Babies died after junior surgeon left to cope on his own
Four babies died at an NHS heart unit where managers were trying to raise the number of patients being treated in order to avoid closure, according to a damning report.
The infants died within three months of each other after being operated on by a relatively junior surgeon who was appointed to raise patient numbers at the John Radcliffe Hospital in Oxford, an external review has found.
Caner Salih, who was left alone on his second day in the post, complained about the age of the equipment and poor working practices at the children’s cardiac unit. He blew the whistle to bosses after four of his patients died within three months and asked to stop operating.
His concerns were ignored and it was only when journalists began to ask questions that the trust managers informed the Strategic Health Authority [SHA] and the health care regulator, the Care Quality Commission, says the report.
It may have been up to six weeks after Mr Salih raised concerns that children’s heart surgery at the trust was suspended. The report, conducted by senior doctors at the SHA, recommends that operations at the unit should never take place again because it is unsafe.
The case raises echoes of the Bristol heart scandal in which 35 babies died and dozens more were left brain damaged amid lax safety and monitoring at the Bristol Royal Infirmary in the early 1990s.
The report, written by Dr Bill Kirkup, the director of clinical standards at the South Central Strategic Health Authority, says that managers at the John Radcliffe were aware that a forthcoming review of children’s heart surgery was likely to recommend the closure of small units which handled few patients. The Oxford Cardiac Centre, based at the hospital, is the smallest in the country, treating just 100 patients a year.
In order to try to boost patient numbers, managers took on another consultant surgeon. The job was Mr Salih’s first consultant post in the UK after working in Australia.
But the report says he was left alone when the senior consultant, Stephen Westaby, went on holiday for three weeks the day after he started.
The report does not criticise Prof Westaby directly but refers to him being “idiosyncratic” and that nurses and anaesthetists had adapted to his ways of working.
Four babies on whom Mr Salih operated died between December 2009 and February 2010. He complained to managers after finding it impossible to continue to operate with what he said was out-of-date equipment and working practices, the report says.
Mr Salih’s competence has not been called into question and there is no suggestion he was in any way responsible for the deaths.
The report examined each of the four deaths in detail and points out that the mortality rates nationally for the procedures they underwent were not high. But each child operated on at the John Radcliffe was extremely ill and this increased the likelihood of a poor outcome.
The report will say that, in at least one case, it is probable the child would have died anyway. In the other three cases it is “difficult to say”.
The first of the babies to die was named in March as Nathalie Lo, who died on Dec 22 when she was 23 days old. She had required corrective surgery on a heart valve.
Her mother, Aida Lo, 29, and her father Zeilo Li, 30, who live in Oxford but are originally from East Timor, have demanded to know if her death could have been prevented.
“A mother wants the best for her child and I trusted my baby to the hospital,” Mrs Lo said earlier this year. “What else could I do? I believed Nathalie was in good hands. But finding out that three other mothers have been through this in such a short time is a big shock. Now I’m angry and I just want to know what happened to my baby.”
Mr Salih’s competence has not been called into question in the report and he has now taken up a similar post at Guy’s and St Thomas’ Hospital.
The report is highly critical of the trust’s handling of the situation, as managers did not inform the SHA or the Care Quality Commission of the claims made about the cardiac unit by Mr Salih at the time that he raised them.
It was not until television reporters began looking into the matter that the trust took action, the report says. The trust was aware that an ongoing review, conducted by Sir Ian Kennedy, who chaired the Bristol inquiry, was likely to recommend that children’s heart surgery be concentrated in fewer, larger units.
The Kennedy review is due to report this month and it is expected to recommend that the number of units offering children’s heart surgery be cut from 11 to five or six, so that each one operates on around 400 cases a year and has an establishment of four surgeons.
Families of the other children who died are understood to support the Oxford unit and there have been campaigns locally to save it from closure.
Nearly 100,000 new homes must be built every year for immigrants to Britain
A lot of new housing in Britain is welfare housing for the poor so this will mean a big and expensive obligation for the taxpayer
Nearly 100,000 new homes must be built every year just to provide housing for immigrants, ministers disclosed yesterday. Four out of every ten new houses or flats [apartments] built to cope with the rising population will go to a migrant, they said.
Over a 25-year period, immigrants will require 2.5million extra homes unless the Government meets its pledges to bring about a major reduction in numbers arriving to live in Britain.
Communities Department spokesman Andrew Stunell said estimates of housing demand and the expected level of housing required by immigrants were prepared in March 2009, but only now revealed.
He said in a Commons written answer: ‘It is estimated that net international migration could account, on average, for 40 per cent of the net growth of households in England over the projection period from 2006 to 2031.’
The housing projections from the Communities Department say that at current birthrates and expected rates of immigration, 252,000 new homes a year will be needed each year until 2031.
Of these, 36,000 will be needed because there will be more people living alone and fewer couples and families, and 116,000 because of rising birthrates. The remaining 100,000 will be needed to house migrants, based on 2006 population figures.
At present the Office for National Statistics estimates that net immigration will run at 180,000 a year for the foreseeable future.
Overhaul of British High School exams ‘could damage maths’
Major reforms of A-levels will lead to a “collapse” in the number of children studying mathematics to a high standard, according to teachers. Coalition plans to toughen up courses could turn teenagers off the subject, it was claimed, leading to the closure of university maths departments.
The comments by the Advisory Committee on Mathematics Education, which represents teachers and academics, is the latest criticism of the Government’s proposed overhaul of A-levels.
Michael Gove, the Education Secretary, wants to phase out AS level exams taken half-way through the traditional two year course, as well as “bite-sized” modules that students can re-sit to boost their grades. He plans to place a greater emphasis on end-of-course exams.
But ACME warned that making maths A-levels harder would “mean fewer students choose to take the qualification”.
In a letter to Mr Gove, Prof Dame Julia Higgins, ACME’s chairman, warns that toughening up maths A-level “will mean fewer students choose to take the qualification”.
The letter – revealed in the Times Education Supplement today – says: “There is a real danger in making A-level mathematics significantly harder than it is currently. It would make it impossible to retain appropriate provision for the full range of students.”
The last major overhaul of A-levels – in 2002 – led to a 19 per cent drop in the number of pupils studying maths in the sixth-form. Maths is already seen as one of the toughest subjects.
She adds: “We feel it is very important that we warn you that implementing such a policy runs a genuine risk of repeating the collapse in the numbers studying A-level mathematics witnessed in 2002.
“We believe that it is very likely that we would again see university mathematics departments closing as a result of this fall in numbers.”
Last week, Cambridge University also criticised proposed changes to A-levels, claiming it could lead to a drop in the number of students from state schools admitted to top institutions.
A spokesman for the Department for Education said: “It’s clear that we need to restore confidence in public exams. We’re listening carefully to universities, employers and academic subject bodies’ views to ensure A-levels are rigorous and equip young people for higher education.
“We will look in detail at exam structure, including whether schools and colleges should be able to offer traditional two-year A-levels alongside or instead of modular A-levels. We will set out detailed next steps later this year.”
Ancient Greek ‘to be taught in British state schools’
Ancient Greek will be taught in state primary schools to boost children’s language skills, it emerged today. Some 160 pupils in three schools will be given lessons in the native tongue of Archimedes and Herodotus from September. The move follows the successful introduction of Latin to dozens of state primaries in England.
The Iris Project, a charity campaigning for the teaching of the Classics, which is leading the latest drive, said the subject had substantial knock-on benefits across the curriculum.
Lorna Robinson, charity director, who will be teaching the one-hour lessons every two weeks, told the Times Education Supplement: “People can be daunted at the idea of learning a language that has a different alphabet as it may feel like an additional challenge.
“Actually, though, we¹ve found that while it does add an extra dimension to the learning it¹s one that people take to quite quickly and really enjoy once they get going. “Ancient Greek is just a wonderful language, full of beautiful words and fascinating concepts.”
Pupils will be taught the alphabet, basic grammar and vocabulary, as well as learning about ancient Greek culture, such as the development of the Olympic Games and the comedies of Aristophanes.
Latin is currently more widely taught than ancient Greek, although it is still mainly confined to private schools. Advocates include Boris Johnson, the Mayor of London, who recently gave a Latin lesson to teenagers at a London secondary.
Under new plans, three Oxford primary schools will be given Greek lessons from September. A further 10 will get one-off taster sessions.
Sue Widgery, head of East Oxford primary in Cowley, where children speak 26 different languages, said: We were sufficiently enthused by Latin to give it a go with ancient Greek. It heightens children’s sense of language, they can see the connections between languages and it is fun.”
Should obese children be put in foster care?
This entire discussion shows how simply being fat is medicalized as a health problem called “obesity”. The fact that people of middling weight live longest is never mentioned, let alone discussed for its implications
In some cases, obese children should be removed from their homes, according to a group of child health specialists from England and Ireland.
If parents fail to provide medical treatment for a child with a chronic disease like asthma or epilepsy, government welfare officials can put the young patient in foster care. Should they do the same for children who are obese — and therefore at risk of developing lifelong complications such as heart disease and type 2 diabetes?
In some cases, the answer is yes, according to a group of child health specialists from England and Ireland. “Childhood obesity can be seen as a failure to adequately care for your children by failing to provide a healthy diet and sufficient activity, whether through direct neglect or more subtly through an inability to deny children the pleasures of energy dense fast food and television viewing,” the experts write in a paper published online Wednesday by the British Medical Journal.
The question isn’t academic. There are sporadic reports in the U.S. of courts removing obese kids from their homes, and it has happened at least 20 times in Britain.
The neglect that leads to obesity may be a sign of other problems in the home. As many as one-third of obese adults say they were sexually abused as children. In addition, one-third report being victims of other kinds of abuse, such as corporal punishment, according to the paper.
With this in mind, pediatricians and other professionals should think about whether obese kids would be better off in the custody of child protective services, the experts write. There are anecdotal reports of dramatic weight loss by kids in foster care, though there are no long-term studies showing that removing obese children from their families results in weight loss. (In fact, one study of 106 British children placed in foster care found that 38 of them became overweight after they joined the foster system.)
Obesity alone isn’t sufficient to warrant a call to child welfare officials, according to the experts. Nor is a kid’s failure to lose weight after being counseled to do so, they added. Even families that put a lot of effort into helping a child shed extra pounds don’t necessarily succeed. But parents who don’t at least try to help their kids should be viewed with suspicion, according to the paper.
“Parental behaviors of concern include consistently failing to attend appointments, refusing to engage with various professionals or with weight management initiatives, or actively subverting weight management initiatives,” the experts wrote. “Clear objective evidence of this behavior over a sustained period is required.”
Researchers should gather hard data on whether children gain or lose weight during time spent in foster care, they wrote. In the meantime, they added, guidelines should be drafted to help professionals decide when to intervene on behalf of obese kids.
New Scientist makes things up
New Scientist has published a rather remarkable leader to go alongside its interview of Phil Jones:
For years, ruthless climate sceptics have harassed scientists, drowning them in freedom of information requests and subjecting them to vicious personal attacks. Climategate was merely the public face of this insurgent war. In that hostile climate, some scientists fired off personal emails that occasionally lacked decorum. The CRU accepts this. When will their opponents apologise for their own excesses?
It would be interesting to see whether the leader writer at New Scientist can explain from where they got the idea that CRU had drowned under FoI requests. This was not the finding of the inquiries. The Information Commissioner specifically told the Parliamentary Inquiry that the level of FoI requests was nothing out of the ordinary:
I am also bound to say that I think a figure of around 60 [requests] has been mentioned. That does not strike me as being an absolutely huge number…I do recall one example—I think it involved Birmingham City Council—where an individual made about 200 requests about a particular allotment site in Birmingham and how that was being developed.
I’d like to invite whoever it is that wrote this column to provide some backing for their claim – perhaps someone who is registered at the New Scientist website can pass the invitation on.
“New evidence” of global warming is just a new cherrypick
Compiled by old frauds. For a start, they left out of their dataset the most accurate climate record of all: The satellite data. You’ll never guess why! Below is the DT report, with further comments at the foot of it
A new climate change report from the Met Office and its US equivalent has provided the “greatest evidence we have ever had” that the world is warming. It is the first time a report has brought together all the different ways of measuring changes in the climate
The report brings together the latest temperature readings from the top of the atmosphere to the bottom of the ocean
Usually scientists rely on the temperature over land, taken from weather stations around the world for the last 150 years, to show global warming.
But climate change sceptics questioned the evidence, especially in the wake of recent scandals like “climategate”.
Now for the first time, a report has brought together all the different ways of measuring changes in the climate. The ten indicators of climate change include measurements of sea level rise taken from ships, the temperature of the upper atmosphere taken from weather balloons and field surveys of melting glaciers.
New technology also means it is possible to measure the temperature of the oceans, which absorb 90 per cent of the world’s heat.
The State of the Climate report shows “unequivocally that the world is warming and has been for more than three decades”.
And despite the cold winter in Europe and north east America, this year is set to be the hottest on record.
The annual report was compiled by the Met Office and the National Oceanic and Atmospheric Administration (NOAA).
Both the NOAA and Nasa have stated that the first six months of this year were the hottest on record, while the Met Office believes it is the second hottest start to the year after 1998.
Dr Peter Stott, Head of Climate Monitoring and Attribution at the Met Office, said “variability” in different regions, such as the cold winter in Britain, does not mean the rest of the world is not warming.
And he said ‘greenhouse gases are the glaringly obvious explanation’ for 0.56C (1F) warming over the last 50 years.
“Despite the fact people say global warming has stopped, the new data, added onto existing data, gives us the greatest evidence we have ever had,” he said.
Sceptics claimed that emails stolen from the University of East Anglia show scientists were willing to manipulate the land surface temperatures to show global warming.
The scientists were cleared by an independent inquiry but the ‘climategate scandal’ as it became known cast a shadow over the case for man made global warming.
Dr Stott said the sceptics can no longer question the land surface temperature as other records also show global warming.
He pointed out that each indicator takes independent evidence from at least 3 different institutions in order to ensure the information is correct. Despite variations from year to year, each decade has been warmer than the last since the 1980s.
“Despite the variability caused by short term changes, the analysis conducted for this report illustrates why we are so confident the world is warming,” he said. “When we look at air temperature and other indicators of climate, we see highs and lows in the data from year to year because of natural variability. Understanding climate change requires looking at the longer-term record. When we follow decade-to-decade trends using different data sets and independent analyses from around the world, we see clear and unmistakable signs of a warming world.”
There are lots of problems with this report. First, none of these so-called indicators is globally accurate at the scale of interest, which is tenths of a degree. In fact no two agree in detail. Notice too that the satellite data is not shown, even though it is the best data we have, because it does not agree at all. What other contra indicators are missing?
Second, if it is warming a little we still do not have any reason to believe that humans have anything to do with it. These folks are confusing the political slogan that “warming” is a hoax, which merely expresses reasonable skepticism about human induced warming, with the narrow scientific claim that it is not warming, which nobody actually makes.
Note this howler from the MET page: “The report points out that people have spent thousands of years building society for one climate, and now a new one is being created one that is warmer and more extreme.”
Thousands of years of constant temperatures? Nonsense. What happened to natural climate variability? Crawling out of the Little Ice Age, which no one wants to return, is rather a different story than this nonsense sentence.
These people just don’t know how to be other than stupidly green. Fortunately it shows and no one is fooled. Those days are over.
And for an absolute encyclopedia of criticisms of the report, just read the “Comments” section at the foot of the DT report. The the public is not fooled. There is the occasional “trust the experts” bleat but the comments are overwhelmingly hostile
“Obese” or “fat”?
“Doctors should call people “fat” rather than “obese” to make it clear that they needed to lose weight, a British health minister said on Wednesday.
Anne Milton, a Conservative, said the term “obese” distanced people from the problem and that calling them fat would encourage “personal responsibility”. She said many National Health Service professionals were worried that if they called people “fat” they might cause offence but she insisted that anyone with such a weight problem needed to know.
Tam Fry, of the National Obesity Forum, which campaigns to raise awareness of the health problems of being overweight, accused Mrs Milton of scientific ignorance. “The word ‘obese’ is a medical description of a weight that is such it might dispose someone to medical problems,” he said. “The word ‘fat’ is a stigmatising word that is the kind children use to insult each other.
“Obese” was once used only for the grossly fat but it is now much more widely applied. I favor reversion to the original usage
Fixed retirement age to be scrapped in Britain: “The government has announced that the default retirement age will be phased out by October 2011. The default retirement age permitted employers to retire workers at the age without justification, and is an exception to United Kingdom labor law, which prohibits employers from making employment decisions on the basis of age and forces them to provide justification for dismissing a worker. Personnel groups and those supportive of the elderly cheered the announcement, while business groups such as the Confederation of British Industry expressed concern about the law. There is merit in both reactions.”