Hospital consultants should consider weekend work to cut NHS deaths
Hospital consultants should consider working weekends and evenings to help cut the rising number of deaths occurring throughout the NHS outside office hours, a senior doctor has said.
Dr Mark Porter, the chairman of the British Medical Association’s consultants’ committee, said doctors should consider new seven-day-week rotations to help cut patient mortality.
Dr Porter, a consultant obstetric anaesthetist at the University Hospital, Coventry, said consultants should make themselves available if needed. He acknowledged that mounting evidence about the problem meant it was time for a change in working practices in the health service.
Ministers are currently considering offering financial incentives to hospitals to improve weekend services.
Research by Dr Foster Intelligence, released last autumn, found that patients admitted for emergency treatment at weekends were almost 10 per cent more likely to die than those admitted during the rest of the week.
That study, disclosed by The Daily Telegraph followed previous other research that made similar conclusions. Staffing levels were viewed as a key factor, particularly the presence or absence of senior doctors.
But Dr Porter said that such a change was not necessary for every speciality or hospital and must be investigated on a case-by-case basis. He told the BBC: “It will need investment by trusts, but it also needs a willingness by doctors. That is the challenge for us. “Consultants understandably feel like they have rightly got away from working weekends. “They will have done that earlier in their career and are wanting to spend time with patients [during the week] providing really good care.”
He added: “But there is mounting evidence of an association between higher death rates and weekend care. “We can’t prove that it is a causal link, but we cannot ignore it either.”
At present consultant cover is commonplace in intensive care and A&E departments but most other areas of hospitals rely on them being on call. This mean means they give advice over the telephone and only come into hospital in emergencies.
David Stout, of the NHS Confederation, which represents managers, said affordability remained a key question. “Having a consultant on call is very different from having one there, overseeing what is being done and making decisions on the wards,” he said.
“The key question is how we afford this. Hospitals can’t just employ more. “It may be that we need to reconfigure services and do some of this care on fewer sites so we make sure we have the right cover. We have to put patients first.”
Earlier this week Dr Porter claimed that consultants were being “increasingly diverted away from seeking to improve patient care” because they are having to spend time fighting a “belligerent and obstinate Government”.
He told the union’s annual conference of hospital consultants in London that they “should be asking themselves” whether the way they currently operated “remains appropriate as medicine advances”.
Sir Bruce Keogh, the NHS medical director, said: “Having more senior staff and consultants around at weekends is fundamental to the NHS shifting from a five-day-week to a seven-day-week. “It will mean better support for junior doctors and key decisions – like what tests to run, what treatment to give and whether to operate – can be made more quickly.”
Last year MPs found that hospital consultants’ productivity had fallen over the last 10 years while their pay has risen significantly.
More than 40 teachers at under-achieving British school strike over ‘dangerous’ pupils
Teachers at an under-achieving school walked out on strike yesterday in a row over ‘out-of-control’ pupils. The staff claim the headmaster and board of governors have failed to support them in tackling dangerous behaviour by unruly children. Incidents highlighted include a firework being let off in a corridor and a knife being brought into class.
Teachers have also reported pupils regularly fighting during lessons and verbally abusing staff.
Castle Vale Performing Arts College in Birmingham is rated ‘satisfactory’ by Ofsted – the third of four possible rankings awarded by the inspectorate. But last year just 29 per cent of students gained five A*-C grades, including maths and English, in their GCSEs – compared with a national average of 58.2 per cent.
Headmaster Clive Owen yesterday said he was ‘disappointed and disturbed’ by the decision of some 40 staff to strike. But the NASUWT teaching union claimed its members had been left with no option but to walk out and called for an investigation into management at the school.
Union representative Ben Ball, who has taught at the school for 32 years, said behaviour was so bad at times that the school resembled a ‘battlefield’. ‘The behaviour of the pupils has got to a stage where action must be taken,’ he said. ‘There is a core group whose behaviour is completely unacceptable, and downright dangerous, who prevent us from teaching the rest of the children.’
He said the school’s behaviour policy was not followed through by senior management, with the result that ‘the kids know that nothing will happen to them if they continue to behave the way they are doing.’ Yesterday morning, most of those on strike manned a picket line outside the school in the city’s 1960s Castle Vale housing estate.
NASUWT has pencilled in March 20 and 21 for two more days of strike action, but said it would suspend these in the event of an approach from the school for further talks.
A teacher on the picket line, who did not wish to be named, said: ‘The children are out of control, they are bringing blades into school, smoking openly and even bully some teachers. But kids will get sent home by the management for not having a pencil case and then when a teacher’s been sworn at by a pupil nothing’s happened.’
The strike meant the school, which has around 800 pupils and 75 teachers, was closed to all but Year 11 students, who are set to take GCSE exams in the summer. Parents had mixed reactions to the action. Some condemned the teachers for walking out, but others had sympathy for their situation. One said the school was ‘like a zoo’ where children ‘run riot’.
Mr Owen said: ‘A number of meetings with the union have been held to avoid this.’ A spokesman for Birmingham Council said it would convene a meeting with all parties in an effort to head off the two further planned strikes.
The high priests of global warming have lost their prestige and the realists are winning the debate
Something extraordinary is happening in the great Climate Wars. I had a taste of it just the other day on an LBC [a London commercial radio station] talk show. The producer had only booked me in for a ten-minute slot, in case the listeners weren’t interested in my boring new book about that tediously hackneyed subject Man Made Global Warming. But the switchboards were jammed and the station ended up keeping me in for a full hour to reply to all the calls.
There was one big problem though: “We can hardly find ANYONE who disagrees with you,” whispered the show’s host, Julia Hartley-Brewer. This was true. By the end, things had got so desperate that I found myself accidentally picking fights with callers who were on my side. An easy mistake to make for someone on my (sceptical) side of the debate: we card-carrying Satanic “deniers” are so used to being vilified at every turn it really feels kind of weird suddenly to be in tune with the popular mood.
And I’m not the only one to have noticed. A climate sceptical blogger called Pointman has written a superb post on the subject(which is well worth reading in full). The enemy – that’s the alarmists who’ve been making most of the running in the last two decades – is in serious disarray. As Pointman puts it: “All reason has fled. There’s a real feeling of April 1945, Berlin, der Fuhrerbunker and its mad occupants, barking unrealistic orders down phones and moving long ago destroyed units around on maps, as if it really meant something.”
It’s a good point and an accurate analogy. The kind of analogy, unfortunately, which will undoubtedly have the usual greenie/lefty suspects wheeling out their favourite Godwin’s Law defence: ie if you ever mention the Nazis it invalidates you argument because, er, it does because someone called Godwin made a “law” saying it does…..
Yup, I’m weariedly familiar with the Godwin’s law weasel-out. Just as I’m familiar with: the “Appeal to Authority” (eg “the Royal Society/the National Academy of Sciences says”; “98 per cent of the world’s climate scientists agree…..”); the crude ad hom: (“James Delingpole is a C***”; “James Delingpole is in the pay of Big Koch”, etc); the straw man (“How can you deny climate change is happening when four of the ten hottest years happened this decade?”). The Warmists use them all the time.
What all these tricks have in common is this: they’re not arguments; they don’t address any of the points we sceptics (or “realists” as we prefer to term ourselves) painstakingly make in article after article, blog after blog; they’re simply rhetorical tropes designed to confuse, obfuscate, distract, wear down, bruise, irritate, hurt, clog up the comments section and give the illusion of moral and intellectual victory. Above all, though, their purpose is to distract from what you might call the climate alarmists’ Polar Bear In The Room: the world stopped warming in 1998, even as CO2 emissions continued to rise; not only that but none of the computer modelers’ doomsday “projections” of runaway climate catastrophe have been even closely matched by observed real world data.
Or, if you prefer to hear this truth served up with world-weary scientific uber-authority, here’s MIT atmospheric physicist Professor Richard Lindzen addressing the House of Commons in February: “Perhaps we should stop accepting the term ‘skeptic’ because ‘skepticism’ implies doubts about a plausible proposition. Current global warming alarm hardly represents a plausible proposition. Twenty years of repetition and escalation of claims does not make it more plausible. Quite the contrary, the failure to improve the cause over 20 years makes the case even less plausible, as does the evidence from Climategate and other instances of overt cheating.”
In the past – till very recently in fact – the powerful, hugely well-funded alarmist lobby has been able to skate over these inconvenient truths by relying on the propaganda techniques outlined above, as well as on the complicity of the political establishment. Not even the Climategate revelations were quite enough to derail the global warming alarmist gravy train.
So what has changed now? One factor, undoubtedly, has been the fall-out from Fakegate or Gleickgate – the failed attempt by prominent environmental activist Peter Gleick to smear the Heartland Institute (the US think tank best known for its annual climate sceptics’ conference) using stolen or faked documents. The attempted smear was bad enough (imagine the media outrage if climate realists had tried something similar!) but where the stunt really backfired was as a consequence of its handling by left-liberal news organisations like the Guardian, the BBC and the New York Times.
All of them leapt into report the story gleefully without bothering to check whether or not it was true. And when evidence began to emerge that it wasn’t true, they compounded their error by seeking to defend Gleick’s duplicity and criminal actions regardless. Numerous left-liberal commentators argued that Gleick was in fact a hero whose crime was entirely justified in seeking to expose the manifest evils of this sinister, right-wing think tank.
Problem was, even this argument wasn’t borne out the facts. As far as environmental think tanks go, Heartland is little more than a Mom & Pop operation, run on the relative shoestring budget of $4.7 million (only a proportion of which goes towards “climate change” issues). Now compare this with the budgets of left-leaning environmentalist pressure groups such as the Sierra Club ($84.8 million), Natural Resources Defense Council ($97 million), or the World Wildlife Fund ($177.7 million). And that’s before you take into account US government spending on climate change issues, which according to calculations by blogger Jo Nova exceeds spending on sceptical science by 3500 to one.
During the last two decades global warming alarmist propaganda has depended on Hitler’s Big Lie principle (whoops: Godwin’s Law. So shoot me). But that principle, as first Hitler discovered and now the AGW lobby is discovering too, is flawed. In fact there are only so many times you can tell a whopping great lie (be it on the solidity of AGW theory or that climate sceptics are lavishly funded by Big Oil) before the people see through it. And once the people discover that they have been consistently lied to (and cheated out of a great deal of money to boot) they don’t like it one bit.
Coming soon – indeed it has already started – is the mother of all backlashes against the AGW alarmism industry. It will happen on lines predicted over a century ago by Gustave Le Bon in his seminal 1895 work, The Crowd.
Le Bon (whose analysis of crowd mentality influenced Freud, Hitler and Mussolini) argued that the secret of demagoguery was to repeat an idea over and over again in order to create a “contagion” which would infect the popular mind and hold the culture in its grip. This is what, until very recently, happened with the global warming religion.
But this contagion can only keep going, Le Bon argues, so long as those spreading it possess “prestige” in the eyes of the mob. Once that “prestige” is lost, the crowd turns brutally against those seers and experts and leaders in whom it once had such faith. Suddenly it sees them for the liars and cheats and manipulators they really are.
This is what is happening now in the great climate debate. Michael “Hockey Stick” Mann’s new book is not selling; George Monbiot is mocked as a conspiracy theorist; the Royal Society’s Sir Paul Nurse climate science ignorance is eviscerated in a report by the Global Warming Policy Foundation; Yale economics professor William D Nordhaus publishes an essay in the New York Review of Books called Why the Global Warming Skeptics Are Wrong – and is almost instantaneously and comprehensively rebutted at Watts Up With That?
The high priests of global warming have lost their prestige. They’re still chanting the same old mantras. But no one’s listening, no one cares.
Government should butt out of marriage and churches
UK Equalities Minister Lynne Featherstone want to legalise gay marriage. Fine by me: I don’t see why gay couples should not be able to sign up for the same obligations, rights and benefits that heterosexual couples observe and enjoy.
She also wants gay couples to be allowed to marry in church, like heterosexual ones. Again, I have no problem with that, if the church is willing to do it.
The Church of England, typically, is divided on the issue. As the Established Church, they do pretty well out of their cosy relationship with the state, not the least of which is that two dozen of their senior executives, the bishops, sit by right in the House of Lords. So when ministers tell them to do cartwheels the Church of England normally swallow their principles, hitch up their cassocks and cartwheel.
The trouble is that some time ago, the state muscled in on marriage. Churches had been doing their own thing for millennia, but when the state started taxing rich folks and paying benefits to poor ones, it had to find some way of defining families so that it could establish the tax base and the appropriate unit to which benefits should be paid (two can live as cheaply as one, and all that). So they nationalised the whole business, and shoehorned everyone into a single set of regulations, as governments do.
But should we be so shoehorned? Maybe one of the reasons why the one-size-fits-all state-produced marriage contract has declined so much is that people today are more individual, and want to fashion their own ways of living, rather than have a standard, off-the-peg package of obligations forced on them. And so they should. People should be able to draw up their own lifetime contracts, accepting some bits of the present marriage contract, rejecting others and adding different ones of their own if they choose. Certainly, the state might insist on some minimum elements if people want to be taxed, and draw benefits, as a family. But apart from that, it should keep its nose out.
Likewise, Ms Featherstone should keep her nose out of what the churches choose to do. They too may have their own minimum standards for marriage, which couples have to sign up to before they can expect to be married on the premises. Fine. Churches are private clubs, let them get on with it. Personally, I would be campaigning for them to accept gay couples, but I wouldn’t force church officials to betray their consciences. These are deeply held ethical positions. Churches have been thinking about the morality of lifetime partnerships a good deal longer than Ms Featherstone has.
I do wish politicians would buzz off and leave us all to our private sphere, allowing us to wallow in our own eccentric diversity rather than forcing us into tidy moulds. At this, rate, they will be demanding that the churches should not discriminate on the grounds of religion, and should accept other faiths into membership. I don’t know what Cardinal O’Brien is going to make of it when he has to hand out wine and wafers to his first Satanist.