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

NHS tainted blood scandal: scheme to compensate victims to be scaled back

A scheme to compensate the victims of an NHS blood contamination scandal is to be scaled back under government plans announced on Monday.

Ministers believe the reforms are necessary because more people are now considered likely to develop serious health issues – and be entitled to higher payouts – pushing the programme as much as £123m over budget.

The government has proposed measures that would cut predicted costs, including limiting the availability of the higher level of financial support under the scheme.

Campaigners said they had significant concerns about the proposed changes. While the Haemophilia Society welcomed the greater clarity, it said it was not confident that the government would achieve its aim of ensuring that no one who received an annual payment would be left worse off.

The scheme was set up to compensate the victims of the tainted blood scandal in the 1970s and 80s, during which thousands of haemophiliacs were mistakenly given blood contaminated with hepatitis C.

“In July 2016, estimates suggested that the reform would be affordable,” the government’s review said. But the Department of Health now believes that more people with pre-cirrhotic hepatitis C would benefit from the scheme’s higher tier of payouts than previously forecast. “Under new assumptions, the reforms would lead to an estimated overspend of between £76m and £123m,” the department’s impact assessment says.

In a bid to cut costs, the health minister Nicola Blackwood outlined plans to limit the highest level of financial support under the new scheme to those infected with hepatitis C who have developed advanced liver disease. A £50,000 lump sum would no longer be offered to those with less advanced infections.

Other changes include dropping plans to introduce a fixed increase in annual payments and reducing the budget available for discretionary payments.

In a written ministerial statement, Blackwood said: “The government does not anticipate that there will be any reduction in current spending as a result of the consultation proposals. No one who currently receives an annual payment will be worse off than they are now as a result of the proposed changes to the annual payments.”

In July, the government unveiled plans to add £125m of funding to its compensation scheme, more than doubling the DoH’s annual spend on the scheme to 2021. That included the new special appeals mechanism for those with chronic hepatitis C infection.

The six-week consultation runs until 17 April.

NHS tainted blood scandal: scheme to compensate victims to be scaled back

NHS ID scheme could deter eligible patients, say MPs

A pilot scheme in which patients are asked to show two forms of identification before receiving NHS treatment could compromise access to care, parliament’s spending watchdog has said.

The public accounts committee urged caution before officials extend the scheme, saying it could lead to entitled patients staying away from hospitals. The MPs have also told the Department of Health to take urgent action to renew a “chaotic” system of recovering money from so-called health tourists.

Trusts are supposed to charge visitors from outside the European Economic Area and Switzerland for non-emergency hospital treatment. For patients from the EEA and Switzerland, trusts should recoup their costs through an insurance scheme.

In November the department’s permanent secretary, Chris Womald told the committee that ID checks were taking place at a hospital trust in Peterborough, an area with a high number of immigrants.

Patients are asked to show passports and utility bills but the committee says in a report: “These documents do not demonstrate entitlement to free NHS care. The biggest challenge is that there is no single easy way to prove entitlement.”

The MPs also point out that some UK-based patients would struggle to bring in such documents. “We are conscious that some people who live in this country and are eligible for free healthcare may struggle to provide passports and utility bills and it is important that their access to care is not compromised,” the report added. “The department should consider a system that would allow verification without compromising patient care.”

The report recommends extending the use of NHS numbers and electronic patient records. “This could help tackle both the very low levels of cost recovery for European Economic Area and Swiss patients, and the problem that some people resident in this country may find it hard to show documents that indicate their entitlement,” it said.

In evidence to the committee, the health department admitted “very little happened” for more than 30 years after legislation was introduced in 1982 to recover money from overseas patients.

In 2014/15 the UK recovered £50m from other European countries and paid out £675m. The health department has set a target to recover up to £500m a year by 2017/18, but forecasts that only £346m will be charged.

The report calls on GPs to do more to help identify patients who should be charged for NHS care following a referral to hospital. It points to a wide variation between NHS trusts in debt collection rates, from 15% to 100%. Just 10 out of 154 hospitals accounted for half of the charges to visitors from outside the EEA – the EU plus Norway, Iceland and Liechtenstein – and Switzerland in 2015/16.

Departmental officials say there will be policy changes and improvements to IT, but admit they have much more to do to enforce the rules.

A health department spokeswoman said other trusts were trialling the scheme piloted in Peterborough, and still more were exploring their own ways of identifying patients.

“We will be announcing further steps very shortly to recover up to £500m a year by the middle of this parliament,” she added.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, welcomed the committee’s report. She said: “It is the role of GPs and our teams to deliver care to our patients, free at the point of need, regardless of their individual circumstances. We must stop perpetuating this idea that general practice should, in whatever way, assist with border control.”

Dr Mark Porter, chair of the British Medical Association, said his members had also raised concerns. “Any charging systems should not prevent sick and vulnerable patients receiving necessary care, otherwise there may be serious consequences for their health and that of the public in general,” he said.

The MPs’ report concludes that the department should publish an action plan by June complete with milestones and performance measures for increasing the amount of revenue from foreign users of the NHS.

Meg Hillier, the chair of the public accounts committee, said it was unacceptable that so much money owed should continue to go uncollected. “This is a problem for the health service as a whole and work to put it right must be driven by central government,” she said.

“We are concerned that financial progress to date does not reflect meaningful progress with implementing the rules and the Department for Health and NHS have much to do if they are to meet their target for cost recovery.”

NHS ID scheme could deter eligible patients, say MPs

GPs get £20m scheme to help them cope with stress

Family doctors with heavy workloads are to receive specialist help to cope with the stress of their jobs in a groundbreaking new NHS initiative.

All 55,000 GPs in England will be able to seek counselling or medication from mental health nurses and psychiatrists in a £20m scheme to keep them healthy. The NHS GP Health Service will be trialled in 13 areas and then rolled out nationally if it proves its worth.

NHS England is encouraging family doctors who have become addicted to drink or drugs as a result of difficulties in their personal or professional lives to refer themselves for treatment.

The GP Health Service is the first support system of its kind in the world, aiming to tackle anxiety, depression and feelings of hopelessness among doctors. It is hoped that GPs who get emotional and psychological support will be less likely to go on sick leave or quit the profession because they feel they can no longer withstand the pressures involved.

Professor Sir Bruce Keogh, NHS England’s national medical director, told the Observer: “Being a GP is tough. It requires a deep knowledge of medicine and an ability to separate the serious from the trivial, coupled with compassion. As the number and complexity of consultations grows, so does the stress of the job. This takes its toll.

“Both sickness and early retirement rates are rising. These pilot schemes aim to offer help on both fronts to key members of the profession who contribute so much to the lives of so many. Helping struggling GPs means a happier, healthier workforce and in turn a greatly improved service for patients,” he added.

Dr Helen Stokes-Lampard, chair of the council of the Royal College of GPs, said: “Being a GP can be incredibly stressful, so it’s no wonder the intense resource and workforce pressures currently facing our profession are increasingly taking their toll on the mental health and wellbeing of family doctors.”

The new scheme is based on the Practitioner Health Programme (PHP), which has been offering mental health support to both GPs and hospital doctors for the last nine years. NHS England is giving the Hurley Group of GP surgeries, which runs the PHP, almost £20m over the next five years to provide the same help to any family doctor who feels they would benefit.

Dr Clare Gerada, a partner in the Hurley Group, said that 80 of 100 doctors the PHP has treated for addiction problems have been able to go back to work afterwards. Similarly, 75% of those with bipolar disorder have returned to the frontline after receiving up to six months of treatment themselves.

The PHP helped one GP, who only wanted to be known as Dr S, who was already struggling to meet demand for patient consultations and neglecting his family life after one of the partners in his busy urban practice retired, when he received a complaint from a patient. That led to Dr S having sleepless nights and feeling that he had let down his partners. His morale declined, he lost his confidence and eventually handed in his notice. After getting help from the PHP, though, he came back to work.

“I had lost my love for the GP job, a job I had wanted to do all my life. I thought it was time to walk away but thanks to PHP I now feel I have brought the enjoyment back into the role,” he said.

“I am relishing my responsibilities and enjoying every day. I would have been a GP on the rubbish heap if it wasn’t for this kind of support service.” He now helps his colleagues at the surgery manage what many GPs describe as the relentless demands on their time and the need to make key decisions about patients’ care and treatment.

GPs will refer themselves to the service. Each of the 13 pilot areas will have a regional network of experienced doctors and therapists. Callers will receive a telephone assessment within 48 hours and then a more detailed face-to-face assessment close to their home, but not at their surgery to protect their privacy. Staff will deal with a range of mental health conditions, although they will leave existing NHS services to handle eating disorders and serious depression.

GPs in Oxfordshire caused a row last week when they revealed they were examining ways of boosting their funding, for example by charging patients for providing appointments outside of normal surgery hours and carrying out minor surgical procedures, such as vasectomies.

Official NHS figures last week showed that the number of full-time equivalent GPs working in England had fallen over the last year, despite the government’s pledge to recruit 5,000 more by 2020.

NHS Digital revealed that the family doctor workforce comprised 34,495 full-time equivalent GPs in September, 97 fewer than a year earlier.

Stokes-Lampard warned that high vacancy rates in GP surgeries were having “a real human impact on our entire practice teams and our patients. We are already running on empty and in many cases working at the absolute limit of what is safe,” she said.

GPs get £20m scheme to help them cope with stress

Government failing on violence reduction scheme by means of A&E departments

A violence reduction sheme involving A&ampE departments sharing anonymised data with police has not been fulfilled. Photograph: Bethany Clarke/Getty Images

Ministers are failing to fulfil a coalition pledge to roll out a violence reduction scheme that has been proven to reduce attacks by as much as 40%, top accident and emergency surgeons claim.

The Tories and Liberal Democrats agreed in 2010 to introduce the nationwide scheme, which involves A&ampE departments sharing anonymised data about violent incidents with police forces, enabling problem spots to be targeted.

But as handful of as a third of A&ampE departments in England have completely adopted the programme, which was pioneered in Cardiff 20 many years ago and has been copied as far afield as South Africa and the US.

Department of Wellness officials have created it clear that A&ampEs ought to share info with police, but a spokesperson admitted it basically did not know how a lot of hospitals have been working the model. It is undertaking a assessment this summer season to discover out.

Dr Adrian Boyle, chair of the good quality in emergency care committee of the University of Emergency Medication (CEM), said he was annoyed at the lack of progress. “The implementation is not functioning as effectively as we would have liked,” he mentioned. “It is aggravating.”

Boyle, an A&ampE consultant who has worked closely with the Division of Wellness and NHS England to get the system up and running, referred to as for the government to give hospitals incentives to introduce the scheme. He mentioned there was a wariness within hospitals about workers to liaising with experts “out of their silo”. The reorganisation of the NHS may possibly also have hampered the programme, he said.

An audit two years in the past discovered two-thirds of A&ampE departments were not sharing information to the standard advisable by the CEM. Boyle mentioned he did not feel the new audit would present any progress.

The architect of the unique Cardiff scheme, Jonathan Shepherd, professor of oral and maxillofacial surgery at the Cardiff school of dentistry, expressed concern at the slowness of the adoption of the model.

He mentioned there was even now as well great an acceptance of “schedule” street violence. “Folks grow to be immune to the concern and the social catastrophe it represents. For health-related personnel, police and local authority employees it becomes a schedule portion of what transpires when you’re on shift at the weekend.

“Pros are used to getting reactive, suturing folks up and arresting offenders rather than taking a a lot more preventative approach. I’m not shocked it is taking some hospitals so prolonged [to adopt the Cardiff model] and others aren’t doing it properly.”

Shepherd’s thought stemmed from research he did in the 1980s which located only a quarter to a third of violent incidents resulting in a journey to A&ampE come to the interest of the police. He realised that for forces to have a full image of what was happening they ought to know about all situations of emergency treatment.

His scheme – the Cardiff violence prevention programme – launched in 2003. Hospital personnel recorded anonymised information of where, when and how a victim had been attacked. This info was shared, making it possible for maps of violence hotspots to be developed and the organisation of operations to tackle the problem.

The outcomes were striking. Inside 5 years there had been an estimated 42% fewer woundings in the Welsh capital in contrast with similar cities.

There was a 35% decrease in the number of sufferers seeking emergency treatment method and one particular study place the savings in economic and social expenses at just below £7m a 12 months. For every £1 invested on the scheme, £82 was saved.

Shepherd mentioned he realised the scheme was working when the price of violence in Cardiff, a well-liked get together city, dropped to amounts noticed in towns this kind of as Eastbourne and Harrogate. Shepherd advised the government essential to do more to fulfil its coalition agreement guarantee. He explained: “In the runup to the 2015 election I feel people will want to be reassured that this government commitment has come to fruition.”

Shepherd’s model or variations of it are in place in Amsterdam and the Western Cape in South Africa. Milwaukee in the US has also been investigating it.

Alun Michael, a former Labour minister and now police commissioner for south Wales, was also surprised that a lot more hospitals had not adopted the model. “Analysing incidents which brought victims of violence to A&ampE has led to considerable and sustained reductions in the variety and seriousness of violent incidents,” he said.

Gary Smith, the director of Cardiff Street Pastors, which assists keep revellers safe in the city centre on Friday and Saturday nights, said he had noticed a big difference in the city in excess of latest many years. “It feels a secure, area to be now. I feel that’s partly because everybody performs collectively so nicely now.” Michael and Smith each explained the programme in Cardiff had led to a wider cultural shift with companies far more utilised to functioning closer and better together.

South Wales police created it clear it believed the scheme was worthwhile. A police spokesperson mentioned the scheme had produced a “important contribution” to the reduction in violent crime. “It is an superb illustration of how partnership perform in Cardiff is producing a genuine big difference to retaining our communities protected.”

There are examples that display the scheme has worked nicely in other places the place it has been adopted. In some, violent crime has fallen by 40%. In Cambridge, for example, analysts realised foreign college students had been being injured on Monday evenings after Addenbrooke’s hospital shared info. Officials found that drinks promotions aimed at foreign students were currently being offered by bars. The premises have been told they must end such promotions.

In the south-east of England, people began attending an A&ampE having been hit by planks of wood and bricks. The information was passed on and council officials realised an open skip had been left close to a nightclub. Such skips had been banned from the area.

Mark Bellis, who advises the World Wellness Organisation on violence prevention who has implemented a productive info sharing scheme in the north west of England, said there remained a reticence in some locations to take it up. “It can function phenomenally well but some are reluctant since of the investment and the time.”

Caroline Shearer, of the anti-knife campaign group Only Cowards Carry stated the government essential to do a lot more to tackle violent crime – like generating sure hospitals shared information.

“The government talks challenging, it demands to act difficult,” she said.

A spokesperson for the Department of Overall health mentioned: “We have been clear A&ampE departments should share details with police and we are about to assessment compliance ahead of the rollout of a new legal regular which all key A&ampEs will be obliged to meet. We’re also supporting hospitals to train nurses to specifically champion this.”

Government failing on violence reduction scheme by means of A&E departments

Mentoring scheme assists young men and women pursue NHS careers

The mentoring scheme permits those aiming for a profession in the health service to request queries and access support and advice. Photograph: Alamy

A pioneering mentoring scheme for youthful individuals who are interested in pursuing careers in the NHS is being run at a key London educating hospital.

Guy’s and St Thomas’s believe in is the initial in the country to offer you mentoring support to young folks above 16, several of whom are not in schooling, employment or training (Neet) to aid them find careers in the health services.

The 1st cohort of 180 mentees began last September, with 45 mentors volunteering from a range of jobs across the trust. The scheme is run on an e-mentoring basis, with mentees being ready to get in touch with their mentors on a weekly basis, to ask questions, get suggestions and support for profession decisions and work applications.

Hannah Reed, coaching and mentoring manager at the believe in, stated there were a quantity of motives it wanted to introduce the scheme.

“We needed to make confident that we have been developing a good relationship with our regional neighborhood, as several of them are our individuals, and our employees,” says Reed.

“We have close to 300 various roles in the trust, so there is a broad choice of occupation pathways for young individuals. We had four major aims: to give people work experience in which possible to boost their confidence and enhance their communication skills to give them something constructive to place on their UCAS types and to make them think more about extended-term careers in the NHS.”

The trust organised an introductory workshop for all mentees, to give them an chance to find out more about the scheme and to meet their mentors. It has also held many occupation fairs with these attending becoming able to communicate to staff from a amount of diverse jobs.

Since January, the second cohort of 85 youthful individuals have been on the e-mentoring scheme, with 67 mentors taking component. A amount of them have been presented a week’s operate knowledge in the trust, as all around forty of them had completed college but had been not functioning.

“A lot of individuals never realise the broad variety of jobs there are in the NHS, as the stereotype is that all NHS personnel are in frontline care, whereas only a proportion of them are,” says Reed.

Considerably, the majority of the mentees are female, with a ratio of close to three:one females to males. This may possibly reflect the perception of the NHS as the house of the caring professions, with fewer males interested in doing work in it.

Hoyin Lam, a 25-year old PhD pupil in transformational medicine, has been acting as a mentor since January. He believes there are benefits for each parties.

“I was interested in assisting people who could be interested in functioning in the NHS, but do not have much concept about how to go about it, or may possibly want some assistance. We had an preliminary introduction and some common guidance, but we are encouraged to tailor the mentoring to the individual, so there is no one particular template. It takes up about an evening a week and I feel I get a lot of benefit from it, as I can use my very own encounter to support other individuals.”

1 of his two mentees is Rasayin Saleh, a 21-yr-previous biomedical sciences graduate, who is interested in turning out to be a biomedical scientist in the NHS.

“I wasn’t quite experienced about this area, and wasn’t positive of the route into this type of task. Since obtaining a mentor, I’ve received a clearer comprehending of what the occupation includes and no matter whether it will suit me as a job. As a outcome, I’ve applied for a traineeship submit in the NHS, and I was in a position to get some advice on my application and my CV, so it is been actually useful for me.”

The e-mentoring scheme has been run in collaboration with NHS Employers and a nearby voluntary group, Brightside, which operates with youthful individuals. The 2nd cohort’s mentoring comes to an end in April and the pilot scheme will then be evaluated. If shown to be productive, the believe in hopes to carry on with the scheme up coming yr.

This write-up is published by Guardian Skilled. Join the Healthcare Specialists Network to get typical emails and unique offers.

Mentoring scheme assists young men and women pursue NHS careers

Advocacy scheme supports older individuals who have been diagnosed with cancer

Advocate Bob Smith has made a bucket listing for 2014 with Brian and will support him achieve almost everything on it.

Brian Potts

I’m 67 years outdated and I utilized to take pleasure in operating a effective company in the motor trade. It was difficult function but exciting and I was not organizing to retire. Over the years I’ve loved foreign travel, sailing and had a really excellent top quality of life. My personal situations have transformed substantially, and I now reside alone in a sheltered flat and can feel lonely and depressed.

I have a supportive household and a tiny quantity of good pals but poor mobility has diminished my independence. My cancer diagnosis has been daily life altering. One of the largest blows has been shedding my driving licence.

My life now consists of watching the Television and searching out of the window of my flat. The minute someone says “cancer” I can not envision that anyone isn’t going to believe, “When am I going to die?”. I was diagnosed with myeloma in March two years ago and I imagined, “This is my last summer”. You wake up every day pondering about it.

I have mobility troubles and a great deal of ache as a result of the treatment. My medication prospects to side effects such as putting on a great deal of bodyweight. The Neighborhood Evaluation and Rehabilitation Team (Cart) helped me with mobility problems and suggested I may possibly like to locate out about advocacy help. I was introduced to Bob, my advocate, at residence and he has also visited me in hospital. Bob is straightforward to chat to and quite easygoing. We met up at my home and have also been out for coffee to the coast which is a place I utilized to go routinely. I would charge Bob as best of the selection.

Bob located out about the local myeloma help group and went along with me to one particular of their meetings. I am now in standard make contact with with them and attend their meetings when I can. He located out about the regional Shopmobility scooters and went with me to attempt them out. I even now require assistance to do my buying but it tends to make it a lot less difficult. Bob can aid to remind me who is concerned in my care. I’ve observed so a lot of individuals that I don’t constantly know who’s who. It really is good to share feelings with a person from outdoors of my household.

No a single should encounter the void that I did among obtaining exams and obtaining an appointment for the real diagnosis. I worried a whole lot for the duration of that time.

Bob Smith

I volunteer as Brian’s independent advocate. My role is to be there for him for the whole cancer journey, nevertheless extended that is, and to speak up for him and voice any considerations, worries, inquiries and options he may have. I have had cancer myself and comprehend the massive affect this has on people.

Brian is very intelligent, friendly and outgoing, with a wonderful sense of humour. He has been married twice, has two daughters and lives shut to his loved ones (which includes his ex-wife) who give him assistance in his day-to-day life with things like shopping, medication and companionship. He can no longer drive, is physically weak, and is in constant discomfort of various ranges. He can only walk a matter of yards with the aid of a strolling stick or frame. He lives alone in a small communal block of flats and when I first met him, he had very low self-esteem. Even though previously effectively-travelled and lively, he felt that he had number of long term prospects of a pleased existence. He found his situation very challenging to accept and suffered bouts of depression and typically grew to become upset when speaking about his predicament. The diagnosis of cancer was, and even now is, tough to bear. He has a number of good buddies but is no longer independent so can not socialise as significantly as he would like. He spends most of his time in his flat watching Tv.

Brian occasionally becomes puzzled and forgetful. He has, on occasion, taken the wrong medication or forgotten to consider them. This has led to him passing out and encountering hallucinations. I was present at one of these occasions.

I initially invested time with Brian to get to know him appropriately, his predicament now and how it used to be when he was fit and nicely to uncover out his emotions and views, his interests and hobbies, his aspirations and hang ups. I have met and spoken to members of Brian’s household to understand their viewpoint. Everyone understands the place I match in and the portion I play to assistance Brian. He often speaks openly and honestly to me, and we have a really excellent romantic relationship. He knows that I understand him, will support him wherever I can and that I will never impose my views on him. I listen to Brian and discover possibilities to conquer troubles or achieve items he wants to do. He loves to have a laugh. Brian occasionally has problems concentrating due to his drug regime and can be puzzled and forgetful. I have spoken to his nurses, medical doctors and consultants for his safety when he has taken incorrect medication. I’ve also phoned the council concerning a bus pass, arranged trials of motorised scooters and introduced him to the myeloma help group. What ever information Brian needs, I source and provide it.

Brian’s image of himself is now far much more optimistic. He smiles much more and we laugh and joke much more than we utilized to. He has started out to socialise far more and is keener to “increase his good deal” and not just accept his current circumstance. We have created a “bucket list” for 2014 and I will help him attain the factors on it and help him make a listing for 2015 as well. He ideas to check out the London boat present, go on a boat trip locally, go to France and have a social outing each and every week. Brian says he appears forward to our visits and truly values them. He didn’t frequently get in touch with his pals but now has an item on his bucket list to do this fortnightly.

When I met him at 1st he explained, “I am no longer any use to any individual. I will never ever have yet another connection with a woman.” Now he says he appears forward to me visiting and having talks with me. He feels a lot more positive about himself and he is satisfied with his 2014 bucket listing.

Brian Potts’s name has been changed

For much more data on becoming a educated advocate, go to Older individuals residing with cancer’s (Opaal) website.

Advocacy scheme supports older individuals who have been diagnosed with cancer

Fiona Nash accused of misleading Senate yet again more than meals rating scheme

The assistant wellness minister, Fiona Nash, stands accused of misleading the Senate for a second time above her controversial intervention to remove a website for the new “healthy star” meals labelling system, a move that has embroiled the minister and her chief of workers in allegations of conflict of interest.

Nash advised the Senate 1 explanation she and her chief of workers, Alastair Furnival, had intervened to pull down the internet site was that a federal and state ministerial forum in December had taken “a unanimous selection to do an extensive expense-benefit analysis” and it was consequently “premature to have the web site live till this report was completed”.

But minutes from that forum meeting confirm accounts provided to Guardian Australia – that Nash unsuccessfully demanded a new regulatory influence statement be undertaken ahead of the new labelling method took result and then unilaterally informed the meeting she would be asking her division to undertake a cost-advantage analysis.

Minutes of the meeting state the forum “considered motions relating to conducting a RIS” which was “not agreed” and that Nash then “informed” the forum she would direct her department to do a expense-advantage evaluation.

Five states are understood to have opposed the minister’s proposal on the grounds an RIS would inevitably delay the scheme’s implementation. Nash lost a vote on the proposal 5-four. She was backed by Victoria, New South Wales and the Northern Territory. Between these efficiently opposing her had been the Labor governments in Tasmania and South Australia that are about to encounter elections.

The leader of the opposition in the Senate, Penny Wong, explained the minutes plainly advised Nash had misled the Senate. In a statement issued late on Thursday, Nash continued to insist the forum had “unanimously” agreed to a price-benefit evaluation but conceded her proposal for an RIS was “not agreed”.

The bitter fight above the minister’s intervention to consider down the website is fuelled by a belief among state governments and consumer groups that she is deliberately delaying the “healthy star” foods labelling – opposed by sections of the meals industry – until finally soon after the Tasmanian and South Australian elections, when conservative victories could give her the numbers to defeat it on the council.

The Tasmanian health minister, Michelle O’Byrne, told Guardian Australia Nash had “no correct to take down the website” and was “clearly hoping if she delays extended ample she will get a diverse outcome”.

South Australia’s well being minister, Jack Snelling, has written an angry “please explain” letter to Nash, about her controversial intervention.

Nash has previously been forced to right her authentic statement to the Senate, that Furnival had “no connection whatsoever” with the lobbying company Australian Public Affairs (APA).

Nash later conceded Furnival, who intervened to pull down the web site, was a “shareholder in the lobbying firm owned by his wife, Tracey Cain”.

APA has acted for Cadbury’s parent firm, the snack food giant Mondelez, as properly as soft drink business group the Australian Beverages Council. Furnival was once chairman of APA and chief economist for Cadbury, but Nash insists there is no conflict of curiosity simply because he “receives no income” from a “shareholding” in his wife’s lobbying firm and the firm has promised not to lobby her or the wellness minister, Peter Dutton. Guardian Australia has established he remains a director of one particular of the companies that helps make up the APA partnership.

Targeted for a second day throughout Senate question time on Thursday, Nash refused to say when she had learned of her staffer’s shareholding in the firm, or when she informed the prime minister’s workplace about it.

“All details close to my chief of employees was given to the prime minister’s workplace in accordance with suitable timing,” she mentioned, but would not be drawn on when that “appropriate time” was. She mentioned it was now “up to industry” no matter whether the June 2014 start date for the new program was met.

The food and grocery business has criticised the scheme for becoming too pricey and confusing, but has also worked with governments and buyer groups on the implementation of the new system.

Guardian Australia understands just hrs soon after the web site went reside last week, as scheduled and broadly anticipated by groups concerned, Furnival rang the division to have it taken down. When staff refused, on the grounds that they were underneath orders from the ministerial forum rather than the minister, Furnival went to the department’s senior executive ranks to intervene.

Guardian Australia more understands that on Wednesday obligation for the labelling scheme was moved from the public servants who have dealt with it for numerous years, and who refused to pull down the web site, to the Wellness Department’s 1st assistant secretary, Nathan Smyth.

In his letter, sent on Wednesday, Snelling “expresses concern” that the minister took down the site without having reference to the state ministers who are jointly responsible for it, and argues that, since the method is voluntary, and because it had been agreed by the ministerial council “I would appreciate your urgent response as to why the web site has been taken down, and I request that it be speedily reinstated”.

The Public Wellness Association chief executive, Michael Moore, mentioned he believed Nash was engaging in “delaying tactics to wait till following state elections that may well mean the ministerial council requires a new form”.

“That would match with an business agenda to avoid or delay the uptake of a method that will enable parents to know how healthy the meals is that they are putting in their children’s lunchboxes. The food sector doesn’t want to mount the direct argument against a system shoppers want, but they are trying to undermine it quietly,” he stated.

Investigation by Option showed 62% of consumers want the existing “daily intake” guides replaced with the well being star rating, and the client group says its study also demonstrates the existing “daily intake” scheme is ineffective.

Option campaigner Angela Cartwright stated her organisation was “not convinced by the government’s explanations for pulling down the internet site … and we know the food and grocery council is reluctant to apply this scheme”.

A spokesman for the foods and grocery council stated the council believed the new technique was “not but prepared to be implemented”, that a price advantage evaluation was needed before it started and that “the evidence that this method will change buyer behaviour is not however settled”

Tracey Cain, Furnival’s wife and APA owner, stated in a statement on Wednesday that “since his resignation and appointment as a chief of personnel with a commonwealth minister [Furnival] has drawn no salary, dividend or revenue share from this business. Following his appointment, the procedure started to transfer Alastair’s shareholding to me as his former co-director. Because final September, Australian Public Affairs has not manufactured representations to both wellness minister, their offices, or the Wellness Division and has created no representations to any other minister of the commonwealth in relation to the overall health portfolio.”

The government’s “standards for ministerial staff” call for that workers “divest themselves, or relinquish control, of interests in any personal firm or enterprise and/or direct curiosity in any public organization concerned in the spot of their ministers’ portfolio responsibilities”.

Nash also conceded that Furnival had not declared any conflict of curiosity at the meeting of federal, state and New Zealand ministers on 13 December, which Nash chaired and Furnival attended.

“Yes, I can verify it was an item on the agenda. Yes, I can verify that I was chairing the meeting. Yes, I can confirm that my chief of employees did not declare an interest.

“I was completely aware of the romantic relationship in between my chief of employees, APA and his previous role within Cadbury and the confectionery business … my chief of workers complies with appropriate internal requirements underneath the statement of standards for ministerial staff,” Nash stated on Wednesday.

The guidelines for the ministerial council state that “members and supporting employees have a accountability to disclose and get realistic measures to stay away from any conflict of interest, real or apparent, in connection with their membership or help of the Forum or its subordinate bodies”.

Nash, who mentioned she had consulted the prime minister’s office on the matter, insisted Furnival’s APA connections did not represent a conflict of interest.

APA is a partnership registered with NSW Fair Trading. NSW Fair Trading records demonstrate APA’s partners are 3 companies – APA Pty Ltd, Strategic Troubles Management Pty Ltd and Centre for Litigation Communications Pty Ltd.

Australian Securities and Investment Commission paperwork present that Furnival is a director of Strategic Issues Management Pty Ltd along with Tracey Cain, who is also secretary.

The prime minister, Tony Abbott, took “on notice” concerns about the affair on Thursday.

Fiona Nash accused of misleading Senate yet again more than meals rating scheme

China"s little one hatch scheme expands for unwanted disabled newborns

A baby hatch named “little one safety island” at the Tianjin Institute of Children’s Welfare, in Tianjin, China. Photograph: China Stringer Network/Reuters

Fangfang was just a couple of days old when she was abandoned on a close to-freezing New Year’s Day in north China. She was fairly lucky. Unlike the a lot of who are found dumped in train stations or toilets, her loved ones left her at a risk-free, warm shelter.

Dozens of babies have been secretly dropped off at the so-known as infant security islands, or hatches, set up late last year below a scheme to protect undesirable offspring.

“We need to have to develop these islands to shield children from even more injury,” says Zhang Min, head of a government-run orphanage in the northern coastal city of Tianjin, exactly where Fangfang was found. The babies there are brought to a cosy room with pink walls, a cradle and an incubator. Fangfang was left in a handbag on the floor.

The Chinese media usually reviews harrowing tales of infants currently being dumped, a problem attributed to youthful females unaware they are pregnant, or the birth of an undesired woman in a society that puts greater value on boys, or China’s strict household preparing guidelines.

In one this kind of case, a baby was found in a skip on the outskirts of Beijing. He did not survive. In another, firefighters in eastern China rescued an abandoned newborn boy from a sewage pipe.

Chinese orphanages have witnessed a falling quantity of abandoned children given that 2005, but officials estimate about ten,000 unwanted kids are received every single year. An unknown quantity of abandoned babies are also adopted informally.

When orphanages in China were overwhelmingly filled with women due to the fact of the cultural preference for male heirs and three decades of a strict 1-youngster policy – if couples have been permitted only a single kid, numerous needed to ensure it was a boy.

The preference stays, but it is much less prevalent as the world’s second-greatest economy grows and the country gets to be wealthier. So the abandoned kids tend to be of the two genders – and they are generally significantly sick or disabled.

Fangfang, the 1st child abandoned at the Tianjin hatch, outside the gates of a city orphanage, has Down’s syndrome and congenital heart condition.

Government officials say little one hatches are required due to the fact some new arrivals have serious illnesses and disabilities and are typically in need to have of fast health-related consideration. Every province have to set up a minimal of two by the finish of the yr.

“With a lot more and more disabled young children, it could mean they die if we locate them even ten minutes late,” says Ji Gang, an official with the China Centre for Children’s Welfare and Adoption.

Child hatches have triggered issues that they could encourage far more mothers and fathers to abandon babies. “Youngster abandonment exists. Little one hatches will not encourage much more mother and father to abandon young children,” says Wang Zhenyao, a social welfare specialist. “They will only offer far more accurate numbers.”

Officials note that China has different charity funds and government wellness insurance schemes to aid the sick and disabled. But they also note that China suffers from a lack of a unified welfare technique.

“If there have been this kind of a method, a lot of mother and father would not abandon their young children,” says Ji, of the welfare and adoption centre. “We would not have to develop so several infant hatches.”

China"s little one hatch scheme expands for unwanted disabled newborns

Football fans get FFIT through Scottish premiership scheme tackling weight problems | Rachel Pugh

Prison officer Alastair Christie at the summit of the Carn a’Gheoid munro in Scotland, soon after dropping 9 stone through the FFIT scheme. Photograph: Fraser Band

If 26-stone St Johnstone football fan Alastair Christie had been advised 4 many years ago that his passion for his Scottish Premiership team would electrical power him to shed nine stone and to conquer 37 of Scotland’s highest mountains, he would have responded with a option expression from the terraces.

But a scheme run by 13 clubs in the Scottish Specialist Football League has aided Christie and hundreds more overweight, middle-aged, football followers to get in form in accordance to study published this week in health care journal, the Lancet and BMC Public Overall health.

The analysis by Glasgow University on 747 men who went by means of the Football Fans in Training (FFIT) programme found that they lost nine instances as a lot weight as these not on it.

The randomised 12-month examine from June 2011 of a well being programme delivered in a football club setting (perhaps a world first) identified that as properly as losing bodyweight on the twelve-week programme, almost forty% of guys in the examine maintained a excess weight reduction of at least five% of their authentic physique fat a yr later on.

In accordance to the 2011 Scottish overall health survey, just below two-thirds (64.three%) of adults, aged sixteen and above, had been classed as obese or obese. With weight problems linked to heart disease, diabetes, stroke, cancer and other wellness issues, these benefits couldn’t come swiftly adequate for individuals operating in public well being. Guys are notoriously hard to engage in wellness programmes but one particular of the excellent successes of FFIT, in accordance to the analysis, was that it attracted guys from across the socio-economic spectrum.

The formula is basic – organise male-only sessions in Scottish premiership clubs and run it “just like going to the pub but with no the beer”, capitalising on the men’s devotion to their club.

“From what I was – a fantastic, big, heavy, strongman – to currently being able to climb mountains, and play football with my son Blair, is like evening and day,” says Christie, 43, a prison officer, who utilised to gasp climbing the stairs in Perth prison. He heard about the programme from a fellow fan. Club-primarily based recruitment was by way of web sites, in-stadium marketing, and FFIT recruitment staff approaching possibly eligible men on match days. Above the weeks, the 15-robust group at the Perth-primarily based St Johnstone FC turned up in their football shirts to discover about a very good diet plan and how to get fitter, with the help of a coach.

Powerful relationships have been formed that turned into walking groups, 5-a-side teams and Munro-bagging parties.

“For me, it was the banter in between everyone and the coaches that produced it feasible,” says Christie. “It produced coming to FFIT entertaining and not a chore. Performing the programme at McDiarmid Park most absolutely spurred me on to change to a more healthy way of life which I have continued.”

Professor Sally Wyke, a single of the two principal investigators from the University of Glasgow says: “We now have ‘gold standard’ evidence that the FFIT programme can assist men drop weight and preserve it off.” Study will now focus on the 60% who did not keep the bodyweight reduction at the 12-month adhere to-up.

Her team has secured a €6m (£5m) EU grant to produce a equivalent programme in Portugal, the Netherlands and clubs in the English Premier League.

Fellow researcher Cindy Gray is doing work with Sale Sharks, an English expert rugby union club, to see if FFIT can function in a rugby context. She is also exploring an equivalent for females.

The FFIT notion has gone into two Scottish prisons – Perth and Castle Huntly, close to Dundee – as a consequence of Christie’s good results. A PE instructor colleague spotted that the guy known as “Large Al” was approaching half his authentic size and he decided that Al’s secret might do some of the prisoners very good.

Kevin Fenton, national director of health and wellbeing at Public Well being England, is interested in FFIT’s achievement. A quarter of adults in England are obese. “There is expanding proof that physical exercise has a essential role in preventing cancer, coronary heart ailment, variety-2 diabetes and high blood stress as a result obtaining much more men physically lively is essential to enhancing the overall health of the population.”

A note of caution is sounded by professor Jason Holford, chairman elect of the Uk Association for the Study of Obesity, who says: “The football sector itself – and other sports like rugby – need to consider it a stage further and wean themselves off alcohol and junk meals sponsorship, as they did with smoking.”

Football fans get FFIT through Scottish premiership scheme tackling weight problems | Rachel Pugh

Dutch scheme aims to reintegrate alcoholics by giving them beer

The males streaming in and out of a modest clubhouse in east Amsterdam could almost be construction staff at the end of a challenging day, taking off their orange reflective vests and cracking jokes as they suck down a couple of Heinekens, waiting for their shell out cheques.

But it truly is only noon, the men are alcoholics and the beers themselves are the pay out cheque.

In a pilot project that has drawn consideration in the Netherlands and around the globe, the city has teamed up with a charity in the hope of enhancing the neighbourhood and possibly the lives of the alcoholics – not by attempting to remedy them, but by offering to fund their drinking outright.

Participants are offered beer in exchange for light perform collecting litter, consuming a decent meal and sticking to their schedule.

“For a whole lot of politicians it was really hard to accept: ‘So you are giving alcohol?’” the Amsterdam East district mayor, Fatima Elatik, said. “No, I am providing people a sense of standpoint, even a sense of belonging. A sense of feeling that they are Ok and that we need them and that we validate them and we never ostracise our people, due to the fact these are folks that reside in our district.”

In practice, the two groups of ten males have to present up at 9am 3 days a week. They start off off with two beers, function a morning shift, consume lunch, get two much more beers, and then do an afternoon shift ahead of a final beer. Sometimes there is a bonus beer. The complete every day shell out package comes to €19 (£16), in beer, tobacco, a meal and €10 money. Participants say a whole lot of that funds also goes in direction of beer.

For years, a group of around 50 rowdy, ageing alcoholics had plagued a park in east Amsterdam, annoying other park-goers with noise, litter and occasional harassment.

The city had experimented with a number of hard solutions, including adding police patrols and temporarily banning alcohol in the park outright, such as for household barbecues and picnics. Elatik explained the city was investing €1m a year on various prevention, therapy and policing programmes to deal with the dilemma, and nobody was satisfied.

Meanwhile, the modest nonprofit Rainbow Group Foundation and its predecessors had been experimenting with ways to get support for alcoholics and drug addicts in the region.

Floor van Bakkum of the Jellinek clinic, 1 of the city’s ideal-acknowledged addiction remedy clinics, said her organisation had a really distinct strategy to treating alcoholism. She has a number of reservations about the Rainbow programme, but approves of it in basic.

She explained a “harm-reduction technique” created sense only when there was no real hope an alcoholic could be cured.

“The Rainbow group tries to make it as easy as achievable [for alcoholics] to reside their lives and that they make as minor as achievable nuisances to the atmosphere they are living in,” she said. “I believe it is great that they are performing this.”

The idea was just that troublemakers may well consume significantly less and cause less trouble if they could be lured away from their park benches with the guarantee of cost-free booze. The Rainbow leader, Gerrie Holterman, explained beer was the obvious choice, since it was easier to regulate consumption. Rainbow still harbours the ambition to remedy alcoholics and move them back to mainstream society and sees the perform-for-beer programme as a 1st step.

“I think now that we are only productive when we get them to drink much less for the duration of the day and give them some thing to believe about – what they want to do with their lives,” Holterman mentioned. “This is a begin to go in the direction of other projects and perhaps one more variety of work.”

She conceded there had only been one person so far who had moved from the programme to standard lifestyle. Several participants have located the guidelines also demanding and dropped out. But she explained nuisance in the park had been reduced, neighbours had been happy and there was a waiting record of candidates who needed to participate.

Elatik stated she could not quantify the price of the programme. Its spending budget comes partly from donations to Rainbow, partly from city funds, but it is less than €100,000.

The foreman of one group participating in the scheme, Fred Schiphorst, takes his job significantly. He wears a suit and tie under his reflective vest. He said he was handled with more respect in the neighbourhood, but admitted his off-the-job consuming was nonetheless up and down.

One more participant, Karel Slinger, 50, stated his lifestyle has not been transformed. He is nevertheless an alcoholic, but he mentioned on the complete items had transformed for the much better.

“Yes, of course, in the park it is wonderful weather and you just drink a whole lot of beer,” he said of his outdated existence. “Now you come here and you are occupied and you have one thing to do. I cannot just sit nonetheless. I want anything to do.”

Dutch scheme aims to reintegrate alcoholics by giving them beer