What the NHS could be like
I thought I might start off today’s postings with a personal story that starts out much like the story that led yesterday’s postings. In yesterday’s story, Brian Paddick told of the amazing run-around he got when a lump came up on his finger.
I live in Australia and have private health insurance — as about 40% of Australians do. I experienced something similar to Paddick’s experience a couple of weeks ago, only the lump was on my arm. I promptly rang a private plastic surgeon who has done stuff for me before and got an appointment for two weeks away — which came up today.
I arrived on time at 1:30 pm and was on the operating table five minutes later. The lump was removed and I was neatly stitched up in about 15 minutes. The stitches were of course covered with a dressing and I was on my way. After a short drive, I arrived home at 2:30. I have an appointment in 10 days time to have the stitches removed and the site of the surgery is only the tiniest bit sore. A plastic surgeon gets good join-ups so the wound heals rapidly and well.
The excised portion was sent off to a pathology firm for diagnosis but as long as they say that the tumour was fully excised, that does not really matter a hill of beans: The tumour is gone and that is that. Why should there be any more runaround in the matter than that? — JR
NHS Trust may be unable to pay staff due to £6 million cash crisis
A major NHS Trust has revealed that a ‘catastrophic’ financial crisis may leave it unable to pay staff their wages in two months’ time. The cash shortfall facing the University Hospitals of Leicester NHS Trust (UHL) means that thousands of doctors, nurses and other staff may not be paid in August, according to a leaked email seen by The Sunday Telegraph.
It comes as David Cameron is struggling to bring in major health service reforms. Last week, the Prime Minister announced a climb-down from his original proposals to hand over the majority of the NHS’s budget in England to GP-led consortia and to allow private companies a bigger role. Mr Cameron has claimed, however, that without reforms the NHS faces a £20 billion ‘black hole’ which will hit patients all over the country.
Malcolm Lowe-Lauri, chief executive of UHL, one of the largest and busiest trusts in the country with a budget of £688 million and 10,000 staff, admits to a cash ‘overshoot’ of between £5 million and £6 million.
In an email to senior staff dated 10 June he warns: “This can only be described as catastrophic.” “What do I mean? Firstly, there is a real issue about whether we will be able to pay our staff by August or September if the present run rate continues.”
The Trust does not have ‘Foundation’ status so, unlike other hospitals, cannot borrow money from the private sector to make good the shortfall, at least temporarily.
Mr Lowe-Lauri goes on to claim he is “surprised” at “the widespread lack of understanding that the consequences of UHL financial failure will reach right into the pockets of everyone”.
John Healey, the shadow health secretary, said: “David Cameron’s first year in government has been a year of chaos and confusion in the health service, as money promised for patient care is wasted on his £2 billion NHS reorganisation. “I fear we may now see hospitals driven to the brink under pressure from the government’s NHS plans.”
In a statement this weekend, Mr Lowe-Lauri confirmed the £6 million “overshoot” in the trust’s spending and said: “We are facing the toughest financial challenge in our 10 year history.”
He blamed the financial crisis on the pressures on the “relentless demand” on the hospital’s emergency department over the winter, the need to hire extra staff on “expensive short term rates” and open extra wards.
Mr Lowe-Lauri added: “Now that the demand is finally dropping we need to quickly stop the spend on extra staff and extra wards, but until now we have not done this quickly enough and the costs have mounted. “If we don’t act now and allow the current situation to continue then theoretically the hospitals run out of cash in September. But we are committed to this not happening because we will act.”
The Trust includes Leicester General, Glenfield and Royal Infirmary hospitals, along with Leicester Children’s Hospital.
Some British university students are now heading to America to study
With the cost of a British university set to triple, we are no longer sneering at the price Yanks put on education. Instead, we’d quite like a slice of that ourselves.
It was revealed this week that the number of British students applying to top American universities has risen by one third in the past year. The news was greeted not with outrage, but with resigned nods of the head.
“There’s no question the fees increase has opened up the whole US market,” says Norman Renshaw, whose firm InTuition Services helps find American scholarships for British undergraduates. “The question parents are asking is whether the increase in UK fees will mean increased investment on the part of those universities. And the answer is no. So they’re coming to the conclusion that they should look elsewhere.”
More and more their gaze is heading westwards. According to the Fulbright Commission, which facilitates the flow of students back and forth across the Atlantic, there has never been a greater British interest in American colleges.
“The number of UK students in the States is 8,861, two per cent up on the previous year,” says the commission’s senior adviser, Lauren Welch. “And that’s just for the year 2009-10, which is before the fees increase became a big issue. Plus, we’ve had a 30 per cent increase in web traffic, and at our last US College Day, in London, we got 4,000 visitors in one day, which was 50 per cent up on the previous year.”
While British universities are turning down more applicants per year, American universities are making strenuous efforts to harvest this sudden, abundant crop of young Brits.
“More British citizens come to Florida than any other nationality – only now we want to import not just holidaymakers, but students,” says J Robert Spatig, of the University of South Florida, in Tampa, who has been on four fresher-hunting trips to the Britain in the past nine months.
“In fact, your £9,000 fee mark is pretty much the same as the amount we charge,” he says, “which is $15,000 [£9,375 at current exchange rates]. The cost of living is much lower in the US, and on top of that, we are in a position to extend scholarships that start at £4,000 per year, and go up to £6,000 for your most able students. All of a sudden, we have become less expensive than your University of Manchester. Plus we have better weather.”
Not all American universities are as fee-friendly as South Florida, however. According to the US College Board, average undergraduate tuition rates are £12,000 at state-funded universities and £16,800 at their private counterparts. And that’s not including living costs of around £5,500 per year. The top institutions charge higher fees, around £23,750.
“It’s very likely that you’ll end up applying to a university you’ve never heard of,” says Welch. “That doesn’t mean it’s not top-notch. There are 4,000 universities in the United States, of which 70 are ranked among the world’s top 200.”
True enough, the choice is astonishing: there are 700 universities in California alone, as opposed to 300 universities and further education colleges in the United Kingdom. So where do would-be applicants start? And how do they know they’re applying to the kind of institution that appears in Social Network, rather than Animal House?
A good place to look is one of the university ranking guides, such as those compiled by US News (America only) or software firm QS (worldwide). Things to consider are size of student population (from 4,000 to 40,000) and level of academic requirement (the lower it is, the better your chance of a scholarship).
But that’s just the start. In terms of prestige (and cost), you need to know if your intended alma mater is one of the eight north-eastern Ivy League universities such as Yale, Harvard or Brown, where Emma Watson, of Harry Potter fame, went to study; one of the 30 “public” Ivies (less famous, but still top-notch, for example Michigan, North Carolina at Chapel Hill); or one of the 62 Association of American Universities colleges (membership by invitation only). Private universities tend to be smaller and more expensive than state-funded ones. Liberal arts colleges have a broader curriculum, and are geared more towards undergraduates, while research colleges are more graduate-orientated.
After finding some possible colleges, a student must take a Sat, or scholarship aptitude test, which is like a grown-up 11-plus, incorporating maths, writing and critical reading. The Fulbright Commission offers limited hand-holding, but you can expect a warmer embrace from organisations that specialise in finding places and scholarships for Brits.
The boldest claims are made by InTuition services, which guarantees 10 academic scholarship offers, or a refund of your fee (£1,560). It also runs a sports scholarship trip to Florida, on which you spend 10 days trying to impress US college coaches (£2,340). For a more modest fee (£995), Pass4Soccer puts on a showcase event, during which young British footballers attempt to catch the eye of American coaches.
“Getting a US soccer scholarship was the best thing that ever happened to me,” says Pass4Soccer’s Tom Nutter, a former England Under-16 footballer, who went to Texas A&M University in 2005, on a 75 per cent scholarship. “The facilities are tremendous, and you get treated like a real professional. I got to play against lots of guys who went on to play for the US national team, and at the end of it all, I came out with a degree, which I might not have got if I’d tried to make it as a pro in England. You’re a student first and an athlete second; the coaches would actually go round the lecture halls in person to check you were attending the classes.”
There’s one thing that all British students acknowledge: you’re expected to work much harder at an American university. “You take five subjects per semester, and in each you have to attend two lectures and one discussion per week, or you get marked down,” says 24-year-old Edward East, who went to the University of Virginia, at Charlottesville.
“You’ve got to keep your grade point average up all the time,” says Lauren Hewett, who is on a tennis scholarship at the University of Tampa, Florida. “I was never entirely comfortable with idea of continual assessment for every piece of work you do, and for every class you attend or don’t attend,” says Adam Alfandary, who, instead of reading history at Cambridge, chose a liberal arts degree at Amherst College, in Massachussetts. “But you learn early on that you’re in a place where people are uncompromisingly serious about education.”
Ask any of these students whether it was worth the hard work, and they all respond in the affirmative.
“I’ve been offered a world of opportunities,” says 21-year-old Laura Tunbridge, who was rejected from all her first-choice universities in Britain, but won a scholarship at Yale. “I’ve been to Ecuador to study Spanish, to Vermont to ski, and to New York to see the City Ballet. Because Yale is a liberal arts college, you study such a wide range. I’m majoring in film studies, but I’ve studied Spanish, philosophy, astronomy, English, applied mathematics and theatre.”
As well as broadening minds, it seems a transatlantic degree strengthens character, too. “He’s so much more mature and confident than when he left Britain,” says accountant Barbara Allen of her son Will, who has just finished a degree in nano-physics at McGill University, Montreal.
“His time there has given him a truly international perspective. He’s still only 22, yet the idea of going to live and work in a foreign country leaves him undaunted. I’m in no doubt that it’s been money well spent.”
100 ‘free schools’ to open in Britain next year
More than 100 schools run by parents, teachers and charities will open in little over a year in a boost to the Coalition’s Big Society programme, ministers will say.
Some 281 applications have been made in the past three months to establish a new wave of “free schools” – government-funded institutions run independent of local council control.
New figures show almost 60 per cent of bids to open new-style schools have been made by community groups. Around a fifth come from independent schools seeking to open satellite campuses for parents unable to pay for a private education.
In most cases, applicants are attempting to establish new schools because of a shortage of places in the local area or to “address historic academic failure”, the Government said.
Michael Gove, the Education Secretary, will use a speech today to insist that his “free school” policy is on track to meet initial targets. Last month, Labour said the Big Society idea – designed to devolve power to communities – was “descending into farce” after Lord Wei, the peer in charge of the reforms, said he would stand down.
Addressing a conference in London today, Mr Gove will point to “extremely promising” recent “free school” applications as evidence that the reforms are working. “Our critics said it was impossible to open a school in little more than a year. Several will open this September,” he said ahead of the speech. “Our reforms are about creating a generation of world-class schools, free from meddling and prescription, that provide more children with the type of education previously reserved for the rich.”
Under the policy, any non-profit making group can apply to open a school free of local council interference. The group will have almost complete independence to hire staff, set teachers’ pay, alter the academic year and write the curriculum.
Some 323 applications were made to open schools last year with about 90 per cent rejected because of weak business cases. Forty were improved, and about 14 schools are expected to open in September.
Of 281 applications made under a new, more rigorous, regime launched this year, it is estimated that around 100 will open in September next year. Of those, most are for mainstream schools, although a small number of bidders are seeking to open institutions for pupils with special needs or those expelled from ordinary primaries and secondaries.
Outrage as British postwoman faces being fired for jumping on her van to stop a thief getting away
A village postwoman who clung to the bonnet of her van in a ‘courageous’ bid to stop a thief driving off with the mail has been threatened with the sack.
Julie Roberts, 51, held on to the moving vehicle for a mile as it weaved through narrow country lanes in a desperate effort to thwart the crook from stealing her deliveries.
Eventually, the thief halted the vehicle and ran off with only a handful of letters.
But far from thanking Miss Roberts’ for her brave actions, her bosses at Royal Mail have launched a disciplinary inquiry and suspended her.
She fears managers will blame her for the opportunistic theft, after she left the keys in the ignition while she stepped out to retrieve a pen that had fallen a few feet away during a delivery.
Outraged MPs, led by the leader of the House of Commons, Sir George Young, have called for her to be reinstated immediately, rather than punished.
And hundreds of people have written to both Royal Mail and Miss Roberts demanding she returns to her round in South Staffordshire, where she has delivered the post for the past 13 years.
Speaking from her home in Wombourne, near Wolverhampton, Miss Roberts, who has worked for Royal Mail for 21 years, said: ‘Being a postie is not just a job, you’re part of the community. ‘I see all the same people every day, say hello and have a chat and get to know about their lives. ‘They’re the same with me, know all about my ups and downs and they are more like friends. ‘So when I saw someone trying to steal the mail of people I care about there was no way I was going to let them.’
After spotting she had dropped her pen while making deliveries in April, she jumped out of her van to retrieve it, only to see a thief had jumped into the driving seat and locked the doors.
‘It was just instinct I jumped on the bonnet and held on for dear life. All the time he was driving I was shouting at him to stop the van,’ she said. ‘I wasn’t really frightened, just determined to hang on.’
But her determination paid off, and the driver finally abandoned the vehicle. A 30-year-old man was later arrested and bailed for aggravated vehicle taking and theft.
‘After he had gone villagers ran up to me to check I was all right. It was a few days later that the whole thing hit me. It was just a bit of delayed shock, but I’ve been struggling a bit since then,’ she said.
‘Colleagues have been brilliant and kept in touch. And I’ve had loads of support from customers. I have had 130 letters and I know people have written to Royal Mail on my behalf. I just want this to be over with so I can move on.’
Unmarried Miss Roberts has no children, risks losing her house if she is sacked by Royal Mail, as she will struggle to keep up the mortgage payments.
Friend Phillipa Day said: ‘It was a snap decision. She dropped her pen and she quickly picked it up and then someone was trying to get in her van. ‘I am quite glad she left the key in the ignition otherwise she would have got beaten up for it.
‘She stopped a robbery and she is being punished for it. Royal Mail have not mentioned her heroism. She has rheumatoid arthritis in her hands, so you would not expect her to hang on to a bonnet like that for that long.
‘All Royal Mail are asking her about is why she left her keys in the van. What they are doing to her is not fair. She deserves better.’
Her views are echoed by Sir George, who said she deserves an award for her bravery, rather than the loss of her job. ‘Julie sounds a courageous lady who was doing her best to defend Royal Mail property,’ he said, adding he would speak to the chairman of Royal Mail to ‘make sure that this lady is recognised as appropriate, rather than penalised’.
South Staffordshire MP Gavin Williamson said: ‘People in South Staffordshire want her back in work and they want Royal Mail to show some common sense and some common decency.’
A Royal Mail spokesman said: ‘We cannot discuss individuals but Royal Mail takes very seriously the security of its customers’ mail and the wellbeing of our employees.’
The prostate cancer vaccine that targets tumours with an ’80 per cent success rate’
Rodent study only so far but if the vaccine is fully developed and results replicated, this would be very good news indeed
A vaccine that destroys advanced prostate cancers while leaving healthy tissue untouched has been developed by scientists. In laboratory tests, the gene therapy jab successfully wiped out 80 per cent of cancers without causing serious side effects.
The British researchers behind its creation said it was a ‘completely new approach’ and predicted that it could start trials on people within a few years.
Although the jab has been tested on prostate tumours, they believe it could work on a range of other deadly cancers including breast, lung and pancreatic cancer.
Unlike a conventional vaccine which is given to prevent infection with a virus or bacteria, the new treatment is used after someone has contracted cancer.
Prof Alan Melcher, from the University of Leeds, who co-led the research, said clinical trials could be underway within ‘a few years’ and that the same technique could work for a host of cancers. ‘So far it looks safe and if it continues to look safe there’s nothing we wouldn’t rule out,’ he said.
Vaccines work by stimulating the body’s immune system to recognise antigens – distinctive proteins that are found on surfaces of cells. Most vaccines are designed to teach the body to seek out and destroy viruses or bacteria. However, scientists are also developing vaccines that provoke an immune response to cancer cells.
The new cancer jab is a form of gene therapy. Researchers first created a library of thousands of randomly-selected snippets of genetic code taken from a healthy prostate and then inserted them into a virus. The modified virus was then cultured in a laboratory and then injected into the bloodstream of a mouse with prostate cancer. When the mouse’s immune system was exposed to the modified virus, it produced an array of antibodies – each one geared up to recognise a different antigen on the surface of a prostate cancer cell, the researchers report in Nature Medicine.
Professor Richard Vile, of the Mayo Clinic in Rochester, Minnesota who took part in the study said: ‘Nobody really knows how many antigens the immune system can really see on tumour cells. ‘By expressing all of these proteins in highly immunogenic viruses, we increased their visibility to the immune system. ‘The immune system now thinks it is being invaded by the viruses, which are expressing cancer-related antigens that should be eliminated.’
Progress has already been made towards developing a similar vaccine treatment for melanoma, the most dangerous form of skin cancer.
Past attempts at gene therapy cancer vaccines often used just one gene from a tumour cell to stimulate the immune system. But finding the right gene has proved difficult. And using two or more genes has raised fears that the immune response would be too strong for the patient to handle.
The researchers used two versions of the vaccine – one based on human prostate tissue, the other using mouse tissue. Both worked, although the human version was more effective.
Injecting the vaccine into the blood, rather than the tumour itself, appeared to prevent the immune system going into ‘overdrive’ and attacking healthy tissue.
Prof Peter Johnson, of the charity Cancer Research UK, which funded the Leeds team, said: ‘Although the vaccine didn’t trigger the immune system to overreact and cause serious side effects in mice, it will need to be further developed and tested in humans before we can tell whether this technique could one day be used to treat cancer patients.’
‘Although we are hopeful that the results of this study could help to form the basis of a new cancer vaccine in future, it is important to remember that the researchers have only investigated the potential of their vaccine in mice. ‘Further research looking at its effect in men is needed before we can be sure of the usefulness of this vaccine. We look forward to the outcome.’
This may be Pat Condell’s best yet