‘NHS pays £20,000 a week for a doctor
Doctors are being hired at rates of £20,000 a week by hospitals to cover NHS staff shortages caused by European rules, an investigation by the Sunday Telegraph has found. In some cases the amounts being paid would be the equivalent to a doctor earning an annual salary of almost £1 million.
And some doctors were rewarded not just for the hours they worked, but for all the time they were on call – including when they were sleeping.
Our investigation discloses how hundreds of millions of pounds have been spent on agency doctors so that hospitals can comply with the European Working Time Directive, which limits the number of hours medics can work, and found that:
-80 per cent of hospital trusts which provided figures admitted spending more than £1,000 per shift on medical cover;
-Hospitals spent more than £2 billion on temporary clinical staff in the two years since the rules came in, a sum which could have paid the wages of 48,000 nurses or 33,000 junior doctors over the period;
-North Cumbria University Hospitals Trust spent £20,000 hiring a surgeon for one week and £14,000 on four days’ cover for a gynaecologist;
-Mid Staffordshire Foundation Trust paid £5,667 for a doctor to cover one 24-hour shift in its casualty unit;
-Christie Foundation Trust in Manchester spent more than £11,000 on six days’ cover for a haematology consultant.
Shortages of medics have arisen since the introduction of the working time directive, which set a maximum 48-hour-week in Aug 2009, and although individual doctors are allowed to opt out of it, they still cannot exceed a limit of 56 hours.
The rules mean that many hospitals have had to either take on more doctors, or use staff from agencies, which recruit from elsewhere in the UK and abroad.
Sir Bruce Keogh, the medical director of the NHS, indicated that pressures are set to grow, as he urged hospitals to be fully staffed at weekends, so treatment can be offered at times which suit patients.
Although the NHS has been protected from cuts by being guaranteed a rise in annual spending in line with inflation by the Coalition, the service is attempting to save £20 billion by 2015, to ensure there are sufficient funds to cope with the rising demands of an ageing population.
Prof Norman Williams, the president of the Royal College of Surgeons, which campaigned against the working time directive, said the sums exposed by the investigation were “extraordinary” and demonstrated the need for the rules to be relaxed.
He said: “These payments amount to close to £1 million a year to cover one post. They cannot be justified and they are not sustainable.”
Prof Williams said: “We are hearing reports that when a consultant retires, trusts are taking a knee-jerk reaction, deciding they won’t fill the post, because they don’t want to commit to the future, and instead they are spending far more on agency rates.”
Andrew Lansley, the Health Secretary, has said that controversial reforms – which are expected to be passed in Parliament this week – to hand most of the NHS budget to groups of GPs, are the best way to prevent the service entering financial crisis. He has also vowed to attempt to negotiate an opt-out of the directive for junior doctors.
The rates being paid for medical cover illustrate the scale of excess in the current system. In total, 83 hospital trusts – out of 164 – responded to Freedom of Information requests about the sum they spent on temporary doctors, nurses and other clinical staff.
These were used to calculate an NHS-wide figure, which shows £1.03 billion was spent in 2010-11 and £1.05 billion the year before.
A total of 34 hospital trusts responded to requests for information about the highest rates paid for shifts. Of those, 28 admitted spending more than £1,000 a day to hire individual doctors and nurses via agencies since April 2009.
The European Union rules meant one cardiologist cost the taxpayer £19,000 to work a 40-hour week, on the basis that he was on-call the rest of the time.
Blackpool Teaching Hospitals Foundation Trust paid more than £2,800 for a locum to be on-call for a 24-hour period, in 2009-10 and 2010-11 – regardless of whether services were required. Stockport Foundation Trust spent £4,500 on two days’ work for a surgeon in Sept 2009, while West Hertfordshire Hospitals Trust spent more than £2,000 a day for stand-in consultants in 2010 and 2011.
Heart of England Foundation Trust had the highest total bill for temporary staff in 2010-11, spending more than £24 million.
Most of the sums paid included fees paid to agencies. However, agencies which hire locum doctors have recently advertised NHS work which pays up to £100 an hour, including time on call.
A post for a cardiologist to work for a week at Dewsbury and District Hospital this month includes up to £4,800 for two days spent on call.
The same £100-an-hour rates were offered for at least one month’s work at Scunthorpe General Hospital in January, with the temporary post offered again this month. Princess Alexandra Hospital trust in Essex paid more than £2,000 for a locum doctor to work a 12.5-hour shift last October.
North Tees and Hartlepool Trust spent £1,870 on 24 hours’ cover for a neonatal consultant in September and £1,950 on 24 hours’ work in its Accident and Emergency department the year before.
A spokesman for North Cumbria University Hospitals Trust said hospitals throughout the country had experienced pressures regarding medical rotas since the working time directive came in. He said the trust had employed locums when it was hard to fill permanent posts.
Manjit Obhrai, medical director of Mid Staffordshire Foundation Trust, said that on occasions when cover was needed, patient safety was always put above cost.
He said: “This means that we have to pay the going rate for those staff who are available to cover, sometimes at short notice – these costs are often extremely high, due to the agencies’ fees.”
Katherine Murphy, chief executive of the Patients Association, said it was “outrageous” that hospitals were spending so much money on agency staff, while patients struggled to access many treatments, such as hip replacements.
Mrs Murphy said: “We cannot afford to shell out such vast sums on locum cover”.
She said the use of temporary staff increased risks to patients, because they were not familiar with the hospitals in which they worked.
A spokesman for the Department of Health said trusts should always seek to negotiate the best value prices for locums.
He said the Government understood there were “real concerns” over the impact of the directive, and had begun EU negotiations to revise it.
Even Britain’s Leftist leader is fed up with Britons who won’t work
Unemployed young men and women who turn down State-backed work training schemes will be stripped of their benefits under a Labour government, Ed Miliband said yesterday. The party leader said that for under-25s without work for at least a year ‘saying no is not an option’.
Labour’s Budget would demand a tax on bank bonuses to fund six months’ work for the young, he said.
Under the ‘Real Jobs Guarantee’ scheme, businesses would be paid up to £4,000 to cover 25 hours-a-week paid experience, he told a Labour youth conference.
Mr Miliband said: ‘It is simply unacceptable to have so many talented young people out of work for an entire year, with their hopes and dreams evaporating. And that’s why my ambition is this: to conquer long term youth unemployment.’
But the policy began to unravel when Deputy Leader Harriet Harman could not say how much it would cost. Asked on the BBC’s Daily Politics programme, she floundered, saying: ‘I’ll have to get back to you on that.’
The tax would raise £1billion, she added – although the party later said it would be £2billion.
Mr Miliband also used his speech in Warwick to tell how the extraordinary life and death of his father taught him to make the most of opportunities.
Marxist academic Ralph Miliband, who fled the Nazis in Belgium, died when Ed was 24. The Jewish refugee had arrived in London at 16 knowing no English and earned money clearing rubble. Within three years, he had a place at the London School of Economics.
Mr Miliband said: ‘He succeeded because he was given a chance. And the opportunity he was given was matched by his sense of striving.
‘He worked hard to make something of himself and that is one of the things I learned from him: hard work and its value. It was just a sense that you shouldn’t waste your potential.’
In a personal interview in The Times yesterday, he attributed his and his elder brother David’s careers in politics to their father. ‘He was a lodestar, something to steer by.’
His father’s death at the age of 70 in 1994 had been the ‘worst thing that happened in my life’, Mr Miliband said.
He admitted that having an older father made him less likely to rebel, as he did not want to put a strain on the elderly man.
Ralph Miliband wanted his youngest son to be an academic but realised that he was more driven by politics.
But Mr Miliband said: ‘The idea that two of his children would be MPs and me the leader, that would not have been what he would have expected.’ Mr Miliband said he still had not apologised to his elder brother for inflicting a shock defeat over him to take the Labour leadership. He said ‘we’ve sort of moved on’ 18 months later.
Mr Miliband married the mother of his two children, Justine Thornton, last year.
Myths about social mobility in Britain
I heard an interesting interview on BBC Radio Four’s Today program the other morning. It was with The Guardian journalist Stephen Armstrong, who has retraced George Orwell’s 1937 journey to Wigan Pier and tracked down some of the sons of men Orwell interviewed for The Road to Wigan Pier. Here’s what Armstrong said:
Orwell met a lot of people on the road to Wigan Pier and he disguised a lot of names. We discovered that we know three of them quite well: a man called Gerry Kennan, who was a union activist, a man called Sid Smith, who was selling newspapers, and a guy called Jim Hammond, who was unemployed, a black-listed communist miner who really wasn’t getting any work.
So I went back to try to meet their sons. Gerry Kennan’s son, unfortunately, died at the end of last year. Sid Smith grew his shop into the largest independent retail newsagent in the north-west and his son Trevor now lives in a large house in green fields on the edge of Wigan. And Tony Hammond is now a retired High Court judge.
The BBC interviewer was astonished. These are only two cases, of course, but social mobility like this is not what The Guardian and BBC journalists expect to find when they go sniffing around northern, working-class towns like Wigan. This story just doesn’t fit with their familiar narrative of class privilege.
For years, I have been trying to convince anyone who will listen that social mobility in Britain is extensive. Like most other advanced capitalist countries, Britain is an open, meritocratic society where talent and hard work count for much more than social origins. Employers are interested not in who your father was but in what your competencies are.
But no matter how many times I set out the statistical evidence, politicians, academics and left-wing journalists refuse to believe it. Government is so convinced there is a problem that it is threatening to withdraw funding from top universities like Oxford and Cambridge unless they accept more working-class entrants on lower grades. Prime Minister David Cameron has appointed a social mobility ‘Tsar,’ Alan Milburn, who describes Britain as a ‘closed shop society.’ Milburn told the BBC last year: ‘In Britain, if you’re born poor, you die poor.’ This despite the fact that 80% of people born to parents under the poverty line in Britain avoid poverty when they reach adulthood.
We might hope that Armstrong’s stories of the retail magnate and the High Court judge might help correct some of these prevailing myths and misconceptions. But when a BBC interviewer gets together with a Guardian journalist, it doesn’t take long for them to revert to type.
Armstrong went on to tell of a 12-year-old in Wigan who thought that to become a High Court judge nowadays, ‘a magician would have to cast a magic spell.’ Armstrong concluded from this that mobility doesn’t exist anymore: ‘The opportunities that they [Orwell’s generation] had seem to have been closed off.’
He went on: ‘Poverty is back to 1936 levels. I met a girl, Sarah, who is living on £2 a day.’
This does sound like appalling poverty. Except it turns out that Sarah had failed to attend an appointment at the Job Centre, so her unemployment benefit was docked. Instead of arranging a new interview, she was living in a homeless hostel and had apparently taken up with some undesirable men. Armstrong concluded from this:
‘So Victorian style poverty and fates worse than death are increasing.’
‘Yes,’ said the BBC interviewer, now safely back in his comfort zone. And with ruffled feathers back in place, Radio Four moved on to its next story.
British regulator says English standards in primary schools ‘too low’
Standards of English in primary schools should be dramatically raised because too many pupils start secondary education with poor reading and writing skills, Ofsted warned today.
In a damning report, the education watchdog said almost a third of pupils who reached national targets at 11 failed to gain good GCSEs in the subject aged 16. It claimed that standards had been “flat” since 2005 because the demands put on children were too low.
Ofsted told of key weaknesses in the way the subject was delivered at all ages, with schools often shunning creative and extended writing tasks and failing to teach the basics of spelling and handwriting.
It also emerged that many schools were placing an “increasing emphasis” on analysing non-literary texts such as holiday brochures and complaint letters to pass exams instead of requiring pupils to read whole novels and poems.
The conclusions were made as Sir Michael Wilshaw, the chief inspector, prepared to outline a 10-point plan to drive up standards of reading and writing.
In a speech on Thursday, he will call on the Government to set tougher English targets for all 11-year-olds amid fears current demands in primary schools are too low – leaving children struggling with the basics in secondary education.
In a further move, Sir Michael will say that more specialist English teachers should be parachuted into primary schools – or clusters of small primaries – to drive improvements.
He also recommends:
* Giving parents regular updates on their children’s reading age – showing whether they are reaching the basic standard expected for their peer group;
* Prioritising Ofsted inspections in schools with the lowest levels of achievement in English;
* Sharpening up the inspection process to ensure all trainee teachers are being taught how to deliver phonics – the back-to-basics method of reading;
* Tightening up regulations for childminders and nurseries to ensure they place a greater emphasis on promoting speaking and listening skills among under-fives.
In a speech at a primary school in west London, Sir Michael will say: “There can be no more important subject than English. It is at the heart of our culture and literacy skills are crucial to pupils’ learning for all subjects.
“Yet too many pupils fall behind in their literacy early on. In most cases, if they can’t read securely at seven they struggle to catch up as they progress through their school careers.
“As a result, too many young adults lack the functional skills to make their way in the modern world. We are no longer a leading country in terms of our literacy performance: others are doing better.”
Currently, the average pupil is expected to achieve at least “Level 4” in exams taken at the end of primary school. This means they can write complex sentences and spell accurately in English.
Figures show around one-in-five children – more than 100,000 – currently fail to reach the benchmark each year. Results have only marginally increased between 2005 and 2011, it was revealed.
But Ofsted warned that hitting the target was no guarantee of success in secondary education. According to data, 45 per cent of pupils who just passed Level 4 at 11 failed to go on to gain at least a C grade in GCSE exams last summer – the result expected of the average 16-year-old. Some 29 per cent of the total number of Level 4 pupils missed out on a C grade.
In a report on the teaching of English, published to coincide with Sir Michael’s speech, Ofsted said that “too few schools gave enough thought to ways of encouraging the love of reading”, with many pupils failing to read whole texts.
A common activity in many English lessons was the “teaching of features of a persuasive text”, said Ofsted, but this was involved “studying holiday brochures or writing letters of complaint” instead of reading novels and poems.
The teaching of writing was also “variable in quality, with too little attention given to spelling and handwriting”, Ofsted warned.
The Department for Education said it was already assessing English standards as part of a wider review of the National Curriculum and was introducing a reading check for all six-year-olds to pick out those struggling the most at the start of school.
“We want England to move back up the international league tables and for children to leave school with the knowledge that will stand them in good stead for their future careers and adult life,” a spokesman said.
But the comments were condemned by teachers’ leaders who accused Ofsted of attempting to undermine schools. Mary Bousted, general secretary of the Association of Teachers and Lecturers, said: “Both Ofsted and the government need to get the balance right between labelling pupils and their teachers as failures, and helping them improve learning. “Countless tests and stressful inspections are not the answer.”
Rainforest remedy to cure toothache: Amazonian plant is turned into painkilling gel
Good if it pans out but most of these wonder discoveries don’t
The agony of toothache can leave you willing to go to the ends of the earth in search of a cure. But you may need to look no further than the depths of the rainforest.
A rare red and yellow plant from the Amazon could offer more effective pain relief than existing drugs and treatments, scientists have claimed.
The ancient herbal remedy is so potent that it might even replace uncomfortable anaesthetic injections for certain procedures – and provide a natural remedy for teething babies.
Cambridge University anthropologist Dr Francoise Barbira Freedman came across the budded plant more than 30 years ago when living with a secretive Peruvian tribe known for practising shamanism.
During her trip she suffered severe pain in her wisdom teeth. She was given the remedy by the tribe’s medicine men and the discomfort ‘went away immediately’.
The plant used by the tribal medicine men is set to revolutionise worldwide dental treatment
The plant used by the tribal medicine men is set to revolutionise worldwide dental treatment
Pugh on the amazing pain-relieving plant
Years later, she was asked to provide Cambridge with some examples of rainforest remedies, and added the Acmella oleracea plant to the list.
Describing the inclusion as an ‘afterthought’, she said: ‘It was added to the bottom of the list, but somehow the list got reversed, and it was the first one tested back in the UK. It was immediately successful and we’ve never looked back.’
Using extracts from the plant, the researchers have developed a gel which blocks the pain receptors found in nerve endings – and could be on the market in only two years’ time.
In early trials, it helped relieve pain during removal of teeth that were impacted, or stuck below the gum line.
The gel was also considered more efficient than the standard anaesthetic used when patients with gum disease need pain relief for scaling and polishing. The effects lasted longer, and patients were more likely to attend follow-up appointments.
In informal tests carried out by a Peruvian dentist, the plant extract also helped treat mouth ulcers and ease pain caused by dentures, braces, gum disease and having teeth removed. And to top it off, there are no known side-effects.
Dr Freedman, who plans to share any profits from the sale of the gel with the Keshwa Lamas community in Peru, said: ‘This treatment for toothache means we could be looking at the end of some injections in the dentist’s surgery.
‘We’ve had really clear results from tests so far, particularly for procedures such as scaling and polishing, and there are many other potential applications.’
These range from soothing the pain of teething in babies to relieving irritable bowel syndrome.
The researcher, who is about to make another visit to the rainforest community, went on: ‘We think people prefer to use natural products and this is particularly the case for baby teething, for which, to my knowledge, there is no clinically tested natural alternative.’
Researchers at Ampika, the company founded by Dr Freedman to commercialise the gel, plan to publish the trial results in an international dental journal and conduct further tests in several countries.
They also want to refine the formula to develop a higher strength and longer-lasting product.
The end of the handyman: Now it’s handyperson
The politically correct would have us live in a world of ‘letter carriers’, ‘chairs’ and ‘coffee without milk’. But who would they bring in to do odd bits and pieces around the house? Jobcentre staff provided the answer yesterday – a handyperson.
The title was revealed after a property firm tried to advertise for an apprentice handyman. A woman Jobcentre worker suggested that the word was sexist and so would prevent young women from taking part in the selection process.
The advice, however, shocked executives at London maintenance company aspect.co.uk, who have refused to fall into line. Bosses at the company said they were keen to do their bit to help tackle youth unemployment by taking on a trainee.
The firm asked a number of Jobcentres in London if they would be willing to give out flyers to advertise the opportunity to the young unemployed. However, it ran up against what it calls ‘ludicrous political correctness’. Directors were astonished to receive a response suggesting its flyers should be changed to replace the word ‘handyman’ with a more inclusive term.
Will Davies, managing director of aspect.co.uk, said: ‘At this time of mass youth unemployment, it’s hardly the time for political correctness. We welcome female and male entrants. But the name is Handyman.’
The Department for Work and Pensions, which is responsible for Jobcentre Plus outlets, yesterday insisted the word ‘handyman’ had not been banned and blamed a ‘local misunderstanding’ for the problem.