100,000 high-risk surgery patients suffer sub-standard care after treatment
As many as 100,000 high-risk patients undergoing surgery in NHS hospitals each year get sub-standard care, a study suggests. It says too many patients are sent back to general wards after surgery rather than being looked after in critical care, increasing their risk of death.
Experts from the National Confidential Enquiry into Patient Outcome and Death believe a significant number of hospitals are not well equipped for dealing with surgical patients, whether they are high or low risk.
They carried out a snapshot investigation of care for more than 19,000 patients having routine and emergency surgery in one week at 300 hospitals, including 829 high-risk patients. Such patients include those who have multiple conditions, serious illness or who are older, and they make up 10 to 20 per cent of more than one million operations carried out each year. In the general population, about 1 per cent of people can be expected to die after surgery, but this rises to 10 to 15 per cent of high-risk patients.
In the study, only 48 per cent of high-risk patients got ‘good care’, there was room for improvement in 20 per cent of cases and the care of 12 per cent was ‘less than satisfactory’.
Almost 20 per cent of high-risk patients were not seen in a pre-assessment clinic before planned surgery, which led to higher death rates among this group.
Just 22 per cent of high-risk patients were sent to critical care following surgery, and the report found the death rate was more than three times higher in those who experts assessed as being wrongly sent elsewhere.
The experts say the figures mean the equivalent of between 50,000 and 100,000 high-risk patients operated on each year are receiving less than good care.
Recommendations in the report include introducing a UK-wide system for rapid and easy identification of patients who are at high risk of dying or suffering complications after surgery, and for all such patients to be seen and ‘fully investigated’ in pre-assessment clinics.
The Royal College of Surgeons said its own studies had uncovered similar concerns. Professor Norman Williams, president of the RCS, said: ‘It is now time for Government to grasp the nettle and ask hospitals to provide publicly available evidence on how they manage high-risk cases.’
Professor Sir Bruce Keogh, NHS medical director, said: ‘The vast majority of operations performed by the NHS are safe and successful. ‘But all patients, especially those at high risk, should receive good care – anything less is simply unacceptable.’
The day I realised I’m not a lonely outsider in my own country
By Tom Utley
Do you ever feel, in your gloomier moments, that you don’t really belong in modern Britain? Are there times when you worry that your attitudes and instincts have fallen far behind the times, leaving you out of kilter with the great mass of your fellow countrymen? I’ve felt like that at least ten times a week.
I’ve felt it as I’ve driven through a ravishing part of the countryside, when suddenly a vast, menacing wind-farm has loomed over the brow of the next hill. There’s one dominating the skyline above Stirling Castle, where Mary Queen of Scots was crowned, which fair breaks my heart.
Was this desecration of one of the noblest views in these democratic islands really a response to the will of the people? So the authorities would have us believe.
I’ve felt it when I’ve heard MPs of every party, even some of the richest, boasting that they always use the NHS and would never dream of going private. Would their constituents honestly think the worse of them if they took out private health insurance instead of adding to the strains on the NHS?
Clearly, this is what most politicians calculate. But, if so, what a blow to my once firmly-held belief in the fundamental common sense and good nature of the British people.
This same feeling of being the odd man out struck me again yesterday, when Radio 4’s Woman’s Hour was droning on in the background with a report on an architecture prize for a new school in South London.
Some woman was telling us what a great shame it was that the Coalition had cut back Ed Balls’s school building programme, claiming that education standards would suffer because it was impossible for children to learn properly in temporary buildings.
There were stacks of statistics and other evidence to prove it, she said, without actually quoting any.
I thought this a highly questionable theory (although the BBC presented it more as a point of information), believing that good teachers mattered far more to a child’s education than modern buildings.
Perhaps I was the only one shouting at the radio that the more money this Government could save, the better for everyone — and that cancelling fancy new construction projects was as good a place as any to start.
But now, joy of joys, I discover that I’m not nearly such an eccentric stranger in my own land and times as I was beginning to fear. On the contrary, my views about almost every subject under the sun are slap, bang in the mainstream of popular opinion. And far from slipping out of fashion, they’re becoming more generally accepted with every passing year. Reader, I belong!
I’m indebted for this revelation to the latest British Social Attitudes (BSA) survey, the Government’s massive annual focus-group, whose findings for 2010 are published this week.
This wonderfully cheering document has fully restored my faith in my fellow countrymen’s deep-down intelligence and common sense, and their refusal to be bamboozled by cant.
The picture it paints of the real Britain is about as far removed as it’s possible to imagine from the fantasy version accepted by every mainstream political party and promoted tirelessly by the BBC and the Left-wing media.
Take climate change. For David Cameron, it was an article of faith from the start that the Conservatives’ chances of election would be greatly improved if they adopted the radical policies espoused by the environmentalist lobby. In his view, this was an essential part of his party’s make-over, vital to his popular appeal.
Hence the windmill on his roof and his jetting off to a Norwegian glacier to be photographed hugging a husky. Hence, too, the slogan that gave him so much pride and pleasure: ‘Vote blue, go green.’
Labour and the Lib-Dems were the same, fiercely competing with each other to be seen as greener-than-thou, in the apparent belief that this would play a treat with the electorate.
Turn to the BSA, however, and you’ll see what the voters were really thinking during election year. It shows that while the political parties were turning ever greener, the people they were fighting to represent were growing increasingly sceptical of the claims of the man-made climate change lobby.
In the year 2000, only 24 per cent believed environmental threats were being exaggerated. Just ten years on, the figure is up to 37 per cent. Yes, we sceptics are still in the minority, but the wind is blowing our way.
Incidentally, the non-metaphorical wind was blowing so hard yesterday that wind turbines all over Scotland and the North had to be switched off.
Truly, the more we see alternative energy working in practice (or, rather, not working), the more fatuous and wasteful it seems. Doesn’t this go at least a little way towards explaining the public’s growing disenchantment?
Where green taxes are concerned, the shift in public opinion is just as pronounced. A decade ago, 31 per cent backed them to combat climate change. Last year, that minority had shrunk to a mere 22 per cent. Yet this doesn’t seem to stop my old schoolmate, that prize ass Chris Huhne, from piling them on. But then when have the Lib Dems, wrapped up in their self-righteous certainties, ever cared a hoot about what the rest of us may think?
It’s the same story with health policy. Over the years, I’ve heard it said a million times that the British people are unshakeably attached to current funding model of the NHS. So often, indeed, that I myself had almost come to believe that most of the public had a visceral horror of the idea of turning to anyone but the state for their medical needs.
Mr Cameron clearly thought much the same, when he made it a central plank of his election manifesto that the Tories would ring-fence spending on the NHS and fight to their last breath to defend it from the taint of privatisation.
But look at the survey findings. Only 24 per cent say that paying for private healthcare is wrong — down from 38 per cent in 1999. This is a huge drop in just a decade, representing a revolutionary shift from faith in the power of the state to self-reliance.
That shift is even more marked in the numbers who believe taxes should rise to pay for health and education. As recently as 2002, 63 per cent said they should. By last year, the figure had more than halved to 31 per cent.
Many put this down to the recession. But can’t it equally be attributed to the experience of the boom years, when Labour poured untold billions of our money into hospitals and schools, to almost negligible effect? Indeed, when it comes to education, the popular perception — as opposed to the fantasy peddled by the fiddled exam grades — is that standards have fallen, not risen.
On social problems, too, the BSA shows attitudes wildly at variance with the official line plugged so remorselessly by the political Establishment.
Apparently, most of us don’t believe that ‘society is to blame’ for child poverty. A whacking 75 per cent put it down to parents’ drug and alcohol problems, with more than half also blaming family breakdown — and a remarkable 63 per cent attributing it to parents’ unwillingness to work.
Meanwhile, 54 per cent think unemployment benefits are too high — up from just 35 per cent in 1983. Yet only last week, George Osborne surrendered to the Lib Dems’ demand that Jobseekers’ Allowance should increase by 5.2 per cent — more than five times as much as a front-line soldiers’ pay.
As he studies this portrait of the real Britain, shouldn’t Mr Cameron reflect that if only he’d presented a truly conservative manifesto to the country, he might have won an overall majority?
Mind you, there’s one BSA finding that doesn’t surprise me in the least: in 1997, 73 per cent of Britons aged 18-35 turned out to vote in the general election. Last year, the figure was down to 47 per cent. But then who can blame those who didn’t bother, when there’s not a single party in the land that speaks for the real Britain?
Brits want the State to stay out of their lives
The faltering economy is making millions of Britons more self- reliant, a study claims today. The survey of social attitudes has found we are becoming more conservative and see government as a less important factor in our lives. Fewer of us want the state to intervene to redistribute wealth to help reduce the inequality gap between rich and poor.
And support for increased taxes to pay for health, education and tackling climate change has slumped, according to the annual British Social Attitudes report.
At the same time, the public has become more willing to accept people educating their children privately and paying for private health insurance.
In another sign that the country has taken a shift to the right, there has been a hardening of attitudes towards the unemployed. More voters believe benefits are too generous and discourage people from going to work; while an increasing number blame child poverty on lazy parents rather than a failure in society.
Penny Young, of the National Centre for Social Research, which carried out the study, said: ‘In a time of economic austerity and social unrest, the big question coming out of this year’s report is whether we are really in it together, or just in it for ourselves?
‘An emerging sense of self-reliance may take the Government some way toward its vision of a more responsible society, but an emphasis on individualism, not Big Society collectivism, may present as much of a challenge as it does an opportunity.’
The 2010 poll of 3,297 people, details of which were released yesterday, found that while 75 per cent agree the income gap between rich and poor is too large, only around a third believe government should redistribute more to solve the problem.
More than half (54 per cent) believe jobseekers’ allowance is too high – up from 35 per cent in 1983.
And while people see child poverty as an issue that government must tackle, 63 per cent believe that parents who ‘don’t want to work’ are a reason why some children live in poverty. Others blame family breakdown or drug and alcohol abuse – rather than the state.
After hitting a peak of 63 per cent just nine years ago, support for tax increases to spend more on public services such as health and education has dropped to 31 per cent.
Britons are increasingly at ease with the idea of higher earners buying private healthcare. While 38 per cent thought this was ‘wrong’ in 1999, the figure has dropped to 24 per cent. There was a similar trend for private education.
Despite acknowledgement of housing shortages, 45 per cent oppose new development in their area. Opposition is highest where shortages are acute, such as the 58 per cent in outer London.
The survey also shows that since 2000, the number prepared to pay higher green taxes has slumped from 31 to 22 per cent.
British children’s playground stripped bare by safety fanatics
The most serious accident any parent can remember at the Allergate playground is the odd grazed knee. Yet the swings, roundabout, see-saw and slide have all been taken away after falling foul of Eurocrats in Brussels and their over-zealous safety regulations.
Parents have described the decision as ‘health and safety gone mad’. Sarah Loach said: ‘People are always talking about kids getting more exercise and then the council takes the play equipment away.’
Ruth Pierce said: ‘My son keeps asking when the slide is coming back. We used to come down here quite regularly. Now I have to drive my boys to another park.’
Ruth Chambers said: ‘The playground’s been used for ten to 15 years plus. It seems crazy that they have suddenly decided it is not suitable.’
The operation to remove all the equipment began two weeks ago after an annual safety audit by Durham County Council ruled it constituted a safety risk. It was deemed to have contravened the European Union safety standard EN 1176 which governs playground equipment. This weighty document lays down complex rules for everything from the maximum speed of a roundabout to the approved angle of a slide.
Nigel Dodds, the council’s sport and leisure manager, said the equipment was removed because it was unsuitable for upgrading. He said most of it was manufactured before 1998, when European safety standards replaced British measures. The council has not ruled out installing new equipment at Allergate, but Mr Dodds said that would depend on the outcome of a countywide play strategy, which is still being drawn up.
David Yearley, from the Royal Society for the Prevention of Accidents, said: ‘Generally speaking, it is important to recognise that compliance with the standards is not mandatory. ‘In cases where equipment does not comply, it is crucial that you assess the risks to users. The equipment might then be made acceptable for use with just a few minor modifications.’
A report by the National Playing Fields Association in 2005 said attempts to eliminate all risks from play areas were making them boring. It added that councils which fear being sued in the event of an accident sometimes interpret safety guidelines, which are only advisory, too harshly.
British small businesses find ill-educated youth unemployable too
There have been many complaints from big business about this
More than a quarter of small businesses struggle to find ‘suitably skilled’ staff despite rising unemployment, a survey revealed yesterday. The report by the Federation of Small Businesses said many of its members were desperate to hire workers but could not find them.
It warned many school leavers and graduates lacked basic skills needed for a job. These range from turning up on time for an interview to being able to write basic English or do the most elementary maths. The survey of more than 1,500 small businesses showed a ‘worrying’ 27 per cent have ‘found it difficult to find suitably skilled staff’.
The issue will be investigated as part of an inquiry into entrepreneurship by the Federation of Small Businesses and MPs on the All-Party Parliamentary Small Business Group.
Brian Binley, Tory MP and chairman of the parliamentary group, said: ‘Small and medium-sized businesses and entrepreneurs are expected to be driving economic growth in support of Britain’s recovery. ‘But they are finding it difficult to get the right people to help them in that task.’
One of the big problems was ‘the poor performance in our primary and secondary schools, especially with regard to literacy and numeracy’.
Unemployment has jumped to a 17-year high of 2.62million, amid warnings it will continue to rise as the Government cuts the state workforce.
Despite the massive number of people looking for a job, there are still 464,000 unfilled vacancies, according to the Office for National Statistics.
To add to the problems facing small firms, the report also found 34 per cent had ‘difficulty securing finance’. The Federation of Small Businesses is calling on the Government to create more competition on the high street to break up the dominance of the ‘big five’ banks – Barclays, HSBC, Lloyds, Santander and RBS.
The Department for Education said the Government was ‘prioritising’ literacy and numeracy by ‘recruiting specialist maths teachers, introducing a phonics-based reading check for six-year-olds and restoring the rigour of GCSE and A-level exams’.
Transgender lessons for British pupils aged five: Classes will ‘overload children with adult issues’, say critics
Children as young as five could be given lessons on ‘transgender equality’ under Government plans. Information about transgender people is set to be included in the curriculum for personal, social and health education lessons, which are taught in thousands of primary and secondary schools.
The proposal is part of a Coalition policy programme entitled ‘Advancing transgender equality – a plan for action’, which was published yesterday.
In it, ministers warn a wide range of steps are needed to combat ‘transphobic bullying’, which is defined as the taunting of children who express ‘gender variant behaviours’.
The document was produced by the Home Office, which is responsible for equality policy within Government. It states that schools need to be ‘more inclusive for gender-variant children’. ‘We know that over 70 per cent of boys and girls who express gender variant behaviours are subject to bullying in schools,’ the document states.
‘Schools should be a safe and supportive environment for children to learn in. ‘Tackling transphobic bullying helps to address unacceptable behaviour and ensures that our society becomes more tolerant.’
As part of its review of PSHE, the Department for Education will consider adding ‘the teaching of equality and diversity, including transgender equality’ to the curriculum.
But critics said there was a danger that children were being overloaded with ‘adult issues’ as a result of such lessons.
Margaret Morrissey, founder of campaign group Parents Outloud, said: ‘These are adult issues and we should leave it until children are older or until they ask. ‘The problem is we are overloading our children with issues that they should not have to consider at a young age. PSHE is already overloaded with other issues. ‘We have given them sex education and teenage pregnancies have risen year on year.
‘We have told children about drugs education and we have a serious problem with drugs. We have told them about drinking and cigarettes and we have more children with alcohol problems and smoking.’
Transgender people include those who have had sex change operations and people who have both male and female sexual organs.
Other measures proposed as part of the equality drive include help for transgender job seekers and rules for the NHS designed to ensure transgender people are dealt with fairly. The move comes after a Government survey found nearly nine out of ten transgender employees suffered discrimination or harassment at work. Also announced yesterday were longer jail terms for murderers who are motivated by hatred of transgender people.
The basic sentence for anyone convicted of such killings will be 30 years, Kenneth Clarke said. Similar attacks on disabled people will also face the same tough minimum term.
The Justice Secretary said that offenders ‘should be in no doubt that they face a more severe sentence for these unacceptable crimes’.
Equalities Minister Lynne Featherstone said: ‘Too many transgender people still face prejudice at every stage of their lives, from playground bullying, to being overlooked for jobs or targeted for crime.’
This year it emerged British passports will no longer contain details of the holder’s sex. The move is designed to spare transgender people and those who are ‘intersex’ from having to tick ‘male’ or ‘female’ on official documents.
Unhealthy lifestyle responsible for ‘half of cancers’ (?)
Prof. Parkin is an industrious little blighter. He has taken seventeen supposed risk factors one by one and done a meta-analysis of the effects of each one. So he has a total of seventeen journal articles in the one issue of the British Journal of Cancer.
His industry did not however seem to include any critical thought. His conclusions are simply reinforcement of the conventional wisdom and he pays no heed to the elementary truth that correlation is not causation — preferring to rely instead on the speculations of epidemiologists. He even makes significant use of heavily criticized analyses from the sensationalist WCRF — e.g. here. Some of his conclusions may be correct but we have no means of knowing which they are. Many of the factors he identified could well in fact be social class effects
Almost half of cancers are caused by an unhealthy lifestyle that could be avoided by quitting smoking, losing weight, exercising and drinking less alcohol, the most comprehensive study of its kind has found.
Around 134,000 cancers each year are the result of a poor lifestyle, Cancer Research UK has found.
In the most wide reaching study yet conducted into the issue, it was found that 14 different lifestyle factors ranging from smoking, to lack of exercise, eating too much salt, not having babies, drinking too much and being overweight contributed to four in every ten cancers diagnosed in the UK.
The findings expose the myth that developing cancer is ‘bad luck’ or down to your genes, the researchers said.
Previous studies had suggested around 80,000 cancers a year could be prevented but they did not take into account occupational exposures to things like asbestos, infections that can cause cancer and sunburn as the latest research has.
In a complex set of research studies, scientists calculated how many cancers and of what type could be attributed to each of the 14 lifestyle factors. The findings were published in the British Journal of Cancer.
Smoking was the biggest factor, causing nearly one in five of all cancers.
But Harpal Kumar, chief executive of Cancer Research UK, said most people would not know that a quarter of all breast cancer cases could be prevented along with half of colorectal cancers.
He added: “Leading a healthy lifestyle doesn’t guarantee that someone will not get cancer but doing so will significantly stack the odds in your favour.”
Dr Kumar said tackling unhealthy lifestyle factors linked to cancer would also reduce the risk of a host of other killer diseases such as heart disease, respiratory problems, kidney disease and others.
Professor Max Parkin, a Cancer Research UK epidemiologist based at Queen Mary, University of London, and study author, said: “Many people believe cancer is down to fate or ‘in the genes’ and that it is the luck of the draw whether they get it.
“Looking at all the evidence, it’s clear that around 40 per cent of all cancers are caused by things we mostly have the power to change. “We didn’t expect to find that eating fruit and vegetables would prove to be so important in protecting men against cancer. And among women we didn’t expect being overweight to have a greater effect than alcohol.”
The study found that alcohol was responsible for 6.4 per cent of breast cancers and almost one in ten liver cancers.
Three quarters of stomach cancers could be avoided, mostly by not smoking, eating too much salt and consuming more fruit and vegetables.
Red meat consumption led to 2.7 per cent of cancers, almost 8,500 cases. Obesity was linked to more than five per cent of cancers or almost 18000 cases, including a third of womb cancers.
Lack of breastfeeding was linked to 3.1 per cent of breast cancers and 17 per cent of ovarian cancers.
The study did not examine how many cancer deaths would be prevented with a healthier lifestyle.
Sara Hiom, director of information at Cancer Research UK, said: “We know, especially during the Christmas party season, that it is hard to watch what you eat and limit alcohol and we don’t want people to feel guilty about having a drink or indulging a bit more than usual. But it’s very important for people to understand that long term changes to their lifestyles can really reduce their cancer risk.”
The World Cancer Research Fund did a similar exercise in 2007 coming up with recommendations to individuals on how to reduce their cancer risk by eating less red meat, taking more exercise and staying slim.
Dr Rachel Thompson, Deputy Head of Science for World Cancer Research Fund, said: “This adds to the now overwhelmingly strong evidence that our cancer risk is affected by our lifestyles.
“We hope this new study helps to raise awareness of the fact that cancer is not simply a question of fate and that people can make changes today that can reduce their risk of developing cancer in the future.”
Ciarán Devane, Chief Executive at Macmillan Cancer Support, said: “No one chooses to have cancer and it would be wrong to blame people for making wrong lifestyle choices.
“For a long time, people have been told that eating healthily, not smoking and exercising regularly can benefit them, and these figures show again the impact a healthy lifestyle can have. Yet these healthy lifestyle messages are clearly not reaching enough people. They also need to be made more relatable to people’s everyday lives.
“There needs to be a cultural change, so that people see physical activity as an integral part of their lives, not just a optional add-on.”
Public Health Minister Anne Milton said: “We all know that around 23,000 cases of lung cancer could be stopped each year in England if people didn’t smoke.
“By making small changes we can cut our risk of serious health problems – give up smoking, watch what you drink, get more exercise and keep an eye on your weight.”
British Leftist politician accused of anti-Semitism after suggesting Britain’s first Jewish ambassador to Israel ‘has divided loyalties’
Divided loyalties is a classic antisemitic slur
“A Labour MP has been accused of making anti-Semitic remarks after suggesting Britain first Jewish ambassador to Israel had ‘divided loyalties’. Paul Flynn, the Newport West MP, made the comments about Matthew Gould during a meeting with chief civil servant Sir Gus O’Donnell.
Mr Flynn’s comments were widely criticised by his members of his own party as well as the Jewish Chronicle newspaper. The LabourList blog also reported that the party’s leadership, including Ed Miliband, thought the comments were ‘totally unacceptable’.
The party’s chief whip Rosie Winterton was also reported to have called Mr Flynn in to discuss his comments.
Mr Flynn later apologised for his remarks saying he regretted the ‘clumsily expressed remarks of mine that have caused anger and upset’.