Melanoma drug ‘too expensive’ for NHS
One thousand patients with a form of aggressive skin cancer will be denied a new drug that could extend their lives by three months, after initial guidance from the NHS rationing body.
The National Institute for Health and Clinical Excellence has issued draft guidance turning down the drug on the grounds that it is too expensive and the long-term benefits of it are not clear.
The drug named Zelboraf, or vemurafenib, is for malignant melanoma that has spread and carries a specific genetic mutation and costs around £1,750 per patient per week.
The makers Roche agreed an undisclosed discount for the NHS but Nice still felt it was not cost effective.
Sir Andrew Dillon, chief executive of Nice said: “We need to be sure that new treatments provide sufficient benefits to patients to justify the significant cost the NHS is being asked to pay. Vemurafenib is an expensive drug and its long term benefits are difficult to quantify.”
It is thought the drug may extend life from around 9.6 months to more than 13 months, a spokesman for Roche said.
It is the second skin cancer drug denied by Nice within ayear after ipilimumab was also turned down, despite evidence showing half of patients on it were still alive after a year.
Gill Nuttall, CEO and founder of melanoma support group Factor 50, said: “This is another truly devastating blow to all melanoma patients and their families, many of whom are very young and with young families.
“Standard treatments that have been available since the 1970s are ineffective and to deny this drug to patients, is tantamount to passing them a death sentence.”
“I am astonished and deeply worried that Nice has not given approval to yet another drug which will significantly alter the lives of melanoma patients. The patients I represent have vowed that again, they will not take this decision lightly.”
Enoch was right!
When most people hear the words ‘Enoch Powell’ they think of the phrase ‘rivers of blood’. It was Powell’s misfortune — partly self-inflicted — that his monumental contribution to political ideas should still be eclipsed by a phrase that he never uttered, misquoted from the speech that still defines him.
Powell was born 100 years ago this Saturday, in a terrace house by a railway line in a suburb of Birmingham, the only child of two teachers.
In time, he would become the most brilliant classical scholar of his generation at Cambridge, the youngest professor in the British Empire, the youngest Brigadier in the Army, an MP, a Cabinet Minister and, in his re-invention as a tribune of the people, one of the most loved and hated men in Britain.
He was, in own words, ‘born a Tory’ — by which he meant he was born with a natural reverence for the institutions of this country, notably its constitution.
Yet he would fight a war with that party that was partly responsible for it losing two general elections in 1974, because his highly intellectual view of what a Tory was, and what a Tory should believe in, was at odds with the pragmatic, centre-left doctrine of Ted Heath, whose nemesis Powell became.
Because of his famous — or notorious — speech on immigration, delivered in Birmingham in April 1968, Powell’s wider achievements have been largely ignored. He served in the Cabinet for just 15 months, but his influence on politics and political thought is greater than that of any other Member of Parliament in the past century.
It was Powell who, in 1957, predicted that excessive State borrowing would bring economic decline. Long before Milton Friedman, the free-market champion who won the Nobel Prize for Economics for demonstrating the link between an expansion in the supply of money and higher inflation, Powell explicitly outlined that argument.
In the Sixties, he mocked the use of prices and incomes policies (with which the government tried to control inflation by limiting increases in wages and prices). He also ridiculed the scape-goating of trades unions for ‘causing’ inflation by demanding big pay rises.
He deplored the waste of public money on nationalised industries and urged what he called their ‘denationalisation’, using the funds freed to pay for tax cuts to encourage economic growth. He also understood that if Scotland had a separate parliament, it would inevitably soon become a separate country.
Almost 45 years ago, before Britain made its successful application to join what was then called the Common Market, Powell warned Britons they would lose the power to govern themselves. Equally presciently, from the moment a single currency was mooted, he pointed out that countries joining it would be stripped of their economic sovereignty — and, if it were to function properly, would lose the right to have their governments determine the exact nature of their public spending.
And, in an age when it was more or less compulsory for Conservative politicians to worship America, and America’s influence in the world, Powell repeatedly made clear his distrust of U.S. foreign policy, believing it would cause more conflicts than it prevented.
He had first seen what he considered to be America’s heavy hand in diplomacy when, as a staff officer, he attended Churchill’s meeting with Roosevelt at Casablanca in 1943. Nothing he saw subsequently made him feel any better about that country.
Yet all these ideas — ideas now espoused with fervour by politicians, and not just those of the Right — remain clouded by the controversy over Powell’s views on what his critics call ‘race’.
In fact, although Powell made many speeches on immigration, he never made one on race: because he was not a racist, and therefore the matter would have been irrelevant and intellectually absurd to him.
He had served in India during World War II learned Urdu and Punjabi to a high standard, loved Indian culture, and said he would have been quite happy to live and die there. He was devoid of any idiotic ideas of racial superiority. However, when as shadow defence secretary he made what he called the Birmingham speech — the Rivers of Blood speech to almost everyone else — the Left seized upon his words in a fit of self-righteous panic, and engaged in one of the most revolting orgies of grand-standing in our political history.
His fellow Conservatives attacked him in order to try to distance themselves from any taint of racism. Socialists attacked him in an attempt to destroy the moral reputation of the Conservative Party.
I knew Powell well for the last 15 or so years of his life — he died in 1998, and he asked me to write his biography. During many long conversations, he never expressed a trace of regret at having made the speech, except in one particular. ‘If I had quoted Virgil in the original (Latin),’ he said of the ‘River Tiber’ phrase that came to distinguish the speech, ‘I shouldn’t have caused so much trouble.’
He may not have regretted what he said on that fateful day, but he came to realise that his use of a vivid classical quotation had derailed his otherwise conventional political career.
He had warned that if the Labour government’s anti-discrimination Race Relations Bill became law, it would allow the immigrant community to ‘agitate and campaign against their fellow citizens’.
The apocalypse was in sight. ‘As I look ahead, I am filled with foreboding. Like the Roman, I seem to see “the River Tiber foaming with much blood”,’ he said.
The allusion was to the Sibyl’s prophecy in Book VI of Virgil’s Aeneid about Aeneas’s return to Rome: ‘I see wars, horrible wars, and the Tiber foaming with much blood.’
Part of Powell’s problem was that hardly anyone in his audience, or who read reports of the speech, had his titanic intellect or his subtlety of mind. Crucially, the speech was made without prior warning to his fellow shadow cabinet members, even though it had discussed the Race Relations Bill two days previously.
Outraged on this count and by the provocative content, Ted Heath sacked him from the shadow cabinet, and Powell’s messianic role in our politics was thereafter conducted from the backbenches and, thanks to his prolific journalism, through the columns of newspapers and magazines.
The Bill was why Powell made the speech: but he was at pains, in the speech itself and later on, to insist that he was doing so in his role as the MP for Wolverhampton South-West. His constituency had witnessed an enormous influx of immigrants in the preceding years.
He stressed that it was not only his white constituents who expressed their resentment at the scale of immigration: the small number of immigrants who had originally come to Wolverhampton in the Fifties had expressed their worries, too, because of the breakdown they perceived in community relations as a result of the barely restricted flow.
Powell had no objection to immigration. He had a profound one, however, to immigration on so large a scale, because it meant immigrants found it impossible to integrate. He had witnessed the disaster of multiculturalism on the sub-continent (such as problems between different religions in India) and had no wish to see communal strife here, but he feared mass immigration would cause it.
Chiefly, he felt compelled to speak on behalf of his constituents. One had told him of his wish to emigrate and see his children settle overseas. He quoted him as saying: ‘In this country in 15 or 20 years’ time the black man will have the whip hand over the white man.’
Powell continued: ‘I can already hear the chorus of execration. How dare I say such a horrible thing? How dare I stir up trouble and inflame feelings by repeating such a conversation? ‘The answer is that I do not have the right not to do so …. I simply do not have the right to shrug my shoulders and think about something else.’
He spoke, too, of communities following customs ‘inappropriate in Britain’; of the strain placed on housing, health, social services and education provision by the influx.
Most inflammatory of all, there was his reference to a little old lady who had excreta pushed through her letterbox by the immigrants who surrounded her.
Powell perhaps was disingenuous in expressing shock and surprise at the effect his speech had. He had warned the editor of his local newspaper, the week before he delivered it, that the speech would ‘fizz like a rocket’.
But I am certain he believed his stature in his party was too great for Heath to sack him, and he never contemplated that the speech would end his front-bench career.
Yet his dismissal had some positive consequences. The most direct of which was an Immigration Act in 1971 that responded to some of his concerns, by limiting the number of people from the Commonwealth who could apply for a British passport.
More than even that, his return to the backbenches gave him a freedom to expound ideas that helped break the destructive post-war consensus, and — not least by Margaret Thatcher’s own account — laid the foundations of what came to be called Thatcherism.
Powell, in league with his friend and admirer, the Labour Left-winger Michael Foot, derailed the joint attempt by the Wilson government and Heath’s opposition, to reform the House of Lords in 1969, which would have made it entirely the creature of the House of Commons.
That same year he began his high-profile crusade against British membership of the Common Market: his arguments were widely ignored then, but are now accepted as having been right by millions who used to discount them.
Mrs Thatcher developed her economic policy directly from Powell’s critique of the Heath government’s massively inflationary spending programme between 1970 and 1972.
But above all, as part of the Conservative Party’s internal opposition between 1970 and 1974, Powell demonstrated a towering integrity and commitment to principle that no other senior politician has ever come near.
‘Too often today,’ he had said shortly after the Birmingham speech, ‘people are ready to tell us, this is not possible, that is not possible. I say, whatever the true interest of our country calls for is always possible. We have nothing to fear but our own doubts.’
He refused to fight the February 1974 election for the Tories, on the legitimate grounds that Heath had broken virtually every promise of his 1970 manifesto. He went on to advise electors to vote for a party that promised a referendum on our continued membership of the Common Market — which meant voting Labour.
Even today, old television footage of the moment when he uttered this view, in a speech in Yorkshire three days before the election that Heath would lose, has the power to electrify.
‘Judas!’ a heckler cried. ‘Judas was paid!’ Powell retorted, in an instant. ‘Judas was paid! I am making a sacrifice!’
Having quit the Conservatives over Europe, Powell was invited to stand as Official Ulster Unionist candidate in South Down. He did, and won. He spent the rest of his parliamentary career (until 1987) as an Ulster MP.
Powell was a man of conspicuous moral greatness, something that, alone, made him unsuited for politics, because it meant he could not keep what he perceived to be the truth to himself.
He had a gift denied to most politicians, which was of making prophecies that were right. He was right about Europe; right about the single currency; right about economic management; right about Lords reform; right about devolution; right about American imperialism; and, with even Trevor Phillips, the figurehead of the Equalities Commission, now arguing that multiculturalism has failed, right about that, too.
Fourteen years after his death, and almost half-a-century after he sat in the Cabinet, his influence on political thought is not only undiminished: it continues to grow.
Old-fashioned passbook account becomes a hit in Britain
I would take one out in Australia if it were available. Online money seems too insecure to me — which is one reason why I have almost all my assets in shares and real property
Everybody laughed at the Yorkshire Building Society last year when it announced plans for a new savings accounts operated solely by using a passbook.
In the days of the internet, surely nobody wanted a savings account which could only be opened and operated by visiting a branch with your passbook?
But, twelve months later, the building society’s ‘Triple Access Saver’ has become the most popular account launched by the 148-year-old mutual.
In fact, it is around three times more popular than any other instant access savings account launched by Yorkshire Building Society over the last year.
The move shows a desire among savers to return to traditional types of customer service as disaffection grows over internet banking.
Mike Helliwell, savings product manager at the Yorkshire, which has 3.3million members, said: ‘This time last year, there was some scepticism about whether – in the age of internet banking – savers really wanted a simple, traditional passbook account. ‘The fact that Triple Access Saver has been our most popular savings account since its launch speaks for itself.
‘Customers appreciate the straightforward terms, ease of use and an attractive, competitive rate without any introductory bonus for a limited period.’
It comes at a time when banks and building societies are increasingly forcing people to go online in order to get the best deal on their savings accounts.
But this is a major problem for many people. Many do not have internet access, while others struggle to use their computer and others simply do not trust online banking.
With the Triple Access Saver, customers do not need have to remember a password or a PIN number.
They simply go into one of the building society’s 227 branches and open an account with a minimum of £100. The maximum balance is £2million.
Customers are allowed to make three withdrawals each year without incurring a penalty, and the account pays a variable interest rate, currently 2.25 per cent.
If they want to put more money into the account, or take out money, they take their passbook into the branch. Only a signature is required.
A Yorkshire spokesman said yesterday they launched the account because so many people were saying how they felt nostalgic about the days of the traditional passbook. It tells them how much money is in their account and the details of all their transactions since they opened it. She said: ‘People like to look at their passbook and to get it updated. They know where they are with a passbook. They can hold it in their hand.
‘People told us that they wanted a traditional account and so we launched one. Our customers did not want to have to go online to get the best deal.’ Unlike many of its rivals, Yorkshire Building Society is opening new branches, rather than closing them down. Over the last two weeks, it has opened branches in Ilkley and Pudsey and a third one opened in Bingley this week. Over the last four years, it has merged with three other building societies – the Barnsley, the Chelsea and Norwich & Peterborough.
When Yorkshire Building Society was founded in 1864 in Huddersfield, nobody was given a passbook. All transactions were recorded on a ledger at the branch.
It was not until people complained that they wanted their own record that the passbook – which was ‘passed’ between the customer and the branch staff – was introduced.
Pesky! Drinking, smoking or being overweight ‘does not harm men’s fertility’
It’s the advice every man trying to become a father wants to hear – have a drink and relax. Researchers said yesterday that they have evidence that it probably won’t harm their chances of starting a family. Nor will smoking, taking drugs or being overweight. They found men with unhealthy lifestyles were likely to be just as fertile as those living more sensibly.
Under NHS guidelines issued in 2004, GPs are supposed to warn men diagnosed with infertility of the dangers of alcohol, tobacco and recreational drugs.
To try to improve sperm quality, infertile men are also urged to avoid being overweight and not to wear tight underwear.
The quantity of ‘swimming sperm’ available is regarded as critical to attempts to conceive, and infertile men are advised to cut out unhealthy habits to improve it. This leads to extra strain for many childless couples at an already stressful time. But a British study suggests many factors that were thought to contribute to sperm problems have little impact.
Estimates suggest around 30 per cent of men in couples seeking IVF treatment are subfertile, and 2 per cent are ‘totally’ infertile, while some studies show dramatic falls in average sperm counts. In some cases, fertility treatment is delayed or withheld on the NHS until couples improve their lifestyles.
However, the number of swimming sperm a man produces appears virtually unaffected by lifestyle choices, claim a team of scientists from Manchester and Sheffield universities.
They recruited 2,249 men from 14 fertility clinics around the UK and asked them to fill out detailed lifestyle questionnaires. Information from 939 of the men who produced low numbers of swimming sperm was then compared with information from 1,310 who produced higher numbers.
The results, reported in the journal Human Reproduction, showed that men with poor quality sperm were 2.5 times more likely to have had testicular surgery, and twice as likely to be of black ethnicity.
They were also 1.3 times more likely to do manual work, not wear loose boxer shorts, or not to have had a child before. But men’s use of tobacco, alcohol and recreational drugs made little difference.
Even being overweight, as measured by body mass index, did not affect sperm quality. The number of swimming sperm broadly correlates with how fertile a man is likely to be. It also often determines the type of fertility treatment that is offered. Study leader Dr Andrew Povey, of Manchester University, said: ‘Our results suggest that many lifestyle choices probably have little influence on how many swimming sperm they have.
‘For example, whether the man was a current smoker or not was of little importance. Similarly, there was little evidence of any risk associated with alcohol consumption. ‘This potentially overturns much of the current advice given to men about how they might improve their fertility.’
Co-author Dr Allan Pacey, senior lecturer in andrology at Sheffield University, said men should still take care of themselves, without feeling the need to ‘become monks’.
But he added: ‘Although we failed to find any association between common lifestyle factors and the number of swimming sperm, it remains possible that they could correlate with other aspects of sperm that we have not measured. These include the size and shape of sperm or the quality of the DNA.’
Britian has wettest June since records began
Temperatures up to 10C below normal and sunshine is down 60 per cent
Britain is set to be lashed by 80mph hurricane force winds bringing three months worth of rain over the next three days with forecasters predicting it will be the wettest June since records began.
Emergency services issued a ‘major flood event’ alert in the South-West and Wales last night with eight inches of rain expected as a massive front of terrible weather sweeps in from the Atlantic.
Forecasters said England and Wales’ appalling June weather is officially the worst since records began more than 100 years ago. The countries are on course for the wettest ever June, temperatures are up to 10C below normal and sunshine is down 60 per cent.
MeteoGroup forecaster Julian Mayes said: ‘We cannot find a period of June weather worse than this month since records began. For a 12-day period, it’s as bad as it can be.
‘There’s no parallel with this month’s combination of very high rainfall, very low sunshine and very low daytime temperatures.
‘The outlook is unsettled and although we don’t yet know for sure if it will be the wettest June, it’s well on the way.’
Cornwall Fire and Rescue Service said its 650 firefighters and 100 support staff were ready to take flood action. A spokesperson said: ‘Ourselves, the police and county council are monitoring the weather forecast and will take appropriate action when needed. We have vast experience dealing with flooding, in particular floods which devastated Cornwall in November 2010.’
When 80mm of rain fell in 24 hours in west Wales last Friday, 150 people were rescued and 850 relocated as 5ft floods swept through caravan parks and villages.
Government forecasters predicted 15-20mm of rain today, plus 70-100mm over higher ground in 48 hours from midnight, with 30-50mm on lower ground.
The Weather Channel forecast more than 100mm on higher ground and warned of a ‘major flooding event.’ Rivers running off higher ground will fill rapidly.
The fresh deluges will fall on top of 42mm of rain in Culdrose, Cornwall, in 24 hours to 10am yesterday, plus yesterday afternoon’s expected 50-60mm from localised ‘torrential downpours.’
British Children go back to basics in maths
Children will be introduced to times tables, mental arithmetic and fractions in the first two years of school as part of a back-to-basics overhaul of the National Curriculum.
Ministers will this week announce key tasks pupils are expected to master at each age under wide-ranging plans to counter more than a decade of dumbing down in schools.
A draft mathematics curriculum suggests that five and six year-olds will be expected to count up to 100, recognise basic fractions and memorise the results of simple sums by the end of the first year of compulsory education.
In the second year, they will be required to know the two, five and 10 times tables, add and subtract two-digit numbers in their head and begin to use graphs.
The proposals are intended to ensure that children are given a proper grounding in the basics at a young age to prepare them for the demands of secondary education and beyond.
It represents a dramatic toughening up of standards demanded in English state schools in a move designed to benchmark lessons against those found in the world’s most advanced education systems, such as Singapore, Hong Kong and parts of the United States.
At the age of nine, pupils should know all their times tables up to 12×12 and confidently work with numbers up to 10 million by the end of primary school, the Government said.
Currently, children only need to know up to 10×10 and familiarise themselves with numbers below 1,000 by the age of 11.
The disclosure is made as part of a sweeping overhaul of core subjects in primary schools, with the new curriculum expected to be introduced by 2014.
Under the proposals:
– Science lessons will place a greater emphasis on early physics and ensure children learn about the solar system and galaxies. They will also be expected to cover the biographies of scientists such as Charles Darwin and promote more practical experimentation, with pupils weighing and comparing objects at seven and wiring basic circuits by the age of nine.
– In English, pupils will be expected to spell a list of almost 240 advanced words by the end of primary school, master grammar and punctuation and read more novels and poems, with children reciting simple poetry in front of classmates at the age of five.
– Foreign languages will be made compulsory from the age of seven – instead of 11 at the moment – with schools given the freedom to teach French, German, Spanish and Mandarin, or ancient languages such as Latin.
The planned overhaul of primary subjects will be put out to a public consultation to be launched this week. Proposals to reform other primary subjects – as well as lessons in secondary schools – will be outlined later this year.
The move is expected to be criticised by teachers who fear that the proposals give them less freedom to dictate the content of their own lessons.
Repeated revisions of the National Curriculum introduced by Labour stripped out swathes of lesson content, including a controversial move to remove Winston Churchill from secondary history lessons.
Last night, a government source said: “Labour and the unions devalued the curriculum and exam system and pointed to rising results to make themselves look good.
“In reality it was a lie that damaged children’s lives and saw us fall behind other countries. The new curriculum will raise standards for all and equip children better to do advanced work at secondary school.”
The changes come amid fears that rising numbers of pupils are leaving school unfit for the demands of the workplace.
A study published today by the Confederation of British Industry discloses that four in 10 companies were forced to offer young employees remedial lessons in English, maths or computing because of poor levels of basic skills.
Simon Walker, the director-general of the Institute of Directors, backed the new curriculum, saying: “International comparisons with high-performing countries have made it manifestly clear that we need to raise the bar.
“We must be more ambitious about the level of achievement we expect from young people, particularly in the core subjects of English, mathematics and science.”
The National Curriculum is compulsory in most English state schools. Academy schools — independent state institutions run free of council control — can ditch the curriculum, although research shows the vast majority follow it.
In the draft document, some of the toughest demands are placed on pupils in maths lessons.
In the first year, pupils are expected to count to 100 using multiples of one, two, five and 10, recognise even and odd numbers and write simple fractions such as a half and a quarter.
In the final two years, pupils will also be introduced to prime numbers, percentages, ratios, long division and probability.
They will also be expected to add, subtract, multiply and divide fractions — a task currently left to secondary school.