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Girl, 5, traumatised after GP assistant wrongly prescribed vaginal pessary, report finds | Children’s health
A five-year-old was left traumatised, bleeding and in severe pain after a physician associate wrongly prescribed her a vaginal pessary, according to a damning report by the health ombudsman.
The parliamentary and health service ombudsman said there were “multiple failures” in the care of the girl, who saw a physician associate (PA) at a GP practice in the East Midlands after complaining of itching and vaginal discharge.
The PA suspected thrush and recommended a vaginal pessary and cream. The five-year-old’s mother, who believed her daughter was being seen by a GP, questioned the treatment and the size of the pessary, but was reassured that it was appropriate.
PAs do not have prescribing rights and their work must be supervised by a doctor who approves the prescription. But the ombudsman found there was no discussion between the PA and GP before the GP authorised the prescription, even though vaginal pessaries are not suitable for prepubescent children and the girl’s symptoms were consistent with vulvovaginitis, not thrush. There was also no questioning of the prescription by the pharmacy that dispensed it.
The mother said that after inserting the pessary, her daughter began to bleed and scream in pain, while the cream burned the girl’s skin. She took her to see an out-of-hours doctor. However, the girl was so distressed and in pain that she asked the doctor not to examine her internally, causing the GP to raise concerns about possible sexual abuse and to contact safeguarding services.
Although it was established the girl’s symptoms were caused by the pessary and cream, not sexual abuse, the mother said the experience was distressing, embarrassing and further added to her trauma.
She said: “I had huge guilt for doing what the PA, who I thought was a GP, told me and feeling as if I had inflicted this trauma on my daughter.
“But I trusted what [they] told me. How are we meant to trust healthcare professionals now?”
Rebecca Hilsenrath, the chief executive of the parliamentary and health service ombudsman, said the “deeply troubling case” was all the more concerning because it could easily have been avoided.
“The breakdown in communication meant the checks and balances designed to make sure patients are treated appropriately and kept safe were not followed.”
The ombudsman said it recommended the GP pay the mother £1,000 and the pharmacy pay £500 and that both organisations had to take action to ensure this did not happen again.
Although the incident occurred in 2023, before a government-commissioned report on physician associates recommended PAs should be banned from diagnosing patients who had not been seen by a doctor, the British Medical Association said the case highlighted the serious consequences of inadequate supervision and failures in clinical oversight.
Dr Emma Runswick, the deputy chair of BMA council, said: “This is a deeply distressing case in which a young child suffered significant and entirely avoidable harm.
“It is particularly concerning that the child’s mother believed her daughter had been seen by a GP when she had in fact been assessed by a physician associate. Patients and families have a right to know who is treating them and whether they are or are not a doctor.”
Prof Gillian Leng, the president of the Royal Society of Medicine, who led the 2025 review, concluded that PAs should be called physician assistants, not associates to make it clearer they are not doctors. She also recommended clearer definitions of which patients could be seen by PAs and for newly qualified PAs to work for two years in hospitals before being allowed to work in GP surgeries.
But the BMA believes the role of PAs in general practice is fundamentally unsafe. Runswick added: “There must be clear limits on scope of practice, greater transparency for patients and robust supervision arrangements to ensure no other child or family experiences harm like this again.”
A Department of Health and Social Care spokesperson said: “Patient safety is our number one priority – this case is unacceptable and our sympathies go out to the patient and her family.
“We are now working at pace to implement each of the Leng Review’s recommendations, with some changes already delivered, and its findings will also inform our forthcoming 10-year workforce plan.”
UK News
Burnham says he would seek to enter any Labour leadership contest
The Greater Manchester Mayor would need to win the by-election in Makerfield to be a possible candidate.
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Zelenskyy calls for face-to-face negotiations in letter to Putin | Ukraine
The Ukrainian president, Volodymyr Zelenskyy, has called for face-to-face negotiations in a public letter addressed directly to the Russian president, Vladimir Putin.
The letter, the first public letter Zelenskyy has written directly to Putin since Russia launched its full-scale invasion in 2022, was a sweeping criticism of the Russian leader’s 26 years in power.
Zelenskyy acknowledged shifting US priorities, saying it would be wrong to simply wait for the Trump administration to return its attention to ending the Ukraine war while it remained heavily focused on the Iran war.
“I am proposing a meeting,” Zelenskyy wrote.
He appeared to be trying to seize a pivotal moment in the war as Ukraine has begun to regain some battlefield leverage, largely through improved long-range strike capabilities that have complicated Russia’s advances. At the same time, Moscow has intensified its deadly aerial campaign across Ukraine, seeking to exploit Kyiv’s shortages and continued vulnerability to ballistic missile attacks.
Putin said on Thursday that Russia would strengthen its air defences to counter recent Ukrainian drone attacks, which have reached deep inside his country and cast a cloud over his showcase economic forum in his home town of St Petersburg.
Speaking during a meeting with heads of international news agencies, Putin acknowledged the damage from Ukrainian drone attacks. “To our regret, some of them break through,” Putin said of the strikes. “Russia has an air defence system, we need to improve it, strengthen it, and we will do that.”
The wide-ranging media session came on the sidelines of the St Petersburg International Economic Forum, Putin’s annual showcase for investment. Hours before the forum opened on Wednesday, a Ukrainian drone attack set ablaze an oil terminal in the city and also hit a nearby naval base.
Putin also said Russia was open for a compromise on Ukraine in line with the understandings reached at his summit with Donald Trump in Anchorage, Alaska, and Ukraine needed to accept them to make a deal to end the conflict, now in its fifth year.
Trump said on Thursday it would be “great” for Zelenskyy to meet Putin – but said both sides had to make compromises, without explaining further.
“I’m glad that they’re maybe talking about meeting. I think we had a lot to do with it,” Trump told reporters in the Oval Office. “I think it would be great if they met. They should – get it done.
“They’re going to both make compromises, I suggested those compromises, and you know, we’ve had a lot to do with it.”
In his letter, Zelenskyy said the proposed talks could be hosted by a neutral third country, ruling out Moscow and Kyiv as venues, and suggested Switzerland, Turkey or Arab states as possible hosts for negotiations.
“It is leaders who resolve the key issues. That has always been the case, and it always will be,” he wrote. “I propose to set a clear date for such a meeting.”
He said Ukrainian intelligence indicated Russia was considering plans to prolong the war into 2027 and 2028, while increasingly relying on ballistic missile strikes to achieve what its ground campaign had failed to accomplish.
Zelenskyy also accused Moscow of seeking to draw Belarus deeper into the conflict and of attempting to destabilise the situation around Transnistria, the breakaway Moldovan region backed by Russia.
The Ukrainian leader argued that Russia was increasingly feeling the costs of the war, pointing to drone attacks deep inside Russian territory, economic strain, fuel shortages, rising prices, and the necessity of more military mobilisation.
Zelenskyy claimed Russia had suffered more than 30,000 soldiers killed or seriously wounded in May alone, saying Ukraine had “video confirmation” of the battlefield losses and that such casualty levels had been sustained month after month.
He said Ukraine also continued to suffer painful losses despite what he described as a favourable casualty ratio.
Zelenskyy said Ukraine was prepared to implement a full ceasefire for the duration of negotiations and proposed an all-for-all prisoner exchange as a first step toward ending the conflict. He also called for the return of civilians and children taken from Ukraine during the war.
“The world has not grown tired of Ukraine, as you long hoped it would. But there is growing fatigue with Russia,” Zelenskyy said, addressing Putin.
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