U.K.: Hepatitis C care 'fails patients'

The NHS approach to hepatitis C needs overhauling, MPs and doctors have said. A report by the All-Party Parliamentary Hepatology Group said care was a "postcode lottery" with many trusts not following official guidelines. And a second report by top doctors said the UK was lagging behind its European neighbours which had set up specialist diagnosis and treatment centres. Campaigners said the failures were costing lives, but the government said services were improving.

The hepatitis C virus, if untreated, can cause cirrhosis, liver failure or liver cancer. Most people who contract the infection can be successfully treated, but - as the virus often does not produce early symptoms- it can go undetected, often for years. The virus is spread through contact with infected blood. Most people contract it through sharing needles to inject drugs.

The All-Party Parliamentary Hepatology Group found that 92% of 191 primary care trusts had failed to fully implement a 2004 Department of Health action plan to tackle the disease. And nearly half of the 107 hospitals quizzed said there were significant delays of up to a year for patients waiting for treatment. Brian Iddon, a Labour member of the cross party group, said the infection was a "hidden timebomb". Campaigners believe about 400,000 people are infected but unaware of it - although the government says its half this number. By the end of 2005, 54,000 people had been diagnosed.

Doctors

The report by leading doctors, which was published to coincide with the MPs' study, said the UK had not responded as well as its European neighbours and management of the virus in the UK was "both unstructured and under-funded". The report details seven recommendations for the government, including developing a detailed strategy for managing the virus; appointing somebody to oversee it; raising awareness and improving testing. It also called for specialist centres to be set up as they have been in France, Germany and Italy to provide diagnosis and treatment.

Report author Professor William Rosenberg, professor of hepatology at the University of Southampton, said: "We are lagging behind many countries and that in not acceptable." Charles Core, chief executive of the Hepatitis C Trust, which commissioned the report by doctors, said lives were being lost because of the failings. "If we do not seize this opportunity we will look back and know that by our inaction we let it happen."

A Department of Health spokeswoman said: "We recognise the importance of hepatitis C as a public health issue." And she said early indications were that awareness campaigns and the national framework were having an impact as more people were being diagnosed. But she added: "The results of the survey may serve as a useful focus for discussion by local NHS organisations."

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ANOTHER NHS FAILURE

The parents of Victoria Climbie called on the Government today not to let her death be in "vain" after a survey discovered many NHS trusts had not implemented all the key recommendations proposed after her killing. Francis and Berthe Climbie urged Health Minister Patricia Hewitt to take "responsibility" for the situation following the poll which highlighted concerns in the child protection system. Lord Laming, who headed the public inquiry into the eight-year-old's death, said it was "unacceptable" to find the system working well in some areas and not in others.

The survey of NHS acute hospital trusts was conducted by Five News correspondent Catherine Jacob, who also interviewed the Climbies. Mr Climbie, speaking from Abidjan on the Ivory Coast, told the programme: "The Government can give all the money it likes, but if the services do not communicate with each other, then it's logical - the child protection system will always fail. "Yes, I have a message for the Health Minister. You are a representative of the Government. You can really change things. If the people who work in your health system are unhappy, then the child protection system will not work. You must take responsibility for it. Protecting children is everyone's responsibility. "When Victoria died, the then Health Secretary Alan Milburn promised us her death would not be in vain. Do not let Victoria's death be in vain."

Victoria, who died in February 2000, had 128 injuries to her body. She had endured months of torture and abuse by her great aunt Marie Therese Kouao and her boyfriend Carl Manning despite being in the care of social services and police. The couple were jailed for life in January 2001 for her murder.

Lord Laming's public inquiry found child protection services had missed at least 12 chances to save her life. The Government later accepted all but one of his 108 recommendations Five News polled 175 NHS acute hospital trusts across England and received responses from 62 of them. In each case the designated and named child protection doctors and nurses were asked whether Lord Laming's nine key recommendations had been put in place. More than two thirds of respondents (71 per cent) said they had not introduced all of them. Nearly half (48 per cent) said recommendation 78, which crucially states health professionals should work from a single set of records for each child, was still not in place.

Asked the question: "Post Laming, do you feel enough is being done to modernise child protection services within the NHS," a third (33 per cent) of respondents said no. Amongst anonymous comments made by NHS staff during the survey, one said: "As far as I'm concerned child protection in this country takes a back seat... until another tragedy occurs."

Commenting on the survey's finding, Lord Laming told Five News: "It vividly illustrates just how far we've got to go before the recommendations of the report have become a reality and there are better outcomes for children across the country. "It is, in my view, unacceptable that in this day and age we are in a situation where in some places the system is working well and therefore within the available resources it is possible to do it, but in other parts of the country, the system is not working well."

Victoria's mother Berthe said: "Six years on, I still find it incredible in such a great country that something like that could happen. "Today, here in the Ivory Coast, when you see a child who you suspect is being badly treated, you do all you can to help them. "But with Victoria, in Great Britain, nobody noticed. Nobody helped her. They didn't see her. She was alone. "You have to put children first. They are still innocent. They do not deserve to be harmed. Remember Victoria."

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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