Just one GP for 500,000 patients: The true scale of crisis in out-of-hours NHS cover revealed
Out-of-hours GPs are being left to care on their own for up to half a million patients.
Cost-cutting NHS chiefs are routinely assigning just one family doctor to districts that stretch over hundreds of square miles.
A third of primary care trusts, which manage GP services, have slashed night and weekend spending over the past 12 months.
In Cornwall, some nights have seen one GP looking after 535,000 patients. In Mid Essex just one doctor is in charge of 370,000 between 7pm and 8am.
And after axing one of its two doctors, North East Essex has the same cover for the 325,000 patients on its books.
Stuart Gray, a GP whose father was killed in 2008 by an incompetent locum doctor, said: ‘I am appalled but not surprised.
‘It would appear some trusts really don’t care about patient safety or put it high on their agenda. I fear many PCT managers are driven by their desire to balance the books. This is morally repugnant.
‘Patients are still put at unacceptable risk by apparently negligent practices.’
The standard of out-of-hours care has been under scrutiny since 2004 when a new contract enabled GPs to opt out of evening and weekend duties. Now only one in four works out of hours.
Many trusts have since outsourced the cover to private firms who hire locum – or temporary – doctors to fill the shifts.
Trusts have been found to be employing doctors from overseas without checking they have the necessary skills or can even speak English.
‘I fear many PCT managers are driven by their desire to balance the books. This is morally repugnant’
Stuart Gray, GP whose father was killed by incompetent locum doctor
In 2008, Dr Gray’s pensioner father David, from Cambridgeshire, died after a German doctor, Daniel Ubani, gave him ten times the recommended dose of a painkiller.
It later emerged Ubani had been hired by Take Care Now, a private firm which had not carried out any checks on him.
Using the Freedom of Information Act, the Mail asked every PCT in England a series of questions about out-of-hours cover.
Of the 90 that responded, 35 had slashed their out-of-hours budgets in the past year. The average cut was 10 per cent.
And 11 trusts employed only one doctor at night to cover between 180,000 and 535,000 patients.
Katherine Murphy, chief executive of The Patients Association, said: ‘These stark figures confirm what patients are telling us – it is incredibly difficult to get access to a GP out of hours either to talk by phone or to arrange a home visit.’
A spokesman from Serco, the private firm which runs out-of-hours cover in Cornwall, said there had been a ‘limited’ number of occasions in the past year when just one GP was on call.
‘It is incredibly difficult to get access to a GP out of hours either to talk by phone or to arrange a home visit’
Katherine Murphy, chief executive of The Patients Association
He said Serco now ensured there were at least two GPs on call at night to cover all of the county’s 1,316 square miles. In addition at least five nurses and paramedics are on duty in cars.
Surgeries should provide a separate out-of-hours number and patients can also call NHS Direct. GPs now have to provide care between 8am and 6.30pm only.
Usually locums are based at an out-of-hours clinic for the duration of the night and will only make a handful of home visits to more serious cases.
A Department of Health spokesman said local NHS groups were obliged to ensure high quality care was in place and should take action over any failings.
Homosexual couples should be allowed to marry in church, says British Leftist leader
Ed Miliband last night said gay couples should be allowed to marry in church. The Labour leader backed Government proposals to change the law to allow gays to be married in a register office or other civil ceremony.
But he insisted the reforms should go further by enabling churches and faith groups to conduct ceremonies if they wish to.
Mr Miliband is expected to impose a three-line whip on his MPs – the strongest possible instruction on how to vote – when the Commons decides whether to back gay civil marriages following a consultation by the Home Office.
David Cameron will offer Tories a free vote, as he regards the issue as one of conscience.
The Government is committed to introducing legislation before the next election in 2015 and polls suggest a significant majority of MPs will back a change in the law.
At the moment, it is illegal for gay couples to be married in church. The Home Office intends to keep this ban.
Its consultation paper states: `It would not be legally possible under these proposals for religious organisations to solemnise religious marriages for same-sex couples.’
Gay couples can already enter a civil partnership, which can be carried out in church and gives them many of the rights of marriage.
But many religious leaders fear that if same-sex civil marriages are allowed, gay activists will use human rights laws to force churches to marry them.
In a video recorded for the Out4Marriage campaign, Mr Miliband said:
`Whether you are gay or straight, you should be able to signify your commitment, your love with the term “marriage”.
`Where faith groups want to provide that opportunity for gay couples as well as straight couples, they should be able to do so. Equal marriage is… a sign of us being a modern country.’
Quakers and liberal Jews have suggested they would host services. But many Tories say gay marriages should not be carried out in church.
Transport Secretary Patrick McLoughlin said he was in favour of civil marriage, but added: `Churches should be protected.’
Colin Hart, of the Coalition for Marriage, said: `Poll after poll shows a majority of the public oppose these changes.
Voters have not had the opportunity to have their say and even within the gay community it is not a priority.’ However, Benjamin Cohen, of
Out4Marriage, said: `There are many gay couples of faith and many faith groups that embrace gay people.
`It’s only right for faith groups that wish to conduct same-sex marriages to be allowed to do so.
`We need full marriage equality, not a half-step that continues to deny gay couples the right to marry in churches, synagogues and meeting houses that are happy to accommodate them.’
Betrayed by the PC brigade: How politically correct British police and social workers betrayed underage white victims
For 20 years or more, there has been a shameful silence about the sexual exploitation of young girls in this country. Hundreds of children – some of them still at primary school – have been groomed by street gangs and turned into sex slaves.
And it is still going on today.
When I have written about this subject after investigations in towns and cities in the North of England, I have been reviled as a hater of our immigrant communities in abusive emails, letters and phone calls by those who continue to deny such things are going on.
For there is an uncomfortable truth about this abhorrent crime which we must not flinch from: the majority of girls ensnared by the street gangs are white, while most of the perpetrators come from the Pakistani and South Asian communities.
Of course, the great majority of people from these communities are decent citizens, and people from all races are capable of evil.
But I believe the controversial issue of these street gangs has been swept under the carpet, regarded as a taboo subject by police officers and social workers terrified of being labelled racist in ever more politically correct modern Britain.
Worried parents alerting social services and police about gangs have been ignored. NHS health clinics, treating the girls for sexual diseases, injuries and pregnancies, have sounded the alarm. Yet nothing has been done.
Teachers who reported teenage girls with hangovers and bruises taking constant calls on their mobiles from older men during school hours have been met with a wall of silence from officialdom.
Shockingly, one middle-class father from Rochdale, Greater Manchester, who told social workers that his 15-year-old daughter had been lured into an underage sex ring based at a local kebab shop, was told by them that the girl was making a `lifestyle’ choice to be a prostitute. The social services refused to help the teenager escape.
Meanwhile, the police told the father there was `no prospect’ of convicting the gang members, who drove his daughter to `cash-for-sex’ sessions with scores of Muslim men in rented houses or public car parks all over the North of England.
At the time, despite her parents raising the alarm and subsequent DNA swabs from the girl’s underwear directly linking her to one of the gang, the police did not act and the gang’s members remained free and continued to sexually abuse her – and many other girls in Rochdale – for another two years.
As this father told me just the other day: `The police were scared stiff of being called racist, so for years they didn’t go after these men. `The social workers were just as bad. They were afraid of saying it is a crime against white girls.’
His is not a lone view. Mohammed Shafiq, director of the Lancashire-based Ramadhan Foundation, a charity working for ethnic harmony, has warned: `The police are over-cautious because they fear being branded racist. That is wrong. These gangs of men are criminals, and should be treated as criminals whatever their race.’
But I have discovered that it is not only the police and social workers who turn a blind eye. The very agencies set up to help the girls recover from the abuse are equally reluctant to admit there is a strong racial element to these hideous crimes.
One charity, Risky Business, operating in Rotherham, refused to answer any of my questions on the racial make-up of the men in the sex gangs.
At another, the Coalition for the Removal of Pimping, in Leeds, the chief executive told me: `This is a crime committed by men. We are trying to work in certain communities to change their attitudes to women. I cannot comment on the race of the criminals involved.’
This week, at last, the full truth began to emerge about the cover-up of crimes Scotland Yard estimates have affected 5,000 British-born children, the majority girls.
At least ten towns and cities on both sides of the Pennines have been particularly plagued by the gangs. Their members get rich because they can reap four times as much money trading young girls for sex as they can trading in drugs.
I have established that in the small city of Blackburn alone, at least 385 girls were groomed by men in a recent two-year period. Sheila Taylor, chairwoman of the National Working Group for Sexually Exploited Children and Young People, has told me that this figure will be similar in any other town of the same size in the North of England or the Midlands.
What is most shocking is the fact that a series of new reports show police and social services have missed hundreds of opportunities to protect the child victims.
Yesterday, an official review of sexual exploitation of girls in Rochdale – ordered after the jailing of nine men aged between 22 and 59 for multiple child sex offences in the town – revealed that 50 children, the vast majority aged ten to 17, were identified [by the authorities] five years ago as having `clear links to take-away food businesses and to associated taxi companies’.
The girls, repeatedly raped, were treated by social workers as `wilful’ young teenagers `engaging in consensual sexual activity’.
`When complaints reached the police, their investigations were inadequate,’ the review said.
From South Yorkshire, confidential documents told the same sorry story. A police intelligence report compiled in 2010 says thousands of sexual exploitation crimes against young white and mixed race girls have gone on in the county.
`There is a problem with networks of Muslim offenders both locally and nationally,’ it reported. `This is particularly stressed in Sheffield, even more so in Rotherham, where there appears to be a significant problem with Asian males exploiting young white females.’
Yet local police, social workers and councils ignored the growing crisis.
One white girl in Rotherham, who was sexually abused by one such gang, was – incongruously – offered lessons in Urdu and Punjabi by social services to help get her over her ordeal.
According to the documents, 54 girls in Rotherham were sexually exploited by three brothers from a `British Pakistani’ family. Eighteen of the girls identified one of the brothers as their `boyfriend’, and he had made several of them pregnant.
Three brothers from another `British Pakistani’ family and 41 associates were linked to the sexual abuse of another 61 girls in the same area. Denis MacShane, the local Labour MP, says the serial sexual abuse of young girls should be a wake-up call for the police, local authorities and Britain’s Asian community. He is demanding an independent public inquiry, and blames a `misplaced racial sensitivity’ for the crisis.
So how are such vile crimes taking place in so-called civilised Britain, and why have such gangs been allowed to flourish so they now believe they can act with impunity?
`They are laughing at the police,’ one youth worker in South Yorkshire told me this week. `These men may get called into the police station for a dressing down, but so few are taken to court.
`They now think they are invincible, and, of course, they’re not frightened of accusing the police of racism themselves if things get tricky for them. Then everything is dropped.’
At the heart of the scandal are uncomfortable cultural issues. Many men of Pakistani heritage believe white girls have low morals compared to Muslim girls.
The same youth worker explained to me: `These girls wear what the men call “slags’ clothing” and show too much of their bodies.’
To add to this cultural divide, the men are often in loveless arranged marriages with wives from Pakistan who speak no English. They want to have sex, and a young virgin free of sexual diseases is the perfect victim.
Gang members are often unemployed, so have time to groom girls – luring them into a trap which is nearly always sprung in the same way.
The girl might be out with her friends in the town centre, often on a Saturday afternoon. She is bored, and when a group of smiling men pull up in a flashy car with blaring rap music, she is flattered.
Tanya’s story illustrates their modus operandi. In 2001, Tanya, a 13-year-old, became Britain’s youngest mother after she was coerced into becoming the sex slave of a gang in Yorkshire.
Tanya went to the local secondary school and lived with her single mother in a neat terraced house. At the shops one day, a group of men came up to her. They took her off in their car and plied her with vodka. They gave her a mobile phone to receive calls from them, and bought her gifts and meals.
After a week or two, they said they wanted to have sex with her in return. Frightened of them, she agreed. She became pregnant, but by then she had slept with so many men from the Pakistani community that she did not know who the father was.
DNA tests by police on five of the most likely candidates did not prove paternity. Two of the gang members who were tested confessed to sleeping with Tanya when she was 12. Shockingly, they were never charged with any offence for having sex with an under-age child.
The birth was hushed up, and the gang got off scot-free. The local council and social services department then went to the High Court in London and secured an injunction stopping anyone – including Tanya and her family – ever talking about the matter again. They have never done so.
The terrifying question is just how many other girls like Tanya have been let down by a system that does not dare tell the truth?
Lessons need to be learnt. And they need to be learnt with great urgency.
History is about stories, not facts
The British PM failed David Letterman’s test, but facts alone are a fool’s way to learn our story
‘So, Mr Cameron, where was Magna Carta signed?” There’s no doubt about it: David Letterman was trying to wrong-foot the Prime Minister when he asked this on live television. What the PM should have answered was: “At the bottom. Hah!”
But if someone asked you where the Magna Carta was signed, what would you say? Runnymede? Young readers who are familiar with my Horrible Histories series may come up with a different (and surprising) answer. We’ll come to that later.
First, it’s worth posing this question: what is the point of history tests? If education is about preparing us for “life”, then knowing that Magna Carta was signed at Runnymede doesn’t really pay the gas bill, does it? Knowing that the Battle of Hastings was fought in 1066 doesn’t improve your parenting competence, your ability to cook, your proficiency in driving or any of the other essential skills you need to survive these days.
A Tory politician once snorted at me: “In history teaching, all that matters are facts, facts, facts.” He had no idea that he was echoing Charles Dickens’s Mr Gradgrind in Hard Times: “Now, what I want is, Facts. Teach these boys and girls nothing but Facts. Facts alone are wanted in life.” But Mr Gradgrind is a parody – an appalling, pompous and preposterous dimwit. And I’m afraid that Mr Tory Politician is a very senior one. This gentleman had been a minister for education at the time when the National Curriculum was evolving. Mr Gradgrind is a comical, fictional character; Mr Gradgrind in charge of our schools isn’t funny at all.
Newspapers, too, get hot under the collar about facts. “Only one 18-year-old in 10 can name a single Victorian prime minister,” railed one report recently, though it didn’t explain why knowing dead prime ministers matters. The story quoted an indignant Welsh professor, who blustered: “Levels of ignorance among the young are an outrage that should be intolerable.” He went on: “One student thought Martin Luther was an American civil rights leader!” (He was, but we’ll let that one pass.)
Now David Cameron has been sandbagged by a smug, devious US interviewer. “Who wrote Rule Britannia?” Do you know, and would it qualify you to run the country? I didn’t know till I read the answer. And I have instantly forgotten it. Does that earn me the derision heaped on the PM? He “suffers a history failure”, said one headline yesterday. A failure? He wasn’t even allowed to phone a friend.
I’m not offering Mr Cameron my sympathy – he is well paid to play the buffoon on American TV. The trouble is that the US public will tar you and me with the same brush. “Gee, those Limeys are so ignorant,” they’ll say. (I think they talk like that.) So thanks for nothing, Mr Cameron.
Apart from high-ranking politicians, who needs facts? History teachers today claim to teach “understanding” as well as facts, facts, facts. But understanding of “what”, exactly? When I trained as a professional actor my drama tutor had a mantra. He said: “The aim of drama is to answer one question, and one question alone: why do people behave the way they do?”
For “drama” read “history”. The joy of history is like the joy of reading fiction – stories about people. The way they behaved is a model of how we could behave now.
Here’s an example. At the moment I’m looking into the story of a man called Harry Watts from Sunderland – a forgotten hero who died 100 years ago. Last winter, a fire service crew refused to wade into an icy lake to reach a man because health and safety rules said that they shouldn’t if the water came over their knees.
Harry Watts rescued 40 people from drowning, by jumping into cold and filthy rivers around the world. If I walk by the River Wear tomorrow and see someone struggling in the water, where do I turn to decide what to do? The answer is history. What would Harry Watts have done? History provides role models and prompts the great question, “Who am I?”
Horrible Histories, meanwhile, show how real people behaved under trauma. So the reader can ask, “How would I behave?” and “Who am I?” in a different sense.
Who wrote Rule Britannia? Who cares? He’s dead and it’s a nasty, xenophobic, outdated rant anyway. (A bit like Star Spangled Banner, Mr Letterman. Remind me: who wrote that?)
So: where did King John sign the Magna Carta? Glad you asked. King John didn’t sign the Magna Carta. Historians say he probably couldn’t write – the idle bloke had clerks to do that sort of boring stuff. King John placed his seal on it. On behalf of my fellow immature Britons (my readers) can I just say, “Nurr-nurr, Mr Letterman”?
Greens Shocked: Britain Plans To Build 20 New Gas Power Plants
Energy and Climate Change Secretary Ed Davey has given the clearest indication yet that he expects gas to continue to play a major role in the UK’s energy mix for at least the next two decades, revealing 20 new gas-fired power plants are likely to built over the next few years.
Speaking to the Guardian, Davey said the government was planning 20GW of new gas capacity by 2030, but insisted that the surge in new gas capacity would not crowd out investment in renewables, nor lead to the UK breaking its legally-binding carbon budgets.
“I strongly support more gas, just as I strongly support more renewable energy,” he told the paper. “We need a big expansion of renewable energy and of gas if we are to tackle our climate change challenges.”
The comments come ahead of the expected release of a new national gas strategy this autumn and what is likely to be a tense debate between the Department of Energy and Climate Change (DECC) and the Treasury over whether or not the upcoming Energy Bill includes a decarbonisation target for the electricity sector for 2030.
Chancellor George Osborne has signalled that he is fiercely opposed to the target, arguing that it would discourage investment in new gas capacity. However, the Lib Dem conference this week passed motions supporting the inclusion of the target on the grounds it is deemed necessary to ensure the UK meets its long term carbon targets.
The latest comments will further anger green groups, particularly after the Lib Dem conference signalled that the party was preparing to step up its support for the low carbon economy.
“Green-lighting a whole fleet of new fossil fuel power stations would cause a huge jump in emissions and blow this autumn’s once-in-a-generation opportunity to replace dirty power stations with clean ones,” said Joss Garman, political director of Greenpeace. “Only days ago Ed Davey and Danny Alexander said they were fully committed to achieving completely carbon-free power in the UK by 2030. Nick Clegg can’t afford to make this another ‘sorry’.”