Black stroke victims receive much better care from the NHS than whites do
A study of more than 3,800 patients found that black people were more likely to be admitted to specialist units for treatment, and to receive therapy afterwards, than white people. In addition, older victims were less likely to receive a brain scan than younger ones.
The authors say the decisions made by NHS staff to favour particular groups were not backed up by evidence. Their study, published in the BMJ on Friday, concluded: “Although the receipt of effective acute stroke care improved between 1995 and 2009, inequalities in its provision were significant, and implementation of evidence-based care was not optimal.”
Researchers at King’s College London analysed data for 3,800 patients who had suffered a stroke in south London between 1995 and 2009. They found that black patients were 76 per cent more likely to be admitted to a dedicated unit than white patients after suffering the brain attack.
The researchers say this result is “rare” among ethnic minority groups and could be down to a misguided belief among staff that “such care is only appropriate for certain subgroups of patients”.
Black stroke victims were also more likely to receive occupational therapy or physiotherapy, regardless of the severity of their stroke or their age. This could be because of factors not accounted for in the study, “such as cognitive impairment”.
In addition, the researchers found that patients aged 75 and over and poorer ones were less likely to receive brain imaging. They admitted that older patients are more likely to die before a scan can be carried out.
“It is, however, important to ensure that elderly patients are not excluded deliberately, as lower rates of brain imaging have implications in delivering effective acute treatment as well as the initiation of secondary prevention measures that could possibly result in poorer outcomes.”
Dr Sharlin Ahmed, research liaison officer at the Stroke Association, said services were not consistent throughout the UK, although there have been improvements. “We know that stroke patients are more likely to survive, make a better recovery and spend less time in hospital if they are admitted to a stroke unit and receive specialist care from a co-ordinated team. “We want every stroke patient to have access to a brain scan within 24 hours and want to see everyone being admitted to a stroke unit so that they get the best possible chance of making a good recovery.”
NHS managers are blocking hospital referrals to save money, say GPs
As many as one in eight patients are being denied a referral made by their GP for services including hip and knee replacements, cataract surgery, allergy services, IVF and removing tonsils, a survey found.
Some 380 GPs responded to the poll for Pulse magazine, with a third saying their referrals were being screened by a referral management centre. The NHS uses these centres to assesses the clinical appropriateness of GP referrals before treatment is allowed to proceed, and trusts admit they help cut costs.
In the latest poll, one in five of GPs said their patients faced restrictions in access to hip and knee replacements, 13 per cent to cataract surgery and allergy services and 10 per cent to services for chronic fatigue syndrome or ME.
Nearly a third of GPs said they had been informed by their primary care organisation of restrictions to IVF, nearly half to varicose vein surgery and a quarter to tonsillectomy.
Around 80 per cent of 32 primary care organisations responding to Freedom of Information Act request said they had referral management centres.
According to the Pulse investigation, NHS South West Essex has written to GPs telling them that 213 different procedures – ranging from allergy treatment to hysterectomy – will no longer be funded except in exceptional circumstances. GPs in the area have had 12 per cent of referrals blocked – four per cent diverted to another health professional or provider, and eight per cent rejected outright.
Dr Anil Chopra, a local GP and medical director at NHS South West Essex, told Pulse: ‘The service restriction policy is part of a plan agreed with local doctors to bring referrals down to a more manageable level. ‘We anticipate we will reduce spending by £1.9m this year.’
NHS Bournemouth and Poole has reduced dermatology referrals by 18 per cent, trauma and orthopaedics referrals by 27 per cent and ear, nose and throat referrals by 31 per cent between the first six months of 2009/10 and 2010/11.
Dr Mahesh Kamdar, a GP from Essex, told Pulse that ramping up referral management was a ‘recipe for disaster’. He added: ‘Patients will realise that their referrals are not going through as fast as they have done, so I’m sure there will be a backlash.’
Richard Hoey, editor of Pulse, said: ‘The NHS is facing an alarming tightening of the screw on funding, and many managers are reacting by placing restrictions on which treatments are funded locally and which referrals they allow. ‘It may be reasonable to screen out some referrals, but simply erecting crude blocks to hospital treatment not only damages patient care, but probably won’t control costs in the long run. ‘All it will do is force up demand for other parts of the NHS and store up problems for the future.’
British government wants to measure people’s happiness
So it can “help”
Hundreds of thousands of people will be asked whether they think the lives they lead are “worthwhile” as part of David Cameron’s plan to measure the nation’s wellbeing.
Government researchers will begin questioning the first 200,000 over-16s across Britain from April to assess how satisfied they are with their lives on a scale of 0 to 10, and how anxious or happy they feel.
Further research is expected to focus on detailed areas that affect individuals’ perceptions of their own happiness, such as the state of their marriage, friendships and personal health.
The initiative has a budget of £2 million a year with the first four questions in the initial survey of 200,000 people costing £500,000 to conduct, according to the Office for National Statistics, which is running the scheme.
The Prime Minister believes the state can have a role in helping citizens “feel better” and has argued that successful governments should improve the quality of life as well as the strength of the economy.
His programme to develop Britain’s first “wellbeing index” follows a similar initiative in France, announced by President Nicolas Sarkozy.
The ONS drew heavily on the recommendations of the French commission when drafting the first questions to be used to measure “subjective wellbeing” in this country.
Initially, four new questions will be included in the ONS’s integrated household survey from April. Respondents will be asked to give answers on a scale of 0 to 10 to the following questions:
· Overall, how satisfied are you with your life nowadays?
· Overall, how happy did you feel yesterday?
· Overall, how anxious did you feel yesterday?
· Overall, to what extent do you feel the things you do in your life are worthwhile?
Paul Allin, head of the wellbeing project at the ONS, said he was confident the questions would produce robust results and that any bias in the answers would be ironed out across such a large sample. “We essentially trust people to give us the answers they give us and we will work what they say,” he said.
Ultimately, the project aims to create a set of results against which the changing health of the nation’s feelings about itself can be measured. Officials also want to enable comparisons to be made between Britain and other countries and will be working with the Organisation for Economic Co-operation and Development.
Mr Allin said: “Subjective wellbeing is one approach to understanding and measuring the wellbeing of the nation. While we want to produce consistent results over time, we will initially regard the results as experimental. There is more work to be done.”
In developing the new questions, the ONS commissioned further research into subjective wellbeing. It found that life satisfaction in Britain had failed to keep pace with rising household income and GDP over the past 40 years.
Other findings from the report, which reviewed a wide range of existing research, suggested that women are generally more satisfied with their lives than men and young people are happier than the middle-aged.
Married people are happier than those who are unmarried and it is more important to “keep up with the Joneses” and match the income of your peer group than to have objectively high rates of pay.
However, the study also suggested that it is possible to be too happy. Excessively happy people can be “gullible” and make “careless” decisions. The optimum level of happiness is to be at seven or eight out of 10, the research said.
Chaotic British State school
A draconian ‘super head’ has been sacked just two days into his new job after suspending seven pupils for minor offences. Craig Tunstall, who earns more than the Prime Minister and is one of Britain’s highest-paid head teachers, lasted less than 48 hours in his role as executive head of a failing primary school.
Within hours of joining, Mr Tunstall, who was thought to have been receiving a pay package of close to £200,000, had excluded seven pupils as young as five. Their offences included wearing the wrong coat in the playground, refusing to finish their school lunch and failing to stand in line. One of the suspended pupils was a five-year-old boy with special needs.
His manner was so authoritarian that staff and children alike said he created a ‘climate of fear’. And he provoked outrage by demanding that all the pupils walked with their hands behind their backs. Council bosses, who had parachuted Mr Tunstall into Oval Primary in Croydon after ousting the previous head, were forced to take immediate action to remove him following a barrage of complaints.
The school was put into special measures last month after a disastrous Ofsted report. Its local council, Croydon, on the recommendation of the Department for Education, arranged for it to be taken over by a body that runs two well performing schools in South London. Mr Tunstall, as executive head of the federation, was brought in to turn Oval Primary around. It is believed the appointment would have boosted his annual pay package to close to £200,000.
In a manoeuvre that shocked the school, he arrived on Thursday, February 17, the morning after the former head teacher, Ruth Johnston, quit. But his tenure was shortlived. The council sacked him before the end of the day on Friday.
One of the children suspended by Mr Tunstall was Callum Simms. The five-year-old, who has special needs, was reprimanded for not lining up quickly enough when asked to by one of his teachers.
His outraged mother, Nikki Simms, said: ‘When I heard from other parents that a number of other kids had been excluded, I did worry for Callum because he has behavioural problems. ‘But he didn’t have a fight or cause a lot of trouble. ‘He’s just a little boy with learning difficulties who didn’t line up in the playground. ‘That he was excluded for something so stupid is unbelievable.’
Another distraught mother, Sarah Ellacott, said her daughter Rachael, seven, came home from school saying pupils had been told to walk with their hands behind their backs as if ‘in prison’. Mrs Ellacott, 27, said: ‘Children were going to school afraid to do anything in case they got suspended. That’s not the way to make children behave.’
Mr Tunstall, who has no children of his own, recently split from his wife Carol, 37, who works for an animal sanctuary.
Until recently he lived in a £500,000 semi-detached red-brick three bedroom house in a residential area in Bromley, Kent – a far cry from the deprived area of Croydon where Oval Primary is located. Mr Tunstall remains the executive head of the Gypsy Hill Federation, which runs two successful primary schools in Lambeth, South London – Kingswood Primary and Elmwood Primary. They have both received outstanding Ofsted reports.
It is Government policy to link failing schools with successful schools in the area. Croydon council leader Mike Fisher yesterday admitted the appointment was a mistake. He said: ‘We apologise for any sort of upset we have caused the parents and that the organisation brought in turned out to be the wrong one – we made a mistake.’
A council spokesman said: ‘We have a strong record of setting up partnerships with schools and have done so successfully in the past. ‘On this occasion it became clear the arrangement would not work and the authority took swift action to resolve it.’
Mr Tunstall, speaking through a friend, refused to comment.
The council is set to announce the appointment of a new head teacher on Monday who is believed to be from a local academy.
Mr Tunstall was revealed to be the eighth highest-paid head in London, earning a salary of £137,991, and a total package of £151,835, last year. The Prime Minister is paid £142,500. Primary school head teachers typically earn around £55,000.
Education Secretary Michael Gove plans to cap head teachers’ pay. It is currently being reviewed by the School Teachers Review Body, which will report in March.
Now FOOTBALLS are “unsafe” in British school playgrounds!
For decades, the nation’s playgrounds have echoed with the thud of a firmly-struck football. But children living in the streets where England football star Steven Gerrard grew up are being denied that innocent, wholesome pleasure – and it’s all in the name of health and safety.
Pupils at a primary school in Huyton, near Liverpool, have been banned from bringing modern synthetic or leather footballs into the playground and told to use balls made of sponge instead.
Teachers say the heavy balls are unsuitable for an enclosed space where young children may be playing, saying it risks injury.
However amid fears over Britain’s childhood obesity epidemic, as well as worries over where our next generation of sporting champions is going to come from, critics last night slammed the edict as an absurd over-reaction.
The rule was spelt out in this month’s newsletter sent out by Malvern Primary School in Huyton, a deprived area with Britain’s second worst obesity record.
The district has nevertheless long been regarded as a hotbed of footballing talent, having produced the likes of Liverpool captain Gerrard in addition to former Everton hero Peter Reid – now manager of Plymouth Argyle – and notorious Newcastle United player Joey Barton.
It informed parents: ‘Please can we request that only sponge balls are brought into school. This is to ensure the safety of all our pupils when on the playground.’
But Tam Fry, chairman of obesity prevention charity the Child Growth Foundation, said: ‘Children must be exposed to risk, otherwise how can they be expected to learn? ‘It may think it is protecting the children, but they could just as easily fall over playing with a sponge ball. ‘Policies like this mean our children are in danger of becoming cocooned cotton buds.’
Critics say it is just the latest obstacle created by political correctness to stand in the way of the exercise and life skills children can gain from taking part in sport.
Last summer a primary school in Devon banned playground football altogether, saying pupils were copying the cheating and fouling displayed at the World Cup.
Shortly afterwards, brothers Henry and Alex Worthington, 12 and 11, were threatened with antisocial behaviour orders by three police officers while having a kickabout in the cul-de-sac where they live in Timperley, Greater Manchester.
Mr Fry added: ‘We do have a litigation culture, but you can’t tell me Steven Gerrard did not play football in the playground – I bet he even fell over a few times.’
And Adrian Voce, director of Play England, which advises schools on safe, fun pastimes, pointed out that last year’s review on health and safety by Lord Young recommended a common sense approach to managing risk in children’s play-times. ‘Research tells us that children need to play adventurously and test themselves, yet many children don’t get the opportunity to do so in our risk-adverse society,’ he said. ‘Children must be allowed to encounter some risks for themselves as a natural part of their play and growing up.’
Knowsley, Huyton’s local district, has among the country’s worst GCSE results, and in 2004 was ranked behind only Hull in a league table of Britain’s fattest towns.
Malvern Primary School yesterday insisted the football crackdown was not new, saying the reminder had been issued after a parent complained that a child was nearly hurt.
It pointed out that its cramped playground was shared by pupils of all ages but stressed it was supportive of sport and backed the importance of physical exercise.
In a statement it added: ‘Malvern Primary School treats the health and safety of its pupils as a top priority and has for a long time had a policy of protecting children by recommending sponge balls in the playground before school starts and during breaks, especially as the playground accommodates children from the age of four to 11.’
British watchdog says electric cars ‘are as dirty as diesel’
Electric cars may portray themselves as ‘zero emissions’ but the overall pollution they generate can be almost as great as a frugal conventional diesel car, consumer watchdogs said today.
Electric cars are a lot more expensive to buy – though they are generally cheaper to run as they plug in for their power from the domestic mains, say experts at Which?
The amount of carbon dioxide – the so-called ‘greenhouse gas’ blamed by scientists for global warming – created to generate the electricity powering an electric car, can be just as great as that created by the internal combustion engine, they say.
The main difference is that while a conventional car’s emissions come out of the vehicle’s exhaust pipe, those created by an electric car are generated at the power station which supplies the electricity.
The findings come as the first ever electric car to pass the European crash test was announced – the Mitsubishi i-MiEVsuper-mini – getting four stars out of a maximum five.
Experts at Which? compared the carbon dioxide created by charging electric cars with that emitted by the most efficient diesel models and concluded:’Sometimes there’s not a great deal of difference.’ And the gap is narrowing as ‘conventional’ cars up their game to cut emissions.
The Which? report noted:’The common manufacturer claim that electric cars produce ‘zero emissions’ ignores the fact that most drivers use a conventional electricity supply to charge them, which has a carbon cost from burning fossil fuels. ‘
To test its theory, Which? looked at three of the first electric cars destined to hit the UK market and put them up against three ‘efficient’ conventional rivals. Experts found, for example, that the electric Smart Fortwo, expected to cost around £21,000, creates an ‘equivalent’ of 84 grams of CO2 per kilometre driven, whereas the £9,540 diesel Smart Fortwo emits 103 grams.
It also compared the Nissan Leaf, the £23,990 electric car, with Volkswagen’s diesel Golf 1.6 TDi Bluemotion costing £16,830. The electric power generated to drive the Leaf is equivalent to CO2 emissions of 81g/km.By contrast, the diesel Golf has CO2 emissions of 108g/km.
Two ‘super-minis’ were also compared. Which? found that the power generated to power the £24,045 Mitsubishi i-MiEV electric car was equivalent to 68g/km. Then similarly sized Suzuki Splash costing £10,410 with a 1.3litre diesel engine has CO2 emissions of 131g/km.
However, electric cars are much ‘greener’ than diesel cars when it comes to localised emissions, as they don’t emit toxic chemicals that degrade air quality. This is especially significant in cities, where the uptake of electric cars is predicted to be highest, says Which? The consumer report concludes:’While we don’t agree with the car makers’ ‘zero emissions’ claims, we can’t knock their efforts to create greener cars.’
Richard Headland, editor, Which? Car, said: ‘We applaud car makers’ efforts to create greener cars – but we don’t agree with their ‘zero emissions’ claims. Until more electricity is produced from renewable sources in the UK, the carbon footprint of driving an electric car may not be as small as owners think.’
The report adds that electric cars are still costly – often more than double the price – despite a £5,000 taxpayer subsidy: ‘Electric cars offer drivers a lower-carbon output and cheaper fuelling costs, but are expensive compared with their traditional counterparts and not as versatile.’
There is also a ‘big question’ over their second hand value as traders will be ‘cautious’. More than seven out of ten (71 per cent) of more than 2,000 Which? members surveyed said there were concerned about the relatively short range of electric cars.
To measure the carbon dioxide created by charging an electric car, Which? followed the advice of the Carbon Trust which states that 544grams of CO2 are emitted per kilowatt hour of electricity used. Which? converted this to an equivalent ‘grams per kilometre’ CO2 rating, to make it easier to compare electric cars with the diesel cars.