The reality of childbirth on the NHS
Code Amber means we’re running out of room; Code Red, and there’s no room at the inn. I’m back on nights at a big London hospital. It’s mid-September and we’re Red. The first thing I look at is the rota. Who else is on? Will they muck in? Are they agency staff, who are expensive and often don’t know where anything is? And the most basic question of all: are there any delivery packs, with swabs, scissors, cord clamps? If not, we’re in trouble.
Tonight, it’s a good team and it needs to be.
The antenatal ward, my responsibility for the next 12 hours, is packed. Postnatal ward is full. The labour ward is rammed. All the festive alcohol at Christmas and New Year means an annual wave of new babies in the autumn, and the deluge is upon us. We have six women in early labour, most of them already have children and may give birth quickly. They all need beds and, more importantly, one-to-one care.
A woman in her late 20s is hooked up to a fetal heart monitor and we notice that the heart rate is dipping, dipping, dipping. There are no doctors here, so we page. All three theatres are open tonight; no one responds. We may have a bad outcome on our hands – serious brain injury, maybe even death – unless we do something. After 20 minutes, I run downstairs to get a doctor myself.
When I get there, the labour ward is Armageddon. Doctors and midwives running in the corridors, trolleys clattering, emergency buzzers going off.
Then, a Brazilian woman walks in supported by her husband. When she removes her trousers, the baby’s head is visible.
She’s never been to our hospital before – in fact, she’d planned to have her baby elsewhere – but they got on the wrong bus in panic and it just happened to stop outside our hospital.
The baby arrives; mother and baby are fine. I say fine. At this point, we have no idea of her HIV status or blood group. We’re supposed to be on top of all these things. But often we’re not.
I get back up to the antenatal ward at 2am to find Julia, one of our early labourers, is now delivering her baby on the bed, in the middle of a four-bedded bay. I grab one of our two remaining delivery packs and help her as the baby is born noisily, quickly and – thankfully – safely.
Julia sustains a second-degree tear, which will need to be stitched, on the wrong sort of bed (this is not a delivery suite) in barely adequate light. The other women in the bay cope stoically. But the two women pregnant with their first babies are shocked. It’s a far cry from what they’ve been led to expect.
At 6.30am, the buzzer goes again. Keren, a young woman who lives near the hospital, is pushing uncontrollably. She is fully dilated, the baby’s head is advancing fast.
A colleague joins me. There’s one delivery pack left. Despite knowing the answer, I phone the labour ward to be told that there are no beds free, so it’s down to us.
Keren is 17 and she’s extremely frightened. Her two friends are by her bed and so are the remains of a recent KFC.
Faced with a girl I’ve barely met, I try to calm her, persuade her to trust us when we tell her not to push, to ‘breathe’ the baby out. It seems to work.
While her friends text furiously on their BlackBerrys – and again, in the middle of a fully occupied four-bedded bay – she gives birth to her first baby.
We shouldn’t be doing this, delivering babies on wards, with little or no privacy for the mothers, let alone no one-to-one care in labour – but we are. It’s unavoidable; if a baby’s going to arrive quickly, there’s not much we can do.
It’s better than delivering a child in the lift, which I’ve done on more than one occasion. Often, there’s simply no room, or too few staff on our labour ward.
The baby’s fine, but now Keren is bleeding. The trickle of blood turns into a gush. We call for help, and I shout to the healthcare assistant to page the doctor. The friends are freaking out. We’re on autopilot now, and within minutes Keren has two intravenous (IV) lines in her hands. A doctor arrives. Keren has fluids, some medication and the bleeding stops.
It’s 7.30am and the traffic is roaring past outside. I started my shift 12 hours ago, and I’ve forgotten to eat, drink or go to the toilet. But there is paperwork to be completed, and lots of it.
I sit with Keren in her room while she breastfeeds her baby and try to write a clear account of events in her notes. My hands are shaking as I drink one, then another cup of coffee. It’s nearly 10am by the time I escape.
The following night, I’m back for more. This time I’m on the postnatal ward, full of exhausted new mothers sleeping in bays of four, cots at their bedside. For once, it’s quiet. I’m looking forward to a rare break. It’s 3.30am. After last night, I need sleep.
Cue the sound of a young first-time mother in bed 19 close to our desk, shouting incoherently at the other babies in the ward to be quiet.
I offer her a cup of tea. But once we’re in the office, she loses it, swearing, shouting that no one understands. She picks up a large folder from the desk and hurls it at the wall. A coffee mug lies in pieces on the floor.
Thirty-five women, now wide awake, peer out from behind their curtains. Some emerge, wheeling their babies in cots, to see what’s going on.
The mother is completely out of control, screaming abuse – and heading straight for her baby. A fellow midwife steps deftly in her way, which is brave of her, and I call security.
We’re trying to raise the psychiatrist, who tells me she’s stuck in A&E with a suspected schizophrenic. When she arrives, we get a hasty diagnosis of puerperal psychosis – a severe form of postnatal depression – before her pager goes again and she runs back to A&E.
With medication, the mother calms down, but for the rest of the shift we’re running on adrenaline. We don’t know where this poor woman is from.
This is a maternity ward, not a psychiatric unit. She will be a guest of the postnatal ward for another week, with a firm diagnosis of full-on psychosis.
We’ve all seen programmes such as Call The Midwife on BBC1 and Channel 4’s One Born Every Minute. We don’t talk about them much at work because they bear no relation to what we go through.
Call The Midwife makes me smile even if it’s for the wrong reasons: a show where a missing bicycle is a crisis! At least, for all its rose-tinted nostalgia, it depicts a time when midwives knew the women they cared for. The close relationship between midwife and mother produced a level of individual care that policy-makers can only dream of now.
Despite appearances, One Born Every Minute – a popular ‘structured reality’ account of life in an NHS maternity unit – is just as removed from our daily reality.
Seeing the midwives sitting down for a staff-room chat with cakes and steaming mugs of tea, is a far cry from our working lives on the ward, in which we are often on our feet for 12 hours without a break. Or with a snatched 30 minutes at 5pm. Since when was lunch at 5pm?
We often joke that if One Born Every Minute came to our unit, they’d get the shock of their lives. I don’t think the television cameras could move fast enough.
The facts paint an altogether more worrying picture than the moving image on TV. The Royal College Of Midwives (RCM) says we are short of more than 5,000 full-time midwives around the country. One in 20 posts are unfilled. London has particular problems. Recent research shows that more than 100 mothers have died in childbirth in the capital in the past five years, twice the rate of the rest of the country. London’s maternal death rate has doubled since 2005, from 11 deaths in 2005-06 to 29 in 2010-11.
Ministers have promised to spend £25 million on new maternity facilities around the country. They will be needed: England is just at the start of the biggest baby boom in 40 years. This year alone we’re expecting more than 700,000 new lives.
Even as it stands, nine out of ten midwives say they can’t give the care they need. Government figures say that one in four hospital trusts is failing to provide adequate quality or safety of care to mothers and new-born babies. If this carries on, the consequences could be dire.
Last month, Cathy Warwick, chief executive of the RCM, said: ‘NHS maternity services, especially in England, are on a knife-edge. We have carried shortages for years, but with the number of births going up and up and up. I really believe we are at the limit of what maternity services can safely deliver.’
Our managers tell us we’re fully staffed, but even they admit that’s questionable.
Terminally ill woman not consulted before ‘do not resuscitate’ notice was placed on her medical records, judge rules
Doctors placed a do not resuscitate order on a patient’s notes without her knowledge or consent, a High Court judge said yesterday.
Grandmother Janet Tracey, 63, had terminal lung cancer when she was admitted to hospital with a fractured neck following a serious car accident.
Despite her poor prognosis, her family say she ‘wanted to have every minute of every day’ and told doctors she wanted to be included in conversations about her care.
So she was ‘distressed’ to discover in March last year that a Do Not Attempt Cardio-Pulmonary Resuscitation (DNA-CPR) order had been placed on her notes.
When Mrs Tracey objected, it was cancelled by staff at Addenbrooke’s Hospital, in Cambridge, only to be reinstated three days later. Mrs Tracey died two days after the second notice was issued.
Yesterday, Judge Nicola Davies said she did not accept the evidence of Dr Andrea Lavinio, a consultant on the neuro-critical care unit, that he had discussed the first order with Mrs Tracey but forgot to record it in her medical notes
In written findings, she said: ‘There is nothing in the records which suggests any agreement to DNA-CPR by Mrs Tracey.’
She said Dr Lavinio may have kept Mrs Tracey in the dark to ‘spare her a conversation which he knew was likely to cause distress to a suffering patient’.
But the findings will reignite the debate over whether patients have the right to decide whether they are resuscitated, or whether the doctor always knows best.
Clinicians are not required by law to gain the consent of patients, but hospital policy states they should discuss it where possible.
The Tracey family claim their mother’s human rights were breached and that Cambridgeshire University Hospitals NHS Foundation Trust acted unlawfully when they ignored her wishes.
They will find out tomorrow whether the case can proceed to a judicial review, where they can challenge the trust’s policy and the national guidelines set down by the Secretary of State for Health.
The family’s QC, Philip Havers, told London’s High Court: ‘When the case is a matter of life or death, it is not good enough for a trust to have a policy that is confusing. ‘There is a real problem out there and this is not a hypothetical or academic issue.’
Judge Davies said: ‘Amongst clinicians responsible for the care of Mrs Tracey, there was unanimity: a DNA-CPR order was appropriate in order to protect her from an undignified and cruel procedure which was of no clinical benefit.’
Mrs Tracey’s four daughters, including Alison Noeland who attended court yesterday, say they were given graphic accounts of resuscitation to pressure them to agree to a second DNA-CPR.
Daughter Kate Master told the hearing: ‘They said they would jump up and down on mum’s chest. ‘They would burn her with electrodes, they would break her ribs that weren’t already broken.’
Lord Faulks QC, speaking on behalf of the hospital, said: ‘Whether or not to give CPR in circumstances like this is a matter for the clinicians, ultimately.’
Sunday lunch with family boosts childrens’ fruit and vegetable consumption: study
Mothers do seem to have strong convictions in favour of the consumption of “greens” so I have no doubt that this is generally true
Families should eat Sunday lunch together, researchers have said, after finding that children who ate with their parents just once a week consume more fruit and vegetables.
Researchers found that children who ate with their parents at least once a week consumed more than one extra portion of fruit and vegetables when compared with those who never ate as a family.
It is thought that parents and siblings setting an example and making mealtimes a social occasion encouraged children to eat more healthily.
Cutting up fruit and vegetables for children, and parents who consume a healthy diet also boosted the intake of children, it was found.
A study of 2,300 primary school children in deprived areas of London found that more than six in ten do not eat the recommended five portions of different fruit and vegetables a day, a total of around 400g.
The findings by Leeds University were published in the in the British Medical Journal’s Journal of Epidemiology & Community Health.
Children who ate a family meal together at a table every day consumed 125g or 1.5 more portions of fruit and vegetables on average than children who never ate with their families.
Even those who reported eating together only once or twice a week consumed 95g or 1.2 more portions than those who never ate together.
Professor Janet Cade, of the University’s School of Food Science and Nutrition, who supervised the study, said: “Even if it’s just one family meal a week, when children eat together with parents or older siblings they learn about eating.
“Watching the way their parents or siblings eat and the different types of food they eat is pivotal in creating their own food habits and preferences.
“There are more benefits to having a family meal together than just the family’s health. They provide conversational time for families, incentives to plan a meal, and an ideal environment for parents to model good manners and behaviour.”
PhD student, Meaghan Christian, who conducted the study, said: “Modern life often prevents the whole family from sitting round the dinner table, but this research shows that even just Sunday lunch round the table can help improve the diets of our families.
“Since dietary habits are established in childhood, the importance of promoting the family meal needs to be more prominent in public health campaigns.
“Future work could be aimed at improving parental intake or encouraging parents to cut up or buy snack-sized fruit and vegetables.”
It is estimated that one in ten children in the UK aged 2-10 is obese. In the last four years the Department of Health has spent over £3.3million on the 5 A Day campaign and a further £75 million on the Change4Life campaign, designed to encourage families to improve their lifestyle through diet and exercise.
Politically incorrect childcare did the trick
A good and happy little boy now. The father was wised up by his own mother
If someone had told me before my son was born that I would find myself bolting him in his room at night, let alone issuing an ultimatum to my partner that I would move out if she didn’t agree, I never would have believed them. I would have found it abhorrent.
I am aware that admitting to this is breaking a major parenting taboo and I fully expect to be vilified. But, before anyone judges me, perhaps they should read my story.
For the previous six exhausting months, Sonny, then three, had refused to stay in bed for more than a few minutes at a time, even in the middle of the night. We’d been to doctor, read endless books, and taken counsel from parents and friends.
Everything had failed. We had failed. Truly, we were at breaking point. It’s no exaggeration to say we were on the brink of losing our relationship, health and sanity. A child refusing to stay put at night sounds so harmless, until you’ve experienced it. Take the night that precipitated my ultimatum. Diana had got up and put Sonny back to bed 37 times, but every single time he got up, opened his bedroom door and came out.
‘I spent hours visiting parenting websites and discovered that the topic is one of the most contentious and emotive in all of parenting’
Finally, Diana collapsed on the landing floor, holding Sonny’s door handle shut as he screamed and pulled and twisted at it from inside.
I knelt beside her and held her as we both sobbed. It was by far the lowest point in our experience of parenthood. If I could have pressed a button and made Sonny go away, at that moment I would have. I hated myself for thinking it, but it was the truth.
Desperate, the next morning I gave Diana a choice: ‘I cannot live like this any more. Either we put a lock on his door, or I am moving out into a hotel.’
Reluctantly, she agreed. Exhausted from months of fractured sleep and on the verge of separation, we had reached rock bottom. We were constantly ill with flu, and a few days previously I’d fallen asleep in a meeting as I tried to close a £1 million deal to launch a website.
It was worse than when Sonny was a newborn and woke every couple of hours. At least then a feed, change or comfort achieved something positive.
Sonny was two-and-a-half when his desire to escape his cot became a serious issue. He is tall and strong for his age, and mastered the art of climbing over the bars.
At first, zipping him into a toddler’s sleeping bag acted as a humane restraint, as it meant he couldn’t get his leg on to the top rung. But he soon worked out how to unzip the bag and extricate himself. Then, one morning shortly before his third birthday, we were woken by the sound of him crashing to the floor. In an attempt to get out, he’d fallen over the side — and we knew it was time for his first proper bed.
But that’s when the trouble really started. At bedtime, Sonny would charge out of bed as we tried to leave his room, yanking the rattly door handle and opening the door.
At first, when we heard the rattling sound one of us would patiently lead him back to bed, then kiss and cuddle him back to sleep.
But he became clingy, and would go berserk when we tried to leave, waking at the tiniest movement. He’d scream until we came back, or wander downstairs to find us.
This would happen five or six times before he fell asleep. It made evening relaxation time impossible.
When we crept past his room to bed, our nerves already frazzled, Sonny would wake at the tiniest squeak of a floorboard, and the agonising process would start again.
After maybe another hour of repeatedly putting him back to bed he would fall asleep, only to wake in the night and repeat the entire performance.
Then, in June this year, my mum came straight out with it. ‘Take his door handle off and put a lock on the outside of his door,’ she said. ‘He’ll soon learn he can’t get out and stay in bed.
‘I locked you in your room. You wouldn’t stop wandering into our room. Everybody did it back then. And it worked.’
This was the first I’d heard of it, yet, amazingly, when I asked around I discovered other family members had done it with their children, too. I was shocked, but I could see the logic. Diana, however, was resolutely against. ‘It’s cruel and might traumatise him,’ she said. ‘It’s not fair.’ ‘Not fair?’ I replied. ‘On who? We haven’t slept in months. We’re ill and argue all the time. Besides, he won’t even remember it.’
Other parents we know were effectively locking their children in their rooms anyway, because higher door handles were out of their child’s reach. Yet even they smarted at the suggestion I bolt Sonny’s door from the outside.
Even among professionals, the technique prompts strong feelings. Clinical child psychologist Dr Angharad Rudkin is vehemently against the practice.
Three months later, however, came the night when Diana and I broke down. It took me threatening to move out before she agreed to a trial period of locking his door for one week.
Removing the handle and drilling the holes in Sonny’s doorframe to fit the small sliding bolt I’d removed from our loo door was a dark moment. The noise it made as it clunked shut ran against every positive sense of nurturing.
The first night was an utter nightmare. We put him to bed as usual, but as we hurried out and I bolted the door, his cry of ‘No, no!’ was followed by him thundering across the room and hammering his fists on the inside of the door.
We’d left a blanket and pillow just inside, as people had recommended. He was fed, watered, warm and had a fresh nappy. There was nothing more we could do; comforting him would only prolong the agony. Yet still we felt like prison wardens.
Sonny cried his lungs out for three solid hours, a hideous, guttural sound that haunts me to this day. In the morning, he was curled up asleep by the door.
When I dropped him at nursery, Sonny was like a zombie, and when I collected him that evening, a concerned carer took me to one side and asked if everything was ok at home. Apparently Sonny had fallen asleep face-first in his lunch. His voice was hoarse.
‘Oh, he just had a bad night,’ I stammered, but was filled was a terrible sense of shame. I felt cruel and heartless — but I also felt that we had to hold our nerve. After all, this was our last hope.
Things improved slightly on the second night. Sonny cried for an hour, but didn’t batter at the door, nor did he wake in the night. And, on the third night, he finally stayed in bed and slept through. The message had got through: there was no point trying to escape.
Miraculously, it had worked. Six months of misery had ended in three nights.
We had our first full night’s sleep in half a year, and immediately felt energised and happier. Sonny was brighter and more alert.
The bolt stayed on. Five months later and Sonny is now three-and-a-half. He still occasionally wakes at 5am, but has everything he wants in his room to entertain him, plus a potty, so he merrily plays away until we go in at 7am.
The whole painful process has transformed our lives. All three of us are well rested, and we all get on better.
I still feel uncomfortable about what I did, but really my only regret is that we didn’t do it six months earlier. It could have saved so much heartache.
Bonfire of red tape to liberate small firms in fresh crackdown on council and quango jobsworths
Council and quango jobsworths who regulate small businesses face a ‘bonfire of excessive red tape’ in a fresh crackdown on their box-ticking culture.
Ministers want to prevent regulators from needlessly burdening businesses and stifling economic growth.
They will tell the ‘men with clipboards’ to use common sense before intervening, and are planning a dramatic overhaul of their guidelines.
In the future, regulators will be forced to consider whether their actions will impinge on a business’s ability to grow and be productive.
The move, ordered by Business Minister Michael Fallon, may be viewed with some scepticism among business leaders, as it is the latest in a long line of desperate attempts to get heavy-handed overseers off the backs of small and medium-sized enterprises.
But Mr Fallon is determined to make a difference. He said: ‘We have started a bonfire of excessive red tape, but I know that it is just as important that we look at the way that regulations are enforced.
‘There is room for far more effective enforcement which reduces the burden on businesses which stick to the rules.’
Last week Chancellor George Osborne set out a ‘package of measures’ to tackle systemic problems in the way that regulations are enforced by over-zealous officials. These included forcing regulators to take into account the potential economic impact of their actions before intervening.
In one example, the owner of a factory producing blue cheese was told by his council that he could not have mould on his produce.
Yesterday the Government also promised to overhaul the appeals process.
At the moment, if a decision is made against a business or company by its local authority, it has to appeal to the same body that made the judgment in the first place. On top of this, companies have to accept the initial judgment that they were in the wrong before they can appeal, meaning they are forced to appeal against a decision they have accepted.
Businesses also say that they cannot complain openly about their local authority, for fear they will be targeted. Because they have the power to spring surprise inspections, businesses say, local regulators will ‘make their lives hell’ if they are publicly criticised.
Ministers will spend a month reviewing the flaws in the system before proposing changes.
Mr Fallon added that non-financial regulators, such as the Environment Agency and the Health and Safety Executive, will face a much tougher regime to cut out ‘crazy’ rulings.
About 60 non-financial regulators, as well as local councils across England and Wales, will be hit by Mr Fallon’s changes.
Cabinet Office Minister Francis Maude has previously said that the Government’s ‘bonfire of the quangos’ – designed to cut down on state-backed organisations which sprung up during New Labour’s period in office – would save taxpayers £2.6billion by 2016.
But the figures have been called into question by MPs on the Public Accounts Committee, who say shutting down government organisations incurs massive costs.
Dr Adam Marshall, from the British Chambers of Commerce, said: ‘The Government does deserve some credit for slowing down the flow of new regulation.’
He added: ‘But only now are they starting to tackle the mountain of existing regulation that many businesses face.’
Alien nation: The new census reveals a Britain that would be unrecognisable even to our grandparents
The future will be another country. They will do things differently there
The Census is not just a description of the state of things on a day in 2011, it is a prophetic document telling us where we are going, whether we like it or not. I don’t.
For the past 60 years or so, we have lived in a nation that was more or less familiar to anyone who had grown up in the pre-war Britain of 1939. Even the devastation of conflict had not transformed it out of recognition.
People behaved, thought, worked, laughed and enjoyed themselves much as they had done for decades. They lived in the same sorts of families in the same kind of houses. Their children went to the same kinds of schools. And they had grown up in a land that was still identifiably the same as their grandparents had known.
And so it went back for centuries.
As recently as 1949, the prices of most goods were roughly the same, and expressed in the same money, as the prices of 1649.
A short-distance time-traveller between 1912 and 2012 might be perplexed and astonished, but he would not be lost.
That period is now coming to an end. I suspect that anyone in Britain, travelling between 2012 and 2112 would be unable to believe that he was in the same place.
What is the most significant single fact in the Census? I do not think there is one. Several are shocking or disturbing, if you are not fond of change, and delightful if you are.
But there are some, which taken together, prophesy a transformation to come.
Look at these – manufacturing is now only the fourth-biggest employer, after supplying and selling goods and services, health and social work and education.
So, in the nation that was once the ‘Workshop of the World’, we now have more teachers than industrial workers.
London is rapidly becoming a separate nation, as different from England as Scotland or Wales are, with indigenous British people now in a minority, in some areas a very small minority indeed, and incidentally with extremes of wealth and poverty not known since Edwardian times.
Then of course there is the decline in Christianity, down by four million, from 72 per cent to 59 per cent; the growth in indifference to religion, with non-believers almost doubling to 14.1 million; and also of Islam, rising so fast that one British resident in 20 is now a Muslim.
The Muslim population is young, and keen on large families, while the Christian population tends to be older and less likely to have children.
This is very much a work in progress, far from complete. A lot of nominal Christians are no longer bothering to pretend to a faith they have never cared much about.
Do not be surprised if, in ten years, the gap between the number of professing Christians and the number of Muslims has grown much smaller.
The secularists, who have so enthusiastically sought to drive Christianity out of British life, may realise with a gulp of apprehension that they have only created a vacancy for Islam – a faith that is not at all troubled by Richard Dawkins.
Perhaps most significant of all is the accelerating disappearance of marriage as the normal state of life for grown-up people.
For the first time, fewer than half of adults are married.
This means many things – a greater number of fatherless households, a greater number of cohabiting couples, the rapid disappearance of what was once a strong social force.
Since the stable married family is a fortress of private life and individuality, its retreat will mean the opposite of that: more state interference and surveillance, more conformism – and more conformists – and mass culture. Its main effect will be on the children.
Many of them will grow up outside what used to be normal, a lifelong two-parent home.
They will, as a result, be different sorts of people. Already, almost half of Britain’s 15-year-olds do not live with their ‘birth parents’; 300,000 sets of parents split each year.
I cannot believe this is not part of the reason for the so-called ‘riots’ of 2011, in which young men brought up without male authority ran wild.
These were equal-opportunity events, and their causes were home-grown, not imported. This will get much, much worse.
Again, conservatives will find this worrying and ill-omened. Liberal ‘progressives’, who have never had much time for the married family, seeing it as a sort of prison, will view it as a liberation.
Edmund Leach, giving his influential Reith Lectures in 1967, put it this way: ‘Far from being the basis of the good society, the family, with its narrow privacy and tawdry secrets, is the source of all our discontents.’
It is striking that just as homosexuals seem to be most enthusiastic about getting married, heterosexuals are tiring of the whole thing.
But now compare the giant political fuss over same-sex marriage with the numbers of people affected. See just what a tiny proportion of the country is involved.
While the decline of conventional marriage involves many millions, there are 105,000 people in civil partnerships, one-fifth of one per cent of the population, one person in 500.
And that is seven years after they first became available.
I have deliberately left migration to the end. The figures are astonishing, with one in ten people in England and Wales now born abroad, and the rate of increase over the past few years equally astounding – almost half of these new citizens have arrived here since 2001.
And, in a figure that has not attracted the attention it should have, almost three million people live in households where no adults speak English as their first language.
The main significance of this is the speed of it. Even now, official immigration still stands at 180,000 a year. Probably these totals are an underestimate, as illegal migrants tend not to fill in forms.
But the really important fact is that this revolution is the result of a deliberate, planned attempt to change this country for ever, and we have the evidence of this.
On October 23, 2009, a former New Labour official called Andrew Neather wrote an article in the London Evening Standard which was that very rare thing – a genuine revelation of a political secret.
The crucial passage described ‘a major shift from the policy of previous governments’.
It disclosed that a ‘big immigration report was surrounded by an unusual air of both anticipation and secrecy ….. there was a paranoia about it reaching the media ….. Earlier drafts I saw also included a driving political purpose: that mass immigration was the way that the Government was going to make the UK truly multicultural.
‘I remember coming away from some discussions with the clear sense that the policy was intended – even if this wasn’t its main purpose – to rub the Right’s nose in diversity and render their arguments out of date. That seemed to me to be a manoeuvre too far.
‘Ministers were very nervous about the whole thing . . . There was a reluctance elsewhere in Government to discuss what increased immigration would mean, above all for Labour’s core white working-class vote …..
‘Part by accident, part by design, the Government had created its longed-for immigration boom. But Ministers wouldn’t talk about it.’ Why not? Because Labour voters wouldn’t have liked it.
‘While Ministers might have been passionately in favour of a more diverse society, it wasn’t necessarily a debate they wanted to have in working-men’s clubs in Sheffield or Sunderland.’
On Friday the Labour leader, Ed Miliband, was still trying to appeal to working-class voters whose views his metropolitan fat-cat party secretly despises.
While praising immigration to his London audience, he pretended to be concerned about it by admitting there is ‘anxiety’ about the pace of change.
He promised (absurdly, since the EU has controlled our frontiers for many years) that ‘Britain must always control its borders’.
But he then swiftly dismissed the idea – which would be the only hope of future harmony – that migrants should assimilate, saying this was ‘wrong for our country’.
He proclaimed: ‘One Nation doesn’t mean one identity. People can be proudly, patriotically British without abandoning their cultural roots.’
Is this true? In the days when the USA still sought to assimilate its migrants, it certainly didn’t think so. It insisted that they became Americans in every way, and as soon as they could.
Half the point of American state schools was the creation of new young Americans.
Since that policy was abandoned 30 years ago, the USA has in reality ceased to be one country, with large areas speaking Spanish and retaining the customs and cultures of their homes, hostile or chilly to their American fellow citizens, who return the favour.
Any observant person in Britain can see the same process in such cities as Bradford, where multiculturalism has created two solitudes with their backs turned on each other.
Bit by bit, the people of this country are ceasing to have key things in common. They don’t share a religion, or a culture, or a history. Many don’t even share a language.
They don’t eat the same food or watch the same TV stations or have a common sense of humour. They sometimes even disagree about whether to drive on the left. They come from completely different legal and political traditions.
In a strange paradox, many of the new Britons are more socially and morally conservative than their indigenous British neighbours, though their presence here is a sort of revolution in flesh and blood.
Many of the new migrants also have a completely different work ethic, not having grown up in our entitlement-based welfare state – which is why one of their main unspoken functions in Labour’s plan has been to keep wages down by providing a huge pool of cheap and willing unskilled labour.
Without mass immigration, the minimum wage would long ago have had to rise sharply, creating the crisis that all economists predicted when it was introduced.
As it is, we are fast becoming a low-wage, unskilled economy, with overcrowded cities, multi-occupied housing and hopelessly strained medical services, transport and schools.
There is also a widening gap between the rich, who can afford servants again for the first time since the era of Downton Abbey, and the poor, who have to be those servants.
The only way we will be able to sustain this is by becoming steadily cheaper, devaluing our currency through inflation and incidentally destroying the savings and pensions of the thrifty.
That will also kill off the welfare state, whose provisions and payouts will gradually shrink to the point where they are valueless.
We are also becoming a more violent, noisy and unrestrained culture, more drunk, more drugged, more indebted, more rootless and less particular.
There is no sign that any of these developments are stopping, or even slowing. Far from it. They are accelerating. They were meant to.
The secret thinkers at the core of the Blair Government wanted to begin the world over again, at home and abroad, though they never dared to tell us how.
As their mighty, unstoppable project unfolds, Britain as we knew it will disappear, as they hoped it would. At least we know who to blame.