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Overseas doctors in UK plan action in Europe
: sion of being "very obstinate" on a matter : that entailed "humiliation and discriminawith overseas the he said. all doctors "When national ; tion" for doctors, nurses, and teachers. British courts", qualificaThe Forum adopted a resolution urging forms of appeal have been exhausted, we: tions are planning a challenge to restricwill be entitled to take the cases to the: that health professionals and teachers tions on their freedom to work in :: with a primary qualification from a councontinental Europe, if European Union European Court of Human Rights." When British members of the Euro- : try outside the European Union, or the proposals on mutual recognition of qualistates linked to the Union through the fications do not take account of their pean Parliament raised the situation faced: Economic Area, "and whose : European demands. : by the 40 000 UK practitioners with over: have been registered as conqualifications seas qualifications at the first reading of On a visit to Strasbourg, Dr Srirama
Overseas doctors in UK plan action in
ferring competence of practice as a doclegislation in June (see Lancet, July 8, p tor, nurse or teacher by an EU/EEA : Mario 112), European Commissioner member state, should be deemed equally : who has for EU : Monti, responsibility "internal market" affairs, refused to :. competent to practise as a doctor, nurse amend the Commission text, saying the: or teacher within any other EU/EEA issue lay outside the scope of the propos- : member state". Venugopal hopes that als. However, the Parliament will have a: Migrants Forum will make a submission chance to revisit the subject when the to next year’s intergovernmental confer: ence at which further EU reforms will be draft is presented for second reading. Venugopal was in Strasbourg for a con- : discussed. ference of the European Union Migrants
Venugopal, president of the Overseas Doctors’ Association, said that the organisation’s contingency plan involves sponsoring "stalking horse" candidates in the form of association members who would apply to practise in France and Germany, the two states regarded as the most hostile to liberalisation. He claimed that the candidates have been selected. "If, as seems almost certain, the applications are rejected, the Association will support appeals against those decisions through
EU agency asks for
more
Forum
European Union’s Committee on Proprietary Medicinal Products has concluded that, although three independently conducted epidemiological studies indicate that oral contraceptives (OCs) containing the progestagens gestodene or desogestrel have a close to twofold risk of venous
at
which he accused the Commis-
Arthur
Rogers
national competent authorities not to take a national stance until a common position had been reached, the CPMP met again Safety of Medicines drew the health proweek. last fession’s attention to on Oct 18, attracting The committee’s latest assesment is that furious protests about the prematurity of: is no evidence that the two types of there the alert (see Lancet Oct 28, p 1149). The OCs in question differ from others in risk safety of other third-generation OCs-eg, ; of cardiovascular mortality or stroke. those containing norgestimate-has not that the three investigator teams been questioned, and the CSM advice Noting will be further analysing their data base, refers specifically to those containing CPMP the awaits further data on the, pergestodene or desogestrel. : risk of acute myocardial reduced, The three studies, not yet published, haps with these OCs . It has also infarction are a WHO multinational study, a cohort asked the concerned for drug companies study based on record linkage led by Prof further data the end of this by year, which H Jick (Boston, USA), and five-country ’., it will review the end of next April. by led Prof W 0
data
The
non-fatal
Europe
thromboembolic events:
compared with levonorgestrel-containing: other combined OCs, the possibility that inherent biases contributed to the differences cannot be excluded. : OCs containing gestodene or desogestrel are the two types of third-generation pills whose association with venous thrombosis the UK’s Committee on or
on
oral
contraceptives
study by Spitzer (Montreal, Canada). Having appealed, after its plenary session on Oct 17-18 to EU : Vivien Choo
.
The NFHS has provided the first direct national estimate of maternal mortality, states do not attend schools. An important step in providing health : estimated to to be 437 deaths per 100 000 The survey found that 39% of women livebirths-ie, over 100 000 women die and population planners in India with reliable statistics has been made with the aged 15-19 and 95% of women aged every year. One in nine children still dies publication of National Family Health Sur- : 25-29, were married. The population of before age 5. 30% children aged 12-23 months have not been vaccinated against women marrying very early has dropped vey, India (1992-93). A collaboration diphtheria, pertussis, tetanus, measles between the Indian Ministry of Health, sharply-the percentage of those marryUS Agency for International Developing before age 13 has declined from 21% poliomyelitis, or tuberculosis,. and 35% of those currently aged 45-49 to 7% of have been only partly vaccinated. ment, and the International Institute for Of the five specific diseases surveyed, : Population Sciences (IIPS), Bombay, the : those aged 15-19. malaria was the most prevalent, affecting About 40% of married women pracsurvey focused on collecting high-quality : 100 000 population. Partial or 3324 per the data for researchers and analysts, espe- : tised family planning, range blindness affected 3000 per complete in state on from the most mortal20% populous cially fertility, family planning, 100 000, physical impairment of limbs to in the most literand and child The 63% maternal health. ity, : (Uttar Pradesh) The most covered 99% of the used 639 per 100 000, and leprosy 120 per : ate state
Family and population health data collected for India
,
[
extending
widely (Kerala). population. According to the survey, Indian women : method of family planning is female sterare having fewer children than beforeilisation (67%), a permanent method: instead of an average of about five chil- : Nearly one of four women do not know of: dren per woman in the eighties, it is less : any modern temporary method, and: than four in the nineties, making the fer- : nearly 20% of currently married: tility rate in India among the lowest in : women-about 30 million-have a need: south Asia. At current rates high-school- ; for family planning that is not being satis- : educated women will have an average of: fied by the current programmes. Also, in two children, the illiterate will have four. : most states the overwhelming majority of: More than two-fifths of school-age girls : women said they had never heard of and more than half in several of the larger. AIDS.:
survey
100000.
Although the implications of the survey have yet to be widely debated, William Goldman of the Population, Health and Nutrition Office of USAID says "We believe the can be used survey by the Indian government to strengthen maternal child health and family planning programmes and policies." Sanjay Kumar
1219
Overseas doctors in UK plan action in
ferring competence of practice as a doclegislation in June (see Lancet, July 8, p tor, nurse or teacher by an EU/EEA : Mario 112), European Commissioner member state, should be deemed equally : who has for EU : Monti, responsibility "internal market" affairs, refused to :. competent to practise as a doctor, nurse amend the Commission text, saying the: or teacher within any other EU/EEA issue lay outside the scope of the propos- : member state". Venugopal hopes that als. However, the Parliament will have a: Migrants Forum will make a submission chance to revisit the subject when the to next year’s intergovernmental confer: ence at which further EU reforms will be draft is presented for second reading. Venugopal was in Strasbourg for a con- : discussed. ference of the European Union Migrants
Venugopal, president of the Overseas Doctors’ Association, said that the organisation’s contingency plan involves sponsoring "stalking horse" candidates in the form of association members who would apply to practise in France and Germany, the two states regarded as the most hostile to liberalisation. He claimed that the candidates have been selected. "If, as seems almost certain, the applications are rejected, the Association will support appeals against those decisions through
EU agency asks for
more
Forum
European Union’s Committee on Proprietary Medicinal Products has concluded that, although three independently conducted epidemiological studies indicate that oral contraceptives (OCs) containing the progestagens gestodene or desogestrel have a close to twofold risk of venous
at
which he accused the Commis-
Arthur
Rogers
national competent authorities not to take a national stance until a common position had been reached, the CPMP met again Safety of Medicines drew the health proweek. last fession’s attention to on Oct 18, attracting The committee’s latest assesment is that furious protests about the prematurity of: is no evidence that the two types of there the alert (see Lancet Oct 28, p 1149). The OCs in question differ from others in risk safety of other third-generation OCs-eg, ; of cardiovascular mortality or stroke. those containing norgestimate-has not that the three investigator teams been questioned, and the CSM advice Noting will be further analysing their data base, refers specifically to those containing CPMP the awaits further data on the, pergestodene or desogestrel. : risk of acute myocardial reduced, The three studies, not yet published, haps with these OCs . It has also infarction are a WHO multinational study, a cohort asked the concerned for drug companies study based on record linkage led by Prof further data the end of this by year, which H Jick (Boston, USA), and five-country ’., it will review the end of next April. by led Prof W 0
data
The
non-fatal
Europe
thromboembolic events:
compared with levonorgestrel-containing: other combined OCs, the possibility that inherent biases contributed to the differences cannot be excluded. : OCs containing gestodene or desogestrel are the two types of third-generation pills whose association with venous thrombosis the UK’s Committee on or
on
oral
contraceptives
study by Spitzer (Montreal, Canada). Having appealed, after its plenary session on Oct 17-18 to EU : Vivien Choo
.
The NFHS has provided the first direct national estimate of maternal mortality, states do not attend schools. An important step in providing health : estimated to to be 437 deaths per 100 000 The survey found that 39% of women livebirths-ie, over 100 000 women die and population planners in India with reliable statistics has been made with the aged 15-19 and 95% of women aged every year. One in nine children still dies publication of National Family Health Sur- : 25-29, were married. The population of before age 5. 30% children aged 12-23 months have not been vaccinated against women marrying very early has dropped vey, India (1992-93). A collaboration diphtheria, pertussis, tetanus, measles between the Indian Ministry of Health, sharply-the percentage of those marryUS Agency for International Developing before age 13 has declined from 21% poliomyelitis, or tuberculosis,. and 35% of those currently aged 45-49 to 7% of have been only partly vaccinated. ment, and the International Institute for Of the five specific diseases surveyed, : Population Sciences (IIPS), Bombay, the : those aged 15-19. malaria was the most prevalent, affecting About 40% of married women pracsurvey focused on collecting high-quality : 100 000 population. Partial or 3324 per the data for researchers and analysts, espe- : tised family planning, range blindness affected 3000 per complete in state on from the most mortal20% populous cially fertility, family planning, 100 000, physical impairment of limbs to in the most literand and child The 63% maternal health. ity, : (Uttar Pradesh) The most covered 99% of the used 639 per 100 000, and leprosy 120 per : ate state
Family and population health data collected for India
,
[
extending
widely (Kerala). population. According to the survey, Indian women : method of family planning is female sterare having fewer children than beforeilisation (67%), a permanent method: instead of an average of about five chil- : Nearly one of four women do not know of: dren per woman in the eighties, it is less : any modern temporary method, and: than four in the nineties, making the fer- : nearly 20% of currently married: tility rate in India among the lowest in : women-about 30 million-have a need: south Asia. At current rates high-school- ; for family planning that is not being satis- : educated women will have an average of: fied by the current programmes. Also, in two children, the illiterate will have four. : most states the overwhelming majority of: More than two-fifths of school-age girls : women said they had never heard of and more than half in several of the larger. AIDS.:
survey
100000.
Although the implications of the survey have yet to be widely debated, William Goldman of the Population, Health and Nutrition Office of USAID says "We believe the can be used survey by the Indian government to strengthen maternal child health and family planning programmes and policies." Sanjay Kumar
1219