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Cautious start to UK local pay scheme
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implicated. A racial tendency could be the reason why most cases of HIDS seem to be European in origin. However, it is conceivable that the under-identification of cases in the rest of the world could be due to the inability of hospital laboratories
collaborative project to the European Commission’s BIOMED II programme, to further investigate the
not
Second-class drugs for third world
a
clinical, genetic, immunopathological, and therapeutic aspects of the
Organisations campaigning to discourage pharmaceutical companies from exporting inferior drugs to developing German
condition. Ideas generated by the discussions contributed to the overall direction of the project. It was agreed that the project would include educational material for patients. In addition, steps will be taken to set up
lively
countries have succeeded-but only to a tiny extent. Surveys by BUKO PharmaKampagne of drugs available in 26 developing countries (on the basis of listings in pharmaceutical indexes) show that, for 1991/92, 53% were "negative"
IgD reliably. Although there are no good therapeutic agents for the syndrome, the pharmacological modulation of cytokines may well prove very satisfactory, so the identi- i a European patient organisation on fication of new cases becomes ever HIDS. more important. : to Joost P H Drenth, Richard J Powell Workshop participants agreed to
measure
Danish
haemophiliacs lose compensation claim
;
token award, since he was the latest of the 8 to have acquired the infection. He is now dead, and the award will go to his father. The plaintiffs had wanted the court to identify who should bear responsibility for the HIV infection (Lancet Feb 4, p 313). This wish was only partly met by the court. Jorgen Jacobsen, the lawyer acting behalf of the haemophiliacs, has on advised them to appeal. He thinks the case might stand a better chance in the since here it will be Court, posSupreme sible to make direct reference to a German case, that was published too late to be used. In Germany a commission’s report has
A Danish High Court has turned down a large claim by the Danish Haemophiliacs Association, which was acting on behalf of 8 Danish haemophiliacs said to have acquired their HIV infection through therapy with factor VIII in the mid-1980s. The court, however, granted 1 of the 8 haemophiliacs Dkr 18718 GC1817) against the National Board of Health and the Ministry of the Interior, thus placing some responsibility for the infection on these two bodies. They should not have allowed the use of non-HIV-screened facplaced large responsibility on doctors, tor VIII after Jan 1, 1986, the court said. producers, and authorities. It has led the The 7 other haemophiliacs were not Minister of Health to give the 1300 HIVgranted compensation since their time of infected German haemophiliacs a public infection could not be proved. Nor could apology on behalf of parliament and to it be proved that any of the defendants announce compensations of DM500 000 the National Board of Health, the MinGC200000). istry of the Interior, or factor VIII: 90 Danish haemophiliacs have been producer Novo Nordisk-could have actinfected with HIV; 47 are now dead. The ed in any other way than they did, the case concerns only 8. court said. The haemophiliac who was awarded compensation was chosen for theKaare Skovmand
(ie, did not meet criteria for efficacy, rational drug combination, adequate clinical testing, acceptable risk/benefit ratio, adequacy of dosage, and dosage form), compared with 60% for 1984 and 1988. 16% of exports were WHO essential drugs in 1991/92, and 12% in 1984 and 1988. The drug companies had reacted in different ways to the report from the first surveys, conducted in 1989. Some large companies withdrew many of their irrational combinations, but others added more than they withdrew. The quality of new introductions varied with region; 73% for the Philippines could be considered "positive", compared with 42% for the African market. The latest survey also revealed shocking examples of the marketing of these drugs in developing countries. For instance, 75 mg amfepramon (a central stimulant) plus 10 mg diazepam were listed as a means of inducing weight loss, and 50 mg nandrolone ampoules for the treatment of osteoporosis, liver cirrhosis, and extensive burns. BUKO is campaigning not just for the withdrawal of ineffective and dangerous drugs and a ban on unethical marketing, but also for more research into treatments for tropical diseases and for fair pricing of drugs in developing countries.
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they reserve the right to revert to the Karl old-style national pay recommendations in the next two years if the monitoring of local pay policies provides them "with that
Cautious start to UK local pay scheme The group that advises the Prime Minister on the pay increases that National Health Service doctors should receive has signalled that there should be a cautious and well-monitored introduction of locally determined pay.’ This recommendation, one of several that were accepted by the government this week, strikes a compromise between the opposing wishes of doctors’ representatives and the health
department. The review body recommended that there should be a "modest development of local pay for hospital consultants" and set out a transitional local pay scheme to that end. The review body made clear that the government must monitor carefully how hospital trusts are making these arrangements. In next year’s review they intend to appraise doctors’ reactions to this changeover scheme. They also emphasise
446
:
for concern". : immediate cause for the review body’s concern was the relatively late decision of the government to include junior doctors in its plan for locally arranged pay schemes. This goes against the government’s previous position and is in direct contradiction with the federation of NHS trust managers, who believe that juniors’ pay should continue to be nationally determined. Junior doctors’ representatives have said in the past that local pay schemes would disrupt training, which is : build around frequent job changes and short-term contracts.
H Kimbel
cause
:
A
more
Sarah 1
Ramsay
Review Body on Doctors’ and Dentists’ Remuneration. Twenty-fourth report. London: HM Stationery Office. 1995.
Pp 51. £8.10.
News in brief Gulf War syndrome The Royal College of Physicians is to examine 500 Gulf War veterans claiming to have the Gulf War syndrome. The UK Ministry of Defence hopes that an independent assessment will dispel impressions of a cover-up. ’õt
HIV prevention trial stopped The US National Institutes of Health ACTG152 trial among children randomised to zidovudine only, didanosine only, or zidovudine plus didanosine has been halted. Death rates, growth failure, opportunistic infections and neurological and neurodevelopmental deterioration were commoner in the zidovudine group.
implicated. A racial tendency could be the reason why most cases of HIDS seem to be European in origin. However, it is conceivable that the under-identification of cases in the rest of the world could be due to the inability of hospital laboratories
collaborative project to the European Commission’s BIOMED II programme, to further investigate the
not
Second-class drugs for third world
a
clinical, genetic, immunopathological, and therapeutic aspects of the
Organisations campaigning to discourage pharmaceutical companies from exporting inferior drugs to developing German
condition. Ideas generated by the discussions contributed to the overall direction of the project. It was agreed that the project would include educational material for patients. In addition, steps will be taken to set up
lively
countries have succeeded-but only to a tiny extent. Surveys by BUKO PharmaKampagne of drugs available in 26 developing countries (on the basis of listings in pharmaceutical indexes) show that, for 1991/92, 53% were "negative"
IgD reliably. Although there are no good therapeutic agents for the syndrome, the pharmacological modulation of cytokines may well prove very satisfactory, so the identi- i a European patient organisation on fication of new cases becomes ever HIDS. more important. : to Joost P H Drenth, Richard J Powell Workshop participants agreed to
measure
Danish
haemophiliacs lose compensation claim
;
token award, since he was the latest of the 8 to have acquired the infection. He is now dead, and the award will go to his father. The plaintiffs had wanted the court to identify who should bear responsibility for the HIV infection (Lancet Feb 4, p 313). This wish was only partly met by the court. Jorgen Jacobsen, the lawyer acting behalf of the haemophiliacs, has on advised them to appeal. He thinks the case might stand a better chance in the since here it will be Court, posSupreme sible to make direct reference to a German case, that was published too late to be used. In Germany a commission’s report has
A Danish High Court has turned down a large claim by the Danish Haemophiliacs Association, which was acting on behalf of 8 Danish haemophiliacs said to have acquired their HIV infection through therapy with factor VIII in the mid-1980s. The court, however, granted 1 of the 8 haemophiliacs Dkr 18718 GC1817) against the National Board of Health and the Ministry of the Interior, thus placing some responsibility for the infection on these two bodies. They should not have allowed the use of non-HIV-screened facplaced large responsibility on doctors, tor VIII after Jan 1, 1986, the court said. producers, and authorities. It has led the The 7 other haemophiliacs were not Minister of Health to give the 1300 HIVgranted compensation since their time of infected German haemophiliacs a public infection could not be proved. Nor could apology on behalf of parliament and to it be proved that any of the defendants announce compensations of DM500 000 the National Board of Health, the MinGC200000). istry of the Interior, or factor VIII: 90 Danish haemophiliacs have been producer Novo Nordisk-could have actinfected with HIV; 47 are now dead. The ed in any other way than they did, the case concerns only 8. court said. The haemophiliac who was awarded compensation was chosen for theKaare Skovmand
(ie, did not meet criteria for efficacy, rational drug combination, adequate clinical testing, acceptable risk/benefit ratio, adequacy of dosage, and dosage form), compared with 60% for 1984 and 1988. 16% of exports were WHO essential drugs in 1991/92, and 12% in 1984 and 1988. The drug companies had reacted in different ways to the report from the first surveys, conducted in 1989. Some large companies withdrew many of their irrational combinations, but others added more than they withdrew. The quality of new introductions varied with region; 73% for the Philippines could be considered "positive", compared with 42% for the African market. The latest survey also revealed shocking examples of the marketing of these drugs in developing countries. For instance, 75 mg amfepramon (a central stimulant) plus 10 mg diazepam were listed as a means of inducing weight loss, and 50 mg nandrolone ampoules for the treatment of osteoporosis, liver cirrhosis, and extensive burns. BUKO is campaigning not just for the withdrawal of ineffective and dangerous drugs and a ban on unethical marketing, but also for more research into treatments for tropical diseases and for fair pricing of drugs in developing countries.
: :
:
-
they reserve the right to revert to the Karl old-style national pay recommendations in the next two years if the monitoring of local pay policies provides them "with that
Cautious start to UK local pay scheme The group that advises the Prime Minister on the pay increases that National Health Service doctors should receive has signalled that there should be a cautious and well-monitored introduction of locally determined pay.’ This recommendation, one of several that were accepted by the government this week, strikes a compromise between the opposing wishes of doctors’ representatives and the health
department. The review body recommended that there should be a "modest development of local pay for hospital consultants" and set out a transitional local pay scheme to that end. The review body made clear that the government must monitor carefully how hospital trusts are making these arrangements. In next year’s review they intend to appraise doctors’ reactions to this changeover scheme. They also emphasise
446
:
for concern". : immediate cause for the review body’s concern was the relatively late decision of the government to include junior doctors in its plan for locally arranged pay schemes. This goes against the government’s previous position and is in direct contradiction with the federation of NHS trust managers, who believe that juniors’ pay should continue to be nationally determined. Junior doctors’ representatives have said in the past that local pay schemes would disrupt training, which is : build around frequent job changes and short-term contracts.
H Kimbel
cause
:
A
more
Sarah 1
Ramsay
Review Body on Doctors’ and Dentists’ Remuneration. Twenty-fourth report. London: HM Stationery Office. 1995.
Pp 51. £8.10.
News in brief Gulf War syndrome The Royal College of Physicians is to examine 500 Gulf War veterans claiming to have the Gulf War syndrome. The UK Ministry of Defence hopes that an independent assessment will dispel impressions of a cover-up. ’õt
HIV prevention trial stopped The US National Institutes of Health ACTG152 trial among children randomised to zidovudine only, didanosine only, or zidovudine plus didanosine has been halted. Death rates, growth failure, opportunistic infections and neurological and neurodevelopmental deterioration were commoner in the zidovudine group.