Patient care at risk under NHS reforms, experts warn

Patients could be denied hip, knee and hernia operations under unprecedented reforms to the NHS, the Royal College of Surgeons has warned ahead of a crucial Commons debate. Operations could be cancelled as GPs try to save money under a new system that gives them control of billion-pound budgets, it has been claimed.

Standards could also suffer as doctors give preference to local hospitals or cheap private providers rather than established regional centres of excellence, while clinicians are ignored under the revised arrangements.

Royal colleges, professional bodies, think tanks and charities have written briefings for MPs on the controversial Health and Social Care Bill ahead of its second reading in the Commons on Monday. They believe the scale and pace of change being imposed on the NHS is too great when it is being asked to find £20 billion of savings within four years.

In one of the most strongly-worded briefings, the Royal College of Surgeons said GP commissioners are likely to avoid buying expensive, but necessary, operations such as hip replacements and hernia surgery in order to save money. “Short-term apparent economies are likely to cost the public purse more in the long term,” it said. It also said that “standards of patient care may be compromised” unless it is made clear that “the lowest price” should not drive decisions.

They also fear that the reorganisation proposed by Andrew Lansley, the Health Secretary, which itself will cost at least £1.4 billion, will lead to the loss of expertise as two tiers of management are removed, and will damage morale among those left behind to implement the reforms. John Healey, the shadow health secretary, said: “These plans will mean more competition over co-operation, and a fragmentation of NHS services that may harm patient care.”

The Coalition surprised the health sector last summer by announcing a complete overhaul of how patient care is bought. Under the Bill published last week, two tiers of management — England’s 152 Primary Care Trusts and 10 Strategic Health Authorities — will be scrapped and their powers given to “GP-led commissioning consortia”.

The new bodies will handle £80 billion of funding. They can choose to buy treatment for patients from “any willing provider” – including private health care firms as well as NHS hospitals. An independent NHS Commissioning Board will decide the overall budget and oversee the service.

Although many accept the need for reform of the 60-year-old NHS, most in the health sector have expressed alarm at the untested proposals and are calling for MPs to make significant changes to the legislation.

In one of the most strongly-worded briefings to politicians, the Royal College of Surgeons warned that GP commissioners are likely to avoid buying expensive, but necessary, operations such as hip replacements and hernia surgery in order to save money. “Short-term apparent economies are likely to cost the public purse more in the long term,” they said. It also said that “standards of patient care may be compromised” unless it is made clear that “the lowest price” should not drive decisions.

The Royal College of Psychiatrists said “services of dangerously poor quality” will be purchased if contracts go to the “cheapest bidder”, and claims that clinicians could be accused of breaking EU competition law if they collaborate too closely on services.

Several commentators, including the Nuffield Trust research body, fear patients will lose faith in their GPs if they believe they are denying them treatment on the grounds of cost. It also pointed out that the pay doctors receive, likely to include cash bonuses, will be “sensitive”.

The Royal College of Physicians said the it is “anxious” that the new system should not lead to the fragmentation of services, which will worsen a nationwide “postcode lottery”.

Paul Jenkins, of the mental health charity Rethink, said: “We want to see better training and support for GPs, who will soon become responsible for commissioning complex mental health services, despite many admitting that they have little understanding of what’s available.”

The Royal College of Nursing expressed “major doubts” that the health Bill will meet its aim of putting patients at the centre of care. Dr Peter Carter, the chief executive, said: “It is our fear that the dual challenge of reform and efficiency savings could damage the quality of patient care.”

Unison, the public service union, says the wholesale reform will “reduce the NHS to little more than a brand name” as private health care firms are given free rein in a “cut-throat system”. It also questions whether the new organisations would be able to organise a nationwide response to problems such as a swine flu pandemic.

Andrew Lansley, the Health Secretary, said: “Clinicians support the purpose of our plans: more patient-centred care, better results for patients and less bureaucracy. “With rising demands on health care and results for patients — like cancer survival — not even at the European averages, the NHS needs to modernise now. “We received over 6,000 responses to our consultation and the Bill has improved as a result.” He added: “We fully intend to have clinical professional leadership on the commissioning board.”


British student union leader pulls out of speaking at fees rally after protesters hurl anti Jewish abuse at him

Antisemitism has always had its chief home on the Left

The national president of the NUS pulled out of speaking at a student fees rally after being surrounded by demonstrators calling for his resignation and shouting anti-Semitic insults at him. Protesters shouted ‘Students, workers, hear our shout! We want Aaron Porter out!’ and ‘Aaron Porter we know you, you’re a f******* Tory too!’

One photographer reported chants of ‘Tory Jew scum’ directed at Mr Porter, who is facing calls to step down as NUS president by members of the National Campaign Against Fees and Cuts, who claim he has ‘lost the confidence of the movement’.

The protest march attended by thousands began peacefully and was escorted by mounted police, but around 150 demonstrators broke off the agreed route and headed towards the city centre, where they targeted Mr Porter. He had been due to speak at the rally but his appearance was later cancelled.

It is understood NUS leaders made the decision, although police sources said he would have been asked if he thought it a good idea to appear in public.

Shortly afterwards a protester called on a loudhailer to break up and return to the march meeting point. He urged: ‘Avoid being kettled, break up and spread your lines.’ Another confronted the officers and told them: ‘Your jobs are next GMP.’ Some demonstrators wearing balaclavas were seen wrestling with police and at least 14 arrests were made.

Demonstrations to highlight the effects of public spending cuts on young people were also held in London today. Chanting ‘No ifs, no buts, no education cuts’, sixth form learners joined under-graduates and others outside the University of London Union ahead of a march on Parliament. The slogans could hardly be heard over the sound of drums as the rally got under way.

Parallels were drawn with the current unrest in Egypt with some demonstrators calling for ‘revolution’ A group of students let off flares outside Downing Street this afternoon

Anger at Government proposals to raise tuition fees and scrap EMAs (Education Maintenance Allowance) appeared to be contained to the slogans chanted by protesters and emblazoned on placards. One drew an analogy between events in North Africa and that in the UK. ‘Ben Ali, Mubarak… Cameron, you are next,’ it read.

As marchers weaved their way through the streets of London, a group at the front started chanting: ‘Revolution, revolution.’ Most, however, seemed content setting their sights on getting the Government to rethink plans to hike tuition fees and cut education budgets.

Under the coalition proposals, universities will be allowed to charge £6,000 a year, or £9,000 a year in ‘exceptional circumstances’. Students also feel aggrieved over the planned scrapping of EMAs, which provide poorer sixth form students with financial assistance.

Moritz Kaiser, a 17-year-old sixth former from Oxford, was among those protesting. ‘The tuition fee hike will affect my family quite badly and it is unnecessary when you look at how much is lost in tax avoidance.’ A dual British-German national, he now intends to head to the European mainland to avoid the additional bill. ‘I was going to study here, but in Germany it is only 500 euros a year, and you get a free bus pass,’ he added.

His friend Lucio Pezzella, also 17 and at sixth form college in Oxford, said the ‘wrong people were being punished’ for the economic plight the UK finds itself in. ‘Ordinary people shouldn’t have to pay for a crisis brought on by the bankers,’ he said.

At a potential flashpoint along the route – Topshop in the Strand – students stopped to yell abuse directed at owner Sir Philip Green, whose tax arrangements have attracted controversy. ‘Pay your tax, pay your tax,’ they chanted. The store was guarded by a line of police, keeping protesters apart from the bemused shoppers trapped inside.

Shortly before 2pm, students started running towards Tory HQ at Millbank Tower. Police attempted to stop their advance but a few broke through and made their way to the entrance. One protester was tackled to the ground and held there for several minutes. The 18-year-old from Essex, who declined to give his name, claimed he had been kneed in the chest and punched by officers as he remained on the ground being restrained.

Later, some of the students moved on the Egyptian Embassy to join those protesting against President Mubarak’s regime. ‘London, Cairo – unite and fight,’ they chanted on arrival.

In other angry scenes, a group of demonstrators started throwing sticks at police. Two arrests were made this afternoon.

Universities and Science Minister David Willetts said: ‘The Government respects the right of all citizens to engage in lawful and peaceful protest. ‘Our student and university finance reforms are fairer than the present system and affordable for the nation. ‘No student will be asked to pay upfront costs, there will be more financial support for poorer students and those who go on to earn the highest incomes will make the largest contributions after they have graduated. ‘Our reforms also put students in the driving seat.’


The Met Office winter forecast lie is finally nailed

And heads must roll

With compliments to Katabasis whose FOI request has been dealt with more quickly than mine… The information in the FOI response he has received today and written up in a detailed blog post goes into much more detail than Bishop Hill’s release from the Quarmby audit team.

A look at the information makes clear there is nowhere left for the Met Office to hide. The Met Office has been caught ‘cold’ lying about its winter forecast in a disgraceful attempt to salvage its reputation. Its claim that it forecast the cold start to the winter lays in tatters thanks to an exchange of emails between the department and the Cabinet Office.

As a result the Met Office is completely discredited. Also utterly discredited is the BBC environment analyst Roger Harrabin, who on the Met Office’s behalf used a column in the Radio Times (later carried in the Telegraph and the Daily Mail) to state that:

In October the forecaster privately warned the Government – with whom it has a contract – that Britain was likely to face an extremely cold winter. It kept the prediction secret, however, after facing severe criticism over the accuracy of its long-term forecasts.

Harrabin went on to say in his piece that:

Why didn’t the Met Office tell us that Greenland was about to swap weather with Godalming? The truth is it [The Met Office] did suspect we were in for an exceptionally cold early winter, and told the Cabinet Office so in October. But we weren’t let in on the secret. “The reason? The Met Office no longer publishes its seasonal forecasts because of the ridicule it suffered for predicting a barbecue summer in 2009 – the summer that campers floated around in their tents.

The email exchange in the screenshot below proves this is a lie. The Cabinet Office civil servant (bottom message) confirms the weather outlook supplied by the Met Office earlier that day is what the government will use in its ‘Forward Look’. The Met Office employee (top message) agrees with it.

The all important sentence is the first. ‘The Met Office seasonal outlook for the period November to January is showing no clear signals for the winter’. The Met Office knew this was the case when it sent Harrabin scurrying off to spin its lie that the Met Office did suspect we were in for an exceptionally cold early winter, and told the Cabinet Office so in October‘. The briefing to the Cabinet Office contains no such warning – and vindicates the parliamentary answer given by Francis Maude when questioned about the forecast the government received from the Met Office.

What is worse is that the Met Office knew this, yet with its claim tried to place responsibility for the lack of prepareness for an extremely cold start to the winter on government inaction. Harrabin added to this by saying he had put in a FOI to the government (referenced in this post) to discover what they were told, the insinuation being it was the government that had something to hide. This is very dangerous ground that leans towards the possibility of the Met Office and a BBC reporter engaging in a joint effort to undermine the government’s credibility.

This leads us to ask a serious question that must be answered: How is it possible that Roger Harrabin could claim the Met Office line he was retailing was the ‘truth’ with such certainty?

  • If Harrabin had seen the evidence and still spun his line then he has knowingly lied to the public
  • If he spun his line without seeing the evidence then he is utterly incompetent and the public can have no faith in the stories he broadcasts and publishes on the BBC

Either way Roger Harrabin’s position is now untenable and in addition to resigning he must make a full public apology. As for the Met Office, the buck stops with the Chief Executive, John Hirst, who has looked on as this false narrative was constructed and insinuations were made to deflect criticism from his department, yet did nothing to correct it.

We now have the truth. It is what many people have suspected since the story materialised. It’s now time for those who engineered the deception and those who allowed it to happen to pay the price for their actions. Over to the executive board of the Met Office and the trustees of the BBC.


Yet Another Warmist Group Says Communist Dictatorship “Looks Very Attractive”

What is with the warmist’s love affair with communist dictatorships? Yet another group of committed climate change worriers has come out to declare their abiding admiration for Chinese-style dictatorship.

The Islington and Hackney Carbon Reduction Action Group (how annoying do they sound?) have posted a notice to say that they are no longer trading carbon with each other, due to the fact that there are now only four people willing to trade carbon with each other, and no one wants to do the maths:

“Back in 2006, I thought that personal carbon allowances would be a great leveller in more ways that just in terms of carbon emissions and perhaps that would be a good thing. But now I think that even moderate greens living in our energy intensive, consumer driven western economies would be perfectly happy to buy up carbon credits from another person without feeling much guilt or being too concerned about the morality of it . . .

Looking at the global stage, back in 2006 I would never have believed that so little would be achieved at the international climate conferences over the following 4 years. But until politicians in the West, accept that the largest per capita emitters have to make the largest emissions reductions, and they can find a way of getting the electorate to still vote for them, progress is going to be slow. The Chinese system of command and control government seems very attractive from afar.”

As The Register points out, the group managed to reduce their carbon emissions to 3.36 tons per person per year by “heroic” efforts, but their Co2 emissions were still way above the supposedly “sustainable” emissions levels of 0.5 tons.

Sadly for the Islington and Hackney Carbon Reduction Action Group, and warmists everywhere, the sort of WWII sacrifices that Greens are calling for are just not going to happen in a democracy, which perhaps explains the evident longing for the Chinese Communist “command and control” style of Government where they can just tell people what to do (for their own good, of course).


I’ve never seen anything so wet in all my life’: British judge slams ‘soft’ sentencing options that prevented him jailing burglar

A judge has hit out after sentencing guidelines prevented him from sending a burglar to prison. Julian Lambert lambasted the justice system as ‘soft’ after he was forced to hand burglar Daniel Rogers, 25, a community sentence.

He said: ‘I’ve never seen anything so wet in all my life – 80 hours’ community work for burgling someone’s house. ‘I very much regret sentencing guidelines which say I should not send you straight to prison. ‘We live in soft times.’

His comments highlight the frustration felt by many judges over restrictions placed on their powers.

The Guideline Judgments Case Compendium sets out clear sentencing guidelines for judges and magistrates. It states that cases of burglary with minimal loss and damage and a low impact on the victim should be dealt with by a community sentence. A burglary with some higher culpability on the part of the offender or having a greater impact on the victim should usually involve a custodial sentence of between nine and 18 months, though the term can be longer.

Burglaries with serious culpability or impact have a starting point of two years’ imprisonment, and the maximum sentence for domestic burglary is 14 years. A judge must also take into account any mitigating factors and aggravating factors such as when the burglary was and whether the occupier was at home. A plea of guilty or not guilty is also a factor.

Bristol Crown Court heard that Rogers broke into a house in the city last year and began looking for valuable items. Owner Ross Campbell discovered Rogers as he rifled through his living room and the burglar snatched computer gear, a wallet and DVDs before running out of the house.

Rogers, who lives in Southmead, Bristol, pleaded guilty to burglary after police tracked him down through a fingerprint left on a games controller.

Jonathan Stanniland, prosecuting, said Mr Campbell heard noises coming from downstairs and found a hooded man in his living room. He said: ‘He chased the man out of the rear door. ‘The man went into the back garden and scaled a fence to next door.’ He added that Mr Campbell had suffered from anxiety after the break-in and feared that he may have been targeted because he and Rogers had three friends in common on Facebook.

Judge Lambert said he despaired of current sentencing guidelines when he was handed a report advising him not to send him to prison. But judges are bound to take in mitigating factors – such as Rogers’s early guilty plea – when it comes to sentencing. It was recommended that he sentence Rogers to just 80 hours’ community work.

But the judge gave him 240 hours, a six-month curfew between 9pm to 6am, a 12-month ban from licensed premises and 18 months of supervision. He told Rogers: ‘You’ve got the lot. It may be easier for you to do the time.’

James Haskell, defending, said his client could do community service and said a curfew would prevent Rogers from going out drinking, which he had used as a ‘coping mechanism’ previously.

Last night the judge’s comments drew support from Sue Lloyd, of Victim Support. She said: ‘Victims often feel let down by the criminal justice system and the complexities of sentencing decisions. ‘Burglary can have a serious impact on a victim, not only because of the theft and damage involved but also the sense of invasion of what should be a safe, private place.’

The Avon and Somerset Probation Service said any probation report supplied to a judge before sentencing was for guidance only. A spokesman said: ‘The pre-sentence report is purely to provide information and act as a guide for the judge.’


Some most embarrassing Wikileaks

To the horror of a European political intelligentsia which has been steadfast to the point of fanatical in its opposition to Israeli “settlements” in East Jerusalem, the Palestinian leadership itself, we now know, has long accepted that the vast majority of Israeli settlements can be considered legitimate and would become part of Israel under any reasonable peace agreement.

This is utterly devastating since it simultaneously shows that everyone from the British Foreign Office and the BBC to the European Commission and the continent’s passionately anti-Israeli NGO community have been adopting a position which was significantly more uncompromising on “settlements” than the Palestinian leadership itself, and also that that same Palestinian leadership had accepted that the so called 1967 “borders” — the gold standard for practically every anti-Israeli polemic around — are irrelevant to the prospects of a lasting peace.

In one of its most resentful leader columns for years, the Guardian was nothing short of apoplectic: not so much with Israel, but with a Palestinian leadership which has effectively blown the credibility of the Guardian’s very own mantras on the MidEast straight out of the water. The Palestinian leadership, the paper declaimed, had been shown to be “weak” and “craven”. Their concessions amounted to “surrender of land Palestinians have lived on for centuries”. And, in words that look alarmingly close to the position adopted by Hamas, “The Palestinian Authority may continue as an employer but, as of today, its legitimacy as negotiators will have all but ended on the Palestinian street.” This is sheer spite.

The Palestinian leadership accepts what any reasonable person has been able to accept for decades. The Guardian then slams them as surrender monkeys. The Guardian newspaper is more hardline against Israel than the Palestinian leadership itself. And bear in mind, as you mull over the implications of that stark and unyielding state of affairs, that the Palestinian Authority is led by Mahmoud Abbas, who is a Holocaust denier.

But it gets worse. The only conceivable way out of this for the anti-Israel community is to turn this all upside down and argue — as analysts, reporters (anyone they can get their hands on) have been doing on the BBC all day — that what this really shows is the extent of Israeli “intransigence”: the Palestinians offer all these concessions, and still the Israelis say no! This was the line adopted by Paul Danahar, the BBC’s MidEast bureau chief, who quite casually averred that, “The Israelis look churlish for turning down major concessions”. Good thing no-one’s taking sides then.

Tragicomically, it just won’t wash. Privately and morally, senior Palestinians can see that there is nothing illegitimate or even especially problematic about most of the “settlements”, (as reasonable observers of the MidEast have been saying for years). This we know from the leaks themselves. But publicly and politically they cannot sell such concessions to their own people. This we know because they are currently trying to distance themselves from the leaks, and because they educate their own people in an implacable rejectionism which extends to the “moderate” Palestinian authority glorifying suicide bombers and other terrorists by naming streets and squares after them.

Logically and reasonably, the Israeli response is to see such “concessions” for what they are: well intentioned in so far as they go, but impossible to implement in practice. Quite apart from the question of Hamas-run Gaza, the Palestinians have been playing the same old game of saying one thing to one audience and something else to another. They are not a credible partner for peace, and the Israelis do not look remotely “churlish” for understanding this.

It will be interesting to see how this whole affair now plays out. But never again can the anti-Israel community play the settlement card and at the same time retain a single ounce of credibility.


About jonjayray

I am former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party. The kneejerk response of the Green/Left to people who challenge them is to say that the challenger is in the pay of "Big Oil", "Big Business", "Big Pharma", "Exxon-Mobil", "The Pioneer Fund" or some other entity that they see, in their childish way, as a boogeyman. So I think it might be useful for me to point out that I have NEVER received one cent from anybody by way of support for what I write. As a retired person, I live entirely on my own investments. I do not work for anybody and I am not beholden to anybody
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