17% more special requests for treatment as NHS rations care
Doctors are being forced to make more special requests for treatment for their patients as NHS managers try to cut costs, a new study suggests.
The number of requests for procedures that are not normally funded – including infertility services, weight-loss surgery and drugs to protect against blindness – has increased by 17 per cent over the past two years. At the same time, however, the proportion of such requests being approved has fallen by 22 per cent.
It provides the latest evidence that NHS managers are increasingly rationing treatment in order to balance the books and contain demand, particularly as they come under pressure to make £20billion in efficiency savings by 2015.
Meanwhile David Cameron again came under pressure at Prime Minister’s Questions on the subject of health, with several MPs challenging him on figures showing that hospital waiting times are rising.
The new investigation by GP, a trade journal, looked at the number of “individual patient funding requests” made by family doctors or hospital consultants in recent years. These are made when a clinician believes that their patient needs a particular procedure or drug, but managers at the local Primary Care Trust do not normally fund it even if it is recommended by Nice, the advisory body.
According to the results of responses to Freedom of Information requests by 103 PCTs, the number of requests rose from 53,000 to 62,000 between 2008-09 and 2010-11, an increase of 17 per cent. At the same time, the proportion approved fell from 59 per cent to 46 per cent, a drop of 22 per cent.
Detailed figures disclosed by the PCTs show that as many as a fifth of the requests were for IVF treatment for childless women and about a tenth were for drugs to treat age-related macular degeneration, the leading cause of blindness in the elderly. A further tenth were for bariatric surgery for the obese.
Neil Churchill, the chief executive of Asthma UK, said: “All patients should be entitled to get drugs that Nice has approved and which doctors think would benefit them. It is simply not acceptable if PCTs are restricting drugs in these circumstances and patients feel they have to campaign for funding.”
Susan Seenan, of the patient group Infertility Network UK, said: “Refusing to fund treatment for couples suffering from infertility flies in the face of good clinical guidance and it is high time that PCTs realised the impact which infertility has on patients.”
Professor Sir Bruce Keogh, NHS Medical Director, said: “Decisions on the appropriate treatments should be made by clinicians in the local NHS in line with NICE guidance. We are working with the Colleges and surgical specialty associations to identify what effective operations the NHS should purchase and which ineffective procedures we should be withdrawing from. This provides the opportunity to direct taxpayers’ money towards effective rather than ineffective treatments.”
In the Commons, Ed Miliband, the Labour leader, asked why waiting times for treatment and in A&E were rising and blamed it on the controversial plans to reform the NHS. “One of the reasons why waiting times have gone up is because you’re diverting billions of pounds away from patient care into this costly reorganisation.”
Mr Cameron replied: “That’s simply not the case. If you look at outpatient waiting times they actually fell in the last month so you’re simply wrong about that, as you usually are.”
After John Healey, Labour’s shadow health secretary, claimed the NHS is starting to “go backwards”, Andrew Lansley, the Health Secretary, wrote back to say: “I take exception to this statement, and would caution you against talking the NHS down in this way.”
McDonalds to the rescue
When Suzanne Franklin fell pregnant, she was at a loss as to how she would eat for two. The 23-year-old had suffered from extreme food allergies for year from eggs to dairy and fruit and vegetables.
Doctors warned her that pregnancy would make the symptoms worse but that antihistamines could harm her baby.
But Ms Franklin knew she wasn’t allergic to McDonald’s burgers – so she ate a Big Mac burger everyday throughout her pregnancy. Any worries about her unusual diet affecting her baby’s growth were unfounded – as she has given birth to her own 10Ib 2oz whopper.
Miss Franklin said: ‘All those burgers definitely didn’t do him any harm. It was the only thing I could eat safely during my pregnancy, so I just lived on them. ‘When Harry was born and the doctors told me that he weighed over 10Ib’s I just couldn’t believe it. ‘I was worried that I wasn’t getting enough nutrients for me and the baby – but Harry definitely proved that wrong.
‘The doctor who scanned me at 20 weeks told me that I must be doing something right as he was so big and healthy – but I never expected him to be that big and neither did they. The doctors expected him to be around 8Ibs.’
Miss Franklin, who lives with partner Paul Wilson, 27, a dental technician, in Dudley, West Midlands, has suffered from extreme food allergies since she was two-years-old. She said: ‘I ate a chocolate covered peanut when I was two years old and it sent my body into anaphylactic shock and I had to be rushed straight to hospital. Doctors told my parents I was lucky to be alive.’
Miss Franklin was diagnosed with a severe nut allergy and she had to carry an adrenaline pen around with her at all times.
But it wasn’t until she was 15 that her allergies became more extreme. She ate a kiwi fruit and her throat closed up, leaving her unable to breathe. She said: ‘I couldn’t breathe, but luckily mum could see what was happening to me and she called an ambulance straight away.
‘But then a week later the same thing happened when I was eating a strawberry and tests showed that I was allergic to eggs, tea, alcohol, rice, oils, fish, and all fruit and vegetables.
‘I became absolutely terrified of eating, as I just seemed to be allergic to everything. For weeks I just lived on bread and water, and I dropped two stone in weight.’
But Miss Franklin discovered she could eat Big Mac burgers – without cheese or salad, so she began to eat them most days.
She was so allergic to other foods that she had to cook dinner separately from her partner and store all her food in airtight containers in the fridge.
She said: ‘I was just desperate to keep eating so that the baby could grow, so I just forced down burger after burger each day.
‘Paul would eat a salad, and I would just look on enviously. The lack of nutrients in my diet meant that I picked up one cold after another, but I was advised not to take any multivitamins in case they triggered an allergic reaction too.
‘I wondered if eating so many burgers would affect the baby, but luckily my 20 week scan showed that the baby was developing fine. It was such a relief.’
By the time Miss Franklin went into labour on Christmas Day, she had gained four stone. She said: ‘My bump had just kept growing and growing – Paul kept joking that it was all the Big Mac’s I was eating.’
Harry was born at Russells Hall Hospital in Dudley, weighing a whopping 10Ib2. Miss Franklin added: ‘I just couldn’t believe it when the doctors told me what he weighed.’
Baby Harry is now three months old – and he has shown signs of inheriting Miss Franklin’s allergies too. He is already allergic to seven different types of milk.
She said: ‘I had hoped that Harry wouldn’t be allergic to all the foods that I am, but it looks as though he may have inherited some of them. But at least he won’t be allergic to burgers.’
Fewer British pupils in private schools as fees rise
Fewer children are being sent to independent schools after average fees climbed above £13,000 for the first time, it emerged today.
Figures show the number of pupils in private education dropped for the third year in a row as fee rises outstripped increases in earnings.
Data from the Independent Schools Council shows the average parent is being forced to pay £13,179 in annual fees this year – a 4.6 per cent increase in 12 months. More families also need help to cover the cost of private education.
The price hike could be fuelling a drop in overall enrolments among families already reeling from the recession and the Coalition’s austerity drive. Figures revealed a 0.5 per cent fall in British children this year, although the number of pupils from overseas jumped sharply.
Last night, school leaders insisted the figures – published as part of an annual census – represented a “good result” for the private sector in the face of a huge squeeze in family income.
They said fee rises were kept to their second lowest level in 17 years as they made “significant cutbacks” to building programmes to ease the financial blow for parents. It was also claimed that the overall drop in pupil numbers was not as severe as the fall witnessed during the last recession in the early 90s.
This suggests many parents are still reluctant to pull children out of private education in favour of state schools after 13 years of Labour.
David Lyscom, ISC chief executive, said: “ISC independent schools are showing remarkable resilience against a difficult economic background, reflecting the high quality of education that our schools offer to parents, and the value for money that this represents.”
The ISC said 1,228 schools completed its census in 2010 and 2011. Among these schools, like-for-like pupil numbers dropped by 0.2 per cent to 505,368, although the fall in British pupils was 0.5 per cent.
Overall, there were 506,500 children in 1,234 schools affiliated to the ISC. Figures also showed:
* Some 14 schools linked to the ISC closed in the last 12 months – double the number a year earlier;
* The number of pupils coming from abroad increased by 5.5 per cent, with 24,554 foreign children now in British independent schools;
* Foreign pupils make up almost 4.9 per cent of places, compared with 4.5 per cent a year earlier, with China, Hong Kong and Germany sending the most;
* The average annual fee increased from £12,558 to £13,179, while day fees rose from £10,713 to £11,208 and boarding costs increased from £24,009 to £25,152;
* In total, some 25 schools charged more than £30,000 in fees;
* A third of pupils are now eligible for fee assistance – a rise of 2.2 per cent – with schools spending £260m on means-tested bursaries.
Mr Lyscom said the rise in the number of poor pupils admitted to ISC schools suggested the Government’s university admissions policy – which appears to prioritise those from state schools – was misguided.
“The fact that over £250 million is now being paid by our schools to children who need financial support must make the Government think carefully about its approach to university admissions,” he said. “It would be very wrong to discriminate against these pupils when they apply to university just because they went to a particular type of school. Our schools help promote social mobility; our statistics show how socially diverse they may be.”
Behaviour “not good enough” at one in five secondaries
Even by Britain’s low standards
More than 550 secondary schools in England are failing to ensure a good level of order in classrooms, amid concerns teachers do not have the power to control pupils.
In some areas behaviour fell below targets in 75 per cent of secondaries, according to the latest data compiled by Ofsted, the schools inspectorate.
Teachers have warned MPs that the level of discipline in schools is worse than official estimates because head teachers cheat inspectors by suspending unruly pupils or bringing in supply teachers during their visits.
A separate report to be published this week by the National Association of Head Teachers will say the conduct of pupils’ families is little better, with one in ten head teachers having been assaulted by a parent or carer in the past five years.
The figures released by Ofsted showed that 82 per cent of secondaries across the country had good or outstanding behaviour – the top two levels of a four-point scale – a slight rise on last year’s 79 per cent.
But the statistics showed there is a need for improvement in 18 per cent of secondaries, and that in areas such as Kingston-upon-Hull and Knowsley, Merseyside, discipline at just one in four schools was rated good or better.
Last week the NASUWT union accused heads of brushing low-level bad behaviour under the carpet instead of doling out punishments for fear of attracting greater scrutiny from parents, governors and local authorities.
Earlier this month staff at a school in Lancashire were reduced to a walkout over pupil indiscipline.
The government has pledged to hand teachers more authority by allowing them to search pupils for banned items, give teachers anonymity when facing allegations of misconduct and remove the need for schools to give 24 hours’ notice of detentions.
There is also concern about the danger posed to heads by aggressive parents, often resulting when a pupil is excluded from school.
Later this week the National Association of Head Teachers will claim as many as ten per cent of heads have been attacked by parents, including cases of victims being hit with chairs and subjected to serious kicking attacks.
Nick Gibb, the schools minister said: “We remain concerned that nearly 1 in 5 secondary schools behaviour is judged as being no better than satisfactory … We support teachers to tackle poor behaviour in our schools because until we deal with the persistent low level disruption prevalent in too many classrooms, we will not see the rise in academic standards demanded by parents.”
A Department for Education spokesperson added that there was no excuse for aggressive behaviour towards school staff.
An Ofsted spokesperson said: “Schools receive no more than two days notice of an inspection. This means it is easier for inspectors to see schools as they really are. There is very little evidence that schools try to mislead Ofsted, and even for those that may wish to they do not have time to make arrangements which might mislead inspectors about standards of behaviour.”
British political correctness allows Indian woman to work only a quarter of the days she was paid for
A woman police constable who took 848 sick days in six years resigned less than a week before she could have been sacked for misconduct. Hina Parekh, 43, made just 11 arrests in her career.
The Hindu WPC, who was born in India, claimed racist abuse and bullying in the Metropolitan Police was making her unwell and was signed off with depression and stress.
But her bosses said she was failing to pull her weight after only turning up to work on 292 days out of a potential 1,140, and put her on a ‘performance improvement’ regime.
Hinah Parekh, 43, claimed that racist abuse from fellow police officers was making her unwell and signed off with depression and stress. She managed an average of only five shifts a month from her job at Belgravia police station in Central London.
However she did not take her case to an employment tribunal and senior officers finally launched disciplinary proceedings. They found that she had worked 327 days out of a potential 1,175 since 2006. Ms Parekh then resigned before she could be sacked.
A Metropolitan Police spokesman today confirmed that Ms Parekh left the police after she learned she faced disciplinary proceedings for unsatisfactory attendance.
He said: ‘A police constable from Westminster borough who had been subject to unsatisfactory performance and attendance proceedings, resigned from service during the past 12 months.’
Reports suggest that senior officers did not act sooner because they feared they would become embroiled in a damaging race row.
Peter Smyth, chairman of the Metropolitan Police Federation said Ms Parekh’s case should have gone through a process within the force to establish whether she was suitable for sick pay. He said: ‘What should have happened after six months is she should have been considered for half pay, then after 12 months go on no pay.
‘Her immediate line manager would be responsible for this, then it goes up a chain. ‘There is an appeals process as well.
A ‘Royal Wedding’ the Victorians might approve of
I am not sure how much interest the Royal wedding today is attracting in the USA but the TV audience is expected to be 2 billion so I thought the backgrounder from Australia below may be of some interest. Australia is a monarchy too, of course, and Prince William will be Australia’s monarch in due course
The last princess whose wedding I watched on telly ended up dying in car crash in Paris. So for Catherine Middleton’s sake, I won’t be tuning in to the Royal Wedding in London tonight.
However, there is much to interest those who are concerned not with dresses and fairytales but with the future of an important institution. For on the fate of Prince William’s marriage could rest the future of the British Crown.
Whatever one’s feelings about the monarchy, for a long time the royal family was respected as a good role model. This is because since the mid-nineteenth century the House of Windsor, nee Saxe-Coburg and Gotha, self-consciously promoted itself as a typical, traditional British family.
When Victoria became Queen, the British Crown, together with the rest of aristocracy, had a reputation for excess to rival their counterparts in pre-revolutionary France. To build the esteem of the monarchy, Victoria and her politically astute husband, Prince Albert, tied its fortunes to the rising force in British society.
The royals won favour with the masses by aping the respectable social values of ‘moral middle class,’ which the Industrial Revolution and Protestant religion summoned into existence. Out went debauchery and in came ideals such as duty to family and nation.
Queen Elizabeth is rightly held in high regard (even among Australian republicans) because, in word and deed, she has continued to model the exemplary behaviour expected of royalty. However, the reputation of the monarchy has been tarnished in recent years, mainly due to the breakdown of the marriages of both the queen’s sons.
One hundred and fifty years of PR was destroyed when Diana gave an unprecedented television interview in the mid-1990s and told the world about confronting Charles over his straying ways. Charles’ insouciant response – ‘Do you seriously expect me to be the first Prince of Wales in history not to have a mistress?’ – was hardly the prerogative of a modern-day British king-in-waiting.
This might have sufficed in more deferential times when the media ignored royal indiscretions. But in this intrusive age, exposing the gap between private acts and the public image exposed the Crown to ridicule and charges of hypocrisy. This is ironic given the permissive attitudes to personal morality that otherwise prevail today. Contemporary society expects royalty to model values that the rest of society is free to disregard!
Nevertheless, one senses that Prince William has grasped the double standard and understands that the monarchy would struggle to survive another scandalous divorce.
Having realised he will be held to the high standards of the past (and keen not to repeat the heartache of his parents), William appears determined to have a ‘Royal Wedding’ in the conventional Victorian senses of both those terms. After a long courtship that included a shared university education, it seems he is marrying for life a woman he loves and respects.
I guess this is a fairytale of sorts. But if ‘Will and Kate’ can use their long and happy marriage to help shore up the foundations of the monarchy, their political achievement will rival that of their famous ancestors ‘Vicki and Bert.’
The above is a press release from the Centre for Independent Studies, dated 29 April. Enquiries to firstname.lastname@example.org. Snail mail: PO Box 92, St Leonards, NSW, Australia 1590.
Horror! British Prime Minister calls woman “Dear”
Above is the lesbian person whom he called “Dear”. I think he deserves a medal for politeness beyond the call of duty.
David Cameron was last night facing accusations of sexism and calls to apologise after he told a shadow minister to ‘calm down, dear’ during Prime Minister’s Questions.
Senior Labour politicians reacted furiously to the throwaway remark – mimicking a car insurance advert starring Michael Winner – which came in response to noisy heckles from frontbencher Angela Eagle.
The party’s deputy leader Harriet Harman accused Mr Cameron of an ‘outdated and sexist attitude to women’ and a senior Labour source said: ‘He should certainly apologise.’
The row blew up after Miss Eagle, Parliament’s most prominent lesbian MP, interjected as the Prime Minister defended the Coalition’s plans to reform the NHS, arguing they were backed even by former Labour MP Howard Stoate, a practising GP.
The Wallasey MP shouted that Dr Stoate stood down at last year’s election, rather than being defeated as the PM claimed.
In response, the Prime Minister told Miss Eagle: ‘Calm down, dear, calm down. Calm down and listen to the doctor.’