Yes, most are still angels. But why is Britain now producing nurses without a scintilla of compassion?
Easy answer: Britain did NOT produce many of the worst ones. The NHS workforce in now substantially overseas-born, with charmers like Nigerians Biobelemoye Toby and Daniel Ubani
Yet again, a report has shown that care for the elderly in our NHS hospitals is shamingly bad. The revelations are appalling: old people lying in agony in their own waste and suffering from dehydration because no one has thought to give them water to drink.
We might consider this to be a problem with the National Health Service, which, obviously, on one level it is. Much more disturbing, however, is what it says about us as a nation.
After more than 60 years with a welfare state and a National Health Service, we live in a Britain whose nurses do not have the ordinary instincts of human kindness.
A generation ago, the cliché about our hospitals was that though they might be underfunded or inefficient, the nurses were angels. Now, when an elderly relative goes into hospital, our primary dread is that they won’t be cared for adequately.
We fear for them, as we would fear for a child going to a rough school. We are afraid that when we have left our father or mother behind in the ward, frail and too weak to help themselves, they will be neglected and bullied.
Of course — and this needs to be stressed — there are many wonderful, dedicated nurses in the NHS who still work tremendously hard to look after their patients under intensely demanding circumstances. But it seems they are decreasing in number.
Proof of this came in the Care Quality Commission report this week. It inspected 12 hospitals which it believes to be ‘fairly representative’ of the NHS. In three of them, it found inadequate assistance given to patients who struggle to eat, no assessment of nutritional needs and nurses failing to give basic care.
Sad to say, we have all experienced it. A relative of mine, aged over 90, lay quite recently in the cancer ward in Charing Cross Hospital in London, ignored by nurses despite our going repeatedly to the ‘desk’ to beg them to come and help him to the loo.
The nurses then coarsely complained when he soiled the bed. But he could not move without assistance and he had made every attempt to get help.
In a recent article in the Mail, Woman’s Hour presenter Jenni Murray wrote: ‘I can’t be the only son or daughter to have walked up to the nurses’ station to find a little group gossiping about boyfriends, or to be faced with a look that says, “Yuk! I didn’t go to university to wipe someone’s bum” when you’ve asked politely for your mother to be helped to the toilet.’
Michelle Mitchell, of Age Concern, said, after another recent damning report, this time from the Health Service Ombudsman: ‘The inhumane treatment of older people described in this report is sickening and should send shockwaves through the NHS and government.
‘It’s difficult to imagine us allowing any other group of people to suffer this indignity and neglect, yet we know this is just the tip of the iceberg; appalling treatment of older people in the Health Service is far too common.’
What sort of a country have we become? What sort of people are they who opt to become nurses, and who would rather stand round at the ‘station’, totally disregarding the needs of the vulnerable people in their care? Does this not signal an extraordinary moral dislocation in society itself?
A reverence for age and a feeling that we should care for the vulnerable in our midst is, surely, something which should be taken for granted in a civilised society.
In modern Britain the opposite seems to be the case. A growing number of old people in our midst face the horrifying prospect of being nursed by those who have no instincts of kindness or common sense.
The Royal College of Nursing has decreed that anyone working as a hospital nurse now needs a degree. The graduates of those academic courses presumably know more about pharmaceuticals than the nurses of yore. But too many of them have not learned basic human decency.
They do not understand that a dignified old person, who hates the humiliation of being immobile, wants to be helped to the lavatory; or, if that is not possible, such a person wants to be helped to a bed-pan in as swift, discreet and good-humoured a manner as possible, not left to lie in their own filth.
The modern nurses may have a degree and be able to put letters after their names, but a number of them apparently do not know that a sick person lying in bed needs to have a glass of water. Such is the prevalence of this failing among nurses that doctors have taken to prescribing water to patients just to keep them hydrated.
We can point to fairly obvious differences between hospitals in the old days, when the National Health Service was first set up, and the hospitals of today. And in all fairness to the hospitals of today, let us all acknowledge that the advances in medicine have been miraculous — even if they have become one of the reasons for the current crisis in care.
For they have allowed people to live longer, so that there are more old people now than could ever have been envisaged by Nye Bevan and the founding fathers and mothers of the NHS.
Of course nursing the elderly is not easy, but that does not explain why, where old hospitals in the fairly recent past were always scrupulously clean, now are too often filthy.
Hospitals were once staffed by nurses whom everyone regarded with respect. Now, too often, they are staffed with nurses whom many of the patients dread because of their bad manners and lack of compassion.
This is partly because the old hospitals were dominated by the matrons and ward sisters, who kept the places spotless and instilled in their trainee nurses a sense of discipline and dedication. Now things are very different.
There are more (grossly overpaid) ‘hospital administrators’ than there are nurses.
One is tempted to say – sack all the administrators now and put the hospitals solely in charge of nurses and sisters. But that would not be the whole solution. As an in-patient, once you are lucky enough to be moved from a trolley on to a ward, you surely should be able to expect a standard of compassion and expert care from the nurses.
Time and again, reports tell us that this is no longer available. Why not? It is not just because the hospitals are poorly administered. It is because far too many young people who have entered the nursing profession seem somehow to have grown up lacking a fundamental compassion which should be innate in every human being, let alone someone going into nursing.
Politicians continue to mouth platitudes about the NHS, and how much we must treasure it, and how much they wish to improve it. But no health service trying to look after an ageing population as large as ours can hope to succeed if we have nurses who lack basic instincts of kindness.
So, we have yet another dismaying report on the condition of the NHS and the appalling treatment of the elderly in hospital wards.
We can hope that the report will lead to improvements, here and there, in the way that certain wards have been run. But the really damning thing about the latest revelations is not what they tell us about the NHS. It is what they tell us about the people working within it.
I repeat, the majority of nurses are dedicated and compassionate. But how do you teach instinctive decency to the growing number of heartless individuals who seem, for whatever reason, to join the nursing profession?
NHS lets 4,500 patients leave hospital emaciated in a year
Nearly 4,500 patients were discharged from hospital last year severely malnourished. An average of 12 a day were allowed to leave wards desperately emaciated – the highest number on record.
Most were elderly patients who were too frail to feed themselves and regularly missed meals because hospital staff were too busy to help them eat.
The number discharged from hospital severely malnourished – suffering from illnesses associated with famines in poor countries – has doubled in four years.
A total of 4,412 were discharged with malnutrition last year, compared with 2,265 in 2005/6 and 2,883 in 2006/7. In the past year alone the figure has increased by a fifth, with 3,633 having left hospital with malnutrition in 2008/9.
Only yesterday a report disclosed that doctors in some hospitals have resorted to prescribing patients drinking water just to ensure they do not go thirsty.
The Care Quality Commission watchdog found that a quarter of hospitals were neglecting the elderly to such an extent they were breaking the law.
Meals are routinely dumped in front of sleeping patients only to be taken away cold and untouched. On some wards the frail and confused are left to pick up food with their hands because nurses are too busy to help feed them.
Figures from the NHS Information Centre show that hundreds of thousands are leaving hospital desperately underweight or suffering some form of nutritional deficiency putting them at risk of illness.
Those with malnutrition have illnesses such as kwashiorkor, where the stomach swells up due to lack of protein, or marasmus, where muscles waste away. Both conditions are more commonly seen in famines in Africa.
Another 210,476 were discharged with anaemia – lacking crucial vitamins and minerals to protect against illnesses. But these figures probably represent only a fraction of cases as many will not be recorded.
Michelle Mitchell, of Age UK, said: ‘It is extremely worrying that the number of patients reported as being discharged from hospital malnourished is up. ‘This figure will represent the minimum number of people being discharged with many others going unreported. Being well fed and hydrated is a basic level of care all patients should expect to receive and these figures highlight the scale of this problem.
Recognition of the issue is high but not enough is being done to transfer words into action on the wards.’
It is very difficult to establish how many people become malnourished in hospitals because many patients are not properly checked for signs of it when they are admitted.
Some elderly patients may be very underweight when they are admitted, especially if they have spent long periods in hospital or have been brought in from a care home.
Over the next few months the care commission will be naming and shaming the hospitals which are failing to ensure the elderly are fed or properly cared for. Those not up to scratch could face fines unless they improve.
Mugabe torturer is given asylum in Britain… and yes it’s in case he’s tortured back in Zimbabwe
A thug who carried out horrific acts of torture for Zimbabwean dictator Robert Mugabe has been allowed to live in Britain – to protect his human rights.
An immigration tribunal found Phillip Machemedze inflicted terrible injuries on political opponents of the vile Mugabe regime. But despite ruling he was involved in ‘savage acts of extreme violence’ – including smashing a man’s jaw with a pair of pliers – immigration judges said he could not be deported.
They said the 46-year-old, who is HIV positive, could himself face torture if he was returned home, having turned his back on Mugabe’s Zanu PF regime. Both he and his wife – who was granted asylum – can stay in Britain indefinitely.
Machemedze worked as a bodyguard to a senior Zanu PF minister, as part of Mugabe’s feared Central Intelligence Organisation.
Court documents exposed the horrendous crimes he committed as a state-sponsored torturer. The tribunal heard he smashed one victim’s jaw with a pair of pliers, before pulling out a tooth.
Another victim, a farmer accused of supporting the rival Movement for Democratic Change, was shocked with electric cables, slapped, beaten and punched unconscious.
On another occasion, a woman MDC member was taken to an underground cell where she was stripped naked and whipped. Machemedze admitted putting salt in her wounds.
He also stripped a man naked and told him he would be forced to have sex with his daughters if he did not talk.
The hired thug told the court he ‘initially enjoyed his job’ but ‘soon had enough of the torture’. He left Zimbabwe and came to Britain in 2000 on a visitor visa. Eight years later, in December 2008, he claimed asylum along with his wife Febbie. The couple live in Bristol. Their daughter also lives in Britain, but two other children are in Zimbabwe.
The immigration tribunal ruled his crimes were so horrendous that he was barred from claiming asylum. However, the judge ruled that he could not be sent home because of the likelihood he will be tortured or executed by the Mugabe regime – breaching his rights under Articles 2 and 3 of the European Convention on Human Rights.
His wife, an MDC activist, was granted asylum. In his ruling, Judge David Archer said: ‘I find the respondent has produced a compelling case that the first appellant has committed crimes against humanity. ‘I reject his claim that he was acting under duress. The first appellant was deeply involved in savage acts of extreme violence.’ He added: ‘I find that the appellant’s protected rights under Articles 2 and 3 of the Human Rights Convention will be breached by returning him to Zimbabwe.
‘Those rights are absolute and whatever crimes he has committed, he cannot be returned to face the highly likely prospect of torture and execution without trial.’
Ministers have faced demands to take action over the more than 350 suspected war criminals living in Britain. Nearly 500 have been targeted by the authorities over the past five years, but just a fifth have been refused entry, kicked out or have left voluntarily. The total includes 75 from Afghanistan, 73 from Sri Lanka, 39 from Rwanda and 32 from Zimbabwe.
A Home Office spokesman said the Government was ‘disappointed’ with the ruling and would seek to appeal. He said: ‘We consider all asylum applications on their individual merits, however it is the Government’s policy that the UK should not be a refuge for war criminals or those who have committed crimes against humanity or genocide.
‘Where someone has been found not to need protection, we expect them to leave voluntarily. For those who choose not to do so, we will seek to enforce their departure.’
More destruction coming for British schools
Poorer pupils to get priority access to good schools over those living nearby.
In the absence of significant discipline, pupil behavior is a major determinant of how good a school is. Pupils from poor backgrounds are often unruly so will simply destroy any school into which they are inserted. It will not benefit the poor kids but it will destroy the educational chances of all the kids. No kid will learn anything much in a chaotic environment.
One hopes and imagines that few school heads will take the “opportunity” that has been handed to them. Would any head want to preside over a behavioral sink?
Poor pupils can be taught perfectly well in a well disciplined environment but that is not an option in Britain today
Ministers will today signal an end to ‘selection by mortgage’ by allowing the most popular schools to discriminate in favour of the poorest children. A new admissions code will let academies and free schools prioritise children on free school meals – whose parents earn less than £16,000.
Currently, only pupils with special needs, in the care of local councils or with siblings at the school can be given such priority when it is oversubscribed.
The move, criticised as an assault on the middle classes, has prompted allegations that the Coalition Government is attempting to socially engineer secondary school admissions.
It will spell an end to well-off parents buying a home in the catchment area of a popular secondary school to secure places for their sons or daughters. In future, even living right next door to an oversubscribed school may not guarantee a place for a pupil. In London, property prices can be inflated by as much as £400,000 close to the best institutions.
The announcement today from Education Secretary Michael Gove is likely to trigger a backlash from many Conservative MPs and the party’s traditional middle-class supporters, who are already angry that the Coalition has ruled out any return to selection by ability.
At present, one third of all secondary schools – 1,070 – are either an academy or in the process of becoming one. Two secondaries become academies every day and the Government wants all schools to convert eventually.
And with many academies heavily over-subscribed – some by ten applications for every place – competition is fierce. This year one in five pupils in England missed out on their first choice of school.
Mr Gove’s proposal will be seen as an attempt to appease Liberal Democrat members of the Coalition, who have pushed existing plans to boost funding for underprivileged children. The Education Secretary believes the change will provide a vital boost for social mobility.
Whitehall sources close to Mr Gove yesterday stressed any change would not be ‘prescriptive’, and schools would simply be permitted to admit children entitled to free school meals in preference to others if they wished to do so.
However, Mr Gove is also introducing incentives for schools to select more poor pupils – the pupil premium and a new performance measure. Under the pupil premium, schools will receive extra funding based on the number of pupils on free school meals. And a new league table performance measure will rank schools on the achievements of their most disadvantaged youngsters.
These incentives will encourage in-demand schools to select poorer pupils over those from wealthier backgrounds who may live on the doorstep.
But schools wishing to prioritise disadvantaged children will have to consult the community first, as is the case with any changes to admissions criteria.
In addition to the controversial new criteria, today’s code will give priority to the children of serving troops – of which there are some 35,000. These children will be able to queue-jump during the application process and will be accepted at ‘full’ primary schools.
The code will also enable selective schools to expand, by removing caps on the number of places they can offer. Many grammars are intending to increase their capacity by as much as 50 per cent by 2015, which will make a selective education more accessible.
Mr Gove’s move follows a report by the Sutton Trust which found England had moved from ‘selection by ability’ to ‘selection by mortgage’.
REDD FACES ALL ROUND
A GLOBAL scheme to reward poorer rain-forested countries for halting deforestation has led to plans for more commercial logging, a blind eye being turned to illegal logging and the displacement of forest people – all helped by McKinsey consultants funded by British and Norwegian taxpayers.
The Reduction of Emissions from Deforestation and Degradation (REDD) scheme aims to allow richer countries to buy “avoided deforestation” as part of carbon trading. This depends on calculating how much forest would have been chopped down and then preventing some of it (at as little cost to the economy as possible).
Not surprisingly, countries have already been accused of overestimating the amount of logging that might have happened without REDD… so when the Democratic Republic of Congo’s (DRC) environment minister announced in January that the country was to lift its moratorium on new logging concessions, this could still somehow be spun as a reduction in deforestation.
There’s funding available from the World Bank to help countries draw up REDD plans, as well as assistance from some enthusiastic European nations. Most of this REDD-readiness money is ending up in the pockets of international consulting firms – and McKinsey has established itself as the market leader.
For instance, the UK’s Department for International Development paid McKinsey £313,000 for work on REDD in Guyana, while Norway and the UK paid the firm for its work in DRC. McKinsey’s advice to Guyana even included weakening environmental laws, as a “more permissive regulatory regime” would ultimately allow them to make more money from REDD.
‘Blame the poor’
In an editorial last month, ahead of an upcoming meeting in Oslo of scientists, REDD-funders and international organisations, Nature magazine called on these funders to “finalize standards and safeguards” governing human rights before handing out more cash.
McKinsey became first pick for REDD work after developing a methodology it calls the “greenhouse gas abatement cost-curve” to estimate potential emissions reductions. A new study by charity the Forest People’s Programme (FPP) looked at the plans devised so far and concluded: “Abatement cost-curves, which aim to determine the least-cost option for the greatest emissions reduction potential, will almost always result in blaming the rural poor for deforestation, as implementing measures to halt small-scale and subsistence agriculture carries an economically lower price than halting industrial logging or even addressing illegal logging.”
The consultancy itself even admitted last month, in a statement responding to various international campaign groups, that: “The abatement costs shown in the cost curve across a range of emissions reductions initiatives do not necessarily reflect the full costs of implementing those initiatives.” For instance, it says, halting subsistence agriculture “could be significantly more expensive than suggested by the cost curve” when attempting to work with millions of farmers across a large country.
But while McKinsey boasts that its cost-curves have been used by more than 25 countries to “inform” decision making, it washes its hands of any ill-effects, adding that the cost-curve is not meant to “determine or generate” policy. Not that developing countries will have any funding left to pay for other policy work once they’ve bought their McKinsey report.
Documents revealed by a Papua New Guinean blog last year showed McKinsey asking for $2.2m (“50% below our usual fees”) to prepare a national REDD plan in 2009. The documents also suggested that they seek to cover the budget for the process “from external sources… eg. Australia, Japan, Germany, UK”.