Migrants may have to register to use public services

Mark Harper, the immigration minister, said that ministers are examining options for a “mandatory register” for European nationals who want to use British services.

He made the disclosure after David Cameron said foreigners are taking advantage of the NHS and should only get free treatment if they have been paying taxes.

The Coalition is under political pressure over the potential arrival in Britain next year of Romanian and Bulgarian workers when restrictions on their movement lapse. Mr Harper said that such arrivals could be forced to register as British residents before being able to use services.

Mr Harper told ITV: “It's certainly an idea we are looking at. Some other EU countries already have a mandatory register for access to public services and we're looking at the costs and benefits to see if it’s sensible.”

The Prime Minister earlier said the health service should not automatically be free for foreigners from outside the EU.

Speaking to workers at B&Q in Eastleigh, he added that Britain must also get better at charging other EU countries when their citizens use the NHS.

"We're not tough enough right now about people coming from the other side of the world who decide to use our health service," he said. "They haven't contributed in their taxes. They should pay when they use the NHS."

Mr Cameron criticised the current system as he was asked about the pressure on NHS services if a wave of Bulgarians and Romanians immigrate to Britain when restrictions are lifted next year.

"We've made some progress. But there's a lot more to do to make sure that, while we're welcoming to immigrants, we don't allow people to come here and take advantage of us, because I think that does happen too often," he said.

He also criticised the scale of welfare spending on British claimants. Up to ten people's annual taxes could go towards supporting the housing benefit of just one family in the most extreme cases, he said.

The Prime Minister said the "scale of the problem" is shown by the £20 billion housing benefit bill, which is two-thirds of Britain's entire defence budget.

Mr Cameron this week launched a review into how foreigners access benefits. On Thursday's visit to support the Conservative Eastleigh by-election campaign, he said this review will look at all welfare payments and services, including health, housing and legal aid as well as traditional benefits.

It comes after GPs wrote to ministers last month demanding changes to stop widespread health tourism costing the NHS millions of pounds a year.

At the moment GPs must treat almost anybody who comes into their surgery. New guidance was issued last year stipulating that “nationality is not relevant” when it comes to registration, and stating doctors had to register those from anywhere on the globe to “promote human rights and public health”.

GPs point out that once a foreigner patient has registered, hospital staff hardly ever check whether they are also entitled to more specialist NHS care.

In 2010 a Department of Health report found that health tourism was costing the NHS at least £10 million a year in unrecovered costs, although doctors believe the true figure is far higher because most goes undetected.

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'Missing' Banksy Jubilee work listed for auction at £450,000

A Banksy painting has been put up for sale on an American auction website, after it was removed from the side of a Poundland shop in Wood Green, north London, last week.

The work appeared last May, and is thought to have been created by the controversial street artist Banksy. Known as Slave Labour (Bunting Boy), the piece shows a young boy hunched over a sewing machine making Union Jack bunting, and has been interpreted as a reaction to the Queen's Diamond Jubilee, the riots of August 2011 and the London Olympics.

The work has now been listed on Fine Art Auctions Miami site as one of the 118 pieces in a Modern, Contemporary and Street Art sale happening on Saturday. It has an estimate of $500,000-700,000 (£322,000-£450,000), and is the second Banksy piece in the sale, alongside 2007 work Wet Dog, which appeared in Bethlehem.

Fine Art Auctions Miami owner Frederic Thut told the Sun that the work had been listed by a "well-known collector". He said that the collector had followed normal procedure, and had signed a contract to say "everything was above board." The collector, who Thut refused to name, is not British and the piece, Slave Labour, is in storage in Europe.

Wood Green residents have expressed anger over the listing, with councillor Alan Strickland saying, "Banksy gave our community that painting for free. Someone has taken it and plans to make a huge amount for themselves, which is disgusting and counter to the spirit in which it was given."

Banksy's work has been at the centre of a number of thefts. In spring 2011 a piece known as Sperm Alarm was taken from outside a hotel in Central London, only to appear on online auction site eBay for £17,000. A gang of thieves, disguised as workmen, were caught trying to steal a piece from a derelict building in Liverpool in 2006.

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Oddest book titles: top ten of all time

The announcement of the shortlist for the Diagram Prize for Oddest Book Title is a humorous reminder of just how inventive, not to mention downright bizarre, authors can be. While the first winner in 1978 – Proceedings of the Second International Workshop on Nude Mice – takes some beating, this year’s six nominees have certainly done their best to stay esoteric and baffling, with titles including God’s Doodle: The Life and Times of the Penis and the wonderfully British How Tea Cosies Changed The World.

Previous winners such as Estonian Sock Patterns All Around the World by Aino Praakli and The Great Singapore Penis Panic and the Future of American Mass Hysteria by Scott D Mendelson show that we’re spoiled for choice when it comes to book titles that raise a snigger or a quizzical eyebrow. So here’s The Telegraph's rundown of the ten oddest book titles ever to grace a cover:

1) The Stray Shopping Carts of Eastern North America: A Guide To Field Identification – Julian Montague

2) An Arsonist’s Guide To Writers’ Homes In New England – Brock Clarke

3) What To Say When You Talk To Yourself – Shad Helmstetter

4) Truncheons: Their Romance and Reality – Erland Fenn

5) Fancy Coffins To Make Yourself – Dale L Power

6) The Art of Faking Exhibition Poultry – George Ryley Scott

7) Penetrating Wagner's Ring – John L DiGaetani (editor)

8) Reusing Old Graves – Douglas Davies and Alastair Shaw

9) The Joy of Uncircumcising – Jim Bigelow

10) Fart Proudly: Writings of Benjamin Franklin You Never Read In School – Carl Japikse

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Oddest book titles: top ten of all time

The announcement of the shortlist for the Diagram Prize for Oddest Book Title is a humorous reminder of just how inventive, not to mention downright bizarre, authors can be. While the first winner in 1978 – Proceedings of the Second International Workshop on Nude Mice – takes some beating, this year’s six nominees have certainly done their best to stay esoteric and baffling, with titles including God’s Doodle: The Life and Times of the Penis and the wonderfully British How Tea Cosies Changed The World.

Previous winners such as Estonian Sock Patterns All Around the World by Aino Praakli and The Great Singapore Penis Panic and the Future of American Mass Hysteria by Scott D Mendelson show that we’re spoiled for choice when it comes to book titles that raise a snigger or a quizzical eyebrow. So here’s The Telegraph's rundown of the ten oddest book titles ever to grace a cover:

1) The Stray Shopping Carts of Eastern North America: A Guide To Field Identification – Julian Montague

2) An Arsonist’s Guide To Writers’ Homes In New England – Brock Clarke

3) What To Say When You Talk To Yourself – Shad Helmstetter

4) Truncheons: Their Romance and Reality – Erland Fenn

5) Fancy Coffins To Make Yourself – Dale L Power

6) The Art of Faking Exhibition Poultry – George Ryley Scott

7) Penetrating Wagner's Ring – John L DiGaetani (editor)

8) Reusing Old Graves – Douglas Davies and Alastair Shaw

9) The Joy of Uncircumcising – Jim Bigelow

10) Fart Proudly: Writings of Benjamin Franklin You Never Read In School – Carl Japikse

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Police under investigation over 'dog's' witness statement

However, when the CPS demanded a witness statement in the name of a force dog, officers realised that it would be taking their canine skills a step too far.

They wrote back explaining that PC Peach was in fact PD Peach, stressing that PD stood for police dog but to no avail.

Eventually, the exasperated handler completed a form as if it had been written by the Alsatian, signing it with a paw print.

The statement read: “I chase him. I bite him. Bad man. He tasty. Good boy. Good boy Peach.”

It stated that the age of the witness was “four” and that his number was PD4341.

The document was pinned to the wall at West Midlands Police Station, much to the amusement of colleagues.

One officer took a photograph of the statement and it soon appeared on Facebook and on several police Twitter accounts, including West Yorkshire’s Police Dog Unit, which wrote: "PD Peach called to give evidence. Would have loved to have been there."

The widely circulated picture was accompanied by the caption: “CPS demanded a statement from "PC Peach," who is actually PD Peach.

“They were told several times Peach was actually a police dog but insisted on a written statement so the case handler sent them this.”

One Facebook user wrote: “Typical of the CPS being dogmatic about getting statements from literally everyone present! I bet they are woofing it down!"

And another asked: “Does CPS stand for Clown Prosecution Service?"

The CPS, however, failed to see the funny side and complained to the police that their mistake had been turned into a very public joke.

PC Mark Tissington, of West Midlands Police, who is believed to have shared the original picture of the witness form, has referred himself to the internal discipline unit although sources suggested it was unlikely to be reprimanded.

Ian Edwards, chairman of the West Midlands branch of the Police Federation, said: “It's a difficult time for police and sometimes humour is a way of venting frustrations.

"I would urge our Professional Standards Department to be even-handed in the way they deal with it.”

The CPS declined to comment.

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Schools, care homes and Armed Forces supplied by firm selling contaminated beef

Sodexo, which supplies to 2,300 outlets, is withdrawing beef from its UK sites “with immediate effect” as the scale of the scandal widened yet further today.

In a second wave of tests, the products linked to samples containing horse DNA were Sodexo's beef burgers, minced beef and halal minced beef, Asda's chilled beef bolognese sauce and a Whitbread Group lasagne and beef burger.

The catering at Ascot Racecourse, which is attended each year by the Queen, is run by Sodexo Prestige, according to the firm's website, and the company won four awards in last year's National Racecourse Catering Awards for its food.

A Sodexo spokeswoman would not confirm which of its sites had been supplied with the frozen products however.

She also declined to name the supplier of the beef products that tested positive for horse DNA and would not say if it was a British or Irish manufacturer.

Sodexo describes itself as "the UK's largest event caterer and provider of corporate hospitality packages".

It has launched an investigation into how beef products were contaminated with horse.

In a statement, the firm said: "Sodexo has had a proactive programme in place to ensure that there is no horsemeat in its supply chain.

"We demanded written assurances from across our supply chain that the products we purchase did not contain horsemeat, and additionally implemented an internal sampling programme.

"Despite repeated guarantees from our suppliers, our sampling has identified a frozen beef product which tested positive for equine DNA. This situation is totally unacceptable.

"We felt the only appropriate response was to withdraw not only this product but all frozen beef products. We will only re-admit into our catering operations products that have affirmatively passed DNA testing, pursuant to laboratory test criteria."

Sodexo said its Tillery Valley Foods business, which supplies meals to the healthcare sector, was not affected.

The company’s part in the horsemeat scandal was revealed today when the Food Standards Agency released the latest tranche of test results submitted by the food industry.

They showed that out of 1,133 meat products checked, six - including Sodexo's - were positive for horse.

It is the latest in a growing list of businesses to announce that its products have tested positive for equine DNA.

Earlier today, Birds Eye said it was withdrawing three beef ready meals from sale in the UK and Ireland. The move follows tests that found 2% of horse DNA in a chilli con carne dish sold by Birds Eye in Belgium.

Birds Eye's spaghetti bolognese, shepherd's pie and lasagne are made by the same Belgian manufacturer, Frigilunch N.V., and are being withdrawn "as a precautionary measure".

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Stolen Banksy Jubilee work listed for auction at £450,000

A Banksy painting has been put up for sale on an American auction website, after it was removed from the side of a Poundland shop in Wood Green, north London, last week.

The work appeared last May, and is thought to have been created by the controversial street artist Banksy. Known as Slave Labour (Bunting Boy), the piece shows a young boy hunched over a sewing machine making Union Jack bunting, and has been interpreted as a reaction to the Queen's Diamond Jubilee, the riots of August 2011 and the London Olympics.

The work has now been listed on Fine Art Auctions Miami site as one of the 118 pieces in a Modern, Contemporary and Street Art sale happening on Saturday. It has an estimate of $500,000-700,000 (£322,000-£450,000), and is the second Banksy piece in the sale, alongside 2007 work Wet Dog, which appeared in Bethlehem.

Fine Art Auctions Miami owner Frederic Thut told the Sun that the work had been listed by a "well-known collector". He said that the collector had followed normal procedure, and had signed a contract to say "everything was above board." The collector, who Thut refused to name, is not British and the piece, Slave Labour, is in storage in Europe.

Wood Green residents have expressed anger over the listing, with councillor Alan Strickland saying, "Banksy gave our community that painting for free. Someone has taken it and plans to make a huge amount for themselves, which is disgusting and counter to the spirit in which it was given."

Banksy's work has been at the centre of a number of thefts. In spring 2011 a piece known as Sperm Alarm was taken from outside a hotel in Central London, only to appear on online auction site eBay for £17,000. A gang of thieves, disguised as workmen, were caught trying to steal a piece from a derelict building in Liverpool in 2006.

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'Super-pod' of dolphins spotted off coast of California

According to the boat's captain, the pod followed the vessel across seven miles of ocean.

Sorry, I could not read the content fromt this page.

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Thandie Newton speaks out about sexism in the film industry

British actress Thandie Newton joined the crowds of people who protested violence against women yesterday as part of the One Billion Rising campaign. In an interview with CNN, she explained about her own experience of humiliation and exploitation during 'casting couch' style interviews she undertook as a teenager.

Newton said she was "definitely objectified to an extreme" as a 16-year-old due to the things she was expected to do in auditions. She told of one "horrific incident" as an 18-year-old where the director asked her to sit with her legs apart and the camera was positioned up her skirt during a screen test.

Newton said she was told to "put my leg over the arm of the chair, and think about [...] how it felt to be made love to by this person." It later emerged that the director played the interview video to other people in his personal time.

Newton went on to say that "we all need to recognise our part in trying to be aware" of sexism and exploitation. "It's really bizarre that violence against women isn't a number one priority," she said. One Billion Rising describes itself as a "global strike" and a "call to men and women to refuse to participate in the status quo until rape and rape culture ends." Comedian Ruby Wax and politician Yvette Cooper also joined the crowds in Westminster.

In 2011 filmmaker Susanna White (Parade's End, Generation Kill) led a campaign to help female directors achieve equality in television. White is part of Directors UK, a group which fights for directors's rights in the industry, which set up the Women's Working Group. In January, the group released an update on the group revealing statistics that showed that while 27 per cent of Director UK's members were women, an average nine per cent of episodes of drama series were directed by women in comparison to 91 per cent by men.

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The 27 Club: in pictures

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Tory MPs want new law to 'lock in' EU referendum pledge

Many Tories, however, were unimpressed by Sir John's comments. They feel emboldened to act because they believe parliamentary pressure effectively forced Mr Cameron to make his referendum promise - and played a big role in his successful bid for a real-terms cut in the EU's budget from 2014-20, which was agreed this month.

In October 2011, 81 Tory rebels defied Mr Cameron's orders at thetime to demand a referendum on EU membership in a Commons vote - a stance which is now party policy following the Prime Minister's landmark speech last month.

A year later, more than 50 Tory Eurosceptics voted with Labour against the government on a real-term reduction in the 2014-20 EU budget.

They have turned their attention to a referendum paving Bill before the next election in an attempt to lock Mr Cameron in to his promise - and put Labour and the Liberal Democrats on the spot in a Commons vote.

Some feel that without a major move this side of the next election, the Conservatives will not be believed by voters. David Cameron pledged in 2009 to stage a referendum on the Lisbon Treaty if the Tories won power, only to back down from his promise later.

Nick de Bois, the secretary of the 1922 Committee of Conservative, backbenchers, said: "David Cameron has shown magnificent leadership with EU policy by putting the UK's interests first, and by inviting the British public to have their say on our future relationship with the EU.

"The icing on the cake would be a paving bill for the referendum inthis parliament to leave no doubt in the public's mind that it is onlyan outright Conservative government, not Labour, and most certainly not a new coalition that will deliver that referendum."

Mark Pritchard, a former secretary of the 1922 Committee, said: "A Bill would help disperse the mistrust of all those inside and outside of parliament who just don’t trust any political leader to deliver on their Europe promises.

"It would give added weight to the Prime Minister’s new European policy”.

Another Tory MP, who did not wish to be named, said: "I share the concern that unless a paving Bill this parliament is achieved, the referendum pledge will only be seen as another pledge which will not be delivered.

"A Bill would show the public we are committed to this, as well allaying some concerns about trust on this issue."

Mr Cameron is determined to resist moves for a paving Bill in the current parliament. In any Commons vote, the Liberal Democrats would be likely to vote with Labour to block it - potentially fracturing the coalition because of the seriousness of the issue.

Ed Miliband, the Labour leader, has been criticised for putting forward a confused message on the referendum pledge after telling MPs he does not support a public vote at the moment.

Amid signs of internal Opposition tensions on the issue, Ed Balls, the shadow chancellor, last week warned Labour would be "stupid" to fight the next election opposing a referendum.

If we allow ourselves either to be the ‘status quo party’ on Europe,or the ‘anti-referendum party’ on Europe, then we’ve got a problem," Mr Balls added.

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Universities attack A-level reforms

The Education Secretary has announced that sixth-formers will be required to take all their A-level exams at the end of a two-year course.

This would mean that AS-levels, which are currently taken at the end of the first year of study, will no longer contribute to pupils’ final A-level grades.

However, the Russell Group of leading research universities said it was “not convinced” that the move was necessary. The universities warned that the plan would make it harder to identify bright students from working-class homes.

The criticism is a blow to Mr Gove, who has asked the Russell Group to establish a new academic board to advise the exams watchdog on the design of the new A-levels.

The universities’ intervention represents the latest in a series of setbacks for the minister. Last week, Mr Gove was forced to abandon his plan to scrap GCSEs and replace the exams with a new English Baccalaureate certificate.

In a statement released on Thursday, Dr Wendy Piatt, director-general of the Russell Group, said her 24 member universities, which include Oxford and Cambridge, “valued” AS-levels “in their existing form”.

“We have argued that AS-levels in their current format are important in giving students the opportunity to take an additional smaller qualification in a contrasting subject alongside their main A-level subjects,” she said.

“This adds valuable breadth and flexibility to their learning programme, and can encourage the take-up of strategically important subjects.

“We are not convinced therefore that a new standalone AS qualification is necessary and are concerned that, with no links to the A-level, it may not deliver the same benefits as the existing AS-levels.”

Dr Piatt said results from AS-levels taken at the end of the first year of study help universities make decisions on which candidates deserve to be offered places.

“Without access to such information, it will be even more difficult for our institutions to identify the most talented students from amongst the very many applicants with excellent results at GCSE,” she said.

“AS-level results after one year of study can also be effective in giving talented students from poorer backgrounds the confidence to apply to a highly selective university, thus helping to widen participation.”

Dr Piatt added: “Whilst we have welcomed the Government's review of the modular structure of the A-level, we do not believe this need be extended to the complete removal of the AS examination from the A-level.”

Cambridge University has already warned that the reforms risk damaging a decade's worth of work to encourage more disadvantaged students to apply.

A spokesman for the Department for Education insisted that AS-levels would be de-coupled from A-levels and would become stand-alone qualifications.

“We need A-levels that are robust, rigorous and match equivalent exams in the world's best education systems,” the spokesman said.

“That is why new A-levels will be linear, with all assessment at the end of two years of study to address the impact of modules and re-sits on grade inflation. As a result, changes must be made to AS-levels.

“AS-levels will therefore be redesigned as high-quality standalone qualifications.”

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We didn't have pancakes on Shrove Tuesday. That's how we roll

For a man of my years, I’ve had a busy couple of weeks of it. It started with a “Saints and Sinners Club” lunch at Lord’s. The Saints and Sinners are a gathering of geezers who fancy themselves “raffish”, who meet once a month for lunch, for no good reason other than good fellowship, a bite of food and a mouthful of wine, to tell each other a few stories and raise a few bob for worthy charities.

There are no rules that I’ve ever discovered (and I’ve been chairman), there are only 100 of us, and if guests want to come to our annual Christmas lunch, they have to pay for it by listening to us sing carols at them.

At Lord’s, we had a question-and-answer session with distinguished figures from the world of sport, and a helping of meat so large that there was unworthy speculation that it might be cheval rather than “boeuf bourguignon”.

Then, on Shrove Tuesday, another lunch at Simpson’s, the roast beef Mecca on the Strand. Although the founder of this feast has a fondness for the school dinners of his youth, he settled for gastronomic safety with chicken. The excuse this time was the Oldie of the Year Awards. Unlike the Baftas, Golden Globes or Oscars, and all of the other self-congratulatory showbiz fandangos, these prizewinners are not picked by retired wardrobe mistresses, make-up ladies or former best-boys, but judges of intellect and discernment, and me, whose discussions can often degenerate into bitter wrangling. Despite recriminations, decisions were taken, and, as readers of a better class of newspaper, you will be aware, among the great and good honoured, the main Golden Oldie award garlanded the leonine brow of Lord Heseltine.

It was a close-run thing; the “Turbaned Tornado”, Fauja Singh, was in the running, in more ways than one, having completed the Toronto marathon last October, at 100 years of age. Next Sunday he’ll hang up his running shoes at the finish of the Hong Kong marathon. He doesn’t drink and he’s a vegetarian, with a beard to put George Clooney to shame.

Then, the charming Samantha Cameron invited to No 10 a group representing charities that had attended the City firm Icap’s Big Day a little while ago, allowing us to imagine we were dealing in millions, while brokers, managers and secretaries all dressed up like cowboys and Indians, soldiers, sailors, doctors and nurses, sheikhs and snorklers. A good-hearted, jolly day, that belied the reputation of a self-centred City.

A reputation further demolished by the PM’s wife’s reception, when those of us representing charities, mine being Children in Need, received handsome donations from Icap’s Michael Spencer.

Not a bad few days. Somewhere in the middle, I’ll swear I saw a pancake and a Valentine’s Day card, but it’s all over now, for it’s Lent. I’m not telling you what I’m giving up, but I’ll have a couple on Patrick’s Day…

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Weak pound and high wholesale prices drive up petrol costs

The rise of 6.24p a litre since early January has been blamed on a plunging pound and stock market speculators driving up the price of fuel.

After surging by 5p a litre over a month, the price of petrol at the pumps has gone up a further 1p in the last five days, the AA said.

The average cost in the UK is now 138.32p a litre, with diesel having risen 4.78p from its mid-January price to an average of 145.10p.

The increase in the price of petrol adds £3.12 to the cost of refilling a typical 50-litre tank, while filling up the 70-litre tank of a Ford Mondeo now costs £4.37 more than six weeks ago.

A two-car family's monthly petrol cost has risen by £13.25.

Drivers have been caught between the pincers of a pound weakened against the dollar and soaring wholesale prices, both due to stock market speculation, the AA said.

Edmund King, its president, said: "This latest surge in fuel prices and its impact on spending indicates that UK drivers and families can't take any more. We're no longer talking of the motorist as a cash cow for tax and speculator greed, but a horse slowly but surely being flogged to death.

"This is the third 10p-a-litre wholesale price surge in 11 months, given extra vigour by currency speculators betting against the pound."

He called on the Government to scrap the planned rise in fuel duty scheduled for the autumn.

"Given the lashing motoring families and UK businesses are taking from speculator-driven fuel prices, we hope the Chancellor spells out clearly in the forthcoming Budget that he can feel the pressure rocketing fuel price inflation places on families and business, and that he will cancel the September rise if that strain is too great," he said.

In December, George Osborne scrapped a 3p rise in duty due in the New Year and postponed the next inflation-linked increase from April 1 until September 1

Regional variations mean Yorkshire and Humberside and the north of England are currently the cheapest for petrol, at 137.6p a litre, with Northern Ireland the most expensive at 138.7p.

Yorkshire and Humberside also remains the cheapest region for diesel, averaging 144.2p, while East Anglia, Northern Ireland and south-east England are the most expensive, at 145.2p.

View the original article here

Weak pound and high wholesale prices drive up petrol costs

The rise of 6.24p a litre since early January has been blamed on a plunging pound and stock market speculators driving up the price of fuel.

After surging by 5p a litre over a month, the price of petrol at the pumps has gone up a further 1p in the last five days, the AA said.

The average cost in the UK is now 138.32p a litre, with diesel having risen 4.78p from its mid-January price to an average of 145.10p.

The increase in the price of petrol adds £3.12 to the cost of refilling a typical 50-litre tank, while filling up the 70-litre tank of a Ford Mondeo now costs £4.37 more than six weeks ago.

A two-car family's monthly petrol cost has risen by £13.25.

Drivers have been caught between the pincers of a pound weakened against the dollar and soaring wholesale prices, both due to stock market speculation, the AA said.

Edmund King, its president, said: "This latest surge in fuel prices and its impact on spending indicates that UK drivers and families can't take any more. We're no longer talking of the motorist as a cash cow for tax and speculator greed, but a horse slowly but surely being flogged to death.

"This is the third 10p-a-litre wholesale price surge in 11 months, given extra vigour by currency speculators betting against the pound."

He called on the Government to scrap the planned rise in fuel duty scheduled for the autumn.

"Given the lashing motoring families and UK businesses are taking from speculator-driven fuel prices, we hope the Chancellor spells out clearly in the forthcoming Budget that he can feel the pressure rocketing fuel price inflation places on families and business, and that he will cancel the September rise if that strain is too great," he said.

In December, George Osborne scrapped a 3p rise in duty due in the New Year and postponed the next inflation-linked increase from April 1 until September 1

Regional variations mean Yorkshire and Humberside and the north of England are currently the cheapest for petrol, at 137.6p a litre, with Northern Ireland the most expensive at 138.7p.

Yorkshire and Humberside also remains the cheapest region for diesel, averaging 144.2p, while East Anglia, Northern Ireland and south-east England are the most expensive, at 145.2p.

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Could acupuncture help relieve seasonal allergies?

By Genevra Pittman

NEW YORK | Mon Feb 18, 2013 5:11pm EST

NEW YORK (Reuters Health) - Acupuncture may help improve seasonal allergy symptoms in some people with runny noses and watery eyes, according to a new study - but the effect seems to be small.

Researchers found 71 percent of people reported an improvement in their allergies after eight weeks of acupuncture. But so did 56 percent of allergy sufferers who were treated with sham acupuncture instead as a comparison.

"It works, but there are a couple of caveats (for) people who might think of using it," said Dr. Harold Nelson, who treats allergies at National Jewish Health in Denver, Colorado.

For example, "This is pretty invasive, particularly when you compare it to something like spraying a nasal steroid in your nose once a morning," he told Reuters Health. It's also more time consuming, and requires finding a qualified, licensed acupuncturist, he noted.

"I wouldn't personally go that route," he said.

Previous studies have conflicted on whether acupuncture may help relieve runny noses and other seasonal allergy symptoms, researchers wrote Monday in the Annals of Internal Medicine.

Led by Dr. Benno Brinkhaus from Charite-University Medical Center in Berlin, Germany, they randomly assigned 422 people with seasonal allergies to receive real or sham acupuncture or to only take antihistamines as needed.

After eight weeks and 12 treatment sessions, average allergy symptom scores dropped among people in the acupuncture group from 2.7 to 1.7 points on a 0-to-6 scale, where lower scores indicate fewer symptoms.

Among patients treated with sham acupuncture, symptom scores improved from 2.3 to 1.8 points, and from 2.5 to 2.2 in the medication-only group.

However, by another eight weeks after treatment ended, there was no longer any difference in the degree of symptom improvement between groups.

People with allergies would likely notice about a half-point change on the symptom scale in their daily lives, the researchers said - the difference between the real and sham acupuncture groups after eight weeks in the current study.

Acupuncture is generally considered safe, they noted. A typical session runs for about $100 and is often not covered by health insurance.

Researchers aren't sure why it might help people with seasonal allergies, other than its possible beneficial effect on the immune system.

Nelson, who wasn't involved in the new study, said antihistamines might not have been the best drug comparison for acupuncture - since daily use of nasal steroids is better at preventing symptoms.

For people with allergies, "I would suggest they use conventional medication on a daily basis, and I certainly prefer nasal steroids over antihistamines," he said.

But medication doesn't work perfectly for everyone, the researchers pointed out.

"We mostly saw patients in our outpatient practice who have had this disease for years," Brinkhaus told Reuters Health. "They are not very happy taking the medications every day, and some of them suffer from side effects of medications."

For those people, acupuncture could be a good add-on option, said Brinkhaus, an acupuncturist and internal medicine doctor.

"It's not an alternative. We use it firstly as some sort of complementary medicine. If the acupuncture has good results, we can reduce the anti-allergic medication," he said.

Dr. Li-Xing Man, who treats sinus and nasal diseases at the University of Rochester Medical Center, New York, said it can be challenging to find an experienced acupuncture practitioner in some parts of the U.S. And based on this study, "it's hard to know whether it's actually helpful."

Still, he told Reuters Health, there doesn't seem to be much harm in giving acupuncture a try.

"It may even be that acupuncture makes you feel better in general, and that's reflected in these questionnaires," said Man, who wasn't part of the research team. "If you find a good practitioner of acupuncture and you can afford it, then go for it."

SOURCE: bit.ly/MnBiCA Annals of Internal Medicine, online February 18, 2013.

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Arkansas Senate passes bill to ban abortions after 20 weeks

LITTLE ROCK, Arkansas | Mon Feb 18, 2013 6:41pm EST

LITTLE ROCK, Arkansas (Reuters) - The Republican-controlled Arkansas state Senate approved a measure on Monday to ban abortions after 20 weeks of pregnancy except in the case of rape, incest or to save the mother's life.

The Pain Capable Unborn Child Protection Act passed the Senate, 25-7, with amendments that allowed for the exemptions in the case of rape or incest. An earlier version of the bill that passed the Republican-controlled House allowed exemptions only for pregnancies that threatened the mother's life.

The bill, which shortens the existing limit of 25 weeks, now returns to the House for consideration of the Senate amendment.

Democratic Governor Mike Beebe has not said whether he would sign the bill into law.

Seven U.S. states have laws that restrict or ban abortion after the 20-week mark and similar laws approved in Arizona and Georgia are facing legal challenges.

Late-term abortions remain relatively rare. Most of the recent state laws banning most abortions after 20 weeks are based on hotly debated medical research suggesting a fetus feels pain starting at 20 weeks of gestation.

(Reporting by Suzi Parker; Editing by Daniel Trotta and Dale Hudson)

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Australian research provides final clue for anti-malaria drug

SYDNEY | Mon Feb 18, 2013 9:25pm EST

SYDNEY (Reuters) - Researchers in Australia have provided the final piece of a puzzle to develop a new anti-malarial drug, which targets the parasite that causes the disease and kills it with a salt overdose.

The drug, the first discovery in the fight against malaria in two decades, holds out fresh hope for conquering the disease, which claims hundreds of thousands of lives a year and is known for its evolving drug resistance.

The malaria parasite, carried to humans by mosquitoes, lives in red blood cells, which are full of salt. To survive, researchers knew it had to have a way of filtering salt out of its body.

"The parasite is quite leaky, it's letting salt in all the time. But that doesn't matter because it's got a very effective molecular salt pump that keeps pushing the salt out again," said Professor Kiaran Kirk, director at the Research School of Biology at Australia National University (ANU).

Research teams in the United States and Singapore had developed a drug that attacked the protein that makes up the salt pump, but it wasn't until the ANU researchers tested it that they confirmed it worked effectively.

"On the one hand, they had a brand new drug, they didn't know how it worked," Kirk said.

"We knew a lot about salt and salt pumps, and it was clear their drug was knocking out our salt pump. That led us to work together."

The drug attacks the salt pump and disables it, causing the parasite to fill up with salt and die. Targeting such a basic function is crucial because malaria tends to evolve quickly, rendering other drugs ineffective.

Other drugs that combat malaria combine or package older drugs together or are altered chemically.

"This is actually the first drug for 20 years to be genuinely new," Kirk said. "Targeting the pump protein is a structure that has never been used before to treat malaria."

The drug is undergoing clinical trials and it will be several years at least before it hits the market. The other two groups involved are the Novartis Institutes for Tropical Disease in Singapore and the Genomics Institute of the Novartis research Foundation.

Malaria infects more than 200 million people worldwide every year and kills around 600,000 of them -- primarily children under the age of five in sub-Saharan Africa.

Experts say one of the most challenging features of this parasite is its ability to evolve and overcome anti-malarial drugs -- a factor that is undermining global work towards eradicating the killer disease.

(Reporting By Thuy Ong; Editing by Elaine Lies and Paul Tait)

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Deadly new virus is well adapted to infect humans, study finds

By Kate Kelland, Health and Science Correspondent

LONDON | Tue Feb 19, 2013 12:09am EST

LONDON (Reuters) - A new virus that emerged in the Middle East last year and has killed five people is well adapted to infecting humans but could potentially be treated with drugs that boost the immune system, scientists said on Tuesday.

The virus, called novel coronavirus or NCoV, is from the same family as the common cold and as SARS, or Severe Acute Respiratory Syndrome. There have been 12 confirmed cases worldwide - including in Saudi Arabia, Jordan and Britain - and five patients have died.

In one of the first published studies about NCoV, which was unknown in humans until it was identified in September 2012, researchers said it could penetrate the lining of passageways in the lungs and evade the immune system as easily as a cold virus can.

This shows it "grows very efficiently" in human cells and suggests it is well-equipped for infecting humans, said Volker Thiel of the Institute of Immunobiology at Kantonal Hospital in Switzerland, who led the study.

NCoV was identified when the World Health Organisation issued an international alert in September saying a completely new virus had infected a Qatari man in Britain who had recently been in Saudi Arabia.

Coronaviruses are a family of viruses that includes those that cause the common cold as well as the one that caused SARS - which emerged in China in 2002 and killed about a 10th of the 8,000 people it infected worldwide.

Symptoms of both NCoV and SARS include severe respiratory illness, fever, coughing and breathing difficulties. Of the 12 cases confirmed so far, four were in Britain, one was a Qatari patient in Germany, two were in Jordan and five in Saudi Arabia.

POSSIBLE TREATMENT

Scientists are not sure where the virus comes from, but say one possibility is it came from animals. Experts at Britain's Health Protection Agency say preliminary scientific analysis suggests its closest relatives are bat coronaviruses.

What is also unclear is what the true prevalence of the virus is - since it is possible that the 12 cases seen so far are the most severe, and there may be more people who have contracted the virus with milder symptoms so are not picked up.

"We don't know whether the cases (so far) are the tip of the iceberg, or whether many more people are infected without showing severe symptoms," said Thiel, who worked with a team of scientists from the Netherlands, Switzerland, Germany and Denmark. "We don't have enough cases to have a full picture of the variety of symptoms."

Thiel said that although the virus may have jumped from animals to humans very recently, his research showed it was just as well adapted to infecting the human respiratory tract as other coronaviruses like SARS and the common cold viruses.

The study, published in mBio, an online journal of the American Society for Microbiology, also found that NCoV was susceptible to treatment with interferons, medicines that boost the immune system and which are also successfully used to treat other viral diseases like Hepatitis C.

This opens up a possible mode of treatment in the event of a large-scale outbreak, the scientists said.

Thiel said that with the future of the virus uncertain, it was vital for laboratories and specialists around the world to cooperate swiftly to find out more about where it came from, how widespread it was, and how infectious it might be.

"So far it looks like the virus is well contained, so in that sense I don't see any reason for increased fear," he said.

(Editing by Pravin Char)

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British shoppers saying nay to meat after horse scandal

People shop at a supermarket in London February 16, 2013. Nearly half of British consumers said they would avoid buying meat from supermarkets affected by the horsemeat scandal, according to a survey this month for Retail Week magazine.

Credit: Reuters/Luke MacGregor

By Clare Hutchison and Alice Baghdjian

LONDON | Mon Feb 18, 2013 12:30pm EST

LONDON (Reuters) - The discovery of horsemeat in products sold as beef has shocked many British consumers into buying less meat, a survey showed on Monday.

The furor, which erupted in Ireland last month and then spread quickly across Europe, has led to ready meals being pulled from supermarket shelves and damaged people's confidence in the food on their plate.

It also raised concerns over food labeling and the complex supply chain across the European Union, putting pressure on governments to explain lapses in quality control.

A fifth of adults said they had started buying less meat after traces of horse DNA were found in some products, according to the poll conducted by Consumer Intelligence research company.

"Our findings show that this scandal has really hit consumers hard, be it through having to change their shopping habits or altering the fundamentals of their diet," David Black, a spokesman for Consumer Intelligence, said.

The online poll, conducted on February 14-15, questioned more than 2,200 adults on their spending habits following the horsemeat scandal. It gave no specific figures on how much meat people were buying, focusing only on broader trends.

More than 65 percent of respondents said they trusted food labels less as a result.

"(Brands) will have to put in place really stringent ways of checking that what's being delivered and what's on the label is indeed what's in there," Black said.

In the month since horsemeat was first identified in Irish beefburgers, no one is yet reported to have fallen ill from eating horse but many supermarkets and fast food chains are already struggling to save their reputations.

Governments across Europe have stressed that horsemeat poses little or no health risk, although some carcasses have been found tainted with a painkiller given to racehorses but banned for human consumption.

Environment secretary Owen Paterson, who met British retailers earlier in the day for talks on how to restore consumer confidence, said Britain was closely cooperating with European countries to investigate what happened.

"Looking ahead, there was absolute determination in the industry to restore confidence in their products," he said in televised remarks. "We look forward to meeting on a regular basis to absolutely make it clear that when consumers buy a product they get what they bought."

British retailers now expect the vast majority of tests on processed beef products to be completed by February 22, according to the British Retail Consortium.

LOCAL BUTCHERS

More than 60 percent of adults surveyed said they would now buy meat from their local butchers, the poll said, while a quarter of adults said they would now buy more joints, chops or steaks instead of processed meat.

Michael Suleyman, who owns a family-run butchers' shop in Brixton, London, said more customers appeared concerned although for now there had not been any difference in sales figures.

"We have seen people panicking and asking us lots of questions like 'where do you get your meat from?'," Suleyman, 51, told Reuters. "We assure our customers by showing them the meat and mincing it for them in front of their eyes."

But with inflation running above central bank targets and an uncertain job market, the spending power of British consumers has been eroded in recent years and, for some, buying more expensive meat is not an option.

Nearly a fifth of respondents said they wanted buy less processed meat such as ready-meals, but could not afford to.

At a London branch of Britain's biggest retailer, Tesco, which found horse DNA in some of its own-brand frozen spaghetti bolognese meals last week, consumers were still buying meat products.

"I've got nothing against horse meat," said Sean Cosgrove, 39, a local government employee. "I think you're being ambitious if you expect top quality meat in those products anyway."

(Writing by Alice Baghdjian and Maria Golovnina; Additional reporting by James Davey and Neil Maidment; Editing by Michael Roddy)

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Program cuts down on unneeded scoliosis referrals

By Andrew M. Seaman

NEW YORK | Mon Feb 18, 2013 1:58pm EST

NEW YORK (Reuters Health) - Educating pediatricians about scoliosis seems to cut down on the number of children who are unnecessarily sent to specialists for curves of the spine, according to a new study.

Researchers found the number of referrals to orthopedic surgeons in one group of pediatricians fell by over 20 percent in the two years after the program was started, compared to the two years before.

"If you're training a certain group of people to treat scoliosis, I think that's good," said Dr. David Feldman, chief of pediatric orthopedic surgery at NYU Hospital for Joint Diseases in New York.

"The question is if that's sustainable," said Feldman, who was not involved with the new study.

Scoliosis, which is a curve of the spine greater than 10 degrees, affects up to 3 percent of children. Mild cases may just need to be monitored by a doctor, but some children need to wear a back brace, or - in extreme cases - need surgery.

The U.S. Preventive Services Task Force, a government-backed group of clinicians, found that routine screening of youths for scoliosis could lead to unnecessary bracing and other specialty care. Those potential harms, they said, outweighed the benefits of screening, but some states still require it.

In the Pediatric Physicians' Organization at Children's, a group of 72 doctors' offices affiliated with Boston Children's Hospital, the researchers found less than 5 percent of the children referred to orthopedic specialists ended up with a back brace, and less than 1 percent had surgery.

The researchers, who could not be reached for comment by deadline, thought starting a training program would teach pediatricians which children should and shouldn't be sent to specialists. That, they write in the journal Pediatrics on Monday, would cut down on the number of unnecessary referrals and save money.

In mid-2009, the researchers held informational sessions to teach pediatricians within the group of doctors at the 72 offices about scoliosis. They also gave the pediatricians tools to decide which children should see specialists, and gave them updates on how many of their patients were being referred.

In the two years before the training, there were about 5 visits to specialists for every 1,000 children per year. In the two years after the training program, that number fell to about 4 visits for every 1,000 children per year.

The researchers estimate the training may have stopped about 131 referrals.

'VERY USEFUL'

The researchers write that they believe the drop in the number of referrals is due to their program, because visits to specialists increased for all other conditions during that time.

Feldman told Reuters Health that it's important that doctors are able to differentiate between scoliosis and other types of malformations, and that they're not postponing treatment for children that need to wear braces.

"I'm concerned about this, but done in the right setting I think it can be very useful," he said.

But the study did have limitations, including that the researchers could not separate children who were referred to specialists by the pediatricians from children who may have been screened for scoliosis at school.

Also, the researchers write that there was a 13 percent increase in the number of x-rays taken by pediatricians to examine the children's spines after the program. They cannot tell whether that is too many.

Feldman added that it's unknown whether this type of program could be applied across the country, or whether it's just effective in this one group of pediatricians.

SOURCE: bit.ly/Y2Ni0Y Pediatrics, online February 18, 2013.

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Thinning attendance pressures Weight Watchers forecast

n">(Reuters) - Weight Watchers International Inc forecast full-year earnings below Wall Street expectations as attendance at its diet meetings remained low so far this year, sending its shares down more than 15 percent after the bell.

The weight management company expects mid- to high-teen declines in attendance in the first quarter.

The company said its marketing strategy has not been effective in an increasingly competitive environment with its diet meetings business losing steam in North America and the United Kingdom.

"Consumers saw their paychecks shrinking by mid-January. Suffice it to say the timing was less than ideal for us," Chief Executive David Kirchoff said on a conference call with analysts.

He said a new program launched in early December failed sustain momentum in 2013.

The company was also weighed down by higher marketing expenses related to first-time TV campaigns in several countries and online ads targeting men in the United States.

"Our January ads lacked the persuasion we needed," Kirchoff said.

The company, which competes with Nestle's Jenny Craig Inc, Nutrisystem Inc and Medifast Inc, said it expects full-year earnings of $3.5 to $4.0 per share. Analyst on average were expecting $4.75 per share, according to Thomson Reuters I/B/E/S.

However, the company reported fourth-quarter results above expectations, with earnings of $1.03 on revenue of $407.9 million.

Analysts had expected earnings of 87 cents on revenue of $397.6 million.

Shares of the company closed at $54.11 on the New York Stock Exchange on Wednesday.

(Reporting by Juhi Arora in Bangalore; Editing by Don Sebastian)

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Horsemeat scandal set to spur tougher EU food tests

500g size boxes of Coop Qualite & Prix Lasagne Verdi Bolognese are seen after purchase from a Coop supermarket in Zurich, February 12, 2013. Coop took the Qualite & Prix Lasagne Verdi Bolognese with beef meat from its French supplier Comigel, produced in Luxembourg, as a precaution in the last days out of their assortment. The Lasagne Verdi Bolognese contains elements of horsemeat, the company said on Wednesday.

Credit: Reuters/Michael Buholzer

By Charlie Dunmore and Adrian Croft

BRUSSELS | Wed Feb 13, 2013 7:50pm EST

BRUSSELS (Reuters) - The European Commission has proposed increased DNA testing of meat products to assess the scale of a scandal involving horsemeat sold as beef that has shocked the public and raised concern over the continent's food supply chains.

"The tests will be on DNA in meat products in all member states," European Union Health Commissioner Tonio Borg told reporters after a ministerial meeting in Brussels to discuss the affair.

The initial one-month testing plan would include premises handling horsemeat to check whether potentially harmful equine medicine residues have entered the food chain, Borg said, with the first results expected by mid-April.

The scandal erupted when tests carried out in Ireland revealed that meat in products labeled as beef was in fact up to 100 percent horsemeat. Operators in at least eight EU countries have since been dragged into the affair, raising fears of a pan-European labeling fraud.

Officials have said no risk to public health from the adulterated foods has been identified at this stage but testing for horse medicine in meat is being undertaken to be sure.

The suspected fraud has caused particular outrage in Britain, where many view the idea of eating horsemeat with distaste, and exposed flaws in food controls.

"This is impacting on the integrity of the food chain, which is a really significant issue for a lot of countries. Now that we know this is a European problem, we need a European solution," Irish farm minister Simon Coveney told reporters before the meeting.

At the urging of ministers, Borg said the Commission would accelerate work on potential changes to EU labeling rules that would force companies to state the country of origin on processed meat products.

Currently the requirement only applies to fresh beef, and is expected to be extended to fresh lamb, pork and poultry from December 2014.

But EU officials have warned privately that the complexity of supply chains would make the requirement almost impossible to implement in practice.

EU and national authorities are still trying to uncover the source of the suspected horsemeat fraud.

"All those countries through which this meat product has passed of course are under suspicion," Borg told a news briefing earlier on Wednesday. "By the countries, I mean the companies in those countries which dealt with this meat product."

He added that it would be unfair at this stage to point the finger at any organization in particular.

NOT JUST HORSE?

On January 15, routine tests by Ireland's Food Safety Authority found horsemeat in frozen beef burgers produced by firms in Ireland and Britain and sold in supermarket chains including Tesco, Britain's biggest retailer.

Concerns grew last week when the British unit of frozen foods group Findus began recalling packets of beef lasagna on advice from its French supplier Comigel, after tests showed up to 100 percent of the meat in them was horse.

The affair has since implicated operators and middlemen in a range of EU countries, from abattoirs in Romania and factories in Luxembourg to traders in Cyprus and food companies in France.

German supermarket chain Real, part of the world's fourth largest retailer Metro, said tests revealed traces of horsemeat in frozen lasagna on Wednesday. Real, which operates more than 300 stores across Europe's largest economy, said it had already removed the ready-meal from its shelves on Friday.

The first evidence that the labeling scandal could go beyond horsemeat also emerged when the upmarket British grocer Waitrose said its testing found that some of its frozen British beef meatballs might contain pork.

The firm, part of the John Lewis Partnership, has withdrawn the product from sale.

Horsemeat is traditionally prized by many consumers in EU countries such as France, Italy and Belgium.

(Additional reporting by Barbara Lewis in Brussels, Maria Golovnina and Victoria Bryan in London, Alexandra Hudson in Berlin; Editing by Mark Heinrich)

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State policies on Medicaid committee disclosure vary

By Andrew M. Seaman

NEW YORK | Wed Feb 13, 2013 4:30pm EST

NEW YORK (Reuters Health) - No standard policy covers whether the state-level Medicaid committee members choosing which drugs and treatments the program pays for should disclose their ties to drug and medical device companies, according to a new report.

Health policy researchers at the University of California, San Francisco, who set out to examine conflict of interest policies for the 47 U.S. states plus the District of Columbia with Medicaid Preferred Drug List committees, found that many have no policy, and in the states that do, rules vary widely.

"The take home message is that there is no such thing as typical. There is no such thing as a uniformed process," said Lisa Bero, the study's lead author.

For Medicaid, the federal- and state-funded insurance program for poor Americans, decisions to pay for drugs are left up to a state committee that's made up of doctors, pharmacists and other healthcare professionals.

The U.S. Centers for Medicare and Medicaid Services, which oversees the federal part of the insurance program, requires that two members of those committees be free of conflicts of interest, but the agency does not define what constitutes a conflict.

That raises concerns over whether committee members with ties to companies may consciously or unconsciously support drugs and products that benefit those relationships, instead of making decisions based on scientific evidence.

Bero and a colleague, who published their findings in JAMA Internal Medicine, searched the states' Medicaid websites to find their policies.

If a state's committee membership policy was not listed on its website, the researchers called or emailed the state Medicaid office.

They were only able to get 27 of the policies. Some state Medicaid offices didn't answer the inquiry, two that did answer said the state had no policy and one state office said the policy is "not in the public domain."

With the 27 state policies they obtained, the researchers compared each against a list of 12 possible disclosure requirements - looking to see whether the policy included, for example, a requirement to disclose any conflicts of interest, or to update disclosure documents on a regular schedule or a ban on ties between members and companies.

Seven of the state policies did not even mention conflicts of interest. Of the remaining 20 policies, five met between two and four of the requirements, 13 met between five and eight requirements and two met nine of them.

Only four of the states - Idaho, Washington, Nevada and Texas - banned committee members from having relationships with companies.

"So if I am a committee member and I have a financial tie with a drug company, I wouldn't be allowed to participate in that discussion. Very few had that type of policy," Bero said.

One state's bureau chief for Medicaid Pharmacy Services quoted in the report told the researchers he didn't worry about conflicts since committee members were not paid to serve on the panel, and "I don't believe that the pharmaceutical industry would pay a committee member an honorarium to be on the committee and attend meetings. That would really be 'over the top.'"

Bero said it's hard to have a "cookie-cutter approach" to the state policies, but that she hoped the federal government would provide some advice on the matter.

"Basically, the medicine people have available to them should be available because they are the safest and most effective medicine for their condition, and not just because it's driven by people's profits motives," Bero said.

Dr. Nirav Shah, commissioner of the New York State Department of Health in Albany, told Reuters Health it's important to note that this does not mean conflicts of interest are happening, but that there is the potential for conflicts of interest.

"We need to do a better job of explaining ourselves, but the public should not be afraid and the public should not be worried," said Shah, who wrote a commentary accompanying the study.

He added that he believes it's hard to make a blanket statement about what type of system states should have, but he agrees that the federal government should issue some guidance.

"We can all do better and work toward greater transparency, and it would be very helpful if we had federal guidance of what we should adhere to because that's a level playing field for everyone," Shah said.

SOURCE: bit.ly/YrGQ23 and bit.ly/12MaHsU JAMA Internal Medicine, online February 11, 2013.

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House Republican aims to repeal Medicare doctor pay cuts

U.S. House Speaker John Boehner (R-OH) (R) listens to Rep. Eric Cantor (R-VA) (L) during a news conference at the U.S. Capitol in Washington, December 22, 2011.

Credit: Reuters/Jonathan Ernst

WASHINGTON | Wed Feb 13, 2013 2:59pm EST

WASHINGTON (Reuters) - Republicans in the House of Representatives will seek a permanent solution to scheduled steep cuts in physician payments from the federal Medicare health insurance plan for retirees and disabled people, a House committee chairman said on Wednesday.

Rep. Fred Upton, chairman of the House Energy and Commerce Committee, told doctors he hopes to send so-called "Doc Fix" legislation to the House floor this summer that would repeal payment reductions enacted in 1997 as part of a law to balance the federal budget.

The 16-year-old "sustainable growth rate" (SGR) provision calls for reductions in doctor pay as a way to control spending by Medicare. Congress has prevented the SGR from taking effect through temporary measures, but that has run up the fiscal and political costs of finding a permanent solution.

U.S. Doctors have voiced frustration about uncertainty caused by the persistent threat of steep reductions in Medicare reimbursement for their services. Some have even threatened to stop serving Medicare patients.

Upton said he believes the nonpartisan Congressional Budget Office has opened "a window of opportunity" for change. The budget office recently lowered its cost estimate for a long-term SGR fix to $138 billion, from $245 billion last August, due to lower Medicare spending on physician services.

"It's obviously a very large amount but a smaller mountain to climb," the Michigan Republican said in a speech to the American Medical Association (AMA).

"Our goal is to get it done this year, to actually have it on the House floor before the end of the summer -- July or the first week of August."

Upton said he would seek support from Democrats in the Republican-controlled House to achieve a bipartisan bill that could muster support in the Democratic-run Senate.

He offered no specifics on how his bill would pay for the cost of repealing the SGR.

In the latest episode of the cat-and-mouse game, physicians escaped a 27 percent reduction in Medicare payments scheduled for January 1, 2013, when Congress enacted a one-year $25 billion Doc Fix as part of its fiscal cliff legislation. The measure holds physician payments unchanged.

Upton and other leading Republicans on his panel have released a legislative blueprint that calls for freezing doctor payment rates for 10 years and basing future increases on their willingness to embrace methods to improve the quality and efficiency of care.

A bill introduced this month by House Democrat Allyson Schwartz and Republican Joe Heck would allow four years of payment increases while new payment and delivery models are vigorously tested.

An AMA proposal calls for a similar transition period, during which physicians would be rewarded for participating in new methods of care delivery.

(Reporting by David Morgan; Editing by David Gregorio)

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Actelion sees Opsumit on U.S. market this year

ZURICH | Thu Feb 14, 2013 2:24am EST

ZURICH (Reuters) - Europe's biggest biotech expects it new heart and lung drug Opsumit to be on sale in the United States this year if it receives approval from regulators in October.

"The assumption is that we will be on the market with macitentan (Opsumit) in the U.S. this year," Chief Financial Officer Andrew Oakley told Reuters in an interview.

Actelion is banking on Opsumit, also known as macitentan, to reduce its dependency on its main product Tracleer, which goes off patent in 2015 and is also facing competition in the U.S. from Gilead's Letairis.

U.S. health regulators are expected to make a decision in October.

Spokesman Roland Haefeli declined to comment on the pricing of Opsumit, saying details would be announced when the drug is launched.

Actelion posted full-year net profit of 303 million Swiss francs ($330 million), in line with a forecast for 303 in a Reuters poll, and said it would hike its dividend by 25 percent.

(Reporting by Caroline Copley)

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More U.S. women using the "morning-after" pill: report

By Susan Heavey

WASHINGTON | Thu Feb 14, 2013 12:10am EST

WASHINGTON (Reuters) - More U.S. women are taking the "morning-after" pill, but generally just once, according to the government's first report on how the emergency contraception drug has been used since regulators eased access to it in 2006.

About 11 percent of sexually active women, or 5.8 million, used the pill between 2006 and 2010, compared to about 4 percent in 2002, the Centers for Disease Control and Prevention said in its report released on Thursday.

Among those who used the pill during those four years, 59 percent said they took it just once, while 24 percent said they used it twice, the report said. Seventeen percent said they used it three times or more.

Emergency contraception has been available by prescription in the United States since 1999. One version of the morning-after pill, known as Plan B, has stirred the most political controversy.

Plan B, much like regular birth control, stops pregnancy by blocking the release of a woman's egg, or it may prevent fertilization or implantation in the uterus. But it must be taken within days after intercourse to work.

The U.S. Food and Drug Administration approved sales of Plan B to adult women without a prescription in 2006 after years of contentious debate. It later loosened the restriction to include 17-year-olds.

Women's health groups lauded the move as a way to prevent unwanted pregnancies. But conservatives warned it could lead to promiscuity, especially among youth, and more sexual assaults.

Amy Allina of the National Women's Health Network said CDC's findings show morning-after pills are not replacing conventional birth control methods for most women, although "there are some for whom it's clearly not a one-time thing."

Activists are still pressing for over-the-counter access and no age restrictions.

The pill is sold by Teva Pharmaceutical Industries Ltd as Plan B. It also is available as a generic. In 2010 the FDA approved another emergency contraceptive called ella, a prescription drug now owned by Actavis Inc.

RACE, EDUCATION

CDC's findings showed the reasons for emergency contraception use varied depending on race and education levels.

Hispanics and blacks were more likely than whites to report using the drug after unprotected sex. More white women said they used it because they were worried their other birth control method had failed, CDC said.

Those with at least some college education were more likely to use the pill than those with a high school education or less, according to the report, which is based on data from the CDC's National Survey of Family Growth.

"The women who are less likely to have access to healthcare are more likely to say 'I didn't use another method, and I turned to emergency contraception to protect myself,'" said Allina.

Some women may choose to use it occasionally if they cannot afford other methods, she added.

In a separate report on Thursday, CDC looked at overall contraceptive use and found that while the number of women using regular birth control pills has remained flat over time, the use of injections, patches and intrauterine devices has grown.

The number of women whose partners have used condoms also rose, the findings showed.

That trend may reflect increased wariness among Americans to have children amid the 2007-2009 economic recession, the effects of which are still being felt by many, according to researchers at the Guttmacher Institute, which also tracks birth control use.

"At the same time, it can make it harder for people to have access to birth control because of costs," especially for disadvantaged women who face higher rates of unintended pregnancies, said Lawrence Finer, head of domestic research for the reproductive research group.

That situation could change in the wake of the 2010 healthcare overhaul that required health insurers to begin covering birth control last year, although the law faces legal challenges.

Religious groups, particularly Catholics, charge that the provision violates their belief against artificial birth control and are fighting to block it.

(Reporting by Susan Heavey; Editing by Xavier Briand)

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Obama Medicare rebate plan could hurt drug companies

By Bill Berkrot and David Morgan

Wed Feb 13, 2013 6:30pm EST

n">(Reuters) - President Barack Obama's decision to spotlight drug rebates as a way to save money on Medicare is likely to be opposed by the pharmaceutical industry, which could potentially lose billions of dollars in profits.

In his annual State of the Union speech on Tuesday, Obama said he would "reduce taxpayer subsidies to prescription drug companies" to rein in the rising cost of Medicare, the $600 billion healthcare program for the elderly and disabled.

Administration officials say the President was talking about requiring pharmaceutical manufacturers to offer rebates on drugs for 10 million people known as "dual eligibles" because they qualify for Medicare and Medicaid, and receive drug benefits through Medicare's Part D prescription drug program. Medicaid is the federal and state funded healthcare program for the poor.

The nonpartisan Congressional Budget Office estimates that requiring rebates for dual eligibles would save $137 billion in Medicare spending. Often the oldest and sickest beneficiaries, dual eligibles account for fewer than 20 percent of Medicare beneficiaries, but more than 30 percent of program spending.

Damien Conover, an analyst with the Morningstar investment research firm, said requiring Medicaid-level rebates for dual eligibles could trim 2 percent to 7 percent from the profits of drug manufacturers. The impact would vary depending on how much of a company's business is in the United States and how much is dependent on Medicare reimbursement, he said.

The U.S. pharmaceutical industry takes in about $300 billion a year in revenue.

"For most companies, it's probably a couple of percent hit to earnings, which is something clearly negative for the industry but manageable," said Barbara Ryan, a long-term pharmaceutical industry analyst, who now runs her own consulting firm. "Whether it could happen or not is another question, but it's unequivocally going to be the hot potato that's thrown around for the industry."

The rebate proposal, which has been circulating among policymakers and think tanks in Washington for years, had drawn industry ire before Obama's remarks on Tuesday.

Eli Lilly & Co Chief Executive John Lechleiter estimated it would cost the industry $112 billion over 10 years and reduce the number of new drugs developed.

"I think this would be disastrous for patients. It would be disastrous for pharmaceutical research. We think it's bad policy and we are going to fight it," he told a biotech conference in New York on Monday.

Other major drug companies contacted by Reuters, including Merck & Co and Pfizer Inc, declined to comment on the potential impact.

Pharmaceutical Research and Manufacturers of America, the industry's chief Washington trade group, warned that the proposal could "up-end" the successful Medicare Part D program that allows beneficiaries to purchase private drug coverage priced through competition.

It was unclear whether the proposal would ever succeed as legislation, given a bitterly divided Congress and predictions by some lobbyists that Medicare would see reforms only under a broad agreement that would require Republicans to accept higher tax revenues.

But analysts say the President, who this week backed away from a separate proposal to raise Medicare's eligibility age to 67 from 65, has few alternatives for wringing fiscal savings from the program. One option is raising costs for wealthier Americans eligible for Medicare benefits, which he also highlighted in his speech on Tuesday.

"Those two ideas are among the most palatable ideas for getting savings from the Medicare program," said Drew Altman, president and chief executive of the nonpartisan Kaiser Family Foundation, which tracks healthcare issues.

(Reporting by David Morgan in Washington and by Bill Berkrot in New York; Editing by Jilian Mincer and Leslie Gevirtz)

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Obama Medicare rebate plan could hurt drug companies

By Bill Berkrot and David Morgan

Wed Feb 13, 2013 6:30pm EST

n">(Reuters) - President Barack Obama's decision to spotlight drug rebates as a way to save money on Medicare is likely to be opposed by the pharmaceutical industry, which could potentially lose billions of dollars in profits.

In his annual State of the Union speech on Tuesday, Obama said he would "reduce taxpayer subsidies to prescription drug companies" to rein in the rising cost of Medicare, the $600 billion healthcare program for the elderly and disabled.

Administration officials say the President was talking about requiring pharmaceutical manufacturers to offer rebates on drugs for 10 million people known as "dual eligibles" because they qualify for Medicare and Medicaid, and receive drug benefits through Medicare's Part D prescription drug program. Medicaid is the federal and state funded healthcare program for the poor.

The nonpartisan Congressional Budget Office estimates that requiring rebates for dual eligibles would save $137 billion in Medicare spending. Often the oldest and sickest beneficiaries, dual eligibles account for fewer than 20 percent of Medicare beneficiaries, but more than 30 percent of program spending.

Damien Conover, an analyst with the Morningstar investment research firm, said requiring Medicaid-level rebates for dual eligibles could trim 2 percent to 7 percent from the profits of drug manufacturers. The impact would vary depending on how much of a company's business is in the United States and how much is dependent on Medicare reimbursement, he said.

The U.S. pharmaceutical industry takes in about $300 billion a year in revenue.

"For most companies, it's probably a couple of percent hit to earnings, which is something clearly negative for the industry but manageable," said Barbara Ryan, a long-term pharmaceutical industry analyst, who now runs her own consulting firm. "Whether it could happen or not is another question, but it's unequivocally going to be the hot potato that's thrown around for the industry."

The rebate proposal, which has been circulating among policymakers and think tanks in Washington for years, had drawn industry ire before Obama's remarks on Tuesday.

Eli Lilly & Co Chief Executive John Lechleiter estimated it would cost the industry $112 billion over 10 years and reduce the number of new drugs developed.

"I think this would be disastrous for patients. It would be disastrous for pharmaceutical research. We think it's bad policy and we are going to fight it," he told a biotech conference in New York on Monday.

Other major drug companies contacted by Reuters, including Merck & Co and Pfizer Inc, declined to comment on the potential impact.

Pharmaceutical Research and Manufacturers of America, the industry's chief Washington trade group, warned that the proposal could "up-end" the successful Medicare Part D program that allows beneficiaries to purchase private drug coverage priced through competition.

It was unclear whether the proposal would ever succeed as legislation, given a bitterly divided Congress and predictions by some lobbyists that Medicare would see reforms only under a broad agreement that would require Republicans to accept higher tax revenues.

But analysts say the President, who this week backed away from a separate proposal to raise Medicare's eligibility age to 67 from 65, has few alternatives for wringing fiscal savings from the program. One option is raising costs for wealthier Americans eligible for Medicare benefits, which he also highlighted in his speech on Tuesday.

"Those two ideas are among the most palatable ideas for getting savings from the Medicare program," said Drew Altman, president and chief executive of the nonpartisan Kaiser Family Foundation, which tracks healthcare issues.

(Reporting by David Morgan in Washington and by Bill Berkrot in New York; Editing by Jilian Mincer and Leslie Gevirtz)

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Evidence lacking on how to help kids after trauma

By Genevra Pittman

NEW YORK | Wed Feb 13, 2013 4:58pm EST

NEW YORK (Reuters Health) - There's no good evidence to say what types of treatment might help ward off anxiety and stress disorders in kids and teens exposed to traumatic events, according to a new analysis.

Researchers said that a few psychological interventions, including talk therapy and school-based programs, "appear promising" for helping young people cope with the kind of trauma stemming from accidents, mass shootings and natural disasters. But so far, there are too many holes in the data to know what to recommend for children's long-term health and wellbeing, according to Meera Viswanathan from RTI International in Research Triangle Park, North Carolina, and her colleagues.

Nicole Nugent, who has studied stress disorders in kids at Warren Alpert Medical School of Brown University in Providence, Rhode Island, said one difficulty is that children get exposed to many different types of trauma, and as a result have many different treatment needs.

Nonetheless, "We can't just say, ‘Let's just not address it until we know more about the interventions that are effective,'" Nugent, who wasn't involved in the new review, told Reuters Health.

"One thing that we know doesn't work is nothing," she said.

"Something horrible happens, and (kids) think, ‘If I don't think about it, if I don't talk about it, it will go away.' And that absolutely doesn't happen."

So-called nonrelational trauma is different from interpersonal trauma, which stems from acts committed by a person the child knows, such as sexual abuse or maltreatment by a friend or family member.

The young victim in the recent Alabama hostage drama, a six-year-old known only as Ethan, who was held in an underground bunker for six days, could have suffered nonrelational trauma because he didn't have a prior relationship with his kidnapper, Viswanathan said.

In an interview today on the "Dr. Phil" television show, Ethan's mother talked about the boy's emotional state since being rescued, including his difficulty sleeping - a symptom common among both kids and adults following trauma.

Viswanathan's team analyzed 25 studies in which children who had been exposed to nonrelational trauma were assigned to a particular treatment intervention or a comparison group.

Depending on the trial, some of those children were already experiencing anxiety and other symptoms related to the trauma.

Treatment programs varied in their methods - from medication to talk therapy - as well as in their intensity and how long they lasted.

None of the studies testing medications such as antidepressants found they had a positive effect on children's mental health, according to the findings published Monday in Pediatrics.

On the other hand, youth who went through some type of talk therapy tended to do better than others who weren't treated at all - though Viswanathan called that pattern a "weak signal."

Researchers said some of what has been learned helping children who experience interpersonal trauma can be applied to young survivors of accidents and natural disasters as well.

"In the absence of other evidence," Viswanathan told Reuters Health, "certainly don't ignore the problem. Provide children with the support that can be available, and also tailor it for the needs of the children."

She urged for more research looking at how kids respond to nonrelational trauma, in particular.

"Sadly, the shootings in Newtown are unlikely to be the last that we see, and we don't want to be in a position that we wish we had better evidence" on how to help children move on.

SOURCE: bit.ly/XAOQ3Z Pediatrics, online February 11, 2013.

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Vitamin D supplement labels may be inaccurate

By Genevra Pittman

NEW YORK | Wed Feb 13, 2013 4:39pm EST

NEW YORK (Reuters Health) - The amount of vitamin D in some supplements may be either much lower or much higher than what's written on the label, according to a new analysis.

Researchers found that off-the-shelf pills from 12 different manufacturers had between 52 percent and 135 percent of their advertised vitamin D content.

And among vitamins mixed by compounding pharmacies, the variation in doses was even greater - from 23 percent to 146 percent of the labeled amount.

"I'm not at all surprised that they're very variable," said Dr. Pieter Cohen, who studies dietary supplements at Harvard Medical School in Boston but wasn't involved in the new research.

"When you need a supplement to work, it's really hard to find one that does," he added - in part because of lax regulation.

Vitamin D supplements can be bought for a few dollars per month.

Together with calcium, they have been tied to improved bone health. Other medical claims made for extra vitamin D - such as its ability to lower blood pressure or boost immunity - are more tenuous.

For the new study, Dr. Erin LeBlanc from the Kaiser Permanente Center for Health Research in Portland, Oregon, and her colleagues chemically analyzed pills from 15 vitamin D bottles purchased at local stores and two doses of compounded vitamins.

Supplement bottles were labeled as containing 1,000, 5,000 or 10,000 international units (IU) of vitamin D. Just one-fourth of the vitamins met the standard of all pills falling between 90 and 120 percent of the expected dose, based on a random selection of five pills per bottle.

Pills made by the one manufacturer that was verified by the U.S. Pharmacopeial Convention (USP) - a third-party tester - were all within six percent of the listed dose, LeBlanc and her colleagues found.

"Consumers buying those products can be more assured that what they're getting in their pills is what's labeled," she said.

Compounded vitamin D pills were marked as 1,000 or 50,000 IU. Those high-dose vitamins can be prescribed by doctors and are mixed by pharmacies, unlike the store-bought brands.

One-third of the pills met the slightly stricter dosing standards for compounded vitamins, according to the findings published this week in JAMA Internal Medicine.

Compounding pharmacies have come under the microscope in recent months after a meningitis outbreak was tied to injectable steroids made by the New England Compounding Center in Framingham, Massachusetts.

LOOSE MANUFACTURING STANDARDS

For most adults, the recommended daily allowance of vitamin D is 600 to 800 IU.

However, people who are deficient in vitamin D are sometimes prescribed high doses to boost the amount in their blood.

"I'm a physician, so I've told my patients to take vitamin D, and I guess I always just figured that if they were taking it from a bottle, they would get the amount that was listed on the label," LeBlanc told Reuters Health.

The main concern with such wide variability, she added, is that people with low vitamin D levels who rely on supplements may end up consistently getting less of the vitamin than is labeled in some cases.

Cohen said laws regulating supplements are often not strictly enforced, so companies can get away with spending less on manufacturing standards at the expense of quality and consistency.

He told Reuters Health the best way for consumers to get supplements with the correct dose of ingredients is to purchase brands with a seal from USP or NSF International, another third-party verifier.

SOURCE: bit.ly/Uep1H1 JAMA Internal Medicine, online February 11, 2013.

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Actelion sees Opsumit on U.S. market this year

ZURICH | Thu Feb 14, 2013 2:24am EST

ZURICH (Reuters) - Europe's biggest biotech expects it new heart and lung drug Opsumit to be on sale in the United States this year if it receives approval from regulators in October.

"The assumption is that we will be on the market with macitentan (Opsumit) in the U.S. this year," Chief Financial Officer Andrew Oakley told Reuters in an interview.

Actelion is banking on Opsumit, also known as macitentan, to reduce its dependency on its main product Tracleer, which goes off patent in 2015 and is also facing competition in the U.S. from Gilead's Letairis.

U.S. health regulators are expected to make a decision in October.

Spokesman Roland Haefeli declined to comment on the pricing of Opsumit, saying details would be announced when the drug is launched.

Actelion posted full-year net profit of 303 million Swiss francs ($330 million), in line with a forecast for 303 in a Reuters poll, and said it would hike its dividend by 25 percent.

(Reporting by Caroline Copley)

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More U.S. women using the "morning-after" pill: report

By Susan Heavey

WASHINGTON | Thu Feb 14, 2013 12:10am EST

WASHINGTON (Reuters) - More U.S. women are taking the "morning-after" pill, but generally just once, according to the government's first report on how the emergency contraception drug has been used since regulators eased access to it in 2006.

About 11 percent of sexually active women, or 5.8 million, used the pill between 2006 and 2010, compared to about 4 percent in 2002, the Centers for Disease Control and Prevention said in its report released on Thursday.

Among those who used the pill during those four years, 59 percent said they took it just once, while 24 percent said they used it twice, the report said. Seventeen percent said they used it three times or more.

Emergency contraception has been available by prescription in the United States since 1999. One version of the morning-after pill, known as Plan B, has stirred the most political controversy.

Plan B, much like regular birth control, stops pregnancy by blocking the release of a woman's egg, or it may prevent fertilization or implantation in the uterus. But it must be taken within days after intercourse to work.

The U.S. Food and Drug Administration approved sales of Plan B to adult women without a prescription in 2006 after years of contentious debate. It later loosened the restriction to include 17-year-olds.

Women's health groups lauded the move as a way to prevent unwanted pregnancies. But conservatives warned it could lead to promiscuity, especially among youth, and more sexual assaults.

Amy Allina of the National Women's Health Network said CDC's findings show morning-after pills are not replacing conventional birth control methods for most women, although "there are some for whom it's clearly not a one-time thing."

Activists are still pressing for over-the-counter access and no age restrictions.

The pill is sold by Teva Pharmaceutical Industries Ltd as Plan B. It also is available as a generic. In 2010 the FDA approved another emergency contraceptive called ella, a prescription drug now owned by Actavis Inc.

RACE, EDUCATION

CDC's findings showed the reasons for emergency contraception use varied depending on race and education levels.

Hispanics and blacks were more likely than whites to report using the drug after unprotected sex. More white women said they used it because they were worried their other birth control method had failed, CDC said.

Those with at least some college education were more likely to use the pill than those with a high school education or less, according to the report, which is based on data from the CDC's National Survey of Family Growth.

"The women who are less likely to have access to healthcare are more likely to say 'I didn't use another method, and I turned to emergency contraception to protect myself,'" said Allina.

Some women may choose to use it occasionally if they cannot afford other methods, she added.

In a separate report on Thursday, CDC looked at overall contraceptive use and found that while the number of women using regular birth control pills has remained flat over time, the use of injections, patches and intrauterine devices has grown.

The number of women whose partners have used condoms also rose, the findings showed.

That trend may reflect increased wariness among Americans to have children amid the 2007-2009 economic recession, the effects of which are still being felt by many, according to researchers at the Guttmacher Institute, which also tracks birth control use.

"At the same time, it can make it harder for people to have access to birth control because of costs," especially for disadvantaged women who face higher rates of unintended pregnancies, said Lawrence Finer, head of domestic research for the reproductive research group.

That situation could change in the wake of the 2010 healthcare overhaul that required health insurers to begin covering birth control last year, although the law faces legal challenges.

Religious groups, particularly Catholics, charge that the provision violates their belief against artificial birth control and are fighting to block it.

(Reporting by Susan Heavey; Editing by Xavier Briand)

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