The Commission for Health Improvement (CHI) said some centres did not meet targets for answering and dealing with calls.

But the CHI’s first annual report on NHS Direct in England and Wales praised it for providing good quality guidance.

The service handles half a million phone calls and half a million internet inquiries a month.

Since NHS Direct was five years ago, it has received more than 20 million calls.

Most calls are made in the evenings and weekends when GPs’ surgeries are closed, and a quarter concern children under five.

Patients ring up about a wide variety of health issues, including faddy diets, ovarian cysts, and strokes.

Success has meant increasing demand for the service and capacity problems for some call centres Jocelyn Cornwell, Commission for Health Improvement

The CHI found the most common questions included: ‘How should I feed my baby?’, ‘What is the male pill?’, ‘Can I get impotence drugs on the NHS?’ and ‘How do I find an NHS dentist?’

Its report said callers found helpline staff to be polite, professional and reassuring, and added that demand for the service was increasing.

It was also praised for giving staff the chance to work flexibly, with more than 60% working part-time.

‘Well regarded’

The CHI did find, however, that some call centres were missing, or close to missing, national performance targets.

Centres should answer 90% of telephone calls within 30 seconds, deal with 90% of calls where patients report symptoms within twenty minutes, and lose fewer than 5% of calls.

Other targets - to process 90% of health information calls within three hours, and ensure less than 0.1% of calls are answered with the engaged tone - are being met, the report said.

Public satisfaction with the service doesn’t necessarily mean that the quality of the advice was good Helen Parker, Which?

Jocelyn Cornwell, CHI’s acting chief executive, said NHS Direct was well regarded by the public and patients, and was proving “very successful”.

“It is now the first port of call for anyone who needs medical help, but is unsure of which part of the health service is best able to help them,” she said.

“Success, however, has meant increasing demand for the service and capacity problems for some call centres.

“There are also complex management , which can create confusion over the of policy, practice and performance and a lack of clarity over roles and .

“For NHS Direct to build on its success and popularity, these issues need to be resolved.”

‘Saving lives’

Helen Parker, editor of Which? magazine, said an investigation it had carried out into NHS Direct had found “fundamental problems” with the service.

She said staff often failed to spot potential emergencies and patients waited “too long” for medical advice.

“It clearly showed that public satisfaction with the service doesn’t necessarily mean that the quality of the advice was good,” Ms Parker said.

“Most people are not medical experts - which is why they call NHS Direct in the first place - and few have the expertise to tell whether or not they’ve been given good medical advice.

“In fact, high satisfaction levels are more likely to relate to how friendly the staff were or how reassured the patient felt.”

But Health Secretary John Reid said NHS Direct provided an excellent service, which had helped saved lives.

“Each week, 3% of people who ring NHS Direct do not recognise the severity of their symptoms and are transferred to the 999 ambulance service,” he said.

The service also played an essential role in reassuring people about their health, he added.

A spokeswoman for the British Medical Association said NHS Direct worked best when it was “fully integrated into primary care, operating
alongside general practice services”.

The Spanish press on Friday is decidedly about a change in the law which could mean the jailing of the Basque prime minister, if he defies Madrid with a planned referendum.

Elsewhere there is a cautious welcome for Iran’s return to the nuclear fold. And in Bulgaria, criticism of the anti-crime record.

‘Go to jail’ card

The Spanish opposition parties’ boycott of the parliamentary vote on Thursday did not prevent the Penal Code from being amended.

The dangerous and avoidable reintroduction of the political crime El Periodico

Madrid’s El Mundo sees the banner held up by protesting MPs with the words “Everyone to prison!” as reflecting an opposition “driven to mockery in its impotence”.

With this attitude, the paper says, “the opposition, far from punching the Popular Party into the ropes, exposed its own powerlessness against the government”.

El Pais is unhappy about the government’s “dubious amendment”, saying it is “undoubtedly a novel idea, but not a good one”.

Barcelona’s El Periodico sees the amendment as an augur of the “dangerous and avoidable reintroduction of the political crime”.

“It is true,” the paper acknowledges, that the Basque prime minister’s plan “encourages the hopes of the men of violence to see their crimes rewarded”, and it “aims to bring about constitutional reforms by fraudulent means”.

But all of this “can be countered with the democratic instruments of the law-based state”, instead of which “the government has chosen to substitute mere threats for the debate of ideas”.

Iran’s nuclear file

Germany’s Der Tagesspiegel welcomes Iran’s signing of an agreement with the UN allowing tougher nuclear inspections, but it warns that much will depend on its .

“Yesterday was a good day for the International Atomic Energy Agency,” the paper says, “and for all those who want to prevent weapons of mass destruction from falling into the wrong hands.”

Persistence paid off, the mediation mission was a success - and this time the hawks in Washington were on the outside. Die Presse

However it points out that the Iranian leadership not long ago appeared divided on the issue, and that hard-liners may still be trying to build a nuclear bomb secretly.

Events in the coming months should clarify matters, the paper suggests, and “show”, “whether the Iranians intend to use ploys, following the example of North Korea or Iraq, or instead are seriously interested in settling their differences with the West”.

Austria’s Die Presse hails the development as “a triumph for diplomacy”, noting that the decision was preceded by visits of the British, French and German foreign ministers, the head of the IAEA and the European Union’s foreign policy chief.

“In the end,” it says, “persistence paid off, the mediation mission was a success - and this time the hawks in Washington were on the outside.”

“When the Europeans pull in the same direction, they can make things happen,” the paper concludes.

The Swiss Le Temps, however, warns that the good news should not be allowed to hide “the disturbing fact” that the whole non-proliferation system is suffering “from a crisis of confidence… with some American political officials challenging the very principle of such a system”.

The paper points to the fact that Tehran has been shown to have benefited from foreign - and specifically Pakistani - technology.

” heavy suspicions fall on Islamabad,” it says, “and some do not hesitate to regard” Pakistan “as the third member of the ‘Axis of Evil’, now that Iraq has fallen”.

Le Temps wonders if Tehran will be willing to put a complete stop to its production of enriched uranium, and concludes that “the Iranian nuclear file” is “far from closed”.

Making waves again

Statements made earlier this week by Austria’s maverick Freedom Party figure Joerg Haider in which he appeared to liken President George W Bush to Saddam Hussein continue to make headlines in the country’s press.

Mafia has infiltrated the State; Interior Ministry doesn’t care Douma

Vienna’s Der Standard says Chancellor Wolfgang Schuessel has failed to come down hard enough on the controversial politician and coalition partner.

He could have demanded Joerg Haider’s resignation from his posts, the paper suggests, and “placed the continuing existence of the coalition on the line in the event of a refusal”.

“He is still on time to do so,” it points out.

Crime worries

Bulgaria’s Troud warns that the opposition Bulgarian Socialist Party (BSP) has not given up the idea of calling “a no-confidence vote in the government over the crime situation in this country”.

This lack of confidence in the government’s crime fighting is echoed in Douma which, quoting the BSP leader, Sergei Stanishev, describes the updated government programme for combating crime as “inadequate”.

“Mafia has infiltrated the State; Interior Ministry doesn’t care,” the paper laments.

Sega, referring to a statement by Mr Stanishev, says that there is “no organised body” to fight against organised crime and “the fight against offenders is led randomly as many efforts are spent on small problems”.

And the government’s latest initiative, the reintroduction of registering with the police when someone visits another city, is not welcomed by the paper.

The lifting of the requirement for such registration in the early 1990s was believed to be “one of the first achievements of Bulgarian democracy at the time,” the paper points out.

The European press review is compiled by BBC Monitoring from internet editions of the main European newspapers and some early printed editions.

Feeling decadent, you could fill up your bathtub with Chanel No. 5 for $1.6m (800,000).

But if you want a 30-second advert during the Super Bowl, the of American football, it will cost almost $2.3m (1.3m).

With declining television audiences in the US, the Super Bowl is one event that can guarantee advertisers the most eyeballs for their buck.

A media event

The cost for advertising has risen dramatically in the last 38 years. In the first Super Bowl in 1967, a spot cost almost $240,000 in today’s dollars.

But there are few television events like the Super Bowl that can guarantee an audience of 140m viewers, especially with a declining network TV audience due to the Internet, DVDs and hundreds of cable, satellite and channels.

Apple has teamed up with Pepsi and former legal targets

“This is a throwback to old TV, when you didn’t have a choice. You couldn’t zap away from the commercials,” said Matt McAllister, an advertising and culture expert at Virginia Tech University.

“The Super Bowl is not just potential exposure to those eyeballs. It is exposure to those eyeballs. The idea that people channel surf at Super Bowl parties is absurd.”

And over the years, the ads have become an event unto themselves.

“The Super Bowl is something where the ads are covered as news themselves,” said Mr McAlister.

They are the only event in the TV year where the ads are previewed, and then critiqued on the morning news shows after the Super Bowl.

“Even the flop ads get free air time,” Mr McAlister said.

Cultural icons

The tone of the ads over the last few years have been more sombre following the attacks of 11 September and the lead up to war in Iraq.

But, back this year is the irreverent tone that has made many of the ads cultural icons.

This year, Pepsi and Apple Computer will be poking fun at online music file traders.

Pepsi will be giving away 100 million from Apple’s iTunes music store, and the commercial features 16 teens who were sued by the recording industry for illegally downloading music.

The ad is set to punk band Green Day singing, “I fought the law (and the law won).”

An ad for office supply store Staples features a worker who rebels against an office supply clerk who demands pastries in exchange for folders and paperclips.

Instead of going through the supply clerk, he buys his supplies at Staples and with the help of some mobster muscle demands a pastry in return.

Politics-free zone

But in addition to humour this year, election year politics has tried to invade this perfect advertising .

Networks banned ads that poked fun at the president

The CBS network rejected ads from political activist group Moveon.org and from People for the Ethical Treatment of Animals (Peta).

The Moveon.org ad criticised President Bush for the ballooning national deficit, and the Peta ad promotes vegetarianism with the message that eating meat can cause impotence.

CBS rejected both ads on the basis of its policy against advocacy advertising, saying the policy was designed to prevent those who can afford advertising from having an undue influence on “controversial issues of public importance.”

Washington Post media critic Howard Kurtz said in an online discussion that the networks’ prohibition against advocacy advertising applies to everyone.

“When some group gets its ad rejected by ABC, CBS or NBC, it cries foul and political bias and censorship. But everyone in the issues realm is basically shut out,” he said.

But Peta spokeswoman Lisa Lange said: “CBS not only takes advocacy ads, but has shown them during the Super Bowl, including Truth.com anti-smoking ads and anti-drunk driving ads sponsored by beer companies.”