Operation follow-up appointments cut to save money
Health authorities have cut the number of follow-up appointments for people who have had operations by up to a third in a single year, figures show, as they strugrgle to save money.
Across England the number of such appointments, routinely offered to check for problems, dropped by 1.2 million between 2009-10 and 2010-11, from 23.4 to 22.2 million, a five per cent fall.
In one trust, Pennine Acute Hospitals NHS Trust, the number of such appointments dropped by 38 per cent; while at Ealing Hospital NHS Trust they fell by 27 per cent.
Doctors are concerned the reductions, revealed by Pulse, a magazine for GPs, jeopardise patient care.
The situation seems to be affecting the whole country, with some health authorities instigating percentage cuts to the number of follow-up appointments they are prepared to fund.
NHS Gloucestershire has told doctors it will be funding 900 fewer rheumatology follow-ups, with dermatology, urology and other departments also affected, according to the county’s local medical committee (LMC). The trust has refused to say what they amount to in percentage terms.
Dr Philip Fielding, chair of Gloucestershire LMC, said members were “concerned patients with chronic conditions could be prejudiced by being discharged to GP practices where there might be neither the skill nor the capacity to treat them”. He added: “This is another of the games hospitals play to save money. Readmissions are obviously a concern because they are more expensive than follow-up appointments. Everything has workload implications for primary care at the moment. There comes a time when enough is enough.”
Sir David Nicholson, chief executive of the NHS, has demanded the service makes “efficiency gains” of up to £20 billion by March 2015.
This is translating into a myriad of cuts, such as stipulating that patients need to demonstrate worse physical hardship before qualifying for pre-planned operations like hip replacements.
The Department of Health is trying to distance itself from such behaviour. On Monday Andrew Lansley, the Health Secretary, said managers would be banned from rationing treatments so that patients died or went private first, as highlighted in a damning report by the NHS Co-operation and Competition Panel earlier this year.
A Department of Health spokesman said: “All patients with a clinical need for a follow-up appointment in hospital should have one. We have not set targets to reduce the number of follow-up appointments and have no plans to do this.”
Unbelievable: Woman left to die because of British “safety” rules
Death would be too kind for the guy responsible
A Lawyer who fell 45ft down a mine shaft died after fire chiefs refused to mount an immediate rescue operation because of health and safety fears. Alison Hume, 44, was left lying in agony in the cold and dark for eight hours with several broken bones.
A report into her death yesterday found she could have survived if rank-and-file firemen had been allowed to do their job and bring her out. One fireman had been lowered down while a paramedic was strapped up in a harness ready to follow.
But bosses refused to use a winch to lift out the mother-of-two because they were slavishly following rules which said the equipment could only be used to save their own staff. Instead they waited through the early hours of the morning for a police mountain rescue team to arrive.
Mrs Hume was lifted out but died shortly afterwards from a heart attack brought on by hypothermia.
Last night her stepfather Hugh Cowan, 69, said: ‘They need to ask why people are using health and safety as an excuse for failure, rather than a reason for success.’
The case is the latest example of emergency service personnel putting their safety ahead of those they are supposed to be rescuing. Ten-year-old Jordan Lyon, of Wigan, drowned in a pond in 2007 after two police community support officers said they were unable to help him due to health and safety regulations.
Earlier this year coroner David Roberts said the emergency services must be prepared to ‘risk their lives’ after hearing how red tape cost vital minutes during Derrick Bird’s Cumbrian gun massacre.
She was found by her teenage daughter before Strathclyde Fire and Rescue Service arrived and fireman Alexander Dunn was lowered to the bottom of the shaft.
Mrs Hume was still conscious but had a collapsed lung, several broken ribs and a broken sternum.
While the rescue operation was in progress, group commander Paul Stewart arrived as a media relations officer. He assumed command after realising he was the most senior officer there.
His first move was to stop a paramedic who was already strapped in a harness from being lowered. And he refused to allow colleagues to rescue her using ropes because they had not received the correct training. Mr Stewart feared they could be sued if the mission failed.
Incredibly, he told a fatal accident inquiry that the operation had a ‘successful outcome’ because the casualty was ultimately removed from the shaft.
Mr Stewart is still in the fire service and is on the waiting list for promotion to divisional commander. Strathclyde Fire and Rescue Service expressed ‘enormous regret’, but refused to apologise until after the report was published last night.
In the report Sheriff Desmond Leslie said Mrs Hume might have survived if she had been removed sooner. He said Mr Stewart and colleague William Thomson were ‘focused on self-justification for the action or non-action taken by them’ and did not reflect on lessons that could be learned from the tragedy. The sheriff added: ‘I found their evidence bullish, if not arrogant.’
The sheriff criticised the fire service’s failure to recognise the urgency of a rescue, noting the firefighter had told the inquiry ‘there was not a huge concern about the time’
Yesterday Scotland’s First Minister Alex Salmond ordered a fresh inquiry. Mrs Hume’s mother Margaret Cowan, 67, said ‘the public will lose all confidence in the fire service’ if the inquiry fails to ‘lead to something positive’. She added: ‘Some people have said to me that if the same thing happened again, they wouldn’t even phone 999 – they would get a rope and do the rescue themselves.’
And Mrs Hume’s father Ian McEwan described his daughter’s death as ‘a needless waste of life’. He said his granddaughter Jayne, 17, still had nightmares about finding her mother, adding: ‘She knew when she cried down to her mum that she was still alive.’
He added: ‘I hope no other family finds themselves in the same situation as we did.’ And Mr Cowan said he felt the fire service’s apology had been ‘forced upon them’.
He added: ‘I just feel have they been prompted by the fact that the First Minister has asked for an inquiry. ‘They did not seem interested in apologising yesterday or earlier today. It’s difficult to see whether I can honestly accept it under the circumstances.’
Former watch commander John Bowman – who had been ordered to rewrite the rule book on rope rescues weeks before the tragedy – yesterday spoke out against his former employers.
Mr Bowman, 52, had warned bosses that changing the rules to prevent firemen using ropes to rescue people was ‘a disaster waiting to happen’.
He said: ‘Many incidents you go to in the brigade don’t end with a successful resolution. Sometimes the person can be dead before you get there, sometimes you just can’t help people. This was not the case for Mrs Hume. It’s not the fire service’s finest hour.’
Last night the Chief Fire Officers Association said there was no uniform approach to the uses of winches in forces across Britain.
However, it said that health and safety legislation must not be ‘allowed to constrain incident commanders when making decisions in dynamic emergency situations’.
The man who turned around the worst school in Britain
Discipline and old-fashioned standards are his secret weapons
Mossbourne Academy is ranked among the top one per cent of schools in the UK. This year, 82 per cent of pupils attained five or more GCSEs at grades A* to C. Many schools in leafy shires covet such success. Eight of its students — one a teenage mother — won places at Cambridge. Ofsted rates it both ‘outstanding’ and ‘exceptional’.
Yet when it opened in 2004, it was rising from the dust of the old Hackney Downs School — closed after it was condemned as the worst school in Britain.
The man behind this transformation is its inspirational head, Sir Michael Wilshaw, whose success has earned him national acclaim and Government recognition. Now, Education Secretary Michael Gove has singled him out to be the next Chief Inspector of Schools.
As head of Ofsted — a post he takes up in January — Sir Michael, 65, hopes to replicate the success of Mossbourne across the country. The challenge is huge, but he intends to tackle it with his customary rigour.
In a week when the Prime Minister accused many schools of ‘coasting’, Sir Michael reiterates his belief in strong leadership, inspirational teaching and a firm sense of order.
Detractors have objected to the parade-ground discipline at Mossbourne; to the regimented playground queues, the scrupulous insistence on courtesy and formal terms of address for teachers.
Sir Michael’s justification for his ethos is incontrovertible: strong discipline allows for learning; without it classrooms descend into mayhem. ‘We recognise that our pupils need more structure at school, not less, if they lack it at home,’ he says. ‘Children here know there are lines which they should not cross. ‘They don’t want a badly behaved class, a chaotic school. They say: “It’s strict but we learn a lot.” It is up to every school to create such a culture of orderly behaviour.’
On his watch at Ofsted, there will be no allowances for difficult home lives, and no woolly tokenism. He abhors the idea — promulgated by Nick Clegg — that standards should be lowered to allow more students from deprived backgrounds access to top universities.
‘If you talk to our eight pupils who won places at Cambridge this year, they’ll say they didn’t want to be singled out for special treatment. ‘If you go to the top universities, you’ll be mixing with the best and it would entrench mediocrity in the state sector if allowances were made for those from disadvantaged backgrounds.’
Failing schools, he insists, should be hauled from the abyss of ill-discipline and under-achievement by heads who brook no excuses. ‘If heads are going to do something about disadvantaged children and close the attainment gap with the best schools, there can be absolutely no excuses not to deliver. ‘It does not matter about levels of poverty, ethnicity or what the child’s background is. I say: I don’t care where you’ve come from. It’s where you’re going that’s important.’
In pursuit of order and control, he supports the move, endorsed by Michael Gove, of imposing boot camp regimes in schools where laxity has led to anarchy and falling academic standards. ‘Where discipline is an issue, there is nothing wrong with Army-style rigour,’ he says. ‘I’ve employed people, both here and at other schools, who have police and Army backgrounds and they have been good teachers. They understand how to deal with difficult children. ‘It’s an absolute nonsense for schools to be turned upside down by a minority. If a youngster is disrupting a class, you deal with it quickly. You nip it in the bud.’
To this end, Mossbourne parents sign a ‘home/school contract’: they agree to obligatory evening and Saturday morning detentions for miscreants. But, equally, there are extra lessons for the gifted and talented; a plethora of sports clubs and drama and music groups — the school is a specialist music academy — all of which extend the school day well into each evening.
‘Our pupils are not obliged to come here, but if they do they must accept that we are in loco parentis and we expect parental support for us,’ says Sir Michael. And he stands by his controversial belief that in areas of deprivation, and where families are dysfunctional, teachers should act as surrogate parents.
‘It’s common sense, isn’t it?’ he asserts. ‘Where there are children whose parents — despite loving them deeply — have not the wherewithal to support them, where the estates they live on are degenerating into chaos because of gangs, school is the only chance they have.
‘If that means getting the children into school earlier, keeping them later, giving them an evening meal and escorting them to bus stops and train stations so they get home without being mugged or bullied; if it means giving them the skills and training to equip them to get a job, then I make no apologies for us being surrogate parents.’
In line with this ethos, the Mossbourne day starts early. On the day I visit, at 7.30am prompt, 220 pupils file in — smart and orderly in regulation grey and crimson uniforms — to read with teachers.
It is part of a programme to bring those who arrive from primary school without the requisite literacy skills swiftly up to speed. ‘Children who cannot read or write properly quickly become disruptive,’ argues Sir Michael.
The sceptical — and professionally envious — have suggested Sir Michael achieves such excellent results because his school creams off the best students from the surrounding area, as a grammar school does through the use of entrance exams. This, he says, is ‘bunkum’.
Geography is the sole criterion for entry: those who live closest to the school get the places. Around 1,500 apply each year for just 180 slots — and they are streamed into four sets according to ability.
Remarkably, 38 per cent of pupils do not speak English as their first language. And not only are 42 per cent of pupils eligible for free school meals, 30 per cent have special educational needs. Despite all these challenges, the school is thriving.
Sir Michael is an old-school pedagogue. Authoritative but not remote, he is imbued with a strong sense of social justice underpinned by his Catholic faith. He has taught — always in tough East London schools — since the late 1960s.
His own background is modest. His father, a postman, suffered spells of unemployment, but Sir Michael benefited from a grammar school education in South London where he grew up. Thanks to a good history teacher, he read the subject at Birkbeck College, London University.
Impeccably attired in grey suit, crisp white shirt and red tie, he tours the school with me, quick brown eyes alert and interested.
He not only greets children by name, but appears to be acquainted with whole families. ‘How’s your brother? An art foundation course? Jolly good,’ he smiles.
Pupils are polite and deferential. They accord him his full title. I am addressed as ‘Miss’, and each class rises to its feet as I enter.
Mossbourne, for all its ‘boot-camp’ severity, is an inspirational school. In morning assembly achievement is publicly honoured. Laurels are presented for success in languages. A Year 7 pupil steps up to receive a certificate of merit for Latin.
‘Someone translate: “Veni, vidi, vici,” ’ Sir Michael asks the assembled 11-year-olds. A hand shoots up. The correct answer (I came, I saw, I conquered) is supplied and he beams his approval.
The school offers a curriculum similar to that of the leading independent schools. As well as the usual sports, rowing — customarily regarded as a public school activity — is on the syllabus. This year a crew will attend Henley Regatta. To those who ask ‘why?’, Sir Michael’s riposte is: ‘Why not?’
Disgusted British pupils force three girls, 15, who made vile Nazi salutes during Remembrance Day silence to stay away from school
No mention of the names or ethnic identity of the offenders. What does that tell us?
Three schoolgirls sickened their classmates by performing a vile Nazi salute during a two-minute silence to mark Remembrance Day.
The 15-year-olds have not returned to Deer Park School in Cirencester, Gloucestershire since Armistice Day, claiming they have been ‘bullied’ over the incident.
The girls were put into detention after the incident for the rest of the day, but many of their fellow pupils felt this punishment did not go far enough. There have been calls for tougher action to be taken against the three and for them to be educated about the horrors of war. Pupils say that the girls should be made to meet the families of fallen soldiers and visit war graves to get a better understanding of how offensive their behaviour was.
The school’s head teacher Chiquita Henson said: ‘I was very disappointed to learn of the actions of the three girls in a classroom away from the main ceremony.
‘But I was encouraged by the strength of feeling expressed by their peers. ‘The pupils involved have expressed their regret for the upset that has been caused and now wish to move on in their learning. ‘We recognise that all young people occasionally make mistakes and are committed to supporting the girls’ return to school.’
The girls have been off school since the incident and it is understood that it is because of the angry reaction of other pupils along with allegations of cyber-bullying.
Mrs Henson added: ‘This year it was a very moving occasion as a bugle played the last post while the Union Jack was lowered.’
Veteran Allen Howe, chairman of the Cirencester branch of the British Legion, said he was appalled to hear of the incident. ‘I was told by my granddaughter who is a pupil at the school,’ he said. ‘It is absolutely disgusting and totally wrong. I thought it was very good that the other pupils have refused to tolerate this behaviour.’
GWPF Responds To New IPCC Report
Natural Variability To Dominate Weather Events Over Coming 20-30 Years
London: For many decades to come, and probably longer, mankind’s influence on the frequency of extreme weather events will be insignificant.
According to a preliminary report released by the IPCC, there will be no detectable influence of mankind’s influence on the Earth’s weather systems for at least thirty years, and possibly not until the end of this century.
The Summary for Policymakers of the Special Report on Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaptation, is in stark contrast to other statements made by the IPCC. It shows that mankind’s influence on the weather is far smaller than natural factors.
If and when mankind’s influence becomes apparent it may be just as likely to reduce the number of extreme weather events as increase them.
Surveying the state of scientific knowledge IPCC scientists say they cannot determine if mankind’s influence will result in more, or fewer, extreme weather events over the next thirty years or more.
The IPCC report says:
“Projected changes in climate extremes under different emissions scenarios generally do not strongly diverge in the coming two to three decades, but these signals are relatively small compared to natural climate variability over this time frame. Even the sign of projected changes in some climate extremes over this time frame is uncertain”
“This shows the depth of our ignorance of this subject,” says Dr David Whitehouse, science editor of the GWPF. “Whilst it is always important to think about the future in the light of changes we observe to the Earth’s climate, in trying to draw conclusions so far ahead based on what we know, the IPCC scientists are speculating far beyond any reasonable scientific justification.”
Even making the questionable assumption that our computer models are good enough to predict what will happen in the future, for projected changes by the end of the 21st century, the uncertainties in those computer models, and the range of natural climatic variability, are far larger than any predicted human-influenced effects.
Extreme weather events have always been with us, and will continue to be so. It is the international community’s responsibility to make those likely to be subjected to them become more resilient.
Contact: Dr David Whitehouse; email@example.com
Dr Benny Peiser firstname.lastname@example.org
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