The nurses too busy to save a life
In this shocking – and revealing – diary, a New Zealand nurse on a typical NHS hospital ward says a lack of basic care and compassion by overworked staff is costing patients’ lives
It breaks my heart to hear of the way decent people are treated in the NHS — JR
The NHS at its best is brilliant, but a new book by a male nurse claims that too often it lets patients down, not through direct negligence, but due to small omissions and a lack of care and time that, added up, can have devastating results.
Here, Michael Alexander (not his real name), describes a busy week in the large London hospital where he worked…
Mr Benson shouldn’t be on my surgical ward — he has a bad case of pneumonia — but there is nowhere else for him to go.
All the wards are at full capacity. The nurse I take over from explains Mr Benson is normally independent and only needs intravenous antibiotics, so he should be straightforward to look after.
I look down at Mr Benson, who is slumped against his pillows, his chin resting on his chest. He might normally be independent and healthy, but the foul infection nestled at the base of his left lung has sapped his strength.
Mr Benson, who is 79, probably doesn’t realise he shouldn’t be here; that he should be somewhere less hurried, with the time to give him the care he needs.
‘I can’t thank you enough,’ he says to me later, as I administer his antibiotics. ‘You’re all so good to me.’
Though I am touched, I hope none of the other patients on the ward catch Mr Benson’s chest infection or, even worse, get a wound infection from him coughing and spluttering.
For not only would this be bad news for all the patients, it would stretch our already thin staff.
I am often responsible for ten to 12 patients, with just one nursing assistant to help me. Back in New Zealand, where I trained, I would usually be responsible for six.
Today, I have three patients for theatre and nine other patients in varying stages of post-surgery recovery. It is all a bit much.
The lack of nurses means medication isn’t always on time and patients aren’t always ready for their operation, irritating the surgeon by making them wait for ten minutes.
Patient hygiene isn’t always as it could be: we have only two showers and neither is accessible for a wheelchair.
Feeding patients, walking them, sitting and talking with them are often left to my one nursing assistant, while I deal with tasks that only registered nurses can do, such as giving medication.
‘I haven’t had a decent wash in over a week,’ one of my patients, Mrs Jones, complains as I walk past. ‘When are you going to take me to the shower?’
Mrs Jones is on bed rest for leg ulcers and is desperate to get out and about.
‘Maybe later this morning,’ I reply, though I know I will disappoint her. ‘It’s pretty busy.’
‘You’re supposed to change my dressing four times a day,’ Mr Smith declares. ‘It’s 11am and nothing’s been done.’
‘Sorry, Mr Smith, I’ll try to get to you soon. My patient from theatre is not very well.’
His face softens.
The patient I am talking about is Mrs Wright, who has lost quite a bit of blood and is being given a transfusion. I am supposed to check on her every half an hour, but sometimes it is nearly an hour before I can make it back.
‘My mother has been sitting on the commode for 20 minutes. This place is a disgrace,’ says the daughter of Mrs Blake, who is in for a hip operation.
‘What sort of establishment is this? I’m going to write a complaint.’
‘Please do,’ I reply, as I help Mrs Blake off the commode.
There is not much else I can say — and perhaps it will help get us more staff on the ward.
I look in on Mr Benson at the start of my shift. It’s nearly lunchtime and he is still in bed. He has slid down and is hunched in a ball, his shoulders up by his ears and his head on his chest.
Why hasn’t anyone thought to get him out? I suppose because no one is around to do so.
Sitting at his bedside holding his hand is another hunched figure, Mrs Benson.
‘Good morning, Mr Benson.’ He lifts his head and gives me a smile. ‘Oh, good morning….’
He breaks off into a bout of coughing that racks his whole body. I have a peep at his drug chart.
Sure enough, his 10am antibiotics haven’t been given. I don’t have time to give them to him because I am overdue to check on another patient, but there is no other nurse in sight.
Back on my own side of the ward, I am running ten minutes late having decided to administer Mr Benson’s antibiotics after all.
Though I never really planned on being a nurse — at 17 I went into it because it would be a guaranteed job — I soon discovered it was so much more than just a way to make a living.
Everyone likes that feeling they get when they help someone, but I really liked it. However, like many nurses, I now find myself increasingly overburdened and do not have the time to do what I know I am capable of — and what is needed.
Mrs Wright needs a fresh unit of blood. I notice that her pain relief, which is being delivered straight into her arm, is nearly empty and will need changing. Plus her antibiotics are an hour overdue — though an hour isn’t too bad, at least for this place.
Forty minutes later, Mrs Wright is back on track and everything is up to date.
‘Any chance you can do my dressing now?’ Mr Smith asks. No longer angry, he sounds almost resigned to his fate.
Today I have the afternoon shift, with a total of 14 patients, none of whom are Mr Benson, but I still want to keep an eye on him.
‘Can you please take Mrs Blake off the commode?’ I ask Trixie, the nursing assistant.
Trixie is only 19 and in her second year of nursing school, and seems overwhelmed. I can’t help but wonder if this will put her off nursing for good.
‘Hello, Mr Benson,’ I say, as I enter his bay. He is in a chair, but he has slipped so far down it is only a matter of time before he is on the floor. I try to lift him but he’s too heavy.
He is not a particularly big man, but he has no strength to help me. ‘I’m stuck,’ Mr Benson manages to say, before bursting into a round of coughing. He slips further down.
There are no medical staff around, so I ask the lady cleaning the floors to help. She remains silent, but follows me into the bay.
‘I’m not allowed to help you lift him,’ she says. ‘I’m not trained.’
I have an ongoing battle with the cleaners in London hospitals: they aren’t allowed to clean up vomit or body fluids, and I am not allowed to use their tools (mop and bucket) — so I usually end up having to wipe up vomit with a towel.
I remember trying to open the cleaning cupboard and finding it locked, with the cleaner refusing to open it for me. I don’t know how much hospitals save by outsourcing their cleaners, but the ones I meet don’t seem to take pride in their work.
I say firmly: ‘I just need a quick lift. It’ll only take a moment. I won’t tell.’ She eventually obliges and apologises afterwards for not helping straight away. ‘The boss says we shouldn’t get involved with the patients. Legal reasons and stuff.’
When the cleaner leaves, Mr Benson clasps my hand. ‘You’re good to me,’ is all he says, succumbing to another bout of coughing.
At the start of the shift, I make a plea to the nurses to keep an eye on Mr Benson. Everyone agrees to make an extra effort. One of them even puts in a request for extra physio.
But this patient needs more than physiotherapy. He needs to be mobilised regularly — to be got up out of bed and not to be left slumped in his chair for hours on end.
He needs his antibiotics on time. He needs to be encouraged to eat and drink. He needs what time won’t allow us to give — though we are capable of giving it — and that is basic nursing care.
In New Zealand, I developed some habits in the care of my post-operative patients that I struggle to keep up with in British hospitals.
I am used to all patients having a complete bed-wash, linen and gown change when they come back from surgery — but here, with such low staffing, I can’t always find the time, and I find other nurses feel the same.
A lot of the older nurses confide in me that they don’t get the time to do all the basic things they have been taught to do.
I suggest Mr Benson be transferred to a medical ward where things happen at a slower speed — there’s not the hurried rush to get someone to or from theatre, none of the intensive immediate post-op care.
Later, I find Mrs Benson at her husband’s bedside again, her head bowed, holding her husband’s hand in silence. She can’t make it every day because she is unable to drive and is reluctant to use the bus because a year ago she had a fall getting off one.
She can’t afford a taxi. She has to rely on the warden from the supervised accommodation where she and her husband live to give her a lift. The warden tries to make a trip to hospital every day, but this is not always possible.
‘I’ve never seen him so frail,’ she says.
I sit down on the side of the bed. ‘We’re doing all we can,’ I tell her. ‘Can I get you anything?’ ‘Tea would be nice.’
I hurry away and get Mr and Mrs Benson cups of tea. It is the first time I have managed to sit down with Mr Benson and not be interrupted. There is work I should be doing, but it will have to wait.
Mr Benson is wheeled past me on his way back from X-ray. He doesn’t notice me, but I grab his charts and am disappointed to see there is still a large white area at the base of his lung. The antibiotics aren’t doing their job.
Meanwhile I have to deal with Dr Hitchcock, who is straight out of Cambridge and doesn’t listen to nurses. Junior doctors like this are a danger to their patients and nursing staff.
Mrs Thornton needs antibiotics for a painful skin infection — and Dr Hitchcock has prescribed a deep injection into the thigh.
But the antibiotics can also be given via a vein: Mrs Thornton already has a line into a vein in her arm, and using this would mean there is no risk of infection or an abscess. It will also be much less painful.
Correcting the error will take Dr Hitchcock 30 seconds. Instead, he scowls and tells me it will have to wait. ‘I’m sorry to interrupt,’ I say, as he chats to his colleagues, and point out the error. ‘If a doctor has prescribed it that way, then it has to be given that way,’ he replies.
Half an hour later, a senior doctor changes the order in an instant — and strides off to give the junior doctor a ferocious ticking off.
Now Mr Benson has been moved to a single room near the nurses’ station. During the night he developed a high temperature. Even before I enter his room, I hear the rattling noises coming from his chest. He is drifting in and out of consciousness.
Mrs Benson is sitting at her husband’s bedside. ‘He’s very ill,’ I say, as sensitively as I can. ‘I know,’ she replies. She’s not crying, but the expression on her face says it all.
‘What do you really think? Please.’ I can feel a lump in my throat. ‘It’s not looking good,’ I begin. ‘He could get better, but the infection seems to have spread. His whole body is battling it.’
‘Is he suffering?’ she asks. Mr Benson’s eyes are closed. His temperature is down and even though he looks horrendous, at the moment he is not suffering. ‘He’s not in pain,’ I say.
I’d like to stay with her, but I’m needed at the end of the ward.
It isn’t always like this, with vast numbers of patients to a single nurse, but it has not been an uncommon experience for me in the UK.
Hospitals have budgets to balance, though I do wonder if they’ve ever calculated the long-term costs.
I hear that billions of pounds are set aside by the Government to provide compensation for legal cases brought against hospitals by patients and their families, but how much of that would be saved if we employed more staff and reduced workloads?
I often think back to a patient I treated in New Zealand.
At 69, Mr Henderson should have still had some good years in front of him, but he had a bad case of pneumonia that antibiotics couldn’t shift.
He was deteriorating fast. Colleen, the nurse who had mostly been in charge of him, was pretty upset — she was just out of nursing school. She thought maybe a change of scene would help, so we moved him into room five — the ‘room with a view’, where you could see into the local gardens and playground.
Then Colleen had an idea — take Mr Henderson, bed and all, into the garden. It was a hell of a risk to take. If anything happened while we were out of the environment of the controlled ward, we could lose our jobs.
‘Look, guys, he’s going to die anyway and he doesn’t have any family,’ she said. ‘Plus we’re not exactly busy. Imagine if it was your father or grandfather in there.’ This clinched it. So four of us — two nurses and two porters — wheeled him out.
I don’t know if it was the feeling of wind on his face, the smell of freshly cut grass or the sound of children playing, but Mr Henderson seemed to come alive.
It was amazing to watch his progress over the coming week. Before long he was sitting up, the grey pallor left his skin and his breathing became less strained.
When he was discharged, the team of doctors congratulated themselves on a job well done— but we knew it was Colleen who had made the difference.
Mr Benson isn’t so lucky. On the seventh day of his stay, he is alive, but no longer conscious. The nurse assistant and I go to turn him onto his other side, but when we start to move him, she gasps: ‘He’s stopped breathing.’
I order her to press the alarm. I don’t want to. Mr Benson should be left to die in peace, but the choice isn’t mine to make. I begin to do chest compressions and have to clench my stomach as I feel the familiar crack of his ribs.
Two doctors arrive, plus two specialist arrest nurses. It is ironic that Mr Benson is receiving all this intense attention from so many people now when all he needed was a little attention to begin with. It feels like for ever, but finally everything is over: the doctors are defeated and Mr Benson is pronounced dead.
Maybe he would have died regardless of the level of care. Maybe it was his time. The painful thing is that we never gave him a chance. What would have helped during his hospital stay is another registered nurse — it might have been enough to give Mr Benson a chance at survival.
It’s not always a single error that kills. Sometimes it’s a collection of problems or conditions that combine, with devastating results.
The story of Mr Benson is one of these combinations, and the story of his last week of life highlights how a health service — unrivalled in its brilliance when it works at its best — can, at its worst, result in the avoidable death of patient.
British Christian GP fighting for his job had prayed to God for a challenge
Dr Richard Scott was given a warning by the General Medical Council after he told a suicidal patient that Christianity may offer help and he is now fighting to keep his job.
Dr Richard Scott was frustrated with his lot. Despite having a flourishing GP practice and happy family life, he felt that he was not making a difference. So he turned to someone who had always helped him in the past.
“I asked God to send me a challenge that would resonate with people,” he says, “to make them see the importance of faith.”
God listened. Within the year, Dr Scott was locked in a battle with the General Medical Council after he suggested to a suicidal patient in August 2010 that religion might do more to help him than medication.
He also found himself fighting for his own life, after being diagnosed with bowel cancer.
Though Dr Scott has undergone painful surgery, radiation and two rounds of chemotherapy, the cancer, he says, has been the least of it.
What upsets him most is the realisation that it has become dangerous today to express Christian beliefs in the workplace.
The GMC, which regulates standards among medical professionals, issued Dr Scott with a warning last March. He had, it claimed, “overstepped the line” when, in a consultation, he urged his 24-year-old patient to give Christianity a chance.
“The man was depressed, and had left his own faith. So I told him, ‘You may find that Christianity offers you something that your own faith did not.’ His mother complained that I was forcing my religion down his throat.”
In finding that Dr Scott pushed his religious views on his patient, the GMC warned that if any further complaints are made about him, the GP of 28 years’ standing risks being struck off the medical register.
His appeal against the official warning was quashed last Thursday, after a four-day hearing that his counsel, Paul Diamond, called “Stalinist”.
From his home in Margate, Kent, Dr Scott said: “It was as if I had stepped into a secret court, with the witness, Patient A, never appearing. He was allowed to give evidence over the telephone, and remained a faceless accuser.”
This proved, he says, “the GMC’s bias against me — and any doctor who wears his Christian faith on his sleeve”.
The same council that allows doctors to promote the healing effects of homoeopathy, chiropractic and reiki, also known as palm healing — which are all unsupported by Western, evidence-based medicine but are backed by belief systems — has banned the mere mention of faith and prayer in a consultation.
Yet, as Dr Scott points out, the medical impact of prayer has been proved in a number of scientific studies.
“Christians recover 70 per cent faster,” he says. “They’re also less likely to get depressed. In America, medical schools have even introduced spirituality and health courses because they recognise the significant role of faith as part of therapy.”
So, too, do the GPs at the Bethesda Medical Centre in Margate. Posters and leaflets at the surgery — which is described in its literature as “expressly Christian” but accepting of patients of all faiths — advises that “if you don’t want to talk about faith, let doctors know”.
The doctors, who include Dr Scott’s wife Heather, do outreach work connected with alcoholics, drug addicts and suicides, and rely on prayers and Bible readings in their mission. The practice, the GP points out, takes its name from the healing pool mentioned in the Gospel of John.
Dr Scott, 51, worries that his case is the latest in an alarming trend that points to the marginalisation of Christianity. Whether it is about abortion or gay marriage, the Christian perspective is under fire from the authorities.
“Look at the GMC,” he says. “It is made up of the great and the good. It is a pillar of the establishment. Yet can they claim to speak for the majority of people in this country? No. More than 70 per cent of Britons, when asked if they believe in God, said yes.”
The former missionary doctor and father-of-three believes that Christians must keep their faith “in the closet” or risk punishment.
“I got off lightly,” he admits, “as I still have a job. Other Christians suffered far more. The electrician who dared display a palm frond in the window of his van was fired; and the nurse who prayed for a patient was suspended.”
Dr Scott believes that efforts to eradicate Christianity’s presence in public life are growing. Before the tribunal hearing, he was vilified in the media as a Bible-thumping zealot; that alone, he says, will intimidate other doctors who dare to infuse their medical work with Christian charity.
By upholding this ruling, he believes the GMC has set a precedent, making it a disciplinary offence to bring faith to work.
Will the midwife who opposes abortion or the doctor who opposes assisted suicide be forced to go against their conscience and participate in procedures they believe to be wrong?
“I fear,” says Dr Scott, “that more and more, the answer will be ‘yes’.”
What is it about the Christian mindset that causes such hostility in today’s liberal society? One reason, I venture, is that our culture prizes individualism, and we have grown accustomed to being able to sleep with whom we want, give birth when we want, and even snuff out life (our own, or an unborn child’s) as we see fit.
Dr Scott agrees that Christianity challenges this self-regard by accepting taboos and cherishing principles that the contemporary “anything-goes” culture has rejected. However, as he point out, such moral absolutism when professed by Muslims is somehow acceptable, but in Christians smacks of imperialism.
Dr Scott fears, too, that religious charities and organisations that run hospitals, schools and hostels for the homeless are being squeezed out of the public arena.
Just as Roman Catholic adoption agencies have been shut down because they refused to place children in their care with homosexual couples, so Christian hospices will be forced to shut if they oppose euthanasia, and Christian hospitals to close if they refuse to perform abortions.
It is a bleak scenario — and totally different from the welcome that Dr Scott received in India and Africa during his years as a medical missionary. While he and his wife worked in Tanzania and Kenya, they found themselves loved and respected because of, rather than in spite of, their faith.
“As Christians, we were seen to bring education and medicines, but also an important ally against the witchdoctors who were causing extraordinary violence and misery among the Masai.
“Even when we were unable to save a life, or a limb, the family would offer us a slaughtered cow in gratitude.”
No slaughtered cows here — though his struggle has brought Dr Scott hundreds of letters and emails of support. He takes comfort in these, especially in messages from atheists.
The British sense of fair play is offended by censorship, especially when its victims are targeted for their beliefs. When a woman cannot wear a cross, or her colleague a hijab, it is not only believers who cry foul.
Are Britons cross enough about this to fight back? “Yes,” Dr Scott is adamant. “I think people are fed up of watching their countrymen being bullied by the thought police.”
The GMC and other authorities, he says, ignore that Britons like to live in a civilised country — one in which everyone is free to have their say — at their peril.
Britain’s Fascist social workers again
The Argentinian dictatorship took children away from Leftists so we see the company they are in
SOCIAL workers want to seize a baby as soon as it is born because they are concerned about the mother’s violent links to the English Defence League.
Durham County Council has told Toni McLeod she would pose a “risk of significant harm” to the baby. Social workers fear the child would become radicalised with EDL views and want it put up for adoption immediately.
Mrs McLeod, who is 35 weeks pregnant, is a former leading member of the EDL, in which she was notorious as “English Angel”. The 25-year-old has a string of convictions for violence, including butting and biting a police officer after an EDL march in 2010 and she has been banned from owning dogs after setting a pit bull on a former partner.
However, her cause has been taken up by Lib Dem MP John Hemming who, despite his loathing for the EDL, raised it in the Commons. He contrasts her treatment with that of the extremist Islamic cleric Abu Qatada, who was allowed to remain with his children when he was briefly remanded on bail earlier this year as the Government tries to deport him.
He said: “It raises a curious question as to why Abu Qatada is allowed to radicalise his children but the state won’t take the chance of allowing Toni McLeod to look after her baby in case she says something social workers won’t like.
“I am very strongly opposed to the EDL, which I believe to be a racist organisation, but I do not think we should remove all of the children of the people who go on their demonstrations, however misguided they may be.”
Mrs McLeod has posted racist abuse on social networking sites but denies being racist. She claims she is no longer active with the EDL and has never been charged with violence against children.
Social workers have told her husband Martyn he would be unable to care for his child because he is a full-time soldier just back from Afghanistan.
Mr Hemming, who chairs the Justice For Families campaign group, said yesterday: “This case is one where the ‘thought police’ have decided to remove her baby at birth because of what she might say to the baby. I wonder what the baby’s father is thinking when he fights for a country which won’t allow him to have a child because of what the child’s mother might say.
“Toni now accepts she was wrong to have gone on EDL demonstrations but freedom of speech means nothing if people are not allowed to say things that are thought to be wrong.”
Mrs McLeod wants to move to Ireland for the birth to avoid England’s social services. Rifleman McLeod, 31, plans to request a transfer to Northern Ireland so he can be with his child.
Durham County Council told Mrs McLeod on Friday her unborn baby was being placed on its child protection register. Last month, a judge ruled that her three other children, who have different fathers, should be permanently removed from her care.
The Sunday Express is unable to give details of the judge’s explanation for legal reasons.
Documents seen by the Sunday Express reveal social workers are worried about Mrs McLeod’s previous alcohol and drug misuse, her “aggressive behaviour” and her alleged “mental health issues” .
They concede she is no longer involved with the EDL but believe she is now involved with a splinter group, the North West Infidels. The social worker’s report states: “Toni clearly needs to break away from the inappropriate friendships she has through either the EDL or break-off group in order that she can model and display appropriate positive relationships to the baby as he/she grows and develops.
“Toni has been a prominent member of the EDL. They claim they are a peaceful group, however, they have strong associations with violence and racism.”
Mr McLeod said: “Toni would never harm a child.”
The council said it was unable to comment.
EU on brink of a new dark age
Boris Johnson (Mayor of London) always writes with a lightness of touch but he is a genuine classicist and it seems to me that his dark vision of the EU below could be largely true of the USA as well
It is one of the tragic delusions of the human race that we believe in the inevitability of progress. We look around us, and we seem to see a glorious affirmation that our ruthless species of homo is getting ever more sapiens.
It is one of the tragic delusions of the human race that we believe in the inevitability of progress. We look around us, and we seem to see a glorious affirmation that our ruthless species of homo is getting ever more sapiens. We see ice cream Snickers bars and in vitro babies and beautiful electronic pads on which you can paint with your fingertip and – by heaven – suitcases with wheels! Think of it: we managed to put a man on the moon about 35 years before we came up with wheelie-suitcases; and yet here they are. They have completely displaced the old type of suitcase.
Aren’t they grand? Life seems impossible without them, and soon they will no doubt be joined by so many other improvements – acne cures, electric cars, electric suitcases – that we will be strengthened in our superstition that history is a one-way ratchet, an endless click click click forwards to a nirvana of liberal democratic free-market brotherhood of man.
Isn’t that what history teaches us, that humanity is engaged in a remorseless ascent?
On the contrary: history teaches us that the tide can suddenly and inexplicably go out, and that things can lurch backwards into darkness and squalor and appalling violence. The Romans gave us roads and aqueducts and glass and sanitation and all the other benefits famously listed by Monty Python; indeed, they were probably on the verge of discovering the wheely-suitcase when they went into decline and fall in the fifth century AD.
Whichever way you look at it, this was a catastrophe for the human race. People in Britain could no longer read or write. Life expectancy plummeted to about 32, and the population fell. The very cattle shrunk at the withers. The secret of the hypocaust was forgotten, and chilblain-ridden swineherds built sluttish huts in the ruins of the villas, driving their post-holes through the mosaics.
In the once bustling Roman city of London (for instance) we find no trace of human habitation save for a mysterious black earth that may be a relic of a fire or some primitive system of agriculture. It took hundreds of years before the population was restored to Roman levels.
If we think that no such disaster could happen again, we are not just arrogant but forgetful of the lessons of the very recent past. Never mind the empty temples of the Aztecs or the Incas or the reproachful beehive structures of the lost civilisation of Great Zimbabwe. Look at our own era: the fate of European Jewry, massacred in the lifetimes of our parents and grandparents, on the deranged orders of an elected government in what had been one of the most civilised countries on earth; or look at the skyline of modern German cities, and mourn those medieval buildings blown to smithereens in an uncontrollable cycle of revenge.
Yes, when things go backwards, they can go backwards fast. Technology, liberty, democracy, comfort – they can all go out of the window. However complacent we may be, in the words of the poet Geoffrey Hill, “Tragedy has us under regard”. Nowhere is that clearer than in Greece today. Every day we read of fresh horrors: of once proud bourgeois families queuing for bread, of people in agony because the government has run out of money to pay for cancer drugs. Pensions are being cut, living standards are falling, unemployment is rising, and the suicide rate is now the highest in the EU – having been one of the lowest.
By any standards we are seeing a whole nation undergo a protracted economic and political humiliation; and whatever the result of yesterday’s election, we seem determined to make matters worse. There is no plan for Greece to leave the euro, or none that I can discover. No European leader dares suggest that this might be possible, since that would be to profane the religion of Ever Closer Union. Instead we are all meant to be conniving in a plan to create a fiscal union which (if it were to mean anything) would mean undermining the fundamentals of Western democracy.
This forward-marching concept of history – the idea of inexorable political and economic progress – is really a modern one. In ancient times, it was common to speak of lost golden ages or forgotten republican virtues or prelapsarian idylls. It is only in the past few hundred years that people have switched to the “Whig” interpretation, and on the face of it one can forgive them for their optimism.
We have seen the emancipation of women, the extension of the franchise to all adult human beings, the acceptance that there should be no taxation without representation and the general understanding that people should be democratically entitled to determine their own fates.
And now look at what is being proposed in Greece. For the sake of bubble-gumming the euro together, we are willing to slaughter democracy in the very place where it was born. What is the point of a Greek elector voting for an economic program, if that program is decided in Brussels or – in reality – in Germany?
What is the meaning of Greek freedom, the freedom Byron fought for, if Greece is returned to a kind of Ottoman dependency, but with the Sublime Porte now based in Berlin? It won’t work. If things go on as they are, we will see more misery, more resentment, and an ever greater chance that the whole damn kebab van will go up in flames. Greece will one day be free again – in the sense that I still think it marginally more likely than not that whoever takes charge in Athens will eventually find a way to restore competitiveness through devaluation and leaving the euro – for this simple reason: that market confidence in Greek membership is like a burst paper bag of rice – hard to restore.
Without a resolution, without clarity, I am afraid the suffering will go on. The best way forward would be an orderly bisection into an old eurozone and a new eurozone for the periphery. With every month of dither, we delay the prospect of a global recovery; while the approved solution – fiscal and political union – will consign the continent to a democratic dark ages.
British School days could be extended to 8pm: PM signals shake-up to improve childcare
School days could be extended until 8pm and red tape on childcare provision slashed under Government reforms.
David Cameron will today launch a commission on childcare to draw up measures to reduce costs for parents and ease bureaucratic restrictions on providers.
It will investigate whether there is red tape that could be abolished or rules – such as adult-to-child ratios for organisations offering childcare – that could be relaxed.
Childminders are generally restricted to looking after no more than three children, but this could be increased to five.
Mr Cameron also wants schools to examine innovative ways of providing after-school childcare.
For example, the Free School Norwich offers affordable childcare six days a week, 51 weeks a year. And the Mossbourne Academy in Hackney, London, operates a longer day, with some pupils staying until 8pm.
The Prime Minister wants more academies and free schools to extend their days, and others to offer after-school clubs.
Parents would generally pay a fee if they wanted their children to go to clubs, but the costs would be considerably less than other forms of childcare.
Work and pensions minister Maria Miller and children’s minister Sarah Teather will lead the commission, which is to report to Mr Cameron by the autumn.
The Prime Minister, speaking at the G20 summit in Mexico, said: ‘Working parents want to know that after school or in the holidays their children will be looked after in a safe, happy environment that is affordable.
‘We want to do all we can to reduce the cost of childcare for parents, and make sure they can find and afford high-quality nurseries, after-school clubs and holiday schemes for their children.’
An Education Department study shows only four in ten parents believe there is sufficient care in their areas for over-fives. And a recent survey by Save the Children and the Daycare Trust suggested working parents are spending more than a third of their incomes on childcare.
State spending on childcare is already among the highest in the world. By 2014, the Coalition will have increased investment by more than £1billion a year.
The commission will look at whether more value for money could be squeezed from some providers. Bureaucratic ‘lunacy’ governing the work of childminders is of particular concern. Ministers believe rules introduced by the last government helped fuel a dramatic collapse in the cheapest, most traditional form of care for working parents.
In 1997, when Labour came to power, there were 100,000 childminders catering for half of families paying for childcare.
But Labour introduced a raft of regulations, including Ofsted inspections and a ‘nappy curriculum’ of targets to be achieved by a child’s fifth birthday. Carers said they were being required to put ‘wash your hands’ signs in bathrooms even though children are often too young to read, and to conduct ‘risk assessments’ if there were pets such as hamsters in their house.
The number of childminders has fallen to 55,000, pushing more families into using nurseries.
Tory MP Elizabeth Truss, who has led a campaign for childcare reform, said: ‘Becoming a childminder is a bureaucratic process, involving registering with Ofsted, a local network and insurance provider.
‘British child-adult ratios are some of the lowest in Europe – 3:1 for childminders looking after under-fives. In the Netherlands, Germany and Ireland that ratio is 5:1.
‘The UK should raise ratios for childminders to 5:1 for the under-fives whilst improving supervision.
‘This would enable higher-paid staff to be attracted to the profession, improving quality, or would make the service more affordable and widely available.’
Seven cups of tea a day ‘raises incidence of prostate cancer by 50%’ among Glaswegians
Some reasonable reservations expressed below about these unusual results. I will refrain from making jokes about Glasgow
Men who drink lots of tea are far more likely to develop prostate cancer, researchers have warned. They found that those who drank seven or more cups a day had a 50 per cent higher risk of contracting the disease than men who had three or fewer.
The warning comes after scientists at the University of Glasgow tracked the health of more than 6,000 men for four decades.
Their findings run counter to previous research, which had suggested that tea-drinking lowers the risk of cancer, as well as heart disease, diabetes and Parkinson’s disease.
The study, led by Dr Kashif Shafique, began in 1970. Participants aged between 21 and 75 were asked to complete a questionnaire about their usual consumption of tea, coffee and alcohol as well as their smoking habits and general health, and had to attend a screening examination.
Just under a quarter of the 6,016 men were heavy tea drinkers, consuming seven or more cups a day. Of these, 6.4 per cent developed prostate cancer over the next 37 years.
Researchers found that the subjects who drank the most tea were often teetotal and led healthy lifestyles.
As a result, they may have been at a lower risk of death from ‘competing causes’, effectively giving them more time to develop prostate cancer, the journal Nutrition and Cancer reports.
Dr Shafique said: ‘Most previous research has shown either no relationship with prostate cancer for black tea, or some preventive effect of green tea. ‘We don’t know whether tea itself is a risk factor or if tea-drinkers are generally healthier and live to an older age, when prostate cancer is more common anyway.’
He added that those drinking the most tea were less likely to be overweight or drink alcohol, and more likely to have healthy cholesterol levels.
‘However, we did adjust for these differences in our analysis and still found that men who drank the most tea were at greater risk of prostate cancer,’ he said. Dr Shafique did stress, however, that his team was ‘unaware of any constituent of black tea that may be responsible for carcinogenic activity in prostate cells’.
Previous research has found health benefits from flavonoids – antioxidant compounds in tea that are thought to control inflammation, reduce excess blood clotting and limit narrowing of the arteries.
Of seven previous studies on black tea and prostate cancer, four found a potentially protective effect while the remainder found no effect either way.
Dr Kate Holmes, head of research at The Prostate Cancer Charity, said: ‘Whilst it does appear that those who drank seven or more cups of tea each day had an increased risk of developing prostate cancer, this did not take into consideration family history or any other dietary elements other than tea, coffee and alcohol intake.
‘It is therefore unclear as to whether there were other factors in play which may have had a greater impact on risk.’
Almost 80 per cent of Britons drink tea, consuming an estimated 165million cups each day. The British tea industry is thought to be worth more than £700million a year.
Dr Carrie Ruxton of the Tea Advisory Panel, an educational body funded by the industry, said just 92 men in the Glasgow study drank more than seven cups a day and went on to develop prostate cancer.
She added: ‘We’re lacking the complete picture because we don’t know what other dietary factors were involved. Other research suggests tea has a protective or neutral effect on prostate cancer, and the authors acknowledge there is no known ingredient in tea that is cancer-causing.
‘Tea-drinking may be a marker for some sort of behaviour that can raise the risk of prostate cancer, but the study does not show it is a cause.’
Prostate cancer strikes 40,000 British men each year, causing more than 10,000 deaths
More publicity for the serious side effects of Statins
Which were once almost universally pooh-poohed as minor
Women on statins, the anti-cholesterol drugs, are at risk of fatigue, a U.S. study has found. Two in five women taking the pills had less energy than before, with one in ten reporting they felt ‘much worse’.
While experts stress that patients should never stop taking their pills before speaking with their doctor, it has been suggested that for some women, this side-effect could outweigh the benefits of the drug.
This news comes on top of previous research that suggested women may not benefit from statins as much as men.
So should women carry on taking the pills? We asked the experts…
WHY DO I NEED STATINS?
Statins reduce the amount of LDL (‘bad’) cholesterol, which can lead to hardening and narrowing of the arteries, raising the risk of heart disease, heart attack and stroke.
Statins are recommended for those with heart disease or a high risk of developing it.
Around five million Britons are taking statins, though last month, a review by researchers at the University of Oxford said everyone over 50 could benefit from them.
WHAT DOES THE NEW RESEARCH SAY?
The new study into fatigue involved two leading statins, pravastatin and simvastatin.
The researchers at UC San Diego School of Medicine looked at more than 1,000 adults, a third of them women, and the effects of statins on energy levels and exercise capacity.
Participants were randomly given a placebo or a statin at an average dose — pravastatin (40mg) or simvastatin (20mg).
The effect appeared to be stronger for simvastatin.
Statins are recommended for those with heart disease or a high risk of developing it
Statins are recommended for those with heart disease or a high risk of developing it
CAN STATINS CAUSE FATIGUE?
Most people think cholesterol comes from our diets — in fact, most is made in the liver. Statins work by blocking enzymes involved in the production of cholesterol.
However, many hormones, including oestrogen, are also metabolised by the liver and it’s thought statins may interfere with this, says Dr Sovra Whitcroft, a gynaecologist at the Surrey Park Clinic in Guildford.
‘As oestrogen promotes sleep, any disruption to its levels could lead to tiredness.’
ANY OTHER SIDE-EFFECTS?
The list of officially acknowledged side-effects has grown. Initially these included upset stomach, headache or insomnia. Memory problems were added in 2009.
However, GPs point to other side-effects such as irritability and ‘generally feeling old’ that are never mentioned in studies, yet are common.
Another concern is hair loss. Dr David Fenton, a consultant dermatologist in London, says this is a rare side-effect he has witnessed.
‘Women shed more hair than they should, and it can exacerbate any genetic tendency towards the female equivalent of male pattern baldness. I see many with thinning patches.’
A recent Greek study, published in the International Journal of Cardiology, suggested up to 10 per cent of patients reported myopathy — muscle pain.
‘There has not been a post-marketing surveillance study of statins,’ says Dr Malcolm Kendrick, a Cheshire GP and author of The Great Cholesterol Con. ‘So no one really knows what the adverse effects may be or how many people experience them.
‘Some say side-effects are vanishingly rare. But many patients I see have probable side-effects from a statin with a significant impact on their quality of life.’
And many experts agree women seem to suffer more side-effects than men. Dr Richard Karas of Tufts University Medical Center in Boston, U.S., says because women are smaller and tend to be older when prescribed statins, this might contribute.
However, the British Heart Foundation reports only one in every 10,000 people who take statins will experience a potentially dangerous side-effect.
The NHS estimates statins save 7,000 lives a year, so the risks are seen to be outweighed by the benefits.
SO DO STATINS WORK ON WOMEN?
It’s generally accepted that for people who have had a heart attack, stroke, or have heart disease, statins can be a life-saver.
But more controversial is whether women benefit in the same way as men. When it comes to preventing another stroke or heart attack (known as ‘secondary prevention’), a key study, the Jupiter trial, found that taking rosuvastatin cut the recurrence rate in men and women.
As Kausik Ray, professor of cardiovascular disease prevention at St George’s University, London, points out, the five-year study ‘was so successful at reducing the incidence of deaths it was stopped after two years’. ‘It found that healthy women at risk of heart attacks benefited significantly as much as men from taking statins.’
However, Dr Kendrick points out that while the recurrence rate dropped for both genders, the death rate dropped only for men.
As well as preventing a second heart attack or stroke, statins are also increasingly being used as ‘primary prevention’ — before there’s any sign of heart disease, let alone a symptom such as angina or a heart attack.
Here, the picture about the benefits for women is less clear. A major review by the Cochrane Library (a highly regarded research organisation) said there was no evidence for using statins for primary prevention unless the patient was deemed at high risk of cardiovascular problems.
The review also pointed out most of the trials were conducted on white, middle-aged men.
So we can’t necessarily assume the findings will apply to older people, who may be at greater risk of adverse effects, and women, who may be at lower cardiovascular risk (thanks to their better lifestyles, oestrogen — which protects the heart — and their naturally higher levels of ‘good’ cholesterol).
For instance, when researchers from Harvard Medical School re-analysed eight major studies in 2007, they concluded there was no evidence statins worked as primary prevention for women. ‘My view is that statins are, for women, completely useless for primary and secondary prevention,’ says Dr Kendrick.
However, Professor Ray disagrees, pointing out that in the Jupiter trial, which was published in the New England Journal of Medicine, 40 per cent of the nearly 18,000 participants were women.
‘The evidence clearly shows that women at risk of heart disease benefit to a similar extent as men, though the number of women in trials is small,’ he says.
I’M TIRED. SHOULD I GIVE UP STATINS?
‘It’s difficult to monitor fatigue — you can’t measure it like cholesterol,’ says Professor Ray. ‘The latest study is useful, but it is not going to change what we do.
‘Fatigue is a common symptom, especially in women, but can be due to other causes.
For example, you may have an underactive thyroid and in premenopausal women fatigue could be related to anaemia. These conditions are often not picked up.’
Dermatologist Dr Fenton points out that tiredness could also be a side-effect of the lifestyle measures many implement when prescribed statins.
‘Losing weight, taking up exercise and restricting a diet by eating less red meat can all cause tiredness. It’s vital to check iron levels.’
Even if the fatigue is linked to statins, don’t stop taking the drug automatically, especially if you’re at high risk for future events, e.g., you are diabetic.
‘If you have a strong family history of heart disease, and a poor lifestyle, or have multiple risk factors, putting up with fatigue may be more sensible than being at risk of heart attack,’ says Professor Ray.
‘You need to discuss this with your GP.’
COULD I SWAP TO ANOTHER STATIN?
‘You can certainly try taking them in a different way,’ says Professor Ray. ‘For example, I’d recommend you take a drug holiday, under medical supervision. Stop taking your statin for a week (which is how long it will take to clear your system) and then see how you feel.’
‘Or you could ask to be swapped to a long-acting statin, such as rosuvastatin, a 5mg twice-weekly tablet, which may suit your body’s digestion.’
Statins have been linked to low levels of co-enzyme Q10 — a natural compound found in cells which is important for turning glucose into energy. ‘This may cause tiredness, but you can’t measure levels in the body, so you can only see if taking a supplement helps by trial and error. ‘It can’t hurt and might help,’ says Professor Ray.
Wind farms to lose subsidies by 2020, says British government minister
Taxpayers could stop subsidising onshore wind farms and solar power providers by the end of the decade, ministers claim. Cabinet Office Minister Oliver Letwin has confirmed that financial support – currently worth around £400million – will have ‘disappeared’ by 2020.
George Osborne is believed to be arguing for a 25 per cent cut in renewable energy subsidies. But Mr Letwin revealed in an email to a campaigner that the cut could go much further.
‘I anticipate subsidies… will come down to zero over the next few years and should have disappeared by 2020, since these forms of energy are gradually becoming economic without the need for subsidies,’ he told Terry Stewart, president of the Dorset branch of the Campaign for the Protection of Rural England.
Mr Stewart, who had written to Mr Letwin – his MP – to complain about plans for 160 wind turbines in Dorset, said: ‘The subsidy for wind turbines is iniquitous – it is a stealth tax.
‘It is being paid out to rich land owners and foreign energy companies and developers.’ Electricity companies have to pay twice the market price for energy from onshore wind farms. This is then passed on through higher bills.
While the Lib Dems are in favour of subsidising ‘green’ energy, more than 100 Tory MPs wrote to David Cameron in January to urge him not to blight the landscape with turbines. There are currently more than 3,000 onshore wind turbines in Britain, with another 4,500 expected to be erected.
Tory MP Chris Heaton-Harris said: ‘This policy is not green, progressive or sensible. The Chancellor should take an axe to these subsidies.’
The revelation is embarrassing for Deputy Prime Minister Nick Clegg, due to attend the United Nations Rio+20 Earth Summit in Brazil tomorrow. The Lib Dem leader has argued national wealth should also be measured by how clean a country’s environment is, rather than just how much money it earns.
Ed Davey, the Liberal Democrat Energy Secretary, will announce details of subsidies for renewable energy from 2013 to 2017 in the next few weeks. It will follow a consultation on whether subsidies should be cut by more than 10 per cent.
John Constable, director of the UK charity Renewable Energy Foundation, said: ‘Extremely high subsidies have harmed the reputation and integrity of the renewables sector, which has been corrupted by easy money and undeserved fortunes.
‘Reductions in subsidies are welcome, but may not be enough to protect the consumer in very hard times, and retrospective cuts, supported by windfall taxes, cannot be ruled out.’
A Department of Energy and Climate Change spokesman said the 2020 date referred to by Mr Letwin was an ‘aspiration’. She added: ‘It is always our aspiration to end subsidies for any energies.’
Are fatties starving the poor?
The familiar zero-sum game fallacy
Overweight people are a threat to future food security and increasing population fatness could have the same implications for world food demands as an extra billion people, researchers have found.
Scientists from the London School of Hygiene and Tropical Medicine examined the average weight of adults across the globe and said tackling population weight was crucial for food security and ecological sustainability.
The United Nations predicts that by 2050 there could be a further 2.3 billion people on the planet and that the ecological implications of the rising population numbers will be exacerbated by increases in average body mass.
The world’s adult population weighs 287 million tonnes, 15 million tonnes of which is due to being overweight and 3.5 million tonnes to obesity, according to the study, which is to be published in BMC Public Health.
The data, collected from the UN and the World Health Organisation, shows that while the average global weight per person is 62 kilograms in 2005, Britons weighed 75 kilograms. In the US, the average adult weighed 81 kilograms. Across Europe, the average was 70.8 kilograms compared with just 57.7 kilograms in Asia.
More than half of people living in Europe are overweight compared with only 24.2 per cent of Asian people. Almost three-quarters of people living in North America are overweight.
Researchers predict that if all people had the same average body mass index as Americans, the total human biomass would increase by 58 million tonnes.
The authors of the study say the energy requirement of humans depends not only on numbers but average mass.
“Increasing biomass will have important implications for global resource requirements, including food demand and the overall ecological footprint of our species,” they wrote.
“Although the concept of biomass is rarely applied to the human species, the ecological implications of increasing body mass are significant and ought to be taken into account when evaluating future trends and planning for future resource challenges. Tackling population fatness may be critical to world food security and ecological sustainability.”
Professor Ian Roberts, who led the research at LSHTM, said: “Everyone accepts that population growth threatens global environmental sustainability – our study shows that population fatness is also a major threat.”