You ARE more likely to die if taken to hospital at weekend: Study confirms that NHS care is worse on a Saturday and Sunday
Patients admitted to hospitals at weekends are far more likely to die than those taken there on weekdays, a major study has confirmed. Chances of recovery are jeopardised because senior doctors are absent and tests and scans are not immediately available.
A study of over 14million NHS admissions found that Sunday patients are 16 per cent more likely to die within the next 30 days than those brought in on a Wednesday. Patients admitted on a Saturday are 11 per cent more likely to die in 30 days.
Alarmingly, the researchers warned that patients who go to hospital at weekends tend to be sicker – making it crucial that they receive the highest standard of medical attention.
This is due to a higher number of road accidents, drink-related injuries and poor out-of-hours GP care that means patients’ deteriorate while treatment is delayed.
Earlier this week, Health Secretary Andrew Lansley ordered a ‘fundamental rethink’ of how hospitals are run at weekends.
Responding to this study Mr Lansley said: ‘It is unacceptable that patients admitted to hospital on a Saturday or Sunday stay longer and have worse results. ‘Much of the rest of the country continues to be open for the public’s needs at weekends – an NHS that revolves around patients should be the same.
‘By opening some services seven days a week, more patients will get the care and treatment that they need when they need it. In some parts of the NHS, this is already happening. ‘On Saturdays and sometimes Sundays, some services have scanners open to provide tests, are doing operations, and have more senior staff around.’
Katherine Murphy, chief executive of the Patients Association, said: ‘The NHS exists to ensure that its users are given the best possible care, 24 hours a day, seven days a week. It is simply not acceptable for somebody to face an increased risk of death just because they were unfortunate enough to suffer an injury or get sick on a Saturday or Sunday as opposed to any other day of the week.’
Researchers from University College London – whose work was commissioned by the Department of Health – looked at 14.2million hospital admissions in 2009/10.
Writing in the Journal of the Royal Society of Medicine, the researchers concluded: ‘There may be aspects of care associated with weekend admissions which disadvantage patients. ‘Some urgent conditions require prompt treatment and in some cases the way weekend care is organised may lead to delays which can adversely affect the outcome.’
The study backs up a report in November by Dr Foster Intelligence linking a higher death rate at weekends with poorer staff levels. Most consultants tend to work office hours and at weekends the wards are left in the hands of junior doctors. In addition, departments responsible for certain scans and blood tests are shut until Monday.
The researchers pointed out that patients admitted at weekends may be more seriously ill. Some who become seriously ill on Friday try and hang on until Monday, during which time they deteriorate further and end up needing urgent treatment. There are also more injuries from road accidents, alcohol and self-harming at weekends.
Dr Andrew Goddard, of the Royal College of Physicians, said: ‘This study is further evidence that patients admitted at weekends are more likely to die following admission than patients admitted to hospital during the week. ‘There are many reasons for this, but the two most important are that the patients are more ill and there are fewer doctors available.’
David Stout, deputy chief executive of the NHS Confederation said: ‘There is no doubt that this is something the NHS has to improve. ‘Patients should never have to worry about what is the “right” time to visit their local hospital.’
Migrants seeking a life in Britain will be asked: Can you make the country better?
Migrants seeking permission to enter Britain must prove they will ‘add to the quality of life’ and not become ‘dependent’ on state support, a minister will say today.
Immigration minister Damian Green will say it is time for a major overhaul of the system left behind by Labour.
He will tell an audience in London: ‘We need to know not just that the right numbers of people are coming here, but that the right people are coming here. People who will benefit Britain, not just those who will benefit by Britain.’
The minister will also criticise the idea of migrants coming to Britain to claim benefits, saying: ‘Importing economic dependency on the State is unacceptable. Bringing people to this country who can play no role in the life of this country is equally unacceptable.’
Mr Green will set out the case for becoming more ‘selective’ about which non-EU citizens are granted a visa to work, study or marry.
He says the debate so far has focused on the Government’s pledge to reduce net migration – the number entering the country, compared to those leaving – from 250,000 last year to the ‘tens of thousands’. But Mr Green argues it is now time also to focus on exactly who is coming here and what they have to contribute.
He will tell the Policy Exchange think-tank: ‘What we need is a national consensus on how we can make immigration work for Britain. We are evidently a long way from such a consensus but I want to start to build it.’
Mr Green, saying the country wants entrepreneurs and exceptional artistic and scientific talent, will add: ‘Britain does not need more migrant middle managers, any more than it needs unskilled labour.’
A string of policy announcements are imminent from Home Secretary Theresa May.
New controls on the spouses of immigrants entering Britain will require them to prove they can speak a certain amount of English, and that they will not be reliant upon benefits. The family will be expected to show they have a household income of up to £26,000 a year.
In a separate move, foreign workers will not be permitted to remain unless they have special skills or investment capital.
Britain will have to find room for three million more people by 2025 even if not a single new immigrant comes here, official estimates revealed yesterday.
The population will grow relentlessly to nearly 65.3million by then, largely because of the impact on the birthrate of mass immigration over the past decade and a half.
Just finding somewhere to put the additional three million people would require three cities the size of Birmingham.
The continuing effects of the large-scale immigration under Labour were set out in Office for National Statistics projections of likely population levels. Without taking any new migrants into account, numbers are predicted to rise from the 2010 population estimate of 62,262,000 to 65,292,000 in 2025. If net migration is 200,000 a year, the 70million mark would be reached in 2027.
Immigration is not just a numbers game – it’s about culture, too
Immigration stirs strong passions. But in Britain the debate about it can be rather confused. During the last election, a friend canvassed a finger-jabbing gentleman who said that he would be voting Liberal Democrat because “Nick Clegg will kick out all the immigrants”.
Most people know the difference between Nick Clegg and Nick Griffin. But do we know what immigration policy we want? Most of us – though fewer than in recent years – back some immigration. Since 1997, the share of our workforce born outside the United Kingdom has doubled from 7 per cent to 14 per cent. Net immigration rose from zero in 1992 to nearly a quarter of a million last year, when half a million people arrived but only half that number left.
The Government is trying to control overall numbers. But voters also want people who will fit in and contribute. Yesterday, Damian Green, the Immigration Minister, gave a speech exploring how to make immigration rules do those two things. He floated the idea that economic migrants might have to earn some kind of minimum salary – perhaps between £31,000 and £49,000 a year.
In this respect, his speech reflects an important change of approach. The Labour administration argued that migration expanded the economy, and had no impact on jobs. The new Government says it is interested not in the total size of the economy, but in the living standards of current residents.
In January, a report from the Migration Advisory Committee looked at whether non-EU immigration improved the welfare of current residents. It concluded that this question was impossible to answer at the moment. How do you compare the effects on jobs, tax, spending, congestion and so on? The report did, however, challenge the idea that migration has no impact on the labour market.
In the long run, migrants don’t “take” anyone’s job. The economy creates new jobs all the time. But it can take a while for this to happen, particularly in a recession. The MAC found that between 2005 and 2010, Britain gained an extra 700,000 working-age migrants from outside the EU. It thought this had reduced the employment of natives by about 130,000. However, they said the same effect might not occur in a period of stronger growth. To put this in context, there are 25 million UK‑born workers, so migrants reduced native employment by half of 1 per cent.
Limiting economic migration to those with better-paying jobs is one way to try to make it more likely that the net effect of immigration is positive for living standards. You might expect migrants with well-paying jobs to have a better chance of fitting in, but other things might help with this, too. For example, the Government has introduced an English language test for spouses, and is considering a test of their attachment to the country. It is also considering a rule that would prevent people on low incomes from bringing spouses. But it is treading warily because of human rights law. Judges recently struck down rules banning spouses aged under 21 from settling in Britain, introduced in a bid to reduce forced marriages.
For most people, culture is as important as numbers. So shouldn’t government also have a policy of integration once people have arrived? English language tuition might help them fit in. What about supplementary schools that mix children with others outside their community? Could housing policy avoid people becoming ghettoised? What kind of public events help people integrate?
The “citizenship test” under Labour became a joke, because it presented being British as if it was mainly about claiming benefits and knowing where the European Parliament meets. But what is Britishness, anyway? While the debate about immigration is becoming more sophisticated, the debate about Britishness and belonging has barely started.
British shopper, 25, asked for ID to buy TEASPOONS – as shop worker says they could be used as drug paraphernalia
A woman was asked to prove her age when buying a packet of teaspoons – as a shop worker claimed they could be used as drug paraphernalia. Elinor Zuke, 25, was told by the self-service checkout at Sainsbury’s that she needed age verification as she tried to buy a £1.19 pack of spoons.
A shop worker then intervened and said it was because of the risk they could be used for drugs – heroin users ‘cook up’ the drug in teaspoons.
Heroin is an illegal Class A drug – so it is irrelevant whether someone is over 18 – the spoon should not be used for that purpose anyway. The maximum sentence for possessing heroin is seven years in prison or an unlimited fine.
Ms Zuke said yesterday: ‘I could not understand what the problem was — when the supervisor said it was because they could be used as drug paraphernalia I was completely shocked. ‘I would imagine the vast majority of spoons sold by Sainsbury’s are used for nothing more nefarious than stirring a cup of tea. Having to prove I was over 18 to buy them seemed total madness.’
Sainsbury’s blamed the mistake on a problem with its stock-keeping units which provide a unique identifier for each product on the shelves. A problem with the system meant that it asked for identification automatically. A spokeswoman said: ‘The self-scan system recognised the spoon’s SKU as one for a knife. This had now been rectified.
‘We are very sorry for any inconvenience caused. Our Think 25 policy is designed to ensure age-related products are sold safely.’
In October 2009, Emma Sheppard, 21, was asked for identification when buying spoons in a Tesco store in Evesham, Worcestershire. She was forced to leave the store without the 57p pack of five spoons because she did not have a passport or driving licence with her. Tesco later apologised for the mistake.
Let’s have a proper debate about the welfare state
Hooked on poverty porn, getting the unelected Lords to do their dirty work… there’s little progressive about today’s welfare-defenders
What is worse: elected politicians proposing to reform the welfare state, or unelected Lords, cheered on by liberals, unilaterally shooting down such reform? It’s the latter. Even if you aren’t a fan of Lib-Con plans to trim the welfare bill (I think it’s daft to imagine such trimming will reverse the economic downturn), you should be far more concerned by the patronising and profoundly undemocratic turn that the so-called radical side in this debate has taken. Today, the defenders of welfare are doing far more harm to what we might term progressive politics than the right-wingers seeking to rethink welfarism.
Yesterday, to the chagrin of liberal activists, the House of Lords failed to support a peer-proposed amendment to the government’s welfare reform bill. Having inflicted a triple defeat on the bill last week, by voting 224 to 186 against proposals relating to disability and incapacity allowances, the Lords had won a special place in the hearts of leftists opposed to the Lib-Cons. These unelected lords and ladies are ‘the only decent politicians left’, chirped one commentator. Another described them as ‘a blessing’. These observers will no doubt be disappointed that the Lords yesterday failed to deliver a fourth blow to the government’s plans, though hopefully they’ll have learned a lesson about how daft it is to rely on the whims of the rich and aloof when pursuing political agendas.
There are two problems with the notion that state welfare is so sacred it should never be reformed, even if that means getting the most undemocratic layer of the British political class to ringfence it from those grubby inhabitants of the elected Commons. Firstly, such an allergic reaction to the idea of having a serious debate about the size and shifting nature of state welfare means that the problems associated with welfarism – which are myriad – are never clarified, far less tackled. And secondly, calling on the unelected second chamber to fight the Commons over welfare is an insult to democracy and to the British public, who are reduced to the level of paupers who need good-hearted Lords to fight their battles and preserve their pennies.
You don’t have to be a fellow traveller of the Lib-Cons (I’ve never voted for either party) to recognise that the welfare system in Britain does need reform – radical reform. The problem with the government’s proposed reforms is that they’re driven by a penny-pinching mentality, designed to save the state cash. The real motivation behind welfare reform should be a humanist one – a recognition that intensive welfarism, the intrusion of the ‘caring state’ into every aspect of less well-off people’s lives, has damaged both individuals and communities and therefore should be questioned and challenged and, in part, done away with.
Of course, all civilised societies should provide for those who, for whatever reason, lack the capacity to feed and clothe and house themselves. Discretely distributed as a fund for those too poor or disabled to provide for themselves, welfare can be a good thing. The problem with the ever-growing welfare state in Britain is its permanency, the way it is now used to sustain, forever, huge swathes of people, including able-bodied people, and the impact that this has on people’s view both of themselves and their communities. When you’re encouraged to become reliant on the state rather than on your own wits or your own mates, your sense of individual resourcefulness declines, and your feeling of attachment to and reliance upon your community becomes corroded.
The social destructiveness of the cult of welfarism can best be seen in that part of welfare that is now most feverishly defended by liberal campaigners: the realm of incapacity and disability benefits. In recent decades, more and more people of working age have been redefined by the welfare state as ‘incapable’ of working or as disabled. This is, to say the least, curious at a time when we are healthier and longer-living than ever before. According to the Organisation for Economic Cooperation and Development (OECD), Britain has one of the highest rates of incapacity/disability benefit-claiming in the Western world. Young people in Britain are more than twice as likely to claim sickness benefits as their Western European counterparts. Strikingly, there has been a big shift from the unemployment camp into the ‘incapable’ camp. In the 1980s, the number of people claiming unemployment benefit was nearly four times higher than the number claiming some kind of disability benefit; by 1997 the numbers were equal; today, the number claiming a disability benefit exceeds the number claiming unemployment benefit. Now, more than three million people are categorised as incapable of working, out of a non-working population of around five million.
Of course, there are many people who have serious impairments or illnesses that prevent them from working, and they should be provided for generously by society. But it’s pretty clear that, in recent decades, society has cynically cast the ‘incapacity’ net ever-wider, leading to more and more people effectively being rebranded as physically or mentally deficient rather than simply unemployed. That way, the unemployment stats can be massaged, and society’s failure to provide people with gainful employment can be redefined as an individual rather than a social failing – apparently it is because these people are weak, pathetic and ‘incapable’ that they cannot work, not because of the structural malaise of capitalist society and the lack of vision amongst those who govern it.
In a twisted irony, the leftists now fighting tooth-and-nail to protect incapacity/disability benefit from any criticism or reform are actually upholding a right-wing creation. Invalidity Benefit, which later became Incapacity Benefit, and which is now mixed together with various disability allowances, was first introduced under Ted Heath’s Tory government in 1971. The number of claimants grew exponentially under the Thatcher and Major governments in the 1980s and 90s – in 1981, 463,000 men and women were claiming invalidity/incapacity benefit; by the mid-1990s it was more than one million. The cynical rebranding of capable men and women as incapable was a useful tool for Tory governments that were throwing people out of work but which didn’t want the unemployment figures to look too shocking. It is remarkable that so-called progressives should now go to the wall to protect this cynical, Tory-invented idea that massive numbers of working men and women are actually too useless or mental or weak to work.
The end result of the spread of the concept of incapacity, and the relativistisation of the category of disability to include increasing numbers of people, is that individuals become both decommissioned and alienated. They are put out to pasture, told that they cannot work, which frequently becomes a self-fulfilling thing; and through their reliance on the faceless state, they become separated from their own communities, coming to be more dependent on the pity and favour of outsiders than on the support and tips of people they know and see every day.
Even worse than uncritically defending such a pernicious system is defending it in an undemocratic fashion. Today, the pro-welfare lobby, clearly disillusioned not only with the Commons but also with the dumb people who elect it, have turned to the unelected Lords to try to preserve the entire welfare state. Radical campaign groups and trade unions call on their members to ‘Adopt a Peer’ – that is, email a lord begging him to vote against government plans on the NHS and welfare – while commentators sing the praises of the peers, saying, yes, they might be ‘ennobled and stuck in an anachronistic institution’ but they are nonetheless willing to ‘speak up for the very poorest and sickest among us’.
A quick glance at history should be enough to shoot down the batty idea that the Lords are potential class warriors defending poor people’s welfare from evil elected officials. The constitutional crisis of 1909-1911 was brought about by the Lords’ refusal to back an early welfare package – Liberal prime minister Herbert Asquith’s ‘People’s Budget’ – and the Asquith government’s subsequent decision to override the Lords helped to define and bolster the ideal of democracy in Britain. Today’s welfare-defenders seem keen to turn the clock back, to revert to a time when the Lords, described by Thomas Paine as the ‘remains of aristocratical tyranny’, were expected to reprimand the Commons. Even if you do your peer-cheering in the name of standing up for ‘the very poorest and sickest’ (what’s with all the patronising Dickensian lingo?), the end result will be the same: the further concentration of moral authority and political power in the hands of a tyrannical few.
With their poverty-porn images of families too sick and destitute to care for themselves, and their love of Lords who stand up and make grandstanding speeches about ‘helping the poor’, today’s welfare-defenders are taking us into Downton Abbey territory – back to a pre-welfare state world of poor laws and posh pity where the very rich were pleaded with to help the lame and the weak. That is the essence of much modern welfare thinking. ‘Please, my lord, stop the evil politicians from taking away my grub and my blankets.’ Screw that. The less well-off are more than capable of looking after themselves, and don’t need to have democracy overturned in their name by unelected twits and their dizzy cheerleaders in the media.
Thousands of ‘Mickey Mouse’ courses will no longer count in British High School league tables
More than 3,000 discredited vocational courses will be downgraded because pupils are shunning tough subjects, Michael Gove declared yesterday.
Schools will be barred from using ‘dead-end’ qualifications – including courses in ‘personal effectiveness’, fish husbandry and nail technology services – to count towards their league table rankings.
Youngsters will instead be encouraged to gain at least a C in English and maths and study science and a language.
The Education Secretary warned against pandering to the view that school is ‘like the movies or a club’ where pupils expect to find lessons ‘exciting’ – and drop out if they are too difficult.
‘If we say that we will tolerate or accept non-attendance on the basis that school is too hard then we are condemning children to a future where, at every stage they face a challenge, we make excuses rather than encouraging them to do better, and that way lies perdition,’ Mr Gove told the Commons education select committee.
‘It’s unacceptable that people are bristling at the requirement that we have children doing English, mathematics and science to an acceptable level.’
Under a GCSE ‘equivalence’ system introduced by Labour, schools were allowed to count more than 3,000 vocational courses towards their league table position.
The courses were deemed equivalent to one or more GCSEs and given league table points in an attempt to motivate disaffected pupils. One approved course was a Level 2 Certificate of Personal Effectiveness, which taught children how to claim the dole.
Chopped from the tables
A report commissioned by the Coalition found that many of the qualifications were ‘effectively dead-end’ with no use in the job market. Its author, Professor Alison Wolf, of King’s College London, said schools had been entering pupils for the courses just to amass league table points.
Mr Gove announced yesterday that only 125 out of 3,175 vocational qualifications for 14 to 16-year-olds meet new criteria for inclusion in league tables.
Of these only 75 will count towards the main yardstick of secondary school performance – the percentage of pupils achieving five A* to C grades including English and maths. And they will count as only one GCSE.
Schools will still be able to enter pupils for the qualifications, but from 2014 they will no longer count toward their league table rankings. Many are expected to wither on the vine.
Former education secretary David Blunkett said: ‘By all means slim them down but do not send the message that this is a wholesale trashing of what was there and that vocational education has been downgraded.’