Releases Saturday 18 May 2002
No 7347 Volume 324
Please remember to credit the BMJ as source when publicising
an
article and to tell your readers that they can read its full text on
the
journal's web site (http://bmj.com).
If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) ONE-OFF LESSON IMPROVES TEENAGERS'
KNOWLEDGE OF EMERGENCY
CONTRACEPTION
(2) PFI HOSPITALS ARE NOT VALUE FOR MONEY
(3) NEW
CONSENT RULES MAY THREATEN OUR
HEALTH
(1) ONE-OFF LESSON
IMPROVES TEENAGERS'
KNOWLEDGE OF EMERGENCY
CONTRACEPTION
(Improving teenagers' knowledge of
emergency
contraception: cluster randomised
controlled trial of a
teacher led intervention)
http://bmj.com/cgi/content/full/324/7347/1179
A single lesson on emergency contraception,
given by a
trained teacher, improves teenagers' knowledge
of the
correct time limits for using emergency
contraception, finds
a study in this week's BMJ.
Researchers recruited 1,974 boys and 1,820
girls in year
10 (14-15 years old) from 24 mixed sex,
state secondary
schools in south west England.
Trained teachers gave pupils in 12 schools
a single lesson
on emergency contraception (intervention
group). The
pupils were actively involved during the
lesson. Pupils in
the other 12 schools did not receive the
lesson until after
the study (control group).
At six months, the proportion of pupils
knowing the correct
time limits for hormonal emergency contraception
(72
hours) and for using the uterine device
as emergency
contraception (five days) was significantly
higher in the
intervention group than in the control
group.
The lesson did not increase pupils' sexual
activity or use of
emergency contraception. This is important,
given the
ongoing debate on the effects of sex education
and the
argument that promoting the use of contraception
encourages sexual activity, say the authors.
The change in the pupils' knowledge may
not translate to a
change in behaviour, as so many other
factors undoubtedly
play a role. However, educating teenagers
on the time
limits for use of emergency contraception
after unprotected
sex is more likely to have an impact on
behaviour than,
say, encouragement to use a condom, they
conclude.
Contact:
Anna Graham, Clinical Research Fellow,
Division of
Primary Health Care, University of Bristol,
Bristol, UK
Email: a.graham{at}bristol.ac.uk
(2) PFI HOSPITALS ARE NOT VALUE FOR MONEY
(Private finance and "value for money"
in NHS hospitals: a
policy in search of a rationale?)
http://bmj.com/cgi/content/full/324/7347/1205
The government claims that using the private
finance
initiative (PFI) to build NHS hospitals
offers value for
money. Yet researchers in this week's
BMJ show that the
costs of private finance are higher and
that NHS trusts pay
much more than they would if the new buildings
had been
publicly funded.
Allyson Pollock and colleagues examined
the structure of
costs for three PFI schemes: North Durham,
Carlisle, and
Worcester. They estimated what the cost
of the new
investment would have been if the scheme
had been
publicly funded, and they examined the
government's value
for money case.
They found that the PFI costs were almost
double the
estimated costs of a similar scheme funded
by public
finance. These higher costs are due in
part to financing
costs that a public sector alternative
would not incur, say
the authors.
Furthermore, the value for money assessment
seems to be
no more than a mechanism that has been
created to make
the case for using private finance, say
the authors. Many
hospital PFI schemes show value for money
only after risk
transfer. However, as other failed private
finance schemes
such as the Benefits Agency and Passport
Office show,
ultimately the risk is not transferred
and the taxpayer ends
up paying for private sector risk.
The government's case for using PFI rests
on a value for
money assessment skewed in favour of private
finance, say
the authors. The private finance initiative
brings no new
capital investment into public services
and is a debt which
has to be serviced by future generations,
they conclude.
Contact:
Professor Allyson Pollock, Health Policy
and Health
Services Research Unit, School of Public
Policy,
University College London, UK
Email: allyson.pollock{at}ucl.ac.uk
(3) NEW CONSENT
RULES MAY THREATEN OUR
HEALTH
(Consent, confidentiality, and the
threat to public health
surveillance)
http://bmj.com/cgi/content/full/324/7347/1210
Undue emphasis on patient consent and over-zealous
application of guidelines on confidentiality
would prejudice
disease surveillance and seriously threaten
the health of the
general public, doctors report in this
week's BMJ.
Surveillance of disease is essential to
protect and promote
public health. Information from routine
patient consultations
is used to identify hazards and control
the spread of
infections and disease. But health surveillance
relies entirely
on prompt and accurate reporting of the
occurrence of
disease by doctors and other health professionals.
In the light of recent guidelines, some
authorities have
questioned whether doctors should share
data of public
health importance that could potentially
identify patients
without either obtaining the patients'
explicit consent or
totally anonymising the data.
Drawing from examples from child health,
the authors
explain how routine surveillance protects
health. Certain
restrictions (for example, always asking
patient or parent
permission before passing on data) would
so damage
surveillance procedures that they would
cease to protect
the health of the public, resulting in
preventable ill health
and deaths.
They argue that the medical profession
needs to do more
to inform the public about the important
ways in which
information about individual patients
is used to protect
health.
They conclude that those responsible for
developing
guidelines on patient confidentiality
and consent, and for
advising doctors, must recognise the public
health duties of
doctors and consider issues related to
health surveillance
so that the health of the public is not
put at risk.
Contact:
Via Public Health Laboratory Service press
office,
London, UK:
Email: sgregor{at}phls.org.uk; ecollins@phls.org.uk
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact: pressoffice{at}bma.org.uk)
and from:
the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)
What's new
Keep updated
Services
Tools
Online poll
Resources
Print issues
