Sunday, August 02, 2009

Elderly Brits last in line for swine flu vaccine

Even though they probably need it most as they often have other infirmities

Pensioners will be at the back of the queue for the new swine flu vaccine as a list of priority groups are drawn up, it has emerged. Health and social care workers will be vaccinated first, followed by pregnant women and all children under the age of five, under initial plans. The first batches of H1N1 vaccine are due to arrive next month with enough for half the population expected to be delivered by December.

It will be the biggest vaccination programme undertaken by the NHS since smallpox in the 1950s. The groups most at risk from the disease will be vaccinated in order of priority as the batches arrive. Experts have said healthy pensioners are not a priority group as they seem to have some immunity to the virus and are not catching it as readily as younger people. [But if they do they are more likely to die]

People under the age of 65 with long-term health problems which may include asthmatics, those with heart disease and people with kidney problems will be vaccinated after young children. Next in line are all young people under the age of 18, followed by the rest of the population, including healthy over 65s, according to sources quoted in Pulse magazine.

Meanwhile the Scottish Executive has also published its vaccine priority groups with healthy over 65s the very last group to be vaccinated. A similar list has been published by the American health authorities and it too lists healthy over 65s as the final group to receive the H1N1 vaccine.

The final decision about the priority list for England will not be made by Andy Burnham, the Health Secretary, until the middle of this month. It will be revealed after a meeting of Cobra – the emergency committee chaired by Mr Burnham – that was set up to co-ordinate the swine flu response from Whitehall. Mr Burnham has made it clear that the priority list will be based on scientific evidence.

On Thursday a meeting was held that looked at the evidence that will guide the vaccination priority list. Those advisers present will now go away and do further work on "prioritisation," according to Whitehall sources before presenting it to the next Cobra meeting. Two plans will be released after that Cobra meeting. The first will look at "critical care planning policy." The second will detail vaccine "licencing, delivery, administration and priority."

A senior Government source said: "We will be governed by the scientific advice and evidence alone. If that says over 65s are not the priority then we will act on that."

Ministers are said to be "irritated" by this week's House of Lords report which questioned aspects of the Department of Health's planning and preparation for the pandemic.

Data released by the Department of Health shows that children under one year old are ten times more likely to contract the virus than the over 75s. Since the outbreak began in England at the end of April an estimated one in every 90 children under the age of one have had H1N1, followed by one in 77 children aged between one and four, then one in 95 children aged between four and 14. In comparison one in 251 people aged between 45 and 64 have so far had swine flu, followed by one in 490 people aged between 64 and 75 and then one in every 833 people aged over 75.

The Government has contracts, worth £155.4m with GlaxoSmithKline and Baxter International for enough vaccine for the entire population, with each person receiving two doses.

A spokesman for the Department of Health said: "We have not yet taken a final decision on who will receive the vaccine first, and are discussing this with our independent scientific experts. Decisions will be made on the basis of the most up-to-date evidence about the severity and spread of the disease and the delivery supply timetables. "By the end of August, we will publish a vaccination plan that will include decisions on priority groups and the method of delivery."

Once the groups most at risk from swine flu and those most likely to develop complications have been vaccinated ethicists have argued that the fairest way of distributing the vaccine to the rest of the population would be on a lottery basis, however this has officially been discounted.

Pensioners [i.e. elderly retirees] and those with chronic conditions, such as heart disease, liver disease, kidney disease, and diabetes controlled by insulin, are offered the seasonal flu vaccine every year and this will not change this winter. [So the oldsters get priority for seasonal flu vaccine but not swine flu vaccine?? Some confused thinking there]

There are early signs that the summer outbreak of swine flu may be peaking with GP consultation rates about flu-like illness having dropped in the past week. However cases are expected to surge again the autumn peaking in December and January.

Earlier this week researchers said where supplies antiviral drugs, used to treat flu and reduce symptoms, are limited they should be prioritised to the young over the elderly because deaths were lower in the over 65s. Prof Robert Dingwall, who sits on the Committee on Ethical Aspects of Pandemic Influenza, set up three years ago, said the debate over prioritisation of the pandemic vaccine based on age had been held within the committee several times.

He said it was unlawful to discriminate against people only by virtue of age. He said: "On the information we have so far unless there is an aggravating factor [which there often is] over 65s don't seem to be at risk from this as they are with seasonal flu. There is a good ethical argument for saying that the fit healthy over 65s are not a priority but there is no reason to discriminate between a 70-year-old asthmatic and a 10-year-old asthmatic."

Prof Dingwall said it was unacceptable to say that over 65s would not get the vaccine because younger people are of more value. But if there was good clinical evidence that younger people were getting swine flu more often and getting it more severely and that was the reason for prioritising younger people for the vaccine then that would be ethically acceptable. Prof Dingwall added: "There will be enough vaccine eventually (for everyone) but we may not be in a position to vaccinate the entire population well into next spring."

Prof Peter Openshaw, director of the centre for respiratory infection at the National Heart and Lung Institute Imperial College London, said: "It is sensible to make sure that the elderly get the ordinary seasonal flu vaccine as they are more likely to contract that. The elderly will in all likelihood [that sounds like a mere specualation] have some antibody protection because of exposure to similar viruses prior to 1968."

He said was also advisable to wait until test results on whether the swine flu vaccine with interact with the seasonal vaccine if given at the same time. The 1918 influenza pandemic was caused by an H1N1 virus and similar strains circulated throughout the 1950s.

The World Health Organisation issued guidance earlier this month saying that all countries should vaccinate front line health workers as their first priority. [That is the obvious priority but I would argue that the second priority ought to be people with other infirmities, regardless of age. Because the people with other infirmities are usually the ones who die. I think that there is a definite devaluing of the elderly above, probably because they usually pay little tax -- JR]


Physically punishing a child with a smack (or a kick) is NOT against the law, says senior British judge

Nasty social workers lose one for a change

Parents can slap and even kick their children when chastising them, a senior judge said yesterday. The remarks at the Appeal Court are the first time the courts have drawn a line at which the ' reasonable' point of punishing children becomes physical abuse. Lady Justice Hallett said: 'Reasonable physical chastisement of children by parents is not yet unlawful in this country.

'Slaps and even kicks vary enormously in their seriousness. A kick sounds particularly unpleasant, yet many a parent may have nudged their child's nappied bottom with their foot in gentle play, without committing an assault. 'Many a parent will have slapped a child on the hand to make the point that running out into a busy road is a dangerous thing to do.'

She was ruling in a case in which a local authority had wanted to take three children into care after allegations of abuse. The judges upheld a lower court decision that while one child had been slapped and kicked, she had not suffered 'significant harm' and the children could stay with their parents.

Lord Justice Ward said no marks had been seen on the child and she appeared to be well nourished, well cared for and with close attachments to her parents.

Ruling he said: 'The harm must, in my judgment, be significant enough to justify the intervention of the State and disturb the autonomy of the parents to bring up their children by themselves in the way they chose.'

Under current law it is illegal for a parent to hit a child if it leaves a bruise. However, a lighter smack or 'reasonable chastisement' is allowed.

But those who want smacking banned said the judge's comments underlined why a law change was needed. Phillip Noyes, of the NSPCC, said: 'These comments are unhelpful and cloud the clear message to parents that hitting and kicking children is always wrong. 'Changing the law to make physical punishment of children illegal would provide a clear basis for child protection and the promotion of alternative forms of discipline. 'Currently the law in the UK on hitting is confusing and leaves children of all ages vulnerable to abuse. 'It is a national embarrassment that the UK is one of only five remaining EU countries which have not given children equal protection under the law on assault or committed to doing so.'

Kevin Barron, Labour chairman of the all-party Commons Health Committee, said the judge's remarks made a 'good case' to ban smacking by law. Adding that there was too much room for doubt, he said: 'We should do what other civilised countries have done and make it unlawful.'


The British Left's attack on families

Straight out of Karl Marx's rule book

Some middle income families would be nearly £10,000 a year better off if the parents were to split up, according to research. The growing penalty that Labour’s taxes and benefits pile on to couples who stick together is bearing down increasingly hard on families with middle range earnings, it found. A husband and wife with two children and earning nearly £35,000 a year between them – well above the average income – are now the biggest losers for keeping their family together. If they were to live apart they would be better off by £186 a week – an increase in the money they can spend of nearly 60 per cent.

The analysis of the price that couples must pay for staying together was carried out by the charity Care, based on tax and benefit tables produced by the Department for Work and Pensions. It showed that the notorious ‘couple penalty’ which Labour has built into the benefits system is growing and that, increasingly, it is putting pressure on people on middle incomes to break up with their partner or to avoid living together with them in the first place.

The couple penalty – mainly caused by Labour’s flagship tax credit benefits, which are heavily biased in favour of single parents – is now coming under political criticism. Tories have promised to even up benefit rules so that couples are no longer much worse off than single parents. Labour MP and former welfare reform minister Frank Field said yesterday: ‘It is vital that we find a way of addressing welfare need without creating perverse incentives for the parents of children on low to modest incomes to live apart.’

The benefit bias against couples has usually been thought to act to persuade people on the lowest incomes to stay single. The high penalties now being imposed on middle income couples suggest that growing numbers of middle class people may now be affected by financial pressure to live without a husband, wife or partner.

The Care analysis was based on the taxes and benefits that would be paid by 98 couples on different earnings and with different numbers of children. It found that 76 out of the 98 would be better off apart, up from 75 families in a similar analysis last year. On average, they would be better off apart by £68 a week. The average cost to the Treasury – and taxpayers – of extra benefits to a couple who choose to live apart is £8,007, up four per cent on last year’s cost to taxpayers.

The worst losers from staying together are a couple with two children who live in private rented accommodation. If one earns £520 and the other £150, and they have child care costs of £120 a week, the couple can expect to have a disposable income of £308 a week after they have paid tax and claimed due benefits. But if they broke up and lived in two different rented flats, their joint disposable income would rise to £494 a week.

A typical couple among the 98 cases examined would have a disposable income of £303 a week – but if they parted and claimed the £68 couple penalty they would be more than 20 per cent better off.

Nola Leach, Care’s chief executive, said: ‘It is very disappointing to see that, far from being eroded, the number of families negatively impacted by the couple penalty has actually increased for the third year in a row. ‘Rather than using taxpayers’ money to create fiscal incentives that make it more likely that children will grow up in a home with only one resident parent, we should at the very least ensure that parents are not disadvantaged by living together under the same roof with their children.’


Gutless British "rescuers"

Nobody must ever take any risks in Britain -- even if people die as a result (!!???). Just don't have an accident in Britain. Those whose job it is may well refuse to help you if it is likely to inconvenience them at all

Police, firemen and paramedics refused to go to the aid of an accident victim who was drowning in just 18 inches of water... because they believed it was too dangerous. A senior fire officer banned his men from using ropes and ladders to climb down a 15ft bank to the victim after carrying out a ‘risk assessment’.

Acting on advice, ten police officers who attended the emergency also failed to rescue father-of-three Karl Malton, 32, as he lay face down in the shallow water.

His body lay there for three hours after a decision was made to send for a ‘water rescue team’ based more than 50 miles away. When relatives arrived at the scene, they found emergency workers standing around drinking tea.

An inquest into Mr Malton’s death yesterday heard that officers no longer have to swim or receive life-saving training.

Last night Mr Malton’s father Peter branded the emergency services’ response to the tragic accident as ‘unacceptable’.

The case has prompted fresh controversy over how health and safety restrictions are preventing the emergency services from fulfilling their most basic duties. The issue flared up two years ago after another inquest heard how two police community support officers stood by while a ten-year-old boy drowned in a pond in Wigan.

Yesterday’s inquest in Spalding, Lincolnshire, heard that Mr Malton, a mechanic, was hit by a car as he walked along an unlit country road near his home in Crowland just after 11pm on May 13 last year.

The driver pulled up and dialled 999 but was told to stay in his car and not try to find the victim. Paramedic Sonya Lawrence arrived within 14 minutes but began to search on the nearside of the car, although it was damaged on the offside. Another 19 minutes later a second ambulance crew arrived and found Mr Malton, who had been thrown unconscious into the dyke by the collision. He was lying face down in the water and appeared to be dead. Paramedic Fergus White climbed over a barrier before deciding it was too dangerous to go down the bank.

‘If we had access to him we would have carried out resuscitation but we had no access,’ he said. ‘The bank was very steep and unstable.’ Mr White admitted that he could not be ‘100 per cent sure’ that Mr Malton was dead. After a further 28 minutes a team of firemen arrived and set up ladders and ropes on the bankside but were ordered to stop by senior officer Edward Holliday. Mr Holliday said: ‘I made the assessment that it would be inadvisable to enter the dyke until a properly trained and prepared crew arrived.’

He called in a water rescue team from Lincoln, more than 50 miles away. Mr Malton’s body was finally recovered using a boat at 2.18am, more than three hours after the crash.

A post-mortem examination revealed that he had drowned but could not determine how long he had been in the water before dying. The inquest was told he would have been dead within ten minutes of entering the water. Deputy Boston coroner Paul Cooper recorded a verdict of accidental death .

Mr Malton’s father Peter said in a statement: ‘Irrespective of the coroner’s verdict about the actual cause and timing of my son’s death the fact remains that he was lying at the bottom of a ditch for three hours. ‘Whether he was dead or alive at the time does not alter the distress caused to the family.’ The family are now preparing a civil action for damages, while police, fire and ambulance services are all reviewing their procedures as a result of the tragedy.


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