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Spain's babies to be fingerprinted at birth
UK Prime Minister promises to boost spending on health
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n an interview with the BBC on Jan 16, UK Prime Minister Tony Blair admitted that the National Health Service (NHS) is seriously underfunded, and pledged to increase expenditure on the service. Blair said that NHS spending should be brought in line with that of other European Union countries by 2005. The UK’s current spend on health is 6·8% of gross domestic
product, whereas the European average is 8%. The government had been stung by a wave of criticism and negative press in the past 2 weeks. Critics pointed to the service’s inability to cope with a modest, and predicted, influenza epidemic. And Robert Winston, fertility expert and Labour peer, gave an interview to the New Statesman magazine, in
which he criticised the goverment’s performance on health. “There is a lot wrong with the health service, and no one is prepared to say so. I shouldn’t really be saying these things to you now”, he said. So far, the government has no clarified how the extra funding is to be raised. Sarah Ramsay
US doctors’ group highlights public-health effects of sanctions ne of the largest medical organisations in the USA, the American College of Physicians–American Society of Internal Medicine (ACP–ASIM), which represents more than 115 000 US doctors, is calling on doctors to use their influence to persuade governments to make economic sanctions less harmful to the health of the people in targeted nations. In a position paper in the current issue of the ACP–ASIM’s journal Annals of Internal Medicine (2000; 132: 158–61), the organisation says that several studies indicate that UN sanctions imposed on Iraq have caused shortages of medicines that are to blame for increased rates of typhus, measles, and tuberculosis, “and a 30% increase in hospital mortality rate for other conditions and a 10% increase in overall mortality rate”. UN sanctions have also
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been linked to the deterioration of many Iraqi water-treatment systems resulting in a increased incidence of waterborne diseases including cholera and typhoid, the ACP–ASIM argues. “According to one study team’s estimate, malnutrition and waterborne diseases led to a three-fold increase in mortality rate in children younger than 5 years of age.” The ACP–ASIM also cites studies that link the US economic embargo on Cuba to nutritional deficiencies that caused an epidemic of otic and peripheral neuropathy that affected more than 50 000 Cubans. “Individual physicians cannot alleviate the suffering caused by sanctions”, the ACIP–ASIM says. “However, the medical and public health professions can help shape the structure and application of economic sanctions to ensure that they
protect the health of persons in the nations that are subject to them.” To reduce the harm they cause, sanctions should be drawn up with five principles in mind, the committee concludes. They should exclude food, medicines, and other materials needed to maintain a population’s health; give neutral agencies the necessary authority to assess the health effects of sanctions and address humanitarian appeals for exemptions; provide mechanisms to supply medical and health-related materials and services to offset any increased morbidity due to the sanctions; and establish a system to oversee the effective delivery of medical and health-related materials. The full text of the paper can be found on the ACP–ASIM website (www.acponline.org). Michael McCarthy
Spain’s babies to be fingerprinted at birth pain’s national health service (Insalud) introduced a new health-card system on Jan 12 to identify newborn babies to prevent their being mistakenly swapped at birth The system, which will come into effect on March 1 in all Insalud hospitals, uses an advanced technique to preserve fingerprints. Immediately after delivery, the midwife will take two sets of fingerprints from both mother and child. The fingerprints will be put on a card that includes other relevant data. Then, and always in the presence of the mother, the two parts of the card are separated; one will be attached to mother’s clinical record. The other half is given to the mother. The new legislation aims to give the baby a fundamental right to his or her identity, which is in line with the UN Declaration on the Rights of the
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Child. Alberto Núñez-Feijoó, Insalud’s president, said the new system will be “safe, reliable, simple, and attainable”. He added that both the baby and the mother will also continue to wear identification wristbands with locking devices. Nevertheless, the move has not been welcome by some health experts, especially Little prints forensic scientists. Miguel Lorente, a forensic clinician and assistant professor of legal medicine at the University of Granada, has pointed out that the new card does not solve all potential doubts about newborn identity. In his opinion, fingerprints are contextual and
do not establish any biological link between mother and her child. He said that the only reliable method is genetic fingerprinting and added that “no judge will admit the new card to establish the mother–child relationship but will always ask for DNA analysis”. But Rafael Matesanz, general director of Insalud’s department of primary and specialist health care, said that DNA analysis had been ruled out because of problems of confidentiality. Matesanz added that DNA tests can always be done later in a child’s life. Xavier Bosch
THE LANCET • Vol 355 • January 22, 2000
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n an interview with the BBC on Jan 16, UK Prime Minister Tony Blair admitted that the National Health Service (NHS) is seriously underfunded, and pledged to increase expenditure on the service. Blair said that NHS spending should be brought in line with that of other European Union countries by 2005. The UK’s current spend on health is 6·8% of gross domestic
product, whereas the European average is 8%. The government had been stung by a wave of criticism and negative press in the past 2 weeks. Critics pointed to the service’s inability to cope with a modest, and predicted, influenza epidemic. And Robert Winston, fertility expert and Labour peer, gave an interview to the New Statesman magazine, in
which he criticised the goverment’s performance on health. “There is a lot wrong with the health service, and no one is prepared to say so. I shouldn’t really be saying these things to you now”, he said. So far, the government has no clarified how the extra funding is to be raised. Sarah Ramsay
US doctors’ group highlights public-health effects of sanctions ne of the largest medical organisations in the USA, the American College of Physicians–American Society of Internal Medicine (ACP–ASIM), which represents more than 115 000 US doctors, is calling on doctors to use their influence to persuade governments to make economic sanctions less harmful to the health of the people in targeted nations. In a position paper in the current issue of the ACP–ASIM’s journal Annals of Internal Medicine (2000; 132: 158–61), the organisation says that several studies indicate that UN sanctions imposed on Iraq have caused shortages of medicines that are to blame for increased rates of typhus, measles, and tuberculosis, “and a 30% increase in hospital mortality rate for other conditions and a 10% increase in overall mortality rate”. UN sanctions have also
O
been linked to the deterioration of many Iraqi water-treatment systems resulting in a increased incidence of waterborne diseases including cholera and typhoid, the ACP–ASIM argues. “According to one study team’s estimate, malnutrition and waterborne diseases led to a three-fold increase in mortality rate in children younger than 5 years of age.” The ACP–ASIM also cites studies that link the US economic embargo on Cuba to nutritional deficiencies that caused an epidemic of otic and peripheral neuropathy that affected more than 50 000 Cubans. “Individual physicians cannot alleviate the suffering caused by sanctions”, the ACIP–ASIM says. “However, the medical and public health professions can help shape the structure and application of economic sanctions to ensure that they
protect the health of persons in the nations that are subject to them.” To reduce the harm they cause, sanctions should be drawn up with five principles in mind, the committee concludes. They should exclude food, medicines, and other materials needed to maintain a population’s health; give neutral agencies the necessary authority to assess the health effects of sanctions and address humanitarian appeals for exemptions; provide mechanisms to supply medical and health-related materials and services to offset any increased morbidity due to the sanctions; and establish a system to oversee the effective delivery of medical and health-related materials. The full text of the paper can be found on the ACP–ASIM website (www.acponline.org). Michael McCarthy
Spain’s babies to be fingerprinted at birth pain’s national health service (Insalud) introduced a new health-card system on Jan 12 to identify newborn babies to prevent their being mistakenly swapped at birth The system, which will come into effect on March 1 in all Insalud hospitals, uses an advanced technique to preserve fingerprints. Immediately after delivery, the midwife will take two sets of fingerprints from both mother and child. The fingerprints will be put on a card that includes other relevant data. Then, and always in the presence of the mother, the two parts of the card are separated; one will be attached to mother’s clinical record. The other half is given to the mother. The new legislation aims to give the baby a fundamental right to his or her identity, which is in line with the UN Declaration on the Rights of the
S
296
Child. Alberto Núñez-Feijoó, Insalud’s president, said the new system will be “safe, reliable, simple, and attainable”. He added that both the baby and the mother will also continue to wear identification wristbands with locking devices. Nevertheless, the move has not been welcome by some health experts, especially Little prints forensic scientists. Miguel Lorente, a forensic clinician and assistant professor of legal medicine at the University of Granada, has pointed out that the new card does not solve all potential doubts about newborn identity. In his opinion, fingerprints are contextual and
do not establish any biological link between mother and her child. He said that the only reliable method is genetic fingerprinting and added that “no judge will admit the new card to establish the mother–child relationship but will always ask for DNA analysis”. But Rafael Matesanz, general director of Insalud’s department of primary and specialist health care, said that DNA analysis had been ruled out because of problems of confidentiality. Matesanz added that DNA tests can always be done later in a child’s life. Xavier Bosch
THE LANCET • Vol 355 • January 22, 2000