NHS coping badly with winter flu
Similar episodes in the past have taught them nothing, apparently
Vital cancer operations are being cancelled as hospitals struggle to cope with soaring numbers of flu victims. Trusts have begun postponing major surgery because intensive care beds that cancer patients might need for post-operative recovery are being kept free to accommodate critically ill patients struck down by the flu virus.
Experts predict that Britain is on course for the first flu epidemic in over a decade after the number of cases more than doubled in the past week. They say rates are rising faster than during December 1999, which marked the start of an outbreak which claimed more than 22,000 lives and brought the NHS to its knees.
There are now 460 people in intensive care, taking up around one in seven beds, up from 182 last week.
Professor John Oxford, a virologist and influenza expert at St Barts and the London Hospital, said the situation was still deteriorating and added: ‘I would not be surprised if we get to epidemic levels within one week.’
The vast majority of victims have swine flu and the strain is proving particularly serious among children, pregnant women and those with underlying conditions such as asthma.
Dr Bob Winter, president of the Intensive Care Society, said that to preserve space in intensive care, hospitals have begun postponing elective surgical procedures – including serious cancer surgery – that require a patient to go on a ventilator while they recover.
Particularly hit are patients needing oesophagectomies, life-saving operations performed on those with cancer of the oesophagus, the tube linking the throat to the stomach. Almost all those who have this operation subsequently require a spell on a ventilator in an intensive care unit.
As with all cancers, it is vital that the operation is performed as early as possible before tumours have the chance to spread to the liver and lungs, at which point the disease is incurable.
Hospitals have begun postponing this procedure, as well as all other major operations such as heart bypasses, because of the growing shortage of intensive care beds.
It was a hospital’s decision to cancel an oesophagectomy during the flu epidemic of 1999-2000 that had tragic consequences for one cancer victim. Mavis Skeet, 74, had been due to have the operation in December 1999 but it was cancelled four times over five weeks because of the flu crisis. She died in June 2000 after the cancer spread to her windpipe and became inoperable.
Yesterday Dr Winter, who works at Nottingham University Hospitals, said: ‘Our own hospital has cancelled elective surgery that involves the need of critical care beds. This includes oesophagectomies and non-urgent cardiac surgery. ‘Other areas in the country I know are doing the same.’
There are concerns that hospitals will also postpone other types of cancer surgery, should the crisis worsen. Many patients having surgery to remove tumours in the bowel, brain, ovaries and stomach go on to intensive care and doctors may cancel these procedures to ensure beds are kept free.
Experts say the outbreak could reach epidemic proportions within the next few days. The latest infection rates show an average of 87.1 cases per 100,000 people – an epidemic is classified as more than 200 per 100,000.
But current rates are increasing much quicker than in December 1999, when there were just 60 per 100,000 over Christmas but more than 200 per 100,000 by New Year. Doctors say flu often spreads very quickly during the festive period as those carrying the virus visit relatives in different parts of the country.
So far this winter nine children and 18 adults are confirmed to have died from the virus, although in reality this number is expected to be much higher.
One intensive care doctor described the outbreak as the worst he had seen in two decades. Dr Ian Jenkins, former president of the Paediatric Intensive Care Society, who works at Bristol Children’s Hospital, said: ‘I’ve not seen this much flu in more than 20 years.’
Despite the increasing warning signs, Britain’s chief medical officer Dame Sally Davies has repeatedly insisted that the figures are in the ‘normal range’ for winter flu. Her attitude is very different from that of her predecessor Sir Liam Donaldson during last year’s swine flu pandemic, who at one stage predicted there could be 65,000 deaths.
The Government has come under fire for scrapping last year’s national flu advertising campaign encouraging people to be vaccinated and follow basic hygiene practices such as washing their hands. Ministers have also been criticised for not offering the flu jabs to the under-5s, who have been among the worst affected by the swine flu.
Health Secretary Andrew Lansley said: ‘We are very clear about those who need to be called for vaccination and we have asked GP surgeries who have the lists of individuals to contact them. ‘There is no additional merit in a vaccination advertising campaign for the general population when there is already a targeted approach for those who need to be called.’
Longer waiting lists on the NHS ‘unless a £10bn black hole is plugged’
Patients will face longer waiting times if ministers do not increase health budgets to plug a looming £10bn shortfall, Whitehall experts have warned. A damning letter to Chief Treasury Secretary Danny Alexander warned the government is complacent about the pace of reform needed to hit efficiency targets.
The Independent Challenge Group, which was set up to scrutinise Whitehall thinking at the time of the spending review, said ministers will face an ‘unpalatable trade-off’ between longer waiting times for patients or having to increase the health budget.
Social care budgets could be in line for ‘even greater’ cuts than the anticipated £3.4 billion reduction and cancer research funding could also be affected, it warned. It also said that the government would have to stop its ‘very bad policy’ of hiring all doctors on graduation.
The letter, obtained by the Guardian, said that plans to hand power of commissioning health services to GPs could at best have ‘patchy’ results.
Healthcare costs are expected to rise from the current £100bn a year to £126bn by 2014/5. This would leave a shortfall of £10bn a year based on projections that health spending should cost around £115bn a year.
The letter said proposed savings of £16bn a year under the Quality, Innovation, Productivity and Prevention (QIPP) programme, which is the body that will push through efficency savings, ‘may not be achievable’.
It comes as Health Secretary Andrew Lansley faces more pressure to deliver on his reforms: the NHS is one of just two areas of government spending that was protected from severe cuts, the other was international aid.
Funding charities such as Cancer Research UK to the tune of £200 million a year was also unaffordable, experts warned.
The letter was written by Adrian Beecroft, the former chief investment officer at APAX private equity group; Legal Services Commission boss Carolyn Downs and director of climate change adaptation at the department of energy and climate change, Robin Mortimer. The experts warned the the NHS could ‘face a significant budget shortfall by the end of the SP [spending] period’.
‘The NHS typically deals with such shortfalls by limiting treatments, leading to increased waiting times. The government will be faced with a choice between dealing with the fallout from increased waiting times or increasing the DH’s budget, perhaps by as much as £10bn per year. To avoid this unpalatable trade-off, the DH settlement needs to build in much greater non-QIPP efficiency savings from the outset.’
A department spokesperson said: ‘The independent challenge group was established as part of the spending review process. The points raised by the group were considered as part of the spending review process. Its work has now concluded. We consulted on our reforms and received a huge number of responses: over 6,000. These have helped us to refine our plans. We have responded to concerns around implementation and are testing several areas of reform to make sure we have the best arrangements in place.’
Labour’s shadow health secretary, John Healey, said the letter was evidence that the ‘high-risk, high-cost reorganisation Andrew Lansley is forcing on the NHS is a massive distraction from improving patient care and making the sound efficiency savings Labour previously planned’. He added that it confirmed Mr Lansley was running a ‘rogue department and operating in isolation from his colleagues’.
Prime Minister David Cameron has asked his minister Oliver Letwin to keep a closer eye on Mr Lansley’s progress with health reforms.
It’s Britain’s coldest Christmas Day ever as mercury plummets to MINUS 18C: UK set for biggest December freeze since 1890
Britons awoke yesterday to the coldest Christmas Day on record. In parts of the country, the mercury touched minus 18C and few places saw temperatures rise above freezing. At 8am in Shawbury, Shropshire, it was minus 15.9C and in Altnaharra, in the Highlands of Scotland, minus 18.2C.
Forecasters predict this December is likely to be the coldest on record. The previous coldest was in 1890, when the average temperature for the whole month for England was minus 0.8C.
The average temperature for all of Britain up to Christmas Eve this year was also minus 0.8C, though forecasters said the weather would improve from Wednesday.
The Arctic snap brought travel chaos in the run-up to Christmas, with thousands of passengers having to sleep in terminal buildings after their flights were delayed by snow and ice.
Their spirits will hardly have been lifted by the revelation that airports throughout Europe and America have put Britain to shame with military-style weather-busting operations. European airport bosses were often able to call on many times more snowploughs, snowblowers and de-icing vehicles than the UK’s busiest airport, which boasts just 46 specialist vehicles. As our pictures show, foreign airports often deployed more than half-a-dozen machines, side by side to clear runways while Heathrow appeared to use just two at a time.
During the chaos at Heathrow, which is run by Spanish-owned BAA, some stranded passengers spent three nights sleeping on the floor and on luggage trolleys. British airline bosses accused BAA’s £1million-a-year chief executive Colin Matthews of ‘blowing it big-time’ as foreign rivals managed to get most of their flights to take off and land.
Unlike BAA, which spent just £500,000 on new snow-clearing equipment in the past year – the equivalent of half Mr Matthews’s pay – continental competitors spent tens of millions to ensure airports would stay open in such conditions.
Similarly, Gatwick, which is owned by a group of international investment funds, has more vehicles than Heathrow, with the first of two new snowploughs delivered last weekend. Gatwick is spending £9 million on new vehicles.
On the Continent, airport emergency plans swung into action to keep passengers moving. At Schiphol in Amsterdam, 98 snowploughs and snowblowers were in action. Although the airport was shut for periods last week, it maintained the best record of flight clearances in Europe.
Arlanda airport in Stockholm has never closed since it opened in 1962. It boasts the world’s fastest snow-clearing team who use a fleet of 17 Plough, Sweep and Blow (PSB) machines specially built by Volvo. Nine of the machines were being driven alongside each other, meaning that two mile-long runways, each 150ft wide, were cleared in less than ten minutes. There was also a fleet of 30 other snowploughs and snowblowers and 20 de-icing machines.
North American airports lead the way when it comes to coping in wintry conditions. Giant snow-melting machines nicknamed ‘snowzillas’ are operated by almost all of the larger airports, including New York and Toronto, where BAA boss Mr Matthews was born.
New York’s JFK, Chicago’s O’Hare and Toronto’s Pearson international airports each run 200 to 300 pieces of heavy snow-moving equipment. And Chicago has 225 machines. One senior airline executive said last night: ‘BAA and their chief executive blew it big-time last week. ‘They were shambolic and all over the place. There was poor planning and little communication both internally in BAA or with the airlines.’
The Queen defies animal rights fanatics
The Queen and the Duchess of Cornwall came under fire from animal rights campaigners yesterday after they both wore fur hats on Christmas Day. The Russian-style hats they wore to attend a church service in Sandringham with other members of the Royal Family were made from fur from different types of fox, claimed experts.
Andrew Tyler, director of Animal Aid, said: ‘This strikes me as an ostentatious display of cruelty. To parade fur in 2010 says something unpleasant about the person wearing it.’
The Cossack-style hat worn by Camilla was made from ‘vintage fur’, by designer milliner Philip Treacy, using a piece of fur which had previously belonged to the duchess’s mother.
A spokesman for the Queen said she could not confirm if Her Majesty’s cream-coloured hat and matching coat trim were made from real fur but experts said they were convinced it was.
Many fashion designers continue to use fur in their collections, and campaigners have expressed fears that it has come back into style. They have called on celebrities and members of the Royal Family to ‘set a good example’ by choosing not to wear animal pelts. The Queen has worn fur in the past and her official robes for State occasions are trimmed with ermine, the winter coat of the stoat.
Camilla faced anger from animal rights organisations last year, when she wore fur twice during an official visit to Canada. First she wore a grey rabbit stole when she visited Newfoundland, together with a hat trimmed with fake fur. She then donned a calf-length cape lined with grey fox fur. Both pieces were said to have been ‘refashioned’ from vintage fur that had belonged to her grandmother, Sonia Cubitt, Baroness Ashcombe, whose mother, Alice Keppel, was a mistress of Edward VII.
The ethical question of ‘recycling’ vintage fur has split opinion, but Mr Tyler said: ‘It doesn’t matter when the animal was killed, it’s a body part and a product of cruelty.’
In 2000 Prince Edward’s wife Sophie apologised after she was seen wearing a fox fur hat. The Countess of Wessex said her decision to wear the hat on a skiing holiday in St Moritz, Switzerland, was ‘an error of judgment’.
Legislation to ban fur farming in Britain was passed that same year following a lengthy campaign highlighting the physical and psychological distress suffered by animals in some fur farms.
However, it remains legal to import fur and in China, now the world’s leading fur exporter, millions of animals who are killed for their fur are often skinned alive, according to the campaign group People for the Ethical Treatment of Animals.
A Peta spokesman said: ‘Britain is a nation of animal lovers and more than 90 per cent of Britons refuse to wear fur. We hope that Her Majesty will choose to wear something more humane in future, that better reflects the values of the British people.’
Sorry, Archbishop, but there IS a big difference between the deserving and undeserving poor
As predictable as the bells pealing out the arrival of Christmas, the Archbishop of Canterbury Dr Rowan Williams has once again managed to mark the festive season by a display of painful moral confusion.
First, he used his sermon at Canterbury Cathedral to rebuke the most prosperous for having yet to shoulder their load in the economic downturn. And then in an article for yesterday’s Mail on Sunday he wrote that the poor should be absolved of any responsibility for their own circumstances.
True, he acknowledged that there were doubtless ‘some who make the most out of the benefits culture’ — although even here he couldn’t resist a swipe at ‘some who have made the most out of other kinds of perks available to bankers or MPs’.
But he warned: ‘The Victorian distinction between the deserving poor and the rest is very seductive.’ And he added: ‘Even if there are those who are where they are because of their own bad or foolish choices in the past, that doesn’t mean they are any less in need in the present. And it can’t be said often enough that most people in poverty — and we should be thinking of children in particular — haven’t chosen it.’
This was an extraordinary thing to say. It means that even if poor people are dishonest or irresponsible, the rest of society must regard them as just as deserving of society’s largesse as the honest poor. But the notion that those who have behaved immorally or irresponsibly should be treated in exactly the same way as those whose behaviour has been irreproachable is itself profoundly amoral.
Of course, no one chooses to be poor. But some people do choose lifestyles that cause them to become poor — such as choosing not to work, or deciding to bring up children on their own.
And what was so disturbing about Dr Williams’s observation was that he seemed to be negating the importance of such choices. Indeed, by demonising the better-off while investing the poor with a halo, he came close to suggesting that wealth — however honestly or arduously earned — is intrinsically evil, while poverty is a holy state.
His core point was that no distinction should be made between the ‘deserving’ and ‘undeserving’ poor — which to him clearly conjures up Dickensian nightmares of workhouses, cruelty and destitution. This distinction was, indeed, a key concept in Victorian times. However, after the development of the Welfare State, the idea that any poor people could be considered ‘undeserving’ was ruled out of court. Contrary to the beliefs of the founder of the Welfare State himself, William Beveridge, it became the accepted view that it was odious to hold any poor people responsible for their own poverty.
The question of individual behaviour and its consequences was airbrushed out of the welfare picture altogether. This was in large measure because Left-wing thinking — in the famous aphorism — replaced Methodism with Marx. And Marxist analysis holds that people are not responsible for their own circumstances, but are instead helpless tools of the capitalist system.
Obviously, many do become poor through cruel twists of fate. But others certainly contribute to their poverty through their own behaviour. For example, many women choosing to have babies without a permanently committed father on board doom themselves and their children to poverty and a host of other terrible disadvantages.
Of course, some lone mothers are the innocent victims of desertion. But it is crucial to offer all poor people assistance which will give them a leg up and out of poverty rather than kick away the ladder of opportunity from beneath their feet. Yet leaving them stranded with no escape route is precisely what the ‘non- judgmental’ view of poverty represented by Dr Williams has brought about.
Which is precisely the woeful state of affairs that the Work and Pensions Secretary Iain Duncan Smith is determined to end.
True, Dr Williams paid dutiful credit to the Government’s welfare reforms for its ‘clear intention to put things in place that will actually reduce poverty and help people out of the traps of dependency’. But clearly, he simply doesn’t understand that this depends to a large extent upon restoring the distinction between the ‘deserving’ and ‘undeserving’ poor that he finds so abhorrent.
That is because it is not motivated by an absence of compassion, as he implies, but by its precise opposite — a deeply principled desire to end the trap of permanent poverty. And the way to do that is encourage behaviour that will end it, through viewing the poor as governed by the same impulses as everyone else.
Dr Williams’s view, however, effectively treats the poor as less than human. The essence of being human, after all, is to be capable of moral choice. And all of us, rich and poor, are capable of making those choices. The choice to be honest rather than fiddling the benefits system. To work, however demeaning the job, in preference to taking state charity. To bring children into the world only where there is a committed father to help bring them up.
But if people who make immoral — or amoral —choices benefit from these, that creates a fundamental injustice throughout society. For there is no surer way of undermining and demoralising those who refuse to cheat the system or who are living lives of self-restraint and responsibility. Yet that is precisely what our non-judgmental culture of dependency has given us — the moral degradation of an entire society.
You might think that the Church of all institutions would be in the forefront of fighting such cultural collapse. So why does Dr Williams put himself on the wrong side of the moral tracks?
Well, his disapproving reference to the Victorians is more than a little revealing. For during that period, it was Christians who spearheaded the great social reform movements which turned Britain from a society riven by crime, illegitimacy and drunken squalor into a tranquil country in which the traditional family was the crucible of social order.
That transformation came about through a profoundly moral view of the world rooted in a muscular Christianity. This upheld the dignity of every human being and the optimistic belief that people could redeem themselves through their own behaviour.
It was these Christian attitudes that led to the abolition of slavery and a host of other reforms. Yet Dr Williams has in the past apologised for the role of the church during this period, radiating deep embarrassment about religious impulses which once were a synonym for progressive attitudes.
This is rooted in a collapse of religious belief within the Church of England which has been going on for decades. Accordingly, it has steadily eroded its commitment to the moral codes embodied in the Bible and embraced instead the secular alternative – the religion of Left-wing ideology.
Thus Sunday school was replaced by social work, morality by expediency and holy war by class war.
Dr Williams undoubtedly wants to do good in the world. And he is far from being a stupid man; he is considered to be a profound thinker and theologian. But it took Iain Duncan Smith, in the striking article he wrote for this paper last week, to use without embarrassment the Biblical figure of Joseph to illustrate one of the key antidotes to permanent poverty — the committed father.
The fact is that what Mr Duncan Smith is doing embodies Christian conscience in a way that appears completely to elude the leader of the Anglican communion.
When a politician boldly links morality, religion and compassion while a religious leader can only spout Left-wing cliches, a society’s foundations have become shaky indeed.
The Speaker of Britain’s House of Commons mocks and opposes free speech about homosexuality
The Speaker is supposed to be an impartial president of the assembly. The present Speaker, Bercow, is a pipsqueak of Jewish origins who once pretended to be a strong conservative but who made a sharp turn Left when that seemed more likely to further his ambitions. It did. He was made Speaker by Labour Party votes.
“Before he was Speaker Mr Bercow supported the previous Government’s attempt to remove a free speech safeguard from a sexual orientation ‘hate speech’ law.
The current law says that, for the avoidance of doubt, criticising same-sex conduct or urging people to refrain from such conduct is not, in itself, a crime.
It was inserted by Parliament to a sexual orientation ‘hate crime’ law following a string of alarming cases where Christians had been investigated by the police for their beliefs about sexual ethics.
Mr Bercow has said the free speech amendment is “at best superfluous, and at worst deeply objectionable”. He has added: “Some—although not all—of its supporters would not even know how to spell the word ‘equality’, let alone sign up to it.”