Government fails to commit to diesel scrappage scheme in UK clean air plan

The government’s new plan to tackle the UK’s toxic air crisis does not commit to a scrappage scheme for dirty diesel cars and places the largest burden for solving the problem on to local authorities.

These could impose charges on older diesel cars to keep them out of polluted areas, but the government said other measures should be considered first.

Ministers were forced to act after a series of humiliating defeats in the courts, which ruled earlier plans illegal. ClientEarth, the environmental law firm which sued the government, is now examining the new proposals and could go back to court again if it decides the measures will not reduce illegal levels of air pollution in the “shortest possible time”, as the law demands.

Levels of nitrogen dioxide, emitted mostly by diesel vehicles, have been above legal limits in almost 90% of urban areas in the UK since 2010. The fumes are estimated to cause 23,500 early deaths a year and the problem was declared a public health emergency by a cross-party committee of MPs in April 2016.

The government first lost to ClientEarth over the adequacy of its strategy in April 2015 and was ordered to come up with a new plan. The release of these proposals was buried on the September Saturday in 2015 when Jeremy Corbyn was first elected Labour leader, while the final plan was published on “take out the trash day” in December that year, along with dozens of other ministerial statements and many hundreds of government documents.

However, the plan included just six clean air zones (CAZs) – Birmingham, Leeds, Nottingham, Derby, Southampton and London – where some polluting diesel vehicles would be charged to enter city centres. ClientEarth, believing this to be inadequate, went back to court and won again in November 2016.

Court documents revealed that the Treasury, then run by George Osborne, had blocked proposals from other government departments for 16 CAZs in towns and cities blighted by air pollution, due to concern about the political impact of angering motorists. Both the environment and transport departments also recommended changes to vehicle excise duty to encourage the purchase of low-pollution vehicles. But the Treasury also rejected that idea, along with a scrappage scheme for older diesels.

The government continued to delay action, asking the court for 10 months to develop another new strategy, but lost again, with the judge ordering a new draft plan by 24 April and a final plan by 31 July.

However, ministers then argued that the tradition of “purdah” before elections, when no official announcements are made, should allow the postponement of the strategy until after the general election on 8 June. This was again rejected, with Mr Justice Garnham saying: “The continued failure of the government to comply with directives and regulations constitutes a significant threat to public health.”

Conservative ministers have sought to blame previous Labour governments for giving tax breaks for diesel cars, which produce less climate-warming carbon dioxide. But experts say all governments since the 1990s have done this.

Furthermore, government officials at the time were aware that diesel cars produce high levels of NO2 but they expected tightening EU emissions regulations to curb the problem.

However, car manufacturers found ways to circumvent the rules and across the industry produced vehicles that emit far more NO2 on the road than in the official lab-based tests. Transport campaigners argue that, as in Germany and France, car makers should be forced to pay for upgrades to their vehicles to cut pollution.

“The real villains here are the car companies who cheated tests, and lied to everyone about the pollution coming from their diesel vehicles,” said Greenpeace’s Areeba Hamid. “Drivers are right to feel conned, but what we can’t do is carry on letting these dodgy diesel cars pollute our towns and cities with toxic air.”

Government fails to commit to diesel scrappage scheme in UK clean air plan

If general practice fails, the whole NHS fails | Kailash Chand

Anyone who has visited their GP recently will be aware of the pressures: the struggle to get an appointment, the difficulty of seeing the same GP more than once, the rush to get you out of the door for the next patient.

The crisis in general practice is unprecedented. The health secretary, Jeremy Hunt, fails to understand the seriousness of the situation facing general practice in England.

There are now 8,000 GP practices in England – one in 20 has disappeared since 2010. The rate of loss of local surgeries has increased. There has been a fivefold rise in the number of GP surgeries approaching senior NHS managers for advice about shutting their doors or merging with nearby practices. Furthermore, a freedom of information request by Pulse magazine revealed 58 practices closed in 2016, with a further 34 shutting because of mergers.

The failure to acknowledge the crisis facing GP services – an under-resourced, over-stretched shell of their former self, struggling to keep pace with patient demand despite the efforts of their staff – could finish off the general practice, “the jewel in the crown of the NHS”, in next few years for good. Hunt never tires of saying GPs are central to his vision for the NHS. But the gap between policy rhetoric and reality has never been starker.

The NHS has the most stressed GPs by western standards, as a result of relentless workloads, endless bureaucracy and the shortest time spent with patients. We have been squeezing the lemon for all sorts of healthcare needs for years. But it is getting to the stage where there is nothing left to squeeze.

The government is asking GP practices to provide more services, including many involving the transfer of hospital care into the community, without the resources required to successfully deliver them. And now, NHS England wants 12 hours a day, seven days a week opening in general practice.

There are not enough GPs to cover current working hours. The colleges want 10,000 more GPs to service the present demand. The promise of 5,000 new GPs not only ignores the fact that the pressures of the profession are putting medical graduates off joining, but also that it takes a good eight to 10 years to train. Practically, it’s not possible to pull so many GPs out of the hat.

Despite all this, Hunt talks of more care in primary care, more access, initiatives and ideas – ignoring the workforce crisis, a funding disaster and the committed GPs facing burnout. General practice’s share of the NHS budget has fallen progressively in the past decade, from a high of 11% in 2006 to less than 8.5% now. Many practices will see further reductions over the next three years, forcing further closures. A combined financial and staffing crisis could cause chaos in primary care for years and ultimately kill off general practice for good.

The root cause of the crisis is this unprecedented combination of rising patient demand and declining resources. Practice incomes have been frozen for several years and this has led to real net incomes dropping by more than 20% since the introduction of the GP contract in 2004. Practices are being brought to their knees by this unprecedented fall in money for primary care and rising demand for GP services. Primary care is imploding faster than people realise and patients are already bearing the brunt of the problem.

General practice is the bedrock of many NHS services and the gatekeeper to the rest. We can either confront the realities facing practices and make plans now to meet growing challenges – or we can bury our heads in the sand and watch this key part of the health service slide into terminal decline.If general practice fails, the whole NHS fails.

Join the Healthcare Professionals Network to read more about issues like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If general practice fails, the whole NHS fails | Kailash Chand

Victorino Chua: "angel turned evil" hospital nurse fails in appeal bid

A hospital nurse who murdered two patients and poisoned others has failed in a bid to challenge his conviction and sentence.

Victorino Chua was jailed for life with a minimum term of 35 years in May last year after being convicted by a jury at Manchester crown court.

His applications for permission to appeal against both conviction and sentence were rejected on Thursday by judges at the court of appeal in London.

The father of two, 50, who was described by police as a narcissistic psychopath, injected insulin into saline bags and ampoules while working on two acute wards at Stepping Hill hospital, Stockport, in June and July 2011.

These were unwittingly used by other nurses, causing a series of insulin overdoses to mainly elderly victims.

When the self-styled “angel turned evil” was sentenced, the trial judge, Mr Justice Openshaw, described his actions as “indescribably wicked”. He said it was a “strikingly sinister and truly wicked feature of the case” that Chua did not know who would fall victim to his actions.

Lord Justice Treacy, sitting with two other judges, announced that the one proposed ground of appeal against conviction was not arguable, and rejected an argument that the minimum term of 35 years was “manifestly excessive”.

Victorino Chua: "angel turned evil" hospital nurse fails in appeal bid

Hormone Therapy At Menopause Fails To Halt Heart Illness Progression

More than a decade ago the Women’s Overall health Research made surprising and essential outcomes when it showed that broad use of hormone substitute treatment did not minimize cardiovascular threat in publish-menopausal females. But the study also led to speculation  that hormone therapy  might be beneficial when delivered closer to the time of menopause. Now a review published in Annals of Internal Medicine demonstrates that menopausal hormone therapy (MHT) might have some favorable results on some cardiovascular danger elements but it does not lessen the progression of atherosclerosis.

In the review, called KEEPS (Kronos Early Estrogen Prevention Research), 727 menopausal women were randomized to placebo or one particular of two types of low dose hormone treatment (oral conjugated equine estrogens or transdermal 17β- estradiol). Following four years there was no distinction between the groups in the primary endpoint of the research, which was the progression of atherosclerosis as measured by carotid artery intima–media thickness (CIMT). There was also no big difference in the coronary artery calcium scores. Ladies in the equine estrogen group had enhancements in their lipid profiles (decrease in LDL and increase in HDL) while women in the transdermal group had improved insulin sensitivity. There was no big difference in the incidence of significant adverse occasions.

The investigators supplied several explanations for the findings, like a research population at reduced danger for athersosclerosis, a reasonably quick examine duration, and the use of minimal dose but not large dose estrogen. “To the extent that these imaging strategies predict CVD events, our findings recommend that MHT neither is a chance nor is protective in the population studied,” they wrote. The study was not powered to appear at clinical events.

Andrew Kaunitz, a expert in women’s wellness and menopause at the University of Florida, explained that although it even now remains unclear what the prolonged term effects of hormone treatment will be on cardiovascular occasions, the study “does not assistance using hormone treatment to avert CVD events.”

Hormone Therapy At Menopause Fails To Halt Heart Illness Progression

Mothers at risk as NHS "fails on psychological well being postnatal care"

Andrea Leadsom, economic secretary to the Treasury, suffered ‘traumatic’ depression right after the birth of her initial son. Photograph: Richard Gardner/Rex

The NHS has been criticised for failing women who endure from postnatal depression by denying a lot of of them potentially existence-conserving providers to support them cope.

Freedom of Info Act responses from 193 NHS trusts across England reveal that only 50 supply a professional perinatal psychological well being services to females around the time they give birth and 5 other individuals supply some sort of provision. Much more than half of the trusts disclosed that they do not offer any formal aid, even although 1 in ten mothers experiences postnatal depression.

Even between the 50 trusts operating such a services, 26 utilize only 1 committed perinatal mental health midwife or physician and many of these operate portion-time. Government overall health advisers advisable 7 many years ago that this kind of care should be available all over the place.

The National Childbirth Trust (NCT), which submitted the FoI requests, said it was totally disgraceful that so few parts of the wellness services provided expert assist to females, some of whom finish up taking their personal daily life simply because they are not able to cope. “The Good [Nationwide Institute for Wellness and Care Excellence] suggestions have been in location for 7 years, so it appalling that they are nevertheless not being properly implemented,” mentioned Belinda Phipps, the NCT’s chief executive. “It is the identical old issue of the NHS recognising physical demands of mothers but failing to recognise their psychological health demands. It is completely disgraceful, when we know that one in ten mothers endure some type of postnatal depression, that there are enormous areas of the country with no provision for their care.

“That is a good deal of girls getting let down by the NHS every year, specially when we know that maternal suicide is a top result in of death in the very first yr right after childbirth,” she explained.

The place is even worse between GP-led clinical commissioning groups, which distribute £66bn a year of the NHS’s £110bn budget and perform a key function in influencing what services are offered locally since they pay out for patients’ care.

Only 5 of 194 clinical commissioning groups previously have a technique for supplying perinatal mental overall health companies, though yet another 34 are creating or planning to create one, in accordance to responses to FoI requests. Health minister Dr Dan Poulter said final year that “expert psychological overall health doctors and midwives are vital in assisting females at risk of suffering from depression”. In 2007, Wonderful issued advice saying that any female depressed following giving birth should get such aid.

While some locations supplied outstanding care, “too typically we have found scenarios exactly where there is no care or quite minor. If there are total areas in which GPs, midwives and well being visitors have no instruction or time to dedicate to this crucial support, females will not get the support and help they want to cope,” Phipps mentioned.

“For numerous parents this will end result in months of misery, damaging both family members relations and children’s wellbeing. In the most intense situations it will outcome in tragedy and loss of existence.”

Last week Andrea Leadsom, the financial secretary to the Treasury, disclosed she had suffered postnatal depression following her first son’s birth, when she was a banker at Barclays, and found it “very traumatic”. More must be accomplished to support ladies with psychological unwell-overall health after they have provided birth to lessen the risk of domestic violence or the child going through “utterly life-altering consequences”, she explained.

Rebecca Cotton, director of psychological well being policy at the NHS Confederation, which represents hospitals, conceded current solutions had been far as well thin on the ground. “We should make certain that each new mom who requirements it is ready to entry mental wellness help,” she added. “This needs to be a priority for the NHS. The consequences of not obtaining it correct can be devastating for mothers, their youngsters and households.”

“Across the nation there are some excellent specialist perinatal psychological well being solutions providing wonderful help. Sadly, there just aren’t ample”, Cotton stated. The confederation says such providers want to be universal in purchase to determine females at chance of or previously suffering from birth-related psychological health issues and deal with them.

Poulter, who still functions part-time as an NHS obstetrician, urged the NHS to give such care a lot higher importance. He has taken a specific interest in maternal mental unwell-wellness and on Tuesday is hosting the newest in a series of roundtable debates at the Division of Health with crucial stakeholders to try out and improve the predicament. Much more needs to be accomplished to give females who need to have it help wherever they dwell, he stated.

“Healthcare systems across the globe have prioritised bodily in excess of mental wellness in maternity for also long,” he advised the Observer. “But we are generating progress in England. From following 12 months mental well being instruction will be obtainable for all midwives, so there are professional staff accessible for every single birthing unit across the nation by 2017.

“Coaching inevitably requires time, but that ought to not cease the NHS acting now to improve care. I urge units across the country to do almost everything they can to help mums’ mental well being,” he said.

Mothers at risk as NHS "fails on psychological well being postnatal care"

Role-play exam for GP trainees fails equality and race bias test, court informed

Karon Monaghan, for the British Association of Doctors of Indian Origin, says the clinical expertise evaluation ‘risks subjective bias’. Photograph: Matrix Chambers

A crucial element of the examination process for GP trainees is racially discriminatory, a court has heard.

The British Association of Doctors of Indian Origin (Bapio) has brought a higher-court action towards the two the Royal School of General Practitioners, which conducts the clinical capabilities assessment (CSA), and the Basic Medical Council, which is accountable for guaranteeing a honest procedure.

At the start of the hearing in central London on Tuesday, Karon Monaghan QC, for Bapio, explained the Royal College’s yearly reports showed that United kingdom graduates from ethnic minority backgrounds have been nearly four occasions more very likely to fail the CSA, and worldwide medical graduates were nearly 15 occasions more probably to fail than white Uk graduates. Nevertheless, nothing at all had been carried out to address the disparity.

Monaghan explained: “The situation arising in this claim is whether, in continuing to adopt and apply the CSA and exit examination for those in search of to join the register of GPs, the defendants failed to comply with the public-sector equality duty and, in the situation of the initial defendant only, is racially discriminatory.”

The CSA was introduced in 2007 to change an existing assessment. It varieties portion of the exit exams taken at the end of 3 many years of vocational education and involves function-enjoying assessments.

Monaghan said it “dangers subjective bias by hunting at a individual and assessing whether or not this particular person communicates [effectively] or not”. She suggested that BME (black and minority ethnic) candidates were significantly less likely to possess the linguistic and cultural capital that would enable them to tell the examiners “what they want to hear”.

She extra: “It really is not ample to say, ‘we are treating you all the identical way’, due to the fact BME candidates could be starting up from a various place.”

Global healthcare graduates had been mainly Indian and Pakistani, the court heard.

Monaghan stated the CSA had “the effect of treating particular racial groups less favourably”.

She explained that the disparate outcome was adequate in establishing indirect discrimination and that it was for the RCGP to display that this was a consequence of non-racial grounds.

The judge, Mr Justice Kenneth Parker, advised that the discrepancy between Uk and non-United kingdom college students could be down to the latter acquiring inferior schooling overseas.

The RCGP and GMC both deny the claims. The hearing is expected to last three days.

Role-play exam for GP trainees fails equality and race bias test, court informed

Shocking Discovery: Seventh Generation fails Toxicity Test

I’ve determined the only way to take away items with toxins from our family is to not purchase ANY merchandise whatsoever.  I’m so amazingly annoyed proper now with companies, labeling, government agencies and the common public in regards to enabling identified harmful toxins to finish up in just about everything we use.  In which it just went completely south for me is that even people companies out there marketing themselves as primarily based on toxin cost-free ideas are failing miserably.

Here’s a extremely shocking discovery I created right now whilst researching organizations we can trust to supply us with merchandise you don’t have to read through the labels on.  I imagined that Seventh Generation whose mission statement is: To inspire a buyer revolution that nurtures the wellness of the subsequent seven generations would be one particular of these businesses.  They checklist all the methods they are lobbying for toxin totally free items and a greener, safer world for our potential generations but when I put in a record of their goods into EWG merchandise security guidebook quite a few of their merchandise do not pass the toxicity test! Even though launching a large PR campaign with cute minor youngsters sporting super hero capes and masks with the slogan “Join the Toxin Freedom Fighters” all the although producing merchandise that don’t come shut to producing the grade. In which has the idea of social conscience and integrity gone?

Seventh Generation Automatic Dishwashing Gel, Lemon.

When I place this merchandise into the EWG Item Safety rating method it obtained an F.  This is on a scale of A – F (A becoming ideal and F essentially failing the toxicity check).

Ingredient Health, Environment, and Disclosure Worries

SODIUM BORATE  Substantial Concern: developmental/endocrine/reproductive effects Some Concern: skin irritation/allergic reactions/injury, respiratory results (EWG Score F)

METHYLISOTHIAZOLINONE  Large Concern: acute aquatic toxicity Some Concern: skin irritation/allergies/damage  (EWG Score D)

Seventh Generation Natural 2X Concentrated Liquid Laundry Detergent, Cost-free &amp Clear (EWG Score D)

And most of the  seventh generation all normal, supposed to be excellent for you and higher priced cleaning products acquire a EWG Score of D.

I subscribed to Seventh Generation’s updates and on the bottom of the welcome electronic mail there was this tiny Quite DISTURBING footnote:

All Seventh Generation products are not acutely toxic and are free of charge of persistent toxicants these and all other solution advantages are plainly promoted to our shoppers.

Sorry, but what the heck does NOT ACUTELY TOXIC mean?

Following coming to this realization that even those out there making an attempt to be better and healthier are genuinely just about selling more item.  I have made the decision that we should all be referred to as to make our personal Everything from things we develop or acquire from somebody we know and trust.  I’m positive a lot of of you readers of Normal Information have already come to this conclusion and are undertaking just that. I believed I could help my readers by delivering the identify of organizations that are truly providing us with toxin cost-free items would not be this kind of an extremely hard activity.

I do encourage you to get the quite valuable app from EWG or use their online manual to be much more informed about the merchandise you use. You can get the EWG Skin Deep App here!

The Organically Clean House: 150 Everyday Organic Cleaning Goods You Can Make Yourself–The Natural, Chemical-Cost-free Way

Connected Site: Toxic Totally free Homes

http://www.ewg.org/guides/search?page=1&ampper_page=15&ampq=seventh+generation&amputf8=%E2%9C%93&ampx=47&ampy=10

Pass this on and please checklist in the feedback any merchandise and/or businesses you think can actually be trusted!

Shocking Discovery: Seventh Generation fails Toxicity Test

Ultimate push to reinstate wellness meals rating web site fails

A last push to reinstate the wellness food rating web site which was pulled down by the assistant overall health minister’s office has failed in a closed-door meeting.

The Front-of-Pack Labelling (FoPL) Oversight Committee met on Monday to examine the implementation of the wellness foods rating method which could see foods rated on its nutrition utilizing stars. The system nevertheless hinges on a choice to be manufactured by state and federal health ministers in June.

It is understood there was a push in the meeting by some to reinstate the well being foods rating internet site but it was shot down with the final decision getting it would not be re-launched right up until at least June.

Opponents of the site’s launch argued that without a style manual the foods rating site could be complicated for buyers and companies.

The assistant well being minister, Fiona Nash’s chief of employees Alastair Furnival resigned last month following intervening to have the internet site pulled when it went live for a number of hours. It emerged he had a stakeholding in his wife’s lobbying firm which represented junk food businesses.

There has been speculation the entire food rating program – commenced by the former Labor government – will be scrapped or watered down but members of the committee emerged optimistic right after meeting for about 6 hours.

Geoff Dobb from the Australian Healthcare Association stated it was “certainly possible” the meals labels could begin to be introduced on goods by the middle of the year.

“The meeting was in the spirit of co-operation with a concentrate on getting the meals star rating program completed by the middle of this 12 months,” he explained.

When asked about the website Dodd mentioned the committee was not on a “witch hunt” and there was “recognition there was some incomplete details, in particular in the design manual, which was a fundamental part of the system”.

“People require the type guidebook so they know what they’re hunting for and what it implies,” he said.

“There’s nonetheless more operate to be completed on finalising the type guide.”

Dodd explained there had been some “minor anomalies” that needed to be worked out prior to the wholesome meals star rating program was ready to be launched.

When asked for an illustration he said there have been issues with how dairy items have been rated that required to be worked out with some things such as custard receiving larger star ratings than merchandise such as cheese.

“We now have in location a procedure to get us via that and see if there are in truth anomalies and how to resolve them,” he explained.

A price-benefit evaluation is currently being undertaken which the ministers will discuss at their June meeting.

Dodd said the cost-advantage evaluation was not going to be a “show stopper” but it has garnered some criticism from other members of the committee.

One particular member, who did not want to be named, stated the analysis was getting viewed with considerably scepticism by supporters of the meals rating technique.

“How do you do a quality cost/advantage examination when the benefit in preventative well being is so difficult to quantify and the expense to to food organizations is so effortless to quantify?” they told Guardian Australia. They said they were content overall with the direction of the meeting.

A spokesman for the Australian Meals and Grocery Council, which represents packaged meals, drink and grocery goods, stated the committee was working in direction of implementing the technique.

“There was a constructive agreement to set up a framework for addressing the anomalies in the algorithm, the design guide and design,” he mentioned.

A spokeswoman for client group Decision echoed the sentiment saying they had been satisfied a framework was getting implemented to deal with anomalies in the method.

The committee is also manufactured up of representatives from government departments of health as well as the Public Health Association of Australia, the Australian Nationwide Retailers Association and the Australian Business Group.

Ultimate push to reinstate wellness meals rating web site fails

Alder Hey children"s hospital fails 4 in five standards checks

The Care Quality Commission identified ‘very worring problems’ at Alder Hey, like managers allegedly not listening to theatre workers complaints. Photograph: Christopher Thomond for the Guardian

A single of England’s 4 kids-only hospitals has “extremely worrying troubles” in its working theatres, in accordance to security watchdogs.

Alder Hey in Liverpool failed to meet 4 of five nationwide standards checked by inspectors from the Care High quality Commission (CQC) in December. There was a faulty emergency phone alarm method, possible safety incidents, and “close to misses” went unreported, while operations had been cancelled due to the fact of employees shortages.

There were also issues in the theatres about lack of ample gear to keep track of patients and poor maintenance checks.

Staffing problems meant that individuals in the theatre recovery spot following surgery had been at improved risk, too.

There have been also complaints from theatre workers that managers did not pay attention to their “repeated issues”. Some wards at the hospital did not have ample certified, skilled and experienced staff, in accordance to the CQC.

The CQC’s regional director, Malcolm Bower-Brown, said: “The troubles we recognized at the Alder Hey hospital are very worrying. We have advised the believe in the place more action have to be taken to make sure national specifications are met and that patients acquire the good quality of care they are entitled to assume.”

The unannounced pay a visit to by the CQC in December came right after it was alerted by theatre workers more than their issues about standards. Its report fails the hospital on care and welfare of individuals making use of its services, staffing, support of employees and high quality monitoring. Cleanliness and infection management met nationwide specifications.

A report by the hospital’s director of nursing, Gill Core, had presently warned of shortcuts in security processes, “restricted reporting of incidents”, and a belief among staff that senior managers condoned the working circumstances.

Two years ago, the Royal University of Surgeons warned that relations within the surgical department had broken down, even though total surgical efficiency was protected.

Louise Shepherd, chief executive of the basis hospital trust, explained there was “no evidence that individuals have been harmed as a consequence of these concerns and we continue to be assured that we are providing a safe service for our youngsters and youthful people”. An action plan had already been created and “many” components of it implemented.

But Shepherd stated it was regrettable that a small number of the theatre staff felt they had had to speak to the CQC about how they had been supported at operate. “Theatres by nature are extremely stressful, demanding operating environments and we are also facing an increased demand on our solutions,” she added.

Alder Hey children"s hospital fails 4 in five standards checks