Is it too late to stop the NHS review?

19. January 2012 stand 17: 01 GMT by Nick Triggle health correspondent of the BBC News great health trade unions have now said against the changes of health workers, it is fair to say, have the Government NHS reforms a pretty big thumbs down.

Both the British Medical Association in the transition from critical friend have the Royal College of nursing and Royal College of midwives joined outright opponents.

The other large health - unison, the admin and support staff such as institution represents - Union was against the plan from the outset.

But despite the chorus of disapproval, Minister for press you said to.

The Bill for the changes is still in the Lords, but are largely intact all the information that colleagues are passed back to the Commons.

Focus would then return to the Lib Dems, getting the Government to carry out his "listening exercise" last spring were involved in.

But it seems unlikely that rebel it this year, are, after all Nick Clegg changes last summer as a victory for the Coalition junior partner proclaimed.

Even though there are the political will, the Bill, scrap however regardless of doubts whether it would be possible even in a practical sense.

The truth is, there are two parts to the review: the political process and the structural changes on the ground.

While the former latter was largely unnoticed by the average patient happens a lot of attention, has attracted.

Stop the invoice

The 151 primary health care were trusts who lose control of budget of NHS GPS under the plans, in about 50 cluster, to shed thousands of jobs in the process merged.

The 10 strategic health authorities, which effectively keep an eye on the system maintained also for four super hubs create together.

In the meantime, come forward despite the opposition of the large unions, enough GP to set up, covering new commissioning groups which will assume the NHS budget from April 2013, 97% of the country.

Many of these facilities was - already set up and some are even households manage ahead of time.

Meanwhile, the National Board, the new system is as well as taking into account their specialist services, such as heart surgery, will oversee well on the way to the formed.

It has a Chief Executive - Sir David Nicholson, who is the current NHS Chief Executive and medical director.

A provisional Finance Chief was made and the other seven members of the national team are in the process of the recruited with salaries of up to £ 170,000 available. You will be expected to March.

In short, this means in some respects it is too late.

As a senior official said union: "Yes, we could scrap of the Bill may curb the participation of the private sector, but what would we do with all the things that already exist?" "We have, have a long reflection."

Source BBC

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Experts review vitamin D advice

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24 January 2012 Last updated at 12:19 GMT Concerns over vitamin D deficiency - A quarter of toddlers affected

The chief medical officer for England, Dame Sally Davies, is to contact medical staff about concerns young children and some adults are not getting enough vitamin D.

Government guidelines recommend some groups, including the under-fives, should take a daily supplement.

However, recent research found that many parents and health professionals were unaware of the advice.

There has been an increase in childhood rickets over the past 15 years.

According to Dr Benjamin Jacobs, from the Royal National Orthopaedic Hospital, links to heart disease and some cancers are also being investigated.

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It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at-risk groups”

End Quote Dame Sally Davies Chief medical officer for England The consultant paediatrician told BBC Breakfast that the hospital saw about one severe case a month of rickets - softening of bones through lack of vitamin D in childhood.

He said: "There are many other children who have less severe problems - muscle weakness, delay in walking, bone pains - and research indicates that in many parts of the country the majority of children have a low level of vitamin D."

The Feeding for Life Foundation report, published in October last year, suggested one in four toddlers in the UK is vitamin D deficient.

However, this may be an underestimate as only vitamin D from food was included, and not any vitamin D obtained through sun exposure.

Vitamin D supplements are recommended for all people at risk of a deficiency, including all pregnant and breastfeeding women, children under five years old, people aged over 65, and people at risk of not getting enough exposure to sunlight.

Vitamin D is mainly obtained from sunlight. However, too much sun exposure increases the risk of skin cancer.

According to one recent study, nearly three-quarters of parents and more than half of health professionals are unaware of the recommendations.

The Department of Health has asked the Scientific Advisory Committee on Nutrition to review the issue of current dietary recommendations on vitamin D.

Dame Sally Davies: "We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements.

Free supplements

"Our experts are clear - low levels of vitamin D can increase the risk of poor bone health, including rickets in young children.

"Many health professionals such as midwives, GPs and nurses give advice on supplements, and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.

"It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at-risk groups."

It has long been known that vitamin D prevents rickets and children were once given food supplements like cod liver oil.

However, this practice was stopped in the 1950s because it was thought unnecessary.

In the last 10 years, doctors have been seeing more cases of vitamin D deficiency, leading to a debate over the use of food supplements and concern that many medical staff are unaware of the problem.

Source BBC

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FDA, Medicare to review medical devices in tandem

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By Alina Selyukh

Fri Oct 7, 2011 3:23pm EDT

n">(Reuters) - U.S. health officials are launching a trial of a program meant to speed up Medicare payment decisions for new medical devices.

The Food and Drug Administration, which regulates the safety and effectiveness of the devices, will review new products in parallel with the Centers for Medicare and Medicaid Services, the agencies said on Friday.

The pilot program could help device makers avoid situations in which they receive FDA approval only to discover that their products fail to win coverage under Medicare, the federal insurance program for the elderly.

Currently, Medicare often does not begin its reviews until the FDA -- which is not supposed to take cost into consideration -- approves the products. A Medicare coverage decision can make or break a medical product.

"The parallel review program has the potential to increase patient access to innovative devices that improve clinical outcomes," CMS Chief Medical Officer Dr. Patrick Conway said in a statement. "Our goal is to reduce regulatory burden and improve patient outcomes."

The Advanced Medical Technology Association (Advamed), which represents device makers, said it was still looking at the program's details but supported any effort to boost timely reviews that are more predictable and efficient.

"However, we believe it is important to preserve the currently separate and distinct regulatory missions of FDA and CMS to ensure that each agency does not influence the functions and decisions of the other and to ensure the confidentiality of all proprietary information provided by manufacturers," Ann-Marie Lynch, Advamed's executive vice president for payment and healthcare delivery policy, said in a statement.

The FDA and the CMS said the "parallel review" process will not change their distinct standards. The agencies on Friday began accepting submissions for participation in the pilot program, which is voluntary and was proposed in September 2010.

For more on the program, please see www.fda.gov/parallel-review .

(Reporting by Alina Selyukh in Washington; Editing by Steve Orlofsky)

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