Friday, June 19, 2009

NHS medication mistakes hitting kids on large scale

Ten thousand safety alerts over medication given to children are being issued annually in the NHS, including serious errors in the calculation of drug doses and health workers forgetting to give patients their medicine, research shows. The first report into health service safety incidents concerning children shows that 61,000 alerts were recorded between October 2007 and September 2008 in the care of patients under 18, with 18,200 involving babies aged under 1 month.

A quarter of the cases were the result of misuse of medication, including examples where patients received ten times too much of a drug owing to a dosing miscalculation. There were more than 2,800 alerts involving wrong or unclear dose or strength and children under the age of 4 were particularly affected.

The report, by the National Patient Safety Agency (NPSA), concludes that over the period there were 33 deaths of children and 39 deaths of newborn babies that had “indicators of avoidable factors”. The findings echo concerns raised in recent years over the lack of treatments tailored for children, and how nurses are often left to carry out complex calculations to ensure that the right amount of a drug tested for adults is given to a child.

The report is the first to calculate the impact of safety alerts on children. It uses information sent in from health trusts to the NPSA’s Reporting and Learning System (RLS) and analysis of key research papers. Of the 900,000 alerts issued annually, 7 per cent were found to involve people under 18. Researchers found that children up to the age of 4 had the second-highest percentage of medication incidents of all age groups, after the over-75s. Most of the incidents reported to the NPSA resulted in no harm or low harm to the baby or child.

Jenny Mooney, head of child health at the NPSA, said that one concern was the very small number of alerts from the primary care sector — only 4 per cent of the 61,000 total — suggesting that the figure was a substantial underestimate.

Dr Mooney said that the review showed that errors could occur when calculating and preparing drug doses for children. “It comes down to the availability in terms of drugs. You would always try to get them in liquid form, but sometimes you may not be able to. You end up having to crush up tablets . . . and it is fraught with potential problems.”

Other examples included confusion over milligrams and micrograms. Among babies, errors relating to treatment or procedure was the most common incident type (3,294 alerts), followed by medication incidents (2,881). Among children, medication incidents were the most commonly reported incident type (7,029), followed by treatment or procedure (5,416) and accidents involving the patient (4,576).

Dr Mooney added that she hoped that reporting of alerts would continue to improve, because a high number of reports did not necessarily indicate that a trust was performing poorly, but that its surveillance was thorough. “It is about changing the culture of reporting,” she said.

The report, called Review of Patient Safety for Children and Young People, said that more than half of accidents involving children related to slips, trips and falls. The report noted that 2,000 children a week are admitted to hospital with accident-related injuries and added: “It can therefore be anticipated that children will also be at risk of accidents while in hospital, and appropriate safeguards should be in place to protect children from accidental injury while receiving healthcare.”

The NPSA is urging NHS organisations to examine a range of best-practice guidance to help to cut the number of incidents, and better training for staff and a review of local procedures for managing medicines.

Kevin Cleary, the NPSA’s medical director, said that the agency had highlighted a range of recommendations for best practice to help to improve care and reduce safety problems: “The majority of patient-safety incidents involving children were reported to have resulted in no harm or low harm. However, we are hoping this constructive feedback will support all trusts and clinicians in delivering even safer clinical care to all NHS patients in the future.”

Case Study: Gentamicin

Gentamicin, an antibiotic used to treat bacterial infections in the very young, was the subject of 400 safety alerts between April 2007 and March 2008. It is administered intravenously for the treatment of neonatal sepsis, but has a narrow therapeutic range: slightly too little or too much can affect its toxicity and efficacy. An analysis of Reporting and Learning System data for neonatal medication incidents involving gentamicin identified 400 incidents. Two thirds of these were related to problems with administration of the drug, 23 per to prescribing and 6 per cent to insufficient monitoring. Gentamicin is the subject of a joint project between the National Patient Safety Agency and the Royal College of Paediatrics and Child Health relating to safe administration.

Best practice in neonatal care, being piloted, includes “no interruption” policies during prescribing, preparing, checking and administering; use of a 24-hour clock when prescribing; and administration of the dose to be given within one hour either side of the prescribed time.


Amazing British government racism

This makes America's "affirmative action" seem weak-kneed

Want to see a GP? Gipsies come first as NHS tells doctors that travellers must be seen at once. Gipsies and travellers should be given priority in NHS hospitals and GP surgeries, doctors have been told. They will be fast-tracked for doctors, nurses and even some dentist appointments above all other patients. GPs have also been told to see any travellers who simply walk in without an appointment, even if all consultation times for the day are full.

They will also be given longer consultations than other patients. Five or ten minutes is the average but travellers will be given 20 minutes and allowed to bring relatives into the consulting rooms. Staff will be given 'mandatory cultural awareness' training so they can fully understand what it is like to be a traveller or gipsy.

It raises the prospect that other patients will suffer worse healthcare and have to wait even longer to see their GP. The guidelines have been introduced because, under race laws, gipsies and travellers are defined as minority ethnic groups and the NHS is obliged to consider their special needs and circumstances. Yet no special treatment is promised for other groups such as those from the Asian sub-continent or Africa.

The guidance also encourages Primary Care Trusts to establish new services for travellers if none exist, and to designate a senior manager to be a named lead for 'Gipsy and Traveller Health'. The rules form part of the Primary Care Service Framework, drawn up by the NHS Primary Care Commissioning - an advisory service for local health trusts - to help all PCTs understand the Department of Health's policy.

It will go on trial for between three and five years, Although PCTs do not necessarily have to follow the guidelines, they could be breaking human rights law and the Race Relations Act of 2000 if they do not. Groups covered by the framework include Scottish gipsy travellers, Welsh gipsies, bargees, circus and fairground showmen and new travellers.

Tory health spokesman Andrew Lansley said: 'No one should get priority treatment in the NHS apart from our Armed Forces, to whom we owe a special debt of gratitude. 'Decisions about who should be treated first should be based on a patient's medical needs, not their ethnic group. 'NHS managers need to get off doctors' and nurses' backs and start letting them get on with what they do best - looking after sick people. 'Such a policy of fast-tracking one section of society over another goes against the founding principles of the NHS.

Labour's botched handling of the new GP contracts and obsession with a tick-box target culture in the NHS mean many people find it difficult to get a GP appointment quickly. 'Families will feel aggrieved that it will now be even harder.'

Mark Wallace, from the Tax-Payers' Alliance, said: 'This kind of special treatment is totally uncalled-for and utterly unjustified. 'The NHS is meant to treat people equally so matter who they are or whatever their race. 'The only priority should be how ill someone is, not their politically-correct concerns. 'This will be incredibly frustrating for people who have paid tax all their lives to fund the NHS and are left struggling to get a doctor's appointment and prompt treatment. 'Hardworking people will be outraged at this double standard.'

The NHS estimates there are 120,000 to 300,000 gipsies and travellers in the UK but there are no firm numbers as the census does not include them as a category.

Traveller spokesman Gratton Puxon, from the illegal camp at Crays Hill in Essex, welcomed the initiative. He said: 'The problem stems from years ago when there was simply no access to healthcare, but things have greatly improved. Health workers visit the site quite regularly if people have chronic problems.'

The Department of Health said: 'We are aware that gipsies and travellers have experienced tremendous difficulties in accessing primary care. 'Partly as a result, community members experience the worst health inequalities of any disadvantaged group. 'The framework suggests fast-tracking for two reasons. First, as a matter of urgency, inroads need to be made into the health problems of gipsies and travellers. 'Second, if mobile community members are not seen quickly, the opportunity could be lost as they move on or are moved on. This should not be to the detriment of service provision to the settled community.'


British Police 'illegally' stopping white people to racially balance stop-and-search figures, watchdog claims

The political correctness news from Britain never stops coming

Police are making unjustified and 'almost certainly' illegal searches of white people to provide 'racial balance' to Government figures. Lord Carlile, the independent reviewer of terror laws, said he knew of cases where suspects were stopped by officers even though there was no evidence against them. He warned that police were wasting time and money by carrying out these 'self-evidently unmerited searches' which were an invasion of civil liberties and 'almost certainly unlawful'.

The searches of, for example, 'blonde women' who fit no terrorist profile come against a backdrop of complaints from rights groups that the number of black and Muslim people being stopped by police is disproportionate. Lord Carlile suggests whites are being needlessly stopped in order to balance the books. Last year, the number of whites searched under anti-terror laws rocketed by 185 per cent, from 25,962 to 73,967. Whites made up around two-thirds of all those stopped, although, compared to the overall population, blacks and Asians remain far more likely to be stopped and searched.

Lord Carlile, a Liberal Democrat peer and QC, condemned the wrongful use of Section 44 of the Terrorism Act 2000 in his annual report on anti-terror laws. He said police were carrying out the searches on people they had no basis for suspecting so they could avoid accusations of prejudice. Lord Carlile wrote: 'I have evidence of cases where the person stopped is so obviously far from any known terrorism profile that, realistically, there is not the slightest possibility of him/her being a terrorist, and no other feature to justify the stop. 'In one situation the basis of the stops was numerical only, which is almost certainly unlawful and in no way an intelligent use of the procedure.

'I believe it is totally wrong for any person to be stopped in order to produce a racial balance in the Section 44 statistics. There is ample anecdotal evidence this is happening. 'I can well understand the concerns of the police that they should be free from allegations of prejudice, but it is not a good use of precious resources if they waste them on self-evidently unmerited searches. 'It is also an invasion of the civil liberties of the person who has been stopped, simply to 'balance' the statistics. 'The criteria for section 44 stops should be objectively based, irrespective of racial considerations: if an objective basis happens to produce an ethnic imbalance, that may have to be regarded as a proportional consequence of operational policing.'

Lord Carlile later said the number of Section 44 searches could be cut by half in London without damaging national security. He added: 'If, for example, 50 blonde women are stopped who fall nowhere near any intelligence-led terrorism profile, it's a gross invasion of the civil liberties of those 50 blonde women. 'The police are perfectly entitled to stop people who fall within a terrorism profile even if it creates a racial imbalance as long as it is not racist."

Officers in England and Wales used the powers to search 124,687 people in 2007/8, up from 41,924 in 2006/7 and only 1 per cent of searches led to an arrest. Nearly 90 per cent of the searches were carried out by the Metropolitan Police which recorded a 266 per cent increase in its use of the power. Lord Carlile said he could see no reason for the whole of Greater London to be permanently designated an area where the power could operate.

He added: 'I repeat my mantra that terrorism related powers should be used only for terrorism related purposes; otherwise their credibility is severely damaged. The damage to community relations if they are used incorrectly can be considerable.'

Shadow Security Minister Baroness Neville-Jones said: 'It is a hallmark of this Government that powers available under terrorism legislation are used for reasons entirely unrelated to those for which they were put on the statute book. 'Inappropriate use of stop and search power is the surest way to lose public support and damage community relations. Lord Carlile rightly condemns this. 'The Government needs to make absolutely sure that anti-terrorism powers are used proportionately and only for terror-related purposes.'

Liberal Democrat home affairs spokesman Chris Huhne said: 'We must row back from random and excessive use of stop and search and reach out to the communities we most rely on for intelligence in the fight against terrorism.'

Home Secretary Alan Johnson said the Metropolitan Police had already begun to review how Section 44 was used across the whole of the capital, including a pilot of its more restricted use.

Today's report also warns of the continuing terrorist threat to the UK. Lord Carlile says there is evidence of ‘small, dissent active and dangerous’ paramilitary groups in Northern Ireland. The Peer also remains pessimistic about ‘the future of international terrorism as promulgated by violent Islamist jihad’.


Scottish Education Awards: Going back to old methods helped me win honour, says teacher of the year

WE'RE used to hearing about schools employing the very latest technology in today's modern classrooms. But for newly-crowned Teacher of the Year Ian Houston, it was dusting off some old equipment which sparked the interest of his students. The physics teacher from St Joseph's College in Dumfries won the praise of pupils, colleagues and judges alike for his original approach to teaching, which included experiments that dated back to the 19th century.

He was just one of the winners announced yesterday at the 2009 Scottish Education Awards, which took place at the City Halls in Glasgow. Ian said: "The history of our school goes back more than 100 years. I found old stuff in our cupboards which no one had a clue how to use, so I bought some old books which had pictures of this equipment. "So we've been able to give them a new lease of life by showing students the old way of doing things, then working up to more modern ways. "A lot of modern science these days involve black boxes where you put stuff in one end and get a measurement out, but with older equipment you get to see what's going on inside."

Ian's teaching methods became so popular that pupils began asking to be transferred to his class, with parents also being struck by the enthusiasm of their kids for the subject.

But Ian himself was surprised to hear that he'd made such an impact. He added: "I was teaching the Advanced Higher class this year, so I made a big effort for it, but it didn't occur to me that I was doing anything unusual. "Like most teachers, I sit there worrying that I'm not doing it properly."

Also celebrating yesterday was maths teacher John MacKenzie. He picked up the Lifetime Achievement Award for 30 years of dedicated work as principal of the maths department at Oban High School. He said: "When I heard I'd been nominated, I was overwhelmed and humbled that my colleagues had gone to the effort of doing that. "So to win the award is wonderful. I'm even more humbled by it. "My colleagues have always said networking is one of my strengths, and if I come across an idea I think will be beneficial to our pupils then I'll certainly pursue it to motivate our young people."

While the day offered John a chance to look back on his career, for other teachers, their days in the classroom are only just beginning. They include chemistry teacher Alice Thompson, of Eastbank Academy in Glasgow, who was named Probationary Teacher of theYear for a mammoth amount of work which included organising a crime scene investigation project for the school's chemistry club. She said: "I applied to the British Science Association for a grant and that allowed us to do some work on forensic techniques. "We set up a fake crime scene, we had a mock murder trial and a lot of different departments got involved. The maths department were looking at the velocity and angles of blood spatter patterns and things like that. It was fantastic."

The Head Teacher of the Year Award went to Paul McLaughlin of St Ninian's High School in Bishopriggs, East Dunbartonshire, for the huge impact he has had on the life and culture of the school since he took over there five years ago. Last year's Teacher of the Year, David Miller, also came from St Ninian's. Paul said: "I feel great to have won this award, but I don't believe that this award is really for me, it is for the whole school. "The school won two awards last year, so it is just amazing to be back again at such an exciting event which is such a great celebration of teachers and teaching." ...

The staff and pupils of Perth Grammar School also went home happy after winning the Ambition award in recognition of their work to improve the school. Head teacher John Low said: "We had a issues in the school in terms of behaviour and morale, but we tackled it head-on and within a matter of weeks, things had improved as the staff and the vast majority of pupils wanted things sorted out. "We worked on the themes of pride, respect and ambition as they were the three things that were missing, and it's worked to the extent that winning has now become a habit within the school. "The energy of the school is now going in the right direction."

More here

In Britain and in Europe generally, the people are forcing the elite to re-evaluate immigration

MORE than a week after the European Parliament elections, the hand-wringing in Britain over the success of the ultra-right British National Party continues. Having secured two seats in the European Parliament - a first for the BNP - many in the political and media class are rehashing, at least implicitly, the line made famous by German playwright Bertolt Brecht. Surely, they wonder, it is time to elect a new people, a more sophisticated, better informed people not prone to nasty and vicious xenophobia.

Mainstream political leaders - Tory and Labour - mutter in disgust. Newspapers mull over whether a 1920s version of militant fascism is emerging. The BNP, with its racist, anti-immigrant agenda, should be driven out of British politics as an illegitimate force, they say.

The BNP is surely a repellent political force, but again elites have misjudged the meaning of its rise.

For better analysis, you need only jump in a taxi to understand what happens when there is a sense that a nation has lost its way. My taxi driver from Heathrow told me he voted BNP for the first time. The next day, another taxi driver said the same. Another day, another taxi driver, another first-time BNP voter. For them, mainstream parties stopped listening to the concerns of working-class people about immigration. Likewise, you will learn more from the letters pages of British newspapers than from the reams of so-called expert analysis devoted to denouncing the BNP's success as a depressing moment for democracy. "The political process must address such concerns, not simply dismiss them as wrong. Denial simply makes things worse, and repression fuels rage among people who feel they have lost their country and want it back," one correspondent wrote to The Independent.

The emergence of the BNP - and, indeed, other similar anti-immigration parties across Europe - is yet another wake-up call that large swaths of the West have failed to discuss the consequences of fast-growing immigration honestly and openly.

Once again we are reminded that multiculturalism rendered such discussion distasteful, where elites presented immigration as a necessary part of a tolerant society, no matter how incompatible the values of these migrants. All cultures were equal, they preached, while deriding Western culture as somehow less equal. Any reservations about the costs and consequences of immigration were discarded as vile xenophobia from the ignorant, intolerant masses.

It is easy to dismiss the concerns of the working class when you are far removed from the daily, social challenges of immigration.

Our own Mark Latham best described that disconnect back in 2002 when he said that: "In my experience, the strongest supporters of the rights agenda are those who do not have to face the daily consequences of irresponsible behaviour. They have the resources to buy themselves away from social problems ... This gives them the luxury of being able to talk about human rights without the need for social responsibility."

How horrifying it must be for the Left to discover that they are partly responsible for the rise of anti-immigration parties such as the BNP. When people feel disenfranchised, ignored by mainstream politicians who have failed to treat them as adults entitled to a serious debate about immigration and a fading national identity, they will resort to unattractive fringe parties to vent their anger.

They turn to parties such as the BNP and the obsessively nationalist UK Independence Party, which out-polled the ruling British Labour Party. And to Hungary's far right party Jobbik, otherwise known as the Movement for a Better Hungary, which won 14.8 per cent of the poll, securing almost as many votes as the ruling Hungarian socialists. And Geert Wilders's Freedom Party in the Netherlands, which doubled its vote campaigning on anti-Islamic concerns, nationalist parties such as True Finns in Finland and Denmark's far-right Danish People's Party, which picked up a second seat in Strasbourg.

Years ago now, writing in Prospect magazine, David Goodhart wrote an important essay warning liberals about the progressive dilemma that confronts many Western countries: sharing and solidarity can often conflict with diversity. "Acts of sharing are more smoothly and generously negotiated if we take for granted a limited set of common values and assumptions," he wrote.

Yet, the more diverse that once homogenous societies become, the more the common culture is eroded. He warned that the reaction to growing diversity will happen through decades, if not generations. After last week's European elections, more people are now realising the inevitable price of diversity.

In a new book, Reflections on the Revolution in Europe, which could not have appeared at a better time given the gnashing of elite teeth about the European elections, Christopher Caldwell describes the revolution under way in Europe. Growing immigrant communities are changing Europe to suit their own cultural identities. They are able to do so only because so many European countries have been left confused and enervated, losing their own sense of self. The march of modernity and globalisation, said the ruling political elites and much of the media, requires an unquestioning acceptance of immigration, regardless of the clash of values. The move away from the old-fashioned notion of solidarity and shared values in favour of diversity and multicultural moral relativism is most apparent in the area of women's rights, where increasing numbers of immigrants from different cultures do not share the West's commitment to equality.

Reviewing Caldwell's book last week in The Guardian, Martin Woollacott could not help but ask whether talk of a fading European identity was "right-wing rubbish" from a "luminary of the The Weekly Standard, the American neo-conservative magazine Rupert Murdoch finances". In the past, that is where much analysis would have stopped.

Now, however, more people such as Woollacott are conceding that Caldwell is right in "underlining the fact that immigration was encouraged by elites who took a ludicrously short-sighted view of its costs and consequences". And right too "that we frequently talk about (immigration) in stupid and dishonest ways".

Woollacott concludes that if Caldwell's book "sharpens a so far sluggish debate, it will have served an important purpose".

The same could be said of the recent elections for the European Parliament. If the many messages and political warnings that resonate from the results are heeded, then the elections will have served Europe and Britain well. Only a more honest discussion about immigration - and the importance of national identity - will prevent further political gains to parties that know how to manipulate the concerns of people such as my early morning taxi driver. Repressing these parties will be interpreted as repressing the genuine concerns of voters. If that happens, Britain - and Europe - will learn an even tougher lesson about repression when there is an even stronger, more unfortunate backlash against immigration and open borders.


Is lack of vitamin D linked to swine flu?

This is an improbable speculation. Vitamin D is added to butter and margarine these days so everybody should be getting enough. Though I suppose that the anti-fat brigade may have reduced usage of butter and margarine among some people. As for the reason why health is unusually poor in Scotland, why are we not mentioning Scotland's rate of alcohol consumption and the inactivity that accompanies high rates of unemployment?

Scotland has a disproportionately high number of swine flu cases. There could be a simple reason. It was all very predictable, I suppose, that when the first UK death from someone suffering from swine flu came, it did not come from St Ives or St Andrews. Jacqueline Fleming lived on a rundown council estate in Glasgow; she came from the other Scotland, the bleak one we garland with jokes and statistics but ultimately prefer to ignore.

The H1N1 outbreak is an uncomfortable reminder that the health gap both between the rich and the poor in Scotland, and between Scotland and practically everywhere else in Europe, is not only inescapable - it is, sadly, one of the things that define this country. How symbolic that Ms Fleming, 38 - the first person with swine flu outside the Americas to die - lived of all places in poor little Carnwadric, a deprived council ward in the West of Scotland. She is, in death, a Scottish landmark, an unintended indictment of this country's disproportionately woeful health record.

Ms Fleming apparently suffered from strokes and seizures. She was described as “a good, quiet woman”; a full-time mother, who lived an existence constrained by lack of opportunity and income. She was expecting her third child. When she caught the illness, which had occurred at a local primary school, she was made doubly vulnerable through her chronic condition and by virtue of the pregnancy. She fell gravely ill, gave birth to her baby at 29 weeks and died two weeks later without regaining consciousness. Her child, Jack, who did not have the virus, died 24 hours later: a private double tragedy that echoed round the world.

The following day, I was invited on The Jeremy Vine Show. We want to ask, said the researcher, why Scotland? Why is swine flu cutting swaths across Scotland, and killing people? The unvoiced question hovered: what's wrong with you people that makes you the sickest in half the world? You can understand where they were coming from. Scotland has 530 confirmed cases of swine flu, 441 possible cases and 300 clinically diagnosed possibles - a total of more than 1,200. By comparison, bigger countries are relatively unscathed. England, with ten times the people, only has 1,062 cases, Austria 7, Portugal 3, France 80, Germany 170, Spain 488 and Ireland 12.

Beneath the soundbites, there are several answers. One can say with absolute certainty that there has been better monitoring here. NHS Scotland and its many limbs, Health Protection Scotland and Health Scotland and NHS Quality Improvement Scotland and the Healthcare Environment Inspectorate and the Information Services Division - I could go on - are just part of one of the most impressive health service data engines in the world. In this regard Scotland purrs along like a Rolls-Royce: few other nations have information that combines high-quality data, consistency, national coverage and the ability to link data to allow patient-based analysis and follow-up. No case of swine flu has a chance of getting away from that lot.

And yes, of course, there's much to monitor. Scotland possesses a health record that would make a Third World dictator wince: hospital admissions from alcohol up 7 per cent on the previous year and up 17 per cent on five years ago; chronic levels of disability from strokes, coronary heart disease and cancer; lung cancer; drug use; a diet built on fat and sugar; and soaring levels of obesity. Surely these endemic weaknesses are what makes us vulnerable to swine flu?

Yes - but it's not the whole answer either. Since devolution, and the pumping in of billions of pounds, NHS Scotland is a fairly magnificent operation. Rates of ill health are declining, although the gap between the most deprived areas and the most affluent is widening, and England's health, similarly blessed with extra funding in the good times, is improving faster than Scotland's.

Which brings us face to face with the disconcerting thing they call the health deficit: the unexplained gap between Scotland's health outcomes and that of the rest of Britain; a gap that still persists even when the epidemiologists factor in all the lifestyle issues; the gap, in other words, that makes the Scots sick no matter how much money is spent on them.

It was fashionable for a while to talk about the biology of poverty, explaining it away by poor housing and a history of deprivation; cooked up with low self-respect and expectation.

But could the puzzle have a simpler answer? Recently The Times has revealed astonishing research showing the links between low vitamin-D levels and poor general health. Multiple sclerosis, cancer and diabetes are just some of the diseases linked to an immune system compromised by lack of the vitamin. And the Scots, living in a cloudy climate, are known to be twice as likely to be vitamin D deficient as the English. Increasing numbers of scientists suspect vitamin D could be the Scots' Achilles' heel.

Influenza, we know, strikes in the winter when vitamin D levels are naturally lowered - hence a possible reason why swine flu is at present widespread in Australia, where it's winter. Could the disproportionate prevalence of H1N1 in Scotland be related to endemic low levels of vitamin D among the population - especially those least likely to buy themselves supplements? It is a huge, intriguing question.


British Navy captain bans brussels sprouts

Good man!

A BRITISH navy captain has banned brussels sprouts from his ship, labelling them the "devil's vegetable". Commanding officer Wayne Keble delivered the order to his 390-strong crew on HMS Bulwark because he hates the vegetable, Britain's Daily Telegraph reported. But he denied speculation he imposed the ban because sprouts make the sailors suffer from flatulence in the cramped conditions on board.

Keble disclosed his order after he was asked to confirm reports he had banned fried foods from his ship on health grounds. He said: "The only thing I have banned on board is brussels sprouts. They are the devil's vegetable and the only thing I do not like, and the only thing I hate. "Brussels sprouts are absolutely banned on board HMS Bulwark. I do not eat them so I do not know what the after-effects are.'' The distinctive smell of sprouts is caused by sulphur compounds released when cooked.

A spokesman for the Royal Navy and the Ministry of Defence said sprouts had only been banned from the captain's table. But a source on board the ship said Keble was "very serious'' about the ban and refused to allow any sprouts on board. "This ban is no joke ... The MoD can say what they like but Captain Keble runs the ship and he has categorically said that sprouts are banned,'' the source said.

HMS Bulwark is at present deployed in the Mediterranean and Far East.


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