By Jeremy Laurance

Drug companies have always bought influence by sponsoring patient groups (see today's page one story in the Independent). How much influence do they wield? If your charity depends for half its income on the industry then it is harder to argue, as Timothy Statham, chief executive of the National Kidney Federation, does in a comment posted below my story, that "the receiving charity would never allow such sponsorship to influence the way it represents its patients' interests."  To most people that would represent a conflict of interest at the very least, which ought to be declared.

By Jeremy Laurance

Congratulations to The Guardian for taking on Matthias Rath, the doctor who promoted vitamin pills to HIV patients in South Africa as a substitute for anti-retroviral drugs (ARVs). Its exposure of his activities brought a libel action which cost the paper hundreds of thousands to defend but from which Dr Rath has now withdrawn. It was a brave decision to fight the case and the paper has been vindicated.

But there was one key fact missing from its extensive coverage of the case. The vitamin pills do actually work.

By Jeremy Laurance

She was a 90 year old woman with a failing heart who was offered an operation to replace a leaky valve.   Being from a robust wartime generation, she turned the offer down observing that it would be “unseemly” when others had greater needs that were unmet.

Libby Purves told this story in her column in The Times about her mother who finally died, aged 92, last week. In the context of the row over NICE’s refusal to approve four expensive cancer drugs, and today's rejection of a 'rule of rescue', it contains an important moral.

By Jeremy Laurance

Sir Jonathan Michael was shocked by the stories he heard of neglect and mistreatment of people with learning disabilities who sought treatment on the NHS. Yesterday's report of the independent inquiry he chaired into the six deaths highlighted last year by Mencap calls for change "from top to bottom" in the NHS to ensure their needs are met.

By Jeremy Laurance

Home deaths have something in common with home births - for too long there has been unwarranted prejudice against both. The medicalisation of what everyone hopes will be natural events has affected both ends of the lifespan. The Government, committed to extending choice, wants to see it offered at our beginning and our end.

Marie Curie's work in Lincolnshire has proved that many people, given the choice, prefer to die at home in familiar surroundings with their families in attendance and that it can be done successfully with the right support. Now the Government is rolling the scheme out nationwide. That is surely to welcomed.

But....it won't suit everyone.

By Jeremy Laurance

Are you a pill popper or a pill avoider? That is the question almost six million people must now face in the UK, after the latest guidelines from the National Institute for Clinical Excellence (NICE) on preventing heart disease, published today. They say that GPs should be routinely assessing their patients aged 40 to 75 for their risk of heart disease and prescribing cholesterol lowering pills to anyone with a 20 per cent increased risk of a heart attack or stroke in the next ten years. Just over 4 million people are currently taking them and NICE estimates another 1.5 million should be. Risk is assessed on factors including smoking, weight, blood pressure, kidney function etc. 

Clinically you cannot argue with NICE's logic. Cholesterol lowering drugs - called statins - reduce the risk of a heart attack by a third. They are so miraculously effective that the Government's Heart Tsar, Roger Boyle, who takes a daily statin himself, suggested last year that all men over 50 and all women over 60 should be taking them, regardless of their risk.

By Jeremy Laurance

Yesterday was a red letter day for science, for medicine and for the hopes of thousands whose families are afflicted by disease. Stem cell research and the use of saviour siblings can proceed unimpeded, thanks to last night's victory in the Commons on the Embryo bill.

Today, it could be a different story. The vote on abortion is expected to be much closer, with a real possibility that the present 24 week limit will be reduced. That would be a disaster for women.

Both sides in the debate are dug in, and there is little prospect of changing minds over the issue of viability. Research published this month in the BMJ by Professor David Field of the University of Leicester shows that while survival rates of babies born at 24 weeks have improved sharply in the last decade, those born at 23 or 22 weeks have shown no change. In other words, advances in medical care have improved the prospects for those over 24 weeks but have made no difference to the outcomes for those born before that limit.

By Jeremy Laurance

Jacqui Smith’s decision to upgrade cannabis to Class B from Class C is pure political posturing designed to persuade Middle England that the Government is tough on drugs. Classification is irrelevant. How many 14 year olds, about to puff on their first joint, will have any idea whether the drug they are ingesting is class C or B or what it means?

Far more helpful to parents and to those young people bent on trying the drug would be clear advice about how to minimise the risks. Cannabis is Britain’s most popular illegal drug used by 2.5 million people a year. Threatening users with an increase in the maximum prison sentence from two years (under Class C) to five years (Class B) for possession will not stop them experimenting.

By Jeremy Laurance

The big question raised by today's latest scare about vitamin pills increasing mortality is: why? How could a simple vitamin supplement, boosting what is found naturally in the diet, shorten life? The researchers, whose findings based on a review of 67 trials involving 232,000 subjects were published by the highly respected Cochrane Library, do not offer an explanation. But in previous research by the same group, led by Goran Bjelakovich, published in the Lancet in 2004, they did come up with a suggestion.

Vitamins are organic nutrients, essential for normal metabolism and good health. But there is a difference between the life-long physiological effects of small amounts ingested in the diet from childhood and pharamcological doses of the same micronutirents taken over a few years in early adulthood or middle age.

By Jeremy Laurance

Make no mistake, the Government's plans to offer checkups to everyone over 40 is not just about saving lives - it is about saving the NHS. Of course ministers are good and altruistic beings who care deeply about the welfare of their fellow citizens. But behind their concern lie some hard nosed calcultations about the escalating cost of provioding health services to an ageing nation.