It's all about health

It's No Guarantee, But You Should Get the Flu Shot Anyway

15.39 egaoart No comments

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As vaccines go, the flu shot is no exemplar. A comprehensive new review of the research, published online by The Lancet Infectious Diseases, finds that the vaccine prevented illness in 59% of adults aged 18 to 64, and in eight of 12 flu seasons studied.

The authors said that evidence of effectiveness was particularly lacking in children aged 2 to 17 and in certain populations that are especially vulnerable to flu like elderly people over 65.

Still, said lead author Michael Osterholm, director of the Center for Infectious Disease Research & Policy at the University of Minnesota, 59% is better than zero, so people should still be getting their annual flu shots.

MORE: No Excuses! A Brief Guide to the Flu Shot

In their analysis, Osterholm and his team included 31 previously published studies (out of 5,707 they considered) — 17 randomized controlled trials and 14 observational studies — chosen based on strict study design criteria. Pooling data from various studies, the researchers found that the H1N1 vaccine was somewhat more effective than the seasonal flu shot, preventing infection in 69% of adults under 65. Nasal spray vaccines, which contain weakened live flu viruses, were more effective still, protecting 83% of children under age 7.

Because of the stringent criteria Osterholm and his team used to exclude trials from their analysis, their findings veer from those of the most recent review by the Cochrane group, which estimated that the flu vaccine was 73% effective when circulating flu strains matched those in the vaccine, and 44% when they didn't.

The findings may come as a surprise to the average consumer, but public health officials and vaccine makers are familiar with the flu shot's imperfect performance. Based on its own recent, unpublished data on the 2010-11 flu season, the Centers for Disease Control and Prevention (CDC) estimates that the vaccine was 60% effective in all age groups combined, cautioning that protection may vary widely:

At least two factors play an important role in determining the likelihood that influenza vaccine will protect a person from influenza illness: 1) characteristics of the person being vaccinated (such as their age and health), and 2) the similarity or "match" between the influenza viruses in the vaccine and those spreading in the community. During years when the viruses in the vaccine and circulating viruses are not well matched, it's possible that no benefit from vaccination may be observed. During years when the viruses in the vaccine and circulating viruses are very well matched, it's possible to measure substantial benefits from vaccination in terms of preventing influenza illness. However, even during years when the vaccine match is very good, the benefits of vaccination will vary across the population, depending on characteristics of the person being vaccinated and even, potentially, which vaccine was used.

MORE: 1 in 10 Parents Skip or Delay Vaccines

Indeed, a study published on Monday found that the vaccine may be even less effective than previously thought in overweight and obese people. About 11 months after it was administered, the vaccine had worn off by a factor of four in twice as many heavy people (50%) as in those of healthy weight (25%), according to the study by researchers from the University of North Carolina at Chapel Hill. What's more, when blood samples from the 461 participants were exposed to the flu virus, 75% of samples from normal-weight people showed the appropriate immune response, compared with only 25% of obese people's blood samples.

"It's clear that what we really need is to develop new and better vaccines," Osterholm told NPR's Shots blog. But because the current vaccine, while not ideal, is safe and moderately effective, and because it would cost so much to introduce a new vaccine that works significantly better, it's held up development.

Scientists are now working on a universal flu vaccine that would offer protection against all flu strains for years. The current flu shot must be reformulated and manufactured anew each year, with the three strains that health officials predict will be the most commonly circulating.

There's another way to boost the potency of flu shots: by adding adjuvants. In a recent study published in the New England Journal of Medicine, researchers found that seasonal flu shots with adjuvants were 86% effective in children aged 6 or younger, compared with a 43% protection rate for conventional shots. No flu shots with adjuvants are currently approved for use in the U.S.

On balance, though, getting the regular old flu shot is better than not getting one. The CDC recommends the vaccine for everyone over 6 months old. It may not eradicate all influenza infections, but it can help prevent illness, hospitalizations and deaths.

MORE: Do Flu Shots Really Work? A Skeptic's View

Meredith Melnick is a reporter at TIME. Find her on Twitter at @MeredithCM. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

Your Product Is Free of Parabens, Sulfates and Lots of Other Things: Should You Care?

15.24 egaoart No comments

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Roxanne Green is a corporate ingredient-reader. What that means is she gets paid to do what savvy (neurotic?) consumers spend hours doing in the cosmetics aisle.

Green, who works at PCC Markets outside Seattle, follows an extensive list from the nonprofit Natural Products Association (NPA) detailing what ingredients the group prohibits. She scrutinizes every label and tosses any products that don't meet the NPA's strict standards. In the course of this laborious work, she's noticed a new marketing trend: an increasing number of shampoos, soaps and moisturizers are touting what they don't contain.

Kiss My Face sunscreen proclaims it's paraben-free. Avalon Organics shampoo boasts it's got no grapefruit seed extract. Even cosmetics giant L'Oreal has a sulfate-free shampoo line. And here's a real doozy: Hugo Naturals soap states it's free of "parabens, phenoxyethanol, SLS, PEGs, propylene glycol, petroleum products, artificial colors or synthetic fragrances."

But what are parabens? Or grapefruit seed extract? And why exactly is sulfate something you don't want in your shampoo?

In the current print issue of TIME, we explore the concept of "ingredient anxiety" — that feeling of stress that bubbles up when you learn you should be avoiding a particular ingredient but you're not exactly sure why. Subscribers can read it here — and try to relax.

After all, even the experts can get overwhelmed. Cara Welch, chief scientist for the NPA, acknowledges that all those polysyllabic chemicals can be really confusing. "Look for ingredients you recognize," advises Welch. "We know not everyone has a Ph.D. in chemistry."

Bonnie Rochman is a reporter at TIME. Find her on Twitter at @brochman. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

IVF Linked to Ovarian Tumors. Should Women Worry?

06.47 egaoart No comments

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When TV host Giuliana Rancic was recently diagnosed with breast cancer after two rounds of in-vitro fertilization (IVF), cancer specialists were widely quoted as saying that there's no evidence that the large hormone doses involved in fertility treatment contribute to breast cancer. The link between IVF and ovarian cancer, however, was muddier.

Part of the problem when studying IVF and ovarian cancer risk is that infertile women already have a slightly higher risk of ovarian cancer than women who are able to conceive naturally, so it's difficult to figure out whether it's the infertility or the IVF that may raise ovarian cancer risk.

MORE: The Case of Giuliana Rancic: Is There a Link Between IVF and Cancer?

Now a study of 25,152 Dutch women with fertility problems — 19,146 of whom underwent IVF, while the rest did not — is the first to try to get around that problem. The researchers found that after about 15 years of follow-up, women who had undergone IVF, which requires hormones to stimulate the ovaries, were twice as likely to have developed an ovarian malignancy, compared with the non-IVF group.

Most of that increase in risk was driven by "borderline" ovarian tumors, however. These are tumors that may turn into cancer and require surgery to remove the ovary, but are rarely life threatening. The IVF group was nearly twice as likely to have a borderline tumor as the general population, and more than four times as likely as the subfertile comparison group.

"Our data clearly show that ovarian stimulation for IVF is associated with an increased risk of borderline ovarian tumors and this risk remains elevated up to more than 15 years after the first cycle of treatment," study author Flora van Leeuwen, head of the department of epidemiology at The Netherlands Cancer Institute, said in a statement.

So, how worried should women be? Not terribly. The absolute risk of ovarian tumors was very low. Researchers found just 61 ovarian malignancies in the IVF group, 31 of which were borderline tumors. In the Netherlands, the researchers note, the cumulative risk of ovarian malignancy, including borderline tumors, is 0.45% in women aged 55. "If our results are true, we would estimate a 0.71% risk for women who underwent IVF," they write — a less than 1% chance.

MORE: Mind-Body Programs Boost Pregnancy Rates for IVF Patients

The other 30 malignancies in the IVF group were invasive cancer. Although the women receiving fertility treatment had more invasive cancers than the comparison group, the difference was not statistically significant, the study found.

Further, the overall rate of ovarian malignancies did not rise with increasing numbers of IVF cycles, suggesting that ovarian stimulation is not causally linked to cancer.

"The main message is that women who have had IVF shouldn't be alarmed. The incidence of ovarian cancer was extremely low," Curt Burger, a co-author of the study published in the medical journal Human Reproduction, told the BBC.

Meredith Melnick is a reporter at TIME. Find her on Twitter at @MeredithCM. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

Panel: Boys should get HPV vaccine given to girls

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ATLANTA (AP) — A vaccine against cervical cancer hasn't been all that popular for girls. It may be even a harder sell for boys now that it's been recommended for them too.

A government advisory panel on Tuesday decided that the vaccine should also be given to boys, in part to help prevent the cancer-causing virus through sex.

Public health officials have tried since 2006 to get parents to have their daughters vaccinated against the human papillomavirus, or HPV, which causes most of the cervical cancer in women.

Federal health officials usually adopt the panel's recommendations and ask doctors and patients to follow them.

The vaccine has been advised for girls since 2006. Just 49 percent of adolescent girls have gotten at least the first of the three HPV shots. Only a third had gotten all three doses by last year.

"Pretty terrible," Schuchat said.

Schuchat indicated the CDC is ready for that kind of argument: "There's no data suggesting that offering a vaccine against HPV will change people's subsequent sexual behavior," she said.

So far, the threat of genital warts hasn't been persuasive: Some data suggest that less than 1.5 percent of adolescent males have gotten the vaccine over the past two years.

Experts at the committee meeting noted an earlier analysis that showed vaccinating boys would not be cost-effective if the female vaccination were high.

"If you do reach high coverage of females, will you stop vaccinating males?" asked Dr. David Salisbury, director immunization for the United Kingdom's Department of Health.

There are two vaccines against HPV, but Tuesday's vote applies only to Merck & Co.'s Gardasil, which costs $130 a dose. The other vaccine wasn't tested for males.

Merck officials bristled at the idea that males would see the vaccine as mainly meant for gay men, noting that HPV-caused anal cancers can occur in heterosexual men.

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AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

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Online:

HPV info: http://www.cdc.gov/hpv/

Associated Press

Boys should get HPV vaccine, CDC advisers say

15.44 egaoart No comments

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CDC: Tests on thousands of people show "no serious safety concerns" The advisory committee votes to recommend males ages 11 to 21 be vaccinatedHPV is the number one sexually transmitted disease in the nation The HPV vaccine has been approved for males since 2009

Atlanta (CNN) -- A federal government advisory committee voted Tuesday to recommend that males ages 11 to 21 be vaccinated against the human papilloma virus, which is blamed for thousands of cases of cancer among women and men.

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices said the vaccine series can be started as early as age 9.

Twelve members of the committee voted in favor of a recommendation that 11- and 12-year-old boys be vaccinated; one member abstained.

In a separate vote involving males age 13 to 21, eight voted in favor; five against, and one abstained. The same recommendation said men ages 22 through 26 may be vaccinated.

Much of the debate focused on whether it would be cost-effective to vaccinate boys against HPV. The vaccine is administered over a six-month period in three doses, each of which costs about $120.

Dr. S. Michael March, clinical professor of pediatrics at the University of Southern California and a member of the group that devised the recommendations, said the cost to vaccinate 11- and 12-year-old boys would be $38 million. "We have the money, we just have to set the priorities," he said. "If we don't, I don't know who will."

HPV is the most common sexually transmitted disease in the United States. At least half of sexually active people will get it at some point in their lives.

Why vaccinate middle schoolers? Experts say that it's important to immunize people before they become sexually active. According to the Guttmacher Institute, which studies sexual health, 13% of 15-year-olds have had vaginal sex. By 19, that figure has risen to 70%. The vaccine is less effective after a person is sexually active.

Study: Males should get HPV vaccine too

The HPV votes took place as part of the advisory committee's meeting in Atlanta. The vaccine is 89% effective against genital warts in males and 75% effective against anal cancer in males, according to CDC.

The HPV vaccine is already recommended for females between the ages of 9 and 26 to reduce the risk of cervical cancer. The CDC recommends girls also get the vaccine at age 11 or 12.

The Food and Drug Administration approved the first HPV vaccine, Gardasil, in 2006. A second vaccine, Cervarix, was approved in 2009.

Gardasil protects against most genital warts and anal, vaginal and vulvar cancers, all of which are associated with HPV, according to the disease agency.

Although the vaccine has been approved for males since 2009, it hasn't been as heavily promoted for them.

Increase in oral cancers linked to HPV

One reason for the push now is that girls aren't getting vaccinated in the numbers doctors had expected. "If the boys are also immunized, it reduces the transmission back and forth," said Dr. William Schaffner, chairman of the Department of Preventive Medicine at Vanderbilt University, who attended the CDC meeting as an adviser but not a voting member.

In addition, the committee voted to recommend that men who have sex with men up to age 26 be vaccinated against HPV because that would protect them from cancers of the penis and rectum.

There also is growing evidence that HPV is responsible for a recent increase in head and neck cancer. A study published this month found approximately 70% of all oropharyngeal cancers are caused by HPV. Oropharyngeal cancers are those that form in the middle of the throat behind the mouth, an area that includes the back third of the tongue, the soft palate, the side and back walls of the throat and the tonsils.

This year, the American Academy of Pediatrics added the HPV vaccine to its list of recommended vaccines for boys.

The HPV vaccine became a political hot potato when Republican presidential contender Michele Bachmann criticized fellow Republican contender and Texas Gov. Rick Perry's support of the vaccine for girls. In 2007, he signed an executive order that required Texas schoolgirls to receive vaccinations against HPV. The order ended up not being implemented.

The CDC notes that the FDA has licensed the vaccines as safe and effective. "Both vaccines were tested in thousands of people around the world. These studies showed no serious safety concerns. Common, mild adverse events reported during these studies include pain where the shot was given, fever, dizziness, and nausea," according to the CDC website.

CNN's Aaron Cooper, William Hudson and Saundra Young contributed to this report.

Education Information

Should Your 2-Year-Old Be Using an iPad?

06.11 egaoart No comments

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From "Baby Touch: Peekaboo" to "Moo, Baa, La La La!," iPad apps for babies are flooding the market. Developers say the apps are educational, and busy parents know that a digital babysitter can buy them a few minutes of valuable time. But is the iPad a healthy thing for young kids?

Apple's iTunes now stocks more than 700 apps for children, including ones that promise to "develop hand-eye coordination and focusing skills in young babies" or teach "fine motor skills" to infants "from 0 to 2.5 years old."

As Healthland reported on Tuesday, the American Academy of Pediatrics (AAP) has advised parents — again — to eliminate screen time for children under 2, citing concerns about language delays and disrupted sleep. The academy's new report drew on studies showing that TV, whether it's the parent or the child watching, interferes with "talk time" between parent and child, which is crucial to language development.

Does the TV effect apply to iPads too? That's not clear. "We just don't have the data yet," says Dr. Ari Brown, a pediatrician and member of the AAP.

Perhaps it depends on how you're using it. Tablets used like a TV should fall under the same guidelines, says Tanya Altmann, a Los Angeles-based pediatrician and author of the best-selling parenting book Mommy Calls. However, she doesn't rule out the possibility that interactive apps may have some value for toddlers. "In some ways, applications are just newer versions of the game that we used to play when we were kids — you tap the cow and it says 'moo,'" she says.

But even apps that simulate conventional toys don't teach children the crucial skills that come from physically engaging the world in three dimensions, says Dr. Dimitri Christakis, director of the Center for Child Health, Behavior and Development at Seattle Children's Hospital. He points to iPad apps that replicate building blocks and Legos. "Surely we would not want that to substitute for actually getting blocks and building something," he says. "This is not how the real world works, and babies do need to learn how the real world works."

So, the jury's still out on tablets for toddlers, but research suggests that educational apps may enhance the learning experience of slightly older children. A recent study funded by the Department of Education showed that the PBS Kids iPhone app "Martha Speaks" boosted 3-to-7-year-olds vocabularies by as much as 31% over the course of two weeks.

Rose Luckin, a professor of learner-centered design at the University of London, has found that tablet-type devices can actually spark the sort of social interaction central to the learning process. She found that 5- and 6-year-olds who recorded school activities on tablets and replayed them for their parents tended to learn better. "One of the key benefits of technologies such as the iPad is that they can become a focus for conversations between parents and children," she says. "If the device is right in the middle of the family, in the kitchen, in the lap, then as a parent, you're much more able to have those kinds of shared experiences."

In other words, tablets might not be all bad if they generate "talk time," rather than replace it. As with anything else, says Luckin, moderation and common sense are key. "If a child just sits all day playing on the iPad on her own, then I'm not sure she's getting the benefits," she says. "My argument about the value of these devices is that they can add to parental time, not take away from it."

When parents are busy, though, the best option may simply be to turn the gadgets off, rather than letting kids use them unattended, says Altmann. "We know parents can't be with their children 24/7," she says. "But don't forget that when we were kids, our moms would just give us toys to play with on the ground and say, 'Play.' Just give them some time to explore occasionally on their own. They don't have to have external stimulation every second of the day."

Should Your 2-Year-Old Be Using an iPad?

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Does the TV effect apply to iPads too? That's not clear. "We just don't have the data yet," says Dr. Ari Brown, a pediatrician and member of the AAP.

Should I get screened for that?

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A mammogram is basically an X-ray of the breast. Plates flatten the breast tissue to take a more accurate photo.Prostate cancer screenings include a blood test and a digital rectal examinationMammograms have helped reduce breast cancer mortality rates in the U.S.Colorectal cancer is one of the leading causes of cancer-related death

(CNN) -- The U.S. Preventive Services Task Force recently announced that it is no longer recommending prostate cancer screening for men.

A spokesman for the Prostate Cancer Foundation told CNN the recommendation is "a tremendous mistake," but the senior author of the task force's report says the prostate specific antigen, or PSA, test does more harm than good. The report says that cancers detected by the test are often slow-growing and would never be harmful, but that treatment could render a man impotent or incontinent or kill him.

It's a debate that's ongoing for several other types of screening as well, but not all are in contention.

Here's what you should know about the four most common types of pre-symptom cancer screenings, including the leading experts' recommendations and what the test involves:

Prostate cancer

Prostate cancer is the most common form of cancer among men, with approximately 30,000 dying from the disease each year.

The American Cancer Society recommends that men over 50 with no special risk factors talk to their doctors and decide on an individual basis -- after weighing the risks of treatment -- if they want to be screened.

The American Urological Association says that making an informed decision about screening is important, but that all men with a life expectancy of 10 years or more should have a baseline PSA test at the age of 40.

Prostate cancer screenings include a blood test for elevated levels of the prostate specific antigen protein and a digital rectal examination. During the digital rectal exam, a doctor will insert a lubricated, gloved finger into the rectum to feel for abnormalities in the prostate.

Breast cancer

The chance of developing invasive breast cancer for American women is a little less than one in eight, according to the American Cancer Society.

The U.S. Preventive Services Task Force released a statement two years ago recommending against yearly mammograms for breast cancer for women in their 40s. The task force said the benefits didn't significantly outweigh the risks. However, the ACS and the Susan G. Komen for the Cure foundation have fought against this recommendation.

Mammograms have helped reduce breast cancer mortality rates in the U.S. by nearly one-third since 1990, according to the American College of Radiology.

The American College of Obstetricians and Gynecologists and the National Cancer Institute recommend that women age 40 and older get screened for breast cancer every one to two years.

A mammogram is basically an X-ray of the breast. Plates flatten the breast tissue to take a more accurate photo, often from two angles, which can be uncomfortable but only takes a moment. The photos are then analyzed for calcifications, which appear as white dots, and any mass that looks abnormal such as a cyst or tumor.

Colorectal cancer

Colorectal cancer is one of the leading causes of cancer-related death, but also one of the most curable if caught early.

The tests that the National Cancer Institute recommends for both men and women over the age of 50 to screen for colorectal cancer and polyps include a flexible sigmoidoscopy, a colonoscopy, a double-contrast barium enema and a virtual colonoscopy. However the ACS says only the colonoscopy can see the complete colon and is best for screening. The U.S. Preventive Service Task Force agrees, giving colorectal screenings an "A" grade.

During a colonoscopy, a thin tube is inserted through the rectum and into the colon. The tube has a light and camera-like apparatus for viewing any polyps or unusual pieces of tissue.

Complications from colonoscopy are rare, but can include tears in the lining of the colon.

Cervical cancer

The number of cases of cervical cancer has decreased significantly in the United States over the past 40 years thanks to regular screenings, according to the U.S. Centers for Disease Control and Prevention. In 2007, 4,021 women died from the disease.

ACS recommends yearly Pap tests for all women beginning at age 21, or three years after they begin having intercourse. At age 30 women may choose to reduce screenings to once every two or three years until they are 70 years old. The U.S. Preventive Services Task Force agrees.

Do not confuse a Pap test with a pelvic exam, the ACS warns. A Pap test will include a gentle scraping of your cervix with a spatula-looking instrument; the cells collected will be sent to a lab for analysis. This is usually done at the start of a pelvic exam, after the doctor has inserted a speculum into the vagina.

Education Information

Should organ donors get free funerals?

02.29 egaoart No comments

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11 October 2011 Last updated at 15:45 GMT Heart in hand

Many believe that organ donation should simply be about altruism Paying the funeral expenses of organ donors is a good idea - but safeguards are needed, argues ethicist Simon Rippon.

The Nuffield Council on Bioethics recommends that the NHS offers funeral expense payments to people who sign the organ donor register, on the condition that they later die in circumstances in which their organs can be donated to others.

This idea is to be warmly welcomed. By providing an additional incentive to people already inclined to sign the organ donor register, it could enable the NHS to provide faster and better treatment, and to save many more of the 1,000 people who die every year in Britain while waiting for an organ. It would also provide symbolic recognition of the priceless gift that organ donors give.

Is there anything ethically questionable about this life-saving proposal?

Well, many people think that organ donation should be a purely altruistic matter, and the Nuffield Council attempts to draw a fine line - recommending policies that may provide extra encouragement to those already inclined to donate for altruistic reasons, while strongly scrutinising proposals for introducing more significant incentives which might persuade people to donate who would not otherwise consider it.

Altruism is undoubtedly a good thing, and its role in motivating organ donations should not be underestimated. But enabling altruism should never trump saving lives.

What we should be concerned about when it comes to incentives for organ donation is not the purity of donors' motives, but the way that payments could facilitate coercion or exploitation of those in poverty.

Organ donation should be a fully free choice for each of us, and never an economically necessary one.

For this reason, it is important that organ donation never becomes the only way to pay for one's funeral. The government currently provides funeral payments from the Social Fund to those in poverty. It must continue to do so as a safeguard against coercion and exploitation, if funeral expenses for donors are introduced.

The Nuffield Council's report also considers moving to an "opt-out" system for deceased organ donation, under which it would be assumed that people consent to donation unless they either opt out before they die, or their family later objects.

The council rightly does not oppose such a system on ethical grounds, because it would leave the choice of donation or non-donation entirely in the hands of individuals and their families, as it is now.

Some people object to an opt-out system on the basis that there will inevitably be a few people who fail to opt out and fail to inform their family of their wishes, even though they would not wish their organs to be used to help others - and these people may have their organs taken without consent.

But there's a straightforward reply, arising from the observation that the vast majority of the public support organ donation, though few get around to signing the donor register.

Under the current, opt-in system, there are many more people who fail to sign the donor register and fail to inform their family of their wishes, even though they would wish to help others with the gift of their organs, and these people's organs may go pointlessly to waste without their consent.

If we wish to fulfil the wishes of the most deceased people, then, the default for those who do not express their wishes should be for them to be available to donate.

Nevertheless, the Nuffield Council raises concerns about the practical effects of a change to opt-out - worrying that it might not substantially increase donation rates, and might even reduce the number of donors by prompting vocal opposition.

My view is that the British public is a bit more sensible than the council gives credit for here, and that an opt-out system would produce substantially more donor organs from among those who mean to sign the donor register "when they get around to it".

Nevertheless, the Welsh Assembly looks set to change the system in Wales to opt-out, and the report notes that this provides a rich opportunity for robust research into the likely effects it would have across Britain. If it's not yet ready to act on opt-out, the government should make this research an urgent priority.

Simon Rippon is a Research Fellow at the University of Oxford's Uehiro Centre for Practical Ethics. He writes regularly on ethical issues at the centre's blog: Practical Ethics

Career Advisor

Why your child's care should be moved

10.07 egaoart No comments

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16 September 2011 Last updated at 00:58 GMT By Dr David Shortland Vice-president of the RCPCH Boy in hospital

Fifty children's wards 'might close' Every parent wants the best care for a sick child.

But - as this government makes its first decision about restructuring hospital care - Dr David Shortland, vice-president of the Royal College of Paediatrics and Child Health says being treated further away from home might be necessary to get the best.

As changes within the NHS and the financial squeeze start to bite, hospitals are looking again at the affordability of keeping skilled paediatricians available on call 24 hours a day in small hospitals where there are similar services within about 30 minutes drive.

There are many units operating with dangerously low levels of staff, and trainee doctors being left to manage wards because there are just not enough senior consultants.

There is increasing pressure from the government to reconfigure children's services so that senior paediatricians are located in more specialist inpatient units, with smaller hospital wards closing or being converted to daytime-only units staffed by specialist nurses and visiting consultants.

It is likely that up to 50 of the existing 218 inpatient wards would need to close in the UK.

Many of these units will have experts on site to see children during the day rather than taking in-patients as they do now.

Although A&E departments don't only provide paediatric services, we are all aware that they are all under the same pressures.

Closures 'inevitable'

It is completely understandable that parents are worried about their local services moving away, but these changes are important so specialist units can achieve and sustain the necessary excellence and quality.

If we want our health service to protect health outcomes and safeguard children and young people, then parents have to face travelling further for treatment if their child needs an overnight stay.

As a parent, I would expect and want my child to have the highest quality care possible - and it is crucial the standards of care are not comprised in any way.

Continue reading the main story

If your local unit can't meet the minimum standards of care for your child - wouldn't you rather drive that little bit further to one that can?”

End Quote These changes will allow doctors and nurses to be more readily available to the sickest children whilst continuing to offer the local service for early diagnosis and observation.

The new changes proposed will ensure that children are seen by senior trainees and consultants with better expertise and experience in a set period of time.

It's also important to highlight that it is not just paediatric services that are feeling the strain on services - we have seen opinion divided over children's heart surgery centres in recent weeks.

The government is also considering reducing the number of units locally and focusing on the regional centres for providing better care and outcomes for patients with a decision to be made by the end of this year, and changes implemented in 2013.

No matter which units are under scrutiny, the quality of care must remain or it only right those who cannot meet minimum standards should be closed down.

But any change should be solely on the basis of ensuring that the right standards of care can be met and children's health is paramount, taking into consideration the implications of longer journeys and transport arrangements.

Closure and changes to children's services are inevitable, but the reasons should be completely about the quality of care and support so children get better.

If your local unit can't meet the minimum standards of care for your child - wouldn't you rather drive that little bit further to one that can?