NHS reaching ‘breaking point’, doctors warn
Financial pressures may mean junior doctors are not given training posts within the NHS and the overall number of places at medical school could drop, a report has said. This is despite extra burdens on the health service, including European rules limiting doctors’ hours, more hospital admissions and people living longer than ever before, according to the study from the UK Royal Colleges of Physicians (RCP).
Those specialties dedicated to looking after very ill people are facing particular strain, it said.
Dr Andrew Goddard, RCP director of medical workforce, said the combination of factors was ‘adding further stress to a system which may reach breaking point within the next few years’.
In 2009, the number of consultant posts created across the UK increased by 10.2 per cent. However, financial pressures on the NHS mean that rise may not continue and there are ‘growing fears’ of a lack of training posts for young doctors.
Dr Goddard said: “We have already seen a drop in the number of new posts being advertised in 2010, and although we have enough doctors in training to develop a consultant-delivered NHS, these doctors need to have jobs to go into if this service is to be realised.”
The latest study comes after the RCP in England warned last week of patients being left in the hands of junior doctors because of inadequate consultant cover on weekends. It is calling on hospitals to ensure consultants are available every single day of the week for at least 12 hours per day.
Sir Richard Thompson, president of the RCP, said: “Patients deserve better care at night and at weekends, delivered by consultant physicians, and this will only be achievable if we continue to increase the number of posts, particularly in acute medicine.”
The latest report found that 59 per cent of consultants “often or always” have to work faster on ward rounds than the 15 minutes per patient recommended by the RCP.
European rules limiting a doctor’s working week to 48 hours is also having an effect, the RCP said, with 58 per cent of consultants doing jobs that previously would have been done by junior doctors. Almost the same percentage said they have “little or no time” to support their trainees.
Today’s report comes as the British Medical Association (BMA) warned that senior doctors are facing cuts to the amount of time they can devote to improving services, research, safety audits and training.
Consultants should have 10 “protected” hours per week – known as supporting professional activities – but hospital trusts have been cutting these hours down in some areas. Dr Mark Porter, chairman of the BMA’s consultants committee, said: “NHS organisations, increasingly squeezed financially and having to achieve more with less, are trying to reduce consultants’ supporting professional activities in a search for ‘efficiency’.
“At its worst this can lead to pressure to treat patients as units of production rather than as individuals engaged in a difficult journey at a testing time. “We believe it represents a false economy. “When consultants have time to reflect on services and improve them, they frequently save the taxpayer significant sums of money.
“The NHS has been tasked with saving £20 billion by 2014, but this already Herculean task will become even harder if staff are denied time to stand back and consider ways of working more efficiently.”
Andrew Lansley, Health Secretary, said: “Sir Richard Thompson is right – patients do deserve better care at night and weekends and senior doctors should be available to provide medical care as needed. “I have already asked Medical Education England to consider with the profession, the service and medical Royal Colleges, how best to secure better patient outcomes and the right level of supervision for trainees through greater consultant involvement in direct clinical care at night and at weekends.
“We are very much aware of concerns about support for junior doctors. “We are clear that provision of service should not be the primary purpose of post-graduate medical training. “Rather, the objective is to produce fully qualified specialists who are able to provide high-quality and safe patient care, and for the service component of training to be properly supervised.”
The “Yes Minister” comedy in real life
He has been at the forefront of the Government’s drive for austerity. But when George Osborne tried to save the Treasury a few pounds by buying the office Christmas tree from B&Q, his economical efforts were thwarted – by health and safety rules.
The Chancellor was told by a senior mandarin that if he ditched the usual £875 tree for a £40 DIY store specimen, the department’s building suppliers would refuse to decorate or water it. Nor would they hand over a ladder for anyone else to do the job.
Mr Osborne announced in October that he was scrapping the £875 tree supplied under Labour as part of a Private Finance Initiative (PFI) contract. He vowed: ‘I am going to go down to a local market and pay for a tree myself.’
But the Treasury’s Permanent Secretary, Sir Nicholas Macpherson, who earns £175,000 a year, warned the idea would fall foul of the Government’s contract, as well as health and safety legislation.
In a memo which resembled something from political comedy The Thick of It, he told Mr Osborne the Treasury was obliged to get its tree from Exchequer Partnerships, the PFI supplier. ‘The catalogue had a choice of Hollyday, Indulgence, Enchantment, Icicle, or Decadence trees, or bespoke tailor-made trees, from £130-875,’ he reported.
Sir Nicholas said he had asked the company ‘about whether we couldn’t buy a tree from B&Q for £40 instead of spending £900’. But Exchequer Partnerships warned that they would not help water ‘an off-contract tree’.
And the senior civil servant added that there were concerns about ‘how would we decorate the tree – EP are not obliged to lend us a ladder’. Sir Nicholas said Exchequer Partnerships ‘also pointed out that they might have to do various health and safety tests on the tree and its decorations, which they would need to charge us for’. The company said it would need to carry out checks ‘if we were using a ladder to decorate the tree’.
Sir Nicholas said there were important questions about ‘who would go and choose the tree from B&Q’ and ‘how would we get the tree into the building from B&Q?’
And the contractors expressed doubts about ‘who would dispose of the tree after Christmas, and how would we do this? Wouldn’t we need a van? And a place to dump it?’
The Chancellor yesterday revealed a free tree was eventually donated by Exchequer Partnerships and has been adorned with £36 worth of decorations from Argos.
But Mr Osborne said: ‘We couldn’t overcome the health and safety rules. So in the end, the Permanent Secretary had to put the star on top because he was the only person in the building cleared to do it. ‘Unfortunately, Exchequer Partnerships wouldn’t provide us with a ladder so the Permanent Secretary had to get a chair from his office and stand on the chair.’
Payout for anti-gay preacher over improper arrest: Landmark ruling in British Christian’s battle for free speech
Police have been ordered to pay compensation to a Christian street preacher who was hauled off in handcuffs for saying that gays will go to hell. A judge condemned the arrest of Anthony Rollins, who quoted the King James Bible on the subject of the ‘effeminate’ as he preached in Birmingham.
Mr Rollins was handcuffed and then held in a cell for nearly four hours after a passer-by dialled 999 and complained that his language was ‘hugely offensive’.
The ruling – which ended with West Midlands police ordered to pay more than £4,000 in damages to the 45-year-old preacher – appears to set a new landmark in the battle between the gay lobby and Christians who want to say in public that homosexual sex is wrong.
It comes as Christian leaders, notably former Archbishop of Canterbury Lord Carey, have been complaining against the use of equality law to force Christians to act against their consciences.
Judge Lance Ashworth QC said at Birmingham county court that police who made the arrest acted ‘as a matter of routine’. ‘This was not done in any way maliciously, spitefully or arrogantly. It was done unthinkingly’.
Mr Rollins has been speaking on the city’s streets as a member of a Christian mission for 12 years. In June 2008 he was handing out leaflets in the city centre and quoting passages from the King James Bible – the Authorised Version which reaches its 400th anniversary next year – that refer to homosexuality.
One of these was from 1 Corinthians condemning the ‘unrighteous’, including fornicators, idolaters, adulterers, effeminate, and ‘abusers of themselves with mankind’.
Effeminate, Mr Rollins explained to his listeners, meant homosexuals. He also quoted the Book of Revelation to the effect that ‘the abominable shall have their part in the lake which burneth with fire and brimstone’.
Mr Rollins said yesterday: ‘The judgment is excellent news. But I didn’t do this for the compensation. I did it for freedom of speech. ‘It was one man who called the police. A van came up with its lights flashing. The officers didn’t even ask me for my version of events.’ He added: ‘I wonder if they would have arrested the Bishop of Birmingham if he had been preaching on the street? Would they have handcuffed him and dragged him off as if he was a common criminal?’
Judge Ashworth’s ruling was dismissive of evidence given by the onlooker who called police and who said he had been offended by the preaching. He said of John Edwards: ‘I was not impressed by him as a witness. He struck me as a man full of his own self-importance who in the witness box relished the attention and greatly embellished his evidence.’
The ruling was praised by the Christian Institute, the think tank which backed Mr Rollins’s court claim. Spokesman Mike Judge said: ‘Street preachers may not be everyone’s cup of tea, but they are part of our Christian heritage. ‘Most people just walk on by and ignore it. The police have no business arresting Christians for quoting the Bible.’
The case is a notable victory for the Christian argument following a series of court reverses in recent years. Street preacher Harry Hammond was convicted and fined in 2001 for holding a sign saying ‘Stop Homosexuality’ and an appeal on freedom of speech grounds failed.
In a key case earlier this year, judges said a relationship counsellor had no right to refuse sex therapy to gays and that Christians had no right to special protection from the law.
A test case on the right of Christian bed and breakfast owners to refuse rooms to gay couples is expected shortly.
UK Government Is Asking For Trouble over energy bills
HOUSEHOLD energy bills could double to £2,500 a year in an “unstoppable” rise driven by the £200 billion fight against climate change, a market expert warned yesterday.
Mark Todd, of energyhelpline.com, said rocketing prices will send costs for hard-pressed families and the elderly into the “stratosphere”. He said consumers will have to pick up the tab for new windfarms, nuclear power plants and the networks needed to support them.
Mr Todd’s worst-case scenario forecast means bills could rise from the current £1,215 average for gas and electricity – so-called dual fuel bills – to £2,472 a year within 10 years. He spoke out as five of the biggest energy firms in Britain told MPs that energy bills will rise by up to 25 per cent over the next decade. That would slap another £303 on the average gas and electricity bill.
Yet campaigners Consumer Focus said that over the past seven years alone domestic dual fuel bills have soared 124 per cent – from an average £543 a year. Mr Todd said: “Both the cold spell and rebound in the economy are contributing factors to wholesale gas prices rising by 56 per cent in the past three months. It’s therefore no surprise that five of the big six energy companies have warned MPs that domestic bills will continue to rise.
“There seems to be an almost unstoppable upward trend with prices creeping up remorselessly. When price drops come they tend to be small, when price rises come they tend to be big.”
The Government is shortly expected to announce a consultation on reforming the energy market.
And on Monday the Climate Change Committee quango laid out a blueprint for cutting carbon emissions which it admitted would require investment of about £150 billion in energy infrastructure up to 2030.
Mr Todd said: “The year’s price rises are only the tip of the iceberg. “An unpalatable cocktail of green taxes, power station investment, a crumbling grid and dwindling gas supplies is set to send prices into the stratosphere. “Energy bills are many homes’ biggest expense. UK consumers must shop around for a better deal.”
Head of energy at Consumer Focus, Audrey Gallacher, said: “It is up to the energy industry to show that any price rises are fair. It must be easy for customers to find the best tariff, switch easily and be confident they are paying a fair price.”
Energy UK, which speaks for the major suppliers, last night urged the public to make homes more energy efficient.
Poor British white boys ‘more likely to struggle at primary school
White kids could be more traumatized by the violent atmosphere that characterizes British “sink” schools
Half of poor white boys leave primary school without a decent grasp of English and mathematics, damning figures show. White British boys from the most deprived families perform worse at the age of 11 than any other group, it was disclosed. They are around 50 per cent less likely to start secondary education with an acceptable standard of the three-Rs than other pupils.
Poor children from black African, black Caribbean, Chinese, Indian, Bangladeshi and Pakistani families all performed better than their white British classmates, figures show. This means thousands of children struggle to write complex sentences, spell accurately or use basic percentages and fractions after seven years of education.
The disclosure – in figures published by the Department for Education – prompted claims that Labour had “let down” young people from the most deprived backgrounds. It comes just days after a major report showed Britain had plummeted in international league tables charting standards of reading, maths and science in secondary schools over the last decade.
Nick Gibb, the Schools Minister, said: “These figures reveal that our education system is letting down half of all 10 and 11-year-old boys who qualify for free school meals. “It is not acceptable that at the end of primary school these children are still not reaching the standard in English and maths they need to flourish at secondary school.
“After seven years of primary school children need to be fluent in these basic skills which is why the Government is putting such an emphasis on improving pupils’ reading ability in the first years of primary school.
“We want to raise academic standards for all young people and to close the attainment gap between those from poorer and wealthier backgrounds, so starkly demonstrated by today’s figures.”
According to figures, 73.5 per cent of all 11-year-olds reached the standard expected for their age group in Sats tests taken this summer, compared with 72 per cent a year earlier.
Data shows white British boys eligible for free meals – the Government’s standard measure of deprivation – were the worst performing group, other than those from gipsy and traveller backgrounds. Only 50.1 per cent of these children – 11,375 – hit targets in both English and maths.
This compared with 68 per cent of poor Indian boys and 66 per cent of those from Chinese families. Some 53.5 per cent of poor boys from black Caribbean backgrounds – traditionally among the worst performing pupils – hit national targets in the three-Rs, it was disclosed.
Among girls, poor white British pupils were also the worst performing group. Some 56.7 per cent achieved good results in England and maths – 6.6 percentage points higher than boys.
Around a quarter of primary schools – 4,000 in total – did not take part in the tests this year following boycotts by two teaching unions, the National Union of Teachers and the National Association of Head Teachers.
The UEA predicted Britain’s present Arctic weather in advance — WAY in advance
See the article below that appeared in the “Windsor Star” on Sept. 11, 1972. Hubert Lamb, the director of the CRU in 1972 says that the overall temperature trend they were forecasting was definitely downwards. Lamb warns that there may be “minor upward fluctuations” but he says we shouldn’t be misled by these into thinking the earth was getting warmer
Tim Ball comments:
Yes, but that was when Lamb, who founded the CRU was still in charge. I discussed the same thing with him when he was advising me on my doctoral thesis. Our discussion about the cold was triggered by my comment that I had never been so cold as I was standing on the platform at Norwich railway station. This included five years of flying search and rescue throughout the Canadian Arctic.
He anticipated the loss of control of CRU and to whom. In his autobiography, “Through all the Changing scenes of Life” he wrote:
“The research project which I put forward to the Rockefeller Foundation was awarded a handsome grant, but it came to grief over an understandable difference of scientific judgement between me and the scientist, Dr Tom Wigley, whom we appointed to take charge of the research.” (p.204)
Wigley went on to oust Lamb and become Director from which position he linked with the IPCC group in conjunction with his protege Phil Jones who replaced him. Wigley moved to Colorado to expand the Climategate debacle with US funding. You can watch Wigley at his unctuous best in the 1990 documentary “The Greenhouse Conspiracy” talking about getting funding.
A few years after I first met with Lamb I learned from a CRU student that “The Prof,” as he almost derisively called him, was still coming in every day but nobody was paying him any mind.
When you read the leaked emails you see that Wigley is the grandfather and eminence grise who they all defer and refer to for his opinion on many issues. I wrote about that here
Incidentally, Lamb received money from the US because the UKMO and other British funding sources ignored his goal of building better historic records. He wrote on page 203 that:
“When the Climatic Research Unit was founded, it was clear that the first and greatest need was to establish the facts of the past record of the natural climate in times before any side effects of human activities could well be important.”
This idea evolved from his difficulties with accurate forecasting for bombers flying over Europe in WWII. He determined that better forecasting required understanding past patterns so he spent time in the archives of the Met Office.
It was an agenda that did not fit with the political use of climate by Wigley, the UKMO, Schneider and many others. Sadly it is a requirement that still limits understanding today, but made worse by the lack of funding to data reconstruction and the closing of weather stations so that data that was already inadequate has become truncated and discontinuous at best.