Foreign doctors who can’t speak proper English to be struck off: NHS must check language skills
Doctors will be struck off if they cannot speak proper English amid fears that patients’ lives are being put at risk, the Health Secretary will say today.
Hospitals and GPs’ surgeries will also be legally obliged to make sure foreign medics have a proper grasp of the language and the way the NHS works.
Andrew Lansley plans to change the rules so doctors found to fall short of the required standards can be permanently barred from practising in this country.
Under the existing system, as many as 23,000 doctors from Europe have registered to work in the NHS despite never having been asked if they can speak English properly. To comply with EU freedom-of-movement requirements, continental doctors and nurses are allowed to work without any formal NHS training. They can be struck off only if they are found to have harmed patients.
MPs and peers have warned that the scandal has compromised patient safety, with particular concern about the increasing use of foreign doctors to provide out-of-hours services.
In one notorious case, pensioner David Gray died after out-of-hours locum Dr Daniel Ubani gave him up to 20 times the recommended amount of diamorphine to treat pain in his kidneys. The German doctor had failed an English test for one primary care trust, so simply applied to work at another.
Mr Lansley said that from next year, foreign doctors will have to prove they can speak English before they can practise in this country.
He also intends to change the law to allow the General Medical Council to strike off any doctor found to have a poor grasp of the language, rather than having to wait for them to cause harm.
‘That is not good enough and it has to change,’ said Mr Lansley. ‘We must be able to take action to protect patients if there are genuine concerns, rather than just hoping for the best.
‘If a doctor can’t speak proper English, they won’t be able to communicate effectively with their patients. It can also lead to situations where doctors put patients’ safety at risk.
‘We need to bring some common sense back and ensure that, if a doctor is judged not to have the language skills to be able to work properly or safely in the NHS, they can be suspended or removed from the register.’
The GMC registers thousands of doctors each year from all over the world. Those from outside the EU have to take rigorous language tests.
However, European laws make it illegal to systematically test EU doctors when they register. Brussels claims this would conflict with the European principle of the free movement of people. As a result, doctors from English-speaking countries such as Australia and Canada face tougher language tests than those from Germany or Lithuania.
The Government says it will get round the EU rules by introducing a requirement for language tests at a local level, with ‘responsible officers’ – senior medics in every NHS organisation – taking charge. They will be given extra powers and put under a legal duty to test English skills and understanding of NHS procedures and medicines. Any that fail in their duty will be struck off themselves.
Niall Dickson, chief executive of the GMC, said: ‘This is a vital issue for patients. ‘They must be able to have confidence that the doctor who treats them has the communication skills needed for the job. ‘We warmly welcome the measures the Secretary of State has unveiled, which we have worked together on for many months.
‘These proposals …. will mean patients receive the assurances they need about the doctors who treat them.’
An hilarious attempt to measure morality
This “philosopher” (below) is a chump who seems to know nothing of prior work in his field. He has attempted to reinvent the wheel and predictably come up with a very poor product. As someone who has written for the academic journals on both the philosophy and psychology of morality, perhaps I should put up a few notes on his work.
The best known attempt to measure moral development is of course that by Kohlberg — which took the Piagetian approach of watching how children’s moral ideas develop. Kohlberg’s two “highest” levels of moral development were not however based on observation but rather on Kohlbeg’s own liberal ideas. As such they are just an expression of opinion and are not in any way authoriative.
Then of course we have the work of Haidt, which is much more empirical and in many ways persuasive. I have recently discussed Haidt at length however so will go no further at this point other than to say that Haidt must be regarded as the leading authority in his field, albeit with some things yet to learn.
In the work of Steare (below), however, we see a reversion to the Kohlberg approach of “science” by opinion. And he seems to think that he has nothing to learn from research that others have done in the field. That double arrogance has led him into one large and very risible mistake. He appears blissfully unaware that the questions he asks are close to identical with the questions that psychologists use to detect lying (i.e. “lie scales” or “social desirability scales) so any correspondence of his conclusions to reality is purely coincidental. His arrogance has led him into naivety. He is a clown trying to make sense out of self-serving statements that are unlikely to be true.
So it is no surprise that he found that older women were more moral. In my studies too I have found that older women were more prone to to “faking good” (i.e. have high lie scale scores).
In the battle for the moral high ground, it seems we have a winner at last. A leading philosopher has claimed that women are more moral than men.
Professor Roger Steare developed the ‘Moral DNA’ test four years ago to measure both a person’s morality and the changes in their value systems when they enter the workplace.
Professor Steare said the results show that your gender and age are most likely to influence your morality – with women and the over-thirties proving the ‘most moral’.
Those taking the test are asked to rate a series of statements about their personal and work life – for example, whether their colleagues or family would say they were ‘honest’ or ‘competent’.
They then have to evaluate assertions about themselves, such as ‘I always honour people’s trust in me’ and ‘I am good at exercising self-control’. Those taking part then receive a report naming them as one of six personality types – Philosopher, Judge, Angel, Teacher, Enforcer or Guardian.
And he revealed that as we get older, we also appear to become more moral. ‘What stood out from the answers was that obedience decreased with age, while reason increased – a logical occurrence as we make the transition from youth to experience,’ he added.
It is time we burst this “bubbling”
Freedom of movement in Britain?
Is it fair that the vast majority of supporters, who behave well, should have their freedom to travel to a popular leisure activity curtailed because of the risk that there will be disorder caused by a small number of troublemakers? That’s the question posed by the rise of the ‘bubble’ match.
‘Bubble’ football matches are the culmination of years of growing restrictions on football fans who follow their team to away matches. Bubble matches are ‘kettling’ on wheels. Travelling fans must be transported on licensed coaches and under police escort, from a designated pick-up point to a designated drop-off point. No independent travel is allowed to the match by car, train or any other means of transport. Fans often must pick up their tickets on route, for example at a motorway service-station at a halfway point. Their freedom of movement is suspended.
Only last weekend, bubble restrictions were imposed on Portsmouth supporters travelling to Southampton for the local derby between two neighbouring teams from England’s south coast. Even if you lived a long distance from the point of departure – including in Southampton itself – as a Portsmouth fan, you were required to leave from the specified Portsmouth departure point in order to go to the match. This is a condition of ticket sales. Fans were met by the police in Southampton, and escorted to and from the ground through what the police call ‘the sterile area’. The Pompey (Portsmouth) Supporters Trust vice-chair, Ken Malley, spoke out against these restrictions: ‘We are against bubble matches because of the human rights issues and because it gives the idea that all football fans have to be controlled.’
Through research and freedom of information (FoI) requests, the Manifesto Club – the civil liberties group I have written a report for – has identified at least 48 bubble matches that have taken place, involving at least 14 major clubs in England and Wales. In spite of loud protests from supporters’ clubs – and declining trouble at football matches – these extreme travel restrictions are still being considered and implemented.
The impact of bubble matches
In order to impose restrictions on travelling supporters, a number of clubs issue vouchers rather than tickets. The vouchers are then exchanged for tickets at a designated point on route to the stadium, often a motorway service-station. The ‘voucher for ticket’ exchange is policed, and travel beyond the point of exchange is also controlled, with coaches and minibuses, but usually not private cars, permitted to travel on to the stadium.
Unsurprisingly, a significant number of fans are put off going to bubble matches, and ticket revenue for the clubs is reduced. At one of the restricted matches, for example, Bristol City took 200 fans to Swansea rather than the usual 2,000, a 90 per cent reduction in support for their team on the day.
The extreme measures involved in bubble matches cause considerable disruption for fans. This is not surprising, because the whole system is designed for the convenience of the authorities – the police and the clubs – rather than for the supporters.
Clubs’ restrictions on visiting fans may make matches cheaper to police. This will happen if the risk category, into which all matches are graded, is lowered because of the tighter controls imposed. Clubs may therefore be tempted to opt for bubble matches, despite their unpopularity, since the savings can be close to £20,000 for a Championship-level fixture.
Of course, authorities claim that these restrictions make visiting supporters feel safer. However, a perverse result of the bubble restrictions is that football supporters can be more exposed to troublemakers, because they are travelling in a convoy of readily identifiable vehicles. Supporters travelling independently by car or train can usually move unobtrusively in and around the stadium, with the application of a minimum amount of common sense and caution. When this is effectively banned, supporters are wholly reliant on police security.
The ‘bubble’ group is unlikely to endear itself to opposing supporters. Indeed, these high-security measures can ratchet up fear and distrust. The sight of kettled supporters being escorted to and from the ground can lead to the very taunting and abuse which the authorities would presumably like to see reduced.
Criminalising football fans
It has become commonplace for travelling football supporters to be regarded with suspicion at best, and as alien and dangerous at worst. Pat-down body searches before entering the ground have been added to bag searches as common practice. Filming of supporters by the police has also become routine. The number of stewards at matches has been growing, as have reports and incidents of their heavy-handed behaviour. Some grounds have introduced webcams for stewards to film spectators at matches, and the practice looks likely to spread.
The bubble match is merely the most extreme example of restrictions on away fans’ freedom of movement. A more common form of restriction comes in the application of the Traffic Commissioner’s Guidelines, under which police can advise coach companies on the route they should take and the time they should arrive in the host town or city.
Although travel restrictions are not as severe as in bubble matches – independent travel is not banned entirely – these guidelines can still lead to extreme restrictions on coach-travelling fans.
One recent case affected Carlisle supporters, travelling for a match in Preston on 26 December 2011. The head of Carlisle United Supporters Club, Kate Rowley, had arranged through her brother (a parish priest in Preston) to stop at the Blessed Sacrament Club prior to the game for food and drink. Food was purchased in readiness for their visit. However, their plans were thwarted when Lancashire Police imposed restrictions on their travel, which meant that coach parties were prohibited from stopping.
Arrests in decline – bubble matches are not necessary
These extreme travel restrictions occur at a time when violent or disorderly incidents in and around football grounds have declined markedly. In the season 2010-11, total attendance at professional matches in England and Wales was more than 37million, representing by far the largest spectator events in Britain. The total number of arrests in that season was 3,089, which represents less than 0.01 per cent of all spectators, or one arrest for every 12,249 people. This was a record low according to the Home Office.
Although bubble matches affect clubs with a history of crowd disorder, all current indications are that football-related violence is at an historic low. It is highly questionable, therefore, whether these extreme travel restrictions are necessary and proportionate.
Bubble match restrictions do not target the minority of troublemakers. Instead, they punish all away fans, and hope to deter the violent minority by doing so. This is surely wrong in principle. Under Britain’s common law, people are treated as innocent until proven guilty, not the other way around. People are held accountable for their own actions, not punished for the actions of others.
We call on football clubs, the police and local authorities to reject and end the extreme and discriminatory practice of bubble matches. Instead, police and football authorities should concentrate on tackling troublemakers and incidents of disorder directly, with the co-operation of football clubs and supporters’ organisations.
Shifting the range of what is politically possibile
Comment from a prominent British free-market group
Yes, it’s wrapped up in unlovely jargon but this is what we exist to do: shift the Overton Window. Chris Dillow:
“But that’s what half of me thinks. Another half remembers Richard Cockett’s description of how libertarian think-tanks helped – over very many years – to shift the Overton window; within my lifetime, private ownership of utilities, for example, has gone from being unthinkable by the political class to taken for granted.”
It’s true that we’re largely seen as being right wing but this is a serious mistake upon the part of those so viewing us. We actually want the poor to get richer, something that makes us rather leftie. That we advocate policies like markets, policies that actually do make the poor richer, makes us unique among lefties, this is true but in this sense we are indeed of the left. As we are in desiring to increase liberty, remove legal and economic privilege and so on.
But what is this Overton Window thing? That’s the set of policies which at any one time can be plausibly taken as being politically realistic. Our job is to shift the perception of the various policies we propose so that, over time, they become part of that set of plausible, possible, political actions.
Madsen has his own way of describing this, that we start out saying something that by the standards of the times marks us out as being complete loons howling in the wilderness. By the time people are drinking the beer made today they’ll be chuckling at the latest weirdness from those nutters. By the time today’s production of good Scotch gets drunk it’ll be a serious policy proposal that one or more political parties is including in a manifesto. And by the time this year’s claret is ready to drink it’ll be a settled part of the legislative landscape and no one at all can remember that we haven’t always done it this way.
And we’ll take such victories from any political party: Red Ken is associated with the Congestion Charge in London but it’s us classically liberal think tanks that set that policy running. Privatising the utilities was enacted by the Tories and I know for certain that the current Lib Dem idea of sharing paternity and maternity leave was inserted into party policy as a result of someone reading this blog. From my pointing out that we don’t in fact have a gender pay gap, we have a motherhood pay gap. And it really shouldn’t be all that much of a surprise to anyone knowing my background that the UKIP flat tax policy has certain similarities to the flat tax ideas of this think tank.
In terms of the future my biggest ambition is to get drug legalisation through in just this manner. We’ve been saying it for years already, that it’s the illegality that causes many of the problems. We’re already seeing serious and sensible politicians running with the idea: heck, Portugal has essentially decriminalised even if not legalised drugs. That Overton Window has already shifted and it is possible to at least conceive now of a future government legalising and taxing appropriately all drugs. It won’t be by the time today’s Scotch is ready to drink, sadly, but I can see it happening by the time this year’s claret is ready.
It’s beyond belief to teach witchcraft in British schools
Teaching Druidry and paganism in schools is just another example of our liberal fear of religious values, says Cristina Odone
Saint Morwenna, who in the 6th century built a church on a cliff with her bare hands, must be turning in her grave. Her beloved Cornwall, the last redoubt of Celtic Christians, is to teach witchcraft and Druidry as part of RE. The county council regards her religion (and that of other Cornish saints such as Piran and Petroc) as no better than paganism.
It makes perfect sense. Fear of being judgmental is so ingrained today that no one dares distinguish between occult and Christian values, the tarot and the Torah, the animist and the imam. Right and wrong present a problem for liberals who spy covert imperialism or racism in every moral judgment. Saying someone has sinned is “disrespecting” them, as Catherine Tate’s Lauren Cooper might say. Speaking of religious values is as dangerous as playing with the pin on a hand-grenade: it could end up with too many Britons blown out of their complacency. No one should dare proclaim that adultery is wrong; greed, bad; or self-sacrifice, good. In doing so, they’d be trampling the rights of those who don’t hold such values.
This mentality is not confined to Cornwall. When the BBC’s The Big Questions asked me to join its panel of religious commentators two years ago, I was taken aback to find it included a Druid. Emma Restall Orr rabbited on inoffensively about mother nature, but I was shocked that her platitudes were given the status of religious belief by the programme makers. Ms Restall Orr exults in her website that the media has stopped seeing Druidism “as a game” and now invites her on serious faith and ethics programmes from ITV’s Ultimate Questions to Radio 4’s The Moral Maze and Sunday Programme.
God, Gaia, whatever: school children are already as familiar with the solstice as with the sacraments. In pockets of Cornwall, children will point out a nun in her habit: “Look, a Druid!” Their parents will merely shrug — one set of belief is as good as another. How long before the end of term is marked by a Black Mass, with only Health and Safety preventing a human sacrifice?
Taxing fast food won’t persuade people to eat lentils and mung beans
By Richard Littlejohn
Doctors are calling on the Government to take urgent action to tackle Britain’s obesity ‘epidemic’. They are demanding ‘bold and tough’ measures aimed at the fast food and soft drinks industries.
This would involve an exciting new range of ‘fat taxes’ and a ban on advertising and sponsorship by the likes of McDonald’s and Coca-Cola.
Manufacturers would also be required to label their products with health warnings detailing the amount of salt, sugar and calories in everything from pizzas to popcorn.
The idea is that if food and drink companies were prevented from backing sporting events such as the Olympics and football’s Carling Cup, people would stop stuffing their faces with burgers and guzzling beer.
No one tucks into half-a-dozen Big Macs and fries because they think it is going to turn them into Usain Bolt, or downs eight pints of lager in the vain hope that they will be able to play football like Robin Van Persie. They do it because they are stupid and greedy.
The poverty lobby is already bouncing up and down about the decision to slap VAT on pasties. They have dubbed it a ‘tax on the poor’. So what will they make of a huge, government-imposed increase in the price of fish and chips and takeaway chicken korma?
As for exclusion zones preventing fast-food chains and burger vans setting up shop near to schools, that’s been tried and has failed spectacularly. When Jamie Oliver attempted to improve the quality of school dinners, parents were queuing up to pass bags of chips through the railings to their ravenous children.
The medical profession is right in one respect. Britain is the Fat Man of Europe. We have overtaken our Continental neighbours and caught up with the Americans in the obesity stakes.
It is estimated that by 2030, half the population will be dangerously overweight and at risk of an early grave thanks to diabetes and assorted cancers.
But calling it an ‘epidemic’ is to suggest that obesity is something which can be ‘caught’, like measles or the flu. Demanding firm action from the Government also implies that the legions of lardbutts waddling the streets are somehow the Government’s fault, the Government’s responsibility and therefore deserving of a Government ‘cure’.
This is part of the depressing modern ‘victim’ culture, which strips people of any responsibility for their own actions and wellbeing. In all but a handful of cases, involving glandular malfunction and mental disorder, obesity is not an illness.
It is the inevitable result of uninhibited gluttony and a lack of willpower and self-restraint. Self-appointed ‘experts’ think that if only the public were ‘educated’ about the calorific content of deep-fried pizzas, they’d stop eating them and embrace a virtuous diet of lentils and mung beans instead.
Don’t be daft. People eat greasy fast food because it tastes good and provides cheap, cheerful instant gratification. They’re actively looking for the sugar rush, not trying to avoid it.
Cigarette packets are plastered with pictures of diseased lungs, skulls and crossbones and grim health warnings in lettering the size of the Hollywood sign. But millions still smoke and the Government is content to keep ramping up the prices and pocketing the proceeds.
Higher taxes on fast food would simply disappear into the vast black hole of state spending, or get frittered away hiring another army of useless, interfering healthy eating co-ordinators from the jobs pages of The Guardian.
Britain’s existing battalions of taxpayer-funded ‘five-a-day’ workers have been conspicuously unsuccessful in persuading the great unwashed to switch from French fries to fruit and vegetables.
When councils forced chip shops to cut the number of holes in salt shakers in a doomed attempt to reduce consumption, the punters simply unscrewed the caps.
As for the other ‘bold and tough’ measures, banning sponsorship and advertising by food manufacturers would be an intolerable intrusion on free speech and freedom of choice.
Driving food and drinks firms to the wall at a time of recession and high unemployment is the economics of the madhouse.
If the state really wants to encourage hideously fat people to lose weight, there’s a simple solution. The easy way to save the hundreds of millions of pounds being spent on treating the obese is to stop indulging them. We’ve all read reports of social workers buying fast food, fizzy drinks and sweets for ‘clients’ too fat to get out of their own beds. If the morbidly obese were left to wallow in their own filth they might get round to losing weight.
We learned recently that some clinics are widening their doors so that their XXXL patients can squeeze through. Why? Tell them that if they can’t get in, they won’t get help.
The NHS shouldn’t have to buy reinforced ambulances and heavy-duty maternity beds to support self-inflicted gutbuckets. Nor should the fire brigade be forced to use forklift trucks and winches to rescue 40-stone monsters from their own homes.
And why should the Health Service budget be expected to stretch to fitting gastric bands to people lacking the willpower to lose weight by eating less and exercising more?
Banning burgers isn’t the answer. There’s nothing wrong with a quarter-pounder, eaten occasionally and in moderation. Why should the rest of us have to pay more for our fast-food treats because some of our selfish fellow citizens are slowly, and not so slowly, gorging themselves to death?
Let them eat cake. It’s their funeral.
Sound wave treatment that zaps prostate tumours could double men’s chance of avoiding debilitating side effects
Men with prostate cancer could soon be offered sound wave treatment that almost doubles their chance of avoiding debilitating side effects. The therapy closely targets tumours, causing much less damage to healthy tissue than conventional surgery or radiotherapy.
High-intensity focused ultrasound (HIFU) is already used in some NHS hospitals and private clinics, often to treat the entire half of the prostate where the cancer was situated. But it is now being used in a more targeted way to treat areas of early-stage cancer just a few millimetres in size.
Experimental research shows this dramatically cuts the number of men suffering incontinence, impotence and other complications due to nerve damage caused by treatment.
Men undergoing traditional treatment – radiotherapy or surgery to remove the whole prostate – have a 50 per cent chance of a ‘perfect outcome’, avoiding the side effects and achieving good cancer control a year after therapy.
In a new trial, men treated with HIFU had a nine in ten chance of achieving the best result. None of the 41 men in the trial had incontinence and just one in ten suffered from impotence after 12 months. Altogether 95 per cent of the men were cancer-free after a year, a report in the medical journal Lancet Oncology says.
HIFU focuses high-frequency sound waves on to an area the size of a grain of rice. The sound waves cause the tissue to vibrate and heat to about 80c, killing the cells in the target area. The procedure is performed in hospital under general anaesthetic and most patients are back home within 24 hours.
Dr Hashim Ahmed, who led the study at University College London Hospitals NHS Foundation Trust and University College London, said: ‘We’re optimistic that men diagnosed with prostate cancer may soon be able to undergo a day case surgical procedure, which can be safely repeated once or twice, to treat their condition with very few side-effects. That could mean a significant improvement in their quality of life.
‘This study provides the proof-of-concept we need to develop a much larger trial in the NHS in the next two years, hopefully backed by the Government, to determine whether it is as effective as standard treatment in the medium and long term.’
Prostate cancer is the most common cancer in men. In the UK, more than 37,000 men are diagnosed each year and the condition leads to approximately 10,000 deaths.
However, men with early-stage prostate cancer can live for years without their disease getting worse and many face the dilemma of opting for therapy that may lead to side effects.
Standard treatments can damage surrounding healthy tissue, with up to a quarter of men suffering urinary incontinence and two-thirds having erectile difficulties as a result.
But the latest trial, funded by the Medical Research Council, the Pelican Cancer Foundation and St Peter’s Trust, used focal HIFU therapy, meaning it targeted the exact areas of cancer using two highly sensitive diagnostic techniques, MRI and mapping biopsies.
Professor Mark Emberton, who leads the research programme at UCLH and UCL, said similar techniques to preserve tissue had been successful in breast cancer treatment, where women have been offered a lumpectomy rather than mastectomy.
Owen Sharp, of The Prostate Cancer Charity, said: ‘We welcome the development of any prostate cancer treatment which limits the possibility of damaging side effects such as incontinence and impotence.
‘However, we need to remember that this treatment was given to fewer than 50 men, without follow-up over a sustained period of time.’
Prostate Action chief executive Emma Malcolm said: ‘Today, men being treated for prostate cancer face a daunting range of side effects, having a 50/50 chance of getting through a year without experiencing incontinence, impotence, or having their cancer spread. ‘[This] research suggests high-intensity focused ultrasound could cut this risk … giving thousands of men a better quality of life.’
Exploring for gas using fracking gets green light in Britain
Exploring for gas using ‘fracking’ can continue safely even though it is likely to cause further earthquakes, a Government-commissioned report says. The technique of hydraulic fracturing is used to extract gas from shale rocks – potentially easing the country’s energy problems.
Work was suspended a year ago by the firm Cuadrilla Resources following two small earthquakes at its site in Lancashire.
While the report says these quakes were caused by the drilling, it concludes that further tremors would not be big enough to cause damage because they would not exceed three on the Richter Scale.
Cuadrilla believes there could be enough shale gas at the site to meet Britain’s gas needs for the next 50 years. Even if the firm can extract only a fraction of it, it would still have an impact comparable to the exploitation of North Sea oil.
Yesterday’s report was rejected by anti-fracking campaigners who fear bigger earthquakes and the contamination of water supplies.
Fracking involves pumping water, sand and chemicals into shale rock down a 9,000ft deep pipeline at high pressure to release gas.
Cuadrilla hopes to establish at least 800 drilling wells on 80 sites in Lancashire.
With a final decision on fracking to be made by the Department of Energy in six weeks, the report is seen as a crucial step toward what would be the biggest gas-drilling operation in Europe. Exploratory drilling licences have also been handed out in South Wales and Cheshire, with Sussex and Kent next in line.
The report recommends one of the strictest monitoring regimes in the world. Any tremor over 0.5 in magnitude would trigger the removal of the fracking fluid while an investigation is held.
The independent report was carried out by experts from Keele University and the British Geological Survey.