Banishing the NHS paper-pushers
Pointless and costly bureaucracy and ludicrous management salaries have no place in this era of austerity
By Max Pemberton
Several years ago, a friend worked as a temp in the NHS. She was the secretary to a group of middle management in a primary care trust (PCT) and spent the summer holiday before going to law school running their office. Within a few weeks, she quit. Not because she couldn’t do the job, but because she was disgusted with the waste she witnessed.
She was told not to work too hard. She would sit in meetings where the same things were discussed repeatedly without any decision being made. She was taken aside by a colleague when she attempted to improve efficiency and asked if she wanted to make everyone unemployed. It was shortly after this incident that she walked out.
All this was particularly galling to me at the time. I was working on a ward for elderly patients with dementia, and the ward didn’t even have its own resuscitation equipment. Instead, the clinical staff had to beg, borrow or steal from other wards.
The amount of fruit that patients were given at lunchtime was cut. I would sit in outpatient clinics and have to tell the families of people with Alzheimer’s that I wasn’t allowed to prescribe the anti-dementia drugs for their loved ones because the government had decreed that at £2.50 a day, they were too costly.
Frontline NHS staff look at the legions of paper-pushers in their offices and wring their hands in despair. Something needs to be done to prune this stratum in the health service, and last week there were the first signs that this might happen.
The Coalition government’s recent plans to improve the NHS will see PCTs and strategic health authorities scrapped. This is a bold move. In recent years, these organisations have morphed into unwieldy bodies that do little more than provide jobs for people who have no hard clinical skills, but who couldn’t quite hack it in the corporate sector.
While these organisations have responsibility for patient care, they are distant and detached, and it is difficult to see how they contribute in any meaningful way to the day-to-day care of patients. Yet, they cost millions to maintain. A report published last week found that more than 300 NHS executives have salaries larger than the Prime Minister. Ian Miller, for example, worked as the interim director of finance and investment for South East Coast Strategic Health Authority and earned £310,000 for nine months’ work from April 2009 to January 2010. This equates to £400,000 a year, which would pay for 14 nurses. Financial experts have described these salaries as “unsustainable”.
The plans are not without potential pitfalls: will GPs, for example, be able to manage such large budgets effectively? But I wholeheartedly support the essence of these proposals, which is that pointless and costly bureaucracy and ludicrous management salaries have no place in this era of austerity.
I also believe that giving power to clinicians will benefit patients. It’s doctors and nurses who have a far greater understanding of what is needed and where resources should be directed than a person with an MBA sitting in an office well away from the action.
My friend, who is now a successful corporate lawyer, says that if the NHS wants to operate along corporate lines, it needs to heed corporate principles: no business would employ so many people who don’t do what the business is set up to do – namely to treat patients. I hope the Government’s proposals address this once and for all, and that patients and those who care for them are put back at the centre of the NHS.
NHS patient told he had a year to live after being wrongly diagnosed with leukaemia wins £175,000 payout
And he has to live with permanent damage from his treatment
A former engineer who was mistakenly told he had one year to live has received a £175,000 payout in an out of court settlement. Anthony Moore, 46, was actually suffering from nerve damage, thought to have been caused by the drugs he was given after the hospital mistakenly thought he had MRSA.
Mr Moore claimed he suffered psychological damage and was left unable to work after wrongly being told by staff at Basildon Hospital, Essex, that he would die. He was prescribed Linezoid, used to treat MRSA, after he was admitted to the hospital for treatment of an infected wound.
Mr Moore was readmitted five days later suffering from severe anaemia, swelling and low haemoglobin levels. Medics diagnosed him with leukaemia and said he was unlikely to survive past 12 months.
But it was later discovered he was instead suffering from peripheral neuropathy believed to have been caused by ‘prolonged and unmonitored’ use of Linezolid.
His solicitor Withy King said: ‘The claimant was incorrectly advised he was suffering from leukaemia and would die within a year but it was subsequently discovered he was actually suffering from peripheral neuropathy. ‘The claimant alleged negligence in prescribing Linezoid as he did not have MRSA and for failing to monitor blood results weekly in accordance with national guidelines. ‘The liability was not disputed.’
Mr Moore suffered nerve damage in his arms and legs as well as nerve palsy in his left knee. He was left unable to walk normally and the damage meant he fell over frequently. His symptoms meant he was unable to carry out his work as an engineer because he had difficulties climbing ladders.
Mr Moore’s symptoms are likely to be permanent and he will probably need further knee surgery with a risk of above-knee amputation.
The best way to teach reading and writing must be settled once and for all
The imimitable Boris Johnson is being surprisingly diplomatic about the desirability of phonics. Does Mayoralty do that to you?
Lurking in the childhood of anyone ambitious there is always the memory of some humiliation that sets them on the path of self-improvement. Show me a billionaire, and I will show you someone who was beaten up for his lunch money. Many is the megalomaniac who first had to overcome a case of acne or puppy fat or being forced by his mother to wear a flowery tie to a friend’s birthday party. You want to know my moment of childhood shame? Shall I tell you when I decided that I was going to have to sharpen up my act to survive?
I must have been about six, and my younger sister must have been about four or five, and we were sitting on a sunny river bank being taught to read by my grandmother. We were reading alternate sentences aloud when my grandmother announced – as my sister Rachel has never ceased to remind me – that the girl was reading better than the boy. Yes, in spite of the 15-month gap between us, she was somehow deciphering the words more easily than I was. I cannot tell you how much it costs me, even now, to report this buried shame. I blushed. I fumed. Beaten! By my kid sister!
As the antelope wakes every morning and knows that he must outrun the lion, so I wake every day and know that I must somehow scamper to keep ahead of Rachel, all-powerful editor of The Lady and authoress of what is currently the number two best-seller in France. I remember the pain and horror at being left behind in the reading stakes, because it is an emotion that is all too common in children in our schools today. Unlike the village schools of Somerset 40 years ago, it seems that our methods of dealing with the problem are painfully inadequate. Over a third of London primary school children reach the age of 11 without being able properly to read and write, and 20 per cent are still having serious difficulties by the time they leave secondary school.
This is a source of huge economic inefficiency, but in every case of illiteracy we are also talking of a grievous personal handicap. If you cannot read properly, you are more likely to suffer from low self-confidence – and if you suffer from low self-confidence, you are far more likely to turn to crime.
That is why I commend an excellent pamphlet by Miriam Gross, published today by the Centre for Policy Studies, in which she examines some of the difficulties with improving literacy in London. She takes aim at some familiar targets of conservative wrath: child-centred learning, by which children are invited to “discover” the meaning of the printed page before them, rather than being taught; the hostility to academic selection that has bedevilled the teaching establishment; the lack of discipline in some schools; the time wasted in considering the “emotional well-being” of the child, rather than good old instruction in reading and writing.
Some of these complaints will no doubt infuriate many hard-working teachers, and some educationalists will be outraged at what they will present as a traditionalist and downright reactionary approach. At the heart of Miriam Gross’s argument is the story of one of the greatest Kulturkampfen of the last century. It is like the dispute between the Big-Enders and the Little-Enders, or the war that raged between those who thought Christ was homoiousios and those who thought he was homoousios in his relation with God the Father – except that this argument matters. [That argument mattered in Byzantine times too — JR]
Ask yourself what happens when your powerful Daily Telegraph-reader eye skitters effortlessly through this article. What cognitive processes are going on in your head? With incredible speed you are decoding clutches of letters into sounds, in order to identify the words; and those words are being virtually simultaneously converted into sense; and the reason you can do this so fast is that hard-wired into your reading brain is an understanding of how the alphabet generates the 44 sounds of the English language; and the best way to reach that instinctive understanding of how letters make sounds is a system known as synthetic phonics.
That is the system that rescued me after the appalling verdict of my grandmother. I remember going to primary school and sitting cross-legged as the class learned C-A-T, and how each sound helped to make up a word, and after a while I had cracked it; and I find it unbelievable that so many children are not given the opportunity to learn by this simple and effective means.
It was about 100 years ago that the split began, and some educationalists began to argue that phonics was too dogmatic, too authoritarian. It was demoralising for children who couldn’t spell out every word in their heads, they said. Perhaps they should be encouraged just to recognise the words – and so was born the system of “whole word recognition”, intended partly to bolster those who found phonics a strain.
And yet the result, say the phonics proponents, is that children are not being given the basic all-purpose deciphering tools they need. That is why literacy has declined in the past 50 years, they claim, and that is why we face a skills shortage caused very largely by the inability of one million working Londoners to read and write.
Are they right? It is time to end this culture war, and to try to settle once and for all, in the minds of the teachers, whether synthetic phonics is the complete answer or not? We have in Nick Gibb, the admirable new schools minister, one of the world’s great militants for synthetic phonics. Indeed, you can have a meeting with Nick on almost any subject, and I can guarantee he will have mentioned it within five minutes. I am almost 100 per cent sure he is right.
And yet I have also met London kids on Reading Recovery programmes who are obviously benefiting hugely from a mixture of phonics and word recognition. It is surely time for the Government to organise a competition, a shoot-out between the two methods, to see which is the most effective for children of all abilities.
And don’t tell me children are averse to competition. Look at me and my sister.
One in five British school leavers can’t read: Trendy teaching is ‘still harming pupils’ learning’
One in five school-leavers struggles to read and write because teachers are shunning traditional classroom methods in favour of trendy ‘child-led’ lessons, a report warns today.
Discredited teaching techniques that encourage children to just find things out for themselves rather than being taught are ‘alive and kicking’ in primary schools, the research claims.
Teachers are encouraged to avoid pointing out mistakes for fear of ‘crushing creativity’ or ‘undermining confidence’, and to give pupils a choice of tasks to undertake in class.
But the approach, typical of the 1960s and 1970s, is ‘neither stimulating nor challenging’ and is continuing to damage children’s reading skills despite attempts by successive governments to introduce more structured teaching methods, according to the Centre for Policy Studies.
The report by Miriam Gross, a literary editor and volunteer teacher, warns that large sections of the education establishment have ignored attempts to put traditional ‘synthetic phonics’ at the heart of reading lessons.
The technique involves children learning the 44 sounds of the English language and how they can be blended together to form words.
But many teachers condemn it as ‘prescriptive’ and ‘boring’. Instead schools continue to use other, more ‘fun’, techniques, including encouraging children simply to memorise whole words and guess at harder ones.
The report, commissioned by Mayor of London Boris Johnson, highlights that more than a third of children who leave the capital’s state primaries at 11 still have difficulties with reading, while one in five teenagers leave secondary school unable to read or write with confidence.
A separate study, by experts at Sheffield University, has found that 17 per cent of 16 to 19-year-olds across the country are functionally illiterate, meaning they can understand only the simplest text.
‘This is less than the functional literacy needed to partake fully in employment, family life and citizenship and to enjoy reading for its own sake,’ the authors said.
Today’s report warns that ‘progressive’ education theories still persist in many schools, damaging the prospects of thousands of children. Teaching of mixed ability classes is widespread, competition discouraged and mistakes of grammar, punctuation and spelling are too often left uncorrected.
Teachers are encouraged not to interrupt-children while they are speaking or to pressure them into learning topics they don’t like. Unlike in other European countries, children are allowed to write in ‘street’ slang – and teachers fail to point out how it differs from correct English usage for fear of stifling ‘self-expression’.
‘The child-led approach is frequently neither stimulating nor challenging. Very young children simply haven’t got the tools or the knowledge to benefit from it or to make sensible choices,’ the report said.
At the same time, too much attention in primary schools is devoted to ‘circle time’, where children sit in a circle discussing emotions and family relationships.
The report said: ‘The great majority of children, at any rate under the age of eight or nine, are neither ready for nor interested in discussions about emotions, backgrounds and relationships.’
The study highlights examples of schools which have achieved outstanding results by shunning the ‘do it yourself’ approach and embracing more structured and rigorous teaching regimes.
The low literacy levels cannot be attributed to immigration, the report said, adding that children who don’t speak English at home are often the most keen to learn.
The report recommends a new Booker prize-style literacy competition for primary schools to drive up standards. Schools would be independently assessed for their reading teaching and the best given a cash award.
British PM David Cameron launches his Big Society
LBJ’s “Great Society” was a name for a vast expansion of welfare so the name chosen by Cameron for his big idea seems rather inpropitious. That he means well there is no doubt but meaning well does not always turn out well. As far as I can see, his scheme is simply to turn over more powers to local government — and many would say that British local governments have performed even more poorly than the British national government. At least Cameron is piloting his scheme first — a very wise move
Local communities will get the power and money to run bus services, set up broadband internet networks and take over neighbourhood recycling schemes under a mass transfer of power from the state to the people, David Cameron will announce today.
In his first major speech on the theme of the “Big Society” since winning the election, the Prime Minister will announce the “biggest redistribution of power from elites in Whitehall to the man and woman on the street”.
Mr Cameron – who is keen to present his administration as offering optimistics new policies that are not just about cuts – will say that the “liberation” of volunteers and activists to help their own communities is the vision which drives his premiership.
As part of his drive to roll back the reach of the public sector, the Prime Minister will attack the previous Labour government for turning state employees into “disillusioned, weary puppets” and communities into “dull, soulless clones”.
He will announce that four areas in diverse parts of the country have been chosen to form a “vanguard” in realising his dream of “people power” in which individuals rather than the state come together voluntarily to solve their problems.
The four – the greater London borough of Sutton and Cheam, the leafy Berkshire council of Windsor and Maidenhead, rural Eden Valley in Penrith, Cumbria, and the metropolitan city of Liverpool – were chosen after they petitioned Downing Street to start their own projects.
They will be the first to be invited to submit applications to the Big Society Bank, a fund which will allocate the proceeds of dormant bank accounts worth hundreds of millions of pounds to help set up volunteer schemes to improve communities.
In a speech in Liverpool – where local people have asked to act as volunteers at a museum in order to extend its opening hours – Mr Cameron will set out how his grand vision of a Big Society would create communities with “oomph”.
Stressing how much concept means to him on a personal level, he will say: “There are the things you do because it’s your duty … But there are the things you do because it’s your passion,” he will say. “The things that fire you up in the morning, that drive you, that you truly believe will make a real difference to the country you love. And my great passion is creating the Big Society.”
During the election campaign, Mr Cameron faced accusations, including from senior figures from within his own party, that the Big Society concept was too vague and intangible to attract voters. Polls showed that two out of three voters had not even heard of it.
But Mr Cameron hopes that putting flesh on the bones of his vision will persuade critics that it can be shared by millions of ordinary Britons who care about their community and are tired of having so many aspects of their life dictated from the centre.
He will say: “The Big Society is about a huge culture change, where people, in their everyday lives, in their homes, in their neighbourhoods, in their workplace, don’t always turn to officials, local authorities or central government for answers to the problems they face but instead feel both free and powerful enough to help themselves and their own communities. “We need to create communities with oomph – neighbourhoods who are in charge of their own destiny, who feel if they club together and get involved they can shape the world around them.”
The four pioneer communities will be helped by dedicated civil servants who will give expert advice if they encounter legal problems or bureaucratic obstacles. Officials will also identify local residents with a particular aptitude for taking part in Big Society projects – they will then receive training to become community organisers, motivating their neighbours to take part in action schemes.
They will also be able to draw on the Big Society Bank, which, Mr Cameron promised, would use “every penny of dormant bank and building society account money” to help finance social enterprises, charities and voluntary groups. Accounts left untouched for at least 15 years will be channelled to good causes. Over time, Mr Cameron said, the Bank would provide “hundreds of millions of pounds” to Big Society projects, with money starting to be distributed from April.
The four vanguard communities have asked for help to set up a variety of different schemes.
Windsor and Maidenhead has already experimented with a project under which local residents were rewarded with financial incentives to improve recycling rates. Phil Redmond, the television executive who created Brookside, Channel 4’s long-running soap opera set up in Liverpool, is behind the scheme for volunteers to staff a local museum outside of office hours.
There are also plans for council budgets to be given directly to the residents’ groups of individual streets to decide how to spend the cash.
Local transport services, including bus and tram groups, could be commissioned by the communities themselves, who would be able to set timetables and improve reliability rates.
One group has asked for the power to buy out local “assets,” including a rural pub.
Another project involves bringing internet broadband to a local community.
Mr Cameron will say: “They’ve all got one thing in common: a firm commitment from this Government to help them realise their dreams. “If there’s a problem or obstacle or bureaucratic log-jam, they will be there, on hand, to help break them down and get things moving. “As these four areas move ahead with their plans, yes, there will be problems – financial problems, legal problems, bureaucratic problems. “Yes, there will be objections – local objections, objections from vested interests. But you know what? We’re happy about that.
“This process is all about learning. It’s about pushing power down and seeing what happens. “It’s about unearthing the problems as they come up on the ground and seeing how we can get round them. “It’s about holding our hands up saying we haven’t got all the answers – let’s work them out, together.”
However, Ed Miliband, the Labour leadership contender, claimed that the Big Society was a means of enabling the Government to cut vital public services. He said: “Cameron’s government is cynically attempting to dignify its cuts agenda by dressing up the withdrawal of support with the language of reinvigorating civic society.”
Muslim drivers refuse to let guide dogs on board British buses
Blind passengers are being ordered off buses or refused taxi rides because Muslim drivers or passengers object to their ‘unclean’ guide dogs. One pensioner, a cancer sufferer, told how had twice been confronted by drivers and asked to get off the bus because of his guide dog, and had also faced hostility at a hospital and in a supermarket over the animal.
The problem to carry guide dogs on religious grounds has become so widespread that the matter was raised in the House of Lords last week, prompting transport minister Norman Baker to warn that a religious objection was not a reason to eject a passenger with a well-behaved guide dog.
While drivers can use their discretion to refuse to carry non-disabled passengers with dogs, they are compelled to accept guide dogs under disability discrimination law.
Yesterday both the Guide Dogs for the Blind Association and the National Federation of the Blind confirmed the problem was common, and, according to the latter organisation was ‘getting worse’.
The tension stems from a strand of Islamic teaching which warns against contact with dogs because the animal’s saliva was considered to be impure, the Muslim Council of Britain said. It urged Muslims to show tolerance and common sense over the issue.
‘We need to be flexible on this,’ a spokesman said. ‘Muslim drivers should have no hesitation in allowing guide dogs into their bus or car. ‘If a dog does lick you, it’s not the end of the world. Just go home and wash yourself.’
George Herridge, 73, a retired hospital maintenance manager, told the Daily Mail he was ‘stunned’ to be twice asked by bus drivers to leave their vehicles because of his guide dog Andy, a black Labrador.
Mr Herridge, who lives with wife Janet, 69, in Tilehurst, Reading, said that on the first occasion two years ago, he got off at the request of a Muslim driver because some Muslim children on board were ‘screaming’ because of the dog.
He found himself in a similar scenario in May last year, when a Muslim woman and her children became ‘hysterical’. Mr Herridge this time refused the driver’s request to alight. He complained to the bus company which launched an investigation. It later informed him the matter had been dealt with ‘internally’.
Jill Allen-King, spokesman for the NFB, said she had been repeatedly left on the kerb by Muslim taxi drivers who refused to take her dog. One cab driver told her he would have to ‘go home now and wash myself’ when she tried to enter his car with her dog.
Mr Baker yesterday warned bus and cab companies that, while there were within their rights to ask a passenger to leave if the dog was causing a nuisance, it was ‘much more questionable to be asked to remove a dog for religious reasons’. He added: ‘One person’s freedom is someone else’s restriction.’
In 2006, Muslim minicab driver Abdul Rasheed Majekodumni was fined £200 and ordered to pay £1,200 costs by magistrates in Marylebone, central London, after being prosecuted for failing to comply with the Disability Discrimination Act when he refused to take a blind passenger because her guide dog was ‘unclean’.
United States Halts Gravy Train for British Global Warming Unit
British newspaper, The Sunday Times reveals that the U.S. government has announced it will stop funding U.K. university at the center of the Climategate scandal.
The Climate Research Unit, University of East Anglia (CRU), the hub of the climate controversy over leaked emails discrediting research into man-made global warming, has been dealt a heavy blow from a key funding source: the U.S. Department of Energy.
Under the header, ‘US halts funds for climate unit’ (July 18, 2010) The Sunday Times report reads, “The American Government has suspended its funding of the University of East Anglia’s climate research unit (CRU), citing the scientific doubts raised by last November’s leak of hundreds of stolen emails.” (Hat Tip: Barry Woods).
The CRU has been the primary source of information for the Intergovernmental Panel on Climate Change (IPCC) that world governments had looked to for the science to substantiate their cap-and-trade green tax policies.
Setback Comes After Official Reviews Give all Clear
The news is a particular blow for the UEA. The university had been upbeat in the wake of three British official inquiries which all cleared the much-maligned CRU of any wrongdoing. However, critics slated each of the inquiries for alleged whitewashing.
The article continues, “The US Department of Energy (DoE) was one of the unit’s main sources of funding for its work assembling a database of global temperatures…”
The announcement will gravely undermine confidence in climate scientists hoping for further research funds from the world’s largest funding source, the U.S. federal government.
Scandal Caused Adverse Public Reaction
Ben Stewart, head of media at Greenpeace, conceded the Climategate scandal influenced public opinion; “It’s pretty hard to say what the impact has been but it would be hopelessly naive to say it has not had an effect.”
Public concerns will not be assuaged by recent revelations that Lord Oxburgh’s committee failed to address the actual science.
Official Inquiries Dismissed as ‘Whitewashes’
Despite independent scientists finding evidence supportive of misconduct, a Parliamentary hearing and the Oxburgh Inquiry affirmed that researchers at the CRU were “subjective” and cherry-picked data, but had done no wrong. Although Lord Oxburgh did conclude that climate researchers were “poor data handlers” and would benefit by consulting outside statistical experts.
Dr. John P. Costella, an independent Australian scientist who studied the leaked emails, took a harsher line referring to what he found as proof of “shocking misconduct and fraud.”
Dr. Costella concluded that the “climate science” community was a facade and that “their vitriolic rebuffs of sensible arguments of mathematics, statistics, and indeed scientific common sense were not the product of scientific rigor at all, but merely self-protection at any cost.”
Government Investigators Ignore Key Witness
As reported on the Climate Audit blog run by McIntyre, Muir Russell review made no attempt to contact the Canadian who originally filed the Freedom of Information (FOIA) requests that CRU unlawfully denied over a three-year period.
Canadian climate analyst, Steve McIntyre had made a compelling impression on attendees at The Guardian debate on Climategate in London on Wednesday July 14, 2010.
By contrast, Phil Jones still looks a broken man despite his immediate reinstatement to his post upon his recent exoneration. Jones escaped criminal prosecution only on a technicality according to the UK’s Information Commissioner’s Office (ICO) the agency charged with investigation the FOIA abuses in the scandal.
Accusations of Official ‘One-sidedness’
But the official British line appears to have cut no ice with the Americans. As The Sunday Times adds, “The DoE peer review panel will now sift through the (Muir Russell) report and decide if American taxpayers should continue to fund the unit.”
The review carried out by Sir Muir Russell, also condemned as a whitewash, was notable for the total absence of any evidence from the principal opposing witness, statistical expert, McIntyre.
The Sunday Times correspondent asked Trevor Davis (head of UEA) to confirm whether Phil Jones (head of CRU) attended a private meeting with Muir Russell in January before the investigating panel was convened in February. Davis confirmed Jones had met Sir Muir Russell privately in January.
Climate Scientists Accused of Cherry-picking Data
Skeptics of the man-made global warming theory point out that police found no evidence of any theft. They argue that the 1,000+ emails and 62MB of data that flooded the blogosphere on November 19, 2009 were not stolen but leaked onto the Internet by a whistleblower within university research department.
Dr. John P. Costella believes there is sufficient evidence to support the hypothesis that a conspiracy existed between an inner clique of climatologists seeking to exaggerate the global historic temperature record.
It is alleged politicized researchers created the illusion that late 20th century global warming was potentially catastrophic and attributable to human emissions of carbon dioxide.
Repercussions for American Climate Researchers?
With British climate research in a financial pickle attention will turn next to those U.S. institutions also implicated in climate data shenanigans.
Currently NASA is facing a legal battle for also refusing to honor FOIA requests for the past three years. The Competitive Enterprise Institute (CEI) has filed a legal challenge against the discredited space agency for also withholding crucial climate data requested by skeptical climate analysts.
While in addition, alleged key U.S. ‘climate conspirator,’ Michael E. Mann is currently in court being pursued for grant fraud by Virginia’s attorney general, Ken Cuccinelli.
There is a new lot of postings by Chris Brand just up — on his usual vastly “incorrect” themes of race, genes, IQ etc.