Critics slam "rip off" 50p-a-minute charge to call patients" hospital phones

Relatives who call patients in hospital are still being forced to pay “rip off” charges of 50p a minute despite a promised clampdown on the issue.

The firm Hospedia, which runs bedside TV and phone services in NHS hospitals and made £21.2m in revenue last year, makes people call loved ones via costly 070 numbers. The charges vary from hospital to hospital, but many trust websites say they cost about 50p a minute or more.

Callers are also forced to listen to a lengthy recorded message of about 70 seconds – which racks up charges before they are even connected to their loved one.The message contains information already obvious to the caller, such as the fact the patient is in hospital, and tells callers to be “patient”. Critics say patients are being treated as “cash cows” and described the charges as “extortionate”.

Hospedia currently manages TV and bedside phone services in 150 NHS hospitals, installing services for free in return for keeping the money charged to patients and relatives.

The firm said in 2014 it planned to phase out the use of 070 numbers but it has not happened. Ofcom reviewed the high costs in 2006 following complaints from users and recommended a substantial reduction in incoming call charges.

It urged the Department of Health to review all aspects of the system, and the way these costs appear “to be borne disproportionately by friends and family”.

The department looked at the issue and agreed to consider a skip facility at the start of the recorded message, enabling callers to bypass it and reduce the cost of the call. But this never came into effect and high call charges have remained.

A health department report in 2007 concluded that decisions on phones should remain with local hospitals. MPs on the health select committee also recommended a reduction in phone costs and called for a skip facility on the recorded message.

Hospedia refused to answer several questions posed by the Press Association, including how much money it makes from 070 numbers and why it still uses them.

A spokesman said: “Ofcom granted us use of the 070 number range to enable every bedside unit to have its own unique telephone number so that friends and relatives can call patients directly, alleviating pressure on nursing staff having to field calls.

“The patient’s bedside phone number is unique to each patient’s account and can follow them around the hospital if they are moved bed, a frequent occurrence.”

He said Hospedia offers free TV on children’s wards and free channels BBC1, BB2, ITV, Channel 4 and channel 5 from 8am to noon on adult wards. Outbound calls to landlines are also free.

He added: “We believe we offer an excellent service, which would not be provided at all if it weren’t for us taking on the investment and on-going management and support costs.

“Patients can choose to pay for our services, beyond those we offer for free, or not.”

But Liberal Democrat leader Tim Farron said: “These charges are a total rip off. When channels are free at home and people have already paid for their TV licence, it is unfair for them to need to pay it again.

“If someone is to spend four weeks in hospital with a full TV package that is the same price as their yearly fee.

“Hospitals and these businesses are treating the sick as cash cows.

“From hospital parking charges, TV packages to making people call expensive phone services, it seems like they try to eke out every bit of cash they can, it’s frankly unacceptable.”

Liz McAnulty, chair of the Patients Association, said: “Phone contact can be hugely valuable and reassuring to people in hospital and their loved ones at home.

“Any facility to provide this must offer a high quality service at a fair price, but Hospedia’s service appears to fail these tests badly.

“It is unacceptable for people calling someone in hospital to be charged heavily for 70 seconds before they even get through.”

Caroline Abrahams, charity director at Age UK, said: “Since older people typically have longer hospital stays and do not always have access to a mobile phone, they and their families are particularly likely to be impacted.”

Lynda Thomas, chief executive for Macmillan Cancer Support, said the cost of calls was “shocking”.

She added: “When you are having cancer treatment, getting a call from a relative can make a huge difference as you can share your worries, seek reassurance, or just hear their voice.

“But if relatives have to pay extortionate amounts to make these calls they may not call, cut it short, or shoulder the burden of these high charges, at a time when the whole family may be struggling financially.”

A spokeswoman for Ofcom said it was “concerned” about 070 costs and wished to hear from customers as part of its ongoing monitoring.

She said there is no requirement on Hospedia to use 070 numbers, adding: “We are concerned about the cost of making calls to and from hospital patients.

“Following an investigation into this, we referred our findings to the Department of Health, which has since changed its rules on mobile phone use in hospitals.

“We are glad that more patients now have the option of using their mobiles when in hospital, but arrangements for bedside phones are managed by the NHS.

“We want to ensure adequate safeguards for consumers so we are examining the use of 070 number ranges, amid concerns that the cost of calling these numbers can be confusing.

“We welcome evidence of any harm so we can further protect consumers.”

A health department spokeswoman said: “Suppliers should always put patients first in the way they provide services.

“Staying connected to friends and family while in hospital is crucial and we expect local hospitals to tackle anything that prevents this.”

Last year, Hospedia doubled its minimum price for a TV package from £2.50 to £5.

Prices for TV packages vary between hospitals, with the Big Bundle TV and internet package costing £17.50 for two days at Newcastle General, but £15 at Ipswich Hospital. Five days can cost £35.

Sky Sports can cost an extra £10 on top each day. Longer-term packages are less costly.

Critics slam "rip off" 50p-a-minute charge to call patients" hospital phones

Theresa May cannot ignore NHS crisis or brush off critics

Most months, and most weeks during winter, the openness the NHS claims to practise yields an array of statistics showing how the service has performed against a range of targets. The figures usually tell a grim story.

Whether it’s ambulance response times to 999 calls, the number of patients waiting more than four hours in A&E or the number waiting longer than they should for urgent cancer care, NHS performance against such metrics is the worst it has ever been.

Jeremy Hunt prefers to trumpet the record numbers of patients being seen, a byproduct of our ageing and increasingly lifestyle-affected population. But few experts take that seriously as an indicator of the health of the health service.

Theresa May will make an important speech tomorrow on mental health, rightly drawing attention to an under-resourced area of enormous concern. But the headlines this weekend are all about a wider NHS crisis that seems to be spiralling dangerously out of control.

May will hope that the intense pressures that prompted the British Red Cross to declare on Friday that the state of hospitals and ambulance services was a “humanitarian crisis” were simply the result of a backlog from the festive period. But the evidence suggests that is not the case; the overload of the system appears to be real and risks to patients rising. Accepting the realities of the ongoing and increasingly visible deterioration of the nation’s most-loved institution would involve significant political risk for the prime minister.

One recently retired NHS trust chief executive believes the deaths at Worcestershire Royal hospital in early January of two patients who had been waiting on trolleys for a bed could become a new “Jennifer’s ear”. Jennifer was a five-year-old who featured in a Labour Party broadcast during the 1992 general election campaign, who had been waiting 11 months for an ear operation. Her plight came to symbolise the Tories’ alleged running down of the NHS.

Media coverage of corridors full of patients on trolleys, waiting to get a bed on a ward, also played a key part in the 1997 election, which Labour won by a landslide. David Cameron’s drive to detoxify the Conservative brand on health, ensuring the NHS was seen as safe in their hands, was conceived in the aftermath of those dark days for his party.

So the parallels being made between then and now by Dr Mark Holland, president of the Society for Acute Medicine, must be worrying for May and Hunt.

True, every winter brings examples of trolleys stacking up in corridors. Two years ago Stoke made headlines; now it’s Worcester’s turn. But the large number of hospitals declaring a red or black alert – their way of saying that they can’t cope, at least temporarily – is not normal. And the huge amount of ambulance crews’ time being wasted looking after patients because A&E staff are too busy to accept them is becoming an urgent problem.

Other serious issues include hospitals having to rush to create extra bed space in order to cope with unprecedented numbers of patients needing to be admitted. Above all, the increasingly long waits for treatment being experienced by more and more people indicate that quite a few hospitals are, as Holland puts it, back to the “chaos” of the 1990s.

The impression is of a service that is wilting, even cracking, under the strain. Dr Taj Hassan, president of the Royal College of Emergency Medicine, which represents A&E doctors, talks of conditions creating “untold patient misery”.

Health experts fear that both quality of care and patient safety are at risk amid a chaos made worse by chronic understaffing.

What is the government’s response? May and Hunt’s stock answers are the disputed “£10bn extra”, combined with “more staff than ever” and the assertion that “demand is no heavier than usual for the time of year”.

But if there are more Worcesters, because doctors, paramedics and hospital staff are too busy to give patients the time they need, or to respond to them quickly enough because they’re tending to others, those pat lines may quickly appear dangerously glib and inadequate.

Theresa May cannot ignore NHS crisis or brush off critics

FDA approval of "female Viagra" leaves bitter taste for critics

It is the modest pink pill that its manufacturers hope will do for girls what Viagra did for men. The choice to give the drug a advertising licence in the US has been cheered on by campaigners for women’s rights, but the question remains no matter whether Addyi is the breakthrough medicine claimed.

Men have the blue diamond-shaped Viagra pill and 25 other individuals as well (even though 17 of individuals are kinds of testosterone), although there has so far been no counterpart for women until finally now. But sex and relationship therapists say Addyi is only moderately powerful, need to not be taken with alcohol, and has potentially severe side-effects which includes fainting and abnormally minimal blood pressure.

Related: FDA approves ‘female Viagra’ pill Flibanserin right after two rejections

Some of the women who testified before the US drug licensing committee, the Foods and Drug Administration, seemed to think the pill would bring back the passion and romance of times past, but there are fears they are currently being sold an unfulfillable dream.

“I am concerned about the expectations that ladies have,” said Cynthia Graham, professor in sexual and reproductive overall health at the University of Southampton. “Among women who spoke at the FDA there had been expectations that you can have sexual desire that is at a large level and absolutely nothing is going to influence it – that it will be correct back the place it was when you met your companion.”

The trials display that Addyi gave females who took it day-to-day a single added sexually satisfying expertise per month.

Graham and other critics believe the FDA was pressured and half-shamed into approving Addyi (generic identify flibanserin) by a campaign headed by a vocal group called Even the Score, which pitched the absence of medication to help females with reduced libido as a gender inequality issue.

It describes itself as a campaign for women’s sexual wellness equity which was “created to serve as a voice for American females who believe that it is time to level the enjoying field when it comes to the treatment method of women’s sexual dysfunction”. On the front page of its internet site now runs a banner saying “Thank you, FDA”. Sprout Pharmaceuticals, which owns Addyi, is one particular of the funders, as is Trimel, one more organization in the very same discipline.

Sprout strategies to enlarge the organization. Its shareholders ought to be in for a windfall if the drug generates even a fraction of the good results and profits Viagra did for Pfizer right after winning a licence.

Sprout’s chief executive, nevertheless, hailed the FDA selection as a victory for females. “It has been a outstanding journey to get to this breakthrough minute. Today we celebrate what this approval implies for all women who have prolonged awaited a medical remedy alternative for this daily life impacting condition,” stated Cindy Whitehead. “We applaud the FDA for putting the patient voice at the center of the conversation and for focusing on scientific proof.”

The determination was not clearcut. The drug, an antidepressant which works on the brain, in contrast to Viagra, was rejected twice by the FDA on the basis of a small benefit and considerable side-results. The last vote was an 18 to six, with none of the panel willing to endorse it without having caveats. Addyi will have a black box warning, that means there are significant side-effects. It is not accepted for girls past the menopause or anyone with an impaired liver. It can lead to lower blood pressure and reduction of consciousness. These dangers are increased if ladies drink.

“Because of a possibly critical interaction with alcohol, remedy with Addyi will only be offered by means of licensed wellness care pros and licensed pharmacies,” stated Dr Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Analysis. “Patients and prescribers must completely realize the risks connected with the use of Addyi ahead of taking into consideration treatment.”

The FDA needs Sprout to do even more research of the impact of alcohol. The one it carried out concerned 25 folks, of whom 23 were males. Graham believes there is small possibility physicians will hold off prescribing it for women who drink or who are publish-menopause. Even in the hours right after the announcement of the licence “we could see indications that the drug is not going to be prescribed only to ladies who are pre-menopausal and really do not drink”, she stated.

Dr Irwin Goldstein, who heads the San Diego sexual medication centre and has been a advisor to Sprout, informed the New York Occasions he would not refuse to give it to casual drinkers.

There are also queries about the accurate scale of unmet need to have. The typically utilised statistic that far more than two-fifths of all women – 43% – knowledge loss of sexual desire dates from a survey in 1999 which failed to ask females no matter whether they have been actually bothered by that. The larger and more current National Attitudes and Sexual Lifestyles study in the Uk found that about ten% of girls had minimal libido and had been experiencing distress as a outcome.

Dr Petra Boynton, agony aunt and psychologist who has researched sexual working, says losing interest in sex is a actual worry for females, “But what are they truly worried about? They consider they are not standard because they do not want intercourse that a lot. They wonder ‘will my partner leave me?’ and ‘am I undesirable or inadequate?’”

There are some who wonder if they are missing out on pleasure, she mentioned, but that is not truly the principal anxiousness. “They are speaking about not currently being good adequate or not measuring up. Men and women have a perception that everyone else is possessing great intercourse all the time with exotic positions.” There is, Boynton explained, “anxiety brought about by misinformation about sex”, that is perpetuated by the media and particularly men’s and women’s magazines. “The cultural wallpaper is telling you that to keep somebody and be desirable and not left alone, which is a enormous fear, you must be possessing and providing regular intercourse.”

Addyi could support a modest number of females, but Boynton pointed out that, like the other medicines for sexual issues, it had only been examined against placebos. It would have been fascinating, she mentioned, to trial it towards candles and bathnights and sex toys – and, for that matter, romantic relationship treatment.

The drug will be on sale in the US from October. Sprout has not stated no matter whether it will apply for a licence to sell it in Europe, but if it did, the verdict may possibly not automatically be the same. “I would be stunned if it is licensed right here,” mentioned Boynton. “But regardless of whether it is licensed or not, it will nonetheless perpetuate the illusion that if you do not have desire, there is something wrong with you.”

FDA approval of "female Viagra" leaves bitter taste for critics

Vaccine price lower pledge not ample, critics inform Pfizer

The pharmaceutical company Pfizer has pledged to minimize the value of its new vaccine against a deadly disease by six%, but campaigners say the reduction is nowhere near enough.

Final week Médecins Sans Frontières named for a reduction of the price of the vaccine against pneumococcal ailment to $ five (£3.30) per little one, claiming the two firms manufacturing it had been producing huge revenue.

At a donor conference in Berlin hosted by Angela Merkel to increase funds for the international vaccines alliance Gavi, Pfizer supplied to reduce the price from $ three.30 a dose to $ 3.10. Each youngster needs 3 doses.

The other firm making the vaccine, the British drugmaker GlaxoSmithKline, mentioned it would freeze the price for ten years for middle-revenue countries that drop Gavi funding because of their escalating wealth.

But MSF mentioned the concessions had been not adequate. “Pfizer’s small price lower for the pneumococcal vaccine is inadequate. We require to see the two Pfizer and GlaxoSmithKline get bolder measures to minimize the cost of this vaccine in building countries so that a lot more youngsters can be protected towards pneumonia,” said Kate Elder, vaccines policy adviser for MSF’s entry campaign.

“Considering Pfizer has raked in practically $ 16bn for this vaccine in just 4 many years, we believe the firm can do significantly far more than a meagre six% discount.”

MSF also would like significantly greater transparency from organizations, complaining that they do not reveal the charges of studying, establishing and manufacturing vaccines nor the charges they charge in different countries. The Guardian launched a crowdsourcing exercise asking readers close to the world to aid fill in the gaps by finding out the value of the vaccine in which they dwell.

“Pfizer claims that it is generating the pneumococcal vaccine accessible to the poorest countries at beneath cost value, but we really do not know if that’s accurate,” Elder mentioned. “We require to see the two Pfizer and GSK opening up their books – being transparent for a adjust – on what the genuine costs of the study, development and production of this vaccine are. The secrecy that shrouds the vaccine industry helps make it practically impossible to have an educated discussion on sensible vaccine costs.”

Vaccine price lower pledge not ample, critics inform Pfizer

Guideline Critics Shift Attacks From Beta Blockers To Statins

With the release today of updated European and US guidelines the ongoing controversy regarding beta-blockers appears to be resolved. But that doesn’t necessarily mean there will be an outbreak of guideline peace and harmony. The critics who helped ignite the controversy over beta blockers now say new statin recommendations contained in the guidelines are based on deeply flawed evidence.

The previous incarnation of the European guideline on perioperative evaluation and treatment of people undergoing noncardiac surgery was the subject of intense criticism due to the scandal discrediting Don Poldermans, a Dutch researcher widely published in the field. To address the current uncertainty US and European medical societies earlier today released updated versions of these guidelines.

“Given the recent publication of several large-scale trials, including POISE-II, and new risk calculators, as well as the controversy regarding the use of beta blockers related to the DECREASE trials, the writing committee felt it was necessary to reevaluate all of the data on cardiovascular care for the patient undergoing noncardiac surgery,” said US Writing Committee Chair Lee Fleisher, in a press release.

Regarding beta-blockers the US and European guidelines now do not recommend routine use in patients who undergo non-cardiac surgery, though people who are already taking beta-blockers should continue taking them. (Previously the European guideline but not the US guideline did support routine use of beta-blockers.) Both guidelines state that beta blocker therapy may be initiated prior to surgery in carefully selected higher risk patients.

Statin Recommendation Comes Under Fire

Both the new European and US guidelines say that preoperative initiation of statin therapy may be considered in patients undergoing vascular surgery and that people already taking statins should continue taking them. Now some of the same critics who attacked the reliability of the beta blocker guideline say that this recommendation is not supported by the evidence.

The new recommendation is based on several observational studies and one randomized controlled trial. (Two other randomized trials were not considered because they were performed by Poldermans’ group and have been discredited.) The  critics, UK cardiologists and researchers Darrel Francis and Graham Cole, say that the one  trial by Durazzo et al has fatal flaws that make it completely unreliable. (Durazzo, it may be worth noting, had been a frequent co-author of Polderman’s and had been a co-author of several of the controversial or retracted studies.)

In an analysis published earlier this year, Cole, Francis, and co-authors wrote that the Durazzo study

…was a double-blind randomised trial of 100 patients undergoing vascular surgery, with a 45-day course of atorvastatin or placebo. It sought reduced perioperative events in the atorvastatin arm, which indeed was what was found: 8% versus 26% (p = 0.031) at 6 months [22].

This study has serious failings, which make it an unsound basis for recommending therapy. First, its sample size calculation is stated to have been based on a 22% event rate at 6 months in a previous paper [23]. In reality, the source article states that the rate was 12% at 6 months. Such a transcription error would cause a study to be approximately 4-fold undersized.

Second, the authors indicate that they designed their study to detect a relative risk reduction of 95%. This study design is not credible as no therapy has ever been so effective in preventing myocardial infarction. If the true effect size was, for example, half of this, this overestimate would have contributed a further ~ 4-fold undersizing of the study.

Third, the survival data published cannot be correct. The paper reports that of the 50 patients in each arm, none were lost to follow-up. Therefore, every patient surviving to each displayed time point should be exactly 2%. With this in mind, in the Kaplan–Meier graphs, almost all the numerical values in the survival follow-up figure contradict the graphical values shown.

Finally, for 50-patient groups with no loss to follow-up, event-free survival rates must again be multiples of 2%. They are quoted as 91.4% and 73.5%, values that are not possible.

Francis and Cole sent the following comment about the new guidelines:

We are very sad that over 100 world authorities were forced to sign the European guideline without all having had time to read the papers on which their recommendations were based, and without being able to openly voice dissent.

Their awful predicament is easiest to see for a therapeutic idea whose road has been very “bumpy” indeed: the perioperative course of statins. The outcome data of the key trial by Durazzo et al has for over 6 months been publically known to be impossible. This is buttressed by Don Poldermans’ now notorious DECREASE III and IV trials, whose own university’s investigation revealed extensive fictionalisation, and by meta-analyses whose events arose mostly or entirely amongst these extraordinary pieces of science.

There are important lessons to learn. First, guidelines must in future have the right to say that all the major trials have now been discredited, so there is no longer a recommendation. If we fail to recognise this, we have truly failed our patients.

Second, never again should we pretend that all the experts have agreed on recommendations. It was always unlikely, and in this case clearly ridiculous.

In an interview, Fleisher, the chair of the US guideline, defended the committee’s recommendation of statins. He said that the committee was aware of the limitations of the Durazzo study and that the recommendation was based on the totality of the evidence, including the observational studies. He agreed that there was a significant need for more high quality studies.

Guideline Critics Shift Attacks From Beta Blockers To Statins

Tory critics of Cameron lead battle to chair overall health decide on committee

Tory MP Sarah Wollaston has spoken out against components of the reorganisation of the NHS. Photograph: Martin Godwin for the Guardian

Two fiercely independent female Tory MPs who have been strongly vital of David Cameron above factors of NHS policy will do battle this week to chair the potent Commons overall health choose committee in a close contest that is currently being watched nervously by ministers.

Outspoken former GP Sarah Wollaston and MP for Bristol North West, Charlotte Leslie, have both rallied strong cross-party assistance, pledging to champion patients’ interests, rather than be in the pocket of government or the healthcare profession.

The election of a fearless Tory MP prepared take on ministers where necessary and hold the NHS to account, is an uncomfortable prospect for Cameron in the runup to a common election in which Labour desires to make the well being support a central problem.

On the eve of hustings in the Commons on Monday, Leslie stepped up efforts to win backing from Labour and Lib Dem as effectively as Tory colleagues, by tearing into Cameron and the health secretary, Jeremy Hunt, for refusing to fire former NHS chief executive Sir David Nicholson, and for allowing him to retire early with a “excess fat pension” following the Mid-Staffs care scandal.

“I believe Cameron and Hunt had been definitely wrong not firing Nicholson or forcing him out,” she advised the Observer. “And I am horrified that he was permitted to retire early with such a large pension (£110,000 a year).”

Among 400 and 1,200 individuals died needlessly at Stafford hospital from 2005 and 2009 as a outcome of appalling care. Leslie also criticised a culture of cover-up in the NHS. “We have had sufficient words. If we want modify, we need to start off implementing some correct disincentives for managers to lie, with total force of the legal method.”

Three other Conservative MPs – former cabinet minister Caroline Spelman, former GP Phillip Lee and David Tredinnick, a keen supporter of alternative medicine, have joined the race to realize success former health secretary Stephen Dorrell, who recently announced he was stepping down as chairman.

Right after the 2010 basic election, the system for selecting select committee chairmen and women was taken out of the gift of get together whips and handed to backbench MPs, who jealously guard their new power, seeing the elections as a chance to express their authority above party hierachies.

Beneath a sharing deal agreed for this parliament, the health committee job is reserved for a Conservative but anybody regarded as a mere government loyalist is unlikely to progress in the race.

Wollaston, the MP for Totnes, is regarded by most MPs as the narrow favourite, possessing brought her expertise of the NHS into parliament and shown herself ready to speak out towards aspects of government NHS reforms she thinks had been unwell-conceived.

She has also criticised the way backbench MPs, especially women, have been locked out of decision making – even when they have personal knowledge of policy places, such as hers in the NHS – and has known as for an end to “posh, male and white” cliques about the leader.

Wollaston has described elements of the authentic NHS reorganisation pushed by former health secretary Andrew Lansley as “fully unrealistic” and “doomed to fail” in terms that infuriated Downing St.

Some senior Tories are attempting to paint Wollaston as “Labour’s candidate” – a move her supporters declare is a clear try to harm her campaign, and misrepresents her backing across the events.

Dr Lee is calling for the committee to be utilised as a cross-party forum in which to produce a consensus on how to accomplish reform of the NHS. He says the political cycle does not permit politicians to strategy for the lengthy term.

Tory critics of Cameron lead battle to chair overall health decide on committee

It"s not sexist when opera critics find fault with Glyndebourne"s body fat girls | Man Dammann

Tara Erraught as Octavian and Teodora Gheorghiu as Sophie in Der Rosenkavalier. ‘I’m not right here to defend the option of words some colleagues employed, but no one seeing the performance could fairly fail to comment on Octavian’s look.’ Photograph: Tristram Kenton/Tristram Kenton

‘Break a leg” is a phrase one often hears outdoors theatres and opera houses. Normally, of program, it indicates “very good luck”. At the moment although, it is just as very likely to be meant actually, as a piece of advice for singers on how to deal with opera critics.

At the heart of the storm enveloping my occupation are the remarks manufactured in 5 broadsheet reviews of Glyndebourne’s new manufacturing of Strauss’s Der Rosenkavalier. In a unusual example of unanimity every review, including this newspaper’s, pointed to a problem with the portrayal of the work’s hero, Octavian, who was described variously as “stocky”, “dumpy” – and in the situation of the Fiscal Times, “a chubby bundle of puppy excess fat”. Octavian, a male character but written for a female voice and hence often played on stage by a lady, is a tricky part for a amount of causes, not least of which is that a married princess, a younger bride-to-be and her country squire fiance are all supposed to discover him devilishly appealing, either when he is dressed as himself – a 17-12 months-old playboy aristocrat – or as a chamber maid known as Mariandel. Oh yes, and the actor taking part in this improbable Adonis has to be in a position to sing like a goddess.

In the case of Glyndebourne’s new staging, the director Richard Jones sought to make Octavian seem more a gauche teenager than a self-assured aristocrat. Tara Erraught, the mezzo-soprano cast in the position, was provided a Little Lord Fauntleroy-style, curly wig, a suit also tight in many areas, and “bum-fluff” stubble on her chin. Her Octavian runs against what we assume to be correct about the character, and in so carrying out disrupts our comprehending of why, in every situation, the 3 other characters want so desperately to get into her, sorry I imply his, trousers.

I am not right here to defend the decision of words some of my colleagues used, but no one particular seeing the functionality could fairly fail to comment on Octavian’s physical appearance. Certainly, any reviewer not asking concerns about this exact level would be failing in their duty to hold the manufacturing and its efficiency to account. None of the reviewers involved dispensed gratuitous misogyny. But this is what, in quite a few newspaper articles or blog posts and columns, radio programmes, and in thousands of tweets and Facebook posts, they stand accused of. Which is ridiculous.

Opera critics, writing in the daily press, normally have amongst 300 and 500 words to assessment a manufacturing, so there is fairly a bit of shorthand concerned. And part of that shorthand is a conflated way of talking about stage characters and singers in a single breath.

But even offered far more room, the dilemma would stay. In opera, characters and singers are more difficult to keep apart than in classical theatre. That is simply because opera is also, or even mostly, about singing. And while when seeking at opera we may possibly be furnished with an illusion of stage characters inhabiting dramatic roles, we also encounter in a much more direct way the specific voices of singers who, while acting with their bodies, are singing in their very own voices.

This bleeding of the private into the abstract, and the blurred lines in between theatrical illusion and enhanced bodily presence by way of unamplified voices, may effectively constitute an argument about why opera critics should be much more circumspect than other individuals in their remarks about singer’s physical appearance.

But it is also one of the causes why opera is an art form capable of making amounts of passion, and attractiveness, which are unique between the arts. Certainly, given the form’s uniquely higher manufacturing values, and the possibility for obtaining existence-improving beauty in each and every tiny bodily and conceptual detail arrayed both on the stage and beneath it in the orchestra pit, we need to be straining each sinew in making an attempt to defend it, and its suitable criticism.

It"s not sexist when opera critics find fault with Glyndebourne"s body fat girls | Man Dammann

Optical Express loses bid to near laser eye surgical procedure critic"s web site

Optical Express says rigid recommendations hold the problems charge in laser eye surgery quite low. Photograph: Alamy

High street optician Optical Express has misplaced a battle to have a internet site that strongly criticised its record in laser eye surgical treatment closed down more than what it claimed were defamatory attacks funded by a industrial rival.

The company’s attorneys tried to have the domain area of the internet site, Optical Express Ruined My Existence, eliminated, but the bid was thrown out by the business that registered the campaign site’s identify. Nominet, the web registry company, stated Optical Express’s primary charge – that the site had been set up and funded by its major competitor, Optimax – was “really significant” and not verified.

Optical Express Ruined My Existence (OERML) was set up in April 2012 by Sasha Rodoy, a campaigner searching for tighter regulation of laser eye surgical treatment with the help of Labour MP John McDonnell. Rodoy had previously run a site referred to as Optimax Ruined My Lifestyle, right up until she came to a confidential settlement with the company.

Dismissing Optical Express’s declare, an specialist panel formed by Nominet said allegations manufactured by the firm had been designed to “impugn the honesty and integrity” of Rodoy, who was named as the respondent in the situation.

It mentioned the substance of the allegation was “that the OERML website is not, as it seems, a bona fide protest website operated by the respondent as part of her campaign against what she perceives as deficiencies in the way refractive eye surgical procedure is practised and regulated.

“As an alternative the complainant alleges that the OERML website and/or the respondent are currently being covertly funded by its bitter competitor Optimax, and this is element of a covert campaign meant to harm the complainant and, presumably, to benefit Optimax.”

But it extra: “The panel is unable to attain a discovering that both the OERML website or the respondent are covertly funded by Optimax.

“If the complainant wishes to pursue an allegation of that nature, it should do so in a forum much more appropriate for identifying significant and disputed allegations of integrity and dishonesty against someone who, on the encounter of issues, appears to be pursuing a bona fide protest campaign.”

Rodoy welcomed the choice and said she had set up the internet site after becoming inundated by complaints about the company, which has 93 stores and 54 consultation centres and is the UK’s greatest practitioner of laser eye surgical procedure.

A single complainant, the Observer has realized, is Ken Cocking, 75, founder, with his sons, of the West Cornwall Pasty Firm, which the household offered in 2007 for £40m.

Cocking, who has asked solicitor Geoffrey Simpson-Scott of law firm Colemans to act for him, says Optical Express failed to notice that he was suffering from glaucoma (which is now sophisticated) in the weeks and months after it replaced lenses in his eyes. He informed the Observer that his daily life was “ruined, utterly ruined”.

He explained: “I advised them that my sight was terrible following the operations and they informed me that there was no dilemma. If they had spotted my issue, I could have been caught early.”

A spokesman for Optical Express said it was “very disappointed” by Nominet’s rejection of its case and was unable to comment on Cocking’s claims.

The spokesman additional: “We think we had a really robust case. We are now actively contemplating our choices with regard to pursuing our challenge by means of other avenues.

“While we can’t comment on the specifics of person patient instances due to confidentiality rules, in a case such as this we would offer ongoing clinical care and do every thing in our electrical power to obtain a optimistic outcome for the patient.

“Laser eye surgery vastly improves the day-to-day lives of hundreds of 1000′s of sufferers in the United kingdom each and every year. In a latest survey of more than 97,000 Optical Express patients, much more than 99% mentioned they would suggest Optical Express to household and friends.

“This is demonstrated by the thousands of thank-you cards, emails and tweets we obtain from grateful individuals each and every 12 months.

“Nevertheless, all surgical procedures carry a danger of complication. Due to Optical Express’s stringent guidelines our complication rate is extremely minimal – .7% in a recent analysis of virtually 27,000 laser eye surgical treatment procedures carried out by our surgeons.

“People patients are managed by a crew of clinical authorities that offer skilled and compassionate care, with 96% of them proceeding to obtain 20/20 vision or better as a consequence.”

Nominet’s choice is the most recent blow to Optical Express, which right up until last summer season was feared to be the next huge name on the substantial street to encounter monetary collapse.

The business, which owed a lot more than £30m to RBS, had a request for a even more loan rejected. The largely state-owned financial institution threatened to seize the firm and promote it to recoup its debts till founder David Moulsdale, who is now chairman, agreed to get the group’s exceptional debts.

Optical Express loses bid to near laser eye surgical procedure critic"s web site

On the web device could be employed to recognize public figures" health care care, say critics

OmegaSolver had entry to NHS hospital episode statistics and supplied an ‘internal database [which] tracks real sufferers inside each hospital within England’. Photograph: Luca DiCecco/Alamy

An on-line device that claimed to be able to use NHS patient hospital data to reveal treatment “appropriate from preliminary diagnosis until the current day” has been pulled from the web right after privacy campaigners warned it could be employed to determine the exact particulars of healthcare care for people in the public eye.

OmegaSolver, a organization founded final yr, had access to NHS hospital episode statistics and supplied an “internal database [which] tracks actual sufferers inside of every hospital within England providing … up-to-date data for every illness spot”. The firm explained its clients integrated drugs companies.

However, the firm’s site was closed down last week following press inquiries to the well being authorities relating to the release of “patient-level” information to the company.

On Sunday it had emerged that a billion NHS patient data have been offered to a subsidiary of Chime Communications, a single of the country’s greatest PR and marketing and advertising companies, which had been functioning with the pharmaceutical sector.

These revelations will place stress on to the Overall health and Social Care Details Centre (HSCIC), the arm’s-length entire body set up to house all of England’s patient information, which says it will release within a fortnight the complete record of organizations, government agencies and charities that have been handed medical information.

Privacy campaigners explained that if the OmegaSolver on-line tool’s claims had been appropriate then the health care histories of individuals in public daily life could very easily be tracked. Phil Booth of MedConfidential pointed out the date when the Labour leader, Ed Miliband, had surgical procedure on his nose to deal with a sleep issue and the hospital exactly where the operation took spot had been in the “public domain”.

“It seems to be like anyone with entry [to the on-line device] could pinpoint and read through off the health-related histories of prominent political figures or pretty significantly anyone who’s had an accident or health care method reported in the press or on the internet. Nick Clegg’s wife’s broken elbow, Tony Blair’s catheter ablation, Ed Miliband’s nose operation – all reported in the media, providing adequate info to spot one occasion and then read across their each and every hospital visit. Ministers and officials declare your information will be anonymous, but it isn’t.”

In response the business explained that its Patient Analyser device, which seemed to track personal sufferers, was an “illustrative instance only”.

It added: “Privacy of the personal is one particular of the basic concepts which underpins the terms and problems governing access to this data, and OmegaSolver takes its commitment to preserving patient confidentiality quite seriously. Measures are in location to make confident that the identity of a patient is in no way found. OmegaSolver has access to data products and examination and makes these available for grouping and linkage functions only.”

The HSCIC said the company had taken down its web site. In a statement the centre stated: “We have been in get in touch with with OmegaSolver and, although discussions are ongoing, they have assured us that the screengrab offered demonstrates aggregated patient information and does not represent the expertise of an personal.”

Nonetheless, the details centre came beneath fire from MPs on the potent health pick committee in excess of its obvious reluctance to get action.

Barbara Keeley, a Labour member of the committee, stated: “We have noticed examples of organisations promoting applications which website link and then show comprehensive info about individual sufferers. It is clear that this data could be linked with other data about that man or woman which means the state of their overall health could then be tracked.”

“Examples have been offered of politicians and their family members who obtained publicity when they had an accident or an operation and were handled in the NHS. If media or social media reports on them can be linked with hospital patient data to track the state of that person’s health, it is of very real concern.”

“It is disturbing that patients are nonetheless being left in the dark about industrial utilizes of their confidential health information. I am asking concerns of wellness ministers about business re-use licences and regardless of whether these will now be revoked and the patient information deleted. I am also asking for audits to be accomplished so that individuals can be reassured that their confidential healthcare details is no longer becoming commercially exploited.”

On the web device could be employed to recognize public figures" health care care, say critics