Truth about Albany Midwives

[Keef]

Well I don't claim to know enough about this to really have a solution.

In social services terms, it would be like a local authority ending an association with a particular care agency. Perhaps Albany should have been put through some sort of "special measures", whereby the issues could have been identified, and rectified at an early stage.

Like I say though, I don't really know the ins and outs of this, and so can't offer an answer.

[jollybaby]

A perinatal death is a disaster for any obstetric unit (and of course the family) and I would be very surprised if Kings didn't keep a record of such events as they are so serious and few and far between. I'm sure if you asked the midwives and doctors involved they could remember and name every case they have been involved with in their career.

And Keef I know what you mean about special measures - but as a parent would be a bit worried about sending a child to a school in special measures I'm not sure that many would be keen to risk a having their baby delivered by a midwifery team in this position.

Having said this I've never had a baby, don't know the full story but DMR to say that if Kings are right they are in the wrong as they have been negligent (as they should have terminated the contract years ago) and if they are wrong they are also in the wrong is not really fair. If there is any concern about fitness to practice it should be investigated. And if that means that work is suspended in the meantime then so be it.

[Keef]

I know what you mean, but actually, a service under special measures is going to be one of the very best places to go to (whatever the service is), as they will not be putting a foot wrong!

[dmr]

jollybaby, I am only quoting what Leoni Penna said on the MSLC meeting, she is the one that mentioned the stuff about the records...I know it sounds unbelievable, that is exactly how I felt, luckily there were around 10 of us there that heard the same.

I totally agree with you "If there is any concern about fitness to practice it should be investigated", but so far all the reasons that Kings gives as to why they have closed the practice have been proved irrelevant. As a mother and King's and Albany's "client" I feel I have got the right to see the report and to have the reasons for the Albany closure explained properly, backed up by an unbias report and not by one which itself says that from the data provided can not draw any meaningful conclusions.

I am just fighting for my right to know the truth!

[mumof3girlies]

I thought I would post some information about HIE, as Kings has decided to post their figures on HIE on their website.

HIE stands for Hypoxic ischaemic(or sometimes induced) encephalopathy, as a health professional(and a former Midwife) working within maternity services I have had experience of babies suffering from this condition.

HIE is now being phased out as a medical term, largely because it is very difficult to diagnose, it is diagnosed by existence of factors varying from seizures, abnormalities in breathing, difficulty in feeding and lack of tone or reflexes. In developing countries with adequate maternity care the rate remains static at about 4/1000 live births, what is most interesting is that elective caesarean section does not change the incidence, which indicates that it is rarely caused by negligence during the labour and delivery period. The BMJ (Dec 1998) in a large study of babies with HIE states 'For many years it was accepted that fetal asphyxia (loss of oxygen) during labour was the major cause of neonatal encephalopathy, however the evidence for this is surprisingly thin'.

Therefore if Kings is implying that because of negligent care during labour the Albany Midwives are responsible for babies with HIE, this is not medically possible. Firstly nobody has actually seen the figures of these apparent babies affected by HIE, they may have been diagnosed with very mild HIE i.e. problems with feeding or poor tone, not uncommon problems in the neonatal period. Secondly, an independant statistician who reviewed the report that Kings produced actually questioned the methodology of the report, most importantly that such a small group of cases were studied (under 40) and that there was no control group. The statistician stated that it was impossible to draw a scientific conclusion from the data supplied.

Kings have chosen to put these figures on their website because they feel they need to justify their appalling treatment and management of skilled midwives, however the facts and figures just don't add up, and hopefully over time and with more and more media coverage (BBC London News and Channel 4 covered our campaign today) Kings will have to publish the report and then it will be ripped to shreds by the scientific community.

I honestly have no idea why Kings College Hospital have chosen to behave in this way, but it is nothing new; the vilification of Midwives and Doctors who assist women in having choice and achieving natural and intervention free birth: Wendy Savage in the 1980's and Caroline Flint in the 1990's both practitioners completely exonerated of any negligence and went on the continue in their practice. Wendy Savage retired in the early 2000s after sitting on the General Medical Council and Caroline Flint continues to practice in her highly successful birth centre in South London.

The truth will out...

[Ann]

However the statement does reiterate that there are nine midwifery-led group practices locally that still exist and that King's has a 9% homebirth rate; which they are rightly proud of.

Why do people think Albany have been selected for special treatment?

Some of you will be aware that Independant Midwives may not practice indepenadantly at Kings and Caroline Flint is one of them.

I'm surprised that HIE is considered an out-dated term as King's Neo-natologists use it all the time. Frederick Still ward ( Neo-natal Unit), is, I'm fairly sure, a world standard centre of excellence.

Midwives have an over-riding responsibilty to make sure that no full term baby ends up there, even if it goes against the parents Birth Plan.

[mumof3girlies]

I did not personally say the term HIE is being phased out, but the author of the counter report that analysed Kings' original report claiming the Midwives had a higher than average rate of HIE. I am in no doubt, that Frederick Still Ward is a world standard centre of excellence.

=Ann wrote: Why do people think Albany have been selected for special treatment?]

Maybe because they have a 14.9% caesarean rate compared to 24% rate at Kings College, an 80% breastfeeding rate at 28 days (35% at 7 days at Kings) and a 4.9/1000 per live births infant mortality rate (Kings 7.9/1000). Interestingly Leonie Penna made a speech at the Albany Anniversary party (just 2 years ago) commending their excellent practice and that if she ever had a baby she would want them as her midwives, she seemed to be quite happy with their ethos and model of working then - remember that Kings have also stated in the past month that The Albany 'don't follow the rules'. Also if you google Leoni Penna you will find her quoting the Albany and their low caesarean rate. Lets not put a slur on these midwives practice as let us be reminded that they are all still registered on the NMC register and have been investigated and cleared by the NMC. I sure Ann if anybody brought into question your midwifery practice you would be devastated...

Ann - are you implying that because Kings prohibits Independant Midwives in particular Caroline Flint that they are unsafe or negligent in their practice? Obviously I cannot speak for all Independant Midwives, but I am certainly sure that Caroline Flint has no claims of malpractice against her.

[seanareprawn]

Ann Wrote:

-------------------------------------------------------

> However the statement does reiterate that there

> are nine midwifery-led group practices locally

> that still exist and that King's has a 9%

> homebirth rate; which they are rightly proud of.

>

> Why do people think Albany have been selected for

> special treatment?

Hi Ann. I think it's good to have someone arguing the case for Kings here to balance up the debate. It's an emotional subject and too easy to rail against the faceless body of Kings rather than look at the facts objectively.

The problem is that the whole situation seems to be mired in hearsay and we are light on facts. Initially (from the More4 news report) it seemed that Kings were terminating the contract due to an unfortunate death of a baby for which they were sued. Subsequently it was discovered that the midwives were cleared of any wrong doing in this case. So this was not the problem.

Now we have this report from Kings about the cases of HIE being higher in the Albany practice. Apparently they commissioned an investigation where they picked a handful of cases and they were studied. This investigation came back showing that it was indeed the case that there were more HIE cases but with the strong caveat that it was statistically inconclusive due to the nature and number of cases selected and the lack of a proper control group. This doesn't sound like good scientific analysis that you can base a decision on.

Now I know that there are other midwifery led practices in Kings, but none of them follow the Albany model of care. They are not the same thing. Closing the practice in this way reduces choice for mothers who want the Albnay model of care and this means that Kings should be answerable to the community when they decide to close it down. The current line of "We have a report that says they contributed to more HIE, but you're not allowed to see the investigation or techniques involved" doesn't really cut the mustard. If the report cannot stand scrutiny, then they should suspend the contract until a proper report that does stand up to scrutiny can be done.

Probably the most interesting information I have found so far is from the NCT statement in support of the Albany found here:

http://www.nctpregnancyandbabycare.com/press-office/press-releases/view/190

The NCT is concerned that the contract has been terminated suddenly ? a situation which we understand to be due to a breakdown in communication and good contract management. This poor management has lead to difficult relationships between the Trust and the Practice, and questions being raised about the care provided.

NCT are obviously privy to more information than I can get hold of, but reading between the lines here I am guessing that one/some of the Albany midwives had clashed with the Kings staff. The continued breakdown meant that Kings decided they could not work with them anymore and wanted to get rid of this thorn in their side. Hence the statisitical investigation with limited data and the subsequent termination of the contract.

Just to make it clear where I'm coming from, I am an 'Albany dad' and enjoyed excellent care from them with the birth of my son. This doesn't mean I will blindly support them purely due to my fantastic experience with them, but I am currently extremely unconvinced by the statements coming from Kings that this was a purely medical decision.

Other links for more info

http://www.radmid.demon.co.uk/123albany.htm

Do your own research.

rgds

sean

[mumof3girlies]

More info here about the report and Alison Mcafarlane - the statistician who reviewed the report that Kings have supplied to the Albany Midwives.

http://www.timesonline.co.uk/tol/news/

[Michael Ryan]

Dear Albany Mums,

My wife and I are from SE London and now live in Shrewsbury where we've had four children and buried two of them. I went to school in Blackheath and studied Civil Engineering at Woolwich/Thames Polytechnic forty years ago.

If both our children had died as infants, my wife or I or both would probably have been suspected of foul play (see articles about Sally Clark & others wrongly accused) and surviving children "taken into care".

The South London Press of 4 May 2007 had article (on page 17) by Julia Lewis about my research into infant mortality rates in electoral wards in London when I'd examined the data for the three-year period 2003-2005.

I've finished analysing the infant mortality statistics in London for the seven-year period 2002-2008 and noticed that the electoral wards that are near to or downwind of incinerators have high rates of infant deaths while the electoral wards that are free from such emissions have low rates or even zero infant deaths as were recorded in twelve London electoral wards.

The Southwark ward of Newington had the highest infant death rate in London for the 7-year period 2002-2008 at 14.0 per 1,000 live births which is around three-times the average rate for England & Wales. The total number of live births in Newington was 1499 for the 7-year period and there were 21 infant deaths.

Eastcote & East Ruislip ward (Hillingdon Borough) had the highest infant death rate in London for the 6-year period 2002-2007 at 13.9 per 1,000 live births. Eastcote & East Ruislip is one of the five percent of "least deprived" wards in London but their residents are being deprived of clean air due to emissions from incinerators at Colnbrook (Slough) and Hillingdon Hospital.

Southwark is "sandwiched" between two incinerators, namely SELCHP in Lewisham and the Kings College Hospital incinerator which is authorised by the Environment Agency to burn radioactive waste - just like the St Mark's Hospital incinerator in Northwick Park, Brent and the White Rose incinerator at Sidcup Hospital.

There won't be many "Albany Mums" in Northwick Park ward which had the highest infant death rate in Brent for 2002-2008 at 12.4 per 1,000 (970 live births and 12 infant deaths) - and maybe not in Sidcup ward either which had the highest infant death rate in Bexley Borough for the same 7-year period 2002-2008 at 7.9 per 1,000.

Here in Shropshire, some electoral wards have had zero infant deaths in each of the sixteen years 1993-2008, ie my entire record of Office for National Statistics data. These "zero infant death wards" are those that have clean air. They also have plenty of poor people as rural Shropshire has always "enjoyed" low wages - just like agricultural districts elsewhere.

Look at the extract from the "infant mortality" sectionpage 471 of Black's Medical Dictionary (1944 edition) because you'll see that the infant death rate rose as there was more exposure to combustion fumes:

"As a general rule it (ie infant mortality) is lowest in agricultural districts, higher in thickly populated mining and manufacturing regions, and highest in large towns where textile industries are carried on and where female labour is largely employed."

Here's the 1st sentence in the conclusion of the Japanese study into infant deaths around 63 incinerators:

"Our study shows a peak-decline in risk with distance from the municipal solid waste incinerators for infant deaths and infant deaths with all congenital malformations combined."

J Epidemiol. 2004 May;14(3):83-93.

Risk of adverse reproductive outcomes associated with proximity to municipal solid waste incinerators with high dioxin emission levels in Japan.

Tango T, Fujita T, Tanihata T, Minowa M, Doi Y, Kato N, Kunikane S, Uchiyama I, Tanaka M, Uehata T.

Department of Technology Assessment and Biostatistics, National Institute of Public Health, Wako, Saitama, Japan.

BACKGROUND: Great public concern about health effects of dioxins emitted from municipal solid waste incinerators has increased in Japan. This paper investigates the association of adverse reproductive outcomes with maternal residential proximity to municipal solid waste incinerators. METHODS: The association of adverse reproductive outcomes with mothers living within 10 km from 63 municipal solid waste incinerators with high dioxin emission levels (above 80 ng international toxic equivalents TEQ/m3) in Japan was examined. The numbers of observed cases were compared with the expected numbers calculated from national rates adjusted regionally. Observed/expected ratios were tested for decline in risk or peak-decline in risk with distance up to 10 km. RESULTS: In the study area within 10 km from the 63 municipal solid waste incinerators in 1997-1998, 225,215 live births, 3,387 fetal deaths, and 835 infant deaths were confirmed. None of the reproductive outcomes studied here showed statistically significant excess within 2 km from the incinerators. However, a statistically significant peak-decline in risk with distance from the incinerators up to 10 km was found for infant deaths (p=0.023) and infant deaths with all congenital malformations combined (p=0.047), where a "peak" is detected around 1-2 km. CONCLUSION: Our study shows a peak-decline in risk with distance from the municipal solid waste incinerators for infant deaths and infant deaths with all congenital malformations combined. However, due to the lack of detailed exposure information to dioxins around the incinerators, the observed trend in risk should be interpreted cautiously and there is a need for further investigation to accumulate good evidence regarding the reproductive health effects of waste incinerator exposure.

More info at www.ukhr.org

Kind regards,

Michael Ryan,

Shrewsbury

[Michael Ryan]

Here's two London articles about my research:

http://www.guardian-series.co.uk/news/wfnews/1592749.Concerns_over_infant_death_rates_in_Chingford_Green/

http://www.hounslowchronicle.co.uk/west-london-news/local-hounslow-news/2008/08/21/baby-death-rates-soar-109642-21573869/

Here's how they are mapping infant death rates in Saginaw:

http://www.mlive.com/living/saginaw/index.ssf/2009/04/saginaw_county_infant_mortalit.html

Here's how I've been mapping data:

http://ukhr.org/incineration/kirklees.pdf

Here's the Health Protection Agency letter to me admitting no relevant studies of health around any incinerator:

http://www.ukhr.org/incineration/justinmccracken8june2009.pdf

Here's text of South London Press article of 4 May 2007:

Health Risk

by

Julia Lewis

FAMILIES living downwind of incinerators are more at risk from infant death, heart disease, cancer and autism, health researchers claim. Michael Ryan and Dr Dick van Steenis believe babies are more likely to die if they are exposed to fumes from incinerators like the South East London Combined Heat and Power Plant (SELCHPP) in Deptford. The researchers point to Office of National Statistics (ONS) figures showing infant mortality rates ward by ward. Areas downwind of the incinerator in Landmann Way have an infant mortality rate more than four times that of wards upwind of the plant. ONS figures show that, in wards north-east of SELCHP, infant deaths are 7.1 per 1,000 compared with 0.9 per 1,000 south of the plant.

Findings

They maintain research carried out in the US backs up their findings but that the Government won?t listen to them. Because of the prevailing westerly wind, they claim, areas to the north-east of an incinerator are most affected by dangerous emissions that contain PM2.5 particles ? a cocktail of heavy metals small they can be breathed in. Dr Van Steenis, a retired GP and once adviser to a House of Commons air pollution select committee, said: ?There is nothing to screen out PM2.5 particles in the UK and there is no regulation.?

Dr Frederica Perera, professor at New York?s Columbia University and director of Columbia Centre for Children?s Environmental Health, said:?Many studies, including our own, have found that in utero or childhood exposures to PM2.5 particles, or pollutants in the particles, are associated with adverse respiratory health and neuro development in children, and may increase the risk of cancers later on in life. But Chris Smith, of the Government?s Environmental Protection Directorate, said no permit would be issued to an incinerator operator if a health risk was likely. Emissions were tightly controlled under EU limits and incinerators regulated. A spokesman for Environmental Services Association, which represents the waste management industry, said incinerators had to operate to ?extremely high? standards.

Kind regards,

Michael Ryan

[sillywoman]

Errr . . . Thanks for that Michael - it's a bit 'abandon hope all ye who live in South East london though'?

[Michael Ryan]

Parts of South East London are very healthy - they're the places that are free from harmful PM2.5 emissions from incinerators & other industrial sources.

If smoking is so bad for us, why is the "smoke" from incinerators considered to be harmless? They're not burning tobacco in them.

There's a safer alternative to incineration which local councils are ignoring. It's called "plasma gasification" and if the health damage costs of incineration are included in comparison, then plasma gasification works out at about one hundred pounds per tonne cheaper than incineration.

Other countries are going for plasma gasification - but the UK is going crazy signing up to 27-year incinerator deals under PFI.

Over 150 years ago, Dr John Snow asked the government to tell Londoners to boil drinking water to stop the cholera deaths. He knew cholera must be transmitted by contaminated water when the rest all believed it was transmitted by "miasma", ie the stench of sewage. Dr Snow was ignored and about 50,000 Londoners died of cholera who should have been saved.

[dmr]

Michael, thanks for posting all your research, you did a really great job. And so sorry to hear about your losses.

Article on The Times. Worth a look, I think it sums up what is going on. http://www.timesonline.co.uk/tol/news/uk/health/article6998883.ece

[dmr]

Another article regarding the Albany.

http://www.eastlondonlines.co.uk/2010/01/a-group-of-midwives-like-no-other/

[taper]

"Errr . . . Thanks for that Michael - it's a bit 'abandon hope all ye who live in South East london though'?"

Perhaps not.

The Health Protection Agency reviewed the scientific evidence on the impact of incinerators recently. See here -

http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1251473371954?p=1231252394302

Key conclusion:

"The evidence suggests that any potential damage to health of those living close to incinerators is likely to be very small, if detectable. The Agency therefore does not believe that studies of public health around individual incinerators are scientifically justifiable"

[sillywoman]

Phew - thanks taper. I can sleep easy in my bed again!

[Michael Ryan]

If the Health Protection Agency were confident that incinerators pose no risk to human health, they'd have published the rats of illness and the rates of premature deaths at electoral ward level around existing incinerators. They cannot to that because they've not even looked at the data yet according to this letter to me from their Chief Executive:

http://www.ukhr.org/incineration/justinmccracken8june2009.pdf

Mr McCracken might care to comment on:

http://ukhr.org/incineration/kirkleesarea.pdf

Doesn't Taper know that Southwark PCT paid the London Health Observatory to try and find out why the infant death rates were so high in Southwark's electoral wards a few years ago.

I've got the report and also a copy of the invoice submitted to Southwark PCT which you might have helped to pay for.

It's no good examining a single borough's wards in London or anywhere else unless the area is very large. The London Health Observatory have the same set of data as me and they should make the effort to aggregate the last seven years' data for each of London's 625 electoral wards and just colour in on a ward map the very high infant death rate wards, ie those of 7.5 per 1,000 live births and above which are clustered around and downwind of incinerators.

If the LHO has a different coloured pencil, they should also colour in the twelve London electoral wards which had zero infant deaths recorded in same 7-year period and note that they are where incinerator emissions aren't landing on people.

Anyone in Southwark or elsewhere in London who wants to know the infant death statistics in their borough should write to their Primary Care Trust and ask under Freedom of Information for a printout of the VS4 birth and mortality data for their borough's wards for each of the last seven or more years. Ask for the sheets to be sent for each year individually & not aggregated - otherwise the data might be "manipulated" as happened to me when I obtained data from Telford & Wrekin PCT and mentioned in this statement of mine:

http://www.publications.parliament.uk/pa/cm200506/cmselect/cmenvfru/780/780we14.htm

Didn't anyone in Southwark read the South London Press on 4 May 2007?

Health Risk

by

Julia Lewis

4 May 2007

FAMILIES living downwind of incinerators are more at risk from infant death, heart disease, cancer and autism, health researchers claim. Michael Ryan and Dr Dick van Steenis believe babies are more likely to die if they are exposed to fumes from incinerators like the South East London Combined Heat and Power Plant (SELCHPP) in Deptford. The researchers point to Office of National Statistics (ONS) figures showing infant mortality rates ward by ward. Areas downwind of the incinerator in Landmann Way have an infant mortality rate more than four times that of wards upwind of the plant. ONS figures show that, in wards north-east of SELCHP, infant deaths are 7.1 per 1,000 compared with 0.9 per 1,000 south of the plant.

Findings

They maintain research carried out in the US backs up their findings but that the Government won?t listen to them. Because of the prevailing westerly wind, they claim, areas to the north-east of an incinerator are most affected by dangerous emissions that contain PM2.5 particles ? a cocktail of heavy metals small they can be breathed in. Dr Van Steenis, a retired GP and once adviser to a House of Commons air pollution select committee, said: ?There is nothing to screen out PM2.5 particles in the UK and there is no regulation.?

Dr Frederica Perera, professor at New York?s Columbia University and director of Columbia Centre for Children?s Environmental Health, said:?Many studies, including our own, have found that in utero or childhood exposures to PM2.5 particles, or pollutants in the particles, are associated with adverse respiratory health and neuro development in children, and may increase the risk of cancers later on in life. But Chris Smith, of the Government?s Environmental Protection Directorate, said no permit would be issued to an incinerator operator if a health risk was likely. Emissions were tightly controlled under EU limits and incinerators regulated. A spokesman for Environmental Services Association, which represents the waste management industry, said incinerators had to operate to ?extremely high? standards.

----------------

How can anyone tell if incinerators are operating at "extremely high" or extremely low standards unless health data is routinely examined?

Kind regards,

Michael Ryan,

Shrewsbury

[Family Room Moderator]

Michael Ryan

Please could you start a new thread to discuss this topic? This thread is for discussion of the Albany midwives.

Sending you a copy of this message by PM.

Thank you kindly

FRM

[dmr]

Dear All

For all of you interested I am sending a link to the CMACE report. Albany Mums read this report and had many serious concerns. Statiticians and the NCT also read the report and have written critiques about it. If anyone is interested on the NCT's critique please drop me an email and will send it to you. In the meantime I am sending links to the NCT statement and the IMUK (Independent midwives UK)statement.

CMACE report

http://www.cmace.org.uk/getdoc/802cb1c6-110f-4657-9bef-3403c81e5ba3/120110_STATEMENT-RE-REPORT-ON-ALBANY-GROUP-PRACTIC.aspx

NCT statement:

http://www.nationalchildbirthtrust.com/press-office/press-releases/view/190

IMUK statement

http://www.independentmidwives.org.uk/?node=11591

The CMACE report does not support King's claim that the Albany Practice is unsafe and it does not advise the closure of the practice. Albany Mums are now demanding a full review, including all KCH maternity services to be conducted. We have also asked from King's statistics and morbidity rates, we are still waiting for this information.

[Michael Ryan]

I suggest that Albany mothers look at the recent written answer to the question put to Boris Johnson by Darren Johnson of the Green Party regarding a map showing the 2002-2008 infant death rates in London's electoral wards.

[dmr]

Dear All

For all of you interested I am sending a link to the CMACE report. Albany Mums read this report and had many serious concerns. Statiticians and the NCT also read the report and have written critiques about it. If anyone is interested on the NCT's critique please drop me an email and will send it to you. In the meantime I am sending links to the NCT statement and the IMUK (Independent midwives UK)statement.

CMACE report

http://www.cmace.org.uk/getdoc/802cb1c6-110f-4657-9bef-3403c81e5ba3/120110_STATEMENT-RE-REPORT-ON-ALBANY-GROUP-PRACTIC.aspx

NCT statement:

http://www.nationalchildbirthtrust.com/press-office/press-releases/view/190

IMUK statement

http://www.independentmidwives.org.uk/?node=11591

The CMACE report does not support King's claim that the Albany Practice is unsafe and it does not advise the closure of the practice. Albany Mums are now demanding a full review, including all KCH maternity services to be conducted. We have also asked from King's statistics and morbidity rates, we are still waiting for this information.

[pk]

so what is it that albany mums hope to achieve?

[Michael Ryan]

Here's the text of e-mail I received yesterday in which Mayor Boris Johnson seems reluctant to look at the aggregated infant death rates in each of London's 625 electoral wards.

Dear Michael

Please find below the answer to the question that Darren Johnson, Green Party Member of the London Assembly submitted on your behalf at the January 2010 Mayor's Question Time, regarding infant mortality rates.

Regards

George Raszka

Green Party Group on the London Assembly

The Queen's Walk

London SE1 2AA

0207 983 4411

Infant mortality Rates

Question number 0042/2010

Meeting date 27/01/2010

Question by Darren Johnson?

Will you publish electoral ward-level data and a map showing the 2002-2008 infant mortality rates in London?

Answer by Boris Johnson

In some boroughs there are only five infant deaths a year, so rates at ward level for single years would be extremely unreliable.

While DMAG could combine several years worth of data to calculate a ward rate, one of the stipulations of their licence is that they do not publish the data online. If you wish to discuss the data in more detail can I suggest you contact Andrew Collinge, Assistant Director of Intelligence, on extension 4652.

---------------------------------------

If anyone in East Dulwich wonders what's been going on with health in UK in general or London in particular, just google "air pollution" with one of each of the following: heart disease, IQ, asthma, low birthweight, infant mortality, stroke, depression, sleep apnea and then ask why no-one at the London Health Observatory or Department of Health seem able to keep up-to-date on the causes of ill-health and premature deaths in UK.

The infant death rates in Boroughs of Lewisham, Tower Hamlets and Newham all rose after SELCHP incinerator started operating in December 1993.

The Los Angeles Times reported link between air pollution and infant deaths in December 1960 while I was waiting for train home from school at Blackheath station. Many of you won't have been born in 1960 and yet here we are, almost fifty years later, still blaming mothers or carers when their babies die instead of doing a proper analysis of data.

[sillywoman]

Michael Ryan,

whilst your information is interesting it's unfair of you to hijack a thread that specifically pertains to the situation surrounding the Albany midwives. Your information, though possibly linked, isn't specifically relevant to the topic under discussion here. Please start your own thread.