Variation in heart attack patient care ‘unacceptable’
Only four in 10 heart attack patients in some parts of the country are getting the after-care they need to maximise their chances of survival, a charity is warning.
Nationwide, some 2,000 patients a year are being “neglected” by not being offered cardiac rehabilitation, which includes advice on how to change one’s lifestyle to avoid another attack, according to research by Heart UK, the cholesterol charity.
Across England, some 95 per cent of heart attack patients are being offered cardiac rehabilitation. However, that varies from 99.8 per cent at Royal Devon and Exeter NHS Foundation Trust to just 36.7 per cent at Mid Cheshire Hospitals NHS Foundation Trust.
The counselling service, that helps patients understand their condition, their medication and what steps they can take to reduce their chances of another attack, has been proven to reduce mortality rates by up to 25 per cent.
Jules Payne, chief executive of Heart UK, described the variation in care as “unacceptable”. He said: “It is encouraging that many patients are offered cardiac rehabilitation after they have had a heart attack but the variation in uptake across the country is unacceptable.
“Action is needed on both a national and local level to ensure that all patients are offered this service to help them to recover and return to normal life as soon as possible after their heart attack.
“Heart UK is deeply concerned that in some areas of the country less than 40 per cent of patients are undertaking cardiac rehabilitation so there is a huge educational job to be done as well.
“Patients have such an increased chance of recovery if they undertake the vital and tremendously valuable aftercare that hospitals should be providing to all.”
British education boss calls for longer school days and shorter holidays… and says if teachers love their jobs they shouldn’t object
Teachers will find themselves ‘in the firing line’ if they fail to ensure their pupils behave and succeed, Michael Gove warned yesterday. Staff who do not see their class improve could be sacked more quickly under his plans to drive up teaching standards.
The Education Secretary upped the ante further by claiming teachers should welcome longer school days and terms.
But unions hit back after his two-pronged assault, with the NASUWT warning of an escalation in industrial action which might lead to strikes.
Speaking on BBC Breakfast, Mr Gove said plans to reduce the time it takes to sack under-performing teachers would force staff to ‘focus’. When asked if a teacher whose class does not improve will be ‘in the firing line’, he replied ‘yes’. Mr Gove added: ‘It’s their responsibility to ensure that children behave and that children succeed.’
He refused to be drawn on how many teachers would be affected by the proposals, saying it would be up to heads to make decisions on where improvement was needed in their staff.
His comments came after the Daily Mail revealed his plans to allow schools in England to sack under-performing teachers in only nine weeks – about a term. Currently the process takes a year or longer. In an interview, Mr Gove said he also wanted parents to ask to go into classrooms to assess how well their children are taught.
He is axing controversial rules that restrict the amount of time heads can observe teachers in the classroom to three hours a year. The aim is to give schools more freedom to monitor staff.
Mr Gove also incensed teachers yesterday by telling ITV’s Daybreak programme: ‘We are all in favour of longer school days, and potentially shorter summer holidays.’
Asked about the potential impact on teachers, he replied: ‘If you love your job then there is, I think, absolutely nothing to complain about in making sure you have more of a chance to do it well.’
But union leaders accused him of bullying teachers. Members of the NASUWT have already voted ‘overwhelmingly’ for industrial action short of strikes on issues including changes to performance management and pay. They have been refusing to cover for absent colleagues and to supervise pupils during the lunch break.
Chris Keates, general secretary of the NASUWT, said the action could be extended if Mr Gove’s ‘relentless attacks’ continue. Heads attempting to introduce the reforms will be met with ‘significant resistance’ from teachers.
‘As far as we’re concerned any school that moved to introduce these procedures, which in our view are unnecessary, then obviously we’ve got the ability to escalate our industrial action,’ she said. ‘We wouldn’t want to move as far as strike action but if that was about protecting teachers’ jobs, that’s what we would do.’
The National Union of Teachers said it has not ‘ruled out or ruled in’ the possibility of future industrial action over the issue. General secretary Christine Blower labelled the proposals as ‘potentially a bully’s charter’.
Brian Lightman, secretary of the Association of School and College Leaders, had initially welcomed the proposals. But yesterday he said: ‘The language of sacking teachers is extremely unhelpful and demoralising for teachers.’ Referring to the prospect of a longer school day, he said: ‘The worst thing we can do for the quality of our education service is to worsen the existing long hours culture.’
The Lords are the only decent politicians left in Britain
It’s always a poor day for politics when the House of Lords becomes not simply the nation’s second Chamber but its conscience, as it did with the Welfare Reform Bill this week. Does it take being ennobled and stuck in an anachronistic institution to be able to speak up for the very poorest and sickest among us?
Anyone who had glibly assumed that Cameron’s own family experience of disability may make his Government less keen to cut the benefits of those who really can’t work was wrong. His experience is of profound disability, not profound poverty.
As the Bill unravels, few deny the need for reform or cutting the deficit. What we cannot stomach is picking on the ill or dying. Is a child born with multiple disabilities, never able to work or pay National Insurance, a ‘something for nothing’ scrounger? Should those with a terminal diagnosis have to worry if they have enough money to get through the week? This is the cruel reality of what was proposed.
Classifying all those on benefits as workshy semi-criminals will not wash, if we get back to basics. We care for the weakest out of decency, not statist ideology. Cuts to the Disability Living Allowance mean the disabled and their families living on less money, and continual assessments.
Lord Patel put it forcefully in the debate: ‘I am sympathetic to cutting the deficit, but I am highly sympathetic to sick and vulnerable people not being subject to something that will make their lives more miserable.’
What does he know? Aren’t the Lords just a bunch of inbred toffs?
Actually, I have had to reassess my view. Lord Patel is an expert on the rights of the disabled. The British-Tanzanian son of Indian immigrants, he is an obstetrician who has specialised in high-risk pregnancies, foetal-growth retardation and standards in health and clinical provision. He may indeed know a thing or two in a way the average supine MP doesn’t.
Indeed, I’ve been impressed the last few times I’ve been to the Lords. Yes, there are elderly hereditaries and pompous bishops – but also people with all types of expertise who would never have been MPs.
As the political class narrows to comprise privileged clones who have done nothing but PR, law or media, we need a Lords full of those who have lived differently. If political success is won only by thrusting, photogenic youthful people with perfect families, we are all poorer for it.
Another hate-filled Muslim in Britain
Ed Miliband’s professional look-alike has been suspended from the Labour Party after allegedly sending offensive messages on Twitter. Police are investigating claims that Shereef Abdallah sent death threats and racist comments to two young women – one of whom is Jewish.
At one point he was sending up to 90 tweets a day. At first the women responded, but as the replies became more threatening they stopped. If the victims tried to block the tweets, Mr Abdallah is said to have simply varied his Twitter address.
When one of the women, who runs a blog called Julie’s Think Tank, expressed support for Tony Blair, he tweeted: ‘Your nightmare is just starting… it will only get worse for you every day 24/7 till you leave twitter… Zionists can’t save you… Racist Tory anti-Islamic scum.’
The blogger, who asked for her full name not to be published, became even more concerned when Mr Abdallah turned up at her university in London.
Other messages to the two women in the past three months included: ‘I am in a war to the death. Stay well clear for your own safety,’ and ‘It will be the worst year of your life. C U in first week in January. I can’t wait to see the fear in your eyes.’
The matter was reported to the police after a former Labour Party press officer, who complained about the remarks, is also said to have been threatened.
The affair is particularly embarrassing for Labour as Mr Abdallah spent several weeks as a volunteer in the office of senior MP Glenda Jackson, canvassing voters and distributing leaflets in her Hampstead and Kilburn constituency during the General Election. The double Oscar-winning former actress narrowly held on to the seat.
With his dark, slicked-back hair and large, staring eyes, Mr Abdallah, 37, looks so similar to the embattled Opposition leader that he is on the books of an agency that provides impersonators for parties and corporate events.
Ms Jackson’s constituency office manager, Rebecca Henney, said: ‘Mr Abdallah was one of a multitude of volunteers who worked for us during the Election campaign. He was in the office for two or three weeks on a semi-regular basis. ‘He displayed none of these tendencies while working for Glenda. If anything, he was slightly shy. This has come as a complete surprise.’
A Labour Party spokesman said Mr Abdallah’s membership had been suspended with immediate effect.
Mr Abdallah, who lives in North London, said his remarks had been taken out of context and that he had been provoked by comments, aimed at him, that he found offensive. But he did admit using the phrase ‘racist Tory anti-Islamic scum’. He said: ‘If you take it in isolation, I accept that it looks very, very bad.’
Harry Fletcher, assistant general secretary of the probation union Napo, which is campaigning for a tightening of the law on stalking, said: ‘Stalking is a serious crime – it can take lives. These and many other victims in the recent past have received direct threats of violence through the social media.
‘Social media providers must take steps to block offensive or threatening emails or tweets and the police must act against alleged perpetrators in the light of the evidence.’
A Scotland Yard spokesman said last night: ‘Officers in Camden are investigating malicious communications following anti-Semitic comments being placed on Twitter. The alleged victim was targeted in a series of tweets and there were several threatening messages between November 2011 and January 2012. ‘Officers believe there could be further victims.’
The improbable mystique of the Army
Héloïse Goodley thought she had a dream job when she started work as a City banker. But at the age of just 27, she traded it in for four-minute meals, ironing her own bed and singing in Nepalese – all part of British Army officer training at Sandhurst. Here, the first woman to write about life at the world-famous military academy reveals some of the bizarre practices she encountered there…
The training at Sandhurst is particularly demanding but, like all military training, is designed to build toughness, esprit de corps and other militarily-important attributes — attributes which are generally advantageous in civilian life too
There was a deathly silence while my father pulled himself together. He is of the generation where people joined a company for life. My mother, ever savvy and in touch with today’s youth, was worried I was a lesbian (I’m not). Until now, I had still kept the whole process a secret, unconvinced that I’d actually make such a radical career leap, but I couldn’t conceal it any longer. I had to tell them. At the age of 27, I was throwing away a perfectly respectable City career. To enlist.
I had managed to go through life in the right order. I worked hard at school, went to university, where after three years of avoiding responsibility, I graduated and took a job at a bank in the City that paid well and made my parents proud.
I bought sharp suits, wore power heels, sat finance exams and spent two hours of my day at the clemency of London Transport, commuting to a desk at HSBC in the shiny glass and chrome of Canary Wharf.
I went along with it for a while, squandering my enviable wage in bars and clubs on the Kings Road, soaking up the bright lights of London with little to show for it.
But it was soul-destroying. The coveted job? It turned out I didn’t want it. Sitting on the train, I scrolled through my BlackBerry and looked for Life Plan B.
I found it at dinner, sitting next to some ghastly hedge-fund manager braying about his assets. He wasn’t the only contemptible idiot at the table; I was surrounded by them. Their pallid, lifeless faces, overworked, bloodshot eyes and thinning hair revealed that their bodies as well as their personalities were destroyed by their jobs.
But there was another dinner guest that night who didn’t fit in either. He was fresh, bright-eyed and energetic, entertaining us with stories of his life in the military, in Kenya, Brecon and Basra. He relished what he did and I was envious. Very envious. As he talked on, he leaned towards me and casually tapped my knee.
‘Héloïse,’ he said with a cheeky grin, ‘you should join the Army.’ The die was cast.
It was January 2007 when I joined the commissioning course at the Royal Military Academy Sandhurst, immodestly described as ‘the finest command and leadership training in the world’.
One month earlier, I’d attended a familiarisation visit. An opportunity for me to experience Army food, scratchy blankets and unnecessary shouting, be measured for the uniform and collect a new pair of military black leather boots to wear in. When I came back a month later to start the course, my feet would already be blistered and raw. Big, heavy, clumpy, boots. We were shown like four-year-olds how to lace them up (there is a specific technique to reduce pressure and injury).
The favoured way to break them in is to protect your feet with medical tape. Then there are those who try to soften the leather by standing in the bath or use leather conditioner, dubbin, or urine. If the whole process is simply too painful, we were told, there is always the Navy, where they wear shoes.
The visit concluded with a question-and-answer session about what to expect at Sandhurst, including lots of helpful little tips like ‘bring lots of sports bras’ and featuring my favourite question of all time from a fellow recruit: ‘Can I bring my horse?’ The answer to which was an even more surprising ‘Yes’.
Along with new boots, I had been given an extensive packing list. The longest section came under the heading ‘Cleaning Kit’ and included: Flash, Cif, J Cloths, Brillo pads, furniture polish, dusters, glass cleaner, Duraglit, Brasso, a silver-cleaning cloth, brushes, cloths, black shoe polish (plain and parade gloss), brown shoe polish, tan shoe polish, an ironing board and a good-quality steam iron. The hairnets, hairpins, grips, plain slides, black elastics, strong hair spray and hair wax didn’t fill me with joy either.
‘Get on parade!’ It was shortly after 5am, ‘death o’clock’, and echoing voices could be heard shouting urgently. I shuffled into slippers and dressing gown, drifting into the stark fluorescent lighting to line up alphabetically for the ‘water parade’, a morning ritual.
It entailed singing the National Anthem before each drinking a litre of water so that later, on parade, we would be bursting for the loo. If ever there was a lesson in self-control, that was it.
We were also required to learn all six verses of the British National Anthem and those too of our foreign cadets. (Nepalese before breakfast is especially demanding).
Then we were dismissed to shower, dress and race to breakfast. In four minutes we had to consume as many calories as possible to sustain us through a morning of standing to attention in the freezing cold.
More than 800 cadets a year walk up Old College steps to assemble for the commissioning course, which is split annually into three intakes. I was one of 32 girls who started that winter, a motley collection of graduates, some school-leavers, serving soldiers, two foreign cadets and me.
From plump to petite, wealthy to working class. Almost a foot separated the tallest and shortest among us. Some could run the mile-and-a-half Army fitness test in eight minutes; others took more than 12.
The umbilical cord with my old life was cut; my midwife for the traumatic process was a female staff sergeant, the pugnacious Staff Sergeant Cox.
Although not tall, SSgt Cox more than compensated with a powerful punch and terrifying pitch in her raised voice. It could make hounds whimper. Her uniform was pristine. A career surrounded by men had sharpened her tongue to a razor.
Her first repressive rules were bans on chocolate and mobile phones. Morale plummeted.
The first five weeks mimic the basic training undergone by the thousands recruited into ordinary soldier ranks (except they endure 14 weeks of hell). It involved a draconian regime of continuous harassment, borstal-like practices and hours of toil: cleaning, ironing, scrubbing and polishing.
My femininity was stripped away, as my tailored suit was replaced with drab khaki coveralls (until my uniform arrived), my long hair was pinned back into a face-liftingly tight bun, while jewellery, perfume and make-up were forbidden.
On field exercise a little later, I smelled and looked like a tramp; we washed with a flannel from a mess tin of tepid water. The appalling reality was revealed to me when, under ‘enemy fire’, I flung myself to the ground, my body armour crushing to my chest, squeezing out a warm puff of noxious air from the depths of my clothing.
Life became a daily struggle for survival; every action seemed punishable. Slouching was forbidden, no hands in pockets, no leaning against walls. Being late was the most grave of offences. Press-ups were the favoured punishment and as the weeks went by I got quite good at them.
My room in Old College was simply furnished with a wardrobe, desk, chest of drawers and bookshelves, which were empty except for a Bible. A white porcelain sink hung from the wall below a mirror. The cream walls were bare apart from a safe where I hid contraband chocolate given to me by my grandmother. Prison cells contain more. The bed comprised a single iron frame with plain wooden headboard, firm mattress and Army-issue rough cotton sheets. Everything had to be ironed, then the bed made for morning inspection with angled ‘hospital corners’. There was to be no evidence that the bed had been slept in – so many slept on the floor.
I, like others, persisted in ironing my sheets while they were still on the bed. This went disastrously wrong for one girl who dropped her hot iron on to her bare foot.
Everything had to be displayed in a specific way with shoes aligned and drawers progressively pulled out, revealing a sequence of T-shirts, jumpers and ‘smiling socks’ (with the bundle-fold facing up in a smile). We worked into the night polishing anything that could be forced to shine. A radio had to be tuned to BBC Radio 4. Clothing had to be folded to the dimensions of A4 paper. On the bed where our uniforms would be laid out. Then, after breakfast, we would stop and scurry into position at SSgt Cox’s arrival, outside our rooms.
Misdemeanours were slight (such as a trace of mud on a running shoe) but punishments severe. All my hard work would come crashing out into the corridor, pulled down off shelves, flung out of drawers or thrown from the window into puddles below.
The woman ruled my every waking and sleeping hour. Just to speak to her we had to go through a pantomime of formalities. If she was in her office, we had to march up to the doorway, arms straight and outstretched, shoulder high, coming to a halt exactly at the office entrance with a ‘check, one, two’, foot stamp, then freeze to attention. And then request: ‘Leave to enter, Staff Sergeant, please.’
I simply could not do it. I had advised on FTSE 100 companies and here I was about to be torn to shreds (again) by a small woman from Hull. ‘Go back and try that again, Miss Goodley,’ she would say as I did a Michael Flatley hopping skip.
Her voice would be pitching higher with each of my attempts. Until finally, she popped, her scream now in full falsetto, the veins in her forehead pulsating: ‘MISS GOODLEY, GET AWAY FROM ME AND DON’T COME BACK UNTIL YOU CAN SHA**ING WELL DO IT PROPERLY!’
I was especially dreadful at drill. I moved like an ill-disciplined robot. The most feared exercise was the ‘mark time’. This was a pointless punishment, which had us all marching on the spot, legs burning with pain as the lactic acid built up. Steam would rise from us in the chilly January air as we willed it to stop. As we were put through our paces, SSgt Cox would strut up and down picking out errors.
‘What are you doing, Miss Goodley? You lunatic. Get in step with the rest of the platoon.’ ‘Come on, Miss Goodley. Left. I said left. All those qualifications and a university degree and you can’t tell left from right.’
On the drill square, SSgt Cox wasn’t the only demon. Company Sergeant Major Porter was a pocket-sized pugilist. He was intensely proficient and had years of experience of training clumsy-footed soldiers. Shrouded in a long heavy overcoat, pace stick swinging in hand, he would peacock around the fringes.
One morning, as I unwittingly performed a Prussian goose step, he swooped in. He swung his pace stick a hair’s breadth from the tip of my nose and forced his scrotum through a mangle as he released the most high-pitched squeal. ‘What the f*** was that, Miss Goodley? If you can’t sort out your legs, I’m going break them both. Then I’ll ram this pace stick up your nose and use it to flick you into the lake. You useless idiot.’
As the spittle of his anger landed on my cheeks I felt my bottom lip curl. I wanted to cry. I wanted to be anywhere but this godforsaken, wet parade square. I wanted my easy London life back.
I am a slow eater and struggled to consume enough calories to get me through the long days. Three meals a day were simply not enough so a fourth was provided to get us through late nights of ironing and polishing
Another member of the training staff, Colour Sergeant Bicknell, fussed terribly over inspection and would exclaim: ‘I want you to dazzle out there, ladies. I want you as smart as carrots you hear? Smart as carrots.’
With drill over, it was non-stop until lunch. Each meal time at Sandhurst involved a mass stampede to the dining hall to make the most of the precious time allocated. Known in the Army as a ‘cookhouse’, the dining hall could seat 300 at the long oak tables, on tall-backed chairs worn smooth from years of bottoms.
The walls were adorned with armour, swords and Royal portraits. Chandeliers hung from the arched ceiling, where narrow stained-glass windows allowed shafts of light to shine down. And, for a reason I never understood, a glass cabinet took pride of place in the middle, containing a sprawled tiger skin. We wolfed down whatever was on offer while the sergeants at the door counted down the seconds.
Quantity and carbs were a priority, with potatoes always on the menu: new, roast, mashed, sauteed, boiled, croquettes and chips, chips, chips. I am a slow eater and struggled to consume enough calories to get me through the long days. Three meals a day were simply not enough so a fourth was provided to get us through late nights of ironing and polishing.
Having already been on the go for eight hours, we would then be marched off to another lesson; fieldcraft, map reading, first aid, foot care and weapon training, which was called ‘skill at arms’.
Sunday mornings we went to chapel – inside, men had to remove their hats but we ladies wore ours, to great advantage. When tipped forwards the forage cap peak masked your eyes, so with head bowed in prayer no one ever knew I was taking a sneaky nap. I was waking even earlier now than when I had worked in the City. I was certainly getting shouted at more.
Sunday nights brought a slice of faux-freedom as we were allowed to run our cars for half an hour to prevent the batteries from going flat. I would savour this moment, singing along to my Girls Aloud CD, and biting heads off jelly babies I found in the glove compartment.
I’m back behind ‘enemy lines’ in the City where I used to work and I have convened with friends for cocktails and gossip in a bar overlooking the Bank of England.
I’ve come straight from having wriggled into jeans (the devil’s cloth and banned at college) behind the wheel of my VW Polo in the Tesco car park in Camberley, Surrey. I’d dusted off the make-up bag and blow-dried my hair.
There is nothing attractive about being a girl in the Army. Out of uniform, I embraced florals and pastels like never before. Reds, pinks, silk and lace. But I could no longer stand in my towering City high heels, as my toes had been allowed to comfortably spread in boots.
I catch the attention of Rupert, a Savile Row-suited fund manager. He is busy leaning into my ear (and peering down my top) telling me about himself. ‘Which bank do you work for?’ he asks.
‘I don’t any more,’ I reply. ‘I’m in the Army.’
He recoils. ‘Really? So are you a lesbian then?’ He looks incredulous as I shake my head. ‘Why on earth would a pretty little girl like you want to go and do something like that?’
I am woken by bagpipes at 05.27 in the corridor. Today is our last day at Sandhurst. Friday, December 14, 2007. The day we are finally commissioned. Hours have been spent pacing the parade square, rehearsing and practising until every step of the final Sovereign’s Parade is in our muscle memory.
Royalty arrives, foreign dignitaries, politicians and military chiefs take their places in the front row to watch the spectacle – a stately display with a brass band and 500 cadets marching around Old College parade square.
My parents, brother and friend Deborah are seated in the stands in the square, huddled in the cold, cameras primed. My father is busy clicking away but when I get home I am disappointed to see that I’m not in a single shot. He had snapped photographs of another girl, thinking she was me.
Sandhurst was the best and worst experience of my life. So much of what I was taught there seemed irrelevant: the marching, crawling and trench-digging. Yet there was other stuff I learned at Sandhurst: the personal pride and stubborn resolve to keep going, to hold my head high and carry on because I can do it. The standards and morals to make the right decisions.
My biggest challenge would come later: dealing with soldiers. Real soldiers who I was expected to command and lead. Soldiers that would make me proud and let me down. Soldiers who would teach me more about command, leadership and the pornography industry in five minutes than any Sandhurst lecture.
I was commissioned into the Army Air Corps and in January 2009, I was deployed on the first of two tours of Afghanistan. I am now a Captain undertaking the role of adjutant for an Apache helicopter regiment. I had known nothing about the military when I joined. I just knew I needed to get a grip and do something with my life, and fortunately I landed on my feet on the other side of a 12ft wall. For me, the Army fits. I have rediscovered the passion that I lacked. It defines who I am. And I’m proud to be part of it.
Britain’s nasty black racist politician again
“Ed Miliband faced new calls to rebuke Labour frontbencher Diane Abbott last night after she told a young, Tory-voting black graduate who asked her for work that she wasn’t doing the ‘black thing’ and should ‘go and work for a white Conservative’ instead.
The new race row involving Ms Abbott comes two weeks after she was forced to apologise for saying ‘white people love to divide and rule’ following the trial of the killers of black teenager Stephen Lawrence.
Politics graduate Jade Knight, 25, told yesterday how she approached Ms Abbott about the chances of work after recognising her at a branch of Boots in London’s Piccadilly.
‘So I went downstairs and found Ms Abbott and said I hoped she didn’t mind me asking her, but if there was any kind of work I could do for her, I would love the opportunity.
‘She said, “You’d be better off working for a white Conservative. You’re a black conservative, you don’t do the black thing.” I couldn’t believe she had said it.
‘She was basically accusing me of selling out, which is not true. I told her being a conservative wasn’t going against my heritage. Anyone who understands black culture knows black culture can be very conservative. I thought she would understand that as she is educated.’
There is a new lot of postings by Chris Brand just up — on his usual vastly “incorrect” themes of race, genes, IQ etc.