Hospitals wasting £500m a year on basic supplies
Hospitals are wasting up to £500million a year by paying too much for basic supplies, according to Britain’s spending watchdog. The National Audit Office found that some health bodies are paying twice as much as others around the country for dressings, clothing and medical equipment. In some areas, individual hospitals are purchasing 177 different types of surgical glove and putting in hundreds of small orders for A4 paper.
It comes even though the National Health Service is under orders to make £20billion in efficiency savings over the next four years.
The NAO recommends that the Department of Health make it easier for trusts to compare the prices of products they buy, and that hospitals collaborate with each other to buy in bulk and so save money.
Because local trusts are independent of Whitehall control, the NAO says they should be held to account by Parliament to improve on the “poor value for money” they provide in procurement.
Margaret Hodge, the chairman of the powerful Public Accounts Committee, said: “It is simply unacceptable that so many hospital trusts are currently paying more than they need for basic supplies. Even for some of the commonest items, the price hospitals pay varies by more than 100 per cent. “Too much purchasing is still done through multiple, low-value orders, which incur high admin costs.
“And the range of similar products that trusts buy is sometimes so wide as to appear ridiculous: how can it be, for instance, that while one trust does its work with just 13 different types of surgical glove, another requires 177? “These are well-known recipes for poor value for money that really ought to have been addressed by now.”
The NAO report states that England’s 165 NHS hospital trusts spend about £4.6bn a year – a tenth of their total expenditure – on “consumables”, such as surgical dressings, drinks, staff uniforms, pacemakers and replacement hip joints.
Because there is no central system for buying these products, managers in individual hospitals make deals with 17,000 different suppliers. One trust employed 45 people in its procurement team.
Although it is “standard practice” in the private sector, health bodies are not required to give each product they buy an individual code, which would help them analyse data and reduce errors.
As hospitals do not know how much others are paying for products, and they buy items in different quantities at different times, price variation is common and the NAO estimates that up to £150m could be saved if it were eliminated. In some cases the amount paid varied by as much as 183 per cent.
In addition, NHS bodies are putting in on average 4,501 order for surgical gloves a year, and could potentially save £7m a year in admin costs just by reducing orders. Further savings could be made by buying in bulk or joining regional “hubs” with other hospitals to make economies of scale and improve their bargaining power with suppliers.
Hospitals are also encouraged to standardise the products they use – one trust used 287 different types of tubes known as cannulas, while another bought 15 variations of A4 paper.
Amyas Morse, head of the National Audit Office, said: “At least 10 per cent of hospitals’ spending on consumables, amounting to some £500 million a year, could be saved if trusts got together to buy products in a more collaborative way.
“In the new NHS of constrained budgets, trust chief executives should consider procurement as a strategic priority. Given the scale of the potential savings which the NHS is currently failing to capture, we believe it is important to find effective ways to hold trusts directly to account to Parliament for their procurement practices.”
The Health Secretary, Andrew Lansley, said: “We welcome the publication of this report. The more efficient the NHS becomes, the more we can invest back into patient care. That is why it’s so important for hospitals to deal with wasteful procurement.
“While it is up to local hospitals to decide how they purchase products, Government has a role in providing support and robust information. We are therefore considering launching a review to help hospitals get better value for money from procurement, drawing on the expertise of Government advisers.”
Migrants ‘must teach their children English’, says Britain’s PM
Migrant families have an obligation to teach their children English before they start school, David Cameron has said. And the Prime Minister pledged that he would bring forward tougher rules to ensure those arriving in the UK had a reasonable standard of English. One in six children do not speak English as their first language.
Ministers believe that children brought up here stand a better chance of succeeding if their parents have a good grasp of the language.
Mr Cameron spoke out after a Commons exchange with Yorkshire Tory MP Kris Hopkins, who said: ‘Sadly in Keighley, too many children start school and don’t speak English.’ He then asked Mr Cameron: ‘Do you agree with me that there is a responsibility and an obligation upon parents to make sure their children speak English?’
Mr Cameron replied: ‘I completely agree with you. The fact is, in too many cases this isn’t happening. ‘The last government did make some progress on making sure people learned English when they came to our country. I think we need to go further. If you look at the figures for the number of people who are brought over as husbands and wives, particularly from the Indian sub-continent, we should be putting in place – and we will be putting in place – tougher rules to make sure they do learn English so when they come, if they come, they can be more integrated into our country.’
A recent study by MigrationWatch found that children who speak English as their first language are in a minority in some inner-city London schools. Birmingham, Bradford and Leicester all have more than 40 per cent of pupils in primary schools who do not have English as a first language.
To date, the Government’s policies have focused upon marriage visas. Since September, those coming to Britain to marry UK citizens have been forced to sit pre-entry tests proving a basic level of English.
Lawyers argue that the tests, which apply only to those from non-English-speaking countries, are discriminatory, and breach human rights law. But Immigration Minister Damian Green argued that the English language requirement would allow for a ‘more cohesive society’.
British prisons treated like a holiday camp
Prison have become too soft and young criminals treat them like a “holiday camp”, the Government’s knife-crime adviser has warned. Brooke Kinsella, the actress whose 16-year-old brother Ben was stabbed to death three years ago, said it was time jails were turned back in to “places of punishment”.
The former Eastenders star, who was personally backed by David Cameron in the election campaign, spoke out as she concluded her review in to tackling knife crime for the Home Secretary Theresa May.
Kenneth Clarke, the Justice Secretary, has already faced criticism that his planned reform of sentencing and rehabilitation will see tens of thousands fewer criminals go to prison.
Following her six-month review, Miss Kinsella said: “Many young offenders said they actually become accustomed to life in a young offenders institution, with some describing it as ‘a holiday camp’ – three hot meals a day, a place to stay, ways of being educated or earning a wage and quite often the opportunity to make friends or hang out with people they already know.
“Just as the new Government is making it more beneficial to work than to be on benefits, so too must we turn prisons and institutions back into places of punishment, where people want to get out and ensure they don’t go back.”
Miss Kinsella also criticised head teachers for not doing enough to teach about the dangers of knife crime in the classroom. She accused many of being too “afraid” because they worry having such lessons will give the school a bad name. She called for lessons to now start for pupils as young as ten and warned more than 20 children a weekend up in hospital with a stab wound.
Mrs May repeated the Government’s view that any adult caught with a knife should expect a prison term and announce more than £18 million funding to tackle crimes involving knives, guns and gangs over the next two years.
“Off the back of Brooke’s recommendations, we will invest money into changing attitudes and behaviour, alongside being tough on those who persist in being involved in senseless crimes,” she said.
Keeping the BBC honest: An uphill battle
An email from Viscount Monckton below regarding the BBC propaganda film “Meet The Skeptics”:
Many people have been kind enough to get in touch with me about the BBC propaganda film “Meet The Skeptics”, in which I was one of a tiny handful of “climate skeptics” featured. The film, a boorish hatchet job tediously typical of today’s shoddily unprofessional BBC, was cut by 30 minutes as a result of a successful High Court action in which I drew attention to a couple of dozen factual errors and far-out unfairnesses in the film, most of which were removed or corrected.
I shall have to bear much of the cost of the action, because not all of the errors were corrected and the High Court did not consider I had a right of reply, even though the film-makers had told me I should be given one on any points that stood against me in the film, and that proviso was also written into the contract between us.
The BBC and the film-makers will also have to bear some of the cost, because the judge accepted that the BBC had failed to respond to my letter of complaint to the Director-General in a timely fashion and it was only after I had issued court proceedings that the BBC carried out the drastic shortening and correction of the film.
If anyone is approached by Fresh One Productions, the film company, or by Rupert Murray, the film-maker, and invited to participate in a documentary, however seemingly innocent, my strong advice is not to agree to take part. They are untrustworthy. They dishonoured their word to me. Their breaches of contract and undertaking in making promises they did not keep, acting in conspiracy with the unspeakable BBC, will now go to court for trial.
Another misleading emission from the BBC
After the Paul Nurse programme the other day, eyebrows were raised over one of the claims in the show, namely that emissions from fossil fuel burning dwarfed natural emissions. Here’s an excerpt from the transcript:
Bob Bindschadler: We know how much fossil fuel we take out of the ground. We know how much we sell. We know how much we burn. And that is a huge amount of carbon dioxide. It’s about seven gigatons per year right now.
Paul Nurse: And is that enough to explain…?
Bob Bindschadler: Natural causes only can produce – yes, there are volcanoes popping off and things like that, and coming out of the ocean, only about one gigaton per year. So there’s just no question that human activity is producing a massively large proportion of the carbon dioxide.
Paul Nurse: So seven times more.
Bob Bindschadler: That’s right.
Aynsley Kellow, writing in the comments said that this was wrong, and so I thought I would try to clarify things by writing to Dr Bindschadler and finding out his source. This is it.
The source is the Arctic Impact Climate Assessment apparently, although I haven’t actually looked for the graph in its original location yet. You can see the 7:1 ratio in the front graph, and you will also see that the graph is comparing two anthropogenic sources of carbon dioxide, namely fossil fuels and land-use changes. Dr Bindschadler has agreed that this the graph therefore doesn’t support the claim he made in the Horizon programme.
Dr Bindschadler suggests that the 7:1 figure is actually not that far out from the correct figure for net anthropogenic:natural carbon dioxide emissions, so the effect of the mistake is limited. We should note, however, that he was originally speaking about emissions rather than net emissions. But even if you look at the net figures I still don’t think the numbers are correct. Prof Kellow has pointed me to this page at Skeptical Science, which puts the net figures at 29 GtCO2 emissions for anthropogenic and a net 17 GtCO2 (450-439+338-332) absorbtion from natural sources. For what Prof Nurse and Dr Bindschadler were actually talking about in the Horizon show, gross emissions, the 7:1 ratio for anthropogenic to natural becomes, by my reckoning 1:27 (i.e. with natural emissions completely dwarfing anthropogenic).*
So in terms of what is interesting us here, the figures in the Horizon show were clearly completely wrong, which I guess we knew. It’s good to have confirmation of this though. The question is, what does this mean for Prof Nurse and the reputation of the BBC?
*Note that the Skeptical Science page is talking in terms of GtCO2 while Dr Bindshadler was talking Gt carbon, but it’s the ratios we are interested in.
Comment by Professor Aynsley Kellow
I did remark to His Grace [Bishop Hill, above] on the irony of Dr Bindschadler quoting the Hockey Stick at him!
For those interested in the detail of the various fluxes, according to the Koran (AR4 IPCC WG1), I refer you to Fig 7.3, which states the fluxes in GT C pa. Here you will find the following figures for anthropogenic fluxes:
Fossil Fuel: 6.4 GT out
Oceans: 20 Gt pa out; 22.2 in (A net anthropogenic sink of 2.2 GT pa)
Land use change: 1.6 GT pa out; Land sink: 2.6 GT pa in (A net anthropogenic sink of 1 GT pa).
The annual non-anthropogenic flux out is adds up to 190.2 GT pa.
The nonanthropogenic flux in is given as 190.2 GT pa
(This seems strange! The best estimate – it’s in the IPCC, it must be true – is that nature is in perfect balance! Wouldn’t you know it!)
The IPCC did not see fit to include Dr Bindschadler’s volconoes as a separate item.
According to this figure, anthropogenic sink activity offsets half of fossil fuel emissions of 6.4 GT pa, so the net anthropogenic figure is a mere 1.7% of natural fluxes (3.2 of 190.2), if we want to talk nets rather than grosses. This is not something we should ignore, but let’s at least state it accurately.
Of course, put in those terms, it doesn’t frighten the children and horses. Either Bindschadler and Nurse knew this and wanted to frighten same children and horses, or were talking through their hats.
Either way, it rather destroys the point of the program, since climate science seems most under attack from Sir Paul Nurse.
Scepticism is not an “attack on science”
Scientific institutions undermine their own authority when they say we should ‘take sides’ over climate change
Sir Paul Nurse, the new president of the Royal Society, has followed his predecessors, Martin Rees and Bob May, by making a loud public statement about the climate debate. Nurse claimed in a recent edition of BBC2’s science programme, Horizon, that science is under attack, and that public trust in scientific theories has been eroded. Like his predecessors, however, Nurse fails to understand why partial statements from the president of the Royal Society do more to impede the progress of debate than move it on.
Although it was advertised as a discussion about an ‘attack on science’, the Horizon film was dominated by the climate change debate. In Nurse’s view, the public are less convinced by climate change than they ought to be. This has followed an ‘attack on science’, which Nurse explained in a somewhat one-sided account of the ‘Climategate’ affair, the leaking of thousands of emails from the Climate Research Unit at the University of East Anglia in November 2009. But as ugly, pointless and unpleasant as that affair was for those involved, if there is something to be said about the character of the debate about climate change, it is that raised passions and low tactics are not unique to either putative ‘side’.
The mistake Nurse made in his treatment of the climate debate is to imagine that it is divided over a simple claim that ‘climate change is happening’. It is this polarisation of the debate into simple categories – scientists verses deniers – that obscures the real substance of debate, its context and its nuances. The reality is that disagreements about climate change are matters of degree, not true-or-false. In turn, disagreements about the consequences of climate change and the proper policy response are also matters of degree.
Thus, the debate is multi-dimensional, and controversy exists throughout. But for Nurse, identifying the areas of disagreement and offering up an analysis isn’t the point. Instead, he takes for granted that ‘the science is in’, and wonders why trust in scientific authority seems to have been eroded. One reason for this loss of trust just might be that controversies and other inconveniences are swept aside by the polarisation of the debate, leaving a perception that authoritarian impulses are hiding behind scientific consensus. But to point this out would not fill an episode of Horizon. Instead, after a rather feeble retelling of the consensus, the film showed Nurse going after the deniers, who, he suspects, are responsible for undermining public trust in science.
This crusade took Nurse to the home of outspoken climate sceptic and Telegraph journalist James Delingpole, who disputes the existence of the consensus and its value to science. The film was clearly constructed around this moment, at which Nurse seemingly delivers a coup de grace to the deniers: ‘Say you had cancer, and you went to be treated, there would be a consensual position on your treatment.’ This ‘doctor analogy’ appears to leave Delingpole uncomfortable, and stuck for words: ‘Can we talk about Climategate… I don’t accept your analogy’, he responds.
Whatever the reason for Delingpole’s hesitance, there are many good reasons for not accepting Nurse’s analogy. The most obvious being that the climate is not like the human body; climate change is not like cancer; climate scientists are not like oncologists; and climate-science research institutions are not like hospitals. But worse is the fact that Nurse’s thought experiment defeats its purpose. He’s asking us to believe that there has been an attack on science and that trust in science is being eroded. But if we presume that Delingpole is forced by the analogy to accept that he should trust the consensus formed by scientists, we must conclude that science is not under attack. An ‘attack on science’ would reject both climate change and medicine.
Nurse’s reasoning is that if we’re not scientists, we are not able to follow the complexities of climate science, and so take arguments about the climate on trust. But newspapers, he observed, are full of contradictory messages. ‘Political opinions’ are expressed through ‘lurid headlines’, causing ‘an unholy mix of the media and politics… distorting the proper reporting of science, and that’s a real danger for us if science is to have its proper impact on society’. Perhaps worse, the internet allows ‘conspiracy theories to compete with peer-reviewed science’. The concern here is that trust in the wrong source prevents the feckless public from responding to the correct messages about climate change, sending us all to our doom. Instead, people should trust in science, because unlike the politically driven newspapers, and internet lunatics, its authority ‘comes from evidence and experiment’.
But there is no attack on science. Even climate-change deniers will still take the advice of oncologists, and will still express criticism of climate-change policies in scientific terms. What Nurse fails to recognise is the difference between science as a process and science as an institution. The reputation of the former is intact; but, as I’ve argued before here on spiked, scientific institutions undermine their own credibility when they interfere in a one-sided way in such debates, regardless of any effort by ‘deniers’. Then, the members of these institutions resort to making BBC documentaries to wonder out loud why no one trusts them anymore.
Aside from the technical complexity that Nurse describes, and the multiple dimensions to the climate debate that he ignores, there is the context of the climate debate to be considered. The background to the climate debate is a collapse of trust in public institutions of many kinds. Echoing this collapse in public reason, Nurse urges, ‘trust no one, trust only what the experiments and the data tell you’. But isn’t this also the message from climate sceptics, who accuse institutional, official science of corruption and political motivation?
It would seem that the sceptics have a good point here. Climate change has come to the rescue of the forgotten old academic department, the tired political establishment, and the disoriented journalist. The possibility of ecological catastrophe injects moral purpose back into public life, in spite of a collapse in trust. Accordingly, local authorities and national governments have, in recent years, transformed their purpose; now their goal is to monitor your bins rather than provide public services. Powerful supranational political and financial institutions have been created to ‘meet the challenge’ of climate change. And these political changes have for the most part occurred without any semblance of democracy; it is presupposed that these organisational changes to public life are legitimate because they are seemingly intended to do good.
Nurse might argue that this reorganisation of public life around environmental issues comes with the blessing of scientific authority, and that it is science which identified the need to adjust our lifestyles and economy. But the greening of domestic and international politics preceded any science. The concept of ‘sustainability’ was an established part of the international agenda long before the IPCC produced an ‘unequivocal’ consensus on climate change; indeed, the IPCC was established to create a consensus for political ends. Nurse, nearly recognising science’s role in the legitimisation of such political ecology, worries about loss of trust. As he noted in the Horizon film, if scientists are not ‘open about everything they do then the conversation will be dominated by people driven by politics and ideology’.
But the conversation is already driven by politics and ideology; it’s simply that Nurse does not recognise environmentalism as political or ideological, and he does not notice himself reproducing environmental politics and ideology. The loss of trust he now observes is not the consequence of politics and ideology, but the all-too-visible attempt to hide politics behind science and highly emotive images of catastrophe. If the presidents of science academies want their trust back, they will first have to admit to the politicisation of their function in an atmosphere of distrust. Nullius in verba, indeed.
The sadness of a climate fraud
Phil Jones is speaking tomorrow to the Spalding Gentlemen’s Society. There is a brief story in the local paper here. One interesting snippet from the article is this quote by Jones:
I received a lot of nasty emails from November to March/April last year from people threatening to kill me among other things. I passed them on to Norfolk police who said they didn’t fulfil the criteria for death threats.
I’m slightly bemused by this – a death threat that doesn’t meet the police’s criteria for death threats. I can’t help but be reminded of the poor chap who sent a joke tweet about blowing up an airport and received the full penalty of the law.
Geography lessons ‘not good enough’ in half of British schools
Children’s knowledge of capital cities, continents, world affairs and the environment is in sharp decline because of poor geography lessons, inspectors warned today. In a damning report, Ofsted said teaching in the subject was not good enough in more than half of English state schools.
Geography – traditionally a cornerstone of the curriculum – is often undermined by a lack of space in school timetables after being edged out by exam practice and other subjects such as citizenship.
Many primary teachers lacked specialist geographical knowledge, the watchdog said, meaning classes often descended into a focus on superficial stereotypes. The subject had practically “disappeared” in one-in-10 primaries.
In secondary schools, classes were often merged with history to form generic “humanities” lessons that focused on vague skills instead of geographical understanding.
Ofsted said the decline severely reduced children’s ability at all ages to grasp key geographical issues, identify countries or capital cities and even read maps properly. In the worst secondary schools, most students were “spatially naïve” and unable to “locate countries, key mountain ranges or other features with any degree of confidence”, the study said.
Christine Gilbert, the chief inspector, said: “Geography provision was outstanding in over a quarter of all the schools we visited but just over half were not using geography to good effect to support pupils in understanding their role in their locality, their country and the wider world.” She added: “Where provision is weaker, schools should focus on developing pupils’ core knowledge in geography, particularly their sense of place.”
Geography is currently a compulsory subject for pupils aged five to 14. But Ofsted’s study – based on inspections of 91 primary and 90 secondary schools – found serious weaknesses in the teaching of the subject throughout the education system.
Geography was “more or less disappearing” in one-in-10 primary schools, the report said. In half the schools visited, pupils in some classes were taught no geography at all.
Improvements were often undermined by primary teachers’ “weak knowledge of geography, their lack of confidence in teaching it and insufficient subject-specific training”, the report said.
Teachers’ lack of expertise occasionally led to a focus on “cultural or exotic aspects” of some countries which could reinforce stereotypes, it was claimed. One lesson for eight and nine year olds seen by Ofsted began with a teacher asking what pupils knew about India. Children said Indians were “famous for their camels”, “do yoga”, “wear colourful clothes” and “ride on elephants”, but the teacher did little to challenge their stereotypes and misconceptions, Ofsted said.
At secondary level, more than half the schools visited cut the amount of time spent teaching geography in the first three years. In many cases, tuition was reduced because timetables were overloaded with other subjects, such as citizenship, or time spent providing “catch-up sessions in English and mathematics”.
Around a third of schools merged history and geography together to form “humanities” lessons, but these classes “tended to focus on generic learning skills rather than knowledge and understanding that was specific to geography”, inspectors warned.
The report said “uninspiring teaching” at the start of secondary school led to a reduction in the number of teenagers opting to take a GCSE in the subject. Some 97 secondaries failed to enter a single pupil for GCSE geography in 2007 but by 2009 it increased to 137. Almost one-in-10 academies – the independent state schools championed by the Coalition – shunned GCSE geography altogether, it was claimed.
The report – Geography: Learning to Make a World of Difference – recommended better on-the-job training for teachers, a more rigorous focus on geography in the first three years of secondary education and a rise in the number of fieldtrips for all ages.
Junk food companies told British Government wants to avoid ‘intrusive’ laws
The Health Secretary has told junk food manufacturers he wants to avoid “intrusive, restrictive and costly regulation”. Andrew Lansley said to senior executives from companies including Mars and PepsiCo that ministers were not interested in “nannying” people about their food choices.
His comments come despite criticism of the Government’s decision to roll back spending on the Change4Life health campaign, in favour of getting commercial companies and charities to fill the gap. Cadbury, Unilever, Coca-Cola, Kellogg’s, Kraft, Mars, Nestle and PepsiCo have all been involved, alongside Britvic and supermarket giant Tesco.
At a public health debate held by The Grocer trade magazine on Wednesday, Mr Lansley said there had been an imbalance in health policy for years, with “big state dominating over big society”. Now there needed to be a “wide range” of interventions to achieve improved health – regulation was just one option.
Mr Lansley said he would not be “scared” to use industry to achieve public health and commercial aims, because companies could reach consumers in a way ministers could not. He added: “Hopefully there will be no need for intrusive, restrictive and costly regulation.”
The Health Secretary also admitted he himself falls outside the healthy weight range. “I know that I’m overweight,” he said. “I know that I should have a BMI of 25 and I’m a BMI of 28.”
Tam Fry, of the National Obesity Forum, said: “Mr Lansley’s reassurance to junk food manufacturers beggars belief. “As Health Secretary, his duty is to reassure the public that the food we are asked to choose from is as healthy as it can be.”
Jacqui Schneider, of the Children’s Food Campaign, added: “There’s absolutely no evidence that industry – which has a vested interest – is able to bring about a change in people’s behaviour.”