Elderly patients condemned to early death by secret use of do not resuscitate orders
The NHS is desperate to get rid of the British elderly. They are too much trouble so will be neglected as much as possible until they die
Elderly patients are being condemned to an early death by hospitals making secret use of “do not resuscitate” orders, an investigation has found.
The orders – which record an advance decision that a patient’s life should not be saved if their heart stops – are routinely being applied without the knowledge of the patient or their relatives.
On one ward, one-third of DNR orders were issued without consultation with the patient or their family, according to the NHS’s own records. At another hospital, junior doctors freely admitted that the forms were filled out by medical teams without the involvement of patients or relatives.
Under medical guidelines, the orders should only be issued after senior staff have discussed the matter with the patient’s family. A form, signed by two doctors, is then placed in the patient’s notes to record what decision was taken.
The findings emerged in spot checks of 100 hospitals undertaken by the Care Quality Commission (CQC), an official watchdog, earlier this year.
A charity for the elderly said the disclosures were evidence of “euthanasia by the backdoor,” with potentially-lethal notices being placed on the files of patients simply because they were old and frail.
Although at least five hospitals were found by the CQC to be in breach of medical guidance regarding consultation with families, the watchdog declared four of the five to be “compliant” with its standards on dignity for patients, which cover broader aspects of care.
In a national report published about the checks last week, the CQC made no mention of its findings about the misuse of DNR notices.
Action on Elder Abuse, an independent charity, carried out its own analysis of the official watchdog’s inspection reports. The charity’s findings, published today, uncover widespread evidence that patients are being left to die, without families knowing that such decisions have been taken.
Documented cases include:
* Inspectors who visited Queen Elizabeth Hospital, run by University Hospitals Birmingham Foundation trust, found no evidence that any of the patients whose files were marked DNR had been informed about the decision, nor their relatives told. The hospital’s own audit showed that in one ward, 30 per cent of cases did not involve any such conversations.
* At University Hospitals Bristol Foundation trust, there was no evidence that a DNR order placed on a patient had been discussed with the person or next of kin. A junior doctor told inspectors that they did “not tend to discuss” such decisions with families.
* At Royal Shrewsbury Hospital, run by Shrewsbury and Telford Hospital trust, a patient was labelled as DNR based on old medical notes from a previous admission – despite the fact their health had improved.
* Asked how decisions to make such orders were made, staff at Royal Devon and Exeter NHS Foundation trust gave an example of an elderly person on the ward with health problems judged to make “resuscitation less appropriate”. The doctor involved did not know if the patient or an advocate had been asked for an opinion, or told that the notice had been imposed.
* At Conquest Hospital, run by East Sussex Healthcare trust, incomplete DNR forms were placed on patients’ files – without their involvement, or the two doctors’ signatures required to validate them. The hospital was the only one of the five to fail CQC’s basic standards on dignity and respect of patients.
Hospitals are not supposed to put the documents in any patients’ files until they have been filled in, in case a blank or half-completed form is mistaken for an order not to resuscitate, as a patient enters cardiac arrest.
In 2009, heart attack victim Peter Clarke was left to die at Derby Hospitals Trust after clerical staff inserted a DNR form into his notes.
Although the document was blank, nursing staff making handover notes misinterpreted it, and said the widower, who had been admitted suffering heart disease and flu-like symptoms, should not be resuscitated if his condition worsened.
When he suffered a heart attack, nurses did not call doctors to revive him. An hour too late they realised the DNR order was blank.
Last year an inquest into his death found staff had been “routinely” placing the forms in medical records before they had been signed and witnessed. The trust stopped the policy, and said it was not aware other patients had been affected.
The dossier of cases was gathered by Action on Elder Abuse because it believes that the NHS inspectorate is uncovering widespread failings, yet doing little to protect elderly patients in immediate danger – and nothing to highlight the misuse of DNR notices.
Gary Fitzgerald, the charity’s chief executive said: “We believe that there is a real danger here that we are seeing euthanasia by default and by the back door. “In some cases it is occurring by accident, because the practices being used are not safe; in others, we are seeing junior doctors taking decisions without consulting patients or family.”
David Tracey is taking legal action against Cambridge University Hospitals NHS trust over the death of his wife Janet in March, claiming doctors twice put DNR orders on her notes – against her explicit wishes.
Mrs Tracey, 63, had been diagnosed with terminal lung cancer in February but was admitted before treatment began, after breaking her neck in a car accident. The trust disputes the family’s account, but has said it cannot comment further.
Last week, CQC said one in five NHS trusts it inspected were failing patients so badly that they were breaking the law, and expressed concern about standards at more than half of trusts.
Although the inspectorate has powers to close hospitals, or wards, and has issued threats, no such measures have been used since the visits took place between March and June.
Nor were any cases referred to safeguarding bodies, which are supposed to intervene if vulnerable adults are being left at risk.
Last night Mr Fitzgerald said: ‘The CQC is there to make sure that better care is provided for everyone, but by failing to make sure that improvements are made it is leaving vulnerable patients completely unprotected.’
Katherine Murphy, chief executive of the Patients Association, said grieving relatives often only found out about the existence of the DNR notice after their loved one had died. She said: “It is absolutely unacceptable, and it heaps so much distress on families.”
Mrs Murphy said that there had been enough reports highlighting hospital failings, and called on CQC to “take action,” including closing services which were not safe.
A spokesman for CQC said the regulator had not left patients in unsafe situations, but raised concerns immediately with staff at the hospital who had a duty to act. In some cases, there were further unannounced inspections, he added.
The regulator said it was the responsibility of hospitals to refer cases to safeguarding bodies, and that CQC would only step in if cases were exceptional.
University Hospitals Birmingham NHS Foundation Trust said it believed appropriate discussions with families and patients were taking place. A spokesman said the trust had recently reviewed and revised its policies, and was introducing a new system to alert clinicians to have such conversations, and to record them.
Royal Devon and Exeter trust said it was making to changes to the way it recorded DNR decisions in light of the CQC inspection.
East Sussex Healthcare trust said its policy was to involve patients and families, but said its record keeping had not been up to standard at the time of the inspection – a matter it has since addressed.
Shrewsbury and Telford Hospital trust said it had noted the CQC’s findings and made improvements.
Almost half of pupil allegations against British teachers are malicious and made up
Nearly half the allegations made against teachers are malicious, unsubstantiated or unfounded, according to a Government study.
The Department for Education survey shows that only three per cent of investigations resulted in a police caution or court conviction for the teacher.
Schools Minister Nick Gibb said the research justified Government plans to allow teachers facing potentially career-wrecking allegations to remain anonymous while investigations took place.
But ChildLine founder Esther Rantzen sounded a note of caution yesterday, pointing out that it was often difficult for the ‘cumbersome’ criminal justice system to protect vulnerable children.
The survey looked at the number and nature of abuse allegations referred to 116 councils in England in the 12 months to April 2010. Of 12,086 claims, 2,827 – 23 per cent – were against teachers, and 1,709 were against school support staff. Forty-seven per cent of the allegations against teachers and 41 per cent of those against non-teaching employees were found to be baseless.
But nearly one fifth of teachers and one third of other staff members were suspended while the accusations were investigated.
Mr Gibb said: ‘Every allegation of abuse must be taken seriously but some children think they can make a false allegation without any thought to the consequences for the teacher concerned. ‘When these allegations are later found to be malicious or unfounded, the damage is already done.’
But Ms Rantzen said: ‘This means that half the allegations made by children require further action. ‘It is very difficult to provide corroboration for serious offences against children because they often happen in secret. So it is not surprising that only a small percentage result in a conviction.’
But she was in favour of the anonymity provision because of ‘terrible’ cases in which ‘good and committed’ teachers had been ‘to hell and back’ after false allegations were made against them.
‘There is no easy way to obtain justice for children. That is why organisations such as ChildLine are so important because we can move them to a place of safety without having to go through the cumbersome and often unfair legal process,’ Ms Rantzen said.
Chris Keates, general secretary of the NAS/UWT teaching union, said the anonymity proposal was a ‘small step in the right direction’ but more needed to be done to protect school staff from malicious allegations.
She said that the Government had failed to address the issue of information being kept by police even after a teacher had been cleared of any wrongdoing.
The Government has already revised its guidance to local authorities and schools to speed up the investigation process when a staff member is accused of an offence. The aim is to insure that allegations are dealt with as quickly as possible.
Other measures in the Government’s Education Bill include preventing appeal panels from sending excluded children back to the school from which they were removed and withdrawing the requirement on schools to give parents 24 hours’ notice of detentions.
Don’t ever touch a doorknob again!
The latest attack on mobile phones would apply “a fortiori” to doorknobs
One in six mobile phones in Britain is contaminated with faecal matter, according to new research released ahead of Global Handwashing Day. Experts say the most likely reason for the potentially harmful bacteria festering on so many gadgets is people failing to wash their hands properly with soap after going to the toilet.
The findings of the UK-wide study by scientists from the London School of Hygiene & Tropical Medicine and Queen Mary, University of London also reveal a tendency among Britons to lie about their hygiene habits.
Although 95% of people said they washed their hands with soap where possible, 92% of phones and 82% of hands had bacteria on them. Worryingly, 16% of hands and 16% of phones were found to harbour E. coli – bacteria of a faecal origin. Harmful E. coli (Escherichia coli) is associated with stomach upsets and has been implicated in serious cases of food poisoning such as the fatal O157 outbreak in Germany in June.
Hygiene expert and UK campaign leader for Global Handwashing Day Dr Val Curtis, from the London School of Hygiene & Tropical Medicine, said: “This study provides more evidence that some people still don’t wash their hands properly, especially after going to the toilet. I hope the thought of having E. coli on their hands and phones encourages them to take more care in the bathroom — washing your hands with soap is such a simple thing to do but there is no doubt it saves lives.”
More ivory tower nonsense here
More nonsense from “The Guardian”
They are really sounding desperate these days. The changes in climate and coffee availability that they say are taking place CANNOT be due to global warming because even Warmist scientists now admit that there has been NO global warming for the last 12 years
Forget about super-sizing into the trenta a few years from now: Starbucks is warning of a threat to world coffee supply because of climate change.
In a telephone interview with the Guardian, Jim Hanna, the company’s sustainability director, said its farmers were already seeing the effects of a changing climate, with severe hurricanes and more resistant bugs reducing crop yields.
The company is now preparing for the possibility of a serious threat to global supplies. “What we are really seeing as a company as we look 10, 20, 30 years down the road – if conditions continue as they are – is a potentially significant risk to our supply chain, which is the Arabica coffee bean,” Hanna said.
It was the second warning in less than a month of a threat to a food item many people can’t live without.
New research from the International Centre for Tropical Agriculture warned it would be too hot to grow chocolate in much of the Ivory Coast and Ghana, the world’s main producers, by 2050.
Hanna is to travel to Washington on Friday to brief members of Congress on climate change and coffee at an event sponsored by the Union of Concerned Scientists. [At least one of whom’s membership is a dog!]
The coffee giant is part of a business coalition that has been trying to push Congress and the Obama administration to act on climate change – without success, as Hanna acknowledged.
Hanna told the Guardian the company’s suppliers, who are mainly in Central America, were already experiencing changing rainfall patterns and more severe pest infestations.
Even well-established farms were seeing a drop in crop yield, and that could well discourage growers from cultivating coffee in the future, further constricting supply, he said. “Even in very well established coffee plantations and farms, we are hearing more and more stories of impacts.” These include: more severe hurricanes, mudslides and erosion, variation in dry and rainy seasons.
The middle-class terrorists: More than 60pc of suspects are well educated and from comfortable backgrounds, says secret M15 file
Two-thirds of British terror suspects are from middle-class backgrounds and those who become suicide bombers are often highly educated, a classified MI5 document reveals.
The paper, marked ‘Secret: UK Eyes Only’, also debunks the myths that terrorists and suicide bombers are ‘loners’ and ‘psychopaths’.
Instead, the security service says that 90 per cent of them can be categorised as ‘sociable’ and have a high number of friends.
The 200-page document, titled Radicalisation Of Muslims In The United Kingdom – A Developed Understanding, was found by a Mail on Sunday reporter in the abandoned residence of the British ambassador in the Libyan capital, Tripoli.
The research paper, which was intended to be read by only MI5 agents and officers, was produced after studying 90 terror suspects investigated by the security service.
While some of the information in the document comes from the interrogation of suspects, other data came from surveillance by spies and informants. The report gives a rare glimpse into how security service agents view Islamic extremists, and what MI5 believes are the main causes of Muslims becoming radicalised.
While the report says that Western foreign policy and the perception that ‘Islam is under siege’ plays a role, they are not the main cause. Instead, the four causes of radicalisation are:
* ‘Trauma’, such as the death of a loved one: Ten per cent of terror suspects became radicalised after a life trauma, says the report.
* ‘Migration’: A third of all extremists ‘migrated to Britain alone’.
* ‘Criminal activity’: Two-thirds of the sample had criminal records.
* ‘Prison’: Muslim prisoners who are not religious are often radicalised in prison. The report identified 60 known Islamist extremists operating in British jails.
The study says that the ‘mean age’ at which a Muslim becomes radicalised is 21.6 years, while anyone between the ages of 16 and 32 is regarded as vulnerable.
The report added: ‘Where data is available, two-thirds came from middle or upper-middle-class backgrounds, showing there is no simplistic relationship between poverty and involvement in Islamist extremism.’
The study also found that half of the suspects it surveyed were married and some had children. ‘This indicates that having commitments to a spouse and children did not necessarily restrain these individuals from becoming involved in activity that may have resulted in lengthy imprisonment, if not death.’
The report adds: ‘The vast majority (90 per cent of those on whom we have data) are described as sociable, with a number of friends. Our data thus tends to contradict commonly held stereotypes of terrorists being “mad”, psychopathic or evil. ‘It also challenges the theory that individuals who turn to radical or extremist networks are those who are unable to make friends in normal life.’
Professor Anthony Glees, a terrorism expert at Buckingham University, said: ‘I am glad MI5 are privately accepting that terror suspects were sociable creatures because for a long time they gave the impression that terrorists and suicide bombers are lone wolves. ‘It is also encouraging that they believe most terror suspects come from middle-class backgrounds. Traditionally, there was a belief among the spooks and police that terrorists were caused by poverty.’
The Home Office, which speaks of behalf of MI5, declined to comment.
Furious British government Minister urges ban on foreign language driving tests
Ministers are considering banning people from taking driving theory tests in foreign languages amid safety fears. The Government is concerned that ‘political correctness’ means thousands of drivers have been granted British licences despite not being able to read road signs.
Under current rules, the theory test can be sat in 19 different languages and candidates are also permitted to attend the practical test with a translator.
Transport Minister Mike Penning said it was ‘incredible’ that 93,407 theory tests were sat in a foreign language last year.
Department for Transport figures show 18,927 were in Urdu, 12,905 in Polish and 298 in Albanian. Some 230 Russians, 452 Romanians and 21 Bulgarians took the test with a translator. More than 1,500 people also took theory tests in a foreign language to qualify as a bus driver.
The taxpayer meets the cost of translating theory tests into foreign languages – but learners must pay for their own translator during the practical test. In total, around seven per cent of all theory tests are not conducted in English.
Tory MP Mr Penning said he was considering how to change the rules. ‘I find it incredible that Labour thought it was a good idea to let people without a basic grasp of English loose on our roads,’ he said.
‘Road safety should be our priority, not political correctness. Instead of spending taxpayers’ money on costly translation services and interpreters, we want to explore whether that money would be better spent on actually helping people to learn enough English to be able to drive safely.’
But details of how an English-only test regime could be introduced without falling foul of EU anti-discrimination laws are still being hammered out.
Warning over British children’s ‘appalling’ handwriting skills
Children are struggling to write their own name because growing numbers of schools are shunning traditional handwriting lessons, academics have warned.
Education standards are at risk as pupils are increasingly allowed to submit essays digitally using email, memory sticks or even presenting PowerPoint displays, it was claimed.
Prof Carey Jewitt, from London University’s Institute of Education, said students’ handwriting skills were “absolutely appalling”, adding that many failed to get the practice they needed at home or in the classroom.
Other academics warned that a failure to teach children to write may stunt their development and hold them back in the classroom.
It comes after the publication of primary school exam results this summer showed that pupils perform worse in writing than any other core subject. A quarter of 11-year-olds failed to reach the standards expected for their age in writing, compared with less than 20 per cent in reading and maths, figures showed.
Prof Jewitt, who has been leading research into the relationship between handwriting and technology for the last 10 years, said the amount of lesson time devoted to the skill had plummeted. “Little children may not be able to write their names but most can type them,” she told the Times Educational Supplement. “Even families on a very low income are using email, using Skype.
“Students’ handwriting we have seen is absolutely appalling because they are not getting any practice. They aren’t handwriting at home.” Observations of lessons in secondary schools suggest that handwriting has now all but disappeared from the classroom, she said.
Teachers increasingly prepare their lessons in digital form in a range of subjects, including English, before presenting them on high-tech white boards. Many children are also allowed to submit essays as computer print-outs, send them to teachers by email or hand in work using memory sticks.
Dr Karin James, from the department for psychological and brain sciences at Indiana University in the United States, told the TES that a failure to develop handwriting skills undermined children’s reading ability. “This is setting their brains up to be able to process letters and words,” she said. “That doesn’t happen with keyboarding or even with tracing the letters. “Creating the form, stroke by stroke, seems to be very important. They need to produce the letters in their minds, then create them on paper.”
One study from Warwick University in 2008 suggested that children who struggled to write fluently devoted more brain capacity to getting words onto a page during tests – interfering with their ability to generate ideas, select vocabulary or plan work properly.
A Department for Education spokesman said: “Handwriting is the most fundamental building block of being educated. “Every single parent expects their children to be taught how to properly write at school. The current National Curriculum stipulates this is an absolute central part of primary school lessons.
“This is a pretty esoteric debate. No one is saying that keyboard skills aren’t important – but if people like Bill Gates and the late Steve Jobs had to learn to write, then so can pupils in schools today. “