New tests on doctors will save 20,000 lives a year by improving quality of care (?)
Hot air. Just more box ticking and hand wringing. The only way to improve the service is to fire a lot of bureaucrats and use the money saved to hire more doctors and nurses and fund better medicines
Health Secretary Andrew Lansley will today unveil plans to grade NHS doctors and hospitals to improve the quality of service for patients. They will be judged against nearly 60 tough new goals designed to save more than 20,000 lives a year.
In a speech at a Central London hospital, he will call on the NHS to focus on not only the speed at which patients are treated, but the quality of care that patients receive.
Figures on hospital death rates, the performances of GPs and surgeons and patients’ experiences will be published as part of the NHS Outcomes Framework.
Fifty-seven indicators will replace the former target-led system and will include a focus on improving cancer survival and a zero-tolerance approach to hospital-acquired infections such as MRSA.
The plans are designed to ensure patients are treated with dignity by measuring the ‘responsiveness’ of staff to patient needs. They aim to improve women’s and families’ experiences of maternity services, increase the number of people who can access an NHS dentist and help older people recover independence after illness.
An indicator on carers who look after sick and elderly relatives is also included.
Mr Lansley will say: ‘We have to clear the decks and be clear this is what we are focusing on. ‘People say in three and a half years’ time, in 2015, at the next election, how will we know whether you’ve succeeded or not? The answer is, “Have the outcomes improved?” ‘It will be my failure if we haven’t improved them and the NHS should feel that it has not succeeded, that is what we are setting out to do.’
Ministers will be expected hold the Health Service to account on delivering increasing improvements. Where performance falls below minimum requirements they will intervene to drive up quality, although how this will work in practice is unclear. The framework will also draw on existing NHS information to reduce ‘administrative burden’.
As NHS cuts back, thousands are forced to pay for their operations
Thousands of patients are having to fork out for their operations because of tough restrictions on GP referrals and NHS cutbacks, figures show. A surge in the number of ‘self-pay’ procedures among desperate patients in recent months has been reported by four private healthcare companies.
At the same time, Department of Health figures show GPs referred 120,293 fewer patients for NHS procedures between July and September compared with the same period last year – a 4 per cent drop. First outpatient appointments fell by almost 100,000 to 4.3million.
There are growing fears that cash-strapped trusts are putting pressure on GPs to delay referrals. In addition, there are concerns that referral management centres, panels that screen GP referrals according to locally set guidelines, are limiting the number of patients who can get NHS treatment.
Trusts are also reducing the availability of some procedures on the NHS, including hip and knee replacements, IVF treatment and plastic surgery.
Four private healthcare companies contacted by the GP newspaper Pulse have seen a dramatic rise in business from patients who do not have medical insurance but have chosen to pay for themselves to avoid blocks placed on GP referrals.
Spire Healthcare, which runs 37 private hospitals, saw a 10 per cent year-on-year increase in the number of self-pay ‘clinically necessary procedures’ it carried out in October. Enquiries about self-pay procedures rose by 33 per cent between August and November.
Nuffield Health, which has 30 private hospitals, has had a big increase in self-pay treatments this year, particularly for orthopaedics and plastic surgery.
BMI Healthcare, which describes itself as ‘Britain’s leading provider of independent healthcare’, said it has seen a ‘continued and steady’ increase in the number of self-pay procedures.
And at Ramsay Health Care, self-pay cases have risen by 5 per cent in the last six months. Industry-wide figures suggest that on average 150,000 patients each year pay for their operations, with the latest figures reversing a falling trend.
Dr Jean-Jacques de Gorter, clinical services director at Spire Healthcare, said: ‘The increase in enquiries about private treatment is largely the result of changes we’re seeing in the healthcare system. NHS funding can only stretch so far.’
Katherine Murphy, chief executive of the Patients Association, said: ‘It is disgraceful that patients feel they must go private to get the treatment they need.’
A Department of Health spokesman said: ‘If a treatment or procedure is clinically necessary then that person should be able to receive it on the NHS. ‘That’s why we announced firm action recently to ban non-clinical rationing measures imposed on patients that don’t take account of their individual clinical needs by March 2013.’
Now the elf n’ safety monsters attack Britain’s Christmas
Thompson Dawson was at Buckingham Palace last week to receive an MBE from the Queen for services to charity. It was a proud moment for the 82-year-old businessman, who has been bringing joy to children for the past four decades while raising money for leukaemia research.
After his wife Marie died from cancer in 1972, Mr Dawson became involved in a charity she helped set up which would arrange Santa Claus visits to children in the Greater Belfast area.
Up to 30 volunteers would give their time every December to dress up as Father Christmas and delight youngsters with a surprise visit to their homes. In exchange, their parents would make a small donation to the charity.
For almost 40 years, Mr Dawson has run the operation with military precision. He is too modest to say how much money he has raised, but it must add up to tens of thousands of pounds, if not more.
This enchanting scheme covered a wide area from Lisburn to Carrickfergus and reached across the sectarian divide, even at the height of the Troubles.
I heard about Mr Dawson from his nephew Colin, who wrote to me after an item in this column concerning instructions which had gone out to parents who volunteer to play Santa in schools that under no circumstances must they allow children to sit on their knee.
Although Mr Dawson has been honoured by the Queen for his achievements, there will be no more home visits from Santa for the children of Belfast.
The scheme has had to be abandoned under the burden of bureaucratic interference. In the past couple of years, vetting of volunteers has become more intrusive and onerous.
Despite the fact that the parents invited the Santas into their homes and were present throughout, every single volunteer is considered a potential paedophile unless he can prove otherwise.
Mr Dawson decided that because of the amount of time and paperwork involved he could no longer continue. When I spoke to him yesterday, he didn’t want to make a fuss but is clearly bitterly disappointed.
His pride at receiving his MBE is tinged with sadness that a scheme which brought innocent pleasure to children and raised thousands for leukaemia research has had to be abandoned.
Mr Dawson hopes to keep the charity going through setting up a Christmas grotto in a local shopping centre, where parents can bring their children. But home visits from Santa, the unique feature of his beloved project in memory of his late wife, are gone for ever — another victim of the hysterical paedophobia of the child protection industry.
As his nephew Colin put it to me: ‘I fully understand the need to protect our children but it saddens and angers me in equal measure that fear has removed the joy and spontaneity of many worthwhile causes and activities that were once taken for granted.’ Amen to that.
Under the guise of ‘protection’, the State delves ever-deeper into our private lives. For instance, Harry Foster writes from Middlesbrough to tell me about his wife’s attempts to give something back to society.
Jackie Foster is a grandmother in her 70s who volunteered to help children read at a local school. Nothing unusual in that. My wife used to do the same when our kids were young.
But the forms she was expected to fill in were both extensive and intrusive — everything from her mother’s maiden name to what qualifications she left school with. They even demanded her marriage and birth certificates. Eventually, when a woman from the council came round to interrogate her, Jackie politely withdrew.
She also applied for a part-time job making tea and coffee in a charity shop run by a local hospice. As well as the usual background checks, they wanted to know what medication she was taking.
As a retired postal worker, who left the Royal Mail after 22 years with an exemplary reference, Jackie was understandably insulted. What damn business was it of anyone if she was taking prescription medicine? She was only going to make tea, for heaven’s sake.
But we’ve been here before. Even women who volunteer to arrange the flowers in churches are subject to criminal records checks, just in case they plan to molest the choirboys.
When it comes to child ‘protection’ we are all considered guilty unless we can prove ourselves innocent in advance.
In the most outrageous example, a supply teacher in Newcastle has been sacked after giving a lift home to a 17-year-old boy who had lost his bus fare.
Martin Davis, who has been teaching for 23 years, was working at Tyne Metropolitan College helping pupils with dyslexia prepare for the world of work.
Last month, the boy approached him and said he had no money for his bus fare home.
‘I said that because he lived on my route home I would give him a lift,’ said Mr Davis, who has two children.
‘A week later one of the office staff at the college pulled me to one side, having heard about me giving the boy a lift, and said it was a stupid thing to do because I was opening myself to all sorts of allegations. I said I was sorry and she just told me not to do it again, and that seemed to be the end of the matter.’
Next thing he knew he was accused of gross misconduct by the agency which employed him, suspended without pay and told there was ‘no way back’.
No wonder thousands of adults who would otherwise willingly volunteer to give up their time to work as sports coaches and youth club leaders are not prepared to put themselves through an impertinent, forensic vetting process to prove they’re not a kiddie fiddler.
There really is something depressingly sick in a system consumed by paranoia, which sees a sinister motive in every act of human kindness and Christian charity — and regards every adult who wants to work with children as a potential paedo waiting to pounce.
Of course, the authorities insist that all this is necessary to protect children and any personal information gleaned will be kept confidential. Right. If you believe that, you probably still believe in Santa Claus.
Santa a ‘Red-faced symbol of over-indulgence’ according to British magazine
Now Father Christmas has been banished from the nation’s newsstands – so as not to upset cash-strapped families who can’t afford presents this year. Radio Times have dropped the iconic figure from the front cover of their Christmas edition, for the first time in nearly a decade.
The TV listings bible said it wanted to reflect the nation’s current mood by banishing Santa, a ‘symbol of the boom years’.
Instead the Radio Times has opted for a ‘festive flowing illustration’ of a Christmas tree, which it feels better reflects the tough economic climate by ‘harking back to simpler times’.
‘This is going to be a difficult Christmas for many people and we have tried a cover that’s nostalgic and makes people feel warm,’ said the magazine’s editor, Ben Preston.
‘For many years Santa has been a cheery fixture of our legendary Christmas double-issue… but somehow that didn’t feel right this year. ‘At a time when so many people are hunkering down with friends and family and turning their backs on extravagant gift-giving, we wanted something different.’
This year’s front cover has been illustrated by artist Kate Forrester, whose other work includes commissions for John Lewis, Tiffany and Penguin Books. According to Mr Preston, the red and green cover is ‘nostalgic and beautiful, to lift the spirits in troubled times’.
It won’t be the first time Santa has been ditched as the cover star during times of austerity. Following the infamous Black Wednesday in 1992 he was replaced with a snowman. And he also disappeared from the Christmas cover when the dotcom bubble burst in the early 2000s.
But the magazine’s sensitive approach hasn’t stopped bosses from increasing the price of the Christmas edition by 4.2 per cent. This year’s edition goes on sale from Wednesday and costs £2.50, up from the £2.40 charged last year.
British charter schools obliged to promote marriage
The importance of marriage is to be taught to every pupil at the Government’s flagship free schools and academies.
The schools will be made to sign up to strict new rules introduced by Michael Gove, the Education Secretary, setting out what pupils must learn about sex and relationships. Headteachers will be told that children must be “protected from inappropriate teaching materials and learn the nature of marriage and its importance for family life and for bringing up children”.
But the decision to spell out an explicit endorsement of marriage in the curriculum for tens of thousands of children is highly politically significant, and likely to be welcomed by Conservative traditionalists who have been concerned at a perceived failure by David Cameron’s Government to deliver on pledges to support married life.
Mr Gove has introduced the “model funding agreement” as a template for how every new free school and academy is run. Ministers want a dramatic increase in the numbers of both types of schools.
The new rules on marriage are set out in clause 28 of the funding agreement – an echo of the controversy under Margaret Thatcher’s government when Clause 28 of the 1988 Local Government Bill banned schools from promoting homosexuality.
The agreement is a distinct change from current guidelines which state that children should learn the nature and importance of marriage and of stable relationships for family life and bringing up children. The reference to “stable relationships”, which alludes to couples living together outside marriage and homosexual partners, has not been included in the model funding agreement documents.
The wording of the section suggests a strengthening of traditional values in schools, but will also provoke opposition from those who believe marriage should not be given a privileged status in the curriculum.
Including the teaching of marriage in funding agreements puts a legal compulsion on headteachers to comply. English, maths, science and RE are the only other curriculum subjects guaranteed in the model document.
If the terms of the agreement are broken, funding for the school can be withdrawn by ministers. It may also be possible for parents to legally challenge schools that are not abiding by the letter of their funding agreements.
The funding agreement clause also bans the use of “inappropriate materials” in schools. It is likely to be seized on by campaigners who last week attacked the use of “explicit” sex education material in primary schools and called for a ban on Channel 4’s “Living and Growing” DVD used in thousands of primary schools which shows cartoon characters having sex in a variety of different positions.
Lessons in personal, social and health education (PHSE), which include sex and relationship education, are currently under review as part of the Government’s general overhaul of the national curriculum, which applies in schools which are not either academies or free schools.
Tens of thousands of children are now taught in academies across the country. The number of “independent” state schools, which receive funding directly from Government and have freedom over finances, curriculum and teachers pay, has mushroomed under the Coalition.
All schools, whether primary or secondary, rated “outstanding” by inspectors can now become academies without going through a lengthy application process, which has triggered a rise in numbers from just over 200 in 2010 to 1,300 now.
The funding agreement marriage clause also applies to the 24 free schools, set up by parents, teachers, faith groups and charities. Sixty more are in the pipeline and Mr Gove has made their expansion his flagship policy.
Nick Seaton, chairman of the Campaign for Real Education, said: “Given the benefits that derive from marriage for young people, a short statement requiring that pupils learn its importance is entirely sensible.”
But Terry Sanderson, president of the National Secular Society, said: “For children brought up by unmarried parents or single parents being told that marriage is the only valid family arrangement will be totally contradictory to everything they know about the world. It opens the door for religious schools to teach a really narrow version of what constitutes an acceptable relationship. “It is telling our children that their own family structure is somehow inferior. A lot of church schools would love to do that and this gives them license to do it.”
Putting marriage at the heart of the curriculum will make Mr Gove popular among many Conservatives, but inflame tensions with the Liberal Democrats.
David Cameron, the Prime Minister, promised to recognise marriage in the tax system in this Parliament. But the plan went on the back burner in coalition talks with the Liberal Democrats, who fiercely oppose special recognition for marriage.
Mr Cameron has said that he intends to honour the pledge before 2015, but George Osborne, the Chancellor, suggested last month there would be no room for tax cuts before the election. In the same month, in a keynote speech to the Conservative Party Conference, Mr Cameron urged party members to back gay marriage.
New Office for National Statistics figures show that marriage is steadily declining, with married couples now making up less than half the population.
However research by the Centre for Social Justice, set up by Iain Duncan Smith, the secretary for work and pensions and the main proponent of tax breaks for married couples, found that children have better outcomes if their parents are married.
However, the issue of marriage is steeped in controversy. But critics said that at a time when the number of cohabiting couples was at record levels, focusing on marriage in lessons would confuse and alienate children.
A spokesman for the Department for Education said: “Academies and free schools have to teach a broad and balanced curriculum. They are required to have regard to the statutory guidance covering sex and relationships education.”
Oxford’s feared admission interviews
This year’s Oxbridge interviews begin tomorrow. I only know this because a friend asked me if I would give her niece a mock one, as she is at a state school where they don’t coach pupils in interview technique, not with quite the same ruthless efficiency as they do at public schools, anyway.
She is hoping to read PPE [Philosophy, Politics and Economics] at Oxford and as I read one of those Ps as a postgraduate – philosophy, at Durham – my friend thought I could perhaps come up with some questions that would test her. She also thought that because I interview celebrities for a newspaper I must know how to throw a curve ball. I tried to explain to her that the average celebrity has a much meaner intelligence than the average Oxbridge candidate, but she wasn’t having it.
We met on Wednesday, then – convenient for the niece because her school was on strike. I don’t know about her, but I learnt a lot. The first thing is that, if she is representative of 17-year-olds, our state education system is far from dumbed-down. Yes, she is expected to get the usual three As, but she was also articulate, composed and thoughtful. And not once in 40 minutes did she say “like”. She even made good eye contact, which I certainly couldn’t at her age.
When I asked her loaded questions – such as “Is a good person more likely to be a good president?” or “Can it ever be moral to cut benefits from the poor?” or “If you have never been to Canada, how do you know it exists?” – she gathered her thoughts for a moment and then gave considered answers.
Before the interview, I’d asked some colleagues who had been to Oxford what kind of questions I should ask. One said that if the niece is asked to throw a brick through the window, she should open it first. Lateral thinking, see. Another said there are no right or wrong answers to the sometimes strange-sounding questions: they are merely opportunities to demonstrate your originality, logic and ability to argue.
This was borne out by Professor Mary Beard on Radio 4. She said that, contrary to the myth that she and her fellow dons are eccentric sadists who enjoy humiliating very bright and very nervous teenagers, all their questions are intended to help rather than hinder the interviewee. “We want them to talk themselves into a place, not out of one.”
Above all, it seems, candidates are judged on their merits, regardless of background. That seems to be confirmed by the news that even Tony Blair couldn’t persuade Oxford to offer a place to Gaddafi’s son in 2002. Saif al-Islam had to make do with a place at LSE (also known as the Libyan School of Economics). I wonder how Saif would have answered one of the questions I put to the niece: Is dictatorship sometimes a better option than democracy?
I’ll leave you with a story a colleague told me. He turned up 24 hours early for his Oxford interview, due to a date mix-up. He sat outside the tutor’s office for an hour before realising, then had to spend the night in college without a change of clothes. The stuff of anxiety dreams, indeed. When it came to the interview he landed a PPE scholarship, but two weeks into his first term he gave up and switched to history, because he found he hated economics.
The politics don was not pleased – but blamed the economics don for not asking him any questions at interview, because he was too keen to disappear for his pre-lunch sherry.
Call for council ‘diet police’ to inspect private sector employees in Britain
What evidence do they have that lectures on diet would reduce illness?
Council inspectors should start monitoring what private sector employees eat at work in order to help improve the country’s health and to reduce sickness rates, a report has concluded. Drastic action is needed to halt the cycle of ill health amid an alarming “sick note culture”, it found.
The report from 2020Health, a think tank, found that the economy is losing tens of billions of pounds in productivity because of a high number of sick days.
The report recommended the role of council “diet police” be increased to offer advice to the private sector. The authors said the proposals in the report, released today, would help reduce the “sick note culture”.
The suggestion is likely to lead to claims of more “meddling” from council inspectors.
Latest figures show that up to three per cent of the active workforce is off sick at any one time. About 175 million working days are lost each year due to ill health, costing the economy more than £100 billion.
Among the report’s recommendations is a move to allow the role of local authority health and safety inspectors to be expanded. This would mean better advice and information on private sector employee diets, the set-up of workstations, and the importance of exercise could be given, the report says.
It also recommended that the private sector be able to increase the amount of “home-based working” for those recovering from ill health, and be able to stipulate a “workplace health” clause when awarding building contracts.
The report’s authors called for services provided by the NHS to reduce illness such as increased cancer and cardiac screening in the workplace.
The report also said people should be allowed to register with health services that are close to their workplace. The authors said that their recommendations were put forward to “complement the Government’s recent announcements on getting the sick back to work”.
It is estimated that about 3.4 million working days could be saved annually in the NHS, Europe’s largest employer, alone if it improved the health of its workforce.
Julia Manning, the think tank’s chief executive, said: “Our proposals would go a long way towards repairing both the nation’s health and its economic fortunes. The importance of health to economies is well established. “Good health improves educational outcomes, enhances performance at work, increases savings rates and reduces the burden on the public purse by decreasing the demand for health services and benefits payments.”
Earlier this month, an independent review for the Government recommended that independent assessment of sickness claims be introduced.
David Cameron has warned that Britain’s sicknote culture in the workplace was acting as a “conveyor belt to a life on benefits”. The Prime Minister said he would act on expert advice that recommended that family doctors should be stripped of the power to sign people off work long-term.
“‘Of course some of these people genuinely can’t work, and we must support them. That’s only fair,” the Prime Minister said. “But it’s also fair that those who can return to work should be supported to do so. We need to end the something for nothing culture.
“‘While 90 per cent of sickness cases are short-term – that stomach bug or flu that we all suffer from occasionally – nearly half of all days lost to sickness absence are because of cases that last four weeks or more.”
Ministers believe that about one in five of those who are absent on long-term sick leave should either never have been signed off in the first place or could go back to work.
The expert report, commissioned for Downing Street, suggested more than three-quarters of GPs admitted they had signed people off sick for reasons other than their physical health.
Mr Cameron said he was alarmed by evidence of the scale of the problem from a report by Dame Carol Black, an expert on health at work, and David Frost, the former director general of the British Chambers of Commerce.