Patients’ lives at risk in NHS hospital wards ‘on brink of collapse’
Patients’ lives are at risk in NHS hospital wards that are “on the brink of collapse” due to a critical shortage of out-of-hours doctors and growing numbers of the elderly.
Some hospitals narrowly avoid “catastrophe” every weekend, research by the Royal College of Physicians has found, because doctors’ shifts are limited by the European Working Time Directive and they do not want to work anti-social hours.
Some are “struggling to cope” with the volume of older patients. Many are discharged in the middle of the night or shunted around “like parcels” to free beds for new arrivals.
If the problem is not tackled there will be more tragedies like the Mid Staffs scandal, in which up to 1,200 mainly elderly patients died from substandard care.
A radical reorganisation of the NHS is needed, according to the college. It may include shutting the worst-performing hospitals to expand care at better ones, with more staff coverage at nights and weekends.
The Hospitals on the Edge report warns that:
* Four in 10 doctors surveyed said that staff shortages were jeopardising patient care
* One in four was concerned about the impact of the Working Time Directive, with one warning that “weekends and bank holidays function on a skeleton staff of doctors – very dangerous”
* Doctors are reluctant to work unsociable hours, leaving one in 10 consultant posts in emergency medicine vacant
* Over-65s account for seven in 10 beds, but the “the system continues to treat older patients as a surprise, at best, or unwelcome, at worst”.
The report notes that the number of beds in acute and general wards has fallen by a third over the past 25 years, while patients have increased. Beds have been cut as better care has led to shorter stays.
Dr Andrew Goddard, medical director for the college’s workforce unit, said: “Many hospitals run a traffic light system for their status: they are green if they are taking in patients; amber if they need to be a bit more careful; red for full or black if they are shut.
“What we’ve seen over the past year or so is that a number of hospitals are on red alert or black alert. A black alert used to be a once-in-a-lifetime thing. Now hospitals are on black alert three or four times a year.
“This has been coming on for a while. The system can’t cope much longer, and we need to radically rethink how we provide the care for acute medical patients, particularly the elderly.”
Prof Tim Evans, of the college’s future hospital commission, said that the Working Time Directive, which limits doctors to a 48-hour week, was a “huge issue”. Many doctors have complained that it has led to gaps in rotas, compromising patient safety, and prevented juniors from acquiring necessary experience.
He said that employment contracts for junior doctors reduced flexibility on working hours and needed to be renegotiated. Prof Evans said: “That leads to fragmented care and tragically to a lack of compassionate care, with staff rushing between patients, firefighting. Acute wards are on the brink of collapse.”
He warned: “There will not be some cataclysmic overnight explosion but there will be a gradual increase in the sorts of tragedies that we’ve heard about at Mid Staffs.”
Sir Richard Thompson, president of the college, said: “One doctor told me that his trust does not function well at night or at the weekend and he is ‘relieved’ that nothing catastrophic has happened when he arrives at work on Monday morning. This is no way to run a health service.”
Suzie Hughes, chairman of its patient and carer network, said that during a recent hospital stay she underwent five ward changes “all of which took place after midnight”.
She added: “All routine blood tests were done at approximately 3am as the junior doctors only had time to do them then. It is clearly unacceptable.”
Health Minister Dr Dan Poulter said: “I completely agree with the RCP (Royal College of Physicians) that older people must be treated with dignity and respect at every stage of their care. Everyone working in the NHS should challenge their attitude to older people every day so that doctors, nurses and all other healthcare professionals are treating them with the dignity and respect that they deserve and have a right to expect.
“We are modernising the NHS so it can continue to do more and improve care – putting doctors and nurses, those who best understand the needs of patients, in charge of improving the NHS. To properly provide dignity in care for older people, we need to see more care delivered at home and in the community. Already we are seeing more patients treated as day cases and more patients receiving improved care outside hospitals.”
Refusing to put pupils’ art up in classrooms? It’s militant British teachers who belong in the playground
Talk about coming back down to earth with a bump! The ecstatic cheers from the Olympic crowds had not died away before the teaching unions declared they were taking industrial action.
So it’s business as usual in bolshy, backward-looking Britain.
As the TUC annual conference ushers in the new political season, the sound of Britain’s neanderthal tendency downing tools is as predictable as the leaves now gently falling from the trees.
The National Union of Teachers and its sister teaching union the NASUWT have issued an unedifying 18-page document entitled National Action Autumn Term.
This instructs teachers to refuse to undertake a wide range of ‘non-teaching duties’ in a dispute over their pensions, jobs and pay.
I hope you are sitting down while reading this.
For the restrictions these unions are placing on teachers’ duties — listed, if you please, under the union’s slogan which declares ‘protecting teachers, defending education’ — are as small-minded as they are deliberately designed to make as much trouble as possible.
Refusing, for example, to supervise pupils during the lunch break. Refusing to cover for absent colleagues.
Refusing to invigilate any public examination or SATS. Refusing to collect money from pupils and parents, investigate a pupil’s absence, or even set up and take down classroom displays.
Refusing to provide more than one written report annually to parents. Refusing to undertake extra-curricular activities unless teachers have ‘volunteered freely’ to do so.
So much for the Olympic spirit of pulling out all the stops to encourage children to develop their sporting skills.
And more stupefyingly obtuse still, teachers are being told to defy ministers’ plans to lift the limit of three hours for the amount of time that can be spent in a year on ‘classroom observation’ — when teachers are checked to see if they are performing properly.
Eh? Why should ‘classroom observation’ be limited to three hours per year? It seems that such observation is required when Ofsted classifies a school as ‘failing’. Well surely such observation becomes even more necessary in those circumstances?
Frankly, it’s these unions who are behaving as if they are in the playground. It’s hard to believe that any grown-ups could be quite so foot-stampingly petulant.
This is surely the National Union of Violet Elizabeth Botts, threatening to ‘thcream and thcream’ until they make not themselves but everyone else ‘thick’. For who is going to suffer from this selfish and irresponsible juvenilia? Why, the pupils, of course, and their parents.
With breathtaking hypocrisy, the union document claims that this action is ‘parent, pupil and public friendly’. But how can the chaos to which it aims to reduce schools possibly be ‘friendly’ to parents or the public?
How can refusing to put up children’s artwork on the classroom wall, for heaven’s sake, possibly be ‘friendly’ to pupils? How can frustrating the ability of headteachers to manage their own schools properly be anything other than harmful to children and the public interest?
This mean-spirited and destructive action is entirely about the interests of teachers rather than the pupils in their care. Whatever happened to teaching being a vocation?
Of course, most teachers are entirely mindful of their overriding duty to their pupils. They think of themselves first and foremost as educationalists, and dedicate themselves selflessly to that crucial role.
Indeed, the number of teachers who actually voted for this action was very small. Almost three-quarters of the membership of the National Union of Teachers failed to vote at all.
But then, isn’t that just all too typical of much union disruption, where tiny numbers of activists effectively hijack the passive majority who then find themselves dragooned into industrial action they would rather not take?
The fact is that the teachers’ work-to-rule reflects a general union militancy currently in the air.
The TUC has suggested it may co-ordinate strike action by public sector workers over pay; the prison officers are leading wild talk of a general strike; and a mass TUC demonstration is planned for next month.
There is no public sympathy for any of this; indeed, the vast majority of people take a very dim view indeed of such anti-social behaviour.
All too aware of this, the two Labour Eds, Miliband and Balls, are desperately trying to distance themselves from such talk.
But then, the teaching unions have form as long as your arm when it comes to damaging the interests of school children — in ways that go far beyond the normal trade union preoccupations with pay and working conditions.
It was the teaching unions which promoted the use of every destructive, ideological and anti-education fad that has gripped the entire education world for decades and abandoned countless thousands of children to illiteracy, innumeracy and ignorance.
It was the teaching unions which implacably denied the patently obvious fact that there were thousands of wholly inadequate teachers who, because it was well-nigh impossible to sack them, were continuing to destroy the life-chances of so many pupils.
It was the teaching unions, too, which fought tooth and nail to frustrate and undermine every single government reform aimed at stamping out such shoddy practices.
Faced with the evidence of mass teaching failure, these unions put the interests of their members first and the education of children last.
In similar vein, this latest call to militancy is also an attempt to avoid poor teachers being held to account.
Take for example the instruction to refuse to submit teachers’ lesson plans for inspection by senior school managers — presumably department heads or head teachers.
In a typically opaque bit of gobbledygook, the union document asserts that teachers are to be held accountable only ‘through their use of suitable approaches to teaching and learning’, not for the way in which they plan ‘learning activities and experiences’ (known to the rest of us as teaching).
Consequently, they huff, lesson plans are to be used purely to support teachers rather than as a means to hold them to account for their work.
What astonishing arrogance!
The importance of lesson plans is that they show whether teachers are organising their lessons properly. Yet the unions are saying that these plans should not be scrutinised by senior staff.
Extraordinary! Imagine the uproar if police officers, say, or nurses — or indeed employees in any place of work — were to assert that aspects of their performance were off-limits for senior managers!
Yet the teachers are saying that they alone should be given carte blanche. This is all of a piece with the attitude that has helped bring Britain’s education system to its knees — the belief that only the teaching profession knows the answers.
As a result, parents have found over and over again that, while they may observe that their child is failing to thrive at school or learn very much, it is virtually impossible to get to the bottom of the problem because so much of teaching is deliberately kept a mystery.
It is this attitude more than anything else which has ensured that mass teaching failure has gone largely uncorrected, and that generations of children have been betrayed by an education system that has veered wildly out of control.
It is more than disappointing that, after a summer of such outstanding co-operation and goodwill celebrating the very best in people, we should now be subjected to such a display of selfish, antisocial and indeed positively nihilistic behaviour.
It is even more dismaying that it is once again vulnerable pupils who will be paying the price of a teaching profession that has forgotten what it is for.
The unfree streets of London
A shocking new Google Map shows the bits of London where you can become a criminal without even realising it
The streets of London may look the same as they did a few years back, but in terms of liberty, they are very different.
UK councils and the police now have powers to demark areas of public space within which everyday freedoms are restricted. There is a new cartography of ‘unfree zones’: areas within which you cannot hand out leaflets, or walk your dog, or drink alcohol. Zones are not generally marked with signs, but when you cross these invisible lines your normal freedoms are suspended; you can be punished for things which are not, outside of the zone, an offence.
Today, the Manifesto Club is launching a Google map, titled Banned in London, which reveals the 435 special zones that now cover half the area of the British capital.
In these areas, people can be fined or prosecuted for activities that would otherwise be perfectly legal – including leafleting, protesting, dog walking, gathering in groups, or drinking. Similar zones have been enacted by local authorities across the UK. In London and most other UK urban areas, there are four different kinds of zone: no-dog zones; no-leafleting zones; alcohol-confiscation zones; and dispersal zones. London also has the distinction of a fifth zone – a restricted protest zone, in the vicinity of the Houses of Parliament.
Within a dog-exclusion zone, you can be fined or prosecuted just for walking your dog. There are currently 219 dog-exclusion zones in London. (These are all parks or open spaces: we didn’t include children’s playgrounds or sports fields, which have long-standing and accepted restrictions on dogs.) In 2011–12, there were 56 fines for the offence of walking dogs in a no-dog zone in London – 24 in Greenwich, 31 in Islington, and one in Camden.
Within a no-leafleting zone, you can be fined or prosecuted for handing out leaflets without a licence. There are 110 leafleting zones in London, within seven different local authorities (and three further local authorities are planning to enact leafleting zones in the near future). Leafleting licence fees are often prohibitively expensive, out of reach for everyone but big businesses: £175.40 in Kensington and Chelsea, £49 a day in Haringey, and £2,000 for the borough of Hammersmith and Fulham. In 2011–12 there were 37 fines issued for the offence of ‘unlicensed leafleting’.
In an alcohol-confiscation zone, officials can confiscate your alcohol without justification, and arrest or fine you if you refuse. It is not required that you are behaving in a disorderly manner to have your alcohol confiscated, only that the police officer ‘reasonably believes that a person is, or has been, consuming alcohol [within the designated area] or intends to do so’. Unopened containers can be confiscated. The refusal to surrender alcohol is an offence, punishable with an on-the-spot fine or prosecution.
There are 74 alcohol-confiscation zones in London, throughout 32 London boroughs (14 boroughs have designated the whole of their territory an alcohol-confiscation zone). In 2010, London police issued 663 on-the-spot fines for the offence of ‘drinking in a designated public space’. Alcohol is often disposed of on the spot and such disposal is not even recorded; but Haringey recorded 1,027 alcohol seizures in 2010, and Hackney recorded 220 seizures in June 2011, suggesting that across London there are thousands of confiscation incidents each year.
In a dispersal zone, a police officer can order you to leave the area for 24 hours, and it is an offence to return within that period. The officer can use this power if he has ‘reasonable grounds for believing that [the group’s] presence or behaviour has resulted, or is likely to result, in a member of the public being harassed, intimidated, alarmed or distressed’. In addition, the dispersal zone is a de facto curfew zone for young people, who cannot be out unaccompanied between the hours of 9pm and 6am. Dispersal orders tend to be particularly used against young people and homeless people. There are 32 active dispersal zones in London, within which there have been 547 recent orders to disperse.
Rights to protest are limited in the restricted protest zone around parliament. The Serious Organised Crime and Police Act 2005 made it an offence to take part in a demonstration in this area without prior authorisation (a demonstration could involve a single person). The law was repealed by the Police Reform and Social Responsibility Act 2011, but this new act introduced new controls, prohibiting the use of ‘amplified noise equipment’ and the possession of ‘sleeping equipment’ in Parliament Square. In addition, Greater London Authority bylaws make it an offence to make a speech or hold a demonstration in Parliament Square without having obtained written permission; and new Westminster Council bylaws enable the seizure of ‘sleeping equipment’ and ‘sound equipment’ in a larger area in the vicinity of parliament.
In short, these five zones criminalise perfectly normal and otherwise legal activities – walking a dog, handing out leaflets, protesting, or just hanging around. Because the areas are often unmarked, members of the public do not know when they are entering them and can therefore commit an offence unwittingly. There have been several recent cases of pensioners caught out by no-dog zones they did not know about.
Open-ended powers give officials a broad degree of discretion to decide who should and should not be punished, which amounts to an ability to make up the law as they see fit. Powers tend to be used disproportionately against certain groups who are seen as ‘up to no good’. Homeless people in some parts of London have their alcohol confiscated on an almost daily basis; some groups of young people are constantly dispersed or moved on. Discretionary powers violate the fundamental principle that criminal law should be specific and predictable and should apply equally to everyone.
Worryingly, these banned zones are being enforced not only by police, but also by a growing force of unaccountable officials. There are now hundreds of council officials with powers to fine people for unlicensed leafleting or walking dogs in the wrong area. Several London councils also contract private security companies to patrol the streets and issue fines. Under the Accredited Persons Scheme, the Metropolitan Police has given police powers to 221 civilians, including private security guards, transport employees, and hospital staff. These ‘accredited’ officials can demand people’s name and address, confiscate their alcohol, and issue fines.
Banned in London reveals how ordinary freedoms and legal protections have been suspended in large parts of our towns and cities. This is the first step in a campaign that will challenge such open-ended powers, with the aim of restoring civil rights in public spaces.
Screening of controversial Channel 4 documentary on history of Islam cancelled after presenter is threatened
Channel 4 has been forced to cancel a screening of the controversial documentary Islam: The Untold Story, after the presenter was threatened with physical violence.
Historian Tom Holland received abusive messages on Twitter and warnings he would come to harm because of the film, in which he suggests that Islam is a ‘made-up’ religion.
The programme has already been aired on Channel 4, sparking more than 1,200 complaints, but the broadcaster was planning a screening for ‘opinion formers’ at its London headquarters later this month.
It had hoped to organise a debate around the screening but the whole event has had to be axed because of fears it would be targeted.
Critics have accused Holland of distorting the history of the religion in Islam: The Untold Story.
His investigation into its origins claimed that there is little written contemporary evidence about the prophet Mohammed.
He also suggests the Koran makes little or no reference to Islam’s holy city of Mecca, and argues there is no evidence for the general assertion that Islam began ‘fully formed’ in the 7th century.
Instead Holland says it has developed over the centuries into the religion we know today.
The Islamic Education and Research Academy accused him of making ‘baseless assumptions’ and engaging in ‘selective scholarship’.
Holland received abusive tweets questioning his views on the religion. Some posted physical threats to the Cambridge-educated historian via Twitter, while one called him a ‘fool’ for suggesting Islam is a ‘made-up religion’.
Ofcom – which received 150 of the complaints regarding the programme’s inaccuracy, alleged bias and offence to Muslims – said it was considering launching an investigation.
A Channel 4 spokeswoman said: ‘Having taken security advice, we have reluctantly cancelled a planned screening of the programme Islam: The Untold Story. We remain extremely proud of the film which is still available to view on 4oD.’
Holland, the author of best-sellers Rubicon and Persian Fire, said that Islam is ‘a legitimate subject of historical inquiry’.
Writing on the Channel 4 website after complaints to both the channel and watchdog Ofcom, he said: ‘We were of course aware when making the programme that we were touching deeply held sensitivities and went to every effort to ensure that the moral and civilizational power of Islam was acknowledged in our film, and the perspective of Muslim faith represented, both in the persons of ordinary Bedouin in the desert, and one of the greatest modern scholars of Islam, Seyyed Hossein Nasr.’
Holland was defended by Dr Jenny Taylor who runs the charity Lapido Media, which encourages better understanding and reporting of religion in the media.
‘He’s shown all of us that Islam is interesting enough to be taken seriously. He’s refused to stick his head in the sand and play blind about the problems or internal tensions that all thinking Muslims know are there,’ she said.
‘He’s not trammelled the sacred heart of an ancient mystery but found hints of an even greater and more awesome reality that is tantalisingly beyond our grasp at the moment, but could just be the key to a shared past and shared future.’
Why British happiness survey will probably make us all a little bit glummer
It has already been ridiculed as a waste of money – and patronising to boot. Now David Cameron’s national happiness index may have another charge to answer. The mission might, by its very nature, make us all a little bit less happy.
In research that will no doubt delight critics of the £2million-a-year wellbeing survey, psychologists have suggested that a constant emphasis on positive emotions in society tends to make people miserable.
Mr Cameron introduced the index as an alternative to GDP.
Its first results, published in July, showed the average adult scored 7.4 out of ten for life satisfaction. But that may already have fallen if the latest findings, from psychologists at the University of Queensland in Australia, are anything to go by.
Dr Brock Bastian, who led the study, said: ‘There is plenty of work showing that pursuing happiness as a goal is counter-productive because when we fail to achieve our goals we feel disappointed and this serves to push the goal further away.
‘In short, when people perceive that others think they should feel happy, and not sad, this leads them to feel sad more frequently and intensely.
Government campaigns focusing on happiness need to acknowledge that true happiness is actually found in a mixture of positive and negative emotion.’
The team carried out a series of studies designed to test the idea that high social expectations of happiness have a negative impact on emotional states.
In one study, 122 Australian students and 100 Japanese students were asked how often and how intensely they had felt a range of negative emotions in the past month.
They were also asked to what extent they felt society expected them to be happy. For both sets of students, feeling greater pressure to be happy was linked to ‘reduced satisfaction with life and increased depression’.
The findings were published in the journal Emotion.
Key global warming report was fudged
Peter Lilley, MP in the British Parliament and a former cabinet minister under both Baroness Thatcher and Sir John Major, is an economist by training. He is not a climate skeptic — indeed, he has accepted the fourth assessment of the International Panel on Climate Change (IPCC) as “founded on science” and sound.
He is also an advocate of sound, evidence-based, public policy (as opposed to policy-based public policy) — something one might expect from a former chairman of the right-wing think-tank the Bow Group.
Why then is he so upset? He is upset and highly critical of the way in which a certain kind of “voodoo economics” has been worked to develop public policy on climate change and is especially irked by the work of Baron Stern of Brentford, the IG Patel professor of economics and government, chair of the Grantham Research Institute on Climate Change and the Environment at the London School of Economics, and 2010 professor of Collège de France.
Lilley is not easily irked. What has caught his full ire is his analytic look-back at the Stern Review on the Economics of Climate Change — a 700-page report released for the British government in October 2006. You can see why in his report What is Wrong with Stern? The Failings of the Stern Review, available from the Global Warming Policy Foundation.
His basic concern is that Stern was, at the time, a government-employed economist who was asked by his government to answer a question which was formulated by government. He gave them the answer they were hoping for.
Put simply, Stern suggested that the benefits of radical action on reducing emissions would be around five times the costs. This is not what most economists were saying at the time and even fewer would say this now. Stern used some voodoo to bend the available data to fit the policy. In other words, policy-based evidence.
Lilley identifies six major failings in the Stern review.
* Comparing a part with the whole. Looking at policies adopted to reduce man-made emissions rather than looking at total CO2 emissions coming from all sources. Stern also just looks at accumulated emissions since the industrial revolution, but ignores known evidence of the ability of the earth to absorb emissions. Lilley suggests that this has a major impact on Stern’s conclusions — he is not dealing with the true state of emissions.
* Describing future centuries as “now.” Stern suggests that global warming will cut GDP by five per cent “now and forever.” Yet his own analysis shows that the economic losses due to responding to emissions with the kind of measures he envisaged were below the costs of mitigation, at least in this century.
* Inconsistent cost of discounting of costs and benefits. Stern doesn’t reveal the rates of discount he uses for his calculations in the report itself, but several studies have done so since. He effectively uses the normal market rates to discount the costs of decarbonizing the economy. Lilley suggests that doing so understates the costs of the policies for emissions management by around 2.5 to five times. It is a sleight of hand.
* Cherry Picking Unreliable Studies. Throughout, Stern cites just those studies that suit his argument (policy-based evidence) rather than the range of studies which should inform this case. To give just one example, his evidence on damage to property due to increased storms “caused” by climate change is around 100 times too large if you accept the premise that climate change causes such storms, something the IPCC itself is not convinced of.
* Ignoring adaptation. Industry and communities are very adaptable. Stern ignores this unless it suits his argument. Lilley gives a specific example — Stern cites the case of a crop that, at 4C will produce significantly lower yields (around 70 per cent lower). Yet farmers have the option of switching to a similar crop (different varietal) where yields would rise dramatically under these conditions, a fact Stern chooses not to share in his report.
* Strange ethics. Several studies have shown that, even if we do nothing, people will be richer by 2020 than they are today. Yet Stern is of the view that “global warming threats humanity with extinction or immiseration” – something highly implausible by all analysis of the impact of the current small amount of warming, according to Lilley. Stern suggests anyone who opposes his view of the needed course of action is being “unethical” and threatening future generations. Lilley suggests that this is, basically, bullshit.
Stern was very influential throughout the world, but most especially in Europe. He suggested a crash program of action to curb emissions in the name of saving humanity. But humanity, at least according to science, is not under threat and we are dealing with natural variations and some modest but marginal human impacts, according to Lilley.
But using voodoo economics and policy-based evidence, the economies of the world that adopted the Stern approach have lowered their growth and made energy costs so high that many jobs have been exported to other jurisdictions, thereby increasing climate change risk rather than lowering it. The policies suggested by Stern are unaffordable and are not producing the benefits that Stern said they would.
Lilley is upset with Stern and with the governments who blindly followed his advice. What he now suggests is a more moderate approach to emissions reduction, placing greater emphasis on innovation activities which may speed adaptation and a recognition that developing nations need to increase their energy supplies in the most efficient and effective ways possible.
Lilley’s analysis is thorough and comprehensive as well as well researched and informed. He is not a climate change skeptic, but a realist and a devotee of evidence-based policies. His critique is worth a read.
Late backdown: British Liberal leader concedes that opponents of homosexual marriage are not “bigots”
Was the Bible written by bigots?
Nick Clegg attracted ridicule after hastily attempting to withdraw a press release in which he referred to opponents of gay marriage as ‘bigots’.
The clumsy attempt at news management by the Deputy Prime Minister’s senior press officer brought immediate comparisons to The Thick of It, the spoof BBC Television show about bungling politicians and civil servants.
Mr Clegg’s office had sent out a press release via email at 3pm informing journalists about a reception he is hosting tonight for “celebrity campaigners, religious figures, activists, charities and politicians” to “celebrate the Government’s historic consultation on equal marriage.”
In a hard-hitting speech at the reception, the press release announced, the Liberal Democrat leader would describe opponents of gay marriage as “bigots”. The full quote read: “Continued trouble in the economy gives the bigots a stick to beat us with, as they demand we ‘postpone’ the equalities agenda in order to deal with ‘the things people really care about’. As if pursuing greater equality and fixing the economy simply cannot happen at once.”
As news of the Deputy Prime Minister’s remarks began circulating in Westminister, Mr Clegg’s team clearly had second thoughts about his frank use of words.