Category Archives: Health

‘We give people their humanity back’: inside Croatia’s pioneering mental health centre

High walls still surround the oldest asylum in the Balkans, an 18th-century building pocked with the artillery scars of last century’s civil war, but the gates are no longer locked. Handles have been replaced on internal doors and bars removed from windows.

“The jail,” said Darko Kovaoic, a 53-year-old poet with schizophrenia who lives here, “has broken open.”

The institution in Osijek, eastern Croatia, is run by Ladislav Lamza, a former social worker who is taking on the government, the health minister, and his own staff to transform the lives of his “beneficiaries” – the patients of what was until recently an old-style asylum.

It was in May 2015 that Lamza ripped down the sign outside – replacing “Home for the Insane” with “Centre for People Like Us” and began moving people out.

“We express many things in that small sentence,” said Lamza. “Because what we have done for the past two centuries is the opposite. We’ve said: ‘You are not like us, you are ugly and mad and I’m not like you.’ This is where we exclude, stigmatise and restrain people for the rest of their lives.

“We have people in need and we provide inappropriate help and the result is catastrophic. I never knew anyone who was rehabilitated. We make equality between criminals and people with disabilities.”

Lamza’s transformation of the centre caused shock and upset: one member of staff pointed out that these were people who should have been “exterminated”.

In four years, 172 out of 200 people have been successfully moved into shared flats dotted around the small city, with carers from the centre visiting them as needed.

As his institution emptied, Lamza ditched the metal bed frames and stained mattresses. Although the paint still peels and the furniture is scratched and sagged, he has turned the bleak, soulless wards into rooms for day classes, a library and a bright cafe where former patients demonstrate how to make pancakes and brew tea for other ex-patients who come by daily to grow cabbages in the gardens or to chat with staff. Staff are no longer janitors, nurses, cooks or cleaners, but all re now “care assistants”. The transformation, says Butkovic Jadranka – formerly a hairdresser here, now running sewing classes and shopping and theatre trips – is amazing.

Slavica Hip left the home three years ago and now lives in Osijek with her boyfriend. ‘In the institution I would take more pills. Now my medication has been reduced. I feel better,’ she says.


Slavica Hip left the home three years ago and now lives in Osijek with her boyfriend. ‘In the institution I would take more pills. Now my medication has been reduced. I feel better,’ she says. Photograph: Photo: Robin Hammond/NOOR

“When we first heard of the director’s plans, I was fearful, everyone was fearful, we thought perhaps he had gone a little crazy. But now everything is completely different. Before it was like they were objects, slightly out of focus objects. Just numbers. Like on a conveyer belt. I never asked anyone’s name. Now they are my friends. People are not dangerous lunatics, they have become citizens, they have become neighbours.”

It is 10 years since Croatia signed the UN’s Convention on the Rights of Persons with Disabilities but Osijek is the only one of Croatia’s 24 mental health institutions, which house a total of 6,700 people, implementing its spirit. “We signed this with our fingers crossed behind our backs. The government still wants people locked up, locked away. People with disabilities, whether mental health or physical, have rights. There are four reasons why inclusion is better than exclusion,” said Lamza. “It’s better for a person, it’s better for the community, it’s legal, it’s cheaper.” He says the cost per person per month in an institution is $ 1,260 (£950). “In the community, even with the maximum 24-hour support, it is $ 1,020.

“The first day I let people go I didn’t sleep: will she hurt someone, will he cope? But there have been no problems. People have thanked us for giving them the best neighbours they have ever had!”

After 12 years in institutions, Branka Reljan, 55, has spent three years living in the community, in a shared flat with her partner Drazenko Tevlli. She speaks fluent German and English but has suffered mental health breakdowns since university and has let go of old ambitions. Now the couple take great delight in visiting cafes and shops. “We met in the institution but love is not allowed so we lived a secret for 11 years. I say I was in prison before. Now I love to make apple pies and buy spices and oils for cooking. It is wonderful for us to have our own keys, to buy fresh juice and to take a bus. We are satisfied with our neighbours. We are happy.”

Zoran Stih and Ruzica Vidakovic met at the institution in Osijek. They moved out in 2015 and are now married and living in an apartment in the town.


Zoran Stih and Ruzica Vidakovic met at the institution in Osijek. They moved out in 2015 and are now married and living in an apartment in the town. Photograph: Photo: Robin Hammond/NOOR

If other asylums in Croatia had any desire to follow Lamza’s care in the community model it would be more difficult. Most were built far from towns.

Rada Matos is the director of Ljeskovica home for mentally ill adults, deep in the Pozega forest, an hour’s drive from Osijek. Lamza describes it as “a warehouse for lost souls”. Matos says she does her best for the 284 people here but points out that Croatia is a poor country and mental health is both under-resourced and stigmatised. “We have no psychologists and no psychiatrists, no professional is interested in coming out here to work, yet perversely we are the main employer in the area for unskilled workers. It’s too far for relatives to visit and there is no community for people to live in even if I had the resources to try. There is a tiny village of uneducated people to whom this is the madhouse.”

There is a long waiting list to come here but few leave. “Maybe two a year,” she said. “We try to explain mental health is an illness, we invite in families, school groups. But what I’d really need to do is move this building somewhere else, somewhere where there is a community.”

Around the grounds and in the corridors, people stand or wander in shabby clothes too big or too small. Miryama Nikoli, 38, is new to Ljeskovica but has been institutionalised for 18 years. Eyes glazed by medication that hasn’t been changed in all that time, she talks to everyone about her daughter, taken away as a baby. “I was sick because of my nerves but now I suffer because of my baby,” she says. “I drink the medicine but I want to see her again.” Matos pulls out her file; her background is heart-breaking and abusive. One line mentions the child, who will now be 18. The file contains four A4 pages.

In Osijek the belief is that lives are better on the outside. Care assistant Vlatka Griner said the hardest task in moving people into the community was to make them use chairs: “At the asylum, they squat in the corridors, smoking. Squat, smoke, move a bit and squat again. What else did they have to do? In only slippers, just slippers because they never went out. When they are in the apartments the hard thing is to get people to sit in chairs. It can take a good two months.

“Then they go to the shops, buy their own food, buy their own clothes, run their own lives. Brush their hair. They’re unrecognisable.”


‘Love was not allowed in the institution. Now we are outside we have our own keys and take a bus. We are happy’

It is not a solution for everyone. Back in Osijek, Zdenko Kovac, 64, is a convicted murderer and, although he claims the scars on his head are from an axe wielded by his wife and he is not deemed dangerous enough for a secure hospital, he has failed to cope outside and is back in the institution where he wants to stay “until I die”.

“He is someone I worry about,” admits Lamza, “he wants to stay and ideally he will.” For others, it was never the right place. Luka Bobanovic, 36, caught a fever aged seven that left him brain-damaged. His mother handed him over to state care and he has been bounced around from institution to institution. “When he came to us he was very disturbed,” said Lamza. “Eight times Luka went through a door or window, either him chasing staff or them chasing him. The doctor told staff to tie him to his bed. I found him like that, tied to his bed, crying for his mamma. The staff shrugged and told me ‘we are scared of him’.”

Now he lives in a small bungalow with three other beneficiaries and round-the-clock care.“Our work doesn’t end when people live outside the institution,” said Lamza. “We are supporting them to live like every citizen of this town, to fall in love, dance, eat pancakes. I want to give people back a reason to live. That is what we have been taking from them, their humanity.

“I’m ashamed of how people lived before, but I’m happy,” Lamza said, “because they’re happy.”

Cross-party MPs request urgent non-partisan debate on future of NHS

Ninety MPs including several senior Tories have urged Theresa May to launch a cross-party convention on the future of the NHS and social care in England.

Sarah Wollaston, chair of the Commons health committee, organised a letter in conjunction with Liberal Democrat former care minister Norman Lamb and Labour former shadow care minister Liz Kendall, that has been sent to the prime minister and the chancellor, Philip Hammond.

The MPs say that the health system has been failing patients and call on Hammond to ensure any moves to lift the public sector pay cap for NHS workers is not funded by raiding existing health budgets.

The signatories, one-third of whom are Conservative MPs, have said only a non-partisan debate can deliver a “sustainable settlement”. They say the failure of normal party politics to secure the future of the system means a non-partisan approach is the only way to ensure action is taken, particularly given that the government does not command a majority.

“The need for action is greater now than ever,” say the MPs, who include about 30 former ministers. “We understand that fixing this is immensely challenging and involves difficult choices.

“We all recognise, though, that patients and those needing care are too often failed by a system under considerable strain. We believe that together we owe a duty of care to the people of this country to confront the serious challenges to the NHS and the social care system.”

The Tory signatories include former education secretary Nicky Morgan, former international development secretary Andrew Mitchell, ex-policy adviser to May, George Freeman, and party grandee Sir Nicholas Soames.

The Labour MPs who have signed include Kendall, Chuka Umunna, Hilary Benn, Frank Field and Caroline Flint. Liberal Democrats signatories include party leader Sir Vince Cable, Ed Davey and Tim Farron.

In a series of tweets Wollaston said:

Sarah Wollaston (@sarahwollaston)

. Govt also needs to focus on the long term, stop planning for health & social care in separate silos as this approach is setting us up for failure. Finance & workforce need urgent attention for the here & now but also for the long term & MPs from all Parties ready to engage

November 18, 2017

Sarah Wollaston (@sarahwollaston)

Current plans to kick social care into the long grass (again) & to separate planning for young and older adults creates even further fragmentation . Essential to think about whole system of NHS & Care

November 18, 2017

In the letter, MPs argued that only a cross-party NHS and social care convention, where there could be a non-partisan debate, would ensure a long-term settlement.

This was echoed by Wollaston in further comments where she said the “simple reality of a hung parliament means that all our constituents will be failed if long-term plans for NHS and [social] care funding do not command cross-party support.”

She added: “It’s better to take a joint approach to planning from the outset and actually deliver.”

Although MPs recognised the immense challenge facing the government involved making difficult choices, they say “patients and those needing care are too often failed by a system under considerable strain”.

Lamb said: “Tribal politics has failed to provide a solution to the existential challenges facing the NHS and social care. We know that the current situation is unsustainable, and these pressures will only get worse as we contend with an ageing population and rising demand for care and treatment.

“This letter shows the strength of cross-party support for a new approach based on cooperation instead of political point-scoring. The fact that so many senior MPs and former cabinet ministers support this initiative is remarkable. Now the government must act on it.”

Kendall said: “Our population is ageing, more people need help and support and our care services desperately need more money to cope, yet any party that comes up with a significant proposal for funding social care risks their political opponents destroying them.

“We could carry on like this for yet another parliament, and yet another election, or we could face up to reality: we will only get lasting change if we secure a cross-party approach.”

The fall per head in NHS funding meant the health service would not be able to meet its routine waiting-time commitments, according to NHS England chief executive Simon Stevens.

Austerity combined with increasing demand for services had created a “mounting toll on patient care”, representatives from the Nuffield Trust, Health Foundation and King’s Fund said earlier this year. They said there was growing evidence that access to some treatments was being rationed and that quality of care in some services was being diluted.

Solving the problem would mean a “steadily increasing share of national income would need to be spent on providing these services, they said.

The UK spends 9.9% of GDP on the health budget – a considerably lower percentage than many other European nations.

Niall Dickson, chief executive of the NHS Confederation, which represents various organisations in the healthcare system, said promises to reform funding were being “kicked down the road”.

He said: “The government promised reform before the election, then said there would be a green paper before Christmas. Now it has been put off until summer next year – and even then we are not being promised firm commitments.”

A government spokesperson said: “We have announced a cross-government green paper on care and support for older people with input from a group of independent experts. We recognise that there is broad agreement across parliament that reform for social care is a priority and look forward to hearing a range of views.”

It said MPs would be consulted on social care, ahead of the green paper policy statement next year. The government had already provided an additional £2bn to social care over the next three years, the spokesperson said, adding that the government was committed to making the sector sustainable.

Anger after report finds birth defects not caused by hormone pregnancy tests

A hormone pregnancy test used in the 1960s and 1970s was not responsible for serious birth defects, according to an official review, which has been severely criticised by campaigners.

An expert working group set up by the Commission on Human Medicines (CHM) concluded there was no “causal association” between a drug called Primodos and severe disabilities in babies.

However, MPs and families who have campaigned against hormone pregnancy tests (HPTs) for more than 40 years, said the report was a whitewash.

Yasmin Qureshi, the MP for Bolton South East, said there should be a judicial review or a separate inquiry to examine allegations of a cover-up by medical regulators at the time.

The Labour MP said: “I am completely disgusted by the report. They clearly have not looked at the evidence that was presented to them. If they had looked at the evidence presented to them they could never have arrived at the conclusion they have now. This report is a complete whitewash. It is not worth the paper it has been printed on.”

Mims Davies, the Conservative MP for Eastleigh, said she was disappointed by the report and would be meeting with the prime minister to raise her concerns.

Davies said: “I was thoroughly dissatisfied by the complete lack of transparency in the creation and preparation of this report, with the only representative of campaigners against these historic injustices on the panel being gagged by a confidentiality agreement and prevented from speaking about the report’s preparation.”

The expert group recommended that families who took an HPT and experienced an “adverse pregnancy outcome” should be offered genetic testing to establish whether there was a different underlying cause.

Campaigners believe that as well as causing disabilities, the drugs could also cause miscarriage or stillbirth.

Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said: “It’s truly shocking and I am appalled by the report. We all feel betrayed, and I feel like I have no faith in government health agencies now. I am distraught for our members, who still haven’t had the answers they need.”

Charlotte Fensome, whose brother Steven has severe epilepsy, said she was horrified by the report.

“I’m obviously hugely disappointed by this report. My parents are 81 and 76, and they are struggling every day with my brother. Every victim of Primodos is a personal tragedy, and I am shocked at how this investigation has been carried out.

“My mother was given Primodos when she was eight weeks pregnant, and my brother was born with severe brain damage. It affects the whole family every single day. This is just a battle, and there is a long war ahead.”

The expert group assessed a number of studies looking at a possible link between women given an HPT to diagnose pregnancy and congenital anomalies in babies, but concluded there was no connection.

The expert group found that “although there was never any reliable evidence that HPTs were unsafe, concern about this issue, coupled with the development of better pregnancy tests” led to the use of HPTs being restricted in the 1970s.

A 1967 report found there might be a link between HPTs and spina bifida, and – following the thalidomide scandal which had recently led to that drug being withdrawn – concerns about HPTs rose dramatically.

Primodos, which was also used to treat menstruation problems, was then withdrawn completely in 1978. “Whether these precautionary actions were sufficiently timely became a subject of controversy,” noted the report.

Modern pregnancy tests measure hormone levels in a woman’s urine. The older HPTs contained synthetic versions of two hormones found naturally in the body. Two pills were taken on consecutive days, with a withdrawal bleed a few days later in those who were not pregnant.

Primodos contained synthetic versions of progesterone and estrogen.

Prof Stuart Ralston, the chair of the CHM, said: “This was a comprehensive and wide-ranging scientific review of all the available evidence on the possible association between HPTs and birth defects by internationally leading experts across a broad range of specialisms.”

Dr Ailsa Gebbie, the chair of the expert working group, said: “Our recommendations will strengthen further the systems in place for detecting, evaluating and communicating risk with use of medicines in pregnancy and help safeguard future generations.”

A spokeswoman for Bayer AG, which acquired Primodos manufacturer Schering in 2006, said: “Bayer notes that a review by an independent expert working group on hormone pregnancy tests of the Commission on Human Medicines has found, consistent with Bayer’s view, based on all available data, that the scientific evidence does not support a causal association between the use of hormone pregnancy tests, such as Primodos, and birth defects or miscarriage.”

Anger after report finds birth defects not caused by hormone pregnancy tests

A hormone pregnancy test used in the 1960s and 1970s was not responsible for serious birth defects, according to an official review, which has been severely criticised by campaigners.

An expert working group set up by the Commission on Human Medicines (CHM) concluded there was no “causal association” between a drug called Primodos and severe disabilities in babies.

However, MPs and families who have campaigned against hormone pregnancy tests (HPTs) for more than 40 years, said the report was a whitewash.

Yasmin Qureshi, the MP for Bolton South East, said there should be a judicial review or a separate inquiry to examine allegations of a cover-up by medical regulators at the time.

The Labour MP said: “I am completely disgusted by the report. They clearly have not looked at the evidence that was presented to them. If they had looked at the evidence presented to them they could never have arrived at the conclusion they have now. This report is a complete whitewash. It is not worth the paper it has been printed on.”

Mims Davies, the Conservative MP for Eastleigh, said she was disappointed by the report and would be meeting with the prime minister to raise her concerns.

Davies said: “I was thoroughly dissatisfied by the complete lack of transparency in the creation and preparation of this report, with the only representative of campaigners against these historic injustices on the panel being gagged by a confidentiality agreement and prevented from speaking about the report’s preparation.”

The expert group recommended that families who took an HPT and experienced an “adverse pregnancy outcome” should be offered genetic testing to establish whether there was a different underlying cause.

Campaigners believe that as well as causing disabilities, the drugs could also cause miscarriage or stillbirth.

Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said: “It’s truly shocking and I am appalled by the report. We all feel betrayed, and I feel like I have no faith in government health agencies now. I am distraught for our members, who still haven’t had the answers they need.”

Charlotte Fensome, whose brother Steven has severe epilepsy, said she was horrified by the report.

“I’m obviously hugely disappointed by this report. My parents are 81 and 76, and they are struggling every day with my brother. Every victim of Primodos is a personal tragedy, and I am shocked at how this investigation has been carried out.

“My mother was given Primodos when she was eight weeks pregnant, and my brother was born with severe brain damage. It affects the whole family every single day. This is just a battle, and there is a long war ahead.”

The expert group assessed a number of studies looking at a possible link between women given an HPT to diagnose pregnancy and congenital anomalies in babies, but concluded there was no connection.

The expert group found that “although there was never any reliable evidence that HPTs were unsafe, concern about this issue, coupled with the development of better pregnancy tests” led to the use of HPTs being restricted in the 1970s.

A 1967 report found there might be a link between HPTs and spina bifida, and – following the thalidomide scandal which had recently led to that drug being withdrawn – concerns about HPTs rose dramatically.

Primodos, which was also used to treat menstruation problems, was then withdrawn completely in 1978. “Whether these precautionary actions were sufficiently timely became a subject of controversy,” noted the report.

Modern pregnancy tests measure hormone levels in a woman’s urine. The older HPTs contained synthetic versions of two hormones found naturally in the body. Two pills were taken on consecutive days, with a withdrawal bleed a few days later in those who were not pregnant.

Primodos contained synthetic versions of progesterone and estrogen.

Prof Stuart Ralston, the chair of the CHM, said: “This was a comprehensive and wide-ranging scientific review of all the available evidence on the possible association between HPTs and birth defects by internationally leading experts across a broad range of specialisms.”

Dr Ailsa Gebbie, the chair of the expert working group, said: “Our recommendations will strengthen further the systems in place for detecting, evaluating and communicating risk with use of medicines in pregnancy and help safeguard future generations.”

A spokeswoman for Bayer AG, which acquired Primodos manufacturer Schering in 2006, said: “Bayer notes that a review by an independent expert working group on hormone pregnancy tests of the Commission on Human Medicines has found, consistent with Bayer’s view, based on all available data, that the scientific evidence does not support a causal association between the use of hormone pregnancy tests, such as Primodos, and birth defects or miscarriage.”

Anger after report finds birth defects not caused by hormone pregnancy tests

A hormone pregnancy test used in the 1960s and 1970s was not responsible for serious birth defects, according to an official review, which has been severely criticised by campaigners.

An expert working group set up by the Commission on Human Medicines (CHM) concluded there was no “causal association” between a drug called Primodos and severe disabilities in babies.

However, MPs and families who have campaigned against hormone pregnancy tests (HPTs) for more than 40 years, said the report was a whitewash.

Yasmin Qureshi, the MP for Bolton South East, said there should be a judicial review or a separate inquiry to examine allegations of a cover-up by medical regulators at the time.

The Labour MP said: “I am completely disgusted by the report. They clearly have not looked at the evidence that was presented to them. If they had looked at the evidence presented to them they could never have arrived at the conclusion they have now. This report is a complete whitewash. It is not worth the paper it has been printed on.”

Mims Davies, the Conservative MP for Eastleigh, said she was disappointed by the report and would be meeting with the prime minister to raise her concerns.

Davies said: “I was thoroughly dissatisfied by the complete lack of transparency in the creation and preparation of this report, with the only representative of campaigners against these historic injustices on the panel being gagged by a confidentiality agreement and prevented from speaking about the report’s preparation.”

The expert group recommended that families who took an HPT and experienced an “adverse pregnancy outcome” should be offered genetic testing to establish whether there was a different underlying cause.

Campaigners believe that as well as causing disabilities, the drugs could also cause miscarriage or stillbirth.

Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said: “It’s truly shocking and I am appalled by the report. We all feel betrayed, and I feel like I have no faith in government health agencies now. I am distraught for our members, who still haven’t had the answers they need.”

Charlotte Fensome, whose brother Steven has severe epilepsy, said she was horrified by the report.

“I’m obviously hugely disappointed by this report. My parents are 81 and 76, and they are struggling every day with my brother. Every victim of Primodos is a personal tragedy, and I am shocked at how this investigation has been carried out.

“My mother was given Primodos when she was eight weeks pregnant, and my brother was born with severe brain damage. It affects the whole family every single day. This is just a battle, and there is a long war ahead.”

The expert group assessed a number of studies looking at a possible link between women given an HPT to diagnose pregnancy and congenital anomalies in babies, but concluded there was no connection.

The expert group found that “although there was never any reliable evidence that HPTs were unsafe, concern about this issue, coupled with the development of better pregnancy tests” led to the use of HPTs being restricted in the 1970s.

A 1967 report found there might be a link between HPTs and spina bifida, and – following the thalidomide scandal which had recently led to that drug being withdrawn – concerns about HPTs rose dramatically.

Primodos, which was also used to treat menstruation problems, was then withdrawn completely in 1978. “Whether these precautionary actions were sufficiently timely became a subject of controversy,” noted the report.

Modern pregnancy tests measure hormone levels in a woman’s urine. The older HPTs contained synthetic versions of two hormones found naturally in the body. Two pills were taken on consecutive days, with a withdrawal bleed a few days later in those who were not pregnant.

Primodos contained synthetic versions of progesterone and estrogen.

Prof Stuart Ralston, the chair of the CHM, said: “This was a comprehensive and wide-ranging scientific review of all the available evidence on the possible association between HPTs and birth defects by internationally leading experts across a broad range of specialisms.”

Dr Ailsa Gebbie, the chair of the expert working group, said: “Our recommendations will strengthen further the systems in place for detecting, evaluating and communicating risk with use of medicines in pregnancy and help safeguard future generations.”

A spokeswoman for Bayer AG, which acquired Primodos manufacturer Schering in 2006, said: “Bayer notes that a review by an independent expert working group on hormone pregnancy tests of the Commission on Human Medicines has found, consistent with Bayer’s view, based on all available data, that the scientific evidence does not support a causal association between the use of hormone pregnancy tests, such as Primodos, and birth defects or miscarriage.”

Anger after report finds birth defects not caused by hormone pregnancy tests

A hormone pregnancy test used in the 1960s and 1970s was not responsible for serious birth defects, according to an official review, which has been severely criticised by campaigners.

An expert working group set up by the Commission on Human Medicines (CHM) concluded there was no “causal association” between a drug called Primodos and severe disabilities in babies.

However, MPs and families who have campaigned against hormone pregnancy tests (HPTs) for more than 40 years, said the report was a whitewash.

Yasmin Qureshi, the MP for Bolton South East, said there should be a judicial review or a separate inquiry to examine allegations of a cover-up by medical regulators at the time.

The Labour MP said: “I am completely disgusted by the report. They clearly have not looked at the evidence that was presented to them. If they had looked at the evidence presented to them they could never have arrived at the conclusion they have now. This report is a complete whitewash. It is not worth the paper it has been printed on.”

Mims Davies, the Conservative MP for Eastleigh, said she was disappointed by the report and would be meeting with the prime minister to raise her concerns.

Davies said: “I was thoroughly dissatisfied by the complete lack of transparency in the creation and preparation of this report, with the only representative of campaigners against these historic injustices on the panel being gagged by a confidentiality agreement and prevented from speaking about the report’s preparation.”

The expert group recommended that families who took an HPT and experienced an “adverse pregnancy outcome” should be offered genetic testing to establish whether there was a different underlying cause.

Campaigners believe that as well as causing disabilities, the drugs could also cause miscarriage or stillbirth.

Marie Lyon, chair of the Association for Children Damaged by Hormone Pregnancy Tests, said: “It’s truly shocking and I am appalled by the report. We all feel betrayed, and I feel like I have no faith in government health agencies now. I am distraught for our members, who still haven’t had the answers they need.”

Charlotte Fensome, whose brother Steven has severe epilepsy, said she was horrified by the report.

“I’m obviously hugely disappointed by this report. My parents are 81 and 76, and they are struggling every day with my brother. Every victim of Primodos is a personal tragedy, and I am shocked at how this investigation has been carried out.

“My mother was given Primodos when she was eight weeks pregnant, and my brother was born with severe brain damage. It affects the whole family every single day. This is just a battle, and there is a long war ahead.”

The expert group assessed a number of studies looking at a possible link between women given an HPT to diagnose pregnancy and congenital anomalies in babies, but concluded there was no connection.

The expert group found that “although there was never any reliable evidence that HPTs were unsafe, concern about this issue, coupled with the development of better pregnancy tests” led to the use of HPTs being restricted in the 1970s.

A 1967 report found there might be a link between HPTs and spina bifida, and – following the thalidomide scandal which had recently led to that drug being withdrawn – concerns about HPTs rose dramatically.

Primodos, which was also used to treat menstruation problems, was then withdrawn completely in 1978. “Whether these precautionary actions were sufficiently timely became a subject of controversy,” noted the report.

Modern pregnancy tests measure hormone levels in a woman’s urine. The older HPTs contained synthetic versions of two hormones found naturally in the body. Two pills were taken on consecutive days, with a withdrawal bleed a few days later in those who were not pregnant.

Primodos contained synthetic versions of progesterone and estrogen.

Prof Stuart Ralston, the chair of the CHM, said: “This was a comprehensive and wide-ranging scientific review of all the available evidence on the possible association between HPTs and birth defects by internationally leading experts across a broad range of specialisms.”

Dr Ailsa Gebbie, the chair of the expert working group, said: “Our recommendations will strengthen further the systems in place for detecting, evaluating and communicating risk with use of medicines in pregnancy and help safeguard future generations.”

A spokeswoman for Bayer AG, which acquired Primodos manufacturer Schering in 2006, said: “Bayer notes that a review by an independent expert working group on hormone pregnancy tests of the Commission on Human Medicines has found, consistent with Bayer’s view, based on all available data, that the scientific evidence does not support a causal association between the use of hormone pregnancy tests, such as Primodos, and birth defects or miscarriage.”

The real saboteurs are the Tory Brexiters destroying the NHS | Owen Jones

Who are the real saboteurs? Is it those who want Brexit to be properly scrutinised by parliament to prevent a disastrous deal which could wreck the economy and shred social provision? Those were, after all, the saboteurs who needed crushing according to the Daily Mail when Theresa May called her calamitous snap election. Or are the real saboteurs those who – through bigotry, twisted ideological zealotry and outright stupidity – are damaging the fabric of the public services we all depend on?

Britain’s National Health Service is propped up by 12,000 doctors from the European Economic Area. Without them, our most treasured national institution – which brings us into the world, mends us when we are sick or injured, cares for us in our final moments – would collapse. So it should be of some concern to us, to put it mildly, that nearly half of them are considering leaving the country, and a fifth have already made actual plans to do so.

What a twisted irony. The leave campaigners made a calculated decision to win the EU referendum with a toxic mixture of lies and bigotry. One of the most striking falsehoods was an extra £350m a week for the NHS after we left: instead it’s being emptied out of desperately needed doctors.

And can you blame them for wanting to leave? We’ve now had years of vitriolic scapegoating of immigrants to deflect responsibility from the banks, the tax-dodgers, the unaccountable corporations, the poverty-paying employers, the rip-off landlords, the neoliberal politicians, and all the other vested interests who have unleashed misery and insecurity upon this country. The positive contribution of immigrants was all but banished from public discussion. The campaign reached a crescendo during the referendum, with immigrants variously portrayed as potential criminals, rapists, murderers and terrorists, validating every bigot in Britain and resulting in a surge in hate crimes on the streets. I wonder why European doctors don’t feel particularly welcome right now?

This is about the worst possible time to haemorrhage doctors. The NHS is enduring the longest squeeze in its funding as a proportion of GDP since its foundation; it’s being fragmented by marketisation and privatisation; it’s under growing pressure because of decimated social care budgets while citizens continue to live longer. Plunging morale – because of privatisation, staff shortages and cuts – is affecting all doctors, regardless of where they’re born: a recent study suggested two-thirds are considering leaving. The consequence? We’re having to look abroad for more doctors. This is a recurring irony of Conservative rule. After the first five years of the coalition government, drastic cuts to nurse training places led the NHS to look for one in four nurses abroad.

How have we allowed the bigots and xenophobes of our unhinged tabloid press and political elite to inflict so much damage? Rather than making our live-saving foreign doctors feel unwelcome, surely we should be focusing on how we can tax the booming wealthy individuals and big businesses so we can invest more in our NHS? It should be abundantly clear who the real saboteurs are. They have already inflicted incalculable damage to our social fabric, our public services, our economy, and our international standing. The question is: how do we prevent them from inflicting even more damage?

Owen Jones is a Guardian columnist

One in five European NHS doctors plan to quit UK, survey reveals

Almost one in five of the NHS’s European doctors have made plans to quit Britain, according to research that has raised fresh fears of a Brexit-induced medical brain drain.

And almost half of the health service’s 12,000 medics from the European Economic Area (EEA) are considering moving abroad, the British Medical Association survey of 1,720 of them found.

The findings come amid growing evidence that Brexit may exacerbate problems of understaffing in the NHS by making both retention and recruitment of EU staff more difficult. In September NHS figures showed that more than 10,000 staff from EU countries had quit since the Brexit vote. And the number of EU nurses coming to Britain has dropped by 89% in the last year, Nursing and Midwifery Council figures released this month showed.

In total, 45% of respondents to the BMA survey said they were thinking about leaving Britain following the result of the EU referendum in June 2016 – three percentage points more than when the BMA ran a similar poll in February – while a further 29% were unsure whether they would go.

Among those who were considering going elsewhere 39% – or 18% of the whole sample – have already made plans to leave. The 12,000 doctors from the EEA (the EU plus Iceland, Liechtenstein and Norway) represent 7.7% of the NHS’s medical workforce.

Some of those leaving have been offered jobs abroad, while others are applying for posts overseas. Some have begun the process of seeking citizenship elsewhere, while others are having their qualifications validated so they can work in another country, the BMA said.

Q&A

What was wrong with the claim that the UK sends the EU £350m a week?

The claim that Britain “sends the EU £350m a week” is wrong because:

  • The rebate negotiated by Margaret Thatcher is removed before anything is paid ​​to Brussels. In 2014, this meant Britain actually “sent” £276m a week to Brussels; in 2016, the figure was £252m.
  • Slightly less than half that sum – the money that Britain does send to the EU – either comes back to the UK to be spent mainly on agriculture, regional aid, research and community projects, or gets counted towards ​the country’s international aid target.

Regardless of how much the UK “saves” by leaving the EU, the claim that a future government would be able to spend it on the NHS is highly misleading because:

  • It assumes the government would choose to spend on the NHS the money it currently gets back from the EU (£115m a week in 2014), thus cutting f​unding for​ agriculture, regional development and research by that amount.
  • It assumes​ the UK economy will not be adversely affected by Brexit, which many economists doubt.

“That so many EU doctors are actively planning to leave the UK is a cause for real concern. Many have dedicated years of service to the NHS and medical research in the UK, and without them our health service would not be able to cope,” said Dr Andrew Dearden, the BMA’s treasurer.

The Labour MP Darren Jones, a supporter of the pro-EU Open Britain campaign, said: “The British people were told last year that Brexit would boost the NHS by £350m a week. Now the evidence is piling up that it will break it instead.

“We all depend on the brilliant work done by doctors, nurses and other staff who come from the EU. There is no chance that we could replace their expertise if they continue to leave the UK.”

But the Department of Health said that figures released last week by the General Medical Council, showing a slight year-on-year rise in 2016-17 in the number of EEA doctors joining its medical register, showed the BMA’s findings were inaccurate.

“This survey does not stand up to scrutiny. In fact, there are actually more EU doctors working in the NHS since the EU referendum, more EU graduates joining the UK medical register and 3,193 more EU nationals working in the NHS overall,” a spokesperson said.

UK patients ‘suffering as they cannot afford assisted dying overseas’

Thousands of terminally ill people who want to travel abroad to end their life in specialist clinics can not afford the costs of doing so, leaving them to face often “painful and traumatic deaths at home”, according to a new report.

The study by the campaign group Dignity in Dying says the UK is outsourcing death to Dignitas – the assisted dying organisation in Switzerland – which only the better off can afford.

The study found that while more than half of Britons would consider travelling to abroad for an assisted death, only a quarter said they could afford the average £10,000 cost.

Sarah Wootton, the chief executive of Dignity in Dying, said the study “exposes the unacceptable reality that is faced by so many dying people in this country.

“By denying terminally ill people the option of an assisted death at home, we are not solving the problem, just outsourcing it to Switzerland – and dying people and their families are the ones paying the price.”

Assisted dying is illegal in the UK and Wootton said terminally ill people are spending their final months “overwhelmed by paperwork [and] being made to feel like criminals”.

She added: “Those that are unable to obtain an assisted death overseas can end up suffering painful and traumatic deaths at home or taking drastic measures to end their own lives. This is not how a civilised country should treat its dying citizens.”

The report is based on polling and in-depth interviews with three groups of people: those with a terminal illness who are considering an assisted death in Switzerland; those who have helped a loved one to have an assisted death in Switzerland; and those whose loved one considered an assisted death in Switzerland but died in the UK.

It found that those without enough money or family and friends to support them were unable to make the tip to assisted dying clinics.

Emil Prysak, 30, from London, said his mother was diagnosed with thyroid cancer, which spread throughout her body. She initially ruled out Dignitas because of the cost involved, but later regretted it due to the pain and suffering she experienced at the end of her life.

Prysak said: “Because of the complexity of her illness, my mum was suffering all the way to the end … She was looking at us, saying ‘Why can I not die? If I had known it was going to be like this I would have gone to Switzerland’ … My mum didn’t want that suffering and that’s haunting me. It will haunt me to the end of my life.”

Caroline Villar, 39 from County Down, was also interviewed. She said when her mother, Margaret, received a terminal diagnosis of cancer, she considered an assisted death in Switzerland but feared the legal implications for her family if they helped her. She ended up dying in pain at home in Northern Ireland.

Villar said: “I think most people believe that modern medicine will stop you suffering, but my mum was crying out for painkillers at the end, and they couldn’t increase the dose because they said if they gave her any more, it would push her over into death. We were all happy for that to happen, to finally end her suffering, but they couldn’t do it.”

Kit Malthouse, the Conservative MP for North West Hampshire, wrote in a foreword for the report that it “shines a light where too few policy makers are willing to look.”

“We must ask whether these terrible experiences can truly be justified by a false dichotomy between dominion over our lives and protection of the vulnerable, a premise long-disproved,” he said.

“The evidence that we need change is overwhelming. It’s time that the UK stopped outsourcing its compassion and began listening to dying people who want and need the most basic choice they will ever face.”

UK patients ‘suffering as they cannot afford assisted dying overseas’

Thousands of terminally ill people who want to travel abroad to end their life in specialist clinics can not afford the costs of doing so, leaving them to face often “painful and traumatic deaths at home”, according to a new report.

The study by the campaign group Dignity in Dying says the UK is outsourcing death to Dignitas – the assisted dying organisation in Switzerland – which only the better off can afford.

The study found that while more than half of Britons would consider travelling to abroad for an assisted death, only a quarter said they could afford the average £10,000 cost.

Sarah Wootton, the chief executive of Dignity in Dying, said the study “exposes the unacceptable reality that is faced by so many dying people in this country.

“By denying terminally ill people the option of an assisted death at home, we are not solving the problem, just outsourcing it to Switzerland – and dying people and their families are the ones paying the price.”

Assisted dying is illegal in the UK and Wootton said terminally ill people are spending their final months “overwhelmed by paperwork [and] being made to feel like criminals”.

She added: “Those that are unable to obtain an assisted death overseas can end up suffering painful and traumatic deaths at home or taking drastic measures to end their own lives. This is not how a civilised country should treat its dying citizens.”

The report is based on polling and in-depth interviews with three groups of people: those with a terminal illness who are considering an assisted death in Switzerland; those who have helped a loved one to have an assisted death in Switzerland; and those whose loved one considered an assisted death in Switzerland but died in the UK.

It found that those without enough money or family and friends to support them were unable to make the tip to assisted dying clinics.

Emil Prysak, 30, from London, said his mother was diagnosed with thyroid cancer, which spread throughout her body. She initially ruled out Dignitas because of the cost involved, but later regretted it due to the pain and suffering she experienced at the end of her life.

Prysak said: “Because of the complexity of her illness, my mum was suffering all the way to the end … She was looking at us, saying ‘Why can I not die? If I had known it was going to be like this I would have gone to Switzerland’ … My mum didn’t want that suffering and that’s haunting me. It will haunt me to the end of my life.”

Caroline Villar, 39 from County Down, was also interviewed. She said when her mother, Margaret, received a terminal diagnosis of cancer, she considered an assisted death in Switzerland but feared the legal implications for her family if they helped her. She ended up dying in pain at home in Northern Ireland.

Villar said: “I think most people believe that modern medicine will stop you suffering, but my mum was crying out for painkillers at the end, and they couldn’t increase the dose because they said if they gave her any more, it would push her over into death. We were all happy for that to happen, to finally end her suffering, but they couldn’t do it.”

Kit Malthouse, the Conservative MP for North West Hampshire, wrote in a foreword for the report that it “shines a light where too few policy makers are willing to look.”

“We must ask whether these terrible experiences can truly be justified by a false dichotomy between dominion over our lives and protection of the vulnerable, a premise long-disproved,” he said.

“The evidence that we need change is overwhelming. It’s time that the UK stopped outsourcing its compassion and began listening to dying people who want and need the most basic choice they will ever face.”