Nine local authorities rated as "poor"

Children's services in nine local authorities have been rated as 'poor' in a report released by Ofsted.

Authorities singled out for criticism were Birmingham, Cornwall, Doncaster, Essex, Haringey, Leeds, Rotherham, Warrington and Wokingham. All received the lowest rating possible.

Out of the 152 English authorities assessed, ten received an 'excellent' rating for children's services, while 94 were judged 'good' and 40 'adequate'.

Authorities that received an 'excellent' rating were Blackburn with Darwen, Camden, City of London, Kensington and Chelsea, Kingston-upon-Thames, Lewisham, Richmond-upon-Thames, Tower Hamlets, Wandsworth, and York.

In the worst performing authorities, Ofsted's identified 'serious weaknesses in aspects of social care provision for children and young people' as well as 'insufficient numbers of permanent and experienced social workers'.

Haringey council, the subject of severe criticism in the wake of Baby Peter's death in 2007, had 'significant weaknesses in areas of social care provision' and 'safeguarding [was judged] to be inadequate', the report said.

The number of under-performing children's services has increased from the eight identified last year.

A press release from Ofsted said: 'These results show that the majority of councils are doing a good job and the vast majority are at least satisfactory...The small number of poorly performing authorities must renew their determination to improve, in the knowledge that it is both possible and necessary.'

In response to the report, Haringey council leader councillor Claire Kober said: 'We continue to work very hard to address the fundamental problems in our child protection services.

'Major changes have already been made and officers and councillors are committed to doing all we can to make Haringey's child protection the best there is.'

Coffee link to prostate cancer risk reduction

Scientists have said there is a link to coffee consumption and a reduced risk of advanced prostate cancer.

While it is too early for doctors to start advising their male patients to take up the habit of regular coffee drinking, data presented at the American Association for Cancer Research Frontiers in Cancer Prevention Research Conference revealed a strong inverse association between coffee consumption and the risk of lethal and advanced prostate cancers.

In the study led by Kathryn Wilson, a postdoctoral fellow at the Channing Laboratory, Harvard Medical School and the Harvard School of Public Health, researchers found men who drank the most coffee had a 60 per cent lower risk of aggressive cancer than men who did not drink any coffee.

'Coffee has effects on insulin and glucose metabolism as well as sex hormone levels, all of which play a role in prostate cancer. It was plausible that there may be an association between coffee and prostate cancer,' said Ms Wilson.

This is the first study of its kind to look at both overall risk of prostate cancer and risk of localized, advanced and lethal disease.

'Few studies have looked prospectively at this association, and none have looked at coffee and specific prostate cancer outcomes,' said Ms Wilson.

'We specifically looked at different types of prostate cancer, such as advanced versus localized cancers or high-grade versus low-grade cancers.'

However, caffeine is actually not the key factor in this association, Ms Wilson added. The researchers are unsure which components of the beverage are most important, as coffee contains many biologically active compounds like antioxidants and minerals.

'Very few lifestyle factors have been consistently associated with prostate cancer risk, especially with risk of aggressive disease, so it would be very exciting if this association is confirmed in other studies,' said Ms Wilson.

'Our results do suggest there is no reason to stop drinking coffee out of any concern about prostate cancer.'

The researchers hope this association might also help understand the biology of prostate cancer and possible chemoprevention measures.

Greater support for mental health sufferers

The government has revealed a ten-year plan to provide better support for people suffering from mental illness.

The strategy, entitled New Horizons: A Shared Vision for Mental Health, sets out ways to increase job opportunities for victims of mental health.

Work and pensions secretary Yvette Cooper said: 'The vast majority of people with mental health conditions work, but for some people it can be very hard to stay in a job.

'We know that work is good for people and that's why we want to give everyone the support they need to stay in a job, or get back to work.'

This support includes a work programme to aid those suffering from mental health to get into work and retain their jobs.

Nine advice lines linking employers to occupational health professionals, and plans to recruit mental health coordinators in Jobcentre Plus districts also aim to improve the chances of mental health sufferers gaining employment.

Health secretary Andy Burnham added that the new measures tackle depression, which is often 'simply forgotten' by society.

Meanwhile, Dr Rachel Perkins, who has supported the government by leading a review into how unemployed people with mental health problems should be supported, agreed sufferers were 'excluded within our society'.

Mental health charity Mind's chief executive Paul Farmer praised the government's plans but admitted concerns over 'how the vision will become a reality'.

Mental illness is the reason cited most regularly for claiming health-related benefits with one in six people being sufferers.

The government currently allocates 13 per cent of its NHS budget to mental health. £35 billion is spent on mental illness every year.

15 swine flu-related deaths in last week

There have been a further 15 swine flu-related deaths in the last week, although 'flu activity' seems to be decreasing, officials figures have shown.

Deaths in individuals with swine flu rose to 178, although the chief medical officer said it was important to remember the figure represents the number of deaths in individuals with swine flu but does not represent the number of deaths that can be directly attributed to the H1N1 virus.

There was an estimated 22,000 new cases in England over the last week, which represents a significant decrease from the week before, during which time there were 46,000 cases of the H1N1 virus diagnosed, down from 53,000 the week before that.

The Health Protection Agency (HPA) estimates a cumulative total number of cases of 790,000 since the pandemic began.

The HPA added that the disease severity continues to be monitored, but was generally mild in most people so far, proving severe in a small minority of cases.

Swine flu hospitalisations in England stood at 747 patients as of 08:00 GMT on December 2nd.

Facebook flirts propositioning doctors

Facebook is being used by patients to send flirty messages to their doctors, the Medical Defence Union (MDU) has said today.

The MDU is warning medics not to respond to the 'amorous approaches' of their patients, saying it would be 'wholly inappropriate' to do so.

The medical organisation said they were aware of a number of cases where patients had propositioned doctors, by sending them an unsolicited message on Facebook, or other social networking sites.

The MDU advises that responding to patients in this way may be seen as overstepping the professional boundary of the doctor/patient relationship.

Dr Emma Cuzner, MDU medico-legal adviser, whose article on the hidden dangers of social networking appears in the latest edition of the MDU Journal, said: 'The pitfalls posed to doctors using social networking sites by inadvertently breaching confidentiality or posting unprofessional content, such as photos, have been well documented. But doctors may be less prepared for patients using sites like Facebook to ask them out on a date.

'Some doctors have told the MDU they feel it would be rude not to reply, if only to politely refuse, but given that this is not a professional route of communication, any correspondence of this sort would clearly stray outside the doctor/patient relationship.'

In one case highlighted in the MDU Journal, a female GP was asked out for a drink by a patient as she left her surgery. When she declined, the patient started pestering the doctor via Facebook and sent her a bunch of her favourite flowers, lilies, which he had ascertained from her freely available Facebook page. The MDU said they helped the GP nip the patient's advances in the bud, and also suggested she considered employing some of the security and privacy settings on the site.

In a separate study in the journal, Karen Roberts, MDU clinical risk manager, reviews claims and complaints about women's health made against GPs.

During the five-year period of the study, there were 48 complaints about the use, or more usually the absence, of a chaperone for an intimate examination. The majority of complainants alleged an inappropriate examination had taken place or that no chaperone was offered, although six patients complained about the presence of a chaperone or that the doctor would not perform the examination without one.

The MDU advises doctors that, as well as offering a chaperone for intimate examinations (of the breast, genital or rectum), communication is often the key to avoiding such complaints.

Dr Cuzner added: 'We are advising our members about the importance of keeping relationships with patients on a professional footing. This is in line with doctors' ethical duties not to pursue improper relationships with patients. Doctors could face a GMC investigation if they are accused of overstepping the boundary.

'They have a duty to maintain the public trust in the profession at all times, in their professional and private lives and not only when at their place of work.'

Preterm births higher among poor mothers

A study published today by the British Medical Journal shows that women from poorer areas are nearly twice as likely to give birth to a pre-term baby as mothers from affluent areas.

The researchers, from the University of Leicester, followed the progress of almost 7,500 pre-term infants born between 1998 and 2007. All the babies were given a 'deprivation' level based on their mothers' postcodes. The study found nearly two times the number of deaths due to pre-term birth in the most deprived areas compared to the least deprived.

A 'pre-term' infant is one with a gestational age of less than 37 weeks. A 2006 BMJ study found that the number of babies not carried to term was increasing in England and Wales, and that these infants accounted for most newborn intensive care admissions – and three-quarters of newborn deaths.

Despite this geographical disparity at birth, the University of Leicester study found that neonatal care was of a similar quality, regardless of postcode. This is in contrast to many other health indicators, which suggest a substantial variation in healthcare quality across the country.

However, the larger applicability of the findings is questionable. The study's data was gathered from babies in one English region only, and therefore only accounted for one-twelfth of UK births.

The study calls for further research to be conducted into the link between deprivation and pre-term births. If the reasons behind the relationship can be established, then action could be taken that might have a substantial impact on the country's pre-term birth rate.

The researchers conclude that this action could significantly lower healthcare costs – both of immediate neonatal care, as well as those relating to the 'long term health problems suffered by some of these babies'.

Cancer charities slam survival rates

Cancer Research UK has branded cancer survival rates 'shocking', after new figures released today placed England well below the European average.

Professor Mike Richards blamed a failure to catch cancer early, telling the BBC's Today programme that 'raising awareness and promoting early diagnosis are essential if we are to bring cancer survival rates up to the level of the best of Europe'.

While the NHS currently uses statistics based on five-year survival rates, Professor Richards called for greater attention to be paid on those over one year. These figures provide a greater indication of whether patients' cancer is being noticed at a time when it can be treated. Early diagnosis clearly plays a role in five-year rates, but here access to drugs and treatment can have more of an influence on a patient's survival.

It is the first time local survival rates from cancer have ever been disclosed, and they show great disparity across English Primary Care Trusts. Lung cancer had the most variable survival rates of the so-called 'big four'. In Kensington and Chelsea, the survival rate was the best in England, with 44 per cent of patients surviving within a year of diagnosis. In Herefordshire, in contrast, the rate was only 15 per cent.

Cancer Research said these figures emphasised that 'the cancer postcode lottery remains a real problem'.

Professor Richards called on GPs to 'play safe' with patients displaying cancer symptoms, but 'Dr Crippen', a columnist for The Guardian, insisted GPs were not to blame. He said that instead the figures could be explained by a 'lack of resources'.

The report is the second to be released following the announcement of the government's Cancer Reform Strategy in 2007. The news is not all depressing. The NHS is close to meeting a 2010 goal to increase five-year survival rates by a fifth on the mid-1990s.

However, it is clear that without further action the chances of survival of English cancer patients will remain far below those of fellow sufferers in continental Europe.

Governments failed to prevent Aids spread

Governments and health agencies failed to prevent the spread of Aids in Africa, scientists have said.

They claims a lack of political will led to missed chances to prevent the spread.

The claims made in the International Journal of STD and AIDS (IJSA) today accuse international agencies and governments of intentionally underestimating the blood-borne spread of HIV and instead focussing on its transmission via sex.

The special edition of the journal claims unsanitary procedures in healthcare, cosmetic care and ritual settings account for a substantial share of HIV transmission. It goes on to allege that bodies including the World Health Organisation and UNAID have underestimated this.

Wallace Dinsmore, a consultant genitourinary physician and IJSA editor-in-chief said, 'African governments, the WHO, Centres for Disease Control and the UNAIDS have prolonged the epidemic in Africa in a way that could at best be described as utter incompetence. At worst, it smacks of callous politicking.

'The science has been there all along but some people have chosen to ignore it because it just didn’t suit their ends.'

Skin punctuation is apparently a major cause behind the continued outbreak and is being over looked.

John Potterat, a leading epidemiologist who co-edited the issue, said: 'Many times in the last seven years researchers have presented evidence at odds with the consensus view that penile-vaginal intercourse is driving African HIV epidemics. Governments and international health agencies deliberately chose to ignore that evidence.

'By uncritically accepting the orthodox view that HIV is almost exclusively transmitted by sex, public health workers and researchers are complicit in prolonging avoidable suffering.'

Report slams 'official' NHS trust ratings

A damning report has found 12 hospital trusts are 'significantly underperforming' - despite nine of them being rated 'good' or 'excellent' by official regulator, the Care Quality Commission (CQC).

The report by the Dr Foster monitoring body also found 5,024 people with low-risk conditions died in hospital last year and at least 209 'foreign objects' were left behind in patients' bodies after surgery.

This has led to criticism about how hospital trusts are rated and highlights the need for rapid improvement of NHS services.

Roger Taylor, director and cofounder of Dr Foster, said: 'Over the last nine years of the hospital guide we have seen a steady improvement in hospital performance but unacceptable variation between hospitals still exists. Dr Foster will continue to publish data in order to provide information to the public, drive improvement in patient care and save lives.'

Despite the criticism, the report also points out a change of attitude and openness from NHS trusts which should be 'rewarded'.

Health minister Mike O'Brien insists 'there is still a lot of work to be done' and the NHS was a 'lot better than it had ever been'. He also defended the work of the CQC as more reliable and broader in scope than independent monitoring organisations.

A spokesman from the Department of Health told inthenews.co.uk: 'We have made real improvements in recent years and England is recognised as one of the world leaders in the international drive to improve the safety of healthcare.

'The vast majority of patients experience high quality, safe and effective care and the CQC's recent survey which showed that 93 per cent of patients rate their overall care as good or excellent,' he added.

Bottom of Dr Foster's league table was Basildon and Thurrock University Hospitals NHS Foundation Trust, which had an emergency task force ordered in to improve standards last week.

Twelve hospital trusts 'underperforming'

A report claims twelve NHS hospital trusts are 'significantly underperforming' despite eight of them being rated good or excellent by the official health regulator.

The Dr Foster report also identified 27 trusts which had unusually high mortality rates, totalling 5,000 more deaths than expected.

But the Care Quality Commission (CQC) which recently issued official ratings of NHS trusts, found eight of the dozen found by the Dr Foster report to be underperforming were either performing 'good' or 'excellently'.

The CQC said Dr Foster's report was part legitimate, part alarmist, and they did not feel action was required.

Roger Taylor, director and co-founder of Dr Foster said: 'Over the last nine years of the hospital guide we have seen a steady improvement in hospital performance but unacceptable variation between hospitals still exists. Dr Foster will continue to publish data in order to provide information to the public, drive improvement in patient care and save lives.

'Hospital trusts should use the guide to carefully investigate where problems exist, even those who have performed well. Patients and the public should use the hospital guide to help make choices about where they want to be treated, to ask the right questions of their health professionals and to hold hospitals to account.'

On Thursday, the CQC sent a task force into Basildon and Thurrock NHS Trust in Essex after it uncovered major lapses in hygiene and unusually high death rates. And 24-hours later, the chairman of Colchester Hospital University NHS Foundation Trust was sacked after inspectors found it had consistently failed to improve waiting times and had death rates 12 per cent higher than expected.

On Friday Cynthia Bower, CQC chief executive, said: 'Swift action is needed at Basildon to nip problems in the bud. We want to ensure the trust takes swift and positive action to prevent poor quality care. We believe that effective action will now take place as a result of this joint regulatory action.'

Overall the Dr Foster report found hospital death rates in England had fallen by seven per cent, but said the level of care varied greatly.

The Dr Foster guide also revealed that last year at least 209 foreign objects were left behind in patients after operations, with nine trusts recording six or more incidents and 82 incidents of 'wrong-site' surgery took place (operating on the wrong body part).

However, the report said whilst these incidents should never occur, the figures were evidence the NHS is developing a 'commendable culture of openness and reporting'.

Slight drop in new swine flu cases

There has been a slight fall in the number of new cases of swine flu in England during the last week, health officials have revealed.

Over the last seven days there were 46,000 cases of the H1N1 virus diagnosed, down from 53,000 the week before.

The number of people in hospital from the virus was also down from 783 to 783, with 154 in intensive care.

However the number of deaths linked to swine flu rose last week, with 28 in the UK as a whole, of which 21 were in England.

Commenting on the rise in deaths, the chief medical officer Sir Liam Donaldson admitted the number of cases 'at the severe end of the spectrum' was continuing to worry health officials.

He added though that the recently launched immunisation campaign had seen an estimated one million people in the 'high risk' groups receive the vaccine.

Obama says 'history calling' on healthcare

Barack Obama has urged the US Senate to reject Republican 'deception' and answer the 'call of history' to approve his landmark healthcare reform plans.

This weekend the House of Representatives voted through a bill to extend healthcare to 96 per cent of Americans; the largest such extension since the mid-1960s.

Speaker Nancy Pelosi, credited by fellow Democrats for driving through the legislation, managed 'oh, what a night' above cheers when the 220-215 victory was announced.

The bill now passes to the Senate, where if successful, a second vote will have to be held in both Houses of Congress to unify the pieces of legislation before it can be signed into law by Mr Obama.

President Obama, who has made healthcare reform his top domestic priority, has called on senators to reject the 'heated and often misleading rhetoric' surrounding the bill.

'Most public servants pass through their entire careers without a chance to make as important a difference in the lives of their constituents and the life of this country,' he said.

'This is their moment, this is our moment, to live up to the trust that the American people have placed in us - even when it's hard; especially when it's hard. This is our moment to deliver.

'I urge members of Congress to rise to this moment. Answer the call of history, and vote yes for health insurance reform for America.'

The president's ten-year $829 billion (£519 billion) plan will see more than 30 million Americans benefit with subsidised insurance and the outlawing of insurance companies denying coverage for pre-existing conditions.

But Republicans remain inflammatorily sceptical about government control of healthcare and plans that, some claim, would grant free insurance to illegal immigrants.

President Obama has already made one concession on abortion, with the bill passed by the House banning federal funding from any cases involving abortion services.

Obama says 'history calling' on healthcare

Barack Obama has urged the US Senate to reject Republican 'deception' and answer the 'call of history' to approve his landmark healthcare reform plans.

This weekend the House of Representatives voted through a bill to extend healthcare to 96 per cent of Americans; the largest such extension since the mid-1960s.

Speaker Nancy Pelosi, credited by fellow Democrats for driving through the legislation, managed 'oh, what a night' above cheers when the 220-215 victory was announced.

The bill now passes to the Senate, where if successful, a second vote will have to be held in both Houses of Congress to unify the pieces of legislation before it can be signed into law by Mr Obama.

President Obama, who has made healthcare reform his top domestic priority, has called on senators to reject the 'heated and often misleading rhetoric' surrounding the bill.

'Most public servants pass through their entire careers without a chance to make as important a difference in the lives of their constituents and the life of this country,' he said.

'This is their moment, this is our moment, to live up to the trust that the American people have placed in us - even when it's hard; especially when it's hard. This is our moment to deliver.

'I urge members of Congress to rise to this moment. Answer the call of history, and vote yes for health insurance reform for America.'

The president's ten-year $829 billion (£519 billion) plan will see more than 30 million Americans benefit with subsidised insurance and the outlawing of insurance companies denying coverage for pre-existing conditions.

But Republicans remain inflammatorily sceptical about government control of healthcare and plans that, some claim, would grant free insurance to illegal immigrants.

President Obama has already made one concession on abortion, with the bill passed by the House banning federal funding from any cases involving abortion services.

MPs: More must be done to stop superbugs

MPs have called for more to be done to tackle hospital infections, saying they are 'disappointed' the Department of Health has not taken on recommendations.

A report from the Commons committee of public accounts (PAC) today said infections such as MRSA were costing the NHS more than a £1 billion a year, and the DoH had 'taken its eye off the ball' regarding infections.

The British Medical Association (BMA) has backed the report, saying the government needs to take more decisive action to tackle infections and superbugs.

Edward Leigh, chairman of the PAC, today said: 'Healthcare associated infections cost the NHS more than £1 billion per year and can lead to serious disability and in some cases death. This is the third time that this committee has reported on the subject and it is disappointing that the department of health still has not taken on board a number of key recommendations.

'There has been progress. The department has achieved significant reductions in MRSA bloodstream and Clostridium difficile infections, for which it set national targets.

'But, in so doing, it has taken its eye off the ball regarding all other healthcare associated infections - which actually constitute most by far (four-fifths) of all infections.'

He added that the evidence available shows avoidable infections, such as surgical site infections, have actually increased.

'Progress in combating these other infections is being bedevilled by a lack of potentially life-saving information,' Mr Leigh added.

'The department is refusing to introduce mandatory surveillance of all hospital acquired infections - as we have recommended twice.

'If it had, it would now have a better grip on what is going on and be able to reduce the risks of patients getting these infections. And the NHS still has no idea how many patients are dying from the other healthcare associated infections.'

In England, some 300,000 patients a year acquire a healthcare associated infection whilst in hospital. For some they can be fatal, and in 2007, there were 9,000 deaths recorded with Meticillin resistant Staphylococcus aureus (MRSA) or Clostridium difficile infections as the underlying cause of a contributory factor.

'The BMA believes that safety must take precedence over political targets. With winter around corner, hospitals will be working at full capacity. Targets need to be more flexible so that doctors are not pressurised to turn around patients too quickly,' chairman of the BMA's consultants' committee, Dr Mark Porter, added.

'While patients obviously want to be treated quickly, we believe, they also want to be treated safely. Putting patients close together in time and space risks cross infection. The NHS must commission and design hospitals with more single rooms rather than larger wards and bays.'

Obama says 'history calling' on healthcare

Barack Obama has urged the US Senate to reject Republican 'deception' and answer the 'call of history' to approve his landmark healthcare reform plans.

This weekend the House of Representatives voted through a bill to extend healthcare to 96 per cent of Americans; the largest such extension since the mid-1960s.

Speaker Nancy Pelosi, credited by fellow Democrats for driving through the legislation, managed 'oh, what a night' above cheers when the 220-215 victory was announced.

The bill now passes to the Senate, where if successful, a second vote will have to be held in both Houses of Congress to unify the pieces of legislation before it can be signed into law by Mr Obama.

President Obama, who has made healthcare reform his top domestic priority, has called on senators to reject the 'heated and often misleading rhetoric' surrounding the bill.

'Most public servants pass through their entire careers without a chance to make as important a difference in the lives of their constituents and the life of this country,' he said.

'This is their moment, this is our moment, to live up to the trust that the American people have placed in us - even when it's hard; especially when it's hard. This is our moment to deliver.

'I urge members of Congress to rise to this moment. Answer the call of history, and vote yes for health insurance reform for America.'

The president's ten-year $829 billion (£519 billion) plan will see more than 30 million Americans benefit with subsidised insurance and the outlawing of insurance companies denying coverage for pre-existing conditions.

But Republicans remain inflammatorily sceptical about government control of healthcare and plans that, some claim, would grant free insurance to illegal immigrants.

President Obama has already made one concession on abortion, with the bill passed by the House banning federal funding from any cases involving abortion services.

WHO calls for action on female healthcare

The World Health Organisation (WHO) has called for action to improve the healthcare of girls and women.

A report by the WHO out today warns that despite progress societies continue to fail women at key times in their lives.

The report, Women and health: today's evidence tomorrow's agenda, was launched today by WHO director-general, Dr Margaret Chan: 'If women are denied a chance to develop their full human potential, including their potential to lead healthier and at least somewhat happier lives, is society as a whole really healthy? What does this say about the state of social progress in the 21st century?

'It's time to pay girls and women back, to make sure that they get the care and support they need to enjoy a fundamental human right at every moment of their lives, that is their right to health.'

The report found that worldwide, women provide the bulk of healthcare - whether in the home, the community or the health system, yet health care continues to fail to address the specific needs and challenges of women throughout their lives.

It also found up to 80 per cent of all healthcare and 90 per cent of care for HIV/Aids-related illness is provided in the home - almost always by women, 'yet more often than not, they go unsupported, unrecognized and unremunerated in this essential role'.

When it comes to meeting women's healthcare needs, some services, such as care during pregnancy, are more likely to be in place than others such as mental health, sexual violence and screening and treatment for cervical cancer, the report found.

Researchers also said that globally, heart attacks and stroke, often thought to be 'male' problems, are the two leading killers of women. Women often show different symptoms from men, which contributes to under diagnosis of heart disease in women. They also tend to develop heart disease later in life than men.

'We will not see significant progress as long as women are regarded as second-class citizens in so many parts of the world,' Dr Chan said.

'In so many societies, men exercise political, social and economic control. The health sector has to be concerned. These unequal power relations translate into unequal access to health care and unequal control over health resources,' she added.

'Fashion police' warning for children's play

Dressing children in inappropriate clothing can prevent their physical activity, scientists have warned today.

A study in the BioMed Central's open access journal found parents who dress their children in inappropriate clothing could be inadvertently hampering their child's physical activity in childcare settings.

The US-based study said three-quarters of children aged 3-6 years old in America spend time in childcare and many spend most of their waking hours in these settings, adding that daily physical activity offers numerous health benefits, and time outdoors has been found to be associated with children's activity levels.

A team of researchers led by Kristen Copeland, from the Cincinnati children's hospital medical centre, looked at why physical activity levels may vary between 53 child-care providers. They said their results through a series of focus groups found that clothing was potentially a significant barrier to children's outdoor physical activity.

Ms Copeland said: 'Child care centres should consider instigating clear and specific policies regarding the type of clothes permitted at these centres so that children's active play opportunities aren't curtailed.'

The researchers said inappropriate clothing included inadequate outdoor clothing, such as a lack of coats and gloves in the wintertime and unsuitable footwear, such as flip flops. The study found also a few children dressed improperly could prevent the entire class from going outside, and therefore restricting physical activity.

Caregivers suggested several reasons why parents may dress their child inappropriately, including forgetfulness, a rushed morning routine, limited income to buy clothes, a child's preference for a favourite item, and parents not understanding the importance of outdoor play.

Swine flu cases rise as 2 die in N Ireland

The number of new cases of swine flu in the last week rose eight per cent from the previous week, to 84,000 new cases.

There have also been two new deaths in Northern Ireland from the H1N1 virus, reports have said today, with 105 people dying in England from the virus since it broke out.

Data from the Health Protection Agency (HPA) found the highest number of cases of the flu-like illness was in the one-to four-year-old age group, and as of yesterday morning there were 848 patients in hospital with swine flu.

It also estimated a cumulative total number of cases of 621,000 since the pandemic began.

Internationally it is believed 6,255 have died globally from the virus, and in the last seven days, the total number of deaths reported globally has increased by five per cent - compared to the 12 per cent increase reported last week.

Green tea cancer prevention claims brewing

The debate over whether drinking green tea is a good preventative measure against cancer has raged on today, with further research coming out in its favour.

Scientists, whose research was published in the Cancer Prevention Research journal, suggest drinking green tea could reduce the risk of oral cancer.

Vassiliki Papadimitrakopoulo, from the University of Texas, said while the results of the research showed no difference in oral cancer development overall between those who took green tea and those who did not, patients who presented with mild to moderate dysplasia had a longer time to develop oral cancer if they took green tea extract.

However, she warned against recommendations that green tea could definitely prevent cancer.

'This is a phase II study with a very limited number of patients who took what would be the equivalent of drinking eight to ten cups of green tea every single day,' said Ms Papadimitrakopoulo.

'We cannot with certainty claim prevention benefits from a trial this size.'

But Dong Shin, from the Emory School of Medicine, said the results of the research were a step in the right direction.

'A clinical trial with a natural compound is no easy task, and these researchers have accomplished that,' he said.

'The lack of toxicity is also important because often when you give supplements at higher doses than what would occur naturally, you induce nausea and vomiting. That did not happen in this trial.'

Neither researchers had a reason why patients concerned about cancer should not drink green tea, but they cautioned against relying on the beverage to definitively reduce their risk of cancer.

Bad hospital communication lets patients down

A review of patients who have died after being admitted into hospital has found communication break downs are letting people down.

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) (2009) reviewed the care of patients who died in hospital within four days of admission.

They found in 25 per cent of cases there was a 'clinically important delay in the first review by a consultant', and poor communication between and within clinical teams was identified by advisors as 'an important issue in 13.5 per cent of cases'.

John Black, president of the Royal College of Surgeons has said the importance of today's report must be recognised: 'This hard hitting report highlights the loss of proper team working in UK hospitals, resulting in dangerous failures of communication which make it harder and harder for clinicians to provide safe care for patients.

'The Royal college of Surgeons has been warning for some time about the dangers of multiple handovers.'

The report found there was a lack of communication both between different grades of doctors within clinical teams, and between different clinical teams and other health care professionals.

Poor-decision making and lack of senior input were also issues, as was the access to CT and MRI scanning. In 16.9 per cent of patients who were not expected to survive on admission there was no evidence of any discussion between the health care team and either the patient or relatives on treatment limitation.

Mr Black added: 'The problems revealed in this report date from 2006 and 2007, when the NHS was already struggling to meet the demands of a 56 hour working week. Now that in theory everyone in the NHS is working for only 48 hours the situation in the country's hospitals can only have worsened.'

The report also said the NHS needed to look at the lack of involvement of trainees in emergency surgery in a supervised learning environment, adding that there was a poor standard of record keeping and some of the basic aspects of clinical care continue to be neglected; in particular the monitoring, recording and management of fluid balance in the elderly and those with multiple comorbidities.