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19 May 2011 Last updated at 12:27 ET

Birmingham City Council acted unlawfully over a decision to reduce its provision of care for disabled people, High Court judges have said.

The judgement has implications for local authorities in England and Wales.

Thursday's ruling said local councils must abide by existing disability laws to eliminate discrimination.

It said councils must take account of people's disabilities, even where that involves treating disabled persons more favourably than others.

'Climate of cuts'

Across the UK there are 122 councils, as well as Birmingham, that currently only provide care to people with either substantial or critical care needs.

The judges said all public bodies had a duty to follow the disability discrimination law, while acknowledging that placed "significant and onerous" obligations on local authorities.

The families of four severely disabled people fought Birmingham council's spending cuts decision and took legal action against the authority.

Solicitor Karen Ashton represented the families and welcomed the High Court ruling in London saying it gave disabled people a voice in law.

'No new money'

She said the council's proposed policy would have had "devastating" results.

"With consequences of this kind, then councils must look if savings can be made elsewhere," she added.

Birmingham City Council said it welcomed the greater clarity of its duties with regard to the Disability Discrimination Act 2005.

Peter Hay, the council's strategic director of adults and communities, said: "The original dilemma between reducing services in different areas remains.

"There is no new money as a result of the judgement and hard choices about meeting growing needs with fewer resources will have to be made by local authorities."

The Conservative-Liberal Democrat run authority had proposed the cuts as part of a plan to save £212m.

In April a court sitting in Birmingham made an interim judgement that the council had acted unlawfully and this latest ruling is the full finding.

'Strong message'

In a statement Unison said: "The council should rightly be condemned for defending the indefensible. Thousands of vulnerable people in the city would have been put at risk if it were not for the intervention of the courts."

Deafblind charity Sense said the ruling should be a warning to all authorities.

Its head of legal services Kari Gerstheimer said other councils in England and Wales may be considering making similar cuts to social care.

"We hope that this judgement sends a very strong message to those councils, that we are in a climate of cuts.

"But even in a climate of cuts there are choices to be made and a civilised society does not choose to cut services to people with the greatest need - that's disabled people."

Previously the council said it had identified £118m worth of cuts by 2014-15 from its adult and communities directorate and needed to save £308m in total in the next four years due to the central government cuts outlined in the Spending Review.

It said only people whose needs were judged to be "critical" would qualify for council-funded care. Following the Adult social care judicial review on Thursday, the council said it would revise its plans and re-run the public consultation.

A council spokesman added: "It is important to point out that Mr Justice Walker has said that we were considerate and thoughtful of disabled people, in making our new offer, that our consultation was extensive but that it needed to be fully informed by impact assessment."

May 20, 2011

 

Rob Summers was a 20-year-old college baseball pitcher when a hit-and-run driver ran him down, paralyzing him from the chest down. But that was five years ago. Summers can now move his legs, feet and toes, and he can even stand up.

That's because of an experimental treatment that combines intensive physical therapy with electrical stimulation of the spinal cord.

"To everyone's disbelief, I was able to stand independently, the third day we turned it on," Summers said.

That may sound just like flipping a switch, but it was hardly that easy.

Summers spent more than two years before that doing what they call locomotor training: daily sessions on a treadmill, supported by a harness while therapists moved his legs.

Then, in 2009, surgeons put electrodes in his lower back, delivering a tiny bit of electricity to his spine.

"The stimulator feels like a tingling, and depending on the voltage it's either a weaker tingling that starts in my abs and goes down to my toes, or as the voltage gets higher it gets more intense," he said.

With the stimulator turned on, therapists helped Summers practice standing and moving his legs. He can now do that on his own. The study was published online in The Lancet.

Reggie Edgerton, one of the researchers, was working on this therapy for years, but seeing Summers move his legs was a big surprise.

"None of us believed that," he said. "I was afraid to believe it when I first saw it."

The researchers think that it's the electrical stimulation that made the difference.

"This demonstrates a concept, and it's a new concept," Edgerton said. "This demonstrates that you can regain voluntary control, but the voluntary control is only regained in the presence of stimulation."

Nerves talk to each other with electrical impulses, so it's not surprising that electricity was somehow involved. It could be that it amplified signals that the nerves were too weak to pick up on their own ? kind of like using a hearing aid to boost sounds. Or it could be that the exercise helped ? there's lots of evidence that intensive exercise can spark the growth of new nerve cells.

But the scientists say they really don't know why this worked ? and they've got much more work to do to figure it out.

Lex Frieden, a professor of rehabilitation at the University of Texas Health Science Center in Houston, was paralyzed in a car crash in 1967.

"Those of us who have spinal-cord injuries who are looking for a cure tomorrow are simply going to have to wait," Frieden said.

Even for Summers, his new ability to move has not become part of normal life. For one thing, he can move only when the electricity's turned on.

"I turn the stimulator on for two hours a day, I try to do one hour of standing, independently by myself, as well I do one hour of voluntary movement, with the stimulator on, moving hips, ankles, knees, just as if I was in the gym," Summers said.

But he's hardly complaining.

"I had a shot in my lower back just the other day as part of a checkup and I felt the entire thing ? the needle go in, the pain, everything," he said. "So that was both good and bad, exciting to experience that again, but knowing that I continue to make progress is very exciting."

Summers says he's happy with this progress, but researchers caution that they've only seen results in this in one patient, and it is far from a cure.

While some states and the federal government debate whether to halt funding of Planned Parenthood and other providers of family planning services, a new study finds that the cost of unintended pregnancies is large, and much of the bill ? about $11 billion per year ? goes to government programs and ultimately taxpayers.

The study by the Guttmacher Institute, a research group that was formerly affiliated with Planned Parenthood, is sure to raise some eyebrows in the anti-abortion community.

In the fight to take away Planned Parenthood's funding (which is more about abortion than family planning, since the organization provides both services), many abortion foes have also claimed that access to contraception actually increases the number of abortions.

 

"Funding for (Planned Parenthood) has increased by the millions over the last several years, and yet STDs and abortion rates continue to rise," said Marjorie Dannenfelser of the Susan B. Anthony List, a group that works to elect anti-abortion women candidates, on NPR's Talk of the Nation.

But those on both sides of the heated abortion issue generally trust and cite Guttmacher's research.

In the current study, Guttmacher researchers looked at federal and state data to calculate how many births resulting from unintended pregnancies were paid for by public programs, primarily Medicaid and the Children's Health Insurance Program.

They found that rates of unintended pregnancy are far higher among poor and near-poor women (those with incomes under twice the federal poverty level) than those with higher incomes. As a result, nearly two-thirds (64 percent) of the 1.6 million births resulting from unintended pregnancies in 2006 were paid for by public health insurance programs.

Put another way, just over half of all births paid for by those programs, 51 percent, were the result of unintended pregnancies.

And this is no small amount we're talking about. Because Congress has expanded health coverage for pregnant women through both Medicaid in the 1980s and early 1990s and CHIP later on, those programs now pay for 48 percent of all births in the U.S. each year, up from 32 percent in 1991.

As a result, the $11.1 billion the programs spent on those unintended pregnancies meant that the federal government and states together spent an average of $180 on maternity and infant care for every woman between the ages of 15 and 44 in the nation.

May 20, 2011

 

Rob Summers was a 20-year-old college baseball pitcher when a hit-and-run driver ran him down, paralyzing him from the chest down. But that was five years ago. Summers can now move his legs, feet and toes, and he can even stand up.

That's because of an experimental treatment that combines intensive physical therapy with electrical stimulation of the spinal cord.

"To everyone's disbelief, I was able to stand independently, the third day we turned it on," Summers said.

That may sound just like flipping a switch, but it was hardly that easy.

Summers spent more than two years before that doing what they call locomotor training: daily sessions on a treadmill, supported by a harness while therapists moved his legs.

Then, in 2009, surgeons put electrodes in his lower back, delivering a tiny bit of electricity to his spine.

"The stimulator feels like a tingling, and depending on the voltage it's either a weaker tingling that starts in my abs and goes down to my toes, or as the voltage gets higher it gets more intense," he said.

With the stimulator turned on, therapists helped Summers practice standing and moving his legs. He can now do that on his own. The study was published online in The Lancet.

Reggie Edgerton, one of the researchers, was working on this therapy for years, but seeing Summers move his legs was a big surprise.

"None of us believed that," he said. "I was afraid to believe it when I first saw it."

The researchers think that it's the electrical stimulation that made the difference.

"This demonstrates a concept, and it's a new concept," Edgerton said. "This demonstrates that you can regain voluntary control, but the voluntary control is only regained in the presence of stimulation."

Nerves talk to each other with electrical impulses, so it's not surprising that electricity was somehow involved. It could be that it amplified signals that the nerves were too weak to pick up on their own ? kind of like using a hearing aid to boost sounds. Or it could be that the exercise helped ? there's lots of evidence that intensive exercise can spark the growth of new nerve cells.

But the scientists say they really don't know why this worked ? and they've got much more work to do to figure it out.

Lex Frieden, a professor of rehabilitation at the University of Texas Health Science Center in Houston, was paralyzed in a car crash in 1967.

"Those of us who have spinal-cord injuries who are looking for a cure tomorrow are simply going to have to wait," Frieden said.

Even for Summers, his new ability to move has not become part of normal life. For one thing, he can move only when the electricity's turned on.

"I turn the stimulator on for two hours a day, I try to do one hour of standing, independently by myself, as well I do one hour of voluntary movement, with the stimulator on, moving hips, ankles, knees, just as if I was in the gym," Summers said.

But he's hardly complaining.

"I had a shot in my lower back just the other day as part of a checkup and I felt the entire thing ? the needle go in, the pain, everything," he said. "So that was both good and bad, exciting to experience that again, but knowing that I continue to make progress is very exciting."

Summers says he's happy with this progress, but researchers caution that they've only seen results in this in one patient, and it is far from a cure.

19 May 2011 Last updated at 19:42 ET By James Gallagher Health reporter, BBC News

A US man who was paralysed from the chest down after being hit by a car is now able to stand with electrical stimulation of his spinal cord.

Rob Summers, from Oregon, said standing on his own was "the most amazing feeling".

He can voluntarily move his toes, hips, knees and ankles and also walk on a treadmill while being supported, according to research in the Lancet.

However, a UK expert said this should not be interpreted as a cure.

Rob Summers is able to stand while his spinal cord is stimulated

Rob was a keen baseball player and in 2006 was part of the team which won the College World Series.

But in that summer he was injured in a hit and run accident and his spinal cord was damaged.

Messages from the brain, which used to travel down the spinal cord, were blocked and he was paralysed.

Doctors surgically implanted 16 electrodes into his spine.

Rob trained daily in trying to stand, walk and move his legs, while electrical pulses were sent to the spinal cord.

Within days he was able to stand independently and eventually he could control his legs and step, with assistance, for short periods of time.

"None of us believed it," said Professor Reggie Edgerton, from the University of California. "I was afraid to believe it."

Rob has also regained other functions such as bladder, bowel and blood pressure control.

He said it had been a "long journey of countless hours of training" which had "completely changed my life".

He added: "For someone who for four years was unable to even move a toe, to have the freedom and ability to stand on my own is the most amazing feeling."

Warning

This study has proved that electrical stimulation works in one person. Four more patients are being lined up to further test the treatment.

Professor Geoffrey Raisman, from the Institute of Neurology at UCL, said: "This one case is interesting, and from one of the leading groups in the world. To what extent this procedure could in the future provide a further and sustained improvement cannot be judged on the basis of one patient.

"From the point of view of people currently suffering from spinal cord injury, future trials of this procedure could add one more approach to getting some benefit. It is not and does not claim to be a cure."

Dr Melissa Andrews, from the Cambridge Centre for Brain Repair, said that while the study was a "little bit mind blowing" people should not say this is a cure.

She added: "I think people need to read this and say the possibility is out there, but it may not come tomorrow. It's the closest we've ever seen and it's the best hope right now."

Professor Susan Harkema, who was part of the study at the University of Louisville, said: "It is really critical to be clear that it's still in a research realm, but stay tuned we're going to learn a lot more every day."

For Rob he sees his story as a message of hope to people who are paralysed and as for walking again: "I see it as a major possibility."

Yemeni President Ali Abdullah Saleh promised Thursday to sign a deal that would end his decades-long rule, a spokesman said, while President Obama called on the embattled leader to transfer power.

Yemen's opposition rejected Saleh's promise, accusing the embattled leader of stalling. Saleh has rejected the agreement before most recently 24 hours before his latest promise to sign.

Yemen is reeling from three months of street protests demanding Saleh's ouster. The United States, which until recently considered Saleh an key ally in fighting Yemen's active al-Qaida branch, has backed away from the leader, calling on him to stand down.

In his speech Thursday on American policy in the Arab world, Obama referred to Yemen directly. He said, "President Saleh needs to follow through on his commitment to transfer power."

Tens of thousands of Yemenis watched the speech on a giant screen in the public square in the capital of Sanaa that has been the focus of the protest movement.

When Obama mentioned Yemen, people chanted, "The people want to topple the regime" the rallying cry made famous in the Tunisian and Egyptian uprisings that inspired the protests in Yemen and elsewhere.

Activist Bashir Mohammed said the speech told repressive regimes that revolutions will determine the future.

"The traditional regimes must learn the lessons of history and work for change or leave," he said.

The most recent effort to end the Yemen's political crisis appeared to collapse Wednesday. The Gulf Cooperation Council has sought to broker an agreement, backed by Washington, for Saleh to leave power in exchange for immunity from prosecution.

But Saleh refused, prompting the coalition's head, Abdul-Latif al-Zayyani, to leave Yemen.

Saleh also rebuffed the deal last month after promising to sign.

On Thursday, presidential spokesman Ahmed al-Sufi said Saleh had changed his mind, agreeing to sign the agreement Sunday during the celebration of Yemen National Day at the Presidential Palace in Sanaa. Al-Sufi said al-Zayyani would return to Yemen for the event.

Al-Sufi said Saleh made the decision after intense diplomatic pressure from Gulf states and other countries.

"The president is ready at any time to sign," he said.

The GCC, however, said in a statement that its foreign ministers would meet in the Saudi capital Sunday to discuss the crisis in Yemen. It said al-Zayyani would attend that meeting.

The Yemeni opposition dismissed Saleh's promise to sign.

"If the president decides to sign on Sunday, nothing will stop him," opposition spokesman Mohammed al-Sabri said. "We are sure that president is playing games with time."

Al-Sabri called on the GCC to take a clear position on Saleh's opposition to the agreement.

"They cannot go along with the president's strategies to gain more time," he said.

The mass protests have posed an unprecedented challenge to Saleh's rule. Several top military commanders and ruling party officials have defected to the opposition, while a crackdown by government forces has reportedly killed more than 150 people.

Yemen, Saudi Arabia's southern neighbor, faced crises even before the protests. It is plagued with widespread corruption, a weak central government, a Shiite rebellion in the north, a secessionist movement in the south and an active branch of al-Qaida in its weakly governed provinces.

19 May 2011 Last updated at 20:22 ET

Pre-eclampsia is a serious condition which can affect up to 10% of pregnant women.

A dietary supplement given to pregnant women at high risk of pre-eclampsia can reduce the likelihood of the disease occurring, a study says.

Writing in the British Medical Journal, researchers says the presence of an amino acid and antioxidant vitamins in the supplement helps to combat abnormally high blood pressure.

More than 600 women took part in the study in Mexico City.

But experts say more research is needed on the effects of the supplement.

Pre-eclampsia is a serious condition where abnormally high blood pressure and other problems develop during pregnancy.

It affects up to 10% of all first-time pregnancies and is dangerous for both mother and child.

Pre-eclampsia is thought to be linked to a deficiency in L-arginine, an amino acid that helps maintain a healthy blood flow.

So, as part of their study in the British Medical Journal, researchers in Mexico and the United States gave 228 pregnant women at high risk of pre-eclampsia daily food bars containing L-arginine and antioxidant vitamins.

Another 222 pregnant women received bars containing only vitamins, and another group of 222 got bars containing no L-arginine or vitamins, the placebo group.

The supplements began when women were 20 weeks pregnant and continued until they gave birth.

Major health risk

The research team found that 30.2% of women developed pre-eclampsia in the placebo group, 22.5% in the group given a vitamin bar and 12.7% in the L-arginine and vitamin group.

The study authors said the L-arginine and vitamin group women were significantly less likely to develop pre-eclampsia.

"This relatively simple and low cost intervention may have value in reducing the risk of pre-eclampsia and associated preterm birth," they said.

But they added that further studies are needed to see whether the results can be repeated.

Gail Johnson, midwife teacher at the Royal College of Midwives, cautioned that it was a relatively small study which excluded some high-risk groups.

"It's a starting point for looking at pre-eclampsia, which poses a significant health risk and is an important thing to solve, but there are lots of questions still to be asked about the effects of the supplement."

Andrew Shennan, professor of obstetrics and gynaecology at St Thomas' Hospital, said there were established scientific reasons why L-arginine and antioxidants reduce the occurrence of pre-eclampsia.

"Previous studies, testing each supplement individually, have shown little effect, so it is exciting that in combination they seem to have such a profound effect on preventing pre-eclampsia."

"However, it is unusual that so many people in the control group developed pre-eclampsia - 30% is an unusually high rate of incidence of the disease so I would be interested to see if the effects of the study could be replicated elsewhere."

18 May 2011 Last updated at 21:24 ET By Nick Triggle Health correspondent, BBC News

The NHS changes affect only England

The debate about the NHS changes in England has "lost contact with reality", a leading Tory MP says.

Ex-health secretary Stephen Dorrell also warned that the "nonsensical" row about competition could lead to concessions that harm patients.

He told the BBC competition was already a key part of the NHS - and was being used to improve services.

Mr Dorrell was speaking out after Nick Clegg suggested he would oppose the promotion of competition in the NHS.

The deputy prime minister has increasingly been taking a tougher stance on NHS reforms, which were put on hold in April amid mounting criticisms among health staff and experts.

He told Lib Dems on Tuesday night that he did not want to see the NHS treated like it was the "electricity or telephone" industries.

Unions have also taken a highly critical stance, warning that the plans could lead to privatisation of the NHS.

'Non-argument'

Much of the concern has been directed at the proposal to give the regulator, Monitor, a duty to promote competition.

But Mr Dorrell, now the chairman of the House of Commons Health Committee but a health secretary under John Major, said: "The idea there is no competition in the NHS is just bonkers. There are few more competitive groups of people than good doctors. They compete and that improves the care of patients."

He also pointed out that competition with the private sector was being seen in other areas of the NHS from hospital care to mental health.

"The private sector has a role to play. That is a non-argument. I think this whole debate has lost contact with any reality."

He said he did not feel strongly about the duty being given to Monitor, suggesting it would make little difference.

"When I was health minister I did not know what the statutory duties were... they just got on with delivering health services."

But he warned the nature of the debate could lead to damaging concessions being made that could harm competition and, ultimately, patients.

"I think there is a significant danger that political understandings are given that have consequences."

The warning was echoed by the NHS Partners Network, which represents health firms already involved in providing NHS care.

David Worskett, director of the network, said: "There is now a danger that if the NHS turns its back on competition, it may be depriving itself of one of the levers it needs to help it adapt and respond to the huge demographic and financial challenges it faces in the next 20 years, whilst maintaining and improving patient care."