NHS contraception bungle
Mainly a matter of poorly-trained or untrained staff, it seems
Hundreds of women have become pregnant after a long-term contraceptive implant failed, it emerged last night. Even more have complained that they were left injured or scarred by the rod inserted into their arm, which was supposed to protect them against conceiving for three years.
The NHS has had to pay compensation to women hurt when the implants were inserted and seven women who were left traumatised by unexpectedly becoming pregnant have received payouts totalling more than £200,000 – an average of more than £28,000 each.
A lawyer revealed that many of the women affected had suffered ‘psychological difficulties’, had miscarriages or decided to undergo abortions after the implants went wrong. One woman who became pregnant and underwent an abortion said the trauma had led to her marriage ending.
The fiasco involving the implant, called Implanon, is one of the worst mass contraceptive failures to hit the NHS in living memory. A total of 584 women who had the hormone-filled rod inserted in their arms have reported unwanted pregnancies to the Medicines and Healthcare Regulatory Agency – the Government’s drugs and medical devices watchdog.
But the total could be far higher, as many women may not have complained after becoming pregnant and either undergoing abortions or giving birth. The MHRA received 1,607 complaints about the implant going wrong, some from doctors deeply concerned that the devices are difficult to insert and that it is impossible to check if they are correctly installed because they are invisible to X-rays.
Implanon’s manufacturer MSD, a subsidiary of global pharmaceutical giant Merck, has now replaced it with an updated product called Nexplanon, which has a new pre-loaded applicator and can be detected by X-ray or CT scan. However, it has not recalled the existing stock of Implanon, meaning women are still being given it.
The £90 device is a flexible rod the size of a matchstick that is inserted under the skin of the upper arm. It gradually releases the hormone progesterone which stops the ovaries from releasing eggs and makes the womb less receptive to fertilised eggs.
It provides protection against pregnancy for up to three years and properly inserted it is 99.95 per cent effective among all users, compared with 99.7 per cent for the Pill.
But investigations showed in some cases the implant was not released from the pre-loaded applicator and never inserted into the arm of the patient. In other women it was delivered too deep to work properly.
One in four women who go to family planning clinics get long-term contraceptive implants. They are especially popular with teenagers, with 10 per cent of 16 to 19-year-olds saying they prefer an implant because they do not have to remember to take a pill.
Last night a woman who had the implant, named only as Lara to protect her identity, told of her trauma when she later discovered she was pregnant. ‘I feel very very disturbed – hitting my head on the table,’ she told Channel 4 news. ‘Weeping like a young child. My mind was so disturbed – thinking why is this happening to me?’ Lara’s marriage collapsed and she suffered nightmares for months after having a termination.
London-based Anthony Gold Solicitors is representing several women with claims for personal loss and damage. Partner Stephanie Prior said: ‘I have clients who fell pregnant as they were unaware that the Implanon device had not been inserted into their arm and they suffered psychological difficulties as a consequence of falling pregnant and later miscarrying or having to make the difficult decision to terminate the pregnancy.’
Another woman, Keisha White, has been left permanently scarred after the implant was inserted too near her muscle.
A spokesman for MSD said the firm was confident about the ‘efficacy and safety’ of Implanon. She said: ‘If the implant is not inserted in accordance with the instructions and on the correct day, this may result in an unintended pregnancy. ‘In addition no contraceptive is 100 per cent effective. ‘MSD encourages consumers to speak with their healthcare providers if they have any questions about contraceptive options and to report any adverse experience associated with any MSD medication.’
Fury over ‘cheapskate’ NHS plan for Indian call centre
An NHS efficiency drive may result in hospital appointments being outsourced to call centres in India. In a move that has been labelled ‘cheapskate’ by furious critics, a senior Health Service official has suggested saving money by sending swathes of administration work to Delhi, Bombay and other cities.
But the prospect of having to ring a call centre in India to book an NHS appointment was pounced upon by critics.
They said the plan could put people’s confidential medical records in danger, and could lead to misdiagnoses because Indian call centre staff are unlikely to know how the NHS works.
The proposal comes despite a scandal two years ago when the confidential medical records of patients at one of London’s top private hospitals were sold on by Indian IT staff.
This weekend a report revealed that the Health Service could save £1billion a year if it cut out waste which sees some trusts paying far more for the same equipment than other trusts.
The study, by NHS Shared Business Services, which attempts to drive efficiency across the service, found shocking examples of waste including eight NHS trusts paying 19 different prices for the same pacemaker – squandering £750 a time.
Managing director John Neilson said the NHS could save hundreds of millions by getting better value for money. But it is his idea of outsourcing NHS administration to India that has proved the most controversial.
Helen Wilkinson, of the Big Opt Out, which urges people to opt out of a national NHS database, said: ‘We would have huge concerns about this. If medical records are to be stored outside of the UK, you would have less control over your data.’
And Geoff Martin, of pressure group Health Emergency, described it as a ‘cheapskate option’. ‘The last thing you want when you have a serious illness is to have to ring a call centre halfway round the world,’ he said.
Beer deregulation in Britain
Schooners (15 oz. in the old money) are mostly drunk in Sydney rather than in Australia generally. I have sunk a schooner or two there myself in the past. People who drank smaller measures tended to be suspected of homosexuality at the time
The traditional cry of ‘Mine’s a pint’ could become ‘Mine’s a schooner’. Under government proposals it will soon be possible to order a new range of measures of alcohol in licensed premises.
One of which would be the Australian schooner measure – which is the equivalent of two-thirds of a pint, or 400ml.
Currently there are strict rules which dictate the size of drinks on offer. For example, a beer can only be served in halves or pints, although a little-known ‘third’ does also exist.
But the Government has decided to rip up the traditional system in a move designed to discourage binge-drinking. And in an added plus for these austere times, the proposals should also slash the price of a round of drinks, as the amount of alcohol per round falls.
The rules will also apply to cider and lager and represents a radical change since the ‘pint’ was introduced by an Act of Parliament in 1698.
David Willetts, Science Minister, said: ‘This is exactly the sort of unnecessary red tape the government wants to remove. ‘We have listened to consumers and businesses. They have called for fixed quantities to be kept – but with greater flexibility. That is what this change will deliver.’
Some commonsense returning to British policing
The Asbo is to be scrapped as part of a major review on tackling anti-social behaviour that will see a return to the common sense policing of yobs, The Daily Telegraph can disclose. Ministers will bin a series of measures, including Labour’s flagship anti-social behaviour orders, and replace them with a streamlined set of powers to make it easier to deal with nuisance and minor crimes.
Officers will also be given more discretion on how to deal with incidents including forcing offenders to make immediate amends, such as repairing a damaged fence, rather than taking more formal action.
The review, expected within weeks, will signal a radical rethink by Theresa May, the Home Secretary, on how to deal with anti-social behaviour after more than a decade of failed promises by Labour.
Sir Denis O’Connor, the Chief Inspector of Constabulary, warned in September that police have lost control of the streets as figures showed that an estimated 14 million incidents of anti-social behaviour take place each year — one every two seconds.
In a related pilot scheme launched today, police will create personal logs for victims of anti-social nuisance to ensure repeat attacks are recorded together and no one falls through the net. The move, to run in eight forces, is aimed at preventing cases such as Fiona Pilkington who killed herself and her daughter, after little was done to stop years of torment from a teenage gang.
But it is the death of the Asbo that will mark the most significant shift in the Coalition’s approach when the review is published. The orders were first unveiled by Tony Blair in 1999 and formed a key part of his Respect agenda. However, they soon became the subject of ridicule, with some offenders claiming it as a “badge of honour” and its use by local authorities has plummeted in the past five years. More than half of the orders are breached and only half of those guilty of a breach are sent to prison as a result. A total of 16,999 Asbos have been issued since 1999 but 55 per cent were breached at least once. In 2005, 4,122 were issued, but only 2,027 in 2008.
Mrs May sounded the death knell for last summer when she said it was “time to move beyond the Asbo”. She called for a “complete change in emphasis”, with communities working with the police and other agencies to stop bad behaviour escalating.
Labour has been criticised for creating a plethora of court orders to tackle nuisance, including parent orders, graffiti removal orders and dog control orders, on top of the Asbo but many of which have been hardly used. The review is expected to tear most of the orders up in their current form and streamline them in to series of simpler sanctions, still including some form of court orders, for the police and local authorities to use against anti-social behaviour.
However, whatever the outcome of the review, there will be nothing known as an Asbo. The move will be met with fierce criticism from Labour who have continued to defend the effectiveness of the Asbo in opposition, insisting it has made a “huge contribution”.
Mrs May also wants to give police more scope to deal with local thugs and nuisance rather than always heading for the courts.
If an officers believes an incident can be dealt with by other action, and with the support of the victim, then they will be entitled to use their judgment. It could mean a yob repairing a fence he has damaged or cleaning up his own graffiti.
Ministers will also ensure more support for victims when reporting issues to the police. Authorities have been accused of not taking anti-social behaviour seriously enough, especially in the aftermath of cases such as Ms Pilkington. She killed herself and her 18-year-old Francecca Hardwick, who suffered from learning disabilities, in October 2007. Their deaths followed 10 years of torment at the hands of yobs who taunted them and pelted their property with stones, eggs and flour.
The Home Office announced a pilot in eight force areas today to ensure reports of anti-social behaviour are dealt with appropriately. Officers will change the way they respond to calls, introduce a new system to log complaints and improve their IT systems in a seven-month project designed to help quickly identify and protect vulnerable victims.
James Brokenshire, the crime prevention minister, said: “It is not acceptable that those most in need either slip through the net or are plain ignored. “It is essential those who raise the alarm and ask for help are listened to and their complaints acted upon promptly.”
Assistant Chief Constable Simon Edens, the lead on the issue for the Association of Chief Police Officers (Acpo), said the pilot scheme “will focus on improving handling and logging of complaints as well as looking at improvements to IT systems to ensure information from partners is shared more easily”.
The trials, in Avon and Somerset, Cambridgeshire, Leicestershire, Lincolnshire, London, South Wales, Sussex and West Mercia will run until July.
Britain’s Common entrance exam could go online
A century-old exam used by the country’s top private schools is to undergo its first major overhaul in decades. Plans are being drawn up to put the Common Entrance exam online in an attempt to make it less stressful for young pupils, according to the Independent Association of Prep Schools (IAPS)
First introduced in 1904, Common Entrance is an exam taken by children applying to private secondary schools, including top institutions like Eton College, at age 11 and 13. Pupils are entered for the exam if they have been offered a place at a school, subject to passing it, and the papers are then marked by the relevant school.
All pupils take Common Entrance in English, maths and science, and at age 13+ they can also take French, geography, German, Greek, history, Latin, religious studies and Spanish. Secondary schools choose which options they require from pupils, which means youngsters applying to more than one school could have to sit several subjects.
Critics have also raised concerns in the past that the exam is too intensive, and overloads prep schools’ syllabuses.
IAPS chief executive David Hanson said: “Other examination systems have come and gone, but Common Entrance has remained because it has great qualities. “What we need to do now is to build on those qualities and make best use of new technology to ease the burden of examinations on young pupils.”
A team of IAPS heads has been working with the association to develop a series of online tests, he said. “These tests can be done online, in the child’s school, which we hope will not only help them to feel more at ease, but also free up time during senior school visits so pupils can really get to know their chosen new school.”