'Monumental U-turn' on cancer drug

A pioneering and life-extending drug repeatedly deemed too expensive will now be offered on the NHS in England.

It is the result of a confidential deal between the health service and the drug company Roche.

Kadcyla, the undiscounted cost of which had been £90,000 per patient, adds an average of six months of life to women with a form of terminal breast cancer.

Campaigners have praised the "monumental" U-turn, which will benefit about 1,200 women a year.

"Tough negotiation and flexibility between the NHS and Roche means both patients and taxpayers are getting a good deal," said NHS England chief executive Simon Stevens.

Cost-effectiveness test

Kadcyla, a combination of two drugs, is used to treat people with HER2-positive tumours that have spread to other parts of the body and cannot be surgically removed.

Scotland decided in April to pay for the drug, but it had been deemed too expensive by the rest of the UK.

In order for a drug to be approved by the regulatory body, the National Institute for Health and Clinical Excellence (NICE), it has to pass a cost-effectiveness test.

The full price drug worked out at £166,000 for every "quality adjusted life year" of good health.

It is not clear how much of a discount has been offered, but it is understood the cost per quality adjusted life year is down to about £50,000.

That is in line with other drugs that extend the life of terminally ill patients.

Delighted

Richard Erwin, general manager at Roche, said: "Close collaboration between Roche, NHS England and NICE has resulted in NICE recommending Kadcyla as a cost-effective treatment.

"This is a positive example of how solutions can be reached when all parties show flexibility."

The Welsh government expects to offer Kadcyla as soon as an equivalent deal is agreed with Roche. And the decision could allow the drug to be prescribed in Northern Ireland too.

Baroness Delyth Morgan, the chief executive at Breast Cancer Now, said: "This is exceptionally good news... we are absolutely delighted."

She added: "Today's landmark decision bodes well for patients looking for reassurances that modern cancer treatments can get through to NHS patients more quickly and can bring transformational improvements in patient outcomes for the future."

A petition by the charity to get Kadcyla funded had amassed more than 115,000 signatures in less than a month.

Gunes Kalkan, from Breast Cancer Care, said: "This U-turn decision is monumental.

"This proves innovative treatments can be made widely available, and it is hugely frustrating this agreement did not come sooner."

BBC NEWS

London fire: 'The working class aren't being listened to'

Maria Vigo has lived opposite Grenfell Tower for 11 years, and she's upset.

Not just with the fire that claimed so many lives in the block she can see from her kitchen window.

She's also upset with how expensive her local playgroup has become, and how the people of north Kensington can't afford the properties in the area.

But - most of all - she's upset that she's not being listened to.

"There was a lot of anger on the school run this morning," she says.

"There's a lot of separation between classes and people are telling me that it's down to social cleansing."

Maria says people are angry that things didn't work in the tower, and that there weren't any sprinklers.

"They need to train us how to get out of buildings safely, not just put up a fire notice," she says.

The mother of two, whose children both have special needs, talks of how, years ago, the affluence of Knightsbridge spilled into parts of Kensington, then Notting Hill, then Holland Park.

She puts her hands into a circle. "We feel like we're being surrounded."

How house prices compare

£1,369,708

Average in Kensington and Chelsea

£220,094

Average for UK

• £66,384 Increase in average Kensington and Chelsea price since 2016

Source: Land Registry

Getty Images

Maria was born in the area, and talks about how local playgroups have been privatised.

"If they were £2 and now they're £7.50, then no-one can afford to take their kids there."

She speaks without drawing breath, frustration spilling out.

"This area's always been working class. It's starting to become a bit less so now, and the working class are feeling that they're being left without a voice.

"The council isn't listening to us. We don't want a pretty building. They should ask us 'What do we need? or 'What would we like?'"

Maria also says a desire for profits is encroaching on the lives of working-class locals.

"Properties are being built in this area that aren't being bought by people in the local community."

The area around Grenfell Tower is busy, especially near Latimer Road tube, but voices are low and sombre.

People stand huddled in groups, looking downcast. Some don't want to talk to the press.

Others take photographs of the blackened block; a scar in the sky that dominates everyone's thoughts.

Young men in sports gear and oversized caps, old men in shirts and trousers, and women in hijabs, all pull out their phones to take photographs of the soot-stained tower, bits of which float onto the street.

People's faces screw up as they look up. No-one can believe what they're seeing.

Snatches of conversation can be heard in the streets.

"Can you imagine how desperate..." says one man to a woman as they walk.

People drive to various churches and buildings that are now refuge centres, trying to hand over bundles of clothes, but they're politely turned away.

One man pulls up to Latymer Community Church in a van, with two big bags of clothes. He's turned away as there are too many clothes being donated now.

He sticks them into his white van, explaining that he's from Essex but was passing and wanted to help. He grins, helplessly.

In the streets, it looks like a mass house move is under way - cars are stuffed with bin liners. Their drivers call out to pedestrians and police officers for directions to drop-off centres.

They too are told their kindness can't be accepted, that so much has been donated, but that nappies are still needed.

Father Bisrat Berhanu, 55, is an Orthodox priest and lives in Lancaster Way. He's been around here for 19 years.

He would visit people in Grenfell Tower, knew families there, and is shocked at what's happened.

"The community is dynamic, it's close," he says.

"The people in the tower blocks knew each other, they were like a family. I've met people who lived there. We've cried together.

"We're feeling shock and shock. Everyone's been ringing me, even people from overseas, asking just what has happened."

He too says that locals feel like they're being pushed out by affluence, that numbers mean more than people do.

"There are conspiracy theories but I don't get into that. We need love and kindness, to try and cure the wound, and cure people's hearts."

Christina Simmons, 56, lives in a street close to the tower and has been a local for 27 years. She's disabled and has difficulty walking.

"People are coming together and rallying together," she says.

"I didn't realise we had so many Eritreans and Somalians, they've all come out to offer support."

She too believes that "they aren't listening to us," a phrase she repeats several times.

"Roads were closed recently because of gas works apparently. Well, I didn't see any works. It creates chaos and I can't walk very far. No-one told us they were closing the roads.

"They don't listen to us. We're being neglected and ignored. I'm bloody angry."

But she does soften her tone, after expressing sympathy for the horrors for those caught up in the fire.

"I'd like to see some community meetings," she says. "Maybe this'll all bring us closer together."

BBC NEWS

London fire: Prime minister orders full public inquiry

Prime Minister Theresa May has ordered a full public inquiry into the fire that engulfed a west London block of flats, killing at least 17 people.

That figure is expected to rise, as fire chiefs do not expect to find any more survivors in the burnt-out Grenfell Tower, in north Kensington.

People have been desperately seeking news of missing family and friends.

The PM said people "deserve answers" as to why the fire spread so rapidly and that the inquiry "will give them".

Mrs May, who made a brief, private visit to the scene earlier, said: "[The emergency services] told me that the way this fire had spread and took hold of the building was rapid, it was ferocious, it was unexpected.

"So it is right that, in addition to the immediate fire report that will be produced and any potential police investigation, that we do have a full public inquiry to get to the bottom of this."

Labour leader Jeremy Corbyn, also visited the site, telling community leaders "the truth has to come out".

The BBC's assistant political editor Norman Smith said if the inquiry followed the course of previous inquiries, it "may well be headed by a judge".

"It will almost certainly hold its evidence sessions in public and those who will give evidence will include the local council, the builders, the contractors but yes too, I suspect the tenants and the relatives of some of the victims," he added.

• Latest updates: Death toll expected to rise
• What we know so far
• Baby 'dropped to safety from tower'
• Eyewitnesses recall harrowing night

More than 30 people remain in hospital - 17 of whom are in a critical condition.

The Queen earlier said her "thoughts and prayers" are with families

Firefighters were called to the 24-storey residential tower in the early hours of Wednesday, at a time when hundreds of people were inside, most of them sleeping.

Many were woken by neighbours, or shouts from below, and fled the building.

Fire crews rescued 65 adults and children, but some stayed in their homes, trapped by smoke and flames.

---

At the scene

By Lucy Manning, special correspondent, BBC News

For the families of the missing, grief is mixing with anger.

They are angry at the lack of information about their relatives. Many just don't know if they are alive, dead or injured.

I spoke to one man: His cousin, her husband and their baby are missing.

He is pleading for the police, the hospitals, the authorities to give him information about those who are injured or who might have died.

It's a complaint I've heard from families after terror attacks: that the system doesn't seem to help the families. That the wait is too long and agonising.

His relatives had to trawl round hospitals and, thanks to a nurse, found two missing children but they haven't found the rest of the family.

Although it's hard for the authorities to deal with these incidents his message to the police, hospitals, officials and politicians is "please please help us."

---

On Thursday morning, London Fire Commissioner Dany Cotton said her crews had identified a "number" of those killed, "but we know there will be more".

Asked how many were still missing, Met Police Commander Stuart Cundy said it would be "wrong and incredibly distressing" to give a number.

"I know one person was reported 46 times to the casualty bureau," he said.

A brief search of all floors in the tower had been carried out, but the severity of the fire and amount of debris meant a thorough search would be "difficult and painstaking", Commander Cotton said.

Sniffer dogs will now be sent in to search for evidence and identification of people still inside, she said.

Temporary structures will be built inside the block in order to shore it up before more thorough work can begin.

The cause of the fire, which took more than 24 hours to bring under control, remains unknown.

Throughout the morning, only wisps of smoke were seen coming from the charred building, but flames were later seen flaring up again on a lower floor.

London-born Adele and her husband visited the scene on Wednesday evening, and the singer was seen comforting people.

Singer Rita Ora pitched in by helping to sort donations outside the tower.

Photographs and messages in English and Arabic have been left for loved ones on a wall of condolence near the tower block.

Alongside them are words of anger and calls for justice, with people saying their safety concerns were not listened to.

• Student helps Grenfell residents before exam
• The man who filmed the Grenfell fire

The local authority - Kensington and Chelsea council - said 44 households had been placed in emergency accommodation so far.

Throughout Wednesday night, people donated food, clothes and blankets for those left without homes.

By early morning some volunteers said they had been overwhelmed with donations and were turning people and vans away.

The government has said checks were now planned on tower blocks that have gone through a similar upgrade.

Construction firm Rydon, which carried out the refurbishment, initially said in a statement that the work met "all fire regulations" - the wording was omitted in a later statement.

Fire risk assessment in tower blocks was "less rigorous" since responsibility for it shifted from the fire brigade to the owner, Sian Berry, housing committee chairwoman of the London Assembly, said.

BBC NEWS

City cancels Mansion House dinner after tower tragedy

A City of London event where the Chancellor, Philip Hammond, was due to give a key speech has been cancelled following the Grenfell Tower tragedy.

He had been due to speak at the annual Mansion House dinner on Thursday night.

Mr Hammond said he had withdrawn from the speech "in view of the Grenfell Tower tragedy", adding: "My thoughts are with the local community."

A spokesperson for the City of London Corporation, which organises the event, echoed the chancellor's comments.

"In the light of the tragedy at Grenfell Tower we are cancelling tonight's Mansion House Dinner. Our thoughts are focussed with the victims and their families and friends."

Figures including Bank of England governor Mark Carney and the Lord Mayor of the City of London, Andrew Parmley, had been due to attend the Bankers and Merchants Dinner along with the chancellor.

A Treasury spokesman said Mr Hammond would deliver the speech intended for the Mansion House dinner in the near future.

His address was set to offer clues on the government's approach to the Brexit talks.

The chancellor had been expected to say that £48bn of funds from the European Union's investment bank would not be put at risk following Brexit.

BBC NEWS

Australian PM Turnbull mocks Trump in leaked audio

Australian Prime Minister Malcolm Turnbull has been recorded apparently mocking US President Donald Trump in footage leaked by the media.

Mr Turnbull was filmed speaking at an event for the Australian media at Parliament House on Wednesday night.

The event is normally not reported on, but the political editor at Australia's Nine Network said he had chosen to break protocol and make it public.

Mr Turnbull said the report was "a breach of faith."

Mr Trump and Mr Turnbull recently repaired ties after a troubled start.

They had an acrimonious first phone call over Mr Trump's reluctance to honour a deal to accept up to 1,200 refugees from Australian detention camps.

But last month the two leaders met in New York, after which Mr Trump described their relationship as "fantastic".

'Winning at the polls'

In the leaked footage, Mr Turnbull performs a jokey routine for guests at the Mid Winter Ball for the media.

Adopting the mannerisms of the president, he says their meeting was "beautiful. It was the most beautiful putting-me-at-ease ever".

"The Donald and I, we are winning and winning in the polls. We are winning so much, we are winning, we are winning like we have never won before," he said.

Mr Turnbull saw a 10-point drop in approval ratings for his government in a March poll, with only a slight recovery in the latest May numbers.

But Mr Trump is also facing tough polling numbers - his disapproval rating hit a new high of 59% in a recent Gallup poll.

Mr Turnbull also jokes that polls are "so easy to win" adding: "I have this Russian guy..." in reference to Mr Trump's long-running difficulties with allegations that his campaign officials may have colluded with Russian hackers to influence the election outcome.

The prime minister appeared on Melbourne's 3AW radio show with Tom Elliott to discuss a different issue, but briefly addressed the controversy and said he, rather than Mr Trump, was the butt of his joke.

"It's a good-humoured roast," he said. "My speech was affectionately light-hearted."

He said the speech was supposed to be "off the record" and that next year, "at the mid-winter ball, I'll read selected passages from budget paper number two."

"It's a breach of protocol, it's a breach of faith, and all those things... you've got to have a laugh, you've got to lighten up."

Nine's political editor Laurie Oakes, who first reported the remarks, said he did not attend the ball himself, but that the audio "just happened" to leak and a sample had been posted on Instagram.

His employer said Mr Oakes "does not believe reporting should be banned at events hosted by journalists".

Australia is one of the closest allies of the United States.

Troops from the two countries have fought together in all recent major conflicts including Iraq and Afghanistan.

BBC NEWS

British Airways technology chaos will cost £80m

The IT meltdown that grounded thousands of British Airways passengers will cost the airline at least £80m, it has emerged.

Willie Walsh, chief executive of BA owner International Airlines Group, told investors its initial assessment of the gross cost "is in the order of £80m".

He promised to provide an update with more details when appropriate.

The chaos was triggered by an engineer who disconnected a power supply.

The major damage was caused by a surge when it was reconnected.

Speaking at IAG's annual meeting in Madridon Thursday, Mr Walsh apologised again for last month's chaos, describing it as a "dreadful experience".

About 75,000 passengers faced severe disruption when BA's system failed over the Bank Holiday weekend.

Mr Walsh said BA was "working hard to ensure that affected passengers are compensated as soon as possible".

He had previously announced an independent investigation "to learn from the experience".

During the outage, the GMB, a union which represents aviation workers, claimed the problems had been caused by BA making IT staff redundant and outsourcing the department last year.

Mr Walsh said on Thursday: "What we do know at this stage, however, is that this failure had absolutely nothing to do with changes to the way we resource our IT systems and services."

IAG chairman Antonio Vazquez said: "You can be reassured that we will do everything in our powers to avoid similar problems in the future and restore our customers' faith in British Airways."

BA was one of several airlines affected by a baggage system problem at Heathrow on Thursday morning.

Hundreds of passengers on flights operated by IAG-owned Iberia, as well as BA and American Airlines at terminals 3 and 5 had to fly out without their luggage.

Heathrow said the problem has now been fixed and apologised.

BBC NEWS

Argentine football player gives opponent the needle

An Argentine football player has caused outrage after admitting that he used a needle to hurt his rivals during a cup match on Sunday.

Federico Allende, a defender for lower-division club Sport Pacifico, bragged in a radio interview about using the needle several times against strikers from top-division club Estudiantes.

Mr Allende said that players had to be clever in order to win.

Pacifico's president Hector Moncada vowed to expel the player.

"We are devastated. This incident has tarnished the team's good work. I will expel him from the club," Mr Moncada told Clarín newspaper.

Pacifico won the match 3-2 and knocked out Estudiantes from the cup competition in a major upset.

The players were received like heroes in the small western town of General Alvear when they returned from Buenos Aires, where the match was played.

'He must hate me'

But the good atmosphere soon turned into bad news.

Allende gave Cordoba's Vorterix Radio an interview on Tuesday in which he said "you need to play dirty" to beat big clubs like Estudiantes de La Plata.

"We knew that we had to play dirty against them and I kept piercing the Estudiantes strikers with a needle," added the Pacifico defender.

"We know that top division players don't like contact, they don't like if we waste time or if we play dirty. So that was the way to do. Football is like that. Football is for the clever," Allende told Vorterix Radio.

Colombian striker Juan Otero said Allende jabbed him many times with a needle and that he complained to the referee during the match.

"I completely nullified Otero. He must hate me," Allende said on the radio.

After hearing the interview, Otero described Allende as "as a nasty man". 

BBC NEWS