Doctors criticise ‘needless’ death toll in childbirth that could be cut by a third if given the right care
Doctors have condemned the ‘needless’ deaths of scores of mothers caused by substandard care in pregnancy and childbirth. They want urgent action over the ‘worrying’ number of women dying from conditions that could have been spotted.
A rise in high-risk pregnancies, including those of older and obese mothers, means women can suffer a complex mix of health problems.
GPs and hospital doctors must be on their guard for preventable or treatable medical conditions, said a group of leading doctors led by Professor Catherine Nelson-Piercy, of King’s College London. They want more obstetric physicians and better training for GPs.
Writing in the British Medical Journal, they said that while the overall number of deaths had decreased since the 1950s, there was a ‘worrying trend’ of a rise in the number dying from conditions not directly caused by pregnancy.
The leading cause of maternal death is heart disease while the second is neurological disease.
Most of these deaths are associated with substandard care and ‘in one third of cases this is classified as major substandard care, where different care might have prevented death of the mother’. ‘These failings require urgent attention,’ insist the doctors.
In March, the Centre for Maternal and Child Enquiries reported that 261 women in the UK died of conditions directly or indirectly related to pregnancy for the three years from 2006 to 2008.
Of those, 107 were ‘direct deaths’ from conditions linked with being pregnant, while 154 died of indirect causes, including infections and underlying health problems.
Some are dying from treatable conditions such as epilepsy, diabetes and asthma, and a failure to diagnose these women properly, investigate their symptoms and treat them amounts to substandard care, wrote the doctors.
They added: ‘Obstetricians and midwives alone cannot reduce indirect maternal deaths – they need support from physicians and general practitioners.
‘But many doctors are unfamiliar with the interaction between pregnancy and medical disease, the safety of radiological investigations in pregnancy, and the risk-benefit ratio for the use of different drugs in pregnancy.’
Dr David Williams of the Institute for Women’s Health at University College Hospital London, said: ‘Many women are now delaying pregnancy until they are older, and as we get older we become more overweight. As a consequence of that there’s more diabetes and hypertension in pregnancy and these pregnancies are higher risk.
‘There is also increasing numbers of women who are having IVF treatment and some of these women are over 40, 45, even 50.’
Dr Williams, one of only four obstetric physicians in NHS specialist centres, is calling for a ten-fold rise in their numbers.
Nurses over-ruling doctors!
Patients referred to hospital by their GPs are being refused treatment by panels of nurses, according to new research. One man was even denied a hip replacement – although his hip was constantly dislocating.
Doctors have criticised NHS trusts for hiring non-doctors to overrule the decisions of more qualified GPs. An investigation by Pulse magazine found that several trusts are are using nurses, podiatrists and physiotherapists to determine whether referrals made by GPs are appropriate.
The ‘referral management centres’ which review referrals by doctors have proved controversial after it emerged they block some GPs’ referrals to save cash. In February, Pulse revealed that one GP in three had their referrals screened by a referral management centre, while up to one in eight referrals is rejected.
The treatments denied to patients included hip and knee replacements, cataract surgery, allergy care, IVF and tonsillectomy.
Five – NHS Bournemouth and Poole, NHS Hertfordshire, NHS Manchester, NHS Oldham and NHS Plymouth – said they used non-doctors to assess GP referrals. NHS Manchester uses two podiatric nurses and a non-medical prescriber with a diploma in podiatric medicine to triage GP referrals for vascular conditions. In NHS Oldham, more than a third of its staff screening GP referrals in ophthalmology, diabetes, urology and musculoskeletal conditions are non-doctors, according to the study.
GP Dr Andrew Mimnagh, from Merseyside, told Pulse he knew of instances elsewhere where ‘patients had come to harm from not being referred’. He said: ‘Nurses assess patients according to rigid criteria and do not have the experience to make flexible decisions in the same way a doctor can.
‘In one case, a patient was rejected for a replacement hip operation by a nurse at a referral centre despite the fact his hip was dislocating. According to the nurse’s criteria, he wasn’t reaching a high enough pain threshold because he already had an artificial hip that cured the pain. ‘Nurses do not have the knowledge to know when they are out of their depth.’
A spokesperson for NHS Oldham said: ‘Nearly all GP referrals go through a referral gateway, run by local GPs. ‘There are some areas where we’ve had multidisciplinary teams in place for some years. They are people with the appropriate clinical skills and experts in that specialty.’
Racial tensions flare after five days of rioting across Britain
Black thugs and useless police
WITH police overwhelmed, a desperate attempt by Birmingham Muslims to protect their properties and mosque has turned to tragedy with three men mown-down. The Muslims of Dudley Road armed themselves with bricks and stones, clubs and cricket bats to fend off carloads of marauding gangs.
Their vigilante stand may have saved a humble row of family-run shops and a red-brick mosque from the looters’ grasp – but at a terrible cost.
A carload of rioters sped into a fleeing crowd of shop defenders, witnesses said, hurling three young men into the air and killing amateur boxer Haroon Jahan, 21, and brothers Shazzad Ali, 30, and Abdul Musavir, 31. Police have since detained the alleged driver of the car, charging him with murder.
“We all had stones in our hands. But we had no defense to stop a car. They revved their engines and drove right at us as fast as they could,” Mohammed Ibrahim, 23, told The Associated Press. “These black men deliberately tried to kill us all.”
Wednesday’s 1 a.m. slaughter has laid bare racial tensions underlying this week’s riots in Birmingham, Britain’s second-largest city and its most ethnically diverse. A fifth of the city’s 1 million “Brummies” are Muslims, most commonly of Pakistani origin. About 7 percent are black, mostly Caribbean, in background.
While the riots that have swept England this week have involved looters of every creed and hue, the street anarchy also sometimes has exposed the racial fault lines that run beneath the poorest urban quarters.
Resident after resident of Dudley Road and its surrounding Winson Green district commented that the attackers were black and accused them of targeting Muslim shops.
The passions echo streetfights from previous years, such as in 2005, when a neighbouring Birmingham district suffered two nights of violence between Caribbean and Asian gangs over unsubstantiated rumours that a gang of Pakistani men had raped a 14-year-old Jamaican girl. Two men were stabbed to death, firefighters faced machete-wielding mobs, and Muslim graves were desecrated during those clashes. The west side also suffered riots in 1981, 1985 and 1991 fuelled by minority hatred of white police and black resentment of the Asians’ dominant position as shopkeepers.
“We’ll hunt down these black men, cut off their heads and feed them to our dogs,” said Amir Hawid, 20, who lives just a hundred meters from the killing scene and heard the screams of the crowd at the moment of impact.
As forensics specialists combed the bloodied, rock-strewn pavement for clues, hundreds of local Muslims and Sikhs – some wearing ceremonial daggers at their waists – packed into a community hall Wednesday to confront three white police commanders who had come seeking to calm tensions. Twice as many Muslims, many in robes and kufi caps, stood outside.
Speaker after speaker complained that they had pleaded by phone for police protection the previous night, when black gangs raided local markets and chased bar staff onto the roof of one pub, yet police failed to respond. Some argued that the police had warned them not to attempt to defend their own streets, yet had offered no alternative.
The three dead men “did nothing wrong! They died because they were doing the job of protecting our community. The job that you lot should have been doing!” one speaker shouted, jabbing an accusatory finger at the police panel.
Detective Superintendent Richard Baker, commander of the 60-strong police team hunting the killers, said they already had arrested the suspected driver and 11 others potentially linked to the shop attacks on Dudley Road. He pleaded for locals to overcome their antipathy to the police, give eyewitness statements and hand over amateur camera footage.
“I will deploy whatever it takes to get justice for this community,” Baker said above a din of muttered heckles and shouted accusations, dozens of men trying to speak at once.
Baker and the local commander, Superintendent Sean Russell, defended their force’s response to the killings – which Russell admitted he could see from the police control centre on a closed-circuit surveillance camera – because gangs were attacking shops in the city centre. That triggered angry cries that police cared more for protecting downtown shopping centres than Muslim communities.
Russell said it took officers 10 minutes to arrive; locals insisted it was a half-hour and the officers arrived in riot gear thinking the Muslim crowd might pose a threat. The officers said they had to be cautious.
Afterward, a chastened Baker said it had been the toughest community meeting of his life. In quiet one-to-one conversations, he offered his cell phone number to local residents and pleaded for them to find eyewitnesses.
“We really want to help you, but you need to help us too,” he told one man, who said he’d been afraid to speak up and express moderate views during the meeting.
And a local black resident, who didn’t want to be identified by name because of fears for his safety, pleaded outside with the departing Muslim crowd not to start targeting blacks in retaliation.
“Don’t take your anger out on everyone. Don’t keep saying it’s black, black, black, black. Don’t take this too far,” he declared, street preacher-style, after abusive comments were directed at him. “I’ve lived and worked here seven years alongside you. I don’t want to be afraid to walk down that street now. Don’t make me afraid, because I didn’t do it, man.”
Several witnesses outside the hall, who like the dead men had taken up crude arms and manned the sidewalks in hopes of keeping the invaders at bay. None expressed confidence that the police would bring justice.
“We will avenge our brothers. This is a tight community, and someone in their group will brag about how they attacked the Muslims,” said Waseem Hussain, 24, who joined the defense of the shops.
Hussain said several carloads of would-be shop raiders began casing Dudley Road, driving cars up and down the road before midnight, as scores of locals were still in the mosque observing the night’s final Ramadan prayers.
He said one carload stopped at the local gas station and convenience store – which had been ransacked the night before and was now closed with metal shutters – and asked a few youths whether there was “anything new to rob.”
He said locals threw stones and bricks at the cars, whose occupants had their windows rolled down. The two sides traded verbal abuse as the cars repeatedly passed, Hussain estimating at least a dozen times. The Muslim crowd grew as prayers concluded around 12:30 a.m.
After the cars canvassed the crowd once again under a hail of rocks, Hussain said, one of the occupants shouted a threat at them: “Are you asking for it?”
Two of the cars did a U-turn at the top of the road, he said, and gunned their engines, shifting their gears rapidly as they reached a speed he estimated at 110 km/h.
“The first car cut extremely close to the crowd but didn’t hit anyone. We all were running for cover, but there were too many people and nowhere to go,” he said.
“Some people didn’t see the second car coming. It went deeper into the footpath and struck these three men, all standing in the same spot,” he said. “They must have flown 20, 30 feet. One, Shazzad, was dead when he hit the ground. All of them were bloody and unconscious. They never had a chance.”
British rioters the spawn of a bankrupt ruling elite
THE riots in London and elsewhere in Britain are a backhanded tribute to the long-term intellectual torpor, moral cowardice, incompetence and careerist opportunism of the British political and intellectual class.
They have somehow managed not to notice what has long been apparent to anyone who has taken a short walk with his eyes open down any frequented British street: that a considerable proportion of the country’s young population (a proportion that is declining) is ugly, aggressive, vicious, badly educated, uncouth and criminally inclined.
Unfortunately, while it is totally lacking in self-respect, it is full of self-esteem: that is to say, it believes itself entitled to a high standard of living, and other things, without any effort on its own part.
Consider for a moment the following: although youth unemployment in Britain is very high, that is to say about 20 per cent of those aged under 25, the country has had to import young foreign labour for a long time, even for unskilled work in the service sector.
The reasons for this seeming paradox are obvious to anyone who knows young Britons as I do.
No sensible employer in a service industry would choose a young Briton if he could have a young Pole; the young Pole is not only likely to have a good work ethic and refined manners, he is likely to be able to add up and — most humiliating of all — to speak better English than the Briton, at least if by that we mean the standard variety of the language. He may not be more fluent but his English will be more correct and his accent easier to understand.
This is not an exaggeration. After compulsory education (or perhaps I should say intermittent attendance at school) up to the age of 16 costing $80,000 a head, about one-quarter of British children cannot read with facility or do simple arithmetic. It makes you proud to be a British taxpayer.
I think I can say with a fair degree of certainty, from my experience as a doctor in one of the areas in which a police station has just been burned down, that half of those rioting would reply to the question, “Can you do arithmetic?” by answering, “What is arithmetic?”
British youth leads the Western world in almost all aspects of social pathology, from teenage pregnancy to drug taking, from drunkenness to violent criminality. There is no form of bad behaviour that our version of the welfare state has not sought out and subsidised.
British children are much likelier to have a television in their bedroom than a father living at home. One-third of them never eat a meal at a table with another member of their household — family is not the word for the social arrangements of the people in the areas from which the rioters mainly come. They are therefore radically unsocialised and deeply egotistical, viewing relations with other human beings in the same way as Lenin: Who whom, who does what to whom. By the time they grow up, they are destined not only for unemployment but unemployability.
For young women in much of Britain, dependence does not mean dependence on the government: that, for them, is independence. Dependence means any kind of reliance on the men who have impregnated them who, of course, regard their own subventions from the state as pocket money, to be supplemented by a little light trafficking. (According to his brother, Mark Duggan, the man whose death at the hands of the probably incompetent police allegedly sparked the riots, “was involved in things”, which things being delicately left to the imagination of his interlocutor.)
Relatively poor as the rioting sector of society is, it nevertheless possesses all the electronic equipment necessary for the prosecution of the main business of life; that is to say, entertainment by popular culture. And what a culture British popular culture is!
Perhaps Amy Winehouse was its finest flower and its truest representative in her militant and ideological vulgarity, her stupid taste, her vile personal conduct and preposterous self-pity.
Her sordid life was a long bath in vomitus, literal and metaphorical, for which the exercise of her very minor talent was no excuse or explanation. Yet not a peep of dissent from our intelllectual class was heard after her near canonisation after her death, that class having long had the backbone of a mollusc.
Criminality is scarcely repressed any more in Britain. The last lord chief justice but two thought that burglary was a minor offence, not worthy of imprisonment, and the next chief justice agreed with him.
By the age of 12, an ordinary slum-dweller has learned he has nothing to fear from the law and the only people to fear are those who are stronger or more ruthless than he.
Punishments are derisory; the police are simultaneously bullying but ineffectual and incompetent, increasingly dressed in paraphernalia that makes them look more like the occupiers of Afghanistan than the force imagined by Robert Peel. The people who most fear our police are the innocent.
Of course, none of this reduces the personal responsibility of the rioters. But the riots are a manifestation of a society in full decomposition, of a people with neither leaders nor followers but composed only of egotists.
Only half of British maths and science teachers have ‘good enough’ degrees to do their jobs
Many trainee maths and science teachers do not have good degrees in their subject, a study suggests. While nine in 10 classics trainees and almost four-fifths of would-be history teachers have a first or 2:1 university degree, this falls to around half for maths and science trainees.
Those training to be foreign language teachers are also less likely to have a ‘good’ degree, with more than a third holding a 2:2 or lower, the Good Teacher Training Guide 2011 found.
Researchers at Buckingham University’s Centre for Education and Employment Research conclude there is a clear link between lower degree qualifications, low course completion rates and the numbers entering teaching.
About 80 per cent of English and history trainee secondary school teachers entered training after completing their course.
But this fell to 70 per cent for maths, 69 per cent for science and 66 per cent for modern foreign languages, all of which are subjects where the numbers with ‘good’ degrees are lower.
Report author Professor Alan Smithers said it means that teacher training departments have more choice when recruiting history or English teachers, but struggle with other subjects.
‘Training departments are able to choose more carefully who they recruit, but if there are not enough people studying science and maths, the training departments really struggle to recruit and bring in people who don’t want to be teachers and are not as well qualified,’ he said.
This has an impact on the enthusiasm of pupils, who are then less likely to take up subjects like science and maths, Professor Smithers said. ‘A teacher, to be really enthusiastic, has to have a full grasp of their subject, so the chances are if you have got a very well qualified historian or somebody teaching classics, they will make the subject come alive for their pupils.
‘But if you have got somebody in maths, or the physical sciences who is really trying to keep up with it themselves, then they are not going to convey the same sense of enthusiasm.
‘Young people can easily be exposed to very enthusiastic historians and people who are struggling with their own grasp of physics.’
Ministers have announced plans to scrap public funding for teacher trainees who do not hold at least a 2:2 in their degree.
The report concludes: ‘The low entry qualifications of some postgraduate and undergraduate trainees, as the Government recognises, has to be tackled. ‘No one wants to see teachers attempting to teach subjects which they do not fully grasp themselves.
‘But if not enough people with the necessary expertise put themselves forward, the difficult question that has to be faced in formulating policy is: is it better to have an able graduate who has not studied a subject at university or someone who has studied the subject at university but not done very well in it?
‘Is it better, for example, to have a good biologist or a poor physicist teaching physics?’
What does the ‘E’ in Environmentalist stand for? Ego, exaggeration, and error’
Says Marcus Gibson, ex-Financial Times journalist in his ’Global warming speech’ at the Oxford Union, Oxford, UK
[13-minute video] What does the ‘E’ in Environmentalist stand for? Ego, exaggeration, and error’, says Marcus Gibson, ex-Financial Times journalist, who demolishes the claims of the global warming clique at the famous Oxford Union debate, on July 14th, 2011. Marcus is the only journalist to have interviewed all of the key members of Royal Society who rebelled against the ‘catastrophe’ theory accepted by the council at the society – and finally got its stance radically changed. Marcus Gibson disputes the conventional view held by the global warming clique.