Health Reports


05 April 2007

An influx of immigrants is behind a "significant" rise in tuberculosis cases in Nottingham, say experts. The number of cases in Notts has more than doubled in two years.

Hotspots for the infectious lung disease are Hyson Green, Forest Fields, Radford and The Meadows, according to the Health Protection Agency. Two-thirds of patients are thought to be in the city centre, with others in outlying suburbs and Mansfield.

Latest figures show there were 118 cases of TB in Notts last year. In 2004 there were 53. Leicestershire had more, with 285 last year and 310 in 2005. In 2004, there were 198. Derbyshire had 80 cases last year, compared to 67 in 2005 and 81 in 2004.

Dr Richard Slack, the Health Protection Agency's consultant in communicable diseases, said the increase was due to people coming from regions with high instances of TB, such as Africa and parts of Asia.

But poor living conditions also play a part in spreading the disease, but Dr Slack warned people not to panic.

"The figures for 2002 to 2006 show an increase in Notts slightly greater than the national average," he said.
"And if you compare the 2004 figure with last year's, there is a significant increase. The disease is largely seen in particular community groups, who come from countries with high instances of TB. There is no doubt this is a disease of overcrowding and to some extent poverty, even in the UK."

The agency is monitoring the situation closely. About 8,000 new cases of TB are currently reported each year in the UK. It can be spread by an airborne germ after a person who has TB of the lungs coughs or sneezes.


Migrants with TB should be sent home, say Tories

28th June 2007

Migrants from 130 countries with a high risk of TB are being cleared to live in Britain without any health checks, it has emerged. Once here, those with the disease are entitled to free treatment on the Health Service. 

The Conservatives said last night that the loophole was fuelling 'health tourism' and any migrant found to have TB should be placed immediately on a plane back home.

Cases of tuberculosis, which can be deadly if left untreated, are rising at 11 per cent a year, with immigrants accounting for seven out of ten new cases. 

Pre-screening of potential migrants - forcing them to undergo health tests before they are granted a visa to visit Britain for six months or more - is taking place in only 11 countries. These are Bangladesh, Cambodia, Eritrea, Ghana, Kenya, Laos, Pakistan, Somalia, Sudan, Tanzania and Thailand. This is despite 131 other countries being described as officially 'high-risk' of TB, which means there are over 40 cases for every 100,000 residents. 

The first test migrants from these nations receive is when they arrive at a British port.

Under Government guidelines, migrants found to have TB on arrival are sent to a GP or NHS hospital, where they are treated at taxpayers' expense. The cost of treatment can range from £1,000 for a patient with nonresistant TB to as much as £125,000 for those with multi-drug resistant TB. 

Tory immigration spokesman Damian Green said: 'People who are infected should not be let-out into the community. There is also clearly a danger of health tourism there, so to some extent we would all feel more comfortable if people could be told you have got to go home to be treated, you have got an infectious disease. They would not have come here without plans to return home if they are coming legally. It would clearly be better all round if they went straight back home to be treated.' 

He added: 'The Government knows this is a long-standing health problem which is getting worse but, despite promising action, it has not delivered. They are screening applicants from very few countries, despite the number regarded as high risk standing at 142 around the world. There is not anything like enough action taking place.' 

According to the Health Protection Agency, the majority of patients newly diagnosed with HIV, TB and malaria are migrants. Around 70 per cent of new cases of TB in 2004 were found among people born outside the UK. 

Latestfigures for 2005 show the disease is on the increase, with the biggest rise among people born abroad. There were 8,113 cases in 2005 - up from 7,321 cases in 2004, a rise of 11 per cent.

Around 300 to 400 people die of TB in the UK each year, with the highest proportion from an Indian, Pakistani and Bangladeshi ethnic background.

A Home Office spokesman said an expansion of TB pre-screening was being evaluated. 


Fears grow over future TB crisis

Sep 28 2007

BIRMINGHAM could face a major tuberculosis outbreak within five years if council officials fail to track how quickly the city's immigrant population is growing, health watchdogs warned today.

Dr Chris Spencer-Jones, director of public health for South Birmingham Primary Care Trust, issued the warning as he addressed the city council's health overview and scrutiny committee.

He spoke out after the committee heard a set of "muddled" figures presented by Alan Randall, the council's lead officer on asylum seekers and refugees, who claimed "up to 100,000" people had settled in the city since 1997.

Of those, 35,000 had been granted permission to stay in the UK, with a further 20,000 coming over from EU countries, and "about 20,000" of Somali origin. But question marks remained over the exact number, how many brought over relatives and how many failed asylum seekers remained in the city.

Dr Spencer-Jones said: "In the health sector, there's already been a very big impact from the immigrants, particularly in cases of HIV and TB.

"We could be incubating TB, particularly in the Somali community, and any downturn in the economy and public health could lead to an outbreak of TB in Birmingham within the next five years."

Methods to vaccinate children have recently been changed.

Instead of all youngsters being given a BCG jab at 13, babies whose parents, grandparents or immediate relatives come from or regularly visit countries where TB is endemic, are actively inoculated.

Coun Deirdre Alden (Con Edgbaston), the committee's chairman, said: "This is a massively complicated issue which also impacts on education and housing, as well as health services across the city. I find it incredible that nobody really knows what's going on, even the experts - that seems to have been the conclusion of this meeting."

Councillors agreed to start an eight-month review of new migrant communities, their needs and how those impact on public services.


Health experts concerned as TB cases in Yorkshire rocket

November 2007

THERE has been a dramatic rise in cases of tuberculosis in Yorkshire, new figures reveal.  A total of 704 people from Yorkshire were infected by the illness last year - up 22 per cent on 2005.

The huge increase is the biggest in any region in the UK, where overall levels of the disease remained static for the first time since the 1980s.

Experts yesterday expressed concern about the increase in the region and plan to hold talks to discuss how to cut the toll of the disease which mainly affects migrant communities.

The highest number of cases was in Bradford, which saw a 19 per cent rise in 2006 to 191 cases, while there was a 20 per cent increase in Sheffield to 107 cases. But the biggest increase was in Leeds where there was a 41 per cent rise to 154 cases.

Nationally, London had the highest number of cases, accounting for 40 per cent of the 8,497 patients diagnosed in the UK. More than 350 people died from the condition.

Ruth Gelletlie, regional director of the Health Protection Agency, said the figures for Yorkshire were clearly a "cause for concern". "However, it should be stressed the region reflects the national picture of TB in that levels of the disease among the general population continue to be very low," she said.

"We have always known that the burden of the disease is greatest among those born in countries where there is high prevalence of TB and the regional position continues to reflect this. TB is a preventable and treatable condition and the key to reducing levels of the disease is early diagnosis and appropriate treatment. We will be bringing together our partners across the region to consider what action can be taken to help reduce the burden of TB in vulnerable populations in our region."

Officials said it was too early to say if the national picture showed signs of a slowdown against a long-term rise in cases over the last two decades. Cases have risen 28 per cent since 2000.


138 people have HIV but don't know

18 February 2008, Sheffield

AROUND 138 people in Sheffield are thought to be living with HIV without knowing it, health chiefs warned today. A new report says 600 people are being treated in the city's hospitals for the virus that can lead to AIDS.

Experts say that of these patients, 414 live in Sheffield and the rest travel from elsewhere for treatment. But they estimate a third more city residents - 138 - could be infected with the virus but do not know it.

The figures are revealed in a report to Sheffield Council's health and community care scrutiny board which warns health services in the city are facing a "major challenge" because of rising demand for testing, advice and treatment for sexually transmitted infections including HIV.

The Royal Hallamshire Hospital's Department of Genito-Urinary Medicine, which treats sexually transmitted infections, has been rebuilt over the last year to create more space to treat patients in the city.

HIV infection patterns are changing in Sheffield, reflecting trends elsewhere in UK.

Previously the majority of patients were gay and bisexual men. But there is now an increase in the proportion of people who need treatment who acquired the infection from countries where HIV is more common.

The report, which will go before the scrutiny board today, says: "Major challenges remain in light of the continuing increase in HIV infection and the changing nature of the population affected by HIV and in relation to sexual health more broadly."

The city's specialist social work team, The Forge Centre, which works with people with HIV is getting the largest number of referrals from people from black, minority ethic communities.

And as part of the drive to help people get early treatment and diagnosis a health team working with asylum seekers is offering screening for HIV and blood-borne viruses for all new clients so people can be diagnosed and treated at an early stage.


Hospital confirms first UK case of extreme drug-resistant tuberculosis

March 21 2008

Doctors have diagnosed the first ever UK case of a virtually untreatable strain of tuberculosis, marking a further step in the disease's fightback against the antibiotics that once kept it in check. A man in his 30s is in isolation at a hospital in Glasgow and is being treated with a cocktail of antibiotics in an effort to control the extreme drug-resistant tuberculosis (XDR-TB), the Guardian has learnt.

A spokeswoman at Gartnavel general hospital confirmed the case and said health officers were tracing people who may have come into close contact with the man.

This is the first time a patient has been diagnosed and treated for XDR-TB in the UK. The World Health Organisation has warned of the danger that XDR-TB poses because of the ease with which the airborne disease can travel in an era of mass migration and global travel.

Tuberculosis is spread only through close and prolonged contact with other people, such as in a family or among children in a school, so there is no suggestion that a single case could spark an epidemic. The arrival of XDR-TB in the UK is, however, a warning of the need for greater vigilance against the disease.
The man, a Somali, was screened for infectious diseases on arrival at Heathrow in November last year. An X-ray revealed TB scars on his lungs, but the disease was not active. The patient, thought to have claimed political asylum, told doctors he had recently undergone a six-month course of treatment for TB and, following an immigration interview, he was allowed to travel to Scotland.

In January he was admitted to Gartnavel after the disease reactivated in his lungs. Cultures later revealed the XDR strain, and health officials were called to trace his close contacts to prevent an outbreak.

XDR-TB first came to public attention in 2006, when a cluster of cases was reported in KwaZulu Natal in South Africa. All 53 patients were HIV-positive and 52 of them died within 25 days. Dr Paul Nunn, head of the WHO's TB resistance team, warned that the cases were "raising the spectre of something that we have been worried might happen for a decade - the possibility of virtually untreatable TB".

The WHO estimates there are 9m cases of TB in the world, with perhaps 2% being XDR-TB. A report in February found that 44 countries had experienced cases. Many cases will have been missed because the correct tests will not have been carried out when the patient failed to respond to treatment.


HIV cases in Britain reach 49,500 after record rise

Independent, The (London), Nov 25, 2003

THE GLOBAL epidemic of HIV, the virus that causes Aids, is tightening its grip on Britain with a record number of new cases diagnosed last year. Soaring rates of all sexually transmitted infections are fuelling the rise, with an estimated 49,500 people living with HIV in 2002, an increase of 20 per cent on the previous year.

Over 15,000 of these - one third - do not know they are infected, increasing the potential for further spread, according to the Health Protection Agency (HPA) which released the figures ahead of World Aids Day on 1 December.

There were 5,711 new diagnoses of HIV to the end of September last year, the highest since records began in 1987. The number of new cases was 15 per cent up on the 4,982 diagnosed in 2001 and is expected to rise to 6,400 when all the reports are received. The rate of infection has more than doubled since 1997.

Two-thirds of the cases were acquired outside the UK, triggering renewed calls yesterday for immigrants to be screened. The cases' overseas origin - most from sub-Saharan Africa - has changed the nature of the epidemic, with heterosexual cases now outnumbering homosexual/bisexual infections two to one.

Tory health spokesman Tim Yeo said: "We cannot justify ignoring the health of those who apply to live permanently in the UK. Not conducting basic health checks for serious diseases such as TB or HIV both disadvantages the applicant and overloads the NHS."

Sir Andrew Green of Migration Watch, the right-wing pressure group, said immigrants wishing to stay in Britain should be screened before they arrived. "There is a substantial problem in the UK and we should not add to it," he said.

The World Health Organisation is opposed to HIV testing at borders on the grounds that it is discriminatory, but the practice is widespread. At least 70 countries, including the US, Australia, Russia, China and most Arab states insist on HIV testing for anyone intending to settle in the country for more than a few months.

Treatment with antiretroviral drugs costs around pounds 15,000 per year for each patient and there is concern that immigrants with HIV/ Aids put an unsustainable burden on the host country's health system, as well as threatening the health of the population. 

A report from the Institute for Public Policy Research, the Labour think tank, said screening immigrants for infectious diseases would drive the problem underground and increase risks by stigmatising victims. It called on the Government to introduce "welcome health checks" for immigrants, in place of compulsory screening.

An HPA report, Renewing the Focus, said the rising trend was putting the sexual health services under increasing pressure.

The health department responded by announcing pounds 15 million for STD clinics in England. A spokesman said the Cabinet Office was examining proposals for dealing with the threat of infectious disease linked with immigration and its impact on the NHS.



Fury over free religious snip on NHS


HOSPITALS in one of our biggest cities are flouting NHS rules by offering FREE circumcisions on religious grounds.

The Heart of Birmingham Primary Care Trust has performed more than 2,000 procedures—costing the taxpayer an estimated £450,000.

Families in the area, which has a large Muslim population, have been inundating hospitals and GPs asking for free religious snips.

But NHS guidelines state circumcisions should only be carried out if there is a clear medical need—NOT based on culture or religion. Muslim and Jewish families usually pay to have their children circumcised shortly after birth. The procedure is either done in a private clinic or by a religious elder.

In Birmingham the cost was waived for half of the 2,000 circumcisions done on the NHS, with parents paying half the £300 op cost in the remainder of cases.

A Department of Health source said: “The guidance is clear. The NHS should not be providing what is essentially a religious ceremony. Trusts like Heart of Birmingham are exploiting a loophole which says they can commission services to meet the needs of local communities. That’s supposed to mean dealing with obesity or the elderly.”

A spokeswoman for the Birmingham PCT, which looks after 300,000 people, said it was responding to local need. She added: “We are one of 10 PCTs offering this service.”

But the government said it was unaware of which trusts were involved.

Meanwhile, Edinburgh-based expert Professor Aziz Sheikh has called for male infant circumcision to be made available on the NHS. He said it would avoid families being “forced into the poorly regulated private sector”.

Worrying Failure to meet challenge of South Asian patients with Type 2 diabetes 

May 2008

New research published in the Lancet, on 24th May 2008, has found a worrying failure of both current and enhanced GP interventions to deal with the particularly challenging effects of Type 2 diabetes on the health of South Asian patients in the UK.

**Type 2 Diabetes is a significantly greater problem for patients of South Asian ethnic background (which includes Indian, Pakistani, Bangladeshi, and other Asians) than it is for other ethnic groups. In the UK the prevalence of type 2 diabetes is four-fold to six-fold higher in people from south Asia than in white Europeans. **

Furthermore, the onset of the illness tends to start more than a decade earlier for such patients. The risk of cardiovascular and renal complications is also far greater in patients from south Asia, with 50% higher mortality.

Up till now health professionals and policy makers have thought that one of the key ways of addressing this particular health care problem in this patient group was to enhance healthcare resources to meet the challenging cultural, communication, and comprehension difficulties in meeting the needs of those communities who also suffer social deprivation.

The researchers (from Warwick Medical School in the University of Warwick, Heart of England NHS Foundation Trust, and the University of Birmingham) put together a culturally sensitive, enhanced care package for general practices aimed at improving cardiovascular risk factors in patients of South Asian origin with type 2 diabetes.  

The package included doubling the time with a practice nurse, using Asian link workers, and input from diabetes-specialist nurses. They then studied the impact of this over a three year period across 1486 patients in 21 GPs’ practices across the inner cities of Birmingham and Coventry.

An earlier pilot study by the researchers on South Asian patients facing particularly challenging health problems relating to their Type 2 diabetes had found that such targeted interventions improved the 40% higher risks of heart disease linked to diabetes in that community and hoped that this more extensive study across a wider variety of South Asian patients with type 2 diabetes would yield similar results.

Despite small but highly significant improvements in the levels of blood pressure and cholesterol across the patient group they found no improvements in the key indicator of haemoglobin A1c . They also only found very small improvements in general quality of life that were nowhere near any definition of cost effectiveness.

This should not be seen as simply a disappointing outcome for a small group of researchers - it is a challenging outcome for South Asian patients in the UK with type 2 diabetes. They are now left still suffering much greater health risks from type 2 diabetes than the rest of the UK population with no obvious way forward to address that problem.

One of the report’s two lead authors, Warwick Medical School researcher Dr Paul O’Hare, said:

"Despite additional nursing resources, we only recorded small improvements for the patients in the study. This may have been due to reluctance of health professionals to intensify treatments and achieve tighter targets beyond those already set in national initiatives for this type of illness. These patient groups may require much more aggressive drug and insulin treatment and far tighter treatment targets for blood pressure and cholesterol than the norm. National guidelines and treatment targets for these patients may need to be aggressively tightened so GPs can begin to address the particularly adverse effects type 2 diabetes has on South Asian patients."

Diabetes cases growing at faster rate in UK than in US

24 February 2009

The number of people diagnosed with diabetes in the UK has risen dramatically and is growing at a faster rate than in the US, a large new study has shown. Nearly all of this increase comes from new cases of type 2 diabetes, which is often tied to obesity. **

Research shows that more and more people are being diagnosed with diabetes in the UK, the US and other developed countries. However, recent studies in the UK have been somewhat limited in size, and haven't looked separately at rates of type 1 and type 2 diabetes. Now researchers have studied a very large group of people to get a clearer idea of how common both types of diabetes are and how rates changed over a 10-year period.

Using a large database of medical records, the researchers gathered information on more than 1.8 million people aged 10 to 79. They grouped people with diabetes by whether they had type 1 or type 2, and also filtered out people with diabetes that had been caused by drug use or pregnancy (gestational diabetes).

The researchers found that from 1996 to 2005:

  • Diabetes became much more common in the UK. In 1996, an estimated 2.8 percent of people had been diagnosed with the disease. By 2005, this had increased to 4.3 percent -- a 54 percent jump.
  • For type 2 diabetes, the rate was 66 percent higher in 2005 than in 1996. The researchers think rising obesity is to blame for much of this increase, as 56 percent of people diagnosed with type 2 were obese in 2005, compared with 46 percent in 1996. The annual rate of new cases of type 1 diabetes remained about the same.
The researchers also compared rates of new cases in the UK and in the US, where diabetes is more common. They found that new cases increased 74 percent between 1997 and 2003 in the UK, compared with only 41 percent in the US.

But it's important to bear in mind that the study tracked only confirmed cases of diabetes. Other research shows that many people with type 2 don't know they have it, so the percentage of people with the disease may be quite a bit higher than 4.3 percent.

So, they think the massive increase of Type2 is all to do with 'increased obesity' in this country...... the afore mentioned articles' "Indian, Pakistani, Bangladeshi, and other Asian" population, which is increasing via massive immigration levels and birthrates, and have a four to six times rate of the illness have nothing whatsoever to do with the increase in Britain since 1996?

Rise in marriages between cousins 'putting children at risk of birth defects', warns Baroness

20th March 2010

A rise in the number of marriages between cousins in Britain has prompted calls for a crackdown on the practice amid warnings it is putting children's health at risk.

Crossbench peer Baroness Deech has called for a 'vigorous' public campaign to deter marriages between family members, which is common in Muslim and immigrant communities.

Her comments come as figures show up to 75 per cent of British Pakistanis in some areas are married to first cousins.

In a speech to be made next week, obtained by The Times, the leading family lawyer will warn that such marriages can be a barrier to the integration of minority communities and increases the risk of birth defects in children.

She is also expected to call for testing for genetic defects when marriages between family members are arranged and for a register of people carrying genetic diseases to be set up in order for two carriers not to be introduced.

She said such a scheme could be possible in Bradford, which has the UK's highest population of Pakistanis.

Up to three-quarters of Pakistanis in Bradford are married to their first cousins.

The trend is also evident in Birmingham, where figures show that one in ten of all children born to first cousins died in childhood or suffered from a serious genetic disorder.

British Pakistanis, half of whom marry a first cousin, are 13 times more likely to produce children with genetic disorders than the general population, according to Government-sponsored research.

Although British Pakistanis account for three per cent of the births in this country, they are responsible for 33 per cent of the 15 to 20,000 children born each year with genetic defects.

Baroness Deech will also suggest that married first cousins use in-vitro fertilisation so that embryos can be tested for recessive diseases. 'Human right and religious and cultural practices are respected not by banning cousin marriage,' she will argue. 'But those involved must be made aware of the consequences.'

In next week's speech, she will say that marriages between cousins is on the rise and the practice is 'at odds with freedom of choice, romantic love and integration.'

But she said the practice was continuing because of financial reasons - either to settle debts or provide financial support for relatives abroad; helping relatives to migrate to Britain or wanting to provide a 'ready-made' family for an immigrant spouse.

Lady Deech will also call for an education campaign to warn of the health risks of such marriages, but will stop short of urging a ban.

'There is no reason, one could argue, why there should not be a campaign to highlight the risks and preventative measures, every bit as vigorous as those centring on smoking, obesity and Aids. Where marriages are arranged, it is possible to test for carrier status and record with results, without stigmatising individuals.'

Her speech is set to reignite a debate from five years ago when Ann Cryer, the Labour MP for Keighley in Yorkshire, said cousin marriages were medieval and called for them to be stopped.

Ms Cryer encouraged discussion the issue this week. 'We have been told to be careful, as discussing it could cause deep offence. Blow that, it does not matter. If people wish to be offended, they will be offended.'

Two years ago Minister Phil Woolas provoked a furore by warning of the health risks of cousin marriages among British Pakistanis. He claimed the practice was sending the number of birth defects among children in these communities soaring.

His comments prompted Gordon Brown's spokesman to state that the issue was not one for ministers to comment on. Instead, he said, it should be addressed by members of the local community and scientific experts.

Mr Woolas insisted that he had a duty to raise the subject of cousin marriage - which is legal in the UK - based on cultural and not religious grounds.

Muslim Council of Britain spokesman Inyat Bunglawala welcomed Lady Deech's comments. He said cousin marriage was popular even though Islamic teaching encouraged wedlock outside the immediate family. 'Certainly education has an important role to play in this area. There are clear dangers to marrying a close relative, which need to be better understood.'

Lady Deech's speech is the latest in a series of family law lectures she has given under the auspices of Gresham College. In a speech last week she said English law no longer had a clear concept of marriage.

She said the traditional Christian image of a lifelong union of man and woman is no longer accurate because of the changing nature of relationships and the introduction of legal rights for same-sex couples. Lady Deech said she believes that human rights law may soon rule that it is discriminatory to ban homosexuals from marrying in the same way that heterosexual couples do.

But she added that some differences between civil partnerships and marriages should be preserved, and criticised recent Labour laws that allow same-sex couples to be named on birth certificates with no mention of a father.


'Deadliest' malaria rising in UK

3 July 2008

More cases of the most dangerous type of malaria than ever before are being brought back to the UK from trips abroad, official figures show.
A Health Protection Agency study identified 6,753 cases of falciparum malaria diagnosed in the country between 2002 and 2006. This is a 30% increase over 15 years, reports the British Medical Journal. 

Experts said many of the cases arose from visits to west Africa made by people visiting relatives and friends. 

Malaria is spread by mosquitoes carrying the plasmodium parasite, and can take weeks or months to emerge after the bite itself. 

Travel to areas where malaria is endemic has increased sharply in the past two decades, from just under 600,000 visits in 1987, to 2.6 million in 2004. 

The HPA study looked at the origins of 39,300 cases of malaria diagnosed in the UK between 1987 and 2006, 20,488 of which were in UK residents coming back from trips abroad, rather than travellers from other countries falling ill during a UK visit. 

Many were less dangerous forms of the disease, but nearly 25,000 of the 39,000 were caused by the plasmodium falciparum parasite. This version is far more likely to prove fatal, and there was a total of 183 deaths. 

Plasmodium falciparum is most likely to be contracted in sub-Saharan and west African countries, and about half of those contracting the illness were visiting friends and family in countries such as Nigeria and Ghana. 

Only two-fifths of the UK travellers had made any effort to prevent the disease by taking prophylaxis drugs before or during their trip, particularly those born in or with family ties to malaria-endemic areas. 

Travel medicine advice is freely available at GP surgeries, and specialist travel medicine clinics in the UK's bigger cities. 

Professor Peter Chiodini, head of the HPA's Malaria Reference Laboratory, said: "There is a prevailing myth that travellers who were born in a malaria-endemic country such as Africa have some 'natural' immunity to malaria and this is simply not the case. Like all other people who go to Africa and Asia they need to make sure they take their anti-malaria drugs and follow the guidelines that are there to protect everyone." 

Dr Jane Zuckerman, from the Royal Free and University College Medical School, and director of the World Health Organisation collaborating centre for reference, research, and training in travel medicine, said that it was important to get the message about malaria to all UK travellers. 

She said: "It may be possible, in some communities, to use religious leaders to communicate this, as this can be very effective." 


Fraud 'draining' NHS

01 February 2007

FRAUDSTERS are draining cash from Calderdale hospitals but bosses don't know the full scale of the problem.

Forged prescriptions people from abroad claiming free care - so-called health tourists - helped push the cost of deception to more than £76 million in the UK last year.

Calderdale and Hudd-ersfield Primary Care Trust's counter fraud specialist, Amanda Little-wood, admitted money was being lost locally but the extent of the corruption was hard to fathom. She said: "The scale is difficult to pinpoint because unless it is reported to us, we just don't know about it." Since last August Mrs Littlewood has investigated 10 cases.

"Health tourists" have travelled from outside the EU seeking free treatment at Calderdale Royal Hospital to which they are not entitled. Other con artists have impersonated family and friends to gain free treatment or prescription drugs. Claims for free eye tests, dental care and interpreters have also been uncovered.

In one case a fraudster faked prescriptions to obtain drugs, which could have been sold on the black market.

"Money that is taken off the NHS fraudulently will have an impact on services. People don't realise the impact they have when they commit fraud. I don't think they really think about the consequences but these consequences could be quite serious," said Mrs Littlewood.



 20 March 2009
Hackney continues to have one of the highest rates of Tuberculosis (TB) in the UK, new figures reveal. Up to 133 cases of the potentially killer disease were reported in the borough last year, according to City & Hackney Primary Care Trust. This compares to around 150.

Around 8000 new cases of TB are reported every year in the UK, with most cases in major cities.

TB symptoms may include fever and night sweats, persistent cough, weight loss and blood in sputum. If you have these symptoms contact your GP and book an appointment. For more information call NHS Direct on 0845 46 47

Left untreated, each person with TB will infect an average of ten to 15 people every year.



Hepatitis B rise leads to migrant screening call

May 19, 2008

One in ten of the Chinese immigrant population in Britain is carrying the hepatitis B virus, a survey suggests, leading to calls for all migrants to be screened upon entering the country. 

Hepatitis B virus (HBV) is the most common serious liver infection in the world, and thought to be the leading cause of liver cancer. 

About one in three of the world’s population is infected by HBV, but half of those who carry the virus never develop any symptoms. 

There has been a massive surge in migration to Britain from areas of high HBV prevalence and a report from the Hepatitis B Foundation UK estimates that more than 325,000 people here are chronically infected with the virus – nearly double the Department of Health’s 2002 estimate of 180,000. Most people infected will eventually clear the virus from their bodies, but about 5-10 per cent become chronic hepatitis B carriers, often without even knowing it. 

Although the prevalence of chronic hepatitis B (CHB) in the resident population is only about 0.3 per cent, 96 per cent of new cases are imported by people who acquired the infection before coming to Britain. **

Of 89 Chinese immigrants screened by the Chinese National Healthy Living Centre in London, 10 per cent were found to be hepatitis B positive. 

There is a particular risk of transmission between children in playgroups, schools and nurseries as the virus is considered 100 times more infectious than HIV. 

At present in the NHS there is no requirement for doctors or nurses from overseas to be tested for infection and in 2003 alone, 700 doctors and about 6,000 nurses came to Britain from areas with a high incidence of hepatitis B. 

David Mutimer, an honorary consultant hepatologist at Queen Elizabeth Hospital, Birmingham, said: “Hepatitis B is a far greater threat than TB for which there is a screening and immunisation programme.” 

Penny Webb, chief executive of Hepatitis B Foundation, called for “an effective screening and immunisation programme”. “The Government must identify those migrants who are chronically infected with hepatitis B at the point of entry into the UK, so that measures can be taken to prevent transmission of the virus,” she said. 


Call me an old cynic, but, in the demographic page article "Number who say they are 'white British' in decline", it states that the number of Chinese in Britain has risen 75% since 2001.

On the Cancer Research website, it says, 
"Liver cancer cases treble in 30 years - In 1975, 865 cases of primary liver cancer were diagnosed in Great Britain but the latest figures for 2006 show that number has risen to 3108. 

Experts attribute this rise to three things: the increase in alcohol consumption, obesity and hepatitis C. Each of these factors can lead to cirrhosis which in turn may develop into primary liver cancer. 

Dr Lesley Walker, Cancer Research UK's director of cancer information, said: "While this increase is a concern, it is important for people to understand how their risk of liver cancer can be reduced by changes to lifestyle.
Now, obviously I am not a medical man. I am just throwing out a wild idea. We are told, endlessly, about how there is a rise in these illnesses in Britain - and it often shows along with the news narrative some footage of fat white women from the neck down waddling down the street, or drunken white women necking glasses of wine whilst it states liver cancer has trebled in 30 years. 

Whilst I am sure drinking culture and an onset of some obesity is undoubtedly a factor in this increase, is it not reasonable to suggest that the rise in Hepatitis being brought to Britain (from all around the world without checks, but particularly China in this case) is helping create this onset of 'liver cancer' in this country amongst all residents here - not to mention direct masses of such people arriving here who are already liable to it, perhaps being the direct ones bumping up the figures quite dramatically on the NHS figures ?.....

I don't know. All I am saying is think differently to what the TV media might be implying as the causes of such 'rises'. 


'HIV test for African nurses' opposed

16 August, 2002

Plans by the British Government to introduce compulsory HIV tests for all new health staff working in the country have been strongly opposed by the Nursing and Midwifery Council ( NMC) and organisations working with HIV infected people.

The Nursing Council says the move has provoked a great deal of surprise and anger within the medical profession.

The plans were prompted by fears that hundreds of nurses recruited by the National Health Service (NHS) from Africa are carrying the virus that can lead to AIDS.

"It came as a bolt out of the blue to us when it was announced," the Head of NMC's Communications, Stuart Skyte, told the BBC World Service programme, Talkabout Africa.

He said if approved, the tests would be a condition of employment imposed by the council which has the powers to ensure that nurses must be in good health before being allowed to work. But "the government does not define what good health means", Mr Skyte said. "One can be HIV positive but in good health."

Speaking on the same programme, the Chief Executive of the National Aids Trust, Derek Bodell, termed recent media reports that nearly 700 infected nurses were last year recruited from Africa as unrealistic and a complete fantasy meant to scare the public.

Mr Bodell said although there are a few infected nurses recruited by the NHS, "we haven't got a blanket invasion of people who have been recruited abroad who are HIV positive."

An official from the African HIV policy Network, Joshua Odongo, said the government's plan would only heighten stigma and the discrimination against African nurses working in the UK.

The UK is currently facing an acute shortage of health workers and has been looking into new ways to recruit health workers from abroad. It is, however, not clear when the government intends to introduce the policy, how frequent health workers would be required to test for HIV and whether a positive test would disqualify a nurse or a doctor from working in the NHS.

At present, HIV tests are voluntary and health workers do not have to undergo screening before working in the UK.

Those found to be infected are restricted in the type of work they can do.

Plans to introduce the tests emerged last year after Wolverhampton Health Authority discovered that it had recruited ten HIV positive nurses from southern Africa.

Doctors say there is no evidence that any patient in Britain has been infected by an HIV positive healthcare worker. 

God forbid we have a bit of "stigma" and "discrimination" against allowing hundreds of poached African nurses  into the UK who have HIV. I mean, the feelings of Black people must come ABOVE the governments duty to protect the health risks to the populace of this country surely?.......

London suffering from shocking rise in rare 'Victorian' diseases

Political Editor

London is in the grip of a startling rise in diseases associated with Victorian times, figures disclose today.

Rare infectious illnesses including typhoid, whooping cough and scarlet fever have soared by 166 per cent in the past two years. Infection rates in the capital are markedly higher than the national averages, warned Justine Greening, the shadow minister for London who assembled the figures.

They include a staggering 214 per cent increase in cases of mumps - up from 125 in 2007 to 393 last year. The disease is easily prevented with vaccine. The rise could be a result of parents shunning the MMR jab after now debunked claims in 2001 that it might be linked to autism. Mumps in adults can lead to hearing loss and damage the nervous system.

Whooping cough cases quadrupled in the five years to 2007, from 63 to 252. The disease is highly contagious, with infections often lasting months. Symptoms include choking spells and vomiting and can cause death, especially in young infants.

Cases of scarlet fever, which causes high fevers, rashes, and even severe damage to internal organs, are up 153 per cent since 2005, with 501 infected in London last year.

Typhoid, associated with poor sanitation and hygiene, has risen steadily since 2004, from 45 to 127 cases per year.

The Conservatives claimed the Government was partly to blame for failing to invest enough in public health and to appoint school nurses.

Ms Greening, the Putney MP, said: "The rise of these highly-infectious and potentially fatal diseases in our city is truly alarming. "The Government must do more to ensure the public health of Londoners."

Schizophrenia 'epidemic' among African Caribbeans spurs prevention policy change

Research shifts government mental health strategy to focus on ethnic minorities and controversial social issues

The Guardian, Wednesday 9 December 2009

It is nothing short of an "epidemic", say the authors of a major study that has found that members of the African Caribbean community are nine times more likely to suffer from schizophrenia than people in the white community.

The study has had a major influence on the thinking behind the Department of Health's (DH) New Horizons in Mental Health strategy document, unveiled on Monday, which has moved away from the aim of having specialist services for ethnic minorities, and towards dealing with controversial social issues that lie behind the very high rates of psychosis.

The worrying figures emerged from a large study carried out by psychiatrists and epidemiologists at the social psychiatry unit of the Institute of Psychiatry at the Maudsley hospital in south London. Named Aesop (Aetiology and Ethnicity in Schizophrenia and other Psychoses), the study involved 500 patients with mental health problems from various ethnic groups, comparing them with a control group of 350 healthy subjects.

The researchers ruled out genetic issues as the cause, and the previously held suspicions that psychiatrists were more inclined to diagnose schizophrenia when dealing with black males in particular. They concluded instead that the root causes lay in a whole range of social factors that lead to severe social isolation – people living alone, unemployment, and the vexed issue of separation from parents due to family breakdowns in the African Caribbean community amounting to a kind of "sensory deprivation" – all of which have a dramatic effect on people with a tendency towards schizoid personalities.

"When you get figures like this . . . you can only call it an epidemic," says Julian Leff, emeritus professor at the Institute of Psychiatry. "We need a programme of social engineering, particularly to try to strengthen family structures in the African Caribbean community, with a view to keeping children in stable families. This may sound very difficult, and it would have to be done by African Caribbean community leaders, but it's feasible."

Louis Appleby, the government's mental health tsar, describes the study as "probably the most important ever done in this field." New Horizons, and a bigger public health and prevention publication to be announced next year, is in line with the findings of the research, says Appleby, adding: "Whereas our previous policy was mainly about reforming community care, this is more about how we can address some of the causes of mental illness, particularly in relation to ethnic minorities."

The issues are controversial, he admits, touching on sensitive issues such as the number of African Caribbean families with absent fathers. "But it's very clear," he says. "There are genuinely very high rates [of schizophrenia], and the causes are social causes affecting people before they come into contact with mental health services. That's quite a step, and you won't find previous documents that have been so clear about these controversial issues. Instead of trying to build separate services for individual groups, it is about a service that is more personal to individuals."

But Paul Corry, director of public affairs for mental health charity Rethink, is less sanguine. He says: "The numbers are so outrageous that you would think there would be really big, properly funded programmes driven through with zeal."

The DH's plan for delivering race equality in mental health care in 2005, which proposed the recruitment of 500 community workers to tackle social issues through 80 new community engagement projects, is still short of recruits. While Appleby says the plan has led to individual projects that "seem to have been successful", what has been more difficult is to evaluate it in a way that shows it has had a single positive outcome, "like better mental health".

Corry agrees that there "are some good ideas being followed up in a few areas by very good individuals", but argues that on race equality in mental health services, the government has failed to provide "the joined-up national lead that we are all looking for".

I guess that white people do not have unemployment, isolation, live alone, etc..... 
Why would scientists "rule out" genetic differences from the outset? What sort of "scientists" are they? Real ones, or ones who's approaches are curtailed by politically correct orthodoxy views that we are 'all the same'? 

"sensory deprivation"?  - Pull the other one, it's got a bell on.


Health tourists owe NHS £22 million, Department of Health reveals

February 27, 2010

Immigrants with unpaid NHS bills could be excluded from Britain under proposals aimed at reducing foreign healthcare tourism.

The Department of Health is trying to recover £22 million from foreign nationals who have had NHS treatment in the past two years and not paid their bills.

Those who do not pay for the healthcare they receive in Britain could in future be banned from entering the country or refused permission to extend their stay. Anyone from outside Britain should pay for NHS treatment received in Britain but under human rights laws health staff must treat anyone with a life-threatening illness.

Trusts reported to be chasing foreign nationals for payment include Imperial College Healthcare in London, which is owed £1.4 million, including two bills of £50,000 owed by patients from Egypt and the United Arab Emirates.

Barts and the London NHS Trust has £1.3 million outstanding, including a £52,000 surgery bill for a Chinese patient, while Pennine Acute Trust, Manchester, is trying to recover £1.2 million, including £34,000 spent on an HIV-positive patient from Malawi.

Among proposals being considered by the Government is a requirement that visitors to Britain to have health insurance as well as extending the period that British residents can stay outside the country before losing their rights to NHS treatment.

Under Home Office proposals, non-payment of bills would also delay an immigrant’s application to become a British citizen. It is feared, however, that some existing debts could be written off, as some immigrants refuse to give their name or address. The proposals could also require medical records to be shared with the Border Agency, which could violate patient confidentiality.

Mike O’Brien, the Health Minister, said that while the NHS had a duty to any person whose health was at immediate risk, “we cannot afford to be an international health service, providing free treatment for all. We are however, determined ... to deliver high-quality care to all those with a legal right to it, while protecting our National Health Service from those who would abuse it.”

Phil Woolas, the Immigration Minister, added: “I believe that those who have benefited from our system should pay the debt they owe. We are now seeking views on denying entry to the UK to those who incur debt to the NHS.”