted infections, including HIV, in gay men and since 2003, the number of HIV diagnoses reported annually has consistently increased and exceeded the annual number of diagnoses throughout the 1980s and 1990s."

Professor Pete Borriello, the director of the HPA's centre for infections, said it was imperative to get across the importance of practising safer sex, particularly among high-risk groups such as gay men and young adults.

He said: "We recommend that gay men should have regular HIV tests, STI clinic attendees should be tested for HIV at every visit and young sexually active adults should be screened for chlamydia annually and after a partner change.

"We need to reinforce the safe sex message for gay men, young adults and the broader community. The best way to protect yourself from contracting an STI including HIV is by practising safer sex by using a condom with all new and casual partners."

    Health watchdog warns of UK sexual health crisis, G, 23.11.2007, http://www.guardian.co.uk/aids/story/0,,2215956,00.html

The cloning revolution:

Ministers to back

controversial change to law

Within 10 years,
doctors could transplant embryos created by three 'parents'
– so eliminating genes that lead to life-threatening conditions –
under plans to be debated by MPs tomorrow.

Opponents fear this will pave the way for human cloning.

Marie Woolf reports
Published: 18 November 2007
The Independent on Sunday

Babies made by cloning techniques from the DNA of two women could be born within 10 years as ministers prepare to give the green light for embryos produced by biological material from three "parents". A new law, to be debated in the House of Commons tomorrow, opens the door for such hybrid eggs to be implanted in women.

The novel procedure is designed to find a cure for mitochondrial disease, a range of life-threatening conditions that affect one in 10,000 people.

The development has delighted scientists who say it will usher in a new wave of groundbreaking genetic research that could prevent thousands of children from being born with debilitating diseases.

But Christian groups and campaigners concerned about developments in human genetics have reacted with horror at what they see as the beginning of human cloning and the approval of "Frankenstein science".

Parliament is expected to split over a clause in the Human Embryology and Fertilisation Bill. Many MPs say the clause will open the door for a new generation of life-saving research to combat mitochondrial disease which can lead to epilepsy, diabetes and fatal damage to vital organs. Nevertheless, any move to allow the creation of a child with the technique will almost certainly spark a row in the House of Commons and protests outside.

The controversial clause will permit embryos to be created from the nucleus of a woman's egg, her partner's sperm and another woman's donated mitochondria, which surround the egg's nucleus and are vital for cell growth. The procedure has so far been carried out only in laboratories. Researchers at the North of England Stem Cell Research Centre, Newcastle, who are leaders in the field, believe that within five years the procedure could be used to carry out trials to create babies.

Professor Alison Murdoch, head of the department of reproductive medicine at Newcastle University, said the Bill would take into account anticipated scientific advances in genetics. "The current work involves transplanting the healthy nucleus from a fertilised egg with damaged mitochondria into a donor egg with healthy mitochondria. We continue to investigate whether transplanting the nucleus from an unfertilised 'unhealthy' egg into an egg before fertilisation would be as effective.

"We are not yet at the stage of clinical trials but we would anticipate that in the lifetime of this Bill we would be. It's a cure for mitochondrial diseases we are working on," she said.

MPs and scientists are delighted that the Bill, which will regulate scientific procedures involving embryos, does not outlaw the practice and allows future MPs to vote on it without a new Act being drafted.

Dr Evan Harris, Liberal Democrat science spokesman and a former GP, said: " It would be wrong to outlaw this potential treatment now, since it would be at least 10 years before there is another chance to repeal such a ban. But it undoubtedly raises new and complex issues." The move means that, unlike other genetic breakthroughs, clinical trials would not require a new Bill. The Government could pass a regulation on a simple parliamentary vote.

The Human Fertilisation and Embryology Authority, which regulates such research, said the new Bill would mean that the law was up to date with scientific developments. "We now need Parliament to provide an updated framework for regulation of the sector to meet the challenges of the years to come," said a spokesman.

Professor Marcus Pembrey of Progress Educational Trust and emeritus professor at University College London, said the Bill offered a potential lifeline to families hit by mitochondrial disease. "The important thing about the Bill is it doesn't close the door for those families with mitochondrial disease. These families suffer more than anyone because all their children are at risk of suffering serious disease. There are thousands who die from this. This is a very politically wise and sensible way of going forward. It is going to give the green light to research."

But opponents say the Bill contradicts a law that banned human cloning in 2001. Andrea Minichiello Williams, public policy director of the Lawyers' Christian Fellowship, said: "It is our concern that this procedure is in effect very close to that involved in human cloning."

That view was shared by Josephine Quintavalle, chair of Comment on Reproductive Ethics. "We fear you could try to cure mitochondrial disease and cause worse diseases. You are not mimicking nature; you are distorting nature."

A Department of Health spokesman said: "In the future, it may be possible to create embryos using an affected woman's egg, her partner's sperm and healthy donated mitochondria. The current legal position is that embryos created by artificial gametes or genetically modified gametes could not be placed in a woman. This prevents reproductive cloning."

Additional reporting by Nina Lakhani

'Caring for the kids is a 24-hour-a-day job. You survive on very little sleep'

Paul and Rachel Preston know better than most how devastating mitochondrial disease can be for a family. Yesterday was the 15th anniversary of their daughter Kirsten's death. She was eight weeks old. They have four other children; three have mitochondrial disease. Looking after their children is a full-time job, without holidays.

Stacey, 13, is severely mentally and physically disabled. She cannot walk but talks a little bit. Kieran, nine, is bedbound but sleeps only when he is sedated. If his mother is not by his side, he becomes frightened and aggressive.

Kieran and Stacey are doubly incontinent and are fed through a tube in their stomachs. Mrs Preston's only "time off" is when Kieran sleeps. Last night she got an hour and a half. Mr Preston said: "You get used to surviving on very little sleep. This is a 24-hours-a-day job. We're never quite sure when one day ends and the next one starts."

Kelly, 19, has a mild version, affecting the development of her body and mind. Stephanie, 16, has not developed any symptoms yet. But she cannot sleep because everybody else is awake at night and left school at 14.

Paul and Rachel found out they are both carriers of faulty mitochondria after Kirsten died. They do not have any symptoms yet, and maybe never will, but many adult carriers do not develop problems until they reach 40. They are both 38. Mr Preston said: "Every twinge, every ache, we worry it is the big bang. We worry not just for ourselves, but for the children. Kieran and Stacey are completely dependent on us."

After Kirsten died Paul and Rachel were offered the chance of IVF with a donor egg and donor sperm. He said: "We turned the offer the down. I can't really explain it, but we wanted to have our own children. Though if we had been offered this new technique, I'm sure we would have taken it."

Nina Lakhani

The reaction: Do you back the new plans to 'clone' babies?

YES

This should be viewed in the same way as kidney transplants or blood transfusions. Failure to enact the Government's proposal on this would stop the research dead in its tracks – and with it the hopes of the affected families

Professor Marcus Pembrey, Progress Educational Trust

NO

By combining the components of eggs from two women, the defective mitochondria could be eliminated. This procedure is very close to that involved in human cloning. The new Bill might accommodate such developments

Andrea Minichiello Williams, Lawyers' Christian Fellowship

Further browsing: Read the Bill in full at http://publications.parliament.uk/pa/ld200708/ldbills/0068006.i-iv.html

    The cloning revolution: Ministers to back controversial change to law, IoS, 18.11.2007, http://news.independent.co.uk/sci_tech/article3172139.ece

Vaccine scheme to combat cervical cancer threat

Friday October 26 2007
10.15am BST
Guardian Unlimited
James Orr and agencies

A multimillion-pound programme will vaccinate all girls aged 12 to 13 to help protect against cervical cancer, the government announced today.

From next September, all those in year 8 will receive the jab as part of a scheme costing up to £100m a year.

In 2009, a two-year "catch-up" campaign will also begin for girls aged up to 18, costing a further £200m annually.

This will mean that all girls aged 16 to 18 (years 12 and 13) will be offered the vaccine from autumn 2009.

Professor David Salisbury, the director of immunisation at the Department of Health, said the initiative would help women "for generations to come".

"We will work closely with primary care trusts (PCTs) to ensure the success of this ambitious programme," he said.

"The benefits of introducing this vaccine into the national immunisation programme will be felt by women and their families for generations to come."

The extensive programme will offer a vaccination against the sexually transmitted infection human papillomavirus (HPV).

HPV causes around 70% of cases of cervical cancer, which kills more than 1,000 women in the UK each year.

Around 2,700 British women are diagnosed with cervical cancer annually and 200,000 women a year also have pre-cancerous changes in their cervix picked up through smear tests.

The jab, which will not be compulsory and is most likely to be delivered in schools, is expected to revolutionise the approach to beating the disease.

It is likely to be administered in three doses over a six-month period.

Today's announcement, which was welcomed by campaigners and cancer charities, came after the Joint Committee on Vaccination and Immunisation (JCVI) recommended that the jab be incorporated into the vaccination programme.

Girls aged 15 to 17 (years 11 and 12) will be offered the jab from autumn 2010, and by the end of the catch-up campaign all girls under the age of 18 should have been offered the protection.

Currently, there are two jabs designed to protect against cervical cancer. The first is Gardasil, made by Merck and Sanofi Pasteur, and the second is Cervarix, made by GlaxoSmithKline.

No decision has yet been taken on which will be used in the programme.

Smear testing will need to continue after the vaccine is introduced, partly because the jab does not protect against all HPV types that may cause cervical cancer.

The health secretary, Alan Johnson, said the jab could potentially save 400 lives each year, with many women prevented from getting HPV in the first place.

He said: "As a society we need to do more to prevent disease and not just treat it. Now more than ever before we need to make the NHS a service that prevents ill health and prioritises keeping people well. This means a shift in focus from a sickness service to a wellbeing service."

The Department of Health will now consider evidence on whether women aged 18 to 25 should also be vaccinated.

The JCVI has said a catch-up programme for that age group is unlikely to be cost-effective but could benefit some individual women.

Some experts had also called for boys to get the jab because they can pass on HPV to unvaccinated partners, including homosexual partners.

Boys will not be vaccinated under today's announcement, after the JCVI said it was not cost-effective.

    Vaccine scheme to combat cervical cancer threat, G, 26.10.2007, http://www.guardian.co.uk/society/2007/oct/26/health.medicineandhealth

British people are the fattest in Europe,

says Government report

Published: 23 October 2007
The Independent
By Jeremy Laurance

British people are the fattest in Europe, drink more alcohol, eat less fruit and vegetables and are more likely to die from smoking than the average across the European Union.

Despite declining teenage pregnancy rates, the UK still has the highest proportion of births to under-20s compared with other western European countries.

The figures are set out in the Health Profile for England 2007, published by the Department of Health yesterday.

They show that one in four adults is obese and the prevalence of diabetes rose by 50 per cent between 1998 and 2003. Britons drink more alcohol per person than the EU average. Binge drinking is highest in the north-east involving one in four adults.

There are 288 deaths per 100,000 people from smoking in the UK compared with an EU average of 263.

The Public Health Minister, Dawn Primarolo, said: "Whilst we have made good progress in stopping people smoking, I am determined to move further and faster to respond to all these challenges – with a cross-government drive to tackle obesity, improve diet and activity levels and promote safe and sensible drinking.

"This country is already regarded as leading the way in key elements in the fight to tackle obesity, for example our approach on food labelling, restricting advertising to children and evidence collected through the Foresight report.

"Our ambition is to reverse the rising tide of obesity and overweight in the population, by enabling everyone to achieve and maintain a healthy weight."

Liberal Democrat health spokesman Norman Lamb said: "Ten years of Labour government has left us with widening health inequalities and a crisis in public health.

"It is shocking that England is still the fattest nation in Europe. Government action on the issue has been half-hearted at best.

"Monitoring overweight kids will do little more than name and shame those with a problem unless schools are given a follow-up plan and the resources to encourage a healthier lifestyle."

    British people are the fattest in Europe, says Government report, I, 23.10.2007, http://news.independent.co.uk/health/article3087274.ece

Horrific state of hospitals

blamed for lethal bug outbreak

which killed 345

Published: 11 October 2007
The Independent
By Jeremy Laurance, Health Editor

Three hospitals in Kent were so decrepit, overcrowded, understaffed and badly managed that when a lethal bacterial infection took hold it spread unchecked, causing death and disease on an unprecedented scale.

An investigation found that more than 1,100 patients were infected with the Clostridium difficile bacterium at the hospitals between April 2004 and September 2006 which directly caused the deaths of 90 of them. In all it contributed to the deaths of 345 people.

It is the worst outbreak of the bacterium recorded by the Healthcare Commission, the Government's NHS watchdog, whose report on the hospitals run by the Maidstone and Tunbridge Wells NHS Trust is published today. The affected hospitals were the Maidstone Hospital with 738 cases, Kent and Sussex Hospital (353 cases) and Pembury Hospital (85 cases).

Mainly affecting elderly patients, C. difficile causes diarrhoea, dehydration, inflammation of the gut and death. It is highly contagious and can be spread on hands, bedclothes and furniture. Yet infected patients who begged for commodes were told by overstretched nurses to "go in the bed", because it was less time-consuming than helping them to the lavatory. The report criticised lack of hygiene involving lavatories, commodes and walking frames.

C. difficile bacterium first came to national attention through an outbreak at Stoke Mandeville hospital in Buckinghamshire – revealed by The Independent in June 2005 – where 334 patients were infected and 33 had died over the previous two years.

An investigation by the Healthcare Commission, published in June 2006, blamed "serious failings" by senior managers who gave priority to government targets and control of their finances and ignored warnings from infection control specialists.

That report came too late to prevent the same errors being made at Maidstone and Tunbridge Wells. Today's report from the commission identifies many of the same failings among senior managers whose "main focus" was on finance rather than on the safety of patients. Anna Walker, chief executive of the Healthcare Commission, said: "What happened to the patients at this trust was a tragedy. This report fully exposes the reasons so that the same mistakes are never made again.

"I urge all trusts to heed the lessons of this report so that they can look patients in the eye and say that everything possible is being done to protect people from infection.

The report includes photographs showing a filthy commode, with faecal stains clearly visible, a dirty shower and sink and beds crammed so close together they resemble wards in a Third World hospital. One ward had 23 beds when it should have had 13. The lapses occurred after the commission had begun its investigation.

Bed occupancy exceeded 100 per cent on some medical wards, where the trust had to open up "escalation" areas to accommodate extra patients, but nurse staffing levels were 10 to 20 per cent below average. Patients were moved around, spreading the infection as they went, in some cases to meet government targets on waiting times in A&E wards. The high turnover of patients and the proximity of the beds made efficient cleaning impossible. The scandal brought the resignation of the trust's chief executive, Rose Gibb, last week.

Glenn Douglas, acting chief executive, said he would review management, as recommended by the commission, and refused to rule out further resignations. He said that C. difficile infection rates at the trust had halved in the past year and were now below the average for England.

The trust had claimed that no patients had died as a result of the C. difficile outbreak and, in a press release issued in June last year, implied that patients were to blame for bringing the bacterium into the hospitals. However, the report found 90 per cent of the cases were acquired by patients after admission.

Malcolm Stewart, medical director of the trust since January 2006 said: "This trust was simply not equipped to deal with an outbreak of this size. We have put in a raft of measures to deal with hygiene and change clinical behaviour. The organisation could have handled press statements better – some of the terminology was sloppy and did give rise to an unfortunate and erroneous impression."

'An undignified and very distressing death'

Mary Hirst was aged 83 when she fell and broke her hip in April 2006. She recovered well from the operation and a consultant at The Maidstone Hospital told her daughter, Jackie Stewart, that she should be home the following week. Ms Stewart, 54, said: "We went to see her on the Thursday and she told us she had diarrhoea. From then on she got progressively worse. Knowing what I know now, I wish I had moved her earlier."

During the following seven weeks, Mrs Hirst battled against the infection, identified later as Clostridium difficile. Later her surgical wound became infected with MRSA. She died on 24 May 2006. Mrs Stewart said: "The care she received was abysmal. My mother died an untimely, undignified and very distressing death and she shouldn't have done. I blame the hospital for it."

    Horrific state of hospitals blamed for lethal bug outbreak which killed 345, I, 11.10.2007, http://news.independent.co.uk/health/article3047615.ece

Labour in crisis:

Staff shortage blamed

for £665m payout in birth errors

Published: 08 October 2007
The Independent
By Jeremy Laurance, Health Editor

Childbirth is claimed to be safer than ever. Yet the price paid by the NHS for deliveries going catastrophically wrong has risen 59 per cent to £259m – enough to fund the consultants and midwives needed to save thousands of babies and mothers from harm

The dangers of childbirth in the modern health service are highlighted today by figures showing that £665m has been paid out over the past three years to settle medical negligence claims where obstetric deliveries have gone catastrophically wrong.

The size of the payout – enough to hire 1,000 extra consultants – reflects the enormous and growing burden of medical negligence on the health service, which is diverting scarce resources from patient care.

In a major report to be published today, the Royal College of Obstetricians will say that too little is being done to reduce the risks of childbirth and make it safer for mothers and babies. It will blame shortages of consultants and midwives, increasing pressure from a rising birth rate, and lack of training.

The report, Safer Childbirth: Minimum Standards for the Organisation and Delivery of Care in Labour, will highlight how a tiny error during labour can result in oxygen deprivation and brain damage to the baby, leading to lifelong disability and a compensation payment of millions of pounds.

Professor Sabaratnam Arulkumaran, the head of obstetrics at St George's Healthcare NHS Trust in Tooting, south London, and the vice-president of the Royal College of Obstetricians and Gynaecologists, said: "We are pressing the Government to increase the number of consultant obstetricians in busy units so that we can provide 24-hour cover.

"If there is a consultant present they are better able to deal with emergencies and prevent disasters. If you save 20 disasters costing £5m each that is £100m. Rather than have more [negligence] cases and pay out on more claims we should spend on more consultants and reduce the number of cases."

Childbirth is claimed to be safer than it has ever been, yet NHS trusts have to pay a £450 "insurance premium" for every baby that is born in case they are sued for negligence if things go catastrophically wrong with the birth.

The payments, totalling £280m for the 618,000 births in 2005-6, are collected by the NHS Litigation Authority, which handles negligence claims against NHS Trusts. The authority received 5,700 claims and paid out a record £560m in compensation in 2005-6, more than half of which (£259m) was for obstetric cases, up from £163m in 2003-4 – a rise of 59 per cent (£96m) in two years.

The figures were released to The Independent in response to a Freedom of Information request.

Last year, for the first time, the NHS Litigation Authority ranked maternity units in a league table according to their level of risk, based on a new standard for maternity care. Out of 154 maternity units in England, 18 are currently ranked Level 3 (the safest) and 54 are ranked Level 1 (least safe), with the remainder ranked Level 2.

Two poorly performing trusts, the Isle of Wight and the Royal Bournemouth, were upgraded earlier this year from the lowest Level 0 to Level 1.

NHS Trusts are not required to improve their risk rating but have a strong financial incentive to do so as it reduces their insurance premium – by 10 per cent for Level 1 rising to 30 per cent for Level 3. A trust delivering 5,000 babies a year and paying a £2.5m annual premium could save £750,000.

Steve Walker, the chief executive of the authority, said the high premiums charged to NHS trusts were necessary because of the "gold-plated" awards made by the courts.

"A judge may award £5m compensation if something goes wrong. I am not disputing that these kids need it – they are going to need teams of carers to look after them round the clock for life. But a minor shortcoming in their care can have the most devastating consequences for the child and the financial consequences for the NHS trust, if it is proved to be due to negligence, are astronomical."

He said the rising cost of compensation was due to legal changes that had inflated settlements and efforts to settle claims more quickly. "It doesn't mean obstetricians are more negligent. It means claims are becoming more expensive."

Compensation is a lottery, with the lucky minority who can prove negligence winning huge sums.

Efforts to reform the medical negligence scheme by the Government's chief medical officer, Sir Liam Donaldson, in a report in 2003, foundered after agreement could not be reached on how to implement his proposed no-fault scheme without massively increasing costs. The high cost of compensating some children diverts resources that could be used to reduce the risks for all.

The annual Confidential Inquiry into Stillbirths and Deaths in Infancy last year found that sub-standard care was to blame for more than 77 per cent of deaths during labour, and more than half might have had a different outcome with greater supervision and better management.

The Healthcare Commission, the Government's NHS watchdog, warned in its annual report in 2005 of poor standards in maternity units. It blamed "weak managerial or clinical leadership" and said some maternity services were "not as good or as safe as they could be".

The commission ordered all health trusts to review their maternity care.

The Royal College of Midwives said a poll carried out earlier this year of 102 maternity department heads (from a total of 216) found two-thirds thought their units were understaffed and one in five had lost staff in the past year.

Dame Karlene Davis, the chief executive, warned that the midwifery service was "heading for meltdown" as midwives struggled with staff shortages, service cuts and a rising birth rate.

She said: "We are looking to Alan Johnson [the Health Secretary] to put maternity issues at the top of his agenda, halt the decline in the service and deliver the first-class maternity care the Government promised."

'It is one of the most poignantly tragic cases' - Kerstin Parkin, dancer

Kerstin Parkin, an internationally known Latin American dancer, received one of the largest compensation settlements in the NHS's history when she was awarded £7m and £250,000 a year for life in 2002 for injuries sustained during the birth of her son, Dylan.

She suffered brain damage following a heart attack in labour brought on by pre-eclampsia, a condition linked to high blood pressure that can trigger convulsions.

The accident happened at what was then Farnborough hospital in Bromley, Kent, in November 1996. The High Court found that hospital staff had failed to take basic steps to prevent the damage and a cardiac emergency team was unable to reach her because they did not know the security code to enter the ward.

The judge, Mr Justice Buckley, said at the time: "It is one of the most poignantly tragic cases I have dealt with."

Today Mrs Parkin lives with her husband, Mark, and son, Dylan, now aged 10, in a large house near Godalming in Surrey, and is cared for round the clock by a team of staff.

Though profoundly disabled she is able to use her limited movements to control a computer and a wheelchair and to play games.

Mr Parkin, speaking earlier this year, said: "The compensation has made an enormous difference because it has enabled Kerstin to live at home with me and our son. It has allowed her to be cared for properly and to be provided with all the therapies and equipment that she needs."

Initially she was only able to move her head and eyes but constant care and therapy have helped her condition to improve.

Mrs Parkin and her husband became dance partners in 1989, the year of their marriage, and went on to international success in the Latin American dance world. They had planned to retire from dancing and concentrate on teaching and choreography when the accident happened.

    Labour in crisis: Staff shortage blamed for £665m payout in birth errors, I, 8.10.2007, http://news.independent.co.uk/health/article3038383.ece

No dignity

for older patients on NHS wards,

says report

· Commission issues formal warnings to eight trusts
· Only five hospitals make grade in survey of 23

Thursday September 27, 2007
Guardian
John Carvel, social affairs editor

Health inspectors are to mount spot checks on NHS hospitals after finding hundreds of older people being treated without dignity or adequate privacy on wards across England.

In a report today on conditions in 23 hospitals, the Healthcare Commission said only five complied with all the government's core standards for dignity in care. Others were found to provide degrading treatment, including making incontinent patients wear nappies and placing older women in mixed-sex bays shielded by skimpy curtains on insecure rails.

The commission included Barts and the London NHS trust among eight hospitals that failed the dignity test and were issued with a formal warning. Another 10 trusts were told to make improvements, including seven of the government's flagship foundation hospitals, which were supposed to be among the best in the country.

The commission appealed to patients, carers and relatives to blow the whistle whenever they have concerns about the treatment of vulnerable older people.

Anna Walker, the chief executive, said: "Where there is evidence that the right care is not being provided, we will use all our powers of assessment and inspection. Patients and the public do not want us to let this issue go - and we have no intention of doing so."

The commission had suspicions about the 23 hospitals after analysing patient surveys and intelligence data. All had declared themselves in full compliance with dignity standards in this year's self-assessments, but seven were found to be failing to provide adequate privacy and 11 were below par on the standard of nutrition.

The commission said many trusts were finding it difficult to provide single-sex accommodation for older patients, as the government requires. People who had suffered a stroke or had MRSA were placed on mixed-sex wards because staff found it easier to care for them.

Inspectors found toilets without locks or with faulty engaged signs. A few toilets were unclean, with an unpleasant smell.

All the hospitals had procedures to weigh older patients to find out if any were losing weight from malnutrition. But staff in one trust were encouraged to guess the patient's weight if it was difficult to weigh them. Many hospitals found it difficult to provide hot meals outside normal hours and some paid insufficient attention to the eating requirements of people from ethnic minorities.

The commission did not identify which hospitals were responsible for these shortcomings.

It noted evidence from the National Patient Safety Agency of an older patient being left for seven hours without the prescribed fluid resuscitation. Another with a wheat allergy was fed Weetabix. The agency said 300 patients were harmed or put at risk of harm over the past 18 months after mistakes involving eating or drinking. Incidents included patients being given food they were allergic to, choking on food and diabetic food being unavailable out of hours.

The commission issued formal warnings to eight trusts of failure to comply with the dignity standards. It told 10 others to make improvements, ranging from providing adequate staff training to ensuring meal times were not interrupted by doctors' rounds and tests.

The report included examples of best practice around England, including one trust which introduced a new gown to protect patients' modesty.

Paul Cann, policy director for Help the Aged, said: "Older people are human beings, not objects or numbers. It's nearly 10 years since we first exposed the shortcomings in hospital care and dignity for older people, yet we are still hearing all the time about shocking abuses of dignity."

Ivan Lewis, the social care minister, said: "Dignity and respect should be at the heart of services for older people. This is why I launched a national dignity campaign and asked the commission to make dignity central to its inspections."

Warnings

The eight trusts formally warned for failing to meet core standards:

Barts and the London NHS trust

Hull and East Yorkshire Hospitals NHS trust

Luton and Dunstable Hospital NHS Foundation trust

Oxford Radcliffe Hospitals NHS trust

Princess Alexandra Hospital NHS trust, Harlow, Essex

Queen Elizabeth Hospital NHS trust, Greenwich, south-east London

West Dorset General Hospitals NHS trust

West Hertfordshire Hospitals NHS trust

    No dignity for older patients on NHS wards, says report, G, 27.9.2007, http://society.guardian.co.uk/health/story/0,,2177677,00.html

Pharmageddon:

the prescription pill epidemic

Our increasing reliance on pills
has resulted in a 27 per cent rise
in prescriptions written by doctors in just five years.

It's costing the NHS £10bn a year,
£200m of which is wasted on drugs that are never used.

Nina Lakhani reports on a dangerous addiction

Published: 26 August 2007
The Independent on Sunday

Britain is in the grip of a prescription drug-taking epidemic, with unprecedented numbers of medicines being handed out by GPs, costing billions of pounds and stretching already tight NHS resources to breaking point.

Prescription drug use has increased by 27 per cent in the past the five years and the NHS drug bill topped £10bn in 2006. GPs prescribed 918 million medicines last year compared with 721 million five years ago, according to figures obtained by The Independent on Sunday.

Health experts put rocketing prescription numbers down to medical advances, but also point to poor prescribing by GPs, growing public demand for a "pill for every ill" and aggressive marketing tactics by the pharmaceutical industry, which prompted one MP to warn that the UK is heading towards what he called "pharmageddon".

Paul Flynn, the Labour MP, warned that a failure to change attitudes would be disastrous. He said: "We are heading towards pharmageddon. The medicalising of society is convincing people they need a pill for everything. Drug companies recruit patients, particularly good-looking and articulate ones, to help promote new drugs in the media. Life and death decisions should not be taken by tabloids."

Doctors now write an average of 81 prescriptions a day compared with 64 five years ago. More than 730,000 prescriptions for antidepressants are being handed out each week, to the point where they almost match those for antibiotics at 870,000 a week.

More than £1bn has been wasted in the past five years on buying and disposing of drugs that were never used by patients, according to new research by the Conservative Party. GPs prescribe thousands of drugs patients don't want or take, according to this survey. The money wasted would pay for a year's worth of the breast cancer drug Herceptin for more than 10,000 women or 100,000 cycles of IVF.

Andrew Lansley, the shadow Health Secretary, said: "Every penny wasted is a penny lost to the improvement of NHS treatment. In an NHS that has a postcode lottery on access to NHS drug treatments, surely we must ensure that only those drugs that are really needed and will be used are prescribed."

News of the wastage comes at a time of growing disquiet at stories of patients being denied access to potentially life-changing drugs on the grounds of cost. Earlier this month, the High Court rejected an appeal by Alzheimer's sufferers for early treatment with a drug they claim helps to slow down the progress of the disease.

The increase in prescriptions will add pressure on GPs to improve their performance. Sir John Bourne, head of the National Audit Office, told the IoS: "If GPs more often followed official guidelines and prescribed generic and other cheaper drugs where suitable, there would be more money to treat patients and pay for expensive or innovative treatments."

GPs aren't 'tuned in' to mental health issues

Doctors are being criticised for overprescribing. Leading psychiatrist Professor Gordon Parker claims that too many people are being wrongly diagnosed with depression and prescribed drugs for perfectly "normal" emotions. Ninety per cent of GPs have said they prescribe antidepressants because there are not enough counselling alternatives, but voluntary organisations that provide such services rarely receive GP referrals. Paul Farmer, chief executive of Mind, said: "Many GPs are not tuned into mental health issues or support services that are available outside the NHS, and what is missing are the mechanisms to make that happen smoothly and effectively. It should be as easy to prescribe a course of counselling as it is to write a prescription."

Defending GPs, however, Professor Mayur Lakhani, chair of the Royal College of GPs, said that the increase should be celebrated as a sign of medical advances. He said: "The argument that society has become medicalised and there is a 'pill for every ill' is an exaggerated one, with no evidence. It is a great time to be a doctor. So much more can be done now. The challenge is for the Government to respond to the aspirations of doctors and patients in saving lives."

But some doctors argue that pressure from growing patient expectations is also behind the increase in prescriptions. Dr Chris Steele, GP and resident doctor on ITV's This Morning, said: "People expect to leave their GP appointment with a prescription in their hand, so if they don't, they are very disappointed. If you tell a patient that you are not prescribing something but want them to do 30 minutes' exercise every day and reduce the fat, sugar and salt content in their diet, a glazed look comes over their eyes and it is like to talking to a brick wall."

Evidence that patients want a "pill for every ill" is supported by the fact that more than 900 million non-prescription or over-the-counter items were also sold last year, and there is growing alarm at the number of people buying drugs from unregulated online pharmacies. Dr Richard Taylor, GP and independent MP for Kidderminster, said: "People now think it is better to take a pill than do something themselves about their own health; for example people want obesity drugs, when the basic thing about obesity is to take exercise and eat only what you need.

"We should be emphasising prevention for every kind of illness, for example, most skin cancers are preventable and a 'statins for all' approach is not helpful at all. Taking money out of treatment to put it into prevention is impossible at the moment; it would need a big change in the current climate. But what needs to be publicised is better self-control."

With 950 drugs currently being developed and no signs of diminishing public expectations, the costs look set to spiral further. Last month Roger Boyle, the Government's heart disease tsar, advocated cholesterol-lowering drugs for every man over 50, arguing that this would save the NHS money in the long term.

Dr Boyle faced criticism for his advice. Critics claimed that his proposal would "medicalise" millions of healthy people and that it failed to recognise that there is no such thing as a risk-free drug. The NHS is not a bottomless pit, they argue, and it has reached a tipping point. The British Medical Association has said for the first time that many health treatments will have to be rationed in the future because the NHS cannot cope with escalating patient demands.

Professor Karol Sikora, a leading cancer specialist, argued that a two-tier system is inevitable. He said: "The NHS is not a bottomless pit. To be fair, it should provide a good core package of cost-effective drugs and the others people should pay for themselves with health insurance. This is an unpopular stance that will not win me any votes, but there is no other solution. The NHS can't provide everything and we need to address this properly."

Some GPs argue that some clinical decisions come down to who shouts the loudest. "It is not possible for the NHS to keep paying for everything. Herceptin makes the front pages, so people with breast cancer get Herceptin, whereas people with Alzheimer's and age-related macular degeneration don't attract the attention, so they miss out," said Dr Taylor.

Marketing of drugs should be seen to be ethical

The pharmaceutical industry also comes in for criticism from those who believe we resort too early to pills. Tony Harrison, a King's Fund associate, said: "The markets are weak, so the drug companies are producing high-cost drugs that don't work very well. The relationship between clinicians and the pharmaceutical industry also needs furthering policing."

A Health Department spokesman said: "More drugs are being prescribed due to advances in medical technology, which means we can treat more conditions. At the same time, it is vital that we have fair prices for drugs and devices, which give value for money to the taxpayer. The Department of Health and the NHS have already put in place a wide range of measures to secure best value for money from the £8bn spent on medicines in primary care and our performance stands up well internationally."

A spokesman for the Association of the British Pharmaceutical Industry said: "We believe it is legitimate for drug companies to market their medicines and provide clinicians with information about them, but it is important that this is seen to be ethical."

Patients' attitudes to their health must change

Health experts maintain that patients themselves need to take more responsibility for their health. The more the NHS spends on drugs the less money there is for preventing diseases. But taking money from cancer drugs to prevent obesity or promote mental well-being would need attitudes to change.

Dr Mark Porter, GP and a BBC health expert, said: "The public owns the NHS, so its first duty must be to provide whatever is demanded by the majority. If that's quick-fix, expensive 'polypills', then so be it. More could be achieved, at a fraction of the price, if people take more personal responsibility and adjusted their lifestyle accordingly."

Patients' views: the best prescription for health

More people than ever are popping pills and the National Health Service cannot keep up. Some people get prescribed life-changing drugs that other people want but do not get. Then there are those who do not want a drug treatment but can't seem to get anything else. As soon as someone hears about a new treatment that might help their condition they want the NHS to pay for it. The situation is complicated but for affected individuals it can mean a matter of life or death, home or hospital.

Kathleen Shaw, 84, lives alone in Bromley, Kent

I am already completely blind in my right eye because of age-related macular degeneration, but when the disease developed in my left eye a new drug was available. My PCT has turned me down due to funding and apparently I don't meet the criteria, but I am going blind. The worst thing is that apart from my eyes I am active woman. I was there at the beginning of the NHS; we put the money in all our working lives so can't they give me something back?

Harriet Loasby, 31, is a part-time student from Hove, East Sussex

I went to see the doctor when I was feeling overwhelmed at university and expected some stress management advice. But I could tell he wasn't listening ... he seemed in a hurry as he prescribed anti-depressants. My mild depression got worse and though I've been prescribed lots of different medications, I've never been offered a psychological therapy by a GP. I can't help wondering if that first doctor had referred me for therapy, the past 10 years could have been very different.

Heather Roberts, 52, from Derby, is married with two children

I was diagnosed with Alzheimer's 18 months ago, I was only 50 and I couldn't believe what was happening to me. Because of my age the doctor prescribed one of the new drugs straight away, and it has given me two years of life back. Before the drug I kept getting lost, I couldn't drive – I was basically withdrawing from the world. Now I can drive and I can make the most of my life. I am horrified that others won't get the same opportunity. Surely everybody deserves a chance.

    Pharmageddon: the prescription pill epidemic, IoS, 26.8.2007, http://news.independent.co.uk/health/article2896181.ece

Anthony Seldon:

Don't worry, be happy

Our nation is rich – so why are we so miserable?
As more of us turn to anti-depressants,
we must teach our children to embrace life
without running to the GP as soon as trouble hits

Published: 26 August 2007
The Independent on Sunday

Britain is becoming more than ever dependant on artificial props to make life liveable. There has been a 55 per cent increase in drugs prescribed over the past decade, and an estimated doubling of the amount of illegal drugs being taken. Some of the prescribed drugs are, of course, essential: but many are not. I am thinking of tranquilisers, anti-depressants, sleeping pills and the rest.

Over the past decade, Britain has become a more prosperous nation. Yet the research evidence very clearly shows that increasing affluence does not lead to an increase in happiness or well-being. Britain has in fact become a sicker and a less happy nation during those 10 years.

When confronted by unhappiness, boredom, or a sense that life is not what it should be, the average Briton responds in a variety of ways.

Spending money is a staple resort, whether on new and unnecessary cars, a change of home or an extension to an existing property, or on more holidays. These do seem to assuage the appetite for a while, but shopping is as enduring a therapy as a gin and tonic. Many people resort to excessive alcohol drinking: how many readers will find the concept of not having a drink this evening difficult? If the answer to that is "yes", then you have a dependency. Others change their partners or take up with a lover. Again, this is a short-term solution, as the evidence shows that the problems that soured the old relationship rapidly reappear in the new.

Illegal drugs relieve boredom and bring a sense of well-being and release from anxiety. Some users escape unscathed. Many do not. Even marijuana, the "safe drug" for those who grew up in the 1960s, '70s and '80s, is now known to trigger schizophrenia and depression in vulnerable people.

People also resort all too quickly to prescribed drugs, the easy fix. Doctors, many of whom lead poor lives themselves, cannot cope with the problems of their patients any more than they can with their own. A flick of a pen on a prescription pad is an all too common response.

And increasing numbers turn to analysis, therapists or counsellors. This trend has been much maligned. The key is, does the counselling lead to dependency on the part of the "patient", usually in the all-knowing therapist? Or does it lead to increasing autonomy? Because it is the loss of self-reliance, encouraged by the welfare state at its worst, which lies at the root of all the problems. The alcoholic, the depressive and the pill-popper are not independent people: they are – in key areas of their lives – children.

Why the malaise of unhappiness is growing in Britain is hard to say. Some people have pointed to increasing insecurity at home and on the streets, with the fear of teenagers ranking higher in the minds of home owners than the fear of global warming. Others blame the fear of international terrorism. Yet fear and insecurity can reduce anxiety: during the Second World War, recorded rates of mental illness fell, rather than rose. In Northern Ireland since the troubles ended, the suicide rate has leapt.

Unrealistic expectations of life are a more likely cause of the malaise. To many, technology was going to provide the answers, in the form of gadgets to make life easy, and with sophisticated entertainment in the home and car, and even while walking in the streets, keeping the mind busy and warding off thinking. Flat-screen, high-definition colour televisions make us no better or happier than the flickering black-and-white screens of the 1950s. Whoever made us believe that technology would make life happier?

We are not a resilient nation, and find it hard to absorb reversals without falling into depression or running to the doctor. For many people, life is hard and insecure. It involves loss of loved ones, broken relationships, loss of jobs, insecurity and economic hardship.

We do not prepare our young people to lead autonomous lives. They are lulled into thinking that the welfare state and modern technology will cocoon them from hardship. When problems come, they are someone else's fault, and someone else has to help them through it. Modern post-industrial society can be a psychologically unhealthy place.

The real cause of the increase in the rise in the taking of inessential prescription drugs, and of unhappiness more generally, is a retreat from the real world, in which ourmodern, post-industrial society connives. We have allowed what should be natural, authentic and simple become artificial, false and complex.

What has happened is so insidious that it is barely discernible, and many fail even to detect that it is happening. The retreat comes on three levels. In relationships, the quality of family life has deteriorated. Families sit down less frequently for meals, and where they do, conversation is less. Parents spend less time with their children, partners less time with each other, while grandparents are increasingly marginalised.

People touch each other less (touching does not have to be inappropriate). We do not cherish our relationships sufficiently. Too often, it is only when we lose a dear friend or a family member that we realise, too late, what can never again be. Relationships are utterly fundamental to happiness and well-being. And we have let them be sidelined.

Life in modern cities, governed by artificial light, artificial sound and an absence of green is not natural or healthy. We also are losing touch with ourselves. For too many, their bodies, minds and emotions are strangers. The hectic pace of modern life affords too little opportunity for reflection and knowing oneself.

What can be done about all of this? I do not believe any of the traditional resorts – taking of inessential pills, and the rest – is necessary or productive. The millions of people in this position can begin by making a pledge today to reduce their drugs by half within one year and total eradication within two years. Those hooked on recreational drugs can follow the same path, while those dependent on alcohol can pledge to cut down or abandon drink altogether. Once one has committed to this course, it is surprising how easy such a decision can be. If one does not, it begs the question "who is in charge of your life"?

Life needs to be lived more consciously and deliberately, and at a slower pace. Every day one should aim to sit down for at least two periods of five minutes and breathe deeply, learning what is in the mind. Much will not be pleasant. But it is better to accept the reality than to run away from it. The benefits of stillness are quite extraordinary, and the excuses for not sitting still are wholly insubstantial. One such reason is that there is "no time to sit still and do nothing". Not true.

By having periods of stillness each day one increases one's efficiency markedly and allows the rest of the day to be used far more effectively. Learning to live more in tune with nature is fundamental. Engagement with the natural world is key to a happy life. Time spent walking through the countryside, looking after flowers in the garden, or fishing, is known to be therapeutic. Walking in the fresh air in the countryside or a park, and focussing on the environment rather than on one's worries is uplifting.

There is nothing artificial about eating and drinking natural food, and looking after the body properly. Regular exercise is also fundamental. Exercising three times a week for 20 minutes is known to have more effect on combating depression than taking Prozac. The human body was designed to be active. Not exercising the body is itself a depressive factor.

Greater time needs to be laid aside for pursuing one's own interests and hobbies. The demands of work and family simply have to be laid on one side. One is not serving either if one becomes resentful and stale. The paint box, the cello and the grease paint, amongst many other pastimes, should all be taken up with benefit.

The heart, though, of making us a more emotionally, mentally and physically intelligent nation is education. Our schools have become pale shadows of what they could and should be. Children are born with our bodies, yet schools do not provide our young with an "owners' manual" on how their bodies, minds and emotions work. We now have the information on "positive psychology", and schools such as my own, Wellington College, are teaching well-being or happiness in association with academic institutions.

Schools, above all, should be helping their students become autonomous human beings, and this lies at the core of well-being, and a well-lived life. There is no excuse at all for schools now not to be teaching this. What has happened is that schools, with their obsessions with exams, are in fact closing the minds of young people, rather than opening minds and hearts, and showing them how to live.

Reducing depression, anxiety and suicide is one reason for the teaching of these skills: it is much easier to prevent a child from falling over a waterfall than to look after the child or adult once they have fallen to the bottom. The teaching also encourages the young to lead happy, fulfilled and creative lives, by developing all their faculties within, including their moral, spiritual, aesthetic and social aptitudes.

The National Health Service needs to change every bit as radically as our education system. Powerful vested interests have built up to look after bodies and minds once they are broken. But the effort needs to be put into stopping minds and bodies becoming unwell in the first place. Again we have this knowledge; all it needs is the political will.

How much longer are we going to carry on as we are? We are becoming sicker by the decade. If current trends continue, we will all be taking prescription drugs before the next century. Britain is beautiful, most of us do not have to worry where our shelter or next meal will come from, and we are surrounded by good people: yet we squander it, and retreat into unreal palliatives when we should be embracing life. It is time that we started to change, before yet more lives are wasted and stunted. Time is running out. If we do nothing, we face a consequence as threatening to us all as global warming.

Antony Seldon is headmaster of Wellington College, Berkshire

Further reading: 'The science of well-being', edited by Felicia Huppert, Nick Baylis and Barry Keverne. Oxford University Press, £39

    Anthony Seldon: Don't worry, be happy, IoS, 26.8.2007, http://comment.independent.co.uk/commentators/article2896170.ece

Late diagnosis blamed

for lower child cancer survival rates

in UK

· Britain lags behind 14 other European countries
· Higher priority urged for paediatric checks

Wednesday August 1, 2007
Guardian
John Carvel, social affairs editor

Children with cancer in Britain have lower survival rates than in other western European countries because the NHS gives them low priority, research reveals today.

Experts in paediatrics and cancer research investigated why only 30% of children in Britain survived neuroblastoma, a tumour of the adrenal gland, compared with 46% in Germany, Belgium, the Netherlands, Luxembourg and Switzerland.

In a keynote comment for today's issue of The Lancet Oncology, they said the most likely reason was late diagnosis caused by inadequate medical monitoring.

In Germany, most children have a primary care paediatrician and those with cancer can be identified during routine health checks. In Britain, NHS guidelines are less thorough with fewer routine examinations recommended.

"Although there is a national service framework for children, there are no targets and children continue to be a low priority for the NHS," said Alan Craft, of the Institute of Child Health at Newcastle University, and Kathy Pritchard-Jones, of the Royal Marsden hospital in London.

The report says "survival for childhood cancer is just one example of the worse state of children's healthcare in the UK compared with many other countries". Mortality rates tables show the UK in 15th position in Europe.

They researchers added: "We need to persuade politicians to ... make an appropriate level of investment, ensuring that the UK improves by comparison with the best-performing countries."

The Lancet paper looked into how Wilm's tumour, another common childhood cancer, affecting the kidney was detected in Germany and Britain between 1994 and 2001. In Germany, 27.4% of patients had the cancer first identified during a visit to a health professional for an unrelated problem or during routine surveillance. But in the UK, only 11% of children treated for the tumour at the Royal Marsden and 4% at the Newcastle hospitals had the cancer identified in this way. In Germany, early diagnosis by routine or incidental examination was linked to the increased survival, the authors concluded.

Prof Craft said last night: "Part of the concern is the whole question of children's health being a low priority for the government. Waiting lists and hospital beds keep chief executives awake at night, but I don't think the health of children does."

Carole Easton, the chief executive of the childhood cancer charity CLIC Sargent, said that UK survival rates for childhood cancer had increased over the past 30 years, with seven out of 10 children now surviving the illness. Alex Markham, senior medical adviser for Cancer Research UK, said: "Five-year survival from childhood cancer in the UK has reached 77%, and for some types of the disease, survival is over 90%."

Much of the data for the Lancet paper was collected between 1977 and 1997. "Since 1997, specialists in the UK have been working with their counterparts across Europe to standardise and improve the treatment and management of children with cancer," said Prof Markham.

The Department of Health said that the number of children successfully treated for cancer had risen from 25% in the 1960s to about 75%.

A DoH spokeswoman said: "Children are a high priority for the NHS. We recognise there is more to do so that our services match the best in Europe."

Late diagnosis blamed for lower child cancer survival rates in UK, G, 1.8.2007, http://www.guardian.co.uk/medicine/story/0,,2138909,00.html