Category Archives: Alergies

One in eight people set to have type 2 diabetes by 2045, says study

One in eight people in the world will have type 2 diabetes by 2045 if obesity continues to climb at the present rate, according to a new study.

Last year, 14% of the global population was obese and 9% had type 2 diabetes. By 2045, 22% will be obese and 14% will be suffering from type 2 diabetes, estimates presented at the European Congress on Obesity in Vienna suggest.

The implications of the expanding numbers are severe for health systems in every country. Diabetes UK estimates that the NHS spends £14bn a year on the disease already, which is about 10% of its budget. People with diabetes need monitoring, treatment and care for the serious potential complications which can include amputations and blindness.

The study was carried out by scientists funded by the pharmaceutical company Novo Nordisk, which makes diabetes treatments, together with the Steno Diabetes Centre in Gentofte, Denmark, and University College London. They say that to prevent type 2 diabetes rates rising above 10%, obesity levels must come down by a quarter.

The institutions collaborated to launch the Cities Changing Diabetes programme in 2014 to accelerate the global fight against urban diabetes. The program began with eight cities: Copenhagen, Rome, Houston, Johannesburg, Vancouver, Mexico City, Tianjin and Shanghai. These have since been joined by a further seven cities: Beijing, Buenos Aires, Hangzhou, Koriyama, Leicester, Mérida and Xiamen.

“These numbers underline the staggering challenge the world will face in the future in terms of numbers of people who are obese, or have type 2 diabetes, or both. As well as the medical challenges these people will face, the costs to countries’ health systems will be enormous,” said Dr Alan Moses of Novo Nordisk Research and Development in Søborg, Denmark.

“The global prevalence of obesity and diabetes is projected to increase dramatically unless prevention of obesity is significantly intensified. Developing effective global programs to reduce obesity offer the best opportunity to slow or stabilise the unsustainable prevalence of diabetes. The first step must be the recognition of the challenge that obesity presents and the mobilisation of social service and disease prevention resources to slow the progression of these two conditions.”

The researchers have calculated the likely rise in obesity for individual countries. If current trends in the US continue, obesity will increase from 39% in 2017 to 55% in 2045, and diabetes rates from 14% to 18%. To keep diabetes rates in the US stable between 2017 and 2045, obesity must fall from 38% today to 28%.

In the UK, they say, current trends predict that obesity will rise from 32% today to 48% in 2045, while diabetes levels will rise from 10.2% to 12.6%, a 28% rise. To stabilise UK diabetes rates at 10%, obesity prevalence must fall from 32% to 24%.

“Each country is different based on unique genetic, social and environmental conditions which is why there is no ‘one size fits all’ approach that will work. Individual countries must work on the best strategy for them,” said Moses.

The tide could be turned, he said, “but it will take aggressive and coordinated action to reduce obesity and individual cities should play a key role in confronting the issues around obesity.”

One in eight people set to have type 2 diabetes by 2045, says study

One in eight people in the world will have type 2 diabetes by 2045 if obesity continues to climb at the present rate, according to a new study.

Last year, 14% of the global population was obese and 9% had type 2 diabetes. By 2045, 22% will be obese and 14% will be suffering from type 2 diabetes, estimates presented at the European Congress on Obesity in Vienna suggest.

The implications of the expanding numbers are severe for health systems in every country. Diabetes UK estimates that the NHS spends £14bn a year on the disease already, which is about 10% of its budget. People with diabetes need monitoring, treatment and care for the serious potential complications which can include amputations and blindness.

The study was carried out by scientists funded by the pharmaceutical company Novo Nordisk, which makes diabetes treatments, together with the Steno Diabetes Centre in Gentofte, Denmark, and University College London. They say that to prevent type 2 diabetes rates rising above 10%, obesity levels must come down by a quarter.

The institutions collaborated to launch the Cities Changing Diabetes programme in 2014 to accelerate the global fight against urban diabetes. The program began with eight cities: Copenhagen, Rome, Houston, Johannesburg, Vancouver, Mexico City, Tianjin and Shanghai. These have since been joined by a further seven cities: Beijing, Buenos Aires, Hangzhou, Koriyama, Leicester, Mérida and Xiamen.

“These numbers underline the staggering challenge the world will face in the future in terms of numbers of people who are obese, or have type 2 diabetes, or both. As well as the medical challenges these people will face, the costs to countries’ health systems will be enormous,” said Dr Alan Moses of Novo Nordisk Research and Development in Søborg, Denmark.

“The global prevalence of obesity and diabetes is projected to increase dramatically unless prevention of obesity is significantly intensified. Developing effective global programs to reduce obesity offer the best opportunity to slow or stabilise the unsustainable prevalence of diabetes. The first step must be the recognition of the challenge that obesity presents and the mobilisation of social service and disease prevention resources to slow the progression of these two conditions.”

The researchers have calculated the likely rise in obesity for individual countries. If current trends in the US continue, obesity will increase from 39% in 2017 to 55% in 2045, and diabetes rates from 14% to 18%. To keep diabetes rates in the US stable between 2017 and 2045, obesity must fall from 38% today to 28%.

In the UK, they say, current trends predict that obesity will rise from 32% today to 48% in 2045, while diabetes levels will rise from 10.2% to 12.6%, a 28% rise. To stabilise UK diabetes rates at 10%, obesity prevalence must fall from 32% to 24%.

“Each country is different based on unique genetic, social and environmental conditions which is why there is no ‘one size fits all’ approach that will work. Individual countries must work on the best strategy for them,” said Moses.

The tide could be turned, he said, “but it will take aggressive and coordinated action to reduce obesity and individual cities should play a key role in confronting the issues around obesity.”

Ex-footballer Terry Butcher accuses British army of failing his son

The former England football captain Terry Butcher has accused the British army of failing his son, who died after developing post-traumatic stress disorder (PTSD).

Butcher told an inquest on Monday that Christopher, 35, had turned to alcohol and drugs after being discharged from the armed forces in April 2015, due to the mental health condition.

“Christopher passed away several months ago. But, in reality, the Chris that we all knew and loved had ceased to exist years before,” Butcher told Ipswich coroner’s court.

“Diagnosed with severe post-traumatic stress disorder, his life spiralled downwards as the demons took control of his mind. In truth after intense tours of Iraq and Afghanistan he became a victim of war.

“These circumstances are all too familiar. Our country has a number of veterans suffering from the same condition, released from the armed forces too early and having to rely on an overloaded NHS that is ill-equipped and underfunded to cope.”

Butcher, who struggled to hold back tears during the hearing, said the armed forces’ duty of care towards personnel had been “discarded too easily, which has resulted in a growing number of our veterans turning to anything that might help including alcohol, drugs and suicide as a means of alleviating the flashbacks and nightmares”.

The inquest heard how Christopher, a former captain in the Royal Artillery, had been haunted by nightmares and flashbacks about the deaths of comrades and civilians in Afghanistan.

Butcher found his son’s body wedged between his bed and a wall when he went to check on him on the morning of 16 October last year at his home in Suffolk.

A postmortem failed to identify Christopher’s cause of death, but found he had an enlarged heart, which could have been caused by drug use. Toxicology tests revealed he had non-lethal levels of cocaine and heroin in his body, as well as prescription drugs he had been taking for several years. A makeshift crack pipe in a sunglasses case was also found in his room.

Suffolk’s assistant coroner, Dr Dan Sharpstone, concluded that Christopher died from an enlarged heart due to uncertain causes with a background of drug use and PTSD.

Butcher remembered his son as a man who had a “glittering career in the army ahead of him, a loving wife and dreams of having children of his own. His unnecessary death has deprived us of a wonderful son, husband, brother and grandson, friend and comrade”.

Sharpstone said: “When people serve in the armed forces, they give everything in the defence of our country and this may result in death or serious injury. However, it can also result in PTSD.”

  • In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

London hospitals to replace doctors and nurses with AI for some tasks

One of the country’s biggest hospitals has unveiled sweeping plans to use artificial intelligence to carry out tasks traditionally performed by doctors and nurses, from diagnosing cancer on CT scans to deciding which A&E patients are seen first.

The three-year partnership between University College London Hospitals (UCLH) and the Alan Turing Institute aims to bring the benefits of the machine learning revolution to the NHS on an unprecedented scale.

Prof Bryan Williams, director of research at University College London Hospitals NHS Foundation Trust, said that the move could have a major impact on patient outcomes, drawing parallels with the transformation of the consumer experience by companies such as Amazon and Google.

“It’s going to be a game-changer,” he said. “You can go on your phone and book an airline ticket, decide what movies you’re going to watch or order a pizza … it’s all about AI,” he said. “On the NHS, we’re nowhere near sophisticated enough. We’re still sending letters out, which is extraordinary.”

At the heart of the partnership, in which UCLH is investing a “substantial” but unnamed sum, is the belief that machine learning algorithms can provide new ways of diagnosing disease, identifying people at risk of illness and directing resources. In theory, doctors and nurses could be responsively deployed on wards, like Uber drivers gravitating to locations with the highest demand at certain times of day. But the move will also trigger concerns about privacy, cyber security and the shifting role of health professionals.

The first project will focus on improving the hospital’s accident and emergency department, which like many hospitals is failing to meet government waiting time targets.

“Our performance this year has fallen short of the four-hour wait, which is no reflection on the dedication and commitment of our staff,” said Prof Marcel Levi, UCLH chief executive. “[It’s] an indicator of some of the other things in the entire chain concerning the flow of acute patients in and out the hospital that are wrong.”

In March, just 76.4% of patients needing urgent care were treated within four hours at hospital A&E units in England in March – the lowest proportion since records began in 2010.

Using data taken from thousands of presentations, a machine learning algorithm might indicate, for instance, whether a patient with abdomen pain was likely to be suffering from a severe problem, like intestinal perforation or a systemic infection, and fast-track those patients preventing their condition from becoming critical.

“Machines will never replace doctors, but the use of data, expertise and technology can radically change how we manage our services – for the better,” said Levi.

Another project, already underway, aims to identify patients who are are likely to fail to attend appointments. A consultant neurologist at the hospital, Parashkev Nachev, has used data including factors such as age, address and weather conditions to predict with 85% accuracy whether a patient will turn up for outpatient clinics and MRI scans.

In the next phase, the department will trial interventions, such as sending reminder texts and allocating appointments to maximise chances of attendance.

“We’re going to test how well it goes,” said Williams. “Companies use this stuff to predict human behaviour all the time.”

Other projects include applying machine learning to the analysis of the CT scans of 25,000 former smokers who are being recruited as part of a research project and looking at whether the assessment of cervical smear tests can be automated. “There are people who have to look at those all day to see if it looks normal or abnormal,” said Williams.

Might staff resent ceding certain duties to computers – or even taking instructions from them? Prof Chris Holmes, director for health at the Alan Turing Institute, said the hope is that doctors and nurses will be freed up to spend more time with patients. “We want to take out the more mundane stuff which is purely information driven and allow time for things the human expert is best at,” he said.

When implementing new decision-making tools, the hospital will need to guard against “learned helplessness”, where people become so reliant on automated instructions that they abandon common sense. While an algorithm might be correct 99.9% of the time, according to Holmes, “once in a blue moon it makes a howler”. “You want to quantify the risk of that,” he added.

UCLH is aiming to circumvent privacy concerns that have overshadowed previous collaborations, including that of the Royal Free Hospital in London and Google’s DeepMind, in which the hospital inadvertently shared the health records of 1.6 million identifiable patients. Under the new partnership, algorithms will be trained on the hospital’s own servers to avoid any such breaches and private companies will not be involved, according to Holmes.

“We’re critically aware of patient sensitivity of data governance,” he said. “Any algorithms we develop will be purely in-house.”

Questions also remain about the day-to-day reality of integrating sophisticated AI software with hospital IT systems, which are already criticised for being clunky and outdated. And there will be concerns about whether the move to transfer decision-making powers to algorithms would make hospitals even more vulnerable to cyber attacks. Hospital IT systems were brought to a standstill last year after becoming victim to a global ransomware attack that resulted in operations being cancelled, ambulances being diverted and patient records being unavailable.

Williams acknowledged that adapting NHS IT systems would be a challenge, but added “if this works and we demonstrate we can dramatically change efficiency, the NHS will have to adapt.”

Critically ill ‘should not be made to die away from home’

One in three people who die in hospital could spend their final days at home if the government introduces and adequately funds a modern community-based health and social care system, a new report says.

The Institute for Public Policy Research (IPPR) says that, while most people would prefer to die at home or in a good care home, they are often unable to do so because of inadequate and underfunded local care.

The researchers analysed investment in long-term care in several European countries, and concluded that there appears to be a correlation between funding levels, modern systems and the proportion of people dying in hospitals. Citing 2017 data from the Survey of Health, Ageing and Retirement in Europe, covering 28 countries, IPPR found the proportion of people dying in hospital in England (47%) was higher than in many EU states, with people dying at home (23%) the second lowest after Sweden and the Czech Republic (22%).

An elderly woman is tucked into bed at home by a care assistant


‘Enabling more people to spend their last days outside hospitals, in more appropriate settings, with properly funded support, will improve their experience of care,’ said IPPR research fellow Jack Hunter. Photograph: Gary John Norman/Getty/Cultura RF

If funding were increased to match that in countries with the lowest rates of deaths in hospitals and the most up-to-date systems – such as the Netherlands – IPPR argues, up to a third of those who currently die in hospital could be at home or in a care setting. Data for England cited in the report also shows marked regional variations, with more people dying in hospital in poorer areas. While 49% died in hospital in the north-west and West Midlands, the proportion was 43% in the south-east.

“Taken together,” the report says, “the variation in hospital deaths between European countries and within England suggests there is significant scope for policy to reduce the proportion of people who spend their final days in hospital, and in doing so potentially develop a model for end-of-life care that is of higher quality and lower net cost to the taxpayer.”

Around 60% of those who reported poor care experienced it in a hospital, and most say they would prefer to be at home, given adequate services.

IPPR research fellow Jack Hunter said: “For too many, the end of life is an even more difficult experience than it needs to be. The fact that those in the most deprived areas are more likely to die in hospital is wholly unjust. Where you live should not affect whether you experience good-quality care at the end of your life.

“Enabling more people to spend their last days outside hospitals, in more appropriate settings, with properly funded support, will improve their experience of care. It will also be more cost-effective for the taxpayer.”

A green paper on care and support for older people is due to be published this summer. In last January’s cabinet reshuffle, Jeremy Hunt kept his health portfolio, but his responsibilities and title were expanded to include social care. This was a signal of long-promised reform, merging the health and care budgets and systems.

The report calls for more power to be devolved to local authorities and for a big cash injection. But it concludes: “It is far from clear that the government’s vision will include the size and scale of investment for care that would be commensurate with a radical shift in funding, nor whether it will also consider long-term options (including devolved fiscal measures) to ensure the long-term sustainability of local authorities.”

47%

Proportion of people in England who died in hospital .

23%

Proportion of people in England who died at home.

£487

Estimated public saving, per person, of shifting care, in final three months of life, from hospital to community.

Italy’s far right use Irish vote to boost anti-abortion campaign

Activists and far-right politicians have seized on Italy’s low birth rate and the attention on Ireland’s referendum on abortion to boost their pro-life campaign.

As the 40th anniversary of Italy’s legalisation of abortion approaches, the renewed effort also comes as the far-right League, which contains many anti-abortion militants, stands on the brink of forming a government with the anti-establishment Five Star Movement following inconclusive general elections in March.

Ahead of the 22 May anniversary, ProVita, the Italian pro-life association, has published a booklet repeating debunked claims that women who have an abortion could be more prone to breast cancer and suicide or become alcoholics or drug addicts.

Quick guide

The Irish abortion referendum

The Irish abortion referendum

-

Photograph: Clodagh Kilcoyne/X03756

The move came after authorities in Rome covered up a huge poster featuring an 11-week-old foetus in the womb on a wall in the Vatican area in April. A message alongside the image said: “You are here because your mother has not aborted you.”

“The plan was to intensify the campaign ahead of the anniversary,” said Alessandro Fiore, a spokesman for ProVita. “But we increased it even more after the poster was censored; we were contacted by many people from across Italy who wanted to do something similar in their towns. The Irish referendum, by chance, also helps to strengthen our message.”

Toni Brandi, the president of ProVita, joined counterparts in Ireland on a recent visit, as the country prepares for a landmark referendum on liberalising strict abortion laws on 25 May.

Italians voted to legalise abortion in a similar plebiscite in 1978. But 70.4% of gynaecologists still refuse to terminate pregnancies for moral reasons, which means it is almost impossible for women to access a safe procedure. That number is around 90% in southern regions, while in the central Molise region only one doctor carries out terminations. Last year a woman in Padua, a city in the northern Veneto region, had to visit 23 hospitals before finding one that would end her pregnancy. Doctors in Rome who do not object to the procedure are banned from going for jobs at hospitals managed by the Vatican.

Politicians from the League and smaller far-right party Brothers of Italy are helping to galvanise the pro-life campaign. Massimiliano Romeo, a senator with the League, said: “Six million children have been killed in the womb [since 1978], then they say we have to import migrants to boost the population.”

If the League succeeds in entering government, the party has pledged to make it a priority to better inform women of what they say are the physical and psychological consequences of abortion.

But claims that abortion leads to depression and suicide, causes cancer and affects future fertility have long been dismissed by medical organisations.

Emma Bonino, a politician who had an illegal abortion at a young age, was at the forefront of bringing about the enactment of the so-called Law 94. Until 1978, illegal abortions were the third-biggest cause of death for women in Italy.

“The campaigning by this group is nothing new,” Bonino, a former foreign minister, said. “They have been there for the last 40 years, as a minority movement – they have the right to exist and express their opinion but we have always managed to fight them. Our duty now is to fight organised conscientious objection – which actually has nothing to do with conscientiously objecting but career.”

Many medics fear being pushed out of the system or not being hired if they perform abortions. And those that do are often shamed. In the late 1990s a doctor killed himself after being exposed for terminating pregnancies in secret.

Ministry of Health data shows that the number of abortions performed each year fell from 233,976 in 1983 to 84,926 in 2016, while the number of moral objectors has risen. Unwanted pregnancies also significantly decreased after Law 94 was introduced, as people could avail themselves of information about contraception which until then had been forbidden thanks to a ban stemming from the Benito Mussolini-era.

There is no data available on the real demand for abortion or on the numbers carried out illegally. In recent years a significant demand is said to come from migrant women who have been forced into prostitution.

Silvana Agatone, a gynaecologist in Rome who does not object, said one of the reasons the health ministry is able to register a decline is because medics who once performed abortions, and who were required to report each procedure, have retired.

“They no longer get as many report cards each month but it doesn’t mean to say women are no longer having abortions,” she said. “It means that illegal abortions are increasing.”

There are fears that access to safe abortion will become even more difficult in future, as fewer medical students are receiving training.

“The Catholic-right has conquered the hospitals – there are so many militants,” said Elisabetta Canitano, a gynaecologist and president of the feminist association Vita di Donna.

“Even if the foetus is incompatible with life – they say ‘God sent it, so God will take it when he decides’. They insist that the woman must go ahead with the pregnancy, even if the child is then sent to a hospice to die.”

Poorest and brightest girls more likely to be depressed – UK study

Brighter girls and girls from poorer families are more likely to be depressed by the time they enter adolescence, according to a study triggering fresh concern about soaring rates of teenage mental illness.

The government-funded research identified the two groups as being most at risk of displaying high symptoms of depression at the age of 14. In contrast, more intelligent boys and boys from the most deprived backgrounds appear not to suffer from the mental troubles that affect their female peers, the academics discovered.

The findings are based on detailed questionnaires filled in by 9,553 boys and girls aged 14 across the UK as part of the Millennium Cohort Study (MCS), which is tracking the progress of people born in 2000 into adulthood.

They add to growing evidence that teenage girls are particularly vulnerable to mental health difficulties. NHS figures show there were sharp increases between 2005/06 and 2015/16 in the number of girls under 18 admitted to hospital in England because they had self-harmed by cutting (up 285%), poisoning (42%) or hanging themselves (331%).

The researchers, led by Dr Praveetha Patalay, also found that being overweight, a history of being bullied and not getting on with peers were the three most common causes of depression in boys and girls aged 14. Their previous finding, that 24% of 14-year-old girls and 9% of boys that age were depressed, stirred widespread debate last year.

Dr Nihara Krause, a consultant clinical psychologist, said the findings about brighter and poorer girls were worrying, given the known links between depression and self-harm, and self-harm and risk of suicide.

“Some children who are depressed will self-harm. Some people say that physical pain is easier to tolerate than emotional pain,” she said. “What’s very concerning, in those who are depressed, is the link with suicide, because more and more studies show that self-harm is a predictor of suicide. Someone who self-harms is more likely to try to take their own life, especially if they are depressed. So these new findings are a concern from that point of view.”

Patalay said girls from families in the bottom two quintiles of household income were 7.5% more likely to be depressed at 14 than girls from the highest income families, but the same pattern was not found in boys.

Cleverer girls also had a significantly higher risk of having high depressive symptoms at 14, she said, and she was doing further research to calculate that risk more precisely among those with “higher childhood cognitive scores”.

Krause said: “Part of it could be that [brighter girls] have a ‘hyper brain’, a more active brain, which often means they have a much higher emotional reaction to things and they are constantly overthinking things.

“For example, if there’s a friendship situation that might be a concern to them, children of higher intelligence might think about all sorts of reasons why this situation has developed and get stressed about it.”

She pinpointed pressure on children to succeed at school – from their parents, schools and themselves – and competition for university places and jobs as a key cause of anxiety and depression in teenagers. In addition, some bright pupils are pushed too much, and those children can develop academically but be less adept at forming friendships, she suggested.

Children of either sex who have been bullied are 5.5% more likely to be depressed at 14, and boys or girls who do not get on well with their peers are 1.5% more likely to exhibit depressive symptoms.

The researchers also found that overweight boys and girls were 5% more likely to be depressed. This has prompted speculation as to whether the huge recent increase in childhood obesity is helping to drive what experts say is a growing mental health crisis in young people.

“We found a substantial link between being overweight and being depressed. Rates of overweight and mental ill-health are increasing in childhood, and they both have enormous consequences through our lives. Tackling these two health issues should be a public health priority,” Patalay said.

Emla Fitzsimons, a co-author of the findings and director of the MCS, said: “The study highlights a sharp increase in mental health problems among girls between ages 11 and 14. We certainly need to be looking at how the use of social media and cyberbullying may affect girls and boys differently.”

Dr Nick Waggett, chief executive of the Association of Child Psychotherapists, said it was unhelpful to highlight bright or poor girls as being at particular risk “when we already now there is a significant burden of mental illness in children and young people, including adolescent girls, and that there is a substantial shortfall in specialist services for them.”

Claire Murdoch, NHS England’s national mental health director, said: “After decades in the shadows, children’s mental health is finally in the spotlight, with more young people seeking help and years of unmet need being addressed. The NHS has responded, with 70,000 more young people set to get help, £1.4bn of extra funding and eating disorder and perinatal mental health services covering the whole country.

“But if the NHS is to meet fully the scale of the challenge then government, schools and councils need to work with us and our patients over the long-term.”

Trump administration to revive Reagan-era abortion ‘gag’ rule

Donald Trump’s administration will reinstate a decades-old policy that will strip federal funds from family planning clinics providing abortion or related services, marking its latest salvo to curtail women’s reproductive rights.

The Department of Health and Human Services will announce the proposal on Friday, an administration official confirmed to the Guardian. The move would revive a policy first implemented by Ronald Reagan in 1988, which effectively barred reproductive health organizations that received federal grants from providing or even discussing abortion with patients.

The policy has been derided as a “gag rule” by abortion rights supporters and medical groups, and it is likely to trigger lawsuits that could keep it from taking effect.

“This is an attempt to take away women’s basic rights, period,” Dawn Laguens, the executive vice-president of Planned Parenthood Federation of America, said in a statement.

She added: “Everyone has the right to access information about their health care – including information about safe, legal abortion – and every woman deserves the best medical care and information, no matter how much money she makes or where she lives. No matter what. They won’t get it under this rule.”

The Reagan-era rule never went into effect as written, although the US supreme court ruled that it was an appropriate use of executive power. The policy was rescinded under Bill Clinton, and a new rule went into effect that required “nondirective” counseling to include a range of options for women.

Federal funds are already barred from being used for abortion services under current US law.

The move will galvanize activists on both sides of the abortion debate ahead of the congressional midterm elections.

Doctors’ groups and abortion rights supporters say a ban on counseling women trespasses on the doctor-patient relationship. They also believe such rules would prevent patients from being able to obtain birth control or other preventive care from reproductive health care providers, and undermine access to safe, legal abortion, particularly among low-income women.

Abortion opponents have long argued that a taxpayer-funded family planning program should have no connection whatsoever to abortion.

“The notion that you would withhold information from a patient does not uphold or preserve their dignity,” said Jessica Marcella of the National Family Planning & Reproductive Health Association, which represents family planning clinics. “I cannot imagine a scenario in which public health groups would allow this effort to go unchallenged.”

She said requiring family planning clinics to be physically separate from facilities in which abortion is provided would disrupt services for women across the country.

Kristan Hawkins of Students for Life of America also backed the move. She said: “Abortion is not healthcare or birth control and many women want natural healthcare choices, rather than hormone-induced changes.”

Abortion opponents claim the federal family planning program in effect cross-subsidizes abortion services provided by Planned Parenthood, whose clinics are also major recipients of grants for family planning and basic preventive care. Hawkins’s group is circulating a petition to urge lawmakers in Congress to support the Trump administration’s proposal.

Known as title X, the nation’s family-planning program serves about 4 million women a year through clinics, at a cost to taxpayers of about $ 260m. Planned Parenthood clinics also qualify for Title X grants, but they must keep the family-planning money separate from funds used to pay for abortions.

The Republican-led Congress has unsuccessfully tried to deny federal funds to Planned Parenthood, and the Trump administration has vowed to religious and social conservatives that it would keep up the effort.

In one of his first acts as president, Trump reinstated a “global gag rule” policy that restricted the US government from providing funds to international family-planning organizations offering abortion-related services or information about the procedure.

Global health advocates have since bemoaned the closure of abortion facilities overseas, with developing areas the most acutely impacted. Trump later expanded upon the action, affecting nearly $ 9bn in funding to combat global health issues such as HIV/Aids, Zika and malaria.

The Associated Press contributed to this report

Guernsey parliament votes against assisted dying

An attempt to legalise assisted dying in Guernsey has been defeated in the island’s parliament after a three-day debate.

Members of the legislature voted against a requete – similar to a private member’s bill – proposed by Guernsey’s chief minister, Gavin St Pier. A series of votes on different clauses were lost decisively.

If the requete had passed, Guernsey would have become the first place in the British Isles to offer euthanasia for people with terminal illnesses.

Supporters of the requete said they were disappointed by the outcome, but believed change was inevitable.

“Naturally we are disappointed with this result, although it was not entirely unexpected. We believe that a majority of the population do support a change in the law. However, we live in a representative democracy and our parliamentary assembly, the States of Deliberation, has by majority, made a democratic decision which settles the matter in Guernsey.”

“We, of course, accept that decision. We remain of the view that this is an inevitable change which in the fullness of time Guernsey will one day adopt.”

The proposal sought to adopt the Oregon model, meaning that euthanasia would be restricted to people with a diagnosis of terminal illness with less than six months to live and full mental capacity. People from other areas of the British Isles would not be able to travel to Guernsey to take advantage of its law.

It was opposed by Christian leaders on the island, the British Medical Association and the Guernsey Disabilities Alliance. A key government committee refused to back the proposal, saying it was not a priority and investigations would be a drain on resources.

The Oregon model has been adopted in six US states as well as Oregon, Canada and the Australian state of Victoria. New Zealand is considering the legislation.

The Netherlands, Belgium and Luxembourg have more permissive laws, based on applicants’ suffering, but not requiring a terminal diagnosis. Switzerland allows assisted dying on compassionate grounds to residents and non-residents.

The requete needed a simple majority of the 40 deputies who sit in Guernsey’s States of Deliberation.

Cancer patient waited 541 days for NHS treatment, report says

The longest waits for cancer treatment in England have soared since 2010, with one patient waiting 541 days, analysis suggests.

Two-thirds of NHS trusts reported having at least one cancer patient waiting more than six months last year, while almost seven in 10 (69%) trusts said they had a worse longest wait than in 2010. This was reflected in the average longest wait rising to 213 days – 16 days longer than in the year the Conservatives entered government.

The official target requires at least 85% of cancer patients to have their first treatment within 62 days of referral by their GP, but this has not been met for 27 months in a row.

More than 100,000 people have waited more than two months for treatment to start since the target was first missed in January 2014.

The longest waiting times data was obtained by Labour through freedom of information requests to England’s 172 acute and community health trusts, to which 95 responded.

Jonathan Ashworth, the shadow health secretary, said: “The number of people needing cancer treatment has risen sharply in the past 10 years and the government has simply failed to increase availability of services at the rate required.

“The truth is that the brilliant efforts of NHS staff around the country to deliver the best for their patients are being hampered by tight NHS budgets. Years of underfunding and abject failure to invest in the frontline doctors and nurses we need, means Theresa May is letting down cancer patients.

“Now we know the astonishing truth that some patients are waiting a year or more just to get treatment. It’s simply not good enough.”

The number of patients waiting more than 62 days last year was double that in 2010 (26,693 compared with 13,354), including 10,000 who waited for more than three months, NHS statistics show.

Every trust bar two who replied to Labour’s survey said that at least one patient had waited more than 62 days for treatment.

The figures also showed a deterioration in longest waits for two other key cancer targets since 2010.

After receiving a diagnosis of cancer, patients should receive their first definitive treatment within a month (31 days) and after an urgent referral for suspected cancer they should see a consultant within two weeks.

In both cases, as with the 62 days target, two-thirds of trusts had lengthier longest waits last year than in 2010. The average longest wait to start definitive treatment rose to 90 days – three higher than in 2010 – with one patient waiting 254 days. The average longest wait for a consultant appointment increased to 66 days – eight time higher than seven years ago – with the worst example being a patient who waited 377 days.

In an ideal world, people would start treatment within a month of being diagnosed, according to Cancer Research UK.

Sara Bainbridge, a policy manager at the charity, said: “Part of the reason why hospitals are struggling to meet the target is because NHS diagnostic services are short-staffed. The government must make sure there are more staff to deliver the tests and treatment that people need on time. The long-term plan for the NHS, which is being developed now, is a good opportunity to be more ambitious about cancer survival and increase staff numbers.”

Andrew Kaye, the head of policy at Macmillan Cancer Support, said: “These findings show that despite the tireless work of doctors and nurses, it appears that some cancer patients are still enduring shockingly long waits to start treatment.

“Long delays can put people under incredible stress at an already difficult time and could also mean that someone’s health could take a turn for the worse.”

A spokesman for the Department of Health and Social Care said: “Cancer care has improved significantly in recent years, with around 7,000 people alive today who would not have been if mortality rates stayed the same as in 2010.

“Nobody should wait longer than necessary for treatment and, despite a 115% increase in referrals since 2010, the vast majority of people start treatment within 62 days – backed by our £600m investment to improve cancer services.”