Category Archives: Cold & Flu

Call for tighter checks on private hospitals used by NHS after MRSA case

Theresa May has been urged to tighten checks on private hospitals used by the NHS after a Labour MP raised the case of a young patient with an open wound who contracted MRSA on a private mental health ward.

Louise Haigh, a Labour frontbencher, called for the NHS to thoroughly investigate the quality of care before it commissions beds and treatment from private providers.

She cited the case in her of a “young women with MRSA with open wounds” on a child and adolescent mental health ward at Cygnet hospital Sheffield, which a report by a healthcare watchdog rated as inadequate in terms of safety.

“NHS England commissions child and adolescent mental health beds at a private hospital in my constituency, which recently received a damning Care Quality Commission report,” she said.

“Does the prime minister share my concern that a shortage of mental health beds risks the NHS placing vulnerable young people in unsafe environments, and will she consider giving NHS England the responsibility for, and the resources to investigate, the quality of care before it commissions?”

In response, May promised to ask Jeremy Hunt, the health secretary, to investigate, while highlighting a “a number of steps to improve mental health” provision in the NHS, including an increase in funding.

But Haigh said she wanted to see more action to make sure private beds paid for by the NHS are safe.

“Clearly the NHS should not be commissioning beds for children and young people unless they are confident they are safe places for them to be treated,” she said.

“This horrifying example suggests that a shortage of beds in the NHS and by private providers is forcing the NHS to place vulnerable young people in situations that are dangerous.

“I want to see NHS England have the responsibility and the resources to ensure that all places are safe and provide decent quality care before they are commissioned.”

Cygnet Health Care, which runs the hospital in Sheffield, said it had proactively notified the Care Quality Commission about cases of MRSA.

A spokesperson for the hospital said: “Our absolute priority is the health and wellbeing of the young people we support. Prior to the CQC’s inspection, we had notified the regulator about two instances of infection relating to patients.

“During the inspection, we further advised inspectors that a member of staff had also tested positive, and had been temporarily removed from the hospital as part of our infection control measures.

“Following the inspection we thoroughly reviewed our infection control protocol, and carried out additional staff training to ensure all measures are followed appropriately.”

MS treatments: life-changing, but hard to access

More than 100,000 people in the UK have multiple sclerosis (MS), the most common cause of serious physical disability in working age adults, according to the MS guidelines set out by the National Institute for Health and Care Excellence.

Although the condition is regarded as relatively rare and public awareness of it is low, recent innovations in treating and assessing MS are creating a fresh focus on the disease. Research suggests, for example, that MRI scans – already used in diagnosis – may be useful in predicting how MS will progress. In addition, a new drug therapy just approved in the US offers help for symptoms in the most chronic form of the condition. But, given that the drug has yet to be licensed in Europe, can the UK keep up with the latest innovations in the treatment of MS?

This was the backdrop to a recent roundtable discussion, supported by biotech company Sanofi Genzyme. Are the tools for assessing MS fit for purpose? How can early diagnosis and treatment be sped up? What matters to patients? These were among the questions explored by a panel of experts.

What is MS?

MS is a lifelong neurological condition that affects the central nervous system and involves damage to the coating around the nerve fibres. Symptoms, varying in severity from mild or remitting to debilitating, include difficulties with walking, balance, vision and speech. In its most chronic form, MS can cause blindness and severe disabilities.

While there is no known cure, the past 20 years has seen a shift from no available treatments to the creation of drug modifying therapies (DMTs) to help control symptoms in some types of the condition. Dr Klaus Schmierer, reader in clinical neurology at Queen Mary University of London and consultant neurologist at Barts Health NHS Trust, said: “MS treatment has really taken off and been revolutionised. We need to pick up that pace.”

There are three types of MS. About 85% of people diagnosed have relapsing-remitting MS (RRMS), with episodes of new or increasing symptoms that worsen then improve over time. About 65% of people with RRMS may develop secondary progressive MS, involving fewer or no relapses but increased disability. The remaining 10-15% of people are diagnosed with primary progressive MS PPMS, which involves worsening symptoms that build up over years without remission.

Recently, the first licensed drug treatment for people with PPMS was approved in the US. The drug, which can slow the rate of progressive MS, is under review by the European Medicines Agency.

Diagnosis, referral and the problem of delays

GPs are the gatekeepers to diagnosis: they cannot diagnose themselves but can refer patients with suspected MS to a neurologist who confirms or rules out the condition. However, the variable symptoms in all types of MS make it a challenge for GPs to decide on when to refer. Debbie Quinn, policy adviser to the UK MS Specialist Nurse Association, said: “GPs are in a very difficult position – where is that threshold? Because some symptoms will come and go for a few years. A lot of the time symptoms will appear like a trapped nerve.”

George Pepper, who was diagnosed with RRMS at 22 and is co-founder of social network Shift MS, said his diagnosis was relatively fast due to his serious symptoms. “I had some discomfort in my shoulder – I didn’t put it down to neurological symptoms. It persisted and, understandably, the GP put it down to a trapped nerve.”

When Pepper developed eyesight problems a few weeks later, the GP knew he had optic neuritis – inflammation of the optic nerve that is associated with MS. That, said Pepper, “was a red flag to my GP”. Attendees also heard that the shortage of neurologists undermines diagnosis rates. Not all hospitals have neurology departments, or magnetic resonance imaging (MRI), which is one of the main methods of diagnosing MS.

“We are still quite short of neurologists. When you look at the current distribution, it is something like one neurologist in 100,000 of the population,” said Schmierer, adding that the UK compares badly to the rest of Europe, which has one neurologist per 25,000 people.

MS Society research showed that 39% of patients wait more than a year to be diagnosed. Dr Jeremy Hobart, consultant neurologist at Plymouth Hospitals NHS Trust said: “There’s a delay in the condition being recognised; a delay in referral to a neurologist; a delay in seeing a neurologist and in the timing of investigations, and in the reporting of those investigations.”

Dr Ann Robinson, a north London GP, suggested diagnosis might be quicker if GPs used the urgent referral system currently in place for patients suspected of having cancer. This would mean patients being referred to a neurologist within two weeks, rather than waiting, in some cases, more than a year. However, Robinson acknowledged that funding constraints make this difficult: “There are no resources or political will to fund a two-week wait.”

Unpopular drugs

Another challenge in MS treatment is the relatively low takeup of available drug therapies. The UK, according to the Association of British Neurologists, is ranked 25 out of 27 European countries for the number of people with the relapsing form of MS who use DMTs. MS Society interim director of research Susan Kohlhaas said: “When people have access to MS nurses and neurologists and feel informed about the treatment out there, they’re much more likely to be on treatment.”

Hobart suggested lowering the investigation threshold to drive up rates of diagnosis: “We have to lower the threshold for investigation … to pick up those who do have the disease.”

However, lower thresholds would be costly, warned London GP Dr Kate Adams. Referring to the fact that MRI scans can cost upwards of £130, she said that while GPs do not limit referrals, “there’s only so much money in the health system”.

Dr Raju Kapoor, consultant neurologist at the National Hospital for Neurology and Neurosurgery in London, said increased costs caused by speeding up diagnosis could be offset by improved health as people stay in work for longer. He said: “We’re getting into health economics – if you remove the lag, we will save money.”

Another approach to improving diagnosis, said Kapoor, is better contact between GPs and the neurologists to whom they refer patients. Kapoor said: “It’s rare for a GP to contact me directly, but when they do it’s actually quite rewarding because you can solve things very fast.” Adams regularly contacts specialists directly, and in Plymouth, said Hobart, GPs directly contact radiologists specialising in the central nervous system to discuss MRI.

Could testing be simpler?

Future strategies, said Peer Baneke, MS International Federation chief executive, could involve spending on new diagnostic tools, such as blood tests. Blood tests are currently used to rule out conditions similar to MS, but Baneke said: “Is it realistic to expect at some stage you could have a different marker for MS that would give an indication of the diagnosis?”

Attendees discussed off-label prescribing options – using medicines outside the terms of their licence if based on evidence and in patients’ best interests. However, as Kapoor said, “the fact we’ve been so rigid has meant we’ve not exposed our patients to a lot of potentially toxic drugs”.

Might the new NHS online system to manage high-cost drugs, Blueteq, result in drug therapies being rationed? No, according to Kapoor: “It’s about what’s on the label, so if a patient says ‘I want a high-cost, high-potency drug’ but they can’t have it, this isn’t based on it being high cost, it’s because the drug isn’t licensed for that particular situation.”

Attendees agreed that treatment decisions should be made jointly by patients and professionals. Pepper said his severe symptoms drove him to immediately consider “the top shelf” of drug therapy. However, he described the patient experience as “hugely variable”. He raised concerns that members of the social network for MS that he founded, Shift MS, may shun available treatment because they are not adequately informed. “I see a lot in our community talking of opting out of treatment – they just don’t particularly want to have treatment,” he said, adding: “I don’t think the implications of that decision are made clear – it’s hugely important to engage people with MS to empower themselves as early s as possible.”

Many around the table echoed Hobart’s optimism that “in relapsing forms of the condition, we can alter the natural history”. In addition, said Kapoor, new developments on the horizon for the progressive form of MS, mean “we are in a better place to control the disease”. The consensus, Robinson concluded, was that treatment must be more efficient – regardless of the type of MS. “Anything that makes access to neurologists and care of patients better is going to impact on people living with MS.”

At the table

David Brindle (chair) Public services editor, the Guardian

Dr Kate Adams GP and Guardian contributor

Susan Kohlhaas Interim director of research, MS Society

Debbie Quinn Policy adviser, UK MS Specialist Nurse Association

Dr Jeremy Hobart Consultant neurologist Plymouth Hospitals, NHS Trust

Dr Raju Kapoor Consultant neurologist, National Hospital for Neurology and Neurosurgery

Dr Ann Robinson GP and Guardian contributor

Peer Baneke Chief executive, MS International Federation

George Pepper Co-founder, Shift MS

Dr Klaus Schmierer Consultant neurologist, Barts Health NHS Trust

Rise in children seeking mental health support after terror attacks

The number of children and young people seeking help from mental health services has spiked in the wake of recent terrorist attacks in England, according to the Royal College of Psychiatrists (RCP).

Hospitals across the Manchester region have seen an estimated 10% increase in children seeking help since a bomb ripped through the Manchester Arena on 22 May, killing 22 people, according to the RCP. Mental health experts in Greater Manchester hospitals received hundreds more patients from June to July compared with previous months.

Dr Louise Theodosiou, a consultant child and adolescent psychiatrist at Royal Manchester children’s hospital and a member of the RCP, described the increase as significant and said the terror attack had a “profound impact on the way the children view their city”.

Just a small fraction of those treated had been at the concert; the majority of patients had felt increased anxiety after watching the events on the news. Anxiety and insomnia were the most common complaints, with children worrying about going out or being on public transport after the attacks.

Theodosiou warned the number affected could be significantly greater, with people also seeking support through school or voluntary services and many others yet to come forward for help.

A similar trend has been noticed in London. Dr Jon Goldin, the vice-chair of the child and adolescent psychiatry faculty at RCP, said there had also been anecdotal evidence of “a rise in children seeking mental health services after recent terror attacks”.

“Maybe the rise hasn’t been as much as Manchester [...] but some of those with a predisposition to anxiety have had it heightened by these recent events,” he said.

The increase could be linked to young people’s consumption of media, with children able to access disturbing footage on their smartphones, according to experts. It could also be a positive sign that efforts to reduce the stigma around mental health were having an impact.

Dr Rachel Langley, a clinical psychologist from Southampton children’s hospital’s sleepdisorder service, said: “Technology has a huge amount to answer for in fuelling a rise in children’s sleep problems. It gives young people access to what is going on in the world and also … the blue light of the screens affects melatonin release.”

She added: “There was a 10-year-old boy I saw recently who has anxiety-related insomnia and he has a specific concern about his dad, who works in London, getting caught up in a terror attack.”

In Manchester more young people are expected to seek help in the coming months and years. Theodosiou said: “It has unmasked vulnerabilities that were not there before. It’s fair to say that of the hundreds of children affected only a small fraction would have witnessed the events.”

She added: “If you think of the bomb as being like an influenza epidemic, those most affected by that will be ones with underlying respiratory problems [...] and in the same way the group most affected by the terror attack in the city have been those who are vulnerable to mental health at the beginning.”

Peter Sweeney, another psychiatrist from Royal Manchester children’s hospital, said services needed to plan ahead to manage post-traumatic stress disorder that could hit families and young people.

“We needed to do lots of work for the survivors initially … they got a high level of support at the start. Our concern now is more about young people who may be experiencing anxiety but are not presenting to us, so those who were at the concert but not seriously injured or those who were not at the concert but affected,” he said.

The message to children should be that these attacks should not alter behaviour and that people should get on with their normal lives, said Goldin. “Children should get that message as well as adults. If you have anxious parents saying ‘don’t go to London etc’ then that doesn’t give the most helpful message.

“One message to get across is that it’s important not to feel that, when a child is anxious about a terror attack, they should be taken straight to children’s mental health services. Usually family and a normal support network can really help them. When things are more enduring, for example several weeks after a traumatic experience a child is still struggling with sleep or their mood etc, then you would want CAMHS [child and adolescent mental health services] to get involved.”

  • In the UK, the Samaritans can be contacted on 116 123, and Childline on 0800 1111. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here.

Rise in life expectancy has stalled since 2010, research shows

A century-long rise in life expectancy has stalled since 2010 when austerity brought about deep cuts in NHS and social care spending, according to research by a former government adviser on the links between poverty and ill-health.

Life expectancy at birth had been going up so fast that women were gaining an extra year of life every five years and men an additional 12 months every three-and-a-half years.

But those trends have almost halved since ministers made a “political decision” in 2010 to reduce the amount of money it put into the public sector, said Sir Michael Marmot. The upward trend in longer life that began in Britain just after the first world war has slowed so dramatically that women now only gain an extra year after a decade while for men the same gain now takes six years to arrive.

The rate of increase was “pretty close to having ground to a halt”, Marmot said.

“I am deeply concerned with the levelling off; I expected it to just keep getting better. Since 2009-2015 it’s pretty flat, whereas we are used to it getting better and better all the time,” added Marmot, who published a major review of health inequalities for Gordon Brown’s Labour government in early 2010.

In 1919 men lived for an average of 52.5 years and women for 56.1 years. That rose to 64.1 years and 68.7 years respectively by 1946. Life expectancy then rose in an almost unbroken gradual upward curve to 77.1 years for men and 81.4 years for women in 2005 and again to 78.7 and 82.6 in 2010, the year David Cameron’s Conservative-Liberal Democrat coalition took office.

Since then life expectancy has continued to creep upwards, but at a slower rate, according to Marmot’s latest analysis. In 2015 average life expectancy in Britain was 79.6 years for men and 83.1 years for women, according to the latest Office for National Statistics data.

Marmot, who is the director of the Institute of Health Equity at University College London, denied the rise had stalled because there was a natural limit to how much life expectancy can increase. “It is not inevitable that it should have levelled off,” he said.

There is no reason why the UK could not emulate Hong Kong, where life expectancy for men is 81.1 years for men and 87.3 for women – the highest in the world – Marmot added. Hong Kong has overtaken Japan in terms of how long citizens can expect to live.

Marmot, who has also advised the World Health Organisation, did not claim that the introduction of austerity had led directly to life expectancy stagnating. But he highlighted that “miserly” levels of spending on health and social care in recent years – at a time of rising health need linked to the ageing population – had affected the amount and quality of care older people receive.

The long-term trend for NHS budget increases is 3.8% a year, with rises of 1.1% a year since 2010. “If we don’t spend appropriately on social care, if we don’t spend appropriately on health care, the quality of life will get worse for older people and maybe the length of life, too,” he added.

Marmot cited the growing numbers of deaths among the over-75s and over-85s and continuing high death rates from heart disease as other key potential factors in the stalling rise in life expectancy.

“Life expectancy has been increasing year on year for a generation, to the extent that we had begun to take it for granted as inevitable. But this authoritative analysis suggests this long period of improvement may now be coming to an end, with big implications for us all,” said a spokesman for the charity Age UK.

Cases of dementia and Alzheimer’s have been rising so rapidly that they are now the leading cause of death for both sexes, among women 80 and over and men 85+.

The increase in dementia and needs of the ageing population will place the NHS and social care services “under considerable strain” in the near future, Marmot added.

Dr Matthew Norton, director of policy at Alzheimer’s Research UK, said: “This report shines a spotlight on a hard truth: that unless we can find ways to prevent and treat dementia, deaths from the condition will continue to rise as our population ages. The reality today is that with no treatments to stop or slow the underlying diseases, the condition is placing an ever-growing strain on our health services.”

The Department of Health played down Marmot’s findings. A spokesman pointed out that the NHS had just last week been judged to be the best, safest and most affordable healthcare system out of 11 rich countries analysed in a major review published by the Commonwealth Fund, a respected US thinktank.

“Life expectancy continues to increase, with cancer survival rates at a record high whilst smoking rates are at an all-time low. We continue to invest to ensure our ageing population is well cared-for, with £6bn extra going into the NHS [in England] over the last two years and an additional £2bn for the social care system,” he added.

Rise in life expectancy has stalled since 2010, research shows

A century-long rise in life expectancy has stalled since 2010 when austerity brought about deep cuts in NHS and social care spending, according to research by a former government adviser on the links between poverty and ill-health.

Life expectancy at birth had been going up so fast that women were gaining an extra year of life every five years and men an additional 12 months every three-and-a-half years.

But those trends have almost halved since ministers made a “political decision” in 2010 to reduce the amount of money it put into the public sector, said Sir Michael Marmot. The upward trend in longer life that began in Britain just after the first world war has slowed so dramatically that women now only gain an extra year after a decade while for men the same gain now takes six years to arrive.

The rate of increase was “pretty close to having ground to a halt”, Marmot said.

“I am deeply concerned with the levelling off; I expected it to just keep getting better. Since 2009-2015 it’s pretty flat, whereas we are used to it getting better and better all the time,” added Marmot, who published a major review of health inequalities for Gordon Brown’s Labour government in early 2010.

In 1919 men lived for an average of 52.5 years and women for 56.1 years. That rose to 64.1 years and 68.7 years respectively by 1946. Life expectancy then rose in an almost unbroken gradual upward curve to 77.1 years for men and 81.4 years for women in 2005 and again to 78.7 and 82.6 in 2010, the year David Cameron’s Conservative-Liberal Democrat coalition took office.

Since then life expectancy has continued to creep upwards, but at a slower rate, according to Marmot’s latest analysis. In 2015 average life expectancy in Britain was 79.6 years for men and 83.1 years for women, according to the latest Office for National Statistics data.

Marmot, who is the director of the Institute of Health Equity at University College London, denied the rise had stalled because there was a natural limit to how much life expectancy can increase. “It is not inevitable that it should have levelled off,” he said.

There is no reason why the UK could not emulate Hong Kong, where life expectancy for men is 81.1 years for men and 87.3 for women – the highest in the world – Marmot added. Hong Kong has overtaken Japan in terms of how long citizens can expect to live.

Marmot, who has also advised the World Health Organisation, did not claim that the introduction of austerity had led directly to life expectancy stagnating. But he highlighted that “miserly” levels of spending on health and social care in recent years – at a time of rising health need linked to the ageing population – had affected the amount and quality of care older people receive.

The long-term trend for NHS budget increases is 3.8% a year, with rises of 1.1% a year since 2010. “If we don’t spend appropriately on social care, if we don’t spend appropriately on health care, the quality of life will get worse for older people and maybe the length of life, too,” he added.

Marmot cited the growing numbers of deaths among the over-75s and over-85s and continuing high death rates from heart disease as other key potential factors in the stalling rise in life expectancy.

“Life expectancy has been increasing year on year for a generation, to the extent that we had begun to take it for granted as inevitable. But this authoritative analysis suggests this long period of improvement may now be coming to an end, with big implications for us all,” said a spokesman for the charity Age UK.

Cases of dementia and Alzheimer’s have been rising so rapidly that they are now the leading cause of death for both sexes, among women 80 and over and men 85+.

The increase in dementia and needs of the ageing population will place the NHS and social care services “under considerable strain” in the near future, Marmot added.

Dr Matthew Norton, director of policy at Alzheimer’s Research UK, said: “This report shines a spotlight on a hard truth: that unless we can find ways to prevent and treat dementia, deaths from the condition will continue to rise as our population ages. The reality today is that with no treatments to stop or slow the underlying diseases, the condition is placing an ever-growing strain on our health services.”

The Department of Health played down Marmot’s findings. A spokesman pointed out that the NHS had just last week been judged to be the best, safest and most affordable healthcare system out of 11 rich countries analysed in a major review published by the Commonwealth Fund, a respected US thinktank.

“Life expectancy continues to increase, with cancer survival rates at a record high whilst smoking rates are at an all-time low. We continue to invest to ensure our ageing population is well cared-for, with £6bn extra going into the NHS [in England] over the last two years and an additional £2bn for the social care system,” he added.

Big tobacco bullies the global south. Trade deals are their biggest weapon | Matthew Bramall and Paul Keenlyside

Cigarette packets often carry the warning to “protect children: don’t make them breathe your smoke”. In 2014, the Kenyan government attempted to do just that – banning the sale of single cigarettes, banning smoking in vehicles with a child and keeping the tobacco industry out of initiatives aimed at children and young people.

But as the Guardian reported last week, British American Tobacco, in an effort to keep Kenyans breathing their smoke, fought the regulations on the grounds that they “constitute an unjustifiable barrier to international trade”.

In fact, big tobacco has a long history of using trade and investment rules to force their products on markets in the global south and attack laws and threaten lawmakers that attempt to control tobacco use.

Back in the 1980s, as cigarette consumption fell off in North America and western Europe, US trade officials worked aggressively to grant American companies access to markets in Asia, demanding not only the right to sell their products, but also the right to advertise, sponsor sports events and run free promotions. Smoking rates surged.

In the 1990s, World Trade Organisation agreements led to a liberalisation of the international tobacco trade, with countries reducing import tariffs on tobacco products. The impact, according to a joint study of the World Health Organisation and the World Bank, was a 5% increase in global cigarette consumption and accompanying mortality rates.

Big tobacco’s lawyers were quick to discover the value of “next generation” trade agreements. In the 1990s, Canada dropped a plain packaging initiative after US manufacturers threatened a suit using the first next-gen trade deal, the North American Free Trade Agreement (Nafta). A few years later, Philip Morris threatened Canada again after it prohibited terms such as “light” and “mild” cigarettes. Philip Morris argued it would be owed millions in compensation for damage to its brand identity.

Philip Morris was able to credibly wield this threat because of the extraordinary powers that Nafta grants international corporations: the right to sue governments in private tribunals over regulations that affect their profits.

A toxic combination of far-reaching and poorly defined “rights” for investors, eye-watering legal costs, and tribunals composed of corporate lawyers with the power to set limitless awards against governments makes investment arbitration and the modern “trade” agreement a formidable weapon to intimidate regulators.

And what big tobacco learned in the global north it has been replicating in the global south, where threats carry greater force against poorer countries that may lack the resources to see down a legal challenge.

In 2010, Philip Morris launched a $ 25m claim against Uruguay after it introduced graphic warnings on cigarette packs. Though Uruguay successfully defended the measure, it still faced millions in legal costs. And Philip Morris effectively won, as Costa Rica and Paraguay held off introducing similar measures.

Such are the fears around big tobacco’s aggressive use of trade and investment rules that the US-negotiated Trans-Pacific Partnership trade deal featured a carve-out excluding big tobacco from investment protections – an explicit admission of the problem.

But this does not go far enough. The important thing to realise is that the problem goes beyond big tobacco. Big oil, big pharma and big mining follow the same playbook, launching investment arbitration cases to defend their business models from governments that would regulate to protect public health, the local environment or the climate.

Rather than target individual companies or sectors, we must push our governments to reform trade and investment rules that grant such extraordinary powers to corporations. That means removing special investor rights and investment courts from trade agreements. It means removing limits on the freedom of governments to protect public health, labour and human rights and the environment.

Of course, this is easier said than done. Robert Lighthizer, US trade representative, served as deputy in a Reagan administration that pressured countries to open their tobacco markets to US exporters in the 1980s.

Vice-President Mike Pence’s record includes opposing smoking regulation, taking huge campaign donations from big tobacco, and denying the causal link between smoking and lung cancer. The EU commission, meanwhile, has been criticized for its meetings with big tobacco while it was negotiating EU-US trade talks.

The good news is that from Brazil to India to Ecuador, countries are stepping away from outdated trade and investment rules. In the UK, the Labour party manifesto opposes parallel courts for multinationals and proposes to review the UK’s investment treaties.

But until we scrap the powers that we grant big tobacco and others to frustrate and bypass our laws, efforts around the world to protect public health will continue to go up in smoke.

Suicide Act breaches human right to dignity, high court told

The 1961 Suicide Act breaches human rights protecting dignity and personal autonomy and should be declared illegal, the high court has been told.

At the opening of a week-long courtroom challenge aimed at legalising assisted dying, Richard Gordon QC said risk could not be entirely removed from making difficult medical decisions at the end of patients’ lives.

Gordon represents Noel Conway, 67, a retired lecturer suffering from motor neurone disease, a terminal degenerative illness. He has been diagnosed as having less than 12 months to live.

Conway, who wants medical help to end his life in the UK, is too unwell to attend the hearing in court nine of the Royal Courts of Justice in London. He is expected to participate by videolink on Wednesday.

The court has been told that section two of the act, which criminalises any attempt to encourage or assist another person in killing themselves, is incompatible with article eight of the European convention on human rights, which guarantees a right to respect for private life.

Gordon said those over 18, diagnosed with a terminal illness and given less than six months to live, who have made a voluntary, clear and settled decision to die and have the ability to undertake a final act, should be allowed medical assistance to carry out their wishes in the UK.

Currently, those wishing to end their lives in a more dignified and less painful way say they have to travel to the Dignitas clinic in Switzerland. Conway and his supporters say the UK ban forces them to make that choice far earlier than should be the case.

Noel Conway


Noel Conway has motor neurone disease. Photograph: Annabel Moeller/Dignity in Dying/PA

“The aim of the challenge is to ensure autonomy for everyone in this group,” Gordon said. “Maybe there will be some risks [to weak and vulnerable people], but risks are already present in the law.”

The legal challenge, he told the court, was not about morality, but the law being incompatible with human rights.

Speaking ahead of the hearing, Lady Meacher, the chair of Dignity in Dying, said: “About 80% of the population support a change in the law to make assisted suicide legal. People feel passionate about this issue and MPs need to understand that.”

In 2015, the House of Commons rejected a private member’s bill to introduce assisted dying. It was talked out before MPs had an opportunity to debate the bill in detail.

Linda Deverell, a patron of Dignity in Dying, which supports Conway’s challenge, said before the hearing that a system requiring the approval of at least two doctors and a judge for assisted dying would provide sufficient legal safeguards.

“A law like that is very tight and it’s been working perfectly well in the US state of Oregon for the past 20 years,” she said.

Deverell’s husband had terminal cancer and travelled to Belgium to end his life. “It was absolutely his choice,” she said. “He had to go earlier than if he could make the choice here.

“Not everyone can do it. People talk about ending their lives, but when it comes to it and saying ‘This is the moment’, not all are comfortable with their own mortality.

“My husband would have had a few more weeks [if assisted dying had been legal in the UK]. He always had a very bad reaction to morphine. The last few weeks when the cancer was in his bones, liver and lungs were very painful.”

The hearing continues.

Suicide Act breaches human right to dignity, high court told

The 1961 Suicide Act breaches human rights protecting dignity and personal autonomy and should be declared illegal, the high court has been told.

At the opening of a week-long courtroom challenge aimed at legalising assisted dying, Richard Gordon QC said risk could not be entirely removed from making difficult medical decisions at the end of patients’ lives.

Gordon represents Noel Conway, 67, a retired lecturer suffering from motor neurone disease, a terminal degenerative illness. He has been diagnosed as having less than 12 months to live.

Conway, who wants medical help to end his life in the UK, is too unwell to attend the hearing in court nine of the Royal Courts of Justice in London. He is expected to participate by videolink on Wednesday.

The court has been told that section two of the act, which criminalises any attempt to encourage or assist another person in killing themselves, is incompatible with article eight of the European convention on human rights, which guarantees a right to respect for private life.

Gordon said those over 18, diagnosed with a terminal illness and given less than six months to live, who have made a voluntary, clear and settled decision to die and have the ability to undertake a final act, should be allowed medical assistance to carry out their wishes in the UK.

Currently, those wishing to end their lives in a more dignified and less painful way say they have to travel to the Dignitas clinic in Switzerland. Conway and his supporters say the UK ban forces them to make that choice far earlier than should be the case.

Noel Conway


Noel Conway has motor neurone disease. Photograph: Annabel Moeller/Dignity in Dying/PA

“The aim of the challenge is to ensure autonomy for everyone in this group,” Gordon said. “Maybe there will be some risks [to weak and vulnerable people], but risks are already present in the law.”

The legal challenge, he told the court, was not about morality, but the law being incompatible with human rights.

Speaking ahead of the hearing, Lady Meacher, the chair of Dignity in Dying, said: “About 80% of the population support a change in the law to make assisted suicide legal. People feel passionate about this issue and MPs need to understand that.”

In 2015, the House of Commons rejected a private member’s bill to introduce assisted dying. It was talked out before MPs had an opportunity to debate the bill in detail.

Linda Deverell, a patron of Dignity in Dying, which supports Conway’s challenge, said before the hearing that a system requiring the approval of at least two doctors and a judge for assisted dying would provide sufficient legal safeguards.

“A law like that is very tight and it’s been working perfectly well in the US state of Oregon for the past 20 years,” she said.

Deverell’s husband had terminal cancer and travelled to Belgium to end his life. “It was absolutely his choice,” she said. “He had to go earlier than if he could make the choice here.

“Not everyone can do it. People talk about ending their lives, but when it comes to it and saying ‘This is the moment’, not all are comfortable with their own mortality.

“My husband would have had a few more weeks [if assisted dying had been legal in the UK]. He always had a very bad reaction to morphine. The last few weeks when the cancer was in his bones, liver and lungs were very painful.”

The hearing continues.