Tag Archives: Failure

Mother killed herself after ‘serious failure’ by mental health unit

A mother who killed herself while suffering from postnatal depression died as a result of a “very serious failure” that allowed her to leave a mental health unit unchaperoned, a coroner has ruled.

Despite having made multiple attempts to kill herself, 32-year-old Polly Ross was allowed to leave the Westlands mental health unit in Hull at about 8.30am on 12 July 2015, telling nurses that she was going to buy cigarettes. She was hit by a train at 11.10am and died instantly.

Speaking at the end of a four-day hearing, coroner Prof Paul Marks said he could not rule that Humber NHS foundation trust had been guilty of clinical neglect, but said the decision to allow her to leave the unit “had a direct causal effect” on her death.

Her mother, Jo Hogg, who was previously employed by the trust as an occupational therapist, thanked the coroner for conducting a “frank and fearless examination” of the circumstances surrounding her daughter’s death.

She said the trust had failed her daughter when she had needed their help the most and that care for women with postnatal depression in the region was “appalling”. She said that mental health services were “not joined up in a way that pays close regard to the complex needs of patients”.

The court heard how Ross, who ran a translation business in Paris before moving back to east Yorkshire in August 2012, had suffered from the extreme form of morning sickness, hyperemesis gravidarum, during both her pregnancies in 2012 and 2014. The condition has received media attention after it was revealed that the Duchess of Cambridge suffered from it during her pregnancies.

The condition caused Ross – who was described as “staggeringly intelligent” – to be hospitalised and put on a drip, which was said to have compounded her mental health issues. The inquest was told that she developed “drug-induced psychosis” after taking cannabis to relieve her symptoms and that when she asked to be admitted to a specialist mother and baby unit in Leeds, she was turned down.

In February 2015, the linguist was sectioned after a breakdown and her children were taken from her care. Over the coming weeks and months she regularly expressed suicidal thoughts and attended A&E on multiple occasions having self harmed or taken an overdose.

In a statement read to the court, Ross’s aunt Emma May, who acted as her carer after she was first sectioned, said she was certain that the few times her niece had left her home since February “were times she attempted to take her own life”. She said: “I cannot understand how she was allowed to leave the unit to buy her own cigarettes the morning she died.”

Giving evidence to the inquest, Dr Robert Kehoe, a Bradford-based consultant psychiatrist, said that while the overall standard of Ross’s care had been good, there were two serious failures on the part of Humber NHS foundation trust.

“One: there was a failure to clarify and state a plan for what should occur in the situation of a patient requesting to leave the unit,” he said. “Two: the effective decision to end the period of 15-minute observations allowed her to leave the unit at around 8.40am that day.”

Ross’s observations had been increased from once an hour to once every 15 minutes on 10 July after a ligature was found in her room. She was not sectioned at the time of her death, but Kehoe said there was “no logic” in increasing her observations only to allow her to leave the unit unescorted.

In a statement, Humber NHS foundation trust said: “We would like to offer our sincerest condolences to Polly’s mother, aunt, other family members and friends for their tragic loss. The thoughts of everyone associated with the trust continue to be with them at this sad time.

“We would also like to offer an unreserved apology to Polly’s family and friends and acknowledge that there were omissions in her care prior to her death on 12 July 2015. The trust acknowledges Prof Marks’ conclusion regarding the circumstances surrounding Polly’s death and has fully implemented all of the recommended improvements highlighted by our investigations.

“The trust will continue to reflect and learn and seek to continually improve the services we provide to patients.”

In October 2015, Marks ruled that Humber NHS foundation trust was guilty of neglect in the case of Sally Mays, 22, who killed herself after being turned away for inpatient mental health care. The same year, a coroner in Bristol raised concerns about mental healthcare for new mothers after 30-year-old Charlotte Bevan jumped off a cliff clutching her baby girl following a “chain of failures” by medical staff.

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.

My ambulance crew is forced to put a plaster over society’s failure

However good the NHS is, it is not a lot of things; it isn’t social care, it isn’t a hotel and it most certainly isn’t a miracle worker. I work as an emergency care assistant on ambulances at the weekend. I can see the amazing things the health service does, but also why it sometimes appears to be falling apart at the seams. The NHS is stretched to breaking point every day. There are a lot of reasons for this and some of them are easy to see.

I’ve lost count of the number of times I have been called to patients who aren’t really patients at all. They are desperately in need of help, but not medical help. They need social care. Or social housing. They need their basic needs to be met, but not an ambulance crew. It’s just that there is no one else who they can call on a Sunday afternoon when, for example, they are at the end of their tether. When the loneliness hits hard, the prospect of not seeing a friendly face for another week is more than they can bear.

In the past this would have been dealt with by ringing another family member, or by a carer or a respite centre to give the family a break. These days, though, families are spread far apart and cuts to local authority budgets mean social care has been decimated. There is no one to call. There is no relief or respite in sight for a lot of these people and so, in desperation, they call an ambulance.

In turn, because the ambulance crew can see that the family cannot cope, that it’s just too much, we have no choice. We take them to hospital in the hope that given a few hours of space the family feels better, more able to continue in the thankless task of caring. We put a plaster over society’s failure.

And so there goes a hospital bed. A nurse, a doctor, all of whose time is taken up, instead of looking after the sick. There goes the protected NHS budget – the one that the government has pledged to increase. Only it’s not really an increase or protected at all, because now, instead of the money being spent on social care, and coming out of local authority budgets, it is coming out of the NHS one.

Then there are the lost souls. Those who drift, who sofa surf or sleep on park benches. Many of them mentally unwell but not acutely so. They don’t need a hospital, they just need somewhere warm and safe. It takes a cold-hearted person to leave someone on a park bench when you know they have nowhere else to go and it is -3C outside. Yet again we, the ambulance crew, paid for by the NHS, spend our time and your money phoning around charities, forgotten contacts in our patient’s phone, in the hope that we can find them a warm bed for the night. If not, due to cuts in social housing, there being no easy access hostels, we take them to the warm waiting room of the hospital. As we sit there sticking plasters on the plight of the homeless, another cardiac arrest call goes unanswered. Another person dies.

Other patients are just too old; their bodies far too weak. Sometimes it happens slowly, other times it is quick. I recently went to a patient who was in his 90s and barely lucid. His daughter insisted he had been fine until he got pneumonia and was taken into hospital for a month.

There was no point telling her that maybe it was just his time to go. That he had lived longer than most people, that the hospital she was blaming for the state of her father was probably to blame, only not in the way that she thought. Years ago, her dad wouldn’t have been taken to hospital to be treated for the pneumonia that nearly killed him. He would likely have just died at home. Instead we dragged him off to A&E for more interventions. When he isn’t restored back to full health, no doubt his daughter will claim that the hospital killed him. Blame, it would seem, is easier than the truth. Sometimes we just need to allow people to die and not play God and attempt miracles.

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Labour’s failure on the NHS is prolonging this health crisis | Polly Toynbee

Remember Mavis Skeet? In 2000 the 74-year-old led the news for weeks when her operation for cancer of the oesophagus was cancelled four times, until it became inoperable and she died. Liam Fox, then shadow health secretary, exclaimed: “This is not an isolated case. The NHS is not coping!”

When does a rumbling NHS crisis erupt into a volcanic political eruption? Labour’s miserable failure to “weaponise” the NHS into a winner in Copeland makes it worth looking back.

Mrs Skeet was the tipping point for Labour. The worst flu epidemic in a decade blew away Tony Blair’s pre-election “waiting lists cut” pledge. Instead Labour stuck to a draconian Tory budget, but this one case sent Blair into the TV studios promising to match average EU spending – and Labour did. The best NHS decade followed: 7% annual budget increases saw waiting times plummet, as heart and cancer results improved.

Margaret Thatcher’s eruption came in 1987 with the NHS squeezed dry. Babies died waiting for operations at the Birmingham Children’s Heart hospital. Through gritted teeth, the NHS “safe in our hands”, she bunged it £100m and punished it with the internal market.

In this latest seismological era, political vulcanologists can’t predict exactly when the top will blow. With its lowest ever funding rises, its hardest years are still to come, despite soaring numbers of the old, hospital admissions up by 31%, and 22% more A&E patients since 2010. Staff shortages follow cuts in nurse training and worsening GP and specialist recruitment. Even if extra is found for social care, the National Audit Office suggests it won’t stem the flow of patients into hospitals.

Are things bad enough yet? The British Medical Association reports that 15,000 hospital beds have been cut in the past six years. The Royal College of Surgeons protests at cancer operations being cancelled. Ambulances frequently stack up outside hospitals. Look at all that molten lava bubbling away.

Mavis Skeet’s death in 2000 became a tipping point for the NHS under Labour. Her operation for cancer of the oesophagus was cancelled four times.

Mavis Skeet’s death in 2000 became a tipping point for the NHS under Labour. Her operation for cancer of the oesophagus was cancelled four times. Photograph: PA

Ahead of next week’s budget, Theresa May pretends the NHS has an extra £10bn – at loggerheads with Simon Stevens, the head of NHS England, who publicly disputes it. What forces a U-turn? Before it was deaths, but already two patients have died on Worcester Royal hospital trolleys, one after a 35-hour wait. Coroners have protested to the health secretary, Jeremy Hunt, after two recent deaths due to lack of intensive care beds: the case of Teresa Dennett, who died from a stroke, and Mary Muldowney, who died after a brain haemorrhage.

The war zone of A&E has featured nightly on BBC news, with a graphic documentary series on the controlled mayhem in barely coping hospitals. When is enough enough? Not quite yet, it seems. The government has been lucky, with no flu epidemic in any recent winters or any Arctic freeze-over. With beds at full capacity, it would only take a mild outbreak to tip over the NHS.

The pressure-cooker is finance: monumental debts swell by millions a month as hospitals receive absurdly frantic threats if they don’t cut back. In December they were told to free beds by cancelling operations, causing longer waiting times and lost revenue from missed operations. Look at King’s College hospital, in south London: its chair, Bob Kerslake, calls official finances “kidology”. Ordered to make a surplus this year, King’s can’t avoid a £2m loss – yet the punishment is a cut in funds, sending its deficit to £30m, and an instruction to make a £26m surplus next year: this is mirage accounting, mirrored everywhere.

So far these debts are Hunt’s and chancellor Philip Hammond’s problem: what do patients care? But if the Treasury really means to recoup the money, plus the £22bn in savings it demands of the NHS by 2020, then Vesuvius will blow. Wards and units will close, staff will be laid off, the chaos will be unprecedented. It can’t happen.

When the government is forced, kicking and screaming, to pay up, who will it blame? It will call the NHS “unsustainable” and “a bottomless pit”. (Hammond already has.) Yet more “reforms” and re-disorganisations will be hurled at it: payment for services, top-up insurance and tax rebates for private payers will resurface. The government will ignore the UK’s fall in the EU spending scale since 2010, and is now sixth out of the G7 countries, with fewer beds, doctors and nurses per capita.

Who has the political heft and credibility to defend it? Fear of Labour’s NHS moral hegemony kept Thatcher, John Major and David Cameron in check. No longer. Labour thought the NHS was its big bazooka in Copeland, where a maternity unit is under threat. But the naked desperation of Labour’s “Babies will die!” leaflets shot the very last bolt in Jeremy Corbyn’s arsenal. Each time he raises the NHS at prime minister’s questions his feeble attempt at “weaponising” sounds pathetically opportunist: May bats him away with balderdash statistics he is too incompetent to refute.

This has never happened before: polls find May more trusted than Corbyn to run the NHS by 45% to 35%. Far worse, Labour’s failure to counter the right’s message has left more people blaming the NHS crisis on migrants and patients’ bad lifestyles than Tory underfunding or rising numbers of older people. As ever the Mail and the rest carry endless NHS tourism or obese wastrel stories – but Labour has always had to fight twice as hard to get a hearing for the facts on the NHS.

Whoever follows Corbyn will now find it ferociously hard to regain that lost NHS ground. By 1997, hammering away in opposition, Labour had made the threadbare NHS the top issue and owned it. Hard-won economic credibility earned it the trust to run the NHS better. Now Ben Page of Ipsos Mori finds the NHS the second issue after Brexit, but Labour doesn’t own it, or anything else: Corbyn falls behind on everything, with every demographic, so even Labour voters prefer May.

Because the NHS crisis has so far exploded in debt rather than closures, most people’s experience is not yet bad enough to reach tipping point. Page says satisfaction is down on 2010, but not rock bottom, with always a long lag in perception. A third would pay more tax for the NHS, but the rest want savings by denying obese people and migrants.

Austerity has entered the nation’s blood stream: Page finds most people still think it necessary – despite the reckless tax cuts ahead. Banging on about “austerity” without specifics gets Labour nowhere. May’s own polling and her Copeland result tell her this – but hubris is her greatest peril. There may be no opposition, but if she and her chancellor really try to squeeze the gargantuan debt out of the NHS, all hell will break loose anyway.

London ambulance staff log calls with pen and paper after IT failure

Staff at one of the country’s biggest ambulance services had to log emergency calls manually overnight because of technical issues in the control room, delaying response times.

It is understood London ambulance service’s computer system crashed, forcing staff to record details of calls by pen and paper for nearly five hours on one of the busiest nights of the year.

A spokeswoman said staff were trained to deal with such situations and were able to prioritise responses to those in greatest need.

The deputy director of operations Peter McKenna said: “Due to technical difficulties, our control room was logging emergency calls by pen and paper from 12.30am to 5.15am.

“Our control room staff are trained to operate in this way and continue to prioritise our response to patients with life-threatening conditions, using the same triage system as usual.

“We also have additional clinicians on duty to offer control room staff clinical advice if it is needed.”

Failure to meet cancer targets shows the NHS can no longer cope

Everywhere is struggling to cope. The increasing failure to hit the waiting time targets for cancer patients reflects systems that are struggling to meet workloads. Hospitals are struggling to get people’s tests done in time, to get their diagnosis for them as soon as possible and to be able to make plans for their treatment.

Three years ago, hospitals were managing to respond to the needs of people by generally meeting NHS waiting time targets for the growing number of those being referred with suspected cancer. The fact that we were hitting the targets didn’t mean that everything was perfect, but it did indicate that the way the system was organised meant that we were coping and working to meet demand. It doesn’t feel like we are coping any more.

Patients are waiting longer for scans, biopsies, pathology results and for treatment plans to be finalised. We are largely meeting the 14-day target and the target for 31 days from diagnosis to treatment. But we are largely failing to meet the 62-day target. That’s the time between someone being referred by their GP and them having their first definitive treatment. Delays are occurring mainly between a suspected cancer patient seeing a specialist and having a definite plan for their treatment drawn up. Myself and colleagues come across this all the time; people who have waited two, three or four weeks for a CT scan or biopsy.

That matters for individual patients because they have a prolonged period of uncertainty. Do I have cancer or do I not? And if I do have cancer, will it be curable? If it was a private hospital or one of the great hospitals in the US or Europe the consultant could expect to have the answers from the tests within a week. But here it can be as long as a month.

There will be some people who get worse while they are waiting for tests to take place or for the results to come back. Their cancers will grow. In a small proportion of them their cancer may spread. If you look after people with cancer it’s a desperate situation to be asking them to wait for their tests and to be planning to see them after a month because they won’t have their results until then, and we know that’s going to be a month of terrible worry for them.

This failure to meet targets, to keep up with the growing demand for cancer care, was a foreseeable problem – and it’s getting worse. Previously we planned for what we knew was going to be the growing number of people needing tests and treatment. Now we need a lot more radiologists and endoscopists, for example, to keep up with what we know is going to be the even greater numbers of people needing cancer care in the years to come. But now it’s not just the tens of thousands of people who have not been treated within 62 days over the last two and a half years since the NHS nationally began missing that target. It’s the fact that we now have a system that’s failing, and that can’t be acceptable.

Peter Johnson is professor of medical oncology at Southampton University and Cancer Research UK’s chief clinician

Teenage girls talk about anxiety: ‘It’s always linked to failure’ – video

One in three teenage girls in England and Wales suffers from anxiety, according to a survey of 14-year-olds for the Department for Education. Orli, a 17-year-old girl from north London, talks to her friends about her anxiety, how she plans to beat it and stop the stigma surrounding it

Secret Teaching: I love teaching, but I’m tired of feeling like a failure

When I began teaching 18 years ago, I poured everything I had into it. I started at a tough inner-city Manchester school. I ran after-school football and film clubs, and produced Shakespeare plays with 8- to 11-year-olds. I was glad to be observed 10 times in a gruelling five-day Ofsted visit (it was 1998). I put so much in and got so much out – I was young, single and I didn’t care about late nights and early mornings.

A few years later I moved to another challenging school down the road, as deputy headteacher. The budget was incredibly tight which meant I had zero management time and taught all week; this was before the luxury of PPA (the time that’s set aside for teachers to do planning, preparation and assessment work). I always had a foot out of the door and an ear cocked for trouble in the corridor – even more so when I spent a term as acting headteacher when the excellent head was in hospital.

I think that’s when my downward spiral started. I’d taken on a class where I had to field chairs being thrown at me, coerce one pupil from the roof and fend off physically abusive parents. I would become frustrated and angry when things went badly (being punched by a parent, the local authority demanding that results improve) and completely elated when things went well (transforming 30% of pupils achieving level 4 into 70%, seeing special educational needs and disaffected year 6 students performing Richard III).

Within three years, I hit a wall. I went back to my hometown, to teach in a successful primary in a leafy, middle-class area. I thought it would give me a chance to work in a less stressful environment. I was wrong. The pressure – in school, from the government and families – was different, but equally debilitating.

It was an outstanding school and the local education authority (LEA) had expectations. “Yours is one of the better schools,” we were told. “For us to reach our target, we need you to up your Sats results, because the other schools in the area are rubbish.” I’m paraphrasing, but the message was clear. I made an initial impact and was expected to carry the year 6 can. It wasn’t the school or the staff’s fault, it’s just the way things were and still are.

Each morning I would wake up feeling sick to my stomach. I spent my lunchtimes alone, sitting outside in the street, struggling to eat the lunch I’d prepared. There was just so much to do.

After a spell in hospital, I was diagnosed with severe depression. School wasn’t the only factor, but it tipped the balance. I was given months off work, saw psychiatrists and other mental-health professionals and had to fight to get back into the classroom nine months later. I managed it (in large part thanks to my now-wife, who I met through this illness) but it was a pyrrhic victory.

The next eight years had some highs – days when I really thought I was “winning” and that I’d taught well – but there were also more lows. There were times when I felt I was sinking; my to-do list was never-ending and parents irrationally expected their children to be level-pegging with their peers without understanding that people children learn at different rates.

When my son was born two years ago, I realised that family is more important to me than the increasingly demanding job that teaching has become. It’s more important than juggling targets and trying to keep up with the latest short-sighted initiative from Whitehall.

Now I’m a supply teacher, and am lucky that I can survive on the money. Half the wages, 10 times the happiness. I don’t plan, I’m home by 4pm and the job just pays the bills. And my mental state is so, so much improved.

I loved teaching and I miss it profoundly. But my mental health means I just cannot juggle all the balls necessary to be good at it. I demand a lot of myself as a teacher and the demands placed on the teaching profession – by local authorities, Whitehall, governing bodies, heads, parents – mean that I feel a failure far more often than I feel that I am of worth.

Why can’t our leaders learn from 30 years of failure in health and education? | John Quiggin

The inadequacy of competition and the profit motive in the provision human services like education and health has been established by harsh experience with consistent failures like PFI hospitals, for-profit schools and private prisons. This failure presents a puzzle: how is it that (assuming we have an adequate income) we can rely on for-profit corporations to put food on our tables and clothes on our backs, but not to educate our children or preserve our health.

In the hands of many advocates of privatisation, this puzzle is turned into a knock-down refutation: if the profit motive works well in providing something as vital as food, it must work well everywhere. The latest instance of this naive faith in the market is the Australian Productivity Commission’s call to privatise public health and housing.

In fact, there is no puzzle here: economists and public policy scholars worked out decades ago how to answer this question in principle, and solved many of the issues in detail. The problem is that the political class, along with much of the economics profession, have done worse than the Bourbons, of whom Talleyrand observed “they have learned nothing, and forgotten nothing”. Leading economist Paul Romer recently observed, echoing earlier comments by Robert Gordon, that macroeconomics has been going backwards since the early 1980s.

The same is true of the regressive microeconomics underlying the dogma that privatisation and market competition are always and everywhere beneficial. Our leaders, and the economists who advise them, have shown themselves incapable of learning from experience, but they have forgotten much that we once knew. In this case, what we once knew was the analysis of market failure that supported the successful mixed economy that came into being in the mid-20th century.

The basic analytical framework was set out in Francis Bator’s 1958 article, “The anatomy of market failure”, (itself drawing on earlier work by the great British economist AC Pigou). It was developed further by a string of contributions from economists like Kenneth Arrow, Joseph Stiglitz and George Akerlof, all of whom received the Nobel Memorial Prize in Economic Sciences for their work.

Taken together with Keynesian macroeconomic theory, this body of work explained why a properly functioning modern economy must be one in which some goods and services are provided by firms competing for profit and others by governments or publicly-funded non-profit organisations. The result is the “mixed economy”, political and social aspects of which were analysed by scholars such as Karl Mannheim and Andrew Shonfield.

Human services are among the sectors of the economy where markets and competition perform badly. The central problems related to human services involve information and finance. These are most obvious in relation to education. Education is for most of us, a once-only experience, and its value is hard to assess, except in retrospect. To some extent, we can make choices on the basis of the reputation of schools and universities. However, these reputations change only slowly over decades, so slowly that no rational for-profit firm would invest in maintaining them.

Moreover, education is hugely expensive, so that most families can’t afford it in the absence of public provision or a public subsidy. The experience of for-profit education in Australia and the US has been that it is far easier to extract public subsidies through scams of various kinds than to compete on the basis of high-quality education.

Many of the same issues arise in healthcare. Obviously, if we knew what was wrong with our health and how to fix it, we wouldn’t need doctors to tell us. As it is, we need to rely on the judgment of our doctors to give us the right treatment and, equally importantly, to tell us when we will get better without treatment. The greater the role of profit in the system, the greater the incentive to provide unnecessary or overpriced services. The example of the United States, which spends more on healthcare than any other country, with worse results, is an illustration.

Information isn’t a problem, or not much of one, in the case of food supply. We buy food on a weekly or even daily basis and have plenty of chances to determine what we like, and which suppliers offer good value for our money. There are things we can’t easily observe, like the cleanliness of food preparation, but these can be dealt with through regulation rather than through governments getting into the food supply business themselves.

Of course, none of this helps if you don’t have enough money to afford the food you need. But long experience has shown that the best way to help poor people afford necessities like food is to give them more money. Neither general food subsidies nor welfare payments tied to food purchases (food stamps) have ever worked as well as income redistribution.

If markets and profits don’t work well in the provision of human services, why should we expect governments and non-profit organisations to do any better? The answer is that that non-profit provision relies on professionalism and a service ethos. These can’t be combined with reliance on direct financial incentives and managerial control.

The Bourbons who have dominated public policy for the past few decades are resolutely hostile to any kind of professional or service ethos. They take for granted the most simplistic versions of textbook economics, in which only monetary incentives matter. On a more sophisticated view of the question, people care just as much about the respect of their peers and belief in the value of their work as they do about the size of their pay packet.

This is ultimately an empirical question, and after 30 years of failure we have more than enough evidence to reach a conclusion. Across the human services sector, markets, incentives and competition rarely work better than non-profit provision and frequently lead to disastrous failure.

Failure to curb junk food ads ‘will hinder parents’ in fight against obesity

A failure to limit the way the junk food industry promotes itself to young people will make life far harder for parents trying to give children a nutritious diet, according to the royal society set up to improve public health.

Related: Theresa May’s climbdown on obesity is her first big mistake | Jackie Ashley

Experts in child health had hoped that the government’s long-awaited plan for fighting childhood obesity would include a comprehensive commitment to rein in the power of the food industry to advertise its more unhealthy products to children.

But, while the Department of Health is understood to have been supportive of the commitment, it was omitted from the plan unveiled last week during the summer recess following intervention by No 10. The decision dismayed many in the public health sector.

The watered-down plan, nine months in the making, was seen as a major victory for the fast food and fizzy drinks industries which have lobbied vigorously against measures that would stop them advertising at key times. Originally due to be unveiled by David Cameron, the revised plan under Theresa May’s new government has been savaged by TV chef Jamie Oliver and health bodies for not going nearly far enough.

Public Health England had produced a large body of evidence that suggested tackling the way the food and drinks companies target children was vital if the plan was to have an impact. But the government’s decision to ignore the evidence represents a huge missed opportunity, according to Shirley Cramer, chief executive of the Royal Society for Public Health (RSPH), which conducted interviews with children and their parents on what needed to be done.

“Everybody was advocating very hard for a ban on advertising junk food before the watershed and for family-based programmes like The X Factor,” Cramer said. “We’ve done quite a lot of research talking to young people who tell us that this – the stuff they see online, on bus tickets on posters near their school – makes an enormous difference. People are worried about the promotions, about the advertising. It’s all about pester power – 75% of parents we spoke to said their kids had seen an ad and they’d give in after half an hour of pestering.”

Cramer described the government plan as a good one but with “some big bits missing”. Only if a range of relevant government departments were to commit to preventative measures could the mounting problem of childhood obesity be adequately tackled, she suggested.

“If you look at teen pregnancies, that was a committed, longstanding strategy that went on for 10 years and now we’ve got the outcomes that are much better than predicted. If you really mean to do something about childhood obesity you can, but you need to get all these things working at the same time.”

The failure to constrain the advertising power of the fast food industry would make the job of councils trying to fight obesity all the more difficult, Cramer said. “For a local authority trying to take action against child obesity it doesn’t make their life easier. Junk food will still be advertised everywhere. It means the fight against childhood obesity will be much harder.”

She also echoed concerns expressed by some supermarket chains that voluntary plans to reduce sugar amounts in food would fail. “If you make it mandatory then, in a competitive sense, everyone knows where they stand. If it’s voluntary then the companies who do something will feel, ‘well the other guys aren’t doing it’. It needs to be a level playing field. We’ve got to do what we did with salt. The evidence is clear: most kids who are overweight or obese get their calories from sugar-sweetened beverages.”

Nearly 10% of all four- to five-year-olds and almost 20% of 10- to 11-year-olds are obese ,according to official figures. Obesity-related health issues now cost the NHS almost £5bn a year. The RSPH reports that half of all adults are predicted to be obese by 2050, more than doubling NHS costs to £10bn a year and with wider economic costs to the nation of almost £50bn.

“If we can reduce the number of children who are obese and therefore the number of adults who are obese we will not only be saving lives but saving the NHS money,” Cramer said.

Patient died throughout drug trial ‘because of numerous organ failure’

She was admitted to Royal Shrewsbury Hospital with a chest infection and died of a number of organ failure on August 24 last year following establishing a variety of viral infections. Dr Atheer al-Ansari, a advisor rheumatologist at the Orthopaedic Hospital in Gobowen, Shropshire, who cared for her throughout the trial, mentioned he was “shocked” by her issue and had never observed a patient with 3 such significant infections ahead of.

Mrs Owen, of Coed Y Go, Oswestry, suffered from rheumatoid arthritis and had been taking part in a clinical examine of a new drug, MK8457, to see if it could ease her symptoms.

He assured the hearing that he had created it clear from the commence that she ought to end taking the medication if she suffered any unwell effects.

Nonetheless, Heidi Knight, on behalf of Mrs Owen’s family, claimed that on the weekend she became sick, Dr Ansari informed her to keep taking the pills. He replied: “I spoke to Mrs Owen 3 instances that weekend and repeated that she ought to end the medication.”

He also sent a letter to her GP giving the very same advice.

Mrs Owen was the only Briton out of 60 patients in the globally study, run by a overall health care business referred to as MSD. In accordance to Dr Ansari, none of the other patients had suffered from severe infection.

Dr Catherine Whittall, analysis programme manager at the Orthopaedic Hospital, confirmed Mrs Owen totally understood the hazards and was content to get part. “Mrs Owen in no way expressed any concern about being on the trial and Dr Ansari often stored her up to date with the hazards and positive aspects,” she said.

The inquest heard Dr Ansari had ordered the review to be discontinued and the hospital had considering that carried out its personal inner assessment into the circumstances of Mrs Owen’s death.

John Ellery, the Shropshire coroner, ruled Mrs Owen had died from multi-organ failure due in component to rheumatoid arthritis and its treatment method.