Saturday, October 5, 2013

NHS pay proposal criticised by health unions

Hospital corridor The NHS's £109bn budget is under severe pressure

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Unions have criticised government moves to halt a pay rise for NHS staff in England.
Public sector pay increases are capped at 1%, but the Department of Health has urged the NHS pay review body to withhold the rise for its 1.3m staff.
It said the increase was unaffordable alongside the current system of small, automatic annual rises.
Rachael Maskell, of the Unite trade union, said staff deserved the pay reward for "holding the NHS together".
Health trusts are currently under pressure to make savings and the NHS wage bill accounts for around 40% of its budget.
The Department of Health (DoH) proposes using the funding intended for the 1% rise to "modernise" pay structures.
It says the automatic increments - linked to length of service and satisfactory performance - add £700m to salary costs.
But the DoH has stressed no decisions on changes to pay have been taken, insisting independent bodies will make their recommendations next year.
The plans, which were outlined in the DoH's submission to two independent pay review bodies, have been criticised by Unite and Labour.
Ms Maskell said: "The Department of Health have got other choices. They're entering into a reorganisation which is costing £3bn, which nobody asked for and isn't adding anything to patient care.
"It is about choices and the NHS staff have already had two years of a pay freeze - 1% last year - and, quite frankly, are really falling behind inflation now with their wages."
Ms Maskell told BBC Radio 4's Today programme that motivation and morale was down among frontline health workers.
"The reality is that staff do deserve this pay reward because they're holding the NHS together at this very difficult time," she said.
However, in its submission to the NHS pay review body, the DoH points to a staff survey suggesting high levels of motivation and morale.
"The government's view, therefore, remains that basic pay increases should only be implemented if there is strong evidence that recruitment, retention, morale or motivation issues require this," the department says in its written submission.

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We recognise fully the economic constraints the NHS is working under but the continued erosion in the real value of contracts for doctors has now reached a critical point”
Dr Mark Porter British Medical Association
Shadow health secretary Andy Burnham suggested the NHS reorganisation had taken money out of front-line services.
"There has to be pay restraint in the NHS as well as other public services... but the NHS has been through some very difficult years - so have NHS staff - and this was a modest increase to recognise the pressure that all families are under.
"To take it away, to break that promise, is just another kick in the teeth."
The department wants the pay review bodies - which set earnings for the NHS workforce and are due to make a recommendation in February or March - to defer the planned 1% pay rise until it has negotiated a move to seven-day working with unions.
Staff representatives have also reacted angrily to the plans.
"What they have done is inflammatory," said Christina McAnea, head of health at Unison and joint chair of the NHS Staff Council.
"They must have known how unions would react. We are not going to negotiate while a gun is held to our head for a paltry 1% pay rise - our members will not react well to that."
'Affordable' service Dr Mark Porter, chairman of the British Medical Association council added: "We recognise fully the economic constraints the NHS is working under but the continued erosion in the real value of contracts for doctors has now reached a critical point."
He told the BBC: "What we won't see is people leaving in droves... healthcare workers are absolutely committed to the NHS and what they do.
"What is going to happen though is we're going to find it increasingly hard to recruit, partly for the specialist skills and partly for the numbers of staff that we'd need to bring into the health service to implement the safe minimum staffing levels."
However, a DoH spokeswoman stressed that the proposals would "help protect jobs and improve care".
She said: "Many NHS staff have continued to receive pay rises of up to 6% and we want to keep working with the trade unions and employers on affordable pay.
"The measures we are proposing will help increase quality for patients and help us realise our vision of an affordable seven-day service."
Setting out the government's spending plans in June, Chancellor George Osborne said ministers were working to "remove automatic pay rises" for teachers, health professionals, prison and police staff.
The department drew attention to Mr Osborne's comments and confirmed it wanted NHS pay to have "stronger links to performance, quality and productivity".

US commitment to Asia remains despite shutdown

Federal workers at a rally to demand a vote to end the government shutdown, outside the Capitol in Washington DC on 4 October Federal workers have been protesting to demand and end to the shutdown
The US commitment to Asia remains undiminished despite President Barack Obama's absence from regional summits, Secretary of State John Kerry has said.
Mr Kerry was speaking at the start of the Apec summit in Indonesia.
Mr Obama cancelled his Asia trip after the partial US government shutdown.
John Kerry: Shutdown "an example of the robustness of our democracy"
The US government closed non-essential operations on Tuesday after Congress failed to agree a new budget. Thousands of federal employees have been sent home. Some are working but not paid.
US-EU trade negotiations have also been postponed because of the shutdown.
'Robust democracy'

Analysis

This is the most recent example of the ongoing problem Mr Boehner has controlling the Republican caucus, especially a rebellious faction hailing from solidly conservative, mostly rural areas across the country.
They've been called the "suicide caucus" in reference to their disregard for their party's survival. In national security debates, immigration reform, disaster relief, defence authorisations, and even agriculture funding, Mr Boehner has found his position undermined by these rebellious legislators.
But these representatives reflect the will of the voters who sent them to Washington, a decidedly different demographic than America at large.
This has forced Mr Boehner to operate more like the tolerant head of a coalition government than an iron-fisted speaker of a past era, who could make or break a politician's career at will.
Republican 'suicide caucus'
As world leaders began gathering for the Asia-Pacific Economic Co-operation (Apec) summit in Bali, Mr Kerry sought to allay concerns that Washington was reducing its global engagement.
"None of what is happening in Washington diminishes one iota our commitment to our partners in Asia," he said.
He said the dispute with the Republicans in the US Congress was "an example of the robustness of our democracy".
But at the same time, he urged Congress to think about how the US was perceived internationally when "we can't get our own act together".
Mr Kerry said areas where the shutdown was affecting US foreign policy funding included:
  • delays in security assistance for Israel
  • nearly all staff suspended at the treasury department's Office of Foreign Asset Control, which monitors sanctions on states like Iran
Mr Obama had been due to begin a four-nation Asian trip on Saturday, heading to Bali and Brunei before travelling on to Malaysia and the Philippines.
House Speaker Boehner: "This isn't some damn game"
The White House said Mr Obama's decision to cancel his Asia trip was made due to the "difficulty in moving forward with foreign travel in the face of a shutdown".
Republicans who control the House of Representatives refused to approve a budget, saying they would only do so if Mr Obama's healthcare reform law was delayed or stripped of funding.
Mr Obama and the Democrats have refused, noting the law was passed in 2010, subsequently approved by the Supreme Court, and was a central issue in the 2012 election which Mr Obama won comfortably.
On Friday, Democrats and Republicans appeared no closer to finding a way out of the impasse.
US President Barack Obama: "Nobody is winning"
Republican House Speaker John Boehner insisted Mr Obama and Democratic Senate leaders open negotiations on the shutdown.
"All we're asking for is to sit down and have a discussion," he said. "This isn't some damn game."
Mr Obama later said he was happy to hold talks with the Republicans, "but we can't do it with a gun held to the head of the American people".
The US also faces running out of money and defaulting on its debt if there is no agreement to raise government borrowing limits later this month.
'Worse than 2008' US officials had been due in Brussels next week to discuss a sweeping free trade pact designed to boost bilateral trade between the European Union and the US.
IMF head Christine Lagarde says it is "mission critical" that the situation is resolved
On Friday, US trade representative Michael Froman informed the EU that financial and staffing constraints made it impossible to send a full negotiating team to Brussels.
He stressed that Washington would continue working with the EU on drawing up the deal, but would have to wait until the shutdown was over.
Reacting to the US announcement, European Trade Commissioner Karel De Gucht said the delay was unfortunate.
"But let me underline that it in no way distracts us from our overall aim of achieving an ambitious trade and investment deal," he added.
Christine Lagarde, managing director of the International Monetary Fund (IMF), said warned earlier that a failure to raise the US debt ceiling would be a far worse threat to the global economy than the current shutdown.
She said it was "mission critical" that the US agreed a new debt limit.

Prince Harry takes part in Sydney navy celebration

Prince Harry attends the International Fleet Review in Sydney Harbour

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Prince Harry has begun his first official trip to Australia by joining centenary celebrations to mark its navy's arrival at Sydney Harbour.
He was greeted by huge crowds as he embarked on survey ship HMAS Leeuwin at the city's Garden Island naval base, before inspecting the flotilla.
The International Fleet Review involves some 40 warships from 17 countries.
After a 20-odd hour flight Prince Harry spent much of the day at sea aboard one of a flotilla of Australian warships in Sydney's magnificent harbour.
He is here as guest of honour for the Australian navy's International Fleet Review.
In a day of pomp and ceremony, dignitaries were offered a 100-gun salute to mark the centenary of the navy arrival into Sydney Harbour back in 1913.
These waters have rarely seen so much traffic. Navy ships from countries around the world joined the Australian fleet to take part - including the Royal Navy's destroyer HMS Daring.
The event has attracted huge crowds with up to a million people expected to have turned out.
The event is the only scheduled public appearance for the prince, who is representing the Queen.
A 100-gun salute marked the start of the celebrations, and Prince Harry was joined by Australia's Governor-General Quentin Bryce on board the Leeuwin to officially review the fleet.
Some 16 tall ships and 8,000 sailors from around the world have been taking part in the event, with warships from countries including the US, China, France and India. Britain sent one of its largest ships, the Type 45 destroyer HMS Daring, to represent the Royal Navy.
An estimated 1.4 million spectators were expected to line the banks of Sydney harbour for the celebrations, which finished with a light show and display involving 7.7 tonnes of fireworks.
'Big fan' After the fleet review, Prince Harry posed for photographs with Australian Prime Minister Tony Abbott, his wife Margie, and two of their three daughters, Frances and Bridget.
The prince changed from his white army dress uniform to a grey suit and blue tie to meet the public and there were shouts of "give us a wave Harry" from the crowd.
One spectator, Sinead Kirrane, 23, originally from Ireland, said: "He (Prince Harry) seems fun, I'm a big fan.
"We are excited to see him and maybe get a smile from him."
Australia"s Chief of the Defense Force Gen. David Hurley and Prince Harry Prince Harry met the chief of Australia's defence force, General David Hurley, before reviewing the fleet
1/3
Giving a speech to an audience that included disabled war veterans, Paralympians and young entrepreneurs, Mr Abbott broached Australian republicanism and said: "Prince Harry, I regret to say not every Australian is a monarchist.
"But today everyone feels like a monarchist today.
"You grace us as your family has graced our nation from its beginning, as the Crown is a symbol of our stability, continuity and decency in public life."
The prince, whose short Australian tour features a one-day trip to Sydney ahead of a brief visit to the Western Australia capital of Perth on Sunday, is not the only British Harry causing excitement in the country.
Singer Harry Styles is currently in Sydney with his band, One Direction.
After he leaves Australia, Prince Harry will head to Dubai to attend a fundraising event for the aids charity, Sentebale.

Afghanistan celebrates cricket World Cup qualification

David Loyn in Kabul says celebrations will carry on for a few days
Celebrations have taken place across Afghanistan after its cricketers qualified for the first time for the World Cup, to be held in 2015.
The team beat Kenya by seven wickets on Friday in their final qualifying match in Sharjah.
More than 1,000 overjoyed fans watched their convincing victory on a giant screen in a stadium in Kabul before taking to the streets in celebration.
There were similar outpourings of joy in most other major cities.
Parts of the southern city of Kandahar ground to a halt as fans celebrated the win in public places.
Skipper and all-rounder Mohammad Nabi described the win as "a gift to a young generation".
Jubilant coach Kabir Khan, a former Pakistan test cricketer, described the victory as the best day of his coaching life.
Afghanistan is one of the world's poorest countries and has been blighted by decades of conflict. Its national cricket team only received associate status, the second tier below Test nations, earlier this year.
They reached a target of 94 to finish second behind Ireland in the World Cricket League and will be in England's group at the 2015 Cricket World Cup, which is being held in Australia and New Zealand.

World Cup 2015 Pool A

England, Australia, Sri Lanka, Bangladesh, New Zealand, Afghanistan, qualifier 3
Their first match in the competition will be against Bangladesh in Canberra on 18 February 2015 and they will also face Sri Lanka, Australia and New Zealand before taking on England in Sydney on 13 March.
Needing a win to move above the United Arab Emirates and the Netherlands, Afghanistan bowled Kenya out for 93, with only Morris Ouma and Rakep Patel reaching double figures.
Afghanistan fans, watching on a big screen in Kabul, celebrate their team reaching the World Cup for the first time Fans watched Friday's match on a big screen in Kabul and found it difficult to contain their excitement
Nawroz Mangal hit 112 not out from 96 balls Almost every shot played by Nawroz Mangal - who hit 112 not out from 96 balls - was cheered to the rafters
Child celebrates in Kabul Young and old were caught up in the excitement of the victory
Fans celebrate in Jalalabad Public delight over the victory was evident in most major cities of the country including Jalalabad
Celebrations in Kandahar In Kandahar, a city often blighted by the Afghan war, the highways were occupied by delighted supporters
Celebrations in Kandahar The win is expected to inspire young people in a country that in recent years has had few sporting achievements
Skipper Nabi was playing in his 27th one-day international and steered his team to victory with an unbeaten 46 that featured three fours and two sixes.
In the 20th over, the 28-year-old thumped a six over long-on and in the next dispatched slow left-armer Shem Ngoche out of the ground. He struck the historic winning runs two balls later with a four through mid-wicket.
"I can't express my feelings," Nabi said. "It is a very big day in my life. I'm sure there will be huge celebrations back home. I'm happy for the people of Afghanistan and look forward to playing in Australia and New Zealand."

World Cup 2015 Pool B

South Africa, India, Pakistan, West Indies, Zimbabwe, Ireland, qualifier 4
Coach Kabir Khan said: "I had very few great and memorable days in my life and this is right up there. It has been a dream for so many years and now we have achieved it.
"There will be tremendous atmosphere in Afghanistan and I'm so happy for them. This year they'll get two Eids [Muslim holidays] to celebrate."
Fans took to the streets of Kabul after the win and could hardly contain their excitement when speaking to the BBC.
"We have big plans for tonight," said supporter Aziz Wali Ahmadzai.
"We are going out with around 100 cars and will join other people who want to celebrate."
Another fan, Wahidullah Mihakhail, said that the victory had provided Afghanistan with something that no politician or militant could: "unity to a nation that has had too many years of war."
Afghanistan had been playing in Division Five of the World Cricket League as recently as 2008.
In 2010, they reached the ICC World Twenty20 in the West Indies by winning a qualification event in UAE, but lost both group games in the tournament to India and South Africa.
They also qualified for last year's World Twenty20 in Sri Lanka after finishing second to Ireland in qualifying, but were beaten by both India and England in the opening group phase.

Marina Shifrin 'I quit' video prompts job hunters

Marina Shifrin's original YouTube resignation went viral
More than 100 people have inquired about the post left by a woman who quit her job by uploading a video of herself dancing to the Kanye West song "Gone", her ex-employer says.
The Taiwanese animation firm Marina Shifrin worked at made a video riposte after her YouTube clip went viral.
In their version company employees dance to the same track wishing her luck and advertising her vacancy.
Ms Shifrin has been offered a job by Queen Latifah on her US chat show.
While appearing as a guest on the Queen Latifah Show she was asked if she might be interested in a role as a digital content producer.
Ms Shifrin - who is now back in the US - thought it was a joke until Queen Latifah said: "I'm a boss and bosses can hire".
The celebrity tweeted later: "This girl was so creative! I had to offer this internet sensation a job."
Spoof riposte Ms Shifrin worked as a comedy writer at Taiwan's Next Media Animation - a company that produces comical cartoons tied to news events.
The subtitles to her resignation video said: "For two years I've sacrificed my relationships, time and energy for this job, and my boss only cares about quantity and how many views each video gets, so I figured I'd make one video of my own to focus on the content instead of worrying about the views.
"Oh and to let my boss know... I quit."
The video has received more than 12.5m hits on Youtube so far.
But in a move that some will regard as a canny public relations step, the company also uploaded a video in which her former colleagues dance to the same song.
Her colleagues' spoof presented their office as a fun place to work complete with a swimming pool.
"We run a creative shop, not a sweatshop. We are not really upset as we know Marina and she is a good egg. This was seen by her as a funny way to leave. She was right, it is awesome," Mark Simon, spokesman for Hong Kong-based parent company Next Media told the BBC.
Many Taiwanese viewers also supported her move on social media, with some saying they admired her for having the gumption to do what many Taiwanese workers would never dare to do.
"Really brave and humorous too!" one user posted.
Next Media Animation said that they had more than 600 employees who - like Shifrin - worked an average of eight hours a day and that despite some "creative differences" there were no hard feelings.
Ms Shifrin could not immediately be reached for comment. But one indication of her thoughts on what had transpired since her video was posted came in a message she wrote on Twitter: "Is this real life?"

Anger as Apple axes China anti-firewall app

Anger as Apple axes China anti-firewall app

OpenDoor on Facebook OpenDoor's app helps users bypass firewalls to access restricted web sites

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Chinese web users have criticised Apple after the company pulled an iPhone app which enabled users to bypass firewalls and access restricted internet sites.
The developers of the free app, OpenDoor, reportedly wrote to Apple protesting against the move.
China blocks users from accessing many websites and strictly polices internet access and censors web users.
The BBC contacted Apple for its response to the report and has yet to receive a reply.
Apple asks iPhone app developers to ensure that their apps "comply with all legal requirements in any location where they are made available to users".
It says that "developers have an obligation to understand and conform to all local laws".
But Zhou Shuguang, a prominent Chinese blogger and citizen journalist, told US-based Radio Free Asia that Apple had taken away one of the tools which internet users in China relied on to circumvent the country's great firewall.
Chinese internet users were disappointed by the move by Apple.
One said: "It was so bad that this was taken away. I can't now jump over the firewall."
Another user wrote: "Apple is determined to have a share of the huge cake which is the Chinese internet market. Without strict self-censorship, it cannot enter the Chinese market."
Many Chinese social media users have only just become aware that the app has been unavailable since July.
The developers of OpenDoor - who wish to remain anonymous - told Radio Netherlands that Apple removed the app because it "includes content that is illegal in China".
A woman holds her iPhone 4 in Hangzou, China 13 January 2012 Apple says developers must conform to local laws
The station reported that the email from OpenDoor to Apple said the removal of the app was inconsistent.
"It is unclear to us how a simple browser app could include illegal contents, since it's the user's own choosing of what websites to view," the email says.
"Using the same definition, wouldn't all browser apps, including Apple's own Safari and Google's Chrome, include illegal contents?"
OpenDoor is not the first app to have been removed from Apple's App Store in China.
It has previously removed a news app by a US-based television broadcaster founded by the outlawed Falun Gong group.
Another app, which enables users to access books banned in China, was also withdrawn.
China has 591 million internet users, according to the latest official figures from China Internet Network Information Centre.
Among them, 464 million accessed the net via smart phones or other wireless devices.

Genepeeks firm to offer 'digital baby' screen for sperm donors

Genepeeks firm to offer 'digital baby' screen for sperm donors

Baby The system simulates 10,000 hypothetical children for each pairing

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A service that digitally weaves together the DNA of prospective parents to check for potential disease in thousands of "virtual babies" is set to launch in the US by December.
New York start-up Genepeeks will initially focus on donor sperm, simulating before pregnancy how the genetic sequence of a female client might combine with those of different males.
Donors that more often produce "digital children" with a higher risk of inherited disorders will be filtered out, leaving those who are better genetic matches.
Everything happens in a computer, but experts have raised ethical questions.
"We are just in the business right now of giving prospective mothers, who are using donor sperm to conceive, a filtered catalogue of donors based on their own underlying genetic profile," Genepeeks co-founder Anne Morriss told BBC News.
"We are filtering out the donor matches with an elevated risk of rare recessive paediatric conditions."
Ms Morriss, an entrepreneur, gave a presentation on the company at the Consumer Genetics Conference in Boston last week.
Advancing technology She was motivated in part by her own experience of starting a family. Her son was conceived with a sperm donor who happened to share with Morriss the gene for an inherited disorder called MCADD.

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We have to be crystal clear about what we're testing for, what risks we're helping to reduce; that there's no guarantee you won't give birth to a sick child”
Anne Morriss Genepeeks
MCADD (medium-chain acyl-CoA dehydrogenase deficiency) prevents those affected from converting fats to sugar. It can be fatal if it is not diagnosed early. Luckily, in Ms Morriss's case, the condition was picked up in newborn screening tests.
"My son has a pretty normal life," Ms Morriss said, "but about 30% of children with rare genetic diseases don't make it past the age of five."
Genepeeks has formalised a partnership with a sperm bank - the Manhattan Cryobank - and has a patent pending on the DNA screening technology.
The start-up benefits from the rapid pace of change in genetic technology.
Indeed, six months ago, Genepeeks' founders decided it was able to use a superior system for DNA analysis (called "targeted exon sequencing") than the one originally envisaged - a result, says Anne Morriss, of falling costs and increased flexibility.
For couples planning babies, other companies already screen one or both partners for genes that could cause disease if combined with a similar variant - so-called "carrier screening".
Digital filter One academic who studies the use of genetic technology commented: "This is like that, but ramped up 100,000 times."
Ms Morriss's business partner, Prof Lee Silver, a geneticist and expert on bioethics at Princeton University, New Jersey, told BBC News: "We get the DNA sequence from two prospective parents. We simulate the process of reproduction, forming virtual sperm and virtual eggs. We put them together to form a hypothetical child genome.
"Then we can look at that hypothetical genome and - with all the tools of modern genetics - determine the risk that the genome will result in a child with disease. We're looking directly for disease and not carrier status. For each pair of people that we're going to analyse, we make 10,000 hypothetical children."
Anne Morriss Anne Morriss was driven to set up Genepeeks through her own experience
The process will be run for the client and each potential donor one by one, scanning for some 600 known single-gene recessive conditions. In this way, the highest-risk pairings can be filtered out.
Anne Morriss added: "At this stage our clients won't be receiving any genetic information back. We're very much focused on the practical utility of helping prospective parents who want to protect their future kids, giving them the option of additional analysis to what is currently being offered in the industry."
But the company's founders have plans to expand the screening beyond single-gene recessive disorders to more complex conditions in which multiple genes play a part.
Indeed, going to the trouble of simulating thousands of digital children deliberately lays the ground for this: "[It's] impossible to get towards an accurate risk calculation in any other way," said Anne Morriss.
And in a video produced by the company, Prof Silver says: "My hope for the future is that any people who want to have a baby can use this technology to greatly reduce the risk of disease being expressed in their child."
Donor ethics To some, such a prospect might appear like a step towards designer babies - until now the preserve of science fiction literature and films such as Gattaca, which envisaged a future of genetic "haves" and "have-nots".
Bio-ethicists approached by the BBC said Genepeeks was a logical outcome of the increasing demand for more information when making reproductive decisions.
However, some raised potential concerns about risk communication and the expansion of screening beyond rare single-gene disorders. But they suggested there were few, if any, regulatory barriers.
One ethicist told BBC News: "The biggest question for me, just from the outset, is the understanding of uncertainty. Even people who have been doing genomics for years still have a hard time figuring out exactly what a risk for a particular genetic predisposition really means for a family.
"Gene-environment interactions can lead to people either having disease or not having disease."
Dr Ewan Birney, associate director of the European Bioinformatics Institute in Hinxton, UK, echoed the point: "It's good that they're focusing on the carrier status of these rare Mendelian disorders where it's potentially more clear-cut. That said, these things are more complex than they first seem," he said.
"I'm sure the scientists appreciate that complexity. But when transmitting that complexity to everyday people, these things can sound more absolute than they really are."
He added: "The thing I would want to stress here is just how complex this is. It's great that people are thinking of using this technology in lots of different ways, but our knowledge gap is very large."
Risk communication to clients was, said Anne Morriss, "absolutely critical to anyone in this industry".
"We have to be crystal clear about what we're testing for, what risks we're helping to reduce; that there's no guarantee you won't give birth to a sick child," she said.
Prof Mildred Cho, associate director of the Stanford Center for Biomedical Ethics in California, raised questions over whether the sperm donor should also receive information about their genome gleaned from the screening process.
"Unlike hair colour, occupation or family history - those are things, presumably, the donor already knows - the thing that's different about this that I see is it could create information that the donor doesn't already have. It also has implications for the donor's other biological family members," Prof Cho told BBC News.
This week it also emerged that California-based consumer genetics company 23andMe had submitted the patent on a DNA analysis tool for planning a child