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Training could save lives of 1,200 learning disabled people – study

Mencap says lack of knowledge may be contributing to avoidable deaths in England each year

Richard Handley, who had Down’s syndrome and died from constipation


A coroner condemned the ‘gross failures’ in the care of Richard Handley, who had Down’s syndrome and died from constipation. Photograph: Handout

A lack of training for health professionals could be contributing to 1,200 avoidable deaths of people with a learning disability in England each year, research has found.

A poll of 506 healthcare professionals for Mencap found 23% had never received training on meeting the needs of patients with a learning disability and 45% thought the lack of training may contribute to avoidable deaths.

The findings were published on Thursday, a week after a coroner condemned “gross failures” in the care of Richard Handley, who had Down’s syndrome and died from constipation.

To prevent such deaths, Mencap, backed by the Royal College of Nursing (RCN), is calling on NHS England and the government to ensure that no health professional can set foot in a hospital without receiving training on learning disability.

The charity’s chief executive, Jan Tregelles, said: “We all need to act to fix this. NHS England has made real efforts to improve care for people with a learning disability but this scandal has been well known over a decade, and families still contact us who believe their loved ones should not have died whilst in hospital care … No family should be left wondering whether or not their loved one could have been saved.”

Research published in 2013 found there were more than three deaths of people with a learning disability every day which could have been prevented by better medical care. Another study, published the same year, found 38% of people with a learning disability died from avoidable causes, compared with 9% of the general population. Despite those figures, Mencap says not enough has been done to address the issue.

To coincide with the launch of its Treat Me Well campaign, Mencap also submitted a number of freedom of information requests to hospitals and English universities on the training they provide.

The responses revealed that 47% of hospitals do not include information on learning disability in their induction training for clinical staff, and 22% of universities were found not to include training on making reasonable adjustments to the care of someone with a learning disability in their undergraduate medicine degree. Making such adjustments is a legal obligation under the Equality Act 2010.

Janet Davies, the RCN chief executive and general secretary, said: “Nursing staff want to be able to deliver the best possible care to every patient, but they need the right education to be able to do that.

“Providers and commissioners of healthcare must offer every member of the nursing team training in how best to meet the needs of people with learning disabilities, and universities must meet their legal obligation to train student nurses in how to provide information for patients with learning disabilities in a way they can understand.”

A Department of Health and Social Care spokesperson said: “Across the NHS health checks, accessible information and staff training are all being put into place to ensure people with learning disabilities are not disadvantaged.”

Training could save lives of 1,200 learning disabled people – study

Mencap says lack of knowledge may be contributing to avoidable deaths in England each year

Richard Handley, who had Down’s syndrome and died from constipation


A coroner condemned the ‘gross failures’ in the care of Richard Handley, who had Down’s syndrome and died from constipation. Photograph: Handout

A lack of training for health professionals could be contributing to 1,200 avoidable deaths of people with a learning disability in England each year, research has found.

A poll of 506 healthcare professionals for Mencap found 23% had never received training on meeting the needs of patients with a learning disability and 45% thought the lack of training may contribute to avoidable deaths.

The findings were published on Thursday, a week after a coroner condemned “gross failures” in the care of Richard Handley, who had Down’s syndrome and died from constipation.

To prevent such deaths, Mencap, backed by the Royal College of Nursing (RCN), is calling on NHS England and the government to ensure that no health professional can set foot in a hospital without receiving training on learning disability.

The charity’s chief executive, Jan Tregelles, said: “We all need to act to fix this. NHS England has made real efforts to improve care for people with a learning disability but this scandal has been well known over a decade, and families still contact us who believe their loved ones should not have died whilst in hospital care … No family should be left wondering whether or not their loved one could have been saved.”

Research published in 2013 found there were more than three deaths of people with a learning disability every day which could have been prevented by better medical care. Another study, published the same year, found 38% of people with a learning disability died from avoidable causes, compared with 9% of the general population. Despite those figures, Mencap says not enough has been done to address the issue.

To coincide with the launch of its Treat Me Well campaign, Mencap also submitted a number of freedom of information requests to hospitals and English universities on the training they provide.

The responses revealed that 47% of hospitals do not include information on learning disability in their induction training for clinical staff, and 22% of universities were found not to include training on making reasonable adjustments to the care of someone with a learning disability in their undergraduate medicine degree. Making such adjustments is a legal obligation under the Equality Act 2010.

Janet Davies, the RCN chief executive and general secretary, said: “Nursing staff want to be able to deliver the best possible care to every patient, but they need the right education to be able to do that.

“Providers and commissioners of healthcare must offer every member of the nursing team training in how best to meet the needs of people with learning disabilities, and universities must meet their legal obligation to train student nurses in how to provide information for patients with learning disabilities in a way they can understand.”

A Department of Health and Social Care spokesperson said: “Across the NHS health checks, accessible information and staff training are all being put into place to ensure people with learning disabilities are not disadvantaged.”

Training could save lives of 1,200 learning disabled people – study

Mencap says lack of knowledge may be contributing to avoidable deaths in England each year

Richard Handley, who had Down’s syndrome and died from constipation


A coroner condemned the ‘gross failures’ in the care of Richard Handley, who had Down’s syndrome and died from constipation. Photograph: Handout

A lack of training for health professionals could be contributing to 1,200 avoidable deaths of people with a learning disability in England each year, research has found.

A poll of 506 healthcare professionals for Mencap found 23% had never received training on meeting the needs of patients with a learning disability and 45% thought the lack of training may contribute to avoidable deaths.

The findings were published on Thursday, a week after a coroner condemned “gross failures” in the care of Richard Handley, who had Down’s syndrome and died from constipation.

To prevent such deaths, Mencap, backed by the Royal College of Nursing (RCN), is calling on NHS England and the government to ensure that no health professional can set foot in a hospital without receiving training on learning disability.

The charity’s chief executive, Jan Tregelles, said: “We all need to act to fix this. NHS England has made real efforts to improve care for people with a learning disability but this scandal has been well known over a decade, and families still contact us who believe their loved ones should not have died whilst in hospital care … No family should be left wondering whether or not their loved one could have been saved.”

Research published in 2013 found there were more than three deaths of people with a learning disability every day which could have been prevented by better medical care. Another study, published the same year, found 38% of people with a learning disability died from avoidable causes, compared with 9% of the general population. Despite those figures, Mencap says not enough has been done to address the issue.

To coincide with the launch of its Treat Me Well campaign, Mencap also submitted a number of freedom of information requests to hospitals and English universities on the training they provide.

The responses revealed that 47% of hospitals do not include information on learning disability in their induction training for clinical staff, and 22% of universities were found not to include training on making reasonable adjustments to the care of someone with a learning disability in their undergraduate medicine degree. Making such adjustments is a legal obligation under the Equality Act 2010.

Janet Davies, the RCN chief executive and general secretary, said: “Nursing staff want to be able to deliver the best possible care to every patient, but they need the right education to be able to do that.

“Providers and commissioners of healthcare must offer every member of the nursing team training in how best to meet the needs of people with learning disabilities, and universities must meet their legal obligation to train student nurses in how to provide information for patients with learning disabilities in a way they can understand.”

A Department of Health and Social Care spokesperson said: “Across the NHS health checks, accessible information and staff training are all being put into place to ensure people with learning disabilities are not disadvantaged.”

Training could save lives of 1,200 learning disabled people – study

Mencap says lack of knowledge may be contributing to avoidable deaths in England each year

Richard Handley, who had Down’s syndrome and died from constipation


A coroner condemned the ‘gross failures’ in the care of Richard Handley, who had Down’s syndrome and died from constipation. Photograph: Handout

A lack of training for health professionals could be contributing to 1,200 avoidable deaths of people with a learning disability in England each year, research has found.

A poll of 506 healthcare professionals for Mencap found 23% had never received training on meeting the needs of patients with a learning disability and 45% thought the lack of training may contribute to avoidable deaths.

The findings were published on Thursday, a week after a coroner condemned “gross failures” in the care of Richard Handley, who had Down’s syndrome and died from constipation.

To prevent such deaths, Mencap, backed by the Royal College of Nursing (RCN), is calling on NHS England and the government to ensure that no health professional can set foot in a hospital without receiving training on learning disability.

The charity’s chief executive, Jan Tregelles, said: “We all need to act to fix this. NHS England has made real efforts to improve care for people with a learning disability but this scandal has been well known over a decade, and families still contact us who believe their loved ones should not have died whilst in hospital care … No family should be left wondering whether or not their loved one could have been saved.”

Research published in 2013 found there were more than three deaths of people with a learning disability every day which could have been prevented by better medical care. Another study, published the same year, found 38% of people with a learning disability died from avoidable causes, compared with 9% of the general population. Despite those figures, Mencap says not enough has been done to address the issue.

To coincide with the launch of its Treat Me Well campaign, Mencap also submitted a number of freedom of information requests to hospitals and English universities on the training they provide.

The responses revealed that 47% of hospitals do not include information on learning disability in their induction training for clinical staff, and 22% of universities were found not to include training on making reasonable adjustments to the care of someone with a learning disability in their undergraduate medicine degree. Making such adjustments is a legal obligation under the Equality Act 2010.

Janet Davies, the RCN chief executive and general secretary, said: “Nursing staff want to be able to deliver the best possible care to every patient, but they need the right education to be able to do that.

“Providers and commissioners of healthcare must offer every member of the nursing team training in how best to meet the needs of people with learning disabilities, and universities must meet their legal obligation to train student nurses in how to provide information for patients with learning disabilities in a way they can understand.”

A Department of Health and Social Care spokesperson said: “Across the NHS health checks, accessible information and staff training are all being put into place to ensure people with learning disabilities are not disadvantaged.”

Training could save lives of 1,200 learning disabled people – study

Mencap says lack of knowledge may be contributing to avoidable deaths in England each year

Richard Handley, who had Down’s syndrome and died from constipation


A coroner condemned the ‘gross failures’ in the care of Richard Handley, who had Down’s syndrome and died from constipation. Photograph: Handout

A lack of training for health professionals could be contributing to 1,200 avoidable deaths of people with a learning disability in England each year, research has found.

A poll of 506 healthcare professionals for Mencap found 23% had never received training on meeting the needs of patients with a learning disability and 45% thought the lack of training may contribute to avoidable deaths.

The findings were published on Thursday, a week after a coroner condemned “gross failures” in the care of Richard Handley, who had Down’s syndrome and died from constipation.

To prevent such deaths, Mencap, backed by the Royal College of Nursing (RCN), is calling on NHS England and the government to ensure that no health professional can set foot in a hospital without receiving training on learning disability.

The charity’s chief executive, Jan Tregelles, said: “We all need to act to fix this. NHS England has made real efforts to improve care for people with a learning disability but this scandal has been well known over a decade, and families still contact us who believe their loved ones should not have died whilst in hospital care … No family should be left wondering whether or not their loved one could have been saved.”

Research published in 2013 found there were more than three deaths of people with a learning disability every day which could have been prevented by better medical care. Another study, published the same year, found 38% of people with a learning disability died from avoidable causes, compared with 9% of the general population. Despite those figures, Mencap says not enough has been done to address the issue.

To coincide with the launch of its Treat Me Well campaign, Mencap also submitted a number of freedom of information requests to hospitals and English universities on the training they provide.

The responses revealed that 47% of hospitals do not include information on learning disability in their induction training for clinical staff, and 22% of universities were found not to include training on making reasonable adjustments to the care of someone with a learning disability in their undergraduate medicine degree. Making such adjustments is a legal obligation under the Equality Act 2010.

Janet Davies, the RCN chief executive and general secretary, said: “Nursing staff want to be able to deliver the best possible care to every patient, but they need the right education to be able to do that.

“Providers and commissioners of healthcare must offer every member of the nursing team training in how best to meet the needs of people with learning disabilities, and universities must meet their legal obligation to train student nurses in how to provide information for patients with learning disabilities in a way they can understand.”

A Department of Health and Social Care spokesperson said: “Across the NHS health checks, accessible information and staff training are all being put into place to ensure people with learning disabilities are not disadvantaged.”

Training could save lives of 1,200 learning disabled people – study

Mencap says lack of knowledge may be contributing to avoidable deaths in England each year

Richard Handley, who had Down’s syndrome and died from constipation


A coroner condemned the ‘gross failures’ in the care of Richard Handley, who had Down’s syndrome and died from constipation. Photograph: Handout

A lack of training for health professionals could be contributing to 1,200 avoidable deaths of people with a learning disability in England each year, research has found.

A poll of 506 healthcare professionals for Mencap found 23% had never received training on meeting the needs of patients with a learning disability and 45% thought the lack of training may contribute to avoidable deaths.

The findings were published on Thursday, a week after a coroner condemned “gross failures” in the care of Richard Handley, who had Down’s syndrome and died from constipation.

To prevent such deaths, Mencap, backed by the Royal College of Nursing (RCN), is calling on NHS England and the government to ensure that no health professional can set foot in a hospital without receiving training on learning disability.

The charity’s chief executive, Jan Tregelles, said: “We all need to act to fix this. NHS England has made real efforts to improve care for people with a learning disability but this scandal has been well known over a decade, and families still contact us who believe their loved ones should not have died whilst in hospital care … No family should be left wondering whether or not their loved one could have been saved.”

Research published in 2013 found there were more than three deaths of people with a learning disability every day which could have been prevented by better medical care. Another study, published the same year, found 38% of people with a learning disability died from avoidable causes, compared with 9% of the general population. Despite those figures, Mencap says not enough has been done to address the issue.

To coincide with the launch of its Treat Me Well campaign, Mencap also submitted a number of freedom of information requests to hospitals and English universities on the training they provide.

The responses revealed that 47% of hospitals do not include information on learning disability in their induction training for clinical staff, and 22% of universities were found not to include training on making reasonable adjustments to the care of someone with a learning disability in their undergraduate medicine degree. Making such adjustments is a legal obligation under the Equality Act 2010.

Janet Davies, the RCN chief executive and general secretary, said: “Nursing staff want to be able to deliver the best possible care to every patient, but they need the right education to be able to do that.

“Providers and commissioners of healthcare must offer every member of the nursing team training in how best to meet the needs of people with learning disabilities, and universities must meet their legal obligation to train student nurses in how to provide information for patients with learning disabilities in a way they can understand.”

A Department of Health and Social Care spokesperson said: “Across the NHS health checks, accessible information and staff training are all being put into place to ensure people with learning disabilities are not disadvantaged.”

Ultra-processed foods may be linked to cancer, says study

Findings suggest increased consumption of ultra-processed foods tied to rise in cancers, but scientists say more research is needed

Ultra-processed foods can include noodles, ready meals, cakes and confectionery which contain additives, preservatives, flavourings and colourings – and often high levels of sugar, fat and salt.


Ultra-processed foods can include noodles, ready meals, cakes and confectionery which contain additives, preservatives, flavourings and colourings – and often high levels of sugar, fat and salt. Photograph: Premier Foods/PA

“Ultra-processed” foods, made in factories with ingredients unknown to the domestic kitchen, may be linked to cancer, according to a large and groundbreaking study.

Ultra-processed foods include pot noodles, shelf-stable ready meals, cakes and confectionery which contain long lists of additives, preservatives, flavourings and colourings – as well as often high levels of sugar, fat and salt. They now account for half of all the food bought by families eating at home in the UK, as the Guardian recently revealed.

A team, led by researchers based at the Sorbonne in Paris, looked at the medical records and eating habits of nearly 105,000 adults who are part of the French NutriNet-Santé cohort study, registering their usual intake of 3,300 different food items.

They found that a 10% increase in the amount of ultra-processed foods in the diet was linked to a 12% increase in cancers of some kind. The researchers also looked to see whether there were increases in specific types of cancer and found a rise of 11% in breast cancer, although no significant upturn in colorectal or prostate cancer.

“If confirmed in other populations and settings, these results suggest that the rapidly increasing consumption of ultra-processed foods may drive an increasing burden of cancer in the next decades,” says the paper in the British Medical Journal.

France is one of the few countries that already specifically warns its people against high levels of ultra-processed foods in the diet on “the precautionary principle”, said Mathilde Touvier, lead author of the study. The foods have already been linked to obesity, but the association with cancer is new.

“The results are very strong – very consistent and quite compelling,” she said. “But we have to be cautious. It is the first study. We should not be alarmist. These results need to be confirmed in other prospective studies.”

Ultra-processed food is a definition created by a group of scientists led by Prof Carlos Monteiro in Brazil, a country which also has national dietary guidelines urging they be eaten as little as possible. The classification system, called Nova, puts foods into four groups – raw or minimally processed foods including seeds, fruit, eggs and milk; processed culinary ingredients such as oils and butter; processed foods including bottled vegetables and canned fish and cheeses; and ultra-processed, which are “formulations made mostly or entirely from substances derived from foods and additives”.

Critics of ultra-processed foods say the processing strips out most of the nutrients, but Touvier says they do not believe the low nutritional value of biscuits and sweets and cakes are the cause of the raised cancer risk they saw. “We did a statistical analysis to try to see if the whole association was only due to poor nutritional quality,” she said. “But the results do not depend on that.”

She said they needed to do more research to figure out whether any rise in cancer is down to the high load of sugar, fat and salt or possibly the additives. “We need to understand the mechanism,” she said. “Maybe in the future we will have an idea whether one or two molecules are the problem and not all the ultra-processed foods.”

Her team now have a massive database of all the additives in specific foods, by commercial names and brands. Over the years to come, she said, “we will be able to quantify the chronic exposure [of people] to the food additives”. They will be able to study their effects alone and in combination with other additives, she believes, to find out whether there is “a cocktail effect”.

Other scientists questioned whether it was practical to group foods as ultra-processed. “The term ultra-processed food is difficult to define in terms of food quality, and is not widely used by nutritional scientists,” said Tom Sanders, professor emeritus of nutrition and dietetics at King’s College London. “From a nutritional standpoint, this classification seems arbitrary and based on the premise that food produced industrially has a different nutritional and chemical composition from that produced in the home or by artisans. This is not the case.

“The approach of categorising dietary patterns that depend on industrially processed food in relation to disease risk is novel but probably needs refining before it can be translated into practical dietary advice.”

A spokesman for the Food and Drink Federation said they were proud of the industry’s track record on reformulation “but recognise that obesity and diet-related diseases are a complex and serious issue and more needs to be done. We believe a whole diet and lifestyle approach, which includes consideration of net calorie intake, and not just the role of individual nutrients or ingredients, is the correct way to tackle such issues.

“Processed food should not be demonised – by working closely with our partners throughout the food supply chain, we can use processing positively to ensure all sectors of society have access to safe, affordable food.”

Tam Fry, spokesman for the National Obesity Forum, said: “A lot of research has limitations and the scientists here are honest enough to acknowledge that theirs needs more work to be conclusive. But there is no smoke without fire: we should heed their fears – and read food labels more carefully. Huge quantities of everyday processed food have excessive levels of sugar, fat and salt stuffed in them and it’s all listed on the packaging.”

Schools are not the answer to childhood obesity epidemic, study shows

Researchers say much wider action is needed after a major programme in primary schools in the West Midlands was shown to have made no difference to obesity levels

Children at more than 50 primary schools in the West Midlands were given a year of extra physical activity sessions and a healthy eating programme.


Children at more than 50 primary schools in the West Midlands were given a year of extra physical activity sessions and a healthy eating programme. Photograph: Alamy Stock Photo

Childhood obesity programmes in schools are not the answer to the epidemic affecting the UK, according to researchers who say much wider local and national action is needed, including curbs on the advertising of junk food.

A major obesity programme introduced into more than 50 primary schools in the West Midlands has failed to have any significant effect on children’s weight. Children were given a year of extra physical activity sessions, a healthy eating programme and cookery workshops with their parents. Families were invited to activity events, including sessions run by Aston Villa football club.

But at the end of 30 months, there was no difference in obesity between those children who took part and those who did not.

The government’s childhood obesity plan, launched from Downing Street in January last year, placed great emphasis on increasing sport and other activity in schools. A number of school-based obesity programmes have been introduced around the country, focusing on increasing physical activity and improving children’s diet in school.

But, says the team from the University of Birmingham’s Institute of Applied Health Research, the negative results from their large study published in the British Medical Journal are in line with what has been found elsewhere; schools may have a role to play but can only be part of the answer to the obesity problem.

“We need to look at ways that we can really engage communities in this agenda, change our local environment and look at how national policies can support diet and physical activity,” said Miranda Pallan, one of the team.

Children, she said “are at the centre of lots of layers of influence”. For primary school children, parents and the wider family are key. “They function within their family. Decisions on what to eat and what they do are determined by their family.”

Adults, who may themselves be obese, are influenced by many different things. Local initiatives in communities can help but national policies on food and the environment are also vital.

The government is tackling sugar levels in soft drinks and foods. “There are some good things in the government’s plan but we would argue that there need to be further measures and there are things like advertising restrictions that would be very good to see,” Pallan said.

“If anything what our research highlights is that although schools are vitally important, they can’t do it alone. We need many, many approaches. Each of those will make a marginal difference. We need to look at the whole picture of the causes and tackle each of those areas.”

The institute created and introduced an ambitious programme called West Midlands ActiVe lifestyle and healthy Eating in School children, dubbed Waves. The programme included extra daily physical activity in schools, a physical activity and healthy eating programme in conjunction with local sporting heroes, regular information to parents about local physical activity opportunities, and workshops on healthy cooking for families at schools.

About 1,400 children aged six and seven took part in the trial. At the start of the trial, height and weight was recorded for each of them, along with other measurements relating to body fat, diet and physical activity levels.

The researchers found no significant difference in weight status and no meaningful effect on body fat measurements, diet or physical activity levels at 15 and 30 months in children taking part in the programme, compared with those not taking part.

They suggest that “nudge” interventions, such as using financial incentives to prompt healthier behaviour, merit further investigation. But they conclude that school based motivational, educational approaches “are unlikely to halt the childhood obesity epidemic.”

Prof Melissa Wake, paediatrician and obesity expert from Victoria, Australia, says in a linked editorial that it is time to step back and take stock. The important findings of the trial “could perhaps help break the cycle of policymakers continuing with ineffective educational preventive approaches that can never hope to greatly impact on the obesity epidemic.”

Premature babies healthier when parents help with hospital care, study shows

Babies in trial put on more weight in first three weeks and parents were less stressed

Premature baby hand


The study was inspired by the example of a hospital in Estonia. Photograph: Jennifer Polixenni Brankin/Getty Images

Premature babies do better if their parents are allowed to help care for them in hospital alongside the nurses, rather than being treated as visitors and left on the sidelines, a new study shows.

Many parents feel acutely anxious, stressed and out of control when their child is in a newborn intensive care unit and there seems to be nothing they can do for her. Inspired by the example of a hospital in Estonia that brings in parents to help with basic care of their baby, doctors in Canada organised a major study in three countries – Canada, Australia and New Zealand – to see what the effect is on the baby.

In their paper in the Lancet Child and Adolescent Health journal, they say that feeling excluded in the premature baby unit could have long-term consequences for the parents. “These feelings of helplessness, anxiety, depression, and fear might contribute to their inability to assume normal parenting roles,” they write.

The study involved 26 hospitals and nearly 1,800 babies, half of whom had basic care from their parents alongside the nursing staff, while the other half did not. Parents had to commit to spending six hours a day, five days a week, in the unit and were trained to help. They bathed, fed and dressed their babies, changed nappies, gave oral medication and took temperatures. They were encouraged to take part in decisions about the baby’s treatment, join ward rounds and chart their infant’s growth and progress.

The babies on what was called FiCare – family integrated care – had put on more weight by 21 days, their parents were less stressed and once the baby went home, the mothers were more likely to breastfeed frequently than mothers who had been less involved in the hospital.

“How care is provided to the family, not just the infant, has a positive effect on the wellbeing of both infant and family,” says Dr Karel O’Brien, of the department of paediatrics, Sinai Health System, Toronto, Canada. “Weight gain, breastfeeding and reduced parental stress and anxiety are all associated with positive neurodevelopmental outcomes, suggesting that integrating parents into the care of infants at this early stage could potentially have longer-term benefits.”

India’s farmed chickens dosed with world’s strongest antibiotics, study finds

Warning over wider global health impacts after findings reveal thousands of tonnes of colostin – the ‘antibiotic of last resort’ – are being shipped to India’s farms

There is nothing to prevent Indian farmers, which include some of the world’s biggest food producers, from exporting their chickens and other related products overseas.


There is nothing to prevent Indian farmers, which include some of the world’s biggest food producers, from exporting their chickens and other related products overseas. Photograph: Dinodia Photos/Alamy

Chickens raised in India for food have been dosed with some of the strongest antibiotics known to medicine, in practices that could have repercussions throughout the world.

Thousands of tonnes of an “antibiotic of last resort” – only used in the most extreme cases of sickness – are shipped to India each year to be used, without medical supervision, on animals that may not require the drugs but are being dosed with them nevertheless to promote the growth of healthy animals.

Routine use of some of the strongest antibiotics, which doctors have said should be preserved for the most extreme cases lest resistance to them should increase and prevent their use for the diseases for which they are intended, is now a common practice in farming in the developing world. The consequences will be felt throughout the world because resistance to strong antibiotics is spread among organisms.

Germs with qualities that can make them dangerous to humans will, if untreated or poorly treated, mutate into more powerful pathogens that are resistant to treatment. Poor or inadequate public heath treatments assists this process, potentially spreading pathogens around the world.

A study by the Bureau of Investigative Journalism has found that thousands of tonnes of colistin, described as an antibiotic of last resort, have been shipped to India for the routine treatment of animals, chiefly chickens, on farms.

The finding is concerning because the use of such powerful drugs can lead to an increasing resistance among farm animals around the world. Colistin is regarded as one of the last lines of defence against serious diseases, including pneumonia, which cannot be treated by other medicines. Without these drugs, diseases that were commonly treatable in the last century will become deadly once again.

There is nothing to prevent Indian farmers, which include some of the world’s biggest food producers, from exporting their chickens and other related products overseas. There are currently no regulations that would prevent such export to the UK on hygiene terms, except for those agreed under the EU. Any regulations to be negotiated after Brexit might not take account of these regulations.