Nurses treat fewer than half of dying patients with the dignity they deserve, warn bereaved relatives
Half of bereaved relatives say nurses did not always treat their loved ones with dignity in their final days, a report has found.
It has raised yet further concerns that hospitals are failing to look after the elderly or terminal-ill patients at the end of their lives.
Only yesterday it emerged that a 22-year-old cancer patient had died of dehydration at a leading hospital having tried to call 999 from his bed.
Now the Government has published the first survey of its kind involving 22,000 bereaved relatives to find out the level of care for dying patients.
It reveals that only 48 per cent of patients were always treated with dignity and respect by nurses in hospital, according to their relatives.
And it also implies that terminally-ill or elderly patients in hospital receive far poorer care than those in hospices or care homes.
Nearly two-thirds of relatives said their loved ones were in pain while they were in hospitals – as staff did not do enough to try and relieve it. By comparison only 38 per cent of the relatives of patients in hospices were in pain and 55 per cent of those in care homes.
And just 30 per cent of patients who died in hospital were given a choice about where they ended their lives, according to relatives. This compared to two-thirds of those who died in a hospice.
Imelda Redmond, director of Policy and Public Affairs, at Marie Curie Cancer Care said: ‘Hospitals are letting people down at a crucial time and this poor care is leaving behind memories of loved ones being treated with little dignity and respect, and dying in pain. This is simply not good enough.
‘Families have told us, in large numbers, that their loved ones do not always get the care they need or deserve at the end of life. ‘There is no reason why we can’t provide a dignified and respectful death, regardless of setting, location or diagnosis. It is now time to learn from these findings and make improvements.’
And Eve Richardson, chief executive of the National Council for Palliative Care and the Dying Matters Coalition said: ‘It’s a real concern that the quality of care people who are dying receive appears to vary so hugely, with hospitals performing especially badly.
‘There is absolutely no excuse for not treating people who are dying with dignity and respect, which is why it is disturbing that hospital staff appear to be failing to do this consistently.’
The survey was sent to the relatives of patients who had recently died in hospital, a care home, a hospice or their own home. They were asked a series of questions about the standards of care in their final three months.
But the findings will prompt yet further concerns over the standard of nursing care, particularly for elderly patients.
Earlier this year, Prime Minister David Cameron ordered nurses to speak to every patient on their ward once an hour to ensure they were not in pain or discomfort.
His intervention followed a spate of damning reports revealing how patients were frequently being left hungry, thirsty and in agony.
Care services minister Paul Burstow said: ‘All people, regardless of their age or condition, should get the best quality care at the end of life.’
Thirty NHS trusts rack up a £300m debt mountain as number being bailed out by taxpayer trebles in just one year
The graph below explains why. The NHS is a huge bureaucracy teeming with useless clerks and “administrators”
More than 30 hospital trusts have amassed debts totalling £300million, it has emerged. The amount of taxpayers’ money being used to bail out stricken hospitals has trebled in the past year.
Only last week it was announced South London Healthcare was being put into special measures as it is on the brink of going bust. Today a report by the National Audit Office warns it and another 30 trusts are in the red, with total debts of £307million.
The Government blames much of the debt on controversial private finance initiative deals, which were expanded under Labour.
The NAO warned that the Government cannot afford to carry on bailing out the trusts.
There are also concerns that the hospitals’ dire financial situation will lead to worsening patient care.
Last year £253million of public money was given to failing hospitals to help them cover everyday running costs – more than treble the £76million spent the previous year. Next year the bailout bill is likely to rise to £300million.
Margaret Hodge MP, chairman of the Public Accounts Committee said: ‘It is shocking that over the past year alone the amount the Department for Health has had to spend on bailing out trusts in financial difficulty rose by 333 per cent.
‘Trusts in particular received significant support; South London Healthcare NHS Trust and Barking and Havering and Redbridge University Hospitals NHS Trust.’
The Government blames much of the debt on botched PFI deals which were encouraged by the Labour government.
These enabled private firms to pay up front for a new cancer ward or maternity department, for example, and the trust would then pay them back in yearly instalments.
But this amount goes up with interest every year and trusts also have to spend large amounts of money maintaining the buildings so they are ‘new’. As such, many have been unable to make these repayments.
The NAO warns that in future, the NHS will not be able to afford to continue bailing these trusts out. It points out that there is unlikely to be any increase in Government spending on the NHS – once inflation is taken into account – for at least the next three years.
The future of South London Healthcare trust is uncertain but health secretary Andrew Lansley is likely to make a decision later this year.
It covers three hospitals – Princess Royal University Hospital in Orpington and Queen Mary’s Hospital in Sidcup in Kent and the Queen Elizabeth Hospital in Woolwich, South London – and any may be closed-down.
Do British graduates need a first-class degree to get a good job?
A combination of too many students, grade inflation and a stalled economy have created a toxic combination for any new graduate seeking paid employment.
After a nail-biting few weeks, the results are in, the champagne corks have popped and graduates up and down the country are breathing a sigh of relief. The hard graft is over, and all that remains for many of the class of 2012 is to attend their graduation ceremonies and toss their mortar boards in the air with a sense of pride.
But after the celebrations have finished, mortar boards aren’t the only things that will come crashing back down to earth this summer. The hundreds of thousands of graduates entering the jobs market over the next few months face increasingly bleak prospects, according to new studies of graduate recruitment.
The latest report, published yesterday, suggests that the labour market has become so competitive that top employers are screening out graduates who fail to gain first-class degrees. Employers say they are so swamped with applications that filtering candidates by the best degree classifications is one of the easiest – and cheapest – ways to reduce the shortlist, the report by the Association of Graduate Recruiters (AGR) says.
A separate study out yesterday by High Fliers Research, a market research company, shows that in 70 per cent of cases, graduate employers demand at least a 2:1 degree. Application levels are now some 25 per cent higher than three years ago, partly because of the backlog of graduates still looking for work since the recession.
An average of 73 students compete for each job, although that number rises to 154 in the retail industry and 142 for investment banking posts. Meanwhile, the number of first-class graduates has more than doubled over the past decade, figures show.
Martin Birchall, managing director of High Fliers Research, says that the demand for first-class intellectual prowess is coming from the top investment banks, consultancies, law firms and accountants in particular.
“The number of first-class and 2:1 degrees has increased notably over the past 10 years – it’s becoming an absolute minimum standard,” he says. “If, during an interview, undergraduates say they might not get a 2:1 after all, many have to withdraw their applications.”
Accountants PricewaterhouseCoopers, the biggest graduate employer, received 33,000 student and graduate applications for around 2,500 graduate-entry jobs this year, although it does recruit on other factors besides academic achievements. Other industries are experiencing the same overload; oil giant BP received 7,000 applications for 244 jobs, while Jaguar Land Rover saw the number of applicants for its scheme rise by 61 per cent over the year to 10,632.
“The volume of applications is so high that companies could fill their places three or four times over with good candidates,” Mr Birchall says. “They will regret that they can’t view all candidates – it’s incredibly harsh, but many good ones slip through the net.”
Michael Barnard, product manager at Milkround, the graduate careers advice site, says the problem stems from the height of the recession, when many big employers froze their graduate schemes. “This created a graduate jobs backlog, or debt, which we haven’t managed to clear yet. It’s really tough for graduates to find work,” he says.
“Graduates can’t expect to just walk into a decent job any more. If you want to work in London – God forbid, it’s the hardest place to find a job in the world – you will have to accept that you probably need to live in a house-share with five strangers, work in a café to pay the bills and start at the bottom with a big employer.”
He agrees that the UK’s financial industry is driving the trend to filter applications by academic achievement. Other sectors, particularly the creative ones such as media, are less concerned about grades and more interested in skills, extra-curricular activities and experience, he says – something that universities often overlook.
“Universities should pay more attention to creative students, where it’s more about what you’ve done at university, the clubs you’re part of, and so on,” he says.
Those employers who sift applications based on academic achievement do also use an online application form, aptitude tests, competency-based interviews and telephone interviews, according to the High Fliers report, based on interviews with the UK’s top 100 graduate employers. Personality questionnaires and group exercises at selection centres are also used to assess how well-rounded a candidate is, giving applicants the chance to show off “softer” skills beyond academic achievements, such as team-working, communication and presenting skills.
But if the majority of employers specify a 2:1 minimum, many candidates with 2:2 degrees or lower won’t get the chance to show off how “rounded” they are if they cannot apply to start with, Mr Birchall says.
Tanya de Grunwald, founder of GraduateFog, a careers website, and who is leading a campaign against unpaid graduate internships, says the balance of power has shifted dramatically to employers in recent years. “Many graduates are having their self-esteem chipped away as they don’t even get a rejection letter. It is a buyers’ market, with graduates having to work harder and harder to get noticed,” she says.
She believes that the push under the previous Labour government to get half of all young people to go to university has hoodwinked young people into thinking that if they get a degree, a well-paid job and high-flying career path will follow. But many of Britain’s top employers still prefer to recruit Oxbridge graduates, she says, meaning that applicants with lower grades, who went to a non-Russell Group university, stand little chance of being seen.
Graduates who have worked hard at university feel they are being let down by the system. More than a third are starting jobs at the non-graduate level because they have no choice, official figures show.
Cait Reilly, a geology graduate from the University of Birmingham, made headlines this year when she decided to take legal action against the Government for being forced to stack shelves in a Poundland store. She had been unable to find work in her subject area and was claiming jobless benefits while volunteering in a museum. But the 22-year-old was told to give up her placement to work at the high street retailer under a government scheme designed to get the unemployed back to work.
Miss de Grunwald says that increasingly, graduates are being forced to work for free with big employers just to get a foot on the career ladder, but this limits opportunities for those from poorer or disadvantaged backgrounds who cannot afford to carry out three‑month unpaid placements.
Mr Birchall suspects “grade inflation” is behind the huge increase in the number of high achievers who have to lower their expectations when they get to the real world of work; a trend that begins at school. “The minute A-star grades were introduced at A-level was a sign that the A-level system is broken as well,” he says. “It has led to a whole generation of pupils applying to university because they want to, not necessarily because they have earned it.”
But Miss de Grunwald is not convinced. “Companies just can’t be bothered to think of a new way to sift applications. There are plenty of reasons why people get 2:2s – perhaps they had family issues, or an illness, or maybe they’re not academic. But they’re good at other stuff, such as building networks or communicating with people, which is essential in careers such as sales.”
Something the experts can agree on is that the grim surveys of recent weeks revolve only around the biggest graduate employers and do not reflect all companies who hire graduates. Plenty of small- to medium-sized businesses (SMEs) are “crying out” for skills and struggle to recruit graduates because they are less well-known, Miss de Grunwald says.
Metaswitch Networks, a fast-growing technology company based in Enfield, hires about 40 graduates a year but has no stringent requirements on academic grades. James Madeley, graduate recruitment manager, says: “Academic ability is an indicator of how clever someone is, but for us it’s about how graduates can logically think through a problem and solve it. We interview and test for that, as a specific skill, rather than degree attainment.”
He thinks universities should forge better links with SMEs to help open graduates’ eyes to the many opportunities that lie outside of the big 100 companies. Mr Barnard agrees: “Candidates unlucky with the big firms can find small- and medium-sized businesses close to the experience they are looking for who are willing to recruit. You’d get more responsibility, quicker,” he says.
For some, it may work out better to avoid the structure and predictability of the large graduate recruitment schemes, Miss de Grunwald argues.
“There are an awful lot of other jobs out there, where graduates can get broad experience and pick up lots of skills. Those that don’t get on to the big schemes have almost dodged a bullet.”
Not what the feminists foresaw
By Rachel Johnson, editor of “The Lady”
Marlborough College has hit on a brilliant way of making parents feel hideous and over-the-hill as their child comes to the end of their happy time at the honey-stoned, Wiltshire alma mater of Kate Middleton, Sam Cam, Sally Bercow etc. The Master three-line-whips the parents of leavers to buy tickets to his “Invitation Dance”.
The above paragraph is rather witty so I suppose I should decode it for non-Brits: Kate Middleton is the future queen of England, Samantha Cameron is the wife of the British Prime minister and Sally Bercow is wife of the Speaker of the House of Commons; “Alma mater” is not widely used in Britan so is a humorous affectation; A three line whip is an instruction to vote given to parliamentarians which is underlined three times. Disobeying one is a serious breach of party loyalty (something expected in Britain); Applying it to an invitation to a ball is therefore also humorous — JR
“Oh my God, the girls,” groaned Giles, a father in his fifties, as we sat with all the other wrinkled parents in black tie (the fathers) or brave jewel shades and shawls (the mothers), watching hordes of teenage supermodels with glossy manes, dewy skins, perfect teeth and sweeping false eyelashes parade about in plunging, backless and even somewhat frontless gowns. “In my day there was perhaps one pretty girl in a year, but now…”
It is true. Girls nowadays are different. My mother bought all my clothes from Debenhams in Taunton, but my daughter’s generation combine the athleticism of Maria Sharapova with the grooming schedule of show ponies at Goodwood.
I’m not sure what to think about this. The fact is, the stunning girls we were all gawping at had spent ages – months, really – “getting ready”. Many had had their hair, nails and make-up done. They wore designer dresses. Now, we all enjoy looking at beautiful young things, but I do worry: after all, many costly decades of what Nora Ephron called “maintenance” and I call “admin” lie ahead of these 18-year-olds, all of whom would have looked sensational had they rolled out of bed and come in their pillow-cases. As Ephron said, the amount of time and money hair consumes as one gets older is “overwhelming” – and as one heads for 70, one is only about eight hours of beauty salon time away from looking like a tramp.
I agree with Giles that teenagers are prettier than they used to be. But when I recall those fronds of fake lashes, and wonder why 18 doesn’t look how it used to, I think there is another factor, one that would disturb feminists such as Naomi Wolf, who argued that the imperative to look beautiful is the force that prevents women from being liberated, and it’s this: far from becoming less onerous, female maintenance/admin is incessant, and starts earlier and earlier for every successive generation of girls.
Free speech for dodgy professors, too
Give me the liberty to know, to utter, and to argue freely according to conscience, above all liberties’, proclaimed the seventeenth-century poet John Milton. To some of my fellow students in the UK, however, it seems this fundamental liberty shouldn’t extend to academics who hold views they dislike.
Last week, Cambridge University students protested against economics supervisor Martin Sewell, who has penned a number of articles on his personal website concerning race, equality between men and women, and eugenics. The dodgy nature of the don’s views on these subjects is fairly clear. For example, in one post Sewell claims: ‘The most likely reason for the high incidence of black crime is blacks’ lower intelligence and greater impulsivity, which themselves are probably biological in origin.’ This is hardly an original claim, and one which has been debunked many times. As well as descriptions of female immigrants appearing to men as ‘exotic fruit’, students have also taken exception to his claims about eugenics, which he says are ‘actually highly desirable: eugenics can help eliminate genetic diseases, reduce personality disorders and increase intelligence via human biotechnology. Time to reconsider.’
Far more problematic than his views, some of which are certainly highly questionable, is the response from the Cambridge University Students’ Union (CUSU). A CUSU representative argued that Sewell is an individual who ‘cannot remain as a supervisor for Cambridge students’. Sewell himself teaches and researches economics, specialising in land economy. How exactly his views on race, eugenics and sexual equality should impact upon this field of research is not made clear. However, even if they did relate to his specific field of research and teaching, his views should be of no significance. Such veiled calls for the man’s dismissal flies in the face of academic freedom.
Universities should be a place where no idea is sacred, where even the most widely-accepted ideas are subjected to intense scrutiny. Academic institutions such as Cambridge should be a place where all controversial viewpoints can be uttered and debated.