NHS waiting times ‘rise by 6 per cent for routine operations’
Patients are facing increasingly long delays before undergoing some of the most common forms of surgery in NHS hospitals, a report has warned.
In a blow to David Cameron’s election pledge to drive down waiting times, official data suggest that waiting times rose by 6 per cent for eight types of surgery between 2010 and 2011.
The research by the Patients Association also found that fewer patients have undergone planned operations such as hernia repairs and joint replacements as the NHS attempts to cut spending by £20 billion.
Experts warned that the trend is leaving thousands of patients in pain awaiting surgery, putting their health and wellbeing at risk.
The average wait for having a new knee rose from 88.9 days to 99.2, while the wait for hernia surgery increased from 70.4 days to 78.3.
Waiting times for gallstone removal rose by 7.4 days over the same period, hip replacement patients waited 6.3 days longer, while waiting times for hysterectomy surgery and cataract removals were delayed by an extra three and 2.2 days on average respectively.
According to data from 93 of England’s 170 acute hospital trusts, the number of operations performed fell by 18,268 between 2010 and 2011.
Professor Norman Williams, president of the Royal College of Surgeons of England, told The Guardian: “It does look as if this report has confirmed something we have been worried about for the last two years, that patients are waiting longer in certain trusts to receive the treatment that they require.
“We are very concerned about this and really worried because patients who do not get the treatment they need within an appropriate time could be storing up problems for the future.”
Health secretary Andrew Lansley said: “There are fewer patients than ever waiting a long time for treatment . The number of people waiting over a year for treatment has reduced by two-thirds since we came into office and the average time patients have to wait for treatment is at the same level as two years ago.”
Nutty British bishop wants to keep Anglicans out of Anglican schools
On Monday in the House of Commons, Michael Gove, the Education Secretary, said that he was keen to work with John Pritchard, the Bishop of Oxford, on extending the role of the Church of England in schools. His words have been taken to mean that the Government will support the creation of a new generation of state-funded Anglican academies.
In theory, that should please anyone who is concerned about two recent social trends. The first has been a steady decline in the country’s position in international educational league tables. The second has been our drift during the same period towards an all-consuming secularity.
For all who favour high standards, and who also believe that moderate religious affiliation benefits children and those involved in their education, the Secretary of State’s support for the expansion of publicly funded Anglican schools can only seem a cause of celebration.
But I’m not so sure. There’s a risk that educational standards, and even Anglicanism itself, might be endangered by the expansion of church schools. My fear is that Anglican schools may be forced, for the sake of becoming more inclusive, to dilute their distinctively religious character, and even to turn away applicants from genuine Anglican backgrounds, to accommodate those who are not.
Last year, the Church put John Pritchard in charge of developing its policy on schooling. He soon disclosed – much to the horror of many Anglicans – that he favoured his Church’s schools reserving no more than 10 per cent of places for children from Anglican backgrounds, an unprecedented level of “inclusiveness”. The bishop justified this, saying, “Our commitment [is] to serve the whole community, including those of other faiths and no faith. We are not a club that exists only for its members.”
He must realise, however, that church schools will only continue to achieve good academic results, and hence remain popular, so long as they preserve enough of their religious character. It’s what drives their success.
The question that should be exercising Bishop Pritchard and Mr Gove in the coming months is whether all or any new Anglican schools should be encouraged, or made, as a condition of extra state funding, to become so socially inclusive that the vast majority of their pupils cease to be from Anglican or Christian backgrounds.
Would it be wise to have admissions policies at Church of England schools that force them to turn away applicants from Anglican or other Christian backgrounds to accommodate those who are not? Surely not. Charity begins at home, after all.
Opponents of faith schools often claim that these schools only achieve better academic results because skewed admissions policies enable them to cream off middle-class children, who are easier to educate. They also claim that savvy, well-off parents know that an educational premium is attached to their children when they’re being taught with children from similar backgrounds.
Such concentrations of middle-class children at faith schools are said to be unfair to children from poor backgrounds, because these disadvantaged children become concentrated in community schools, often adversely affecting the performance of each other.
In support of their claims, critics of faith schools cite dodgy statistics that seem to bear them out. One is that nearly two thirds of Church of England primary schools have fewer pupils on free school meals than is the average for non-religious schools in their neighbourhoods. The same applies to nearly half of the Church’s secondary schools.
But such charges against faith schools are wrong because these statistics are misleading. There is no guarantee that distributing middle-class children evenly across all schools would improve the academic performance of children from poorer backgrounds. More likely, it would so widely diffuse their presence in the classroom as to spoil any potentially beneficial effect from it. The appropriate solution to the over-concentration of children who are difficult to teach in some schools is not to dilute the ethos of faith schools. It is, rather, to continue what the present Government has already started: to attach a pupil premium in the form of extra funding to schools for every child they admit from a socially disadvantaged background.
More important, pupils of faith schools often perform better on average academically than their counterparts at community schools, even when their levels of social deprivation, as measured by eligibility for free school meals, are similar.
Several studies suggest that children at faith schools do better than children at more secular schools because of the religious outlooks they share with each other, their parents and teachers. If so, the Department for Education and the Church of England would do well to tread cautiously when expanding the number of Anglican schools. The price of expansion may be too high if, to accomplish it, they are forced to water down their distinctive religious ethos and character for the sake of government funding.
The Church of England should be the last body to need reminding that it was for the sake of a mere mess of pottage that Esau lost his birthright.
BOOK REVIEW of The Obesity Epidemic by Zoe Harcombe (Columbus Publishing Ltd 328 pp £20)
Reviewed by Dr. Alick Dowling
This masterly fully-referenced comprehensive survey of the field in 136,000 words demolishes current advice. Those who absorb her message reject misguided policy from World Health Authorities.
The author, an experienced nutritionist is brave to challenge, not only the current `consensus’ of the medical establishment, but also that shared by her fellow nutritionists and dieticians, that `cholesterol’ is responsible for heart attacks and strokes. `I regularly attend obesity conferences where I am a lone and unwelcome voice in amongst an overwhelming majority of dieticians.’ (p 272)
I knew nothing about her book until Feb 2012 (though published in 2010) when Zoe Harcombe featured on spacedoc.com. I wrote to her:
“How refreshing to see a nutritionist writing sense about fats. I admire your sensible response to Dr Malcolm Kendrick’s ‘The Great Cholesterol Con’. To put my cards on the table: I am a long-retired GP born in 1920 who reviewed his book for the Bristol MedChi website (also on John Ray’s blog “Food & Health Skeptic”. See here). This mentions my booklet ‘Enjoy Eating Less’, a copy of which I would be happy to send you as it might interest you as we have written on the same subject”
We exchanged copies.
As a member of ‘thincs’ (The International Network of Cholesterol Sceptics), Harcombe admires Malcolm Kendrick’s The Great Cholesterol Con, agrees that Cholesterol is not responsible for heart attacks and nor are statins the answer to a non-existent problem.
In turn Kendrick supports Harcombe: Switching from high fat to high carbohydrate could be the single greatest cause of the recent obesity epidemic. Kendrick does not exclude other causes.
Having read (and re-read!) her full text (hoping to review it for the Bristol Medchi site) I realized table 1 on p 2 reveals an anomaly, which I missed at the first reading, not discussed by Harcombe.
This table shows that between 1966 and 1982 UK percentages of overweight and obese rose from 14% to 44% for men, from 11% to 26% for women. This was long before the wrong advice was substituted in 1983, when the percentages started the even sharper rise vividly described by Harcombe.
What happened in the late 70s/early 80s before Harcombe’s obesity epidemic took off? The alternative suspect is Portion size!
Nearly 50 years ago, large portion sizes, associated with affluence in developed countries, was then the predominant cause of obesity. With our 6 children age 14 to 5, we visited New York in 1964 (en route to Edmonton in Canada to stay with our Canadian/Polish brother-in-law and their family of 6 children). We saw for the first time enormous portion sizes and widespread obesity, obvious then in New York, noticeable in Canada, but then rare in the UK.
This was nearly 2 decades before the 1983 wrong medical advice was given to switch from fats to high carbohydrate, which Harcombe denotes as the beginning of the obesity epidemic.
Large-sized portions in the past were confined to the affluent, for example the Edwardian penchant for enormous meals. Only after WWII did such affluence spread to a wider society. The early clear signs from Table 2 towards the `epidemic’ of obesity were later fuelled by bad medical advice.
For the overweight it is common sense that food portions return to `normal’ levels. Eating less is one way to do this, and accepted as sensible, though difficult, by most of the obese. Advising `eating less’ was shorthand for reducing portion size for those with a weight problem. If eating too much of almost anything, not just processed food, can cause obesity, it is commonsense to recommend those affected to eat less.
Her writing style is humorous and clear. Her book is not easy reading because much of the material is technical, especially when she has to deal with the complexities of the cholesterol controversy and the arguments used to maintain the `consensus’ that `fats’ and cholesterol are bad for us. She is to be congratulated for her success in surmounting these difficulties.
Many other factors complicate individual problems. Harcombe recognizes a strong genetic factor, why some people are never likely to be thin. She has three dietary tips:
1) Eat real food,
2) Eat three meals a day & don’t snack,
3) Manage carbohydrates for weight problems.
She deplores all processed food. I am more relaxed. Small quantities of carefully chosen processed food don’t need to be totally banned. Our versatile digestive system is robust enough to deal with processed foods, unless overwhelmed by sheer quantity.
Harcombe thought my `advice and book would have been invaluable before the obesity epidemic took hold’. It is still relevant and helps those readers who are prepared to limit their food intake.
Harcombe had the misfortune to be involved in the Minnesota Starvation scheme in her teens (p 42 & 54). It is probable this has influenced her attitude to hunger, and that a neural pathway `remembers’ it for her as an addiction to food. For most people in the affluent world hunger is not something to be feared.
James le Fanu, not mentioned by Harcombe, should be remembered for his early championing of Kendrick’s book in the Telegraph (18/3/2007, 25/3/07, 1/4/07, 8/4/07) when he described `taking a statin holiday’. He was attacked by a cardiologist (Weissberg) as naive for being taken in by someone like Kendrick.
To return to the book: The Obesity Epidemic: the excellent Contents Page shows the structure and how well the material is organized. The Index is not as complete as expected, with no mention of metabolic rate. In contrast the 399 footnotes with valuable references are separated by Chapters, after the Index.
The research needed to analyze these – many needed hours of computation – is most impressive. They rebut those who question the author’s competence to pronounce on technical matters. The Glossary and Abbreviations are useful; the Appendix has 4 rather technical pages, presumably needed to complement the footnotes.
After the Introduction (pp 12) the content is divided into 4 parts, these subdivided into 16 Chapters. The book ends with a brief Summary (p 280-285).
1: General principle: Eat less/do more. This has 4 relatively brief chapters 1-4 (pp 13-44) Chapter 4 (pp 37-42) explains the Minnesota `Starvation Experiment’ May 1944 when 200 conscientious objectors volunteered to starve as an alternative to call-up; Harcombe unwittingly as a teenager (p 42) had a similar experience.
2: The Calorie Formulae (p 46-51): – To lose one pound of fat.” 3 chapters 5-7 (pp 52-79) all devoted to `calories’
3: The Diet Advice The bulk of the book (pp 87-231) with a short `What should we eat’ survey (p 82-86) followed by the Chapters 8-14. Chapter 8, the major one is devoted to Cholesterol, including a Pre-amble and a `Post-amble’ the latter being an eloquent summary why Cholesterol should be regarded as a `good thing’. See the end of this review for a clinching argument.
Chapter 9 (pp 126-136) details how and why medical advice was changed in 1983 for the worse as mentioned above. Denis Burkitt (p 136) is rebuked for recommending fibre to be in our diet. However he did not do so for nutritional reasons, but to help to eliminate abdominal problems, which it did. I remember hearing him on this subject.
Medical advice then for irritable bowel and colitis was to `rest’ the colon by starvation, which made painful abdominal cramps worse. Patients soon learnt to ignore such advice, just as now many refuse to take statins.
Chapter 10 “What is our current advice, a short account” (pp 137-152) is followed by Chapter 11 “Have we reviewed the U turn” (pp 153-166). Chapter 12 “Eat Less Fat” (pp 167-191) contrasts with Chapter 13 (“Base your meals on starchy foods” (pp 192-211). The last Chapter of this section 14 “Do More” (pp 212-231), is a controversial one about exercise.
4: How can we stop The Obesity Epidemic (p 232-235). 2 Final Chapters 15 & 16 (p 236-273). Chapter 15 was the most stressful and difficult to write (p 258); it comes over as a challenge to her tenacity in seeking answers from obstructive officials. The final Chapter 16, which is devoted to the question of how to organize obesity management without impinging on freedom to choose, raises more questions than it answers. The summary at the end rounds off her advice.
To summarize: Harcombe and I are both outside the present Health Adviser’s `consensus’ on the evils of cholesterol. Many other contributors in the `obesity’ field are also in this position.
When will the medical establishment realize their vulnerability to being sued for ignoring the increasingly known dangers of statins? Many victims will be eager to initiate actions. The web makes this a likely prospect.
Harcombe is trenchant about Bariatric Surgery: (p 271) I have not proposed bariatric surgery as a solution, because a fundamental premise of this book is that we need to remember why we eat.
Campbell-McBride calls the gut the second brain of the body. Do we have full and certain knowledge of what will happen long term by surgically altering our digestive tract in such drastic ways? She goes on to describe a victim who was unable to eat lamb because he knew he could not digest it, but who was able to eat bread, potato and pastries and was gaining weight at a steady pace.
She has 2 footnotes on this subject, 379 and 380, referring to A study on the economic impact of bariatric surgery from The American Journal of Managed Care and The Association for the Study of Obesity Annual Conference, Liverpool (June 2009) respectively.
Since then there have been unexpected research developments involving recently identified hormones PYY and ghrelin that control respectively sensations of fullness and hunger. These control body weight by `talking’ from the gut to the brain (see Campbell McBride above).
Dr Carel Le Roux (Imperial College & King’s College London) believes that bariatric surgery has a powerful and unexpected side effect: it can re-balance the hormones so the patient would `stop thinking like a fat person and think and behave like a thin one’.
It remains to be seen whether this is substantiated but if it is there must surely be a less radical procedure than bariatric surgery to do this `re-balancing’, for example via pills or injections. Research into `discordant identical twins’ who have different weights, presumably due to these hormones being `unbalanced’ is part of this ongoing research in the field of epigenetics.
For those who still have a lingering doubt that Cholesterol must still be an evil substance, as many doctors and dieticians still believe, despite the arguments presented here and in her book, and for readers who find the complexities of the saturated and unsaturated fats, and the idiotic subdivisions of `good’ and `bad’ cholesterol too difficult to comprehend, a final word from Harcombe, might convince or at least comfort by its common-sense explanation that as cholesterol is made by the body it is unlikely to be something that is harmful or will kill us. (p 123).
Human breast milk contains significant quantities of cholesterol.. . . It would not do so if cholesterol were in any way a harmful substance. (p 124).
See also Addiction to food: A relevant review of Theodore Dalrymple’s book Junk Medicine subtitled Doctors, Lies and the Addiction Bureaucracy
Received via email from the author
Time to start fracking
Matt Ridley writes from Britain
It is now official: drilling for shale gas by fracturing rock with water may rattle the odd teacup, but is highly unlikely to cause damaging earthquakes. That much has been obvious to anybody who has followed the development of the shale gas industry in America over the past ten years. More than 25,000 wells drilled have caused a handful of micro-seismic events that can barely be felt.
The two rumbles that resulted from drilling a well near Blackpool last year were tiny. To call a two-magnitude tremor an earthquake is a bit like calling a hazelnut lunch. Such tremors happen naturally more than 15 times a year but go unnoticed and they are a common consequence of many other forms of underground work such as coalmining and geothermal drilling. Earthquakes caused by hydroelectric projects, in which dams load the crust and lubricate faults, can be much greater and more damaging. The Sichuan earthquake that killed 90,000 in 2008 was probably caused by a dam.
So can we now get on and start a home-grown shale gas industry? The economic and environmental benefits could be vast. Just consider the effect that shale gas has had in the US. It has lowered the price of gas to a quarter of that in Europe, thus slashing the cost of energy, reviving manufacturing, creating jobs, halting the expansion of expensive nuclear power and cutting carbon emissions.
The Harvard School of Engineering and Applied Science concluded in February that the surprise fall in America’s carbon emissions – by 7 per cent in 2009, probably more since – was caused largely by a switch from coal to shale gas. “A slight shift in the relative prices of coal and natural gas can result in a sharp drop in carbon emissions,” according to Professor Michael McElroy, who led the study.
All over America coal and nuclear projects are being cancelled or mothballed because of cheap gas. (Declaration of non-interest: I have interests in coalmining; so shale gas is bad news for me, but good news for the country and the planet.)
Yet listening to the debate in Britain about “fracking”, you would think that we were in a different universe. Tony Juniper, the BBC’s favourite green, was arguing yesterday that shale gas might increase carbon emissions because of leakage of methane into the atmosphere. His evidence? A study by Cornell University that has been discredited. Not only was the study partly funded by an anti-fracking pressure group called the Park Foundation but it also made a series of elementary howlers, such as using a cherry-picked short time frame because methane does not stay in the air for long and mistaking Russian theft of gas from pipelines for leakage.
Besides, the proof of the pudding is in the data: shale gas has already cut carbon emissions in a way that wind, biomass and solar power have failed to do. Wind still produces less than 0.5 per cent of all energy and has displaced no fossil fuels. Biomass has been shown to increase carbon emissions, by encouraging deforestation. And solar power, for all its local promise in desert countries, is still an irrelevance globally and a boondoggle nationally.
What about groundwater contamination? This too is mostly hogwash. Since there is usually a mile of rock between aquifers and where the fracking happens, contamination from fracking is highly implausible. More than 25,000 wells have been sunk and there has only been a handful of potential contamination events, most of which proved to be natural.
Of course, failure of the well casing or surface chemical spills can happen occasionally, as in any industry. But the chemicals used in fracking – less than 0.5 per cent of the solution used to displace the gas – are ordinary chemicals of the kind that you find under your kitchen sink: disinfectants, surfactants and the like.
The campaign to stop shale gas proving its case in the market is political, not scientific. Behind it lies vested interests. The Russian gas industry, which is alarmed at losing its impending near-monopoly on European gas supplies, has been vocal in its criticism of shale gas. The coal and nuclear industries too would like to see this baby strangled at birth, but have been less high-profile.
Most of the opposition, though, has come from those with a vested interest in renewable energy, including the big environmental pressure groups, which are alarmed that the rich subsidies paid to wind, biomass and solar may be under threat if gas gets too cheap and cuts carbon emissions too effectively. Their entire rationale for subsidy, parroted by their dutiful poodle Chris Huhne, when Energy Secretary, is that gas would get more expensive until even wind and solar looked cheap. That was wishful thinking.
Even if you do not think carbon emissions are the highest environmental priority, there is a more fundamental reason why using gas is good for the planet. No other species needs or uses it. Every time you grow a biofuel crop, harvest timber for a biomass power station, pave a desert with solar panels or dam a river for a hydro plant, you are stealing energy from the natural world. Even the wind is needed – by eagles for soaring, by bats for feeding (both are regularly killed by wind turbines). As the only species that uses gas, the more we use it the more we can leave other sources of energy for nature.
‘I was appalled by the killing of Osama bin Laden’: British far-Leftist says terror leader should never have been shot
Ken Livingstone waded into further controversy yesterday by claiming U.S. special forces were wrong to kill Osama Bin Laden.
To the surprise of observers at a Westminster lunch, the Labour veteran declared that the death of the world’s most notorious terrorist had ‘appalled’ him.
Mr Livingstone – who is trailing Tory Boris Johnson in the London mayoral race – has previously caused anger over terrorism with his outspoken support for Irish republicans and Palestinian militants.
But his comments on the death of a man who masterminded the deaths of thousands of innocent civilians around the world are likely to raise further doubts about his suitability for high office in London, where Al Qaeda bombings killed 52 in July 2005.
He told a lunch for political journalists: ‘I was appalled to see Osama Bin Laden in his pyjamas shot in front of his kid. ‘The best way to demonstrate the values of a Western democracy is you put Osama Bin Laden on trial and challenge what he says.’
Mr Livingstone, whose Left-wing views saw him ostracised by Labour under Tony Blair, also hailed Ed Miliband’s ‘genuine Labour values’ and suggested that next month’s mayoral contest was a dress rehearsal for the general election expected in 2015.
He said: ‘For the first time in my life I’ve been invited for dinner with the leader of the Labour Party, so there’s a shift there. Ed represents genuine Labour values – that’s why I voted for him and believe he will make a real change if we win.
A wise Scotswoman
Grabbing a coat as I dash out of the door to collect my 11-year-old daughter from school, I catch sight of myself in the hall mirror. It’s never a joy to behold.
Inevitably, the remnants of mascara hastily applied in the morning have all but gone, my cheeks are flushed and there’s the double chin I know will disappear only with surgery.
And, as I look down, I realise I haven’t bothered to change out of the Lidl fleece and supermarket jeans I flung on when I walked the dog in the morning.
At the playground gates, I stand like a thorn between the roses. I know I’ll never win any awards for my looks – except perhaps for Most Frumpy Mummy.
While I wouldn’t belittle myself so much as to say I’m the definition of ugly – although the mirror on a Sunday morning might disagree – I’m definitely more ‘plain Jane’ than Jane Birkin.
While some people have their imperfections, and when put together still look stunning, mine just make me look imperfect.
But far from being disheartened or disappointed by my image, I’m delighted – because there are many upsides to being the ugly duckling.
My suspicion that it’s to my advantage was confirmed when I read Samantha Brick’s recent account in the Mail of the problems she’d encountered for being too attractive.
While Samantha says she has struggled to make female friends because women are jealous of her beauty, I think the opposite is true for me. The fact I’m no threat in the looks league means I’ve always had lots of pals.
All my life I have gathered beautiful women around me like a Victorian butterfly collector. My current friends – the women with whom I gossip over coffee, walk the dog and go to parties – tend to be stunning, toned and well-groomed.
But it was the same even when I was a girl. Growing up on a farm in rural Scotland, fashion and appearance weren’t things that were important to me. I spent my life in jodhpurs or clothes that wouldn’t show the mud. What was the point of a pretty dress when there was a saddle to buy?
While the other teenage girls would be scouring Jackie for make-up tips, I’d be drooling over a new rug for my pony in Horse & Hound.
I certainly didn’t have any pressure at home to try to glam myself up. My mother, who in her youth was a stunner, had taken to rural life like a duck to a grimy pond.
Her favourite daughter, from the four she had produced, wasn’t the one in the prettiest dress, but rather the one who could make her clothes last longest between washes.
However, despite my lack of interest in what I looked like, even at 15 my friends were the prettiest girls in the school.
There was Vicky – slim, blonde and with a smile that could light up the geography room. Two decades later, I was still comforting male friends pining over her.
Then there was Vivien – petite, brunette and slightly mysterious – the polar opposite of me, who was plump, blonde and loud.
Another was Ann, who oozed sex appeal before any of us knew what it meant, but you knew the moment she entered any room, even without seeing her, because of the sound of boys’ jaws hitting the ground.
But even though I was wearing knitted socks while these girls preferred sexier 20 denier tights, the friendships worked. I wasn’t competing against them to become the alpha girl, or vying for the attentions of the coolest boys.
In fact, what I did was make them look good when standing beside me. Of course, at first I’d wonder why they were always dancing with boys, but I didn’t lose sleep about it and was a good lesson to learn.
And, for my part, having the best looking friends in the year meant I was part of the package when it came to inviting the in-crowd to parties.
It’s not as though my love life has been as dry as the Sahara – I’ve even managed to get married twice.
It’s just if you don’t look good, it’s very easy for men to overlook you in that first instance. You have to develop other ways to attract them.
My first husband fell for me because I told him some salacious gossip that intrigued him more than any model looks I might have had, or designer top I might have been wearing.
My second husband – I live in Edinburgh with him and my three children – works in agriculture, so any well-groomed woman has him running for the hills.
Much more HERE