More NHS hospitals face financial difficulties and mergers
More leading NHS hospitals face financial difficulties and the threat of mergers, the head of the watchdog for the sector has warned. Dr David Bennett, the chairman of Monitor, also warned that his own senior staff are “particularly stretched” as they try to prepare for the Government’s “significant” reforms to the health sector.
His comments come as a former adviser to the Department of Health warns that the controversial reorganisation could see GPs fined for breaking competition law if they do not allow private firms to provide services.
And despite David Cameron’s attempt to salvage the widely-criticised Health and Social Care Bill, by giving the public and the medical profession a fresh opportunity to suggest improvements, a senior Church of England bishop has become the latest high-profile critic of the Government’s methods.
The Rt Rev Nick Baines, the new Bishop of Bradford, wrote that the proposals had “not been properly thought through” while their implementation was a “mess” that had seen “ideologically driven” ministers “patronising” their opponents.
In the latest sign that even leading officials within the health sector are concerned at the scale of the changes, coming at a time when the NHS has to save £20billion in three years, the new Business Plan published by Monitor contains a series of warnings.
A foreword written by Dr Bennett, a former chief policy adviser to Tony Blair, states that the regulator for financially independent Foundation Trust hospitals “supports the Government’s proposals to move to a more devolved system for the NHS”.
But he goes on to say there is a “great deal of work to be done” as Monitor prepares to become the economic regulator in the new regime, and its workload has “led to pressure on resources” that has meant “senior staff are particularly stretched”.
Meanwhile “there may also be an increase in those [hospitals] facing financial difficulties”, as they deal with a “significant productivity challenge”, and in time “weaker NHS trusts [will] seek to merge with established foundation trusts”.
The report itself says “pressure continues to mount on both management capacity and financial viability as expectations and demand continue to rise and finances become more constrained”.
Under the new regime Monitor will be given the similar powers to the Office of Fair Trading and will ensure that GPs, who will be given control of an £80billion budget to commission treatment, consider private, state-run and voluntary-sector hospitals.
In a paper published online by the BMJ, Dr Rupert Dunbar-Rees, a qualified GP who worked as an adviser on procurement to the Department of Health for three years, and Robert McGough, a solicitor, state that the reforms “further open up the NHS to EU competition law”.
The new GP-led commissioning bodies will have to put out to tender contracts for goods and services, such as management support, and face fines and damages if a court rules that their deals have been unfair.
In purchasing treatment, “commissioners will have to be careful not to prejudice the principles of fairness and transparency by favouring a provider whose staff has given advice”. Some medics claim this will mean fragmenting care for patients, as GPs will be fearful of discussing treatment with NHS hospital staff in case they are accused of colluding.
In written evidence to the Health Select Committee, Andrew Lansley, the Health Secretary, has insisted that commissioners will not face fines from Monitor.
He said: “Monitor would have power to investigate potential breaches of the regulations, either on its own initiative or in response to complaints. Monitor would be able to require commissioners to take action to prevent or remedy a breach of the regulations, including, potentially, by setting-aside a contract where due process had not been followed. However, Monitor would have no power to impose fines on commissioners, as was discussed by the Committee.”
In another development, the King’s Fund – a leading health think-tank – has published the results of a simulation exercise it carried out into the reformed NHS.
Researchers playing the parts of key bodies in the new system found that GPs were “overwhelmed” by their workload and struggled with the financial management tasks they were required to carry out, with the challenges likened to “building a plane while learning to fly it”.
Flood of Tunisians headed for Britain
A flood of refugees from war in Tunisia has arrived in Italy, and Italy has now decided what to do with them, as we see below. Italy will give them permits that will allow them to go anywhere within the Schengen area. Guess one place that is in the Schengen area? Calais! The rest follows. Britain might even accept them legally. Good for Britain’s Mosques but not much else in Britain
Italy and Tunisia have signed an accord on handling the immigration emergency. The accord was signed in Tunis by Interior Minister Maroni after lengthy negotiations with the local authorities. Maroni explained that this was “a bilateral technical cooperation accord to counter illegal immigration and to strengthen collaboration between the two countries’ police forces; repatiations are also envisaged”.
In order to monitor application of the accord, the government has set up an interministerial contact group, which includes, in addition to the Presidency of the Council, the Ministers of Foreign Affairs, the Interior, Defence, Infrastructure and Transport, Economic Development and Labour and Social Policies, with coordination by the Office of the Diplomatic Advisor to the President of the Council.
The accord was illustrated by Berlusconi and Maroni today at Palazzo Chigi in a meeting of the “director’s booth” set up by the government, regions and local bodies, at which a government strategy was drafted for the difficult management of the 25,800 persons thus far landed, of which 2,300 are actually refugees fleeing Libya, and the reminder Tunisians.
Reporting to the Lower House, Maroni said that a decree would be signed today on temporary permits for immigrants arriving in Italy that would allow them to circulate throughout the Schengen area. The Interior Minister will be meeting tomorrow with his French counterpart to outline a common intervention system, and will be in Brussels on Monday to request activation of the provisions of EU Directive 55/2001 on temporary protection, which would allow any willing Union Member to take in a share of the immigrants, even after their arrival in Italy.
The theme of immigration will be among the items on the agenda of a summit meeting on 26 April in Rome between Silvio Berlusconi and French President Nicolas Sarkozy.
Don’t be nasty to criminals! Knife thug walks free because British judge was rude to him
A thug has walked free from court after his conviction for knife possession was overturned because the trial judge was ‘rude’ to him. Koenya Tedjame-Mortty, 32, had been found guilty by a jury after being caught by police driving around London armed with knives.
But in a decision that has caused outrage, judges at the Court of Appeal quashed the conviction on the basis that the judge in his case was ‘rude, harsh and sarcastic’, leaving the villain too ‘unsettled’ to give ‘credible evidence’ in his own defence.
During his trial at Kingston Crown Court last year, Judge Fergus Mitchell reprimanded the career criminal for intimidating a boy doing work experience at the hearing.
The judge told him to ‘shut his mouth and listen’, asking him how dare he speak to the boy, who had complained of being accosted outside court and being stared at in an ‘unpleasant and threatening manner’.
The circuit judge, who summoned the defendant before him to investigate a possible contempt of court, also threatened to revoke his bail shortly before he was called to give evidence in his defence.
At the end of a short trial, the thug was found guilty of two counts of possession of a bladed article after the jury heard he had been driving the car with a kitchen knife and a craft knife in the back.
He was handed a seven-month suspended sentence and ordered to carry out 100 hours of unpaid community work on November 19. But Tedjame-Mortty immediately appealed, saying the exchange with the judge had left him feeling ‘anxious and shaken’.
This week, three Court of Appeal judges agreed with him, saying they could not rule out the possibility the ‘quality’ of his evidence was affected by Judge Mitchell’s ‘wholly inappropriate’ intervention. ‘We do not think that we can safely exclude the possibility that he may have given his evidence less credibly than he would have done if the judge had dealt with the matter appropriately. ‘There is no reason why a reprimand in a measured tone at the end of the day would not have been sufficient.
‘We do not want this judgment to be regarded as requiring judges to treat defendants with kid gloves before they give evidence. ‘The difference in this case is that the quality of the defendant’s evidence could have been affected by the conduct on the part of the judge, which was wholly inappropriate’
Mr Justice Keith castigated Judge Mitchell for raising his voice, using an ‘unpleasant tone’ and being ‘rude, harsh and sarcastic’ to the serial offender, who has a string of convictions for drink-driving, among other offences.
The landmark ruling has appalled MPs and former home secretaries who fear it will set a dangerous precedent, forcing the judiciary to ‘bow and scrape to career criminals’.
Last night there were mounting calls for the extraordinary decision to be reversed at the Supreme Court after appeal judges rejected requests by the Crown Prosecution Service for a re-trial.
The perverse case comes on the back of a contentious declaration this week by leading Appeal Court justices who said victims of crime should have no say over what happens to criminals, as some just want revenge.
Yesterday former home secretary David Blunkett said the decision sent an alarming message about attitudes to knife crime. He told the Daily Mail: ‘It is astonishing that the appeal judges did not agree to a mistrial, which would have allowed the case to be re-heard, rather than overturning the conviction.
‘Whatever the harsh treatment by the original judge, the defendant clearly had a case to answer and in the interests of justice and, in particular, the avoidance of the wrong sort of messages getting out on carrying knives, the Crown Prosecution Service was right to ask for the trial to be re-run. ‘The public do begin to wonder whose side the law is on.’
David Green, of think-tank Civitas, said the case had set a dangerous precedent for the judiciary. ‘It’s accepted that judges have to have a judicial temperament. They have to manage the proceedings and if someone is intimidating a young boy, it’s their duty to say something about it.’
The £650m apology: Forget Britain’s own ailing education system, that’s what Britain’s giving to Pakistani schools
David Cameron vowed to hand hundreds of millions of pounds of taxpayers’ money plus vital military secrets to Pakistan yesterday to make amends for offending the Muslim nation last year. The Prime Minister pledged to invest £650million in Pakistani schools at a time when the education budget at home is being cut.
Britain is also to give highly sensitive military technology to combat roadside bombs to the Pakistani security services, which are widely blamed for funding and arming the Taliban.
In a huge gamble with the lives of British troops in Afghanistan, Mr Cameron agreed to spend millions more on a centre of excellence for the country’s soldiers and spies near Peshawar, a hotbed of militancy.
The gesture came after Mr Cameron sparked a diplomatic rift last year when he accused the country of ‘looking both ways’ on terrorism.
The technology deal sparked fears that the Pakistani intelligence service, the ISI, would hand details to the Taliban, enabling them to build more effective improvised explosive devices (IEDs).
The huge cash injection for schools by the Department for International Development will make Pakistan the UK’s biggest recipient of overseas aid.
It is designed to get four million children into the classroom – 17million currently get no schooling. Pakistan spends just 1.5 per cent of its national income on schools but is placing billion-pound orders for six Chinese submarines and 36 fighter aircraft.
The UK will have no control of the curriculum in schools receiving funding, meaning taxpayers could see their money pumped into madrassas peddling extremism.
Mr Cameron defended the payments, saying it was ‘in our interest’ to help Pakistan. He said: ‘If Pakistan is a success we’ll have a good friend to trade and invest and deal with. ‘If we fail we’ll have all the problems of migration, of extremism, problems that we don’t want to see. So it’s in our interest that Pakistan succeeds.’
Pakistan’s Prime Minister Yusuf Raza Gilani said he believed a ‘root cause’ of terrorism was illiteracy.
But Tory MP Philip Davies said: ‘Particularly at the moment when we’ve got no money, there’s absolutely no justification for increasing the amounts that we give to other countries. ‘That is especially the case with countries that can afford to spend billions on defence. If they can afford submarines they can afford to educate their own people. ‘We need to concern ourselves with our own schools because countries around the world are overtaking us in educational attainment.’
In a speech to university students, Mr Cameron vowed to get over the ‘tensions’ sparked by his comments last year and create a ‘new start’ in relations with Pakistan. But he also said Pakistan had to raise taxes and stamp out corruption to justify British generosity. ‘Understandably, the British people want to know every penny we spend is going to the right places.
‘I need to convince them that it is. But my job is made more difficult when people in Britain look at Pakistan, a country that receives millions of pounds of our aid money, and see weaknesses in terms of government capacity and waste.’
Mr Cameron, who was accompanied on his one-day visit by Tory party chairman Baroness Warsi, who is of Pakistani origin, ducked questions about whether he could guarantee that the ISI will not hand the anti-IED technology to the Taliban.
Britain’s Labour Party government put mediocrity ahead of bright children
Labour institutionalised mediocrity in schools by encouraging teachers to neglect capable pupils, according to an analysis of GCSE results. Teachers focused their attention on bumping-up pupils from a grade D to a C in order to improve their ranking in school league tables.
Meanwhile those youngsters who were considered bright enough to get a grade B or higher at GCSE have been neglected. And those at the bottom of the pile – who would take too much work to get to grade C – have been consigned to the scrap heap, according to research by the think tank Policy Exchange.
The analysis of GCSE grades from 2000 to 2009 shows the proportion of pupils getting A*, A and B grades has remained static while the number achieving a C grade has soared by 25 per cent. This is the first time the practice, which has become so ingrained that it is even incorporated in teachers’ manuals, has been illustrated in an authoritative study of GCSE results.
One manual reminds maths teachers: ‘Students who achieve a GCSE grade C or above in mathematics help to boost the school’s statistics and so show the school in a better light for Ofsted and for league tables.’ As a result schools have failed to help hundreds of thousands of bright pupils better their chances in life, the report suggests.
Professor Deborah Eyre, author of the study, said: ‘Children who try harder do better. But because of a fear of appearing “elitist”, pupils are not being encouraged to put in the effort which will bring about excellence. ‘We need an approach which will recognise and nurture signs of high performance in every subject – both academic and vocational. ‘There are many more pupils capable of high performance than we currently recognise.’
Schools watchdog Ofsted has found that some 46 per cent of students do not feel they are intellectually challenged at school.
James Groves, of Policy Exchange, added: ‘Schools need a focus on high achievement. If we are to produce enough skilled adults who will be able to compete in a vastly tougher global economy, then we cannot afford to waste any potential at all. ‘Just being able to master basic skills is no longer enough. We need a workforce that can take on anyone in the world and beat them.’
A lot of hot air: Wind farms ‘working at just 21% of capacity’
Britain’s wind farms produce far less electricity than their supporters claim – and cannot be relied upon to keep the lights on, a study from a conservation charity showed yesterday.
A damning report from the John Muir Trust found the UK’s heavily subsidised wind farms were working at just 21 per cent of capacity last year. Yet the renewable energy industry claims their turbines work at 28 to 30 per cent efficiency on average.
The Trust also found that for extended periods all the UK’s wind turbines linked to the National Grid muster less than 20 megawatts of energy at a given point, enough power for fewer than 7,000 households to boil their kettles.
Stuart Young, author of the report, said: ‘Over the two-year period studied, the wind farms in the UK consistently generated far less energy than wind proponents claim is typical. ‘Sadly, wind power is not what it’s cracked up to be and cannot contribute greatly to energy security in the UK.’
The UK has more than 3,100 working wind turbines. According to the wind industry, they are capable of generating more than 5.2 gigawatts of electricity – enough for nearly three million homes. Another 10,000 are planned for the next decade to meet EU climate change targets.
The report covered the output of around half of the UK’s turbines. The rest supply local grids and their output is not included in day by day figures.
Industry body RenewableUK said the report was incomplete. It said onshore wind farms worked at 27.6 per cent capacity between 2006 and 2009 and offshore at 31.1 per cent.