No blanket bans on procedures, says NHS panel
Local health authorities should not apply blanket bans to treatment labelled as being of ‘low clinical value’, an NHS panel has said
More and more primary care trusts (PCTs) have started making it harder for people to get treatment for a range of procedures, like knee replacements, cataract removals, varicose veins and obesity surgery.
For example, some have started issuing edicts that all obese patients awaiting certain operations must go on weightloss courses. They argue these are for clinical reasons, although many doctors and patients believe the real reason is to save money.
Now a team of experts, called the Quality, Innovation, Productivity and Prevention Right Care Team, has issued its “emerging views” to stop what it said was becoming a postcode lottery of care.
Surgical specialist groups and the National Institute for Health and Clinical Excellence (Nice) should work with NHS managers to create “value-based clinical commissioning guidance”, it said, according to GP magazine.
The panel was commissioned by Professor Sir Bruce Keogh, medical director of the NHS, to look at the issue.
Andrew Lansley, the Health Secretary, is very concerned at the NHS being seen to ration care. He said: “It is unacceptable for NHS bodies to deny patients the care they need or impose blanket bans on treatment. We have been clear that decisions about treatment for patients must be clinically justified and take the individual patient’s needs into account.
“If a patient needs treatment then they should be able to receive it on the NHS although what is suitable for one patient may not be suitable for another with different medical or personal circumstances.
“Under our modernisation plans, we are giving even greater power to clinicians so they are able to ensure their patients receive the high quality care they need.”
Parents must have the right to spank their children to instil discipline, says Boris Johnson
The Mayor of London spoke after a senior Labour MP blamed his party’s partial ban on smacking children for last August’s riots.
Former education minister David Lammy called for a return to Victorian laws on discipline, saying working-class parents needed to be able to use corporal punishment to deter unruly children from joining gangs and wielding knives.
He claimed parents were ‘no longer sovereign in their own homes’ and feared that social workers would take their children away if they chastised them.
Labour’s 2004 law did not completely ban smacking, but said a smack should cause no more than a reddening of the skin.
Last night Mr Johnson supported Mr Lammy, saying the current law was ‘confusing’, meaning that parents do not know how far they can go in terms of smacking their children.
‘People do feel anxious about imposing discipline on their children, whether the law will support them,’ he told the Pienaar’s Politics programme on BBC Radio 5 Live.
‘Obviously you don’t want to have a licence for physical abuse or for violence and that’s very important.’
The Mayor said he believed he had the support of Education Secretary Michael Gove.
‘I know that people will have their own views, but let me just say on the issue that’s been raised a lot of times with me; the issue of are you allowed to chastise, are you allowed to impose discipline?’
Middle class Brits priced out of university by soaring tuition fees as applications fall by nearly 10%
Thousands of middle-class youngsters have been priced out of university by the trebling of tuition fees to £9,000-a-year, figures revealed yesterday.
Sixth-formers from families with pre-tax incomes between £40,000 and £80,000 have been hardest hit by fee hikes which threaten to leave graduates with debts of £50,000.
Several thousand youngsters from middle and higher-income homes have been put off applying by the prospect of paying up to £9,000-a-year in tuition charges on top of living costs. They fail to qualify for grants and other scholarships designed to lessen the impact of the new charging regime on the poorest.
Families earning less than £25,000 are eligible for maintenance grants to help meet living expenses, with universities also offering means-tested bursaries. Pupils with household incomes up to £42,600 qualify for partial grants.
The number of university applicants across England has fallen by nearly 10 per cent following news that most universities will impose higher charges this autumn. Older students have deserted higher education in greatest numbers, with lesser falls among 18-year-old school leavers.
But official figures yesterday showed a sharper fall among better-off sixth-formers than ‘disadvantaged’ candidates. According to the Universities and Colleges Admissions Service, the proportion of youngsters applying from the wealthiest fifth of the country dropped 2.5 percentage points – a fall of 3,000. These families live in postcodes that are most likely to send children to university. Their likely average gross household income is around £80,000.
The proportion of applicants from middle-earning families dropped by about one percentage point. In contrast, the percentage of pupils applying from the poorest fifth of England dipped just 0.2 points – around 280 students. These families live in postcodes least likely to send children to university, with a likely average income of £11,800-a-year.
On average, one in 20 18-year-olds who would have been expected to apply to university this year has failed to do so, UCAS said.
The figures suggest that wealthier youngsters are deciding in greater numbers to look for jobs instead of study for three years or more and build up mortgage-style debts in the process. The trend will be seen as mounting evidence of pressure on the so-called ‘squeezed middle’ – the group bearing the brunt of economic policies aimed at easing Britain’s financial woes.
Mary Curnock Cook, UCAS chief executive, said: ‘Our analysis shows that decreases in demand are slightly larger in more advantaged groups than in disadvantaged groups. Widely expressed concerns about recent changes in higher education funding arrangements having a disproportionate effect on more disadvantaged groups are not borne out by this data.’
Ministers insisted the number of 18-year-olds applying to university had largely held up despite the controversial fees policy, one of the Coalition’s most bitterly-contested reforms. Sources pointed out the number of school-leavers from affluent backgrounds applying for university was still significantly higher than from lower-income groups.
But Shabana Mahmood, Labour’s higher education spokesman, said: ‘The decision of the Tory-led Government to treble tuition fees to £9,000 is hitting young people and their aspirations. It is clear the drastic increase in fees and the increased debt burden is putting people of all ages off going to university and investing in their future. Most students will be paying off their debts most of their working lives.’
The figures show how total applications for degree courses starting in the autumn were down 7.4 per cent – almost 44,000. Of these, 25,789 were aged 19 to 21. Many applied last year, causing a spike in recruitment.
The overall drop in applications was softened by a rise in the numbers from outside Europe.
Among UK students, applications were down 8.7 per cent – and 9.9 per cent among those living in England. In contrast, the number of applications from Scottish students – who will not pay tuition fees next year – dropped just 1.5 per cent.
Under the reforms, graduates only start repaying their loans when their income reaches £21,000. Outstanding repayments are written off after 30 years. Graduates on lower incomes are charged less interest than those who land top jobs.
Sally Hunt, general secretary of the University and College Union, said: ‘We cannot afford a system that puts people off university if we are to compete in the modern world.’