Complaint figures are hidden by NHS trusts: Missing data means 150,000 total is only part of the picture
Almost 150,000 complaints were made about the NHS last year – but the full scale of dissatisfaction is unknown because so many trusts failed to register the information at all.
Although there was a 2.4 per cent drop in complaints, a report from the NHS Information Centre shows 29 of the 138 foundation trusts across England did not submit any returns.
Foundation trusts are allowed to withhold the data and in the previous year 18 had chosen to do so.
Patients’ groups and politicians attacked the lack of transparency among the increasing number of trusts failing to disclose their figures.
Rosie Cooper, Labour MP for West Lancashire, and member of the Commons health select committee, said: ‘Foundation trusts need to realise that they are not a law unto themselves.
‘The money they get belongs to the taxpayer and they need to be publicly accountable for that money, which includes the numbers of complaints, their waiting times and mortality rates.
‘If they are not made to reveal all, then this is a fraud against the taxpayer. Real patient choice depends on having correct and timely information.’
Patients Association chief executive Katherine Murphy added: ‘You cannot have individual organisations picking and choosing what information they will and won’t feed back.
‘You can have local management, local involvement, local anything you want. But if local people do not have access to data to enable them to make comparisons then it is a waste of time.’
Latest figures show just over 148,000 written complaints were made about the health service in 2010/11, 3,700 fewer – or 2.4 per cent – compared with the previous year.
Of the total complaints made about hospital care, the category ‘all aspects of clinical treatment’ accounted for 44 per cent, or 43,200, slightly up on the previous year.
Miss Murphy said: ‘This strikes at the heart of this government’s agenda for reform. The current plan is for all trusts to become foundation trusts and gain ‘‘independence’’. We need to make sure there are the right safeguards in place.
‘Our support for the principles of these reforms will rapidly evaporate if we suspect that after it’s all over people won’t know whether their local hospital is any better or worse off. Not just local, but national comparable data is an absolute must.’
NHS Information Centre chief executive Tim Straughan said: ‘Data about 148,200 complaints was submitted to this report, but I would encourage all foundation trusts to report their complaints to us so that future reports can tell the complex story based on information from every trust.’
Paul Hodgkin, chief executive of Patient Opinion, a website where patients can comment on their NHS experience, said: ‘The fact so many trusts have refused to supply data on complaints means that this report simply cannot be treated as an accurate indicator of how well the NHS is performing.’
A Department of Health spokesman said: ‘Making more information available to patients and the public is essential to inform choice and drive improvements in the quality of care.’
Sue Slipman, chief executive of the Foundation Trust Network, said: ‘Our expectation is that all foundation trusts are making their complaints information publicly available.
‘As independent organisations, they are not under any obligation to report to the Department of Health on this matter, and have therefore not withheld information. They take patient complaints extremely seriously and seek to learn from them and improve services.’
David Starkey’s views on race disgrace the academic world, say historians
Notably, they don’t say WHERE he is wrong. They just object to generalizations. But rejecting all generalizations is philosophically incoherent. It would make all discourse impossible
David Starkey has brought his profession into disrepute by voicing theories about race “that would disgrace a first-year undergraduate”, according to leading academics.
More than 100 historians have signed an open letter expressing their dismay at Starkey’s controversial comments on the riots during an appearance on the BBC’s Newsnight programme.
They asked the BBC to stop referring to Starkey as a “historian” on anything but his specialist subject, the Tudors, claiming that he is “ill-fitted” to hold forth on other topics.
Signatories to the letter include academics from Cambridge and the London School of Economics, institutions at which Starkey once taught.
Starkey’s Newsnight appearance caused outrage earlier this month when he was asked about the cause of the riots and replied: “What has happened is that a substantial section of the chavs… have become black. The whites have become black. A particular sort of violent, destructive, nihilistic gangster culture has become the fashion.”
In a letter to the Times Higher Education magazine, the collective of 102 academics said: “His crass generalisations about black culture and white culture as oppositional, monolithic entities demonstrate a failure to grasp the subtleties of race and class that would disgrace a first-year history undergraduate.
“In fact, it appears to us that the BBC was more interested in employing him for his on-screen persona and tendency to make comments that viewers find offensive than for his skills as a historian.
“In addition to noting that a historian should argue from evidence rather than assumption, we are also disappointed by Starkey’s lack of professionalism on Newsnight.
“Instead of thoughtfully responding to criticism, he simply shouted it down; instead of debating his fellow panellists from a position of knowledge, he belittled and derided them. On Newsnight, as on other appearances for the BBC, Starkey displayed some of the worst practices of an academic, practices that most of us have been working hard to change.”
The letter asked why the BBC had invited Starkey to discuss the riots when his academic research and published works have nothing to do with the subject.
“In our opinion, it was a singularly poor choice,” they said, adding that “the poverty of his reductionist argument… reflected his lack of understanding of the history of ordinary life in modern Britain. It was evidentially insupportable and factually wrong.
“The problem lies in the BBC’s representation of Starkey’s views as those of a ‘historian’, which implies that they have some basis in research and evidence: but as even the most basic grasp of cultural history would show, Starkey’s views as presented on Newsnight have no basis in either.”
Among the signatories are Paul Gilroy, professor of social theory at the London School of Economics; Steven Fielding, professor of political history of at the University of Nottingham; Richard Grayson, professor of 20th century history at Goldsmith’s, University of London; and Tim Whitmarsh, professor of ancient literatures at the University of Oxford.
Liberal leader pledges to defend British human rights laws
Nick Clegg has opened up a new rift in the Coalition by pledging to resist Conservative attempts to change human rights laws in the wake of this month’s riots.
The Deputy Prime Minister said it is a “myth” that Britain’s human rights laws are harmful and insisted that they must not be abandoned. Mr Clegg’s argument, set out in a newspaper article, is at odds with David Cameron’s views.
In the wake of the disturbances in London and other English cities earlier this month, the Prime Minister signalled a fresh move to challenge the Human Rights Act, declaring that he would not be restrained by “phoney human rights” concerns.
The legislation, which enacts the European Charter on Human Rights, is blamed by many Conservatives for problems in the criminal justice system. Critics say that over-zealous application of the law leads the police and other authorities to put too much emphasis on the rights of criminals and suspects, and not enough on the needs of victims.
Without naming Mr Cameron, Mr Clegg criticised people who have allowed “a myth to take root that human rights are a foreign invention, unwanted here, a charter for greedy lawyers and meddlesome bureaucrats.”
He added: “This myth panders to a view that no rights, not even the most basic, come without responsibilities; that criminals ought to forfeit their very humanity the moment they step out of line; and that the punishment of lawbreakers ought not to be restrained by due process.”
This is not Mr Clegg’s first dispute with Mr Cameron over human rights laws. The Deputy Prime Minister has an ongoing disagreement with his Conservative colleagues over the issue of votes for prisoners. After a ruling from the European Court of Human Rights – which oversees the charter – Britain is obliged to let prisoners vote in general elections. A majority of MPs have opposed that change, and Mr Cameron has said he will listen to the Commons.
However, Mr Clegg – supported by Kenneth Clarke, the Conservative Justice Secretary – is insisting that Britain has no choice but to accept the court judgement and allow at least some prisoners to vote.
Mr Clegg accepted that some aspects of the court must be changed, but insisted that there is no question of the UK pulling out of the convention.
Some Conservatives want the UK to pull out of the convention, but Mr Clegg said that must not happen: “As we continue to promote human rights abroad, we must ensure we work to uphold them here at home. We have a record we should be proud of and never abandon.”
The Human Rights Act and the European Convention on Human Rights have been “instrumental” to protecting British civil liberties, he said.
What caused the Industrial Revolution?
I am reproducing the whole of an article by Prof. Boudreaux below as it is itself a very condensed treament of a big topic. I follow the article, however, with what I believe is a better argument
Few questions in economic history are discussed and debated as much as this one. Even if you happen to be among the small number of people who regret what historian (and Freeman columnist) Steve Davies calls “the wealth explosion” of the past couple of centuries, you must nevertheless find this question intriguing, for it asks about the causes of what is surely the single greatest change in human history.
For at least 70 millennia the standard of living of the vast majority of us humans was at, or very near, subsistence. Then all of a sudden (in the great sweep of history)—boom! Starting in the eighteenth century living standards shot upward not only for royalty and the landed nobility but for everyone. And to this very day our standard of living—including our life expectancy and measures of healthfulness—continues to rise.
Why? A question so momentous elicits plenty of answers. Among the well-known answers that have been offered over the years are capitalist exploitation of workers; capitalist exploitation of colonies; religious beliefs that promoted savings and risk-taking; and England’s 1688 Glorious Revolution, which is said to have made property rights more secure. And new answers continue to be offered, such as economist Gregory Clark’s thesis, explained in his book A Farewell to Alms, that genes equipping human beings especially well for carrying out enterprise and commerce were passed down from the English nobility into the English middle classes—thus equipping the bourgeoisie finally to do its thing.
Some of these answers are more plausible than others (with Clark’s being among the least plausible). But not a single one is satisfactory. None explains why the Industrial Revolution began where it began (northwestern Europe) or why it began when it began (the eighteenth century). Another explanation is needed.
And another explanation has indeed just been offered: a change in rhetoric. This rhetoric-based thesis comes from the great economist and historian Deirdre McCloskey in her 2010 book Bourgeois Dignity. It’s a book that, like only three or four others I’ve read, caused a major change in my thinking.
McCloskey reviews with awesome thoroughness all the major (and many not-so-major) explanations for the Industrial Revolution. She finds them all wanting.
Some of these explanations are more obviously flawed than others. Capitalist exploitation of workers, for instance, fails spectacularly as an explanation on a variety of fronts, not the least of which is that the very people from whom the newly created wealth is supposedly extracted (the masses) are the same people who have benefitted most from this wealth explosion.
If capitalist wealth was wrenched from the bent backs and sweaty brows of the working class, then surely workers as a group would today be much poorer rather than (depending on how you count) 10 to 100 times wealthier than were their pre-industrial peasant ancestors. As McCloskey emphasizes, “[M]odern economic growth did not and does not and cannot depend on the scraps to be gained by stealing from poor people. It is not a good business plan.”
A more plausible explanation is one associated most familiarly with the Nobel economist Douglass North and his frequent coauthor Barry Weingast. It’s an explanation I once accepted. According to North and Weingast, the replacement of the Stuart monarchs by William and Mary in the late seventeenth century resulted in more secure property rights in England, which in turn sparked the Industrial Revolution.
While everyone with a modicum of sense understands that the Industrial Revolution would not have happened if private property rights in England weren’t secure, McCloskey argues persuasively that the Glorious Revolution—for all of its undoubted benefits—did not bring about much of a change in England’s property laws or in the security of private property rights. Here’s what McCloskey writes on page 318:
England when at peace, which was the usual case throughout its history, was a nation of ordinary property laws, no more or less corrupt than Chicago in 1925 or the American South under segregation, places in which innovation flourished. It was so, for example, even when the Stuart kings were undermining the independence of the judiciary in order to extract the odd pound with which to have a foreign policy in a new age of standing armies and floating navies. And the amounts extracted, contrary to the Northian suggestion that the king owned everything, were by modern standards pathetically small. The figures offered by North and Weingast themselves imply that total government expenditure under James I and Charles I was at most a mere 1.2 to 2.4 percent of national income. . . .
“[T]he Stuart kings, grasping though they were, and emboldened (as were many monarchs at the time) by the newly asserted divine right of kings, were nothing like as efficient in predation as modern governments—or indeed as were the Georgian kings of Great Britain and Ireland who eventually succeeded the Stuarts.”
Indeed so. This explanation fails.
The mainstream economist’s long-preferred explanation is capital accumulation. It fares no better than does the capitalist-exploitation thesis and the North-Weingast thesis.
According to the capital-accumulation thesis, people (for any of a variety of different reasons) began to save more. These savings were transformed into capital goods whose use increased the productivity of labor. And so the Industrial Revolution happened.
But as McCloskey points out, history is full of instances in which people saved just as much as in northwestern Europe at the dawn of the Industrial Revolution, but without unleashing any revolutionary industrial forces. Moreover—and contrary to a thesis still fondly held by many people from Marxists to Reagan Republicans—economic growth does not require substantial capital accumulation. It can be, and has been, funded largely out of retained earnings.
What does best explain why the Industrial Revolution began in northwestern Europe in the eighteenth century is that for the first time in history people then and in that part of the world began to talk about the bourgeoisie with respect. This new “habit of the lip” (as McCloskey calls it) replaced the older habit of talking about entrepreneurs and merchants as being, at best, contemptible functionaries whose services society might need in some measure but whose importance to society fell far below the services supplied by warriors, royalty, noblemen, and priests.
With merchants and entrepreneurs in eighteenth-century Holland and England finally accorded widespread dignity, society’s best and brightest no longer avoided the world of private business to pursue careers at court or on the battlefield. The power of the bourgeoisie in these countries with tolerably secure private property rights was thus finally unleashed to revolutionize the economy—first in northwestern Europe and, continuing to today, the rest of the world.
The question discussed above is of immense interest to those of us who are interested in history. But I think the explanation in terms of rhetoric favored above by Prof. Boudreaux is at best a very partial explanation. One immediately asks WHY the rhetoric about the bourgeoisie changed. No answer is given.
Prof. Boudreaux seems to be a pretty thoroughgoing libertarian and, as is common in such circles, sees genetics as of only minor importance. That is presumably why he so airily dismisses Gregory Clark’s thesis in terms of genetics and natural selection (i.e. in pre-modern times the rich and powerful had greater reproductive success).
But why he so airily dismissed the Weberian explanation in terms of Calvinism (“religious beliefs that promoted savings and risk-taking”) is mysterious. I can however provide my own reasons for dismissing Weber’s thesis (at least in its narrowest sense of applying to Calvinists only) so I will not dwell on that.
I, on the other hand can see no reason to doubt the process that Clark describes (briefly outlined here) except in one important respect: The same thing must have happened in Tokugawa Japan but the same result was certainly not observed.
I take it as given that no one factor is alone sufficient to account for the industrial revolution. Prof. Boudreaux mentions above a number of factors that could have had a facilitatory effect (security of property rights, capital accumulation, a long period of peace etc.) and it seems obvious to me that when you have a lot of those factors present at the one time and in the one place you then reach what we know from nuclear physics as a “critical mass”: There is a long buildup with nothing obviously changing and then suddenly it all does change in a big way. A “tipping point” is a similar concept, one much relied upon by Warmists but which anybody who has ever seen an oldfashioned set of counterweighted scales in use will readily understand. You keep adding weights to one side of the scale and nothing happens. But add that last weight and the scale suddenly tips up.
And it seems to me that the genetic process described by Clark is an important one of those crucial factors which together gave rise to the industrial revolution.
But surely the favourable factors came together somewhere else at some time? And Tokugawa Japan would seem to be such an instance. It had the longest period of peace of any country in history, the genetic process described by Clark should have occurred and it was a very orderly law-bound society.
So we have to look at factors beyond the Clark thesis. And I think that the responsible factors are easy to see. Mercants were NOT respected, no religious innovation akin to Calvinism was allowed and the laws were very unequally applied. A Samurai had far greater rights than a farmer, for instance.
So Clark’s process cannot stand alone but, seen as a tributary joining with others to form a mighty river of change, it surely has an important place.
And those tributaries started flowing much sooner than is popularly believed. The birth of scientific thinking was surely important in sparking things like the invention of the steam engine and scientific thinking goes back a very long way. It started of course with the ancient Greeks but was lost for a time. The Renaissance is often seen as the revival of Greek learning which in turn sparked the beginning of modern science with Galileo and his telescope etc.
On closer examination, however, the Renaissance was not such a sudden change. There was a continuing quiet evolution of thinking even in the “dark” ages and much that is attributed to the Renaissance came in fact from Medieval times. See here.
Which leads me to my final point: That the whole of history led up to the Industrial revolution. Human capabilities continually expanded in fits and starts and even occasionally gave rise to real civilizations such as ancient Athens and Rome. But, to re-use again the “critical mass” concept, none of the advances in capability and understanding were quite enough to ignite a great change. When enough capability and understanding had built up, however, the scales tipped (to change the metaphor). The industrial revolution seemed sudden but it was in fact the accumulation of thousands of years of social evolution. Everything finally came together at last.