"Quality of life is something I say I have, not something that someone else tells me I have got.". All had very limited movement so communication was difficult without special equipment.The misdiagnosed patients remain severely physically and mentally disabled. However, the majority had stated very strongly that they wanted to live, Dr Andrews said, and described their quality of life as good. Eight could spell out letters to relatives.Two-thirds of the patients knew where they were and had a sense of time. Three-quarters were able to learn new information, such as the names of staff, and two-thirds could process information such as simple arithmetic.Dr Andrews, director of medical services at the hospital, said one of the principal findings was that vegetative state - he wants persistent or permanent to be dropped from the title - is very difficult to diagnose. "It cannot be made by even the most experienced specialist from a bedside assessment," he said.Two-thirds of the misdiagnosed patients were found to be blind and had been thought to be unaware because they did not track objects with their eyes or blink when threatened. They can breathe on their own but most have to be fed through a tube.Doctors at the Royal Hospital for Neuro-disability in London, Britain's only specialist centre for vegetative state, studied 40 patients referred there since 1992 from hospitals where they were diagnosed as PVS;17 (about 43 per cent) were found to be misdiagnosed, some after just a few days' assessment.According to a report in tomorrow's British Medical Journal, all 17 patients could communicate by pressing a buzzer or pointing with their eyes to make simple choices.

The extent of misdiagnosis revealed in this first detailed study of PVS, has profound legal and ethical implications. It raises the possibility that some patients, for whom tube feeding or vital treatment was withdrawn at the request of their family with court approval, were not, in fact, in a vegetative state. There are between 1,000 and 1,500 PVS patients in Britain.In the light of the findings, Dr Keith Andrews, author of the study and a world authority on vegetative state, is urging doctors to refer any patient in this condition to a specialist team before making any application to discontinue feeding.PVS is used to describe patients with severe brain damage who spend time awake and asleep; who show no meaningful response to things around them and whose movements and reactions are reflex. And scores of other patients in non-specialist centres, diagnosed as PVS, may be acutely aware of what is going on, but are being cared for as if they were not, and given no opportunity to communicate. Seventeen patients diagnosed as being in a persistent vegetative state - some for as long as four years - were in fact aware of themselves and their surroundings and could communicate with carers, according to a study. The committee has asked itself, 'why is it that cycling is 12 times safer in Denmark than in the UK?' and has reached the conclusion that safety policies and road design must change."5 House of Commons Transport Committee: Risk Reduction for Vulnerable Road Users, Paper 373, HMSO, pounds 14 10. Despite a large increase in the numbers of pedestrians and cyclists in the city, casualties in the two groups have fallen by 36 per cent and 30 per cent respectively, compared with national drops of 15 per cent and 12 per cent. The committee wants the Department of Transport to formulate a national strategy for achieving road safety goals and to take into account the benefits of shifting from cars to walking and cycling when assessing road schemes.Lynne Sloman of the Pedestrians Policy Group said: "Road safety officers treat walking as dangerous; they give kids Tufty Club badges, make them wear reflective clothing and tell parents not to let them walk to school alone".Colin Graham of the Cyclists' Public Affairs Group said: "This report confirms that bad road safety policy has been putting the brake on bike use. And the economic pressure on skippers like John Carno simply to sell up and take decommissioning cash will increase.

Whether they accept, said Mr Macrae, "will depend on what is on offer".But in the meantime the herring fever is in evidence.. The conventional approach to road safety of trying to dissuade vulnerable road-users is misguided and should be replaced by a strategy of encouraging cyclists and pedestrians back on to the streets, an all-party group of MPs said yesterday. A report by the Commons Transport Committee cites the city of York, where a radical programme to reduce road speeds and promote cycling and walking has led to a 40 per cent drop in road casualties in the past 15 years, compared with a UK average drop of 1.5 per cent. We will survive." He talked of the need for "effective stock management" and said:"it's clear that there is a problem ... it is not insurmountable, but we cannot fish for 365 days a year".In the short-term Fraserburgh will suffer. The town's large processing plants, employing hundreds of people, will need to import fish from foreign markets The pelagic fleet will need to look beyond the North Sea.