Target culture ‘knocks care out of nursing’ says expert as he warns workers are unable to stand up to abuse
A generation of nurses and carers have had their compassion ‘knocked out of them’ by a blindly target-driven workplace culture, an expert has warned.
An obsession with targets and jargon is stifling their innate desire to care for patients and care home residents, Professor Keith Brown said.
The professor, who is in the process of overhauling the training received by Britain’s care professionals, said many workers felt unable to stand up to abuse if they saw others mistreating patients.
He pointed to the example of the abuse scandal at the Winterbourne View private hospital in Bristol, which he said showed how those not perpetrating abuse had found it easier to ‘turn a blind eye’.
He said: ‘The vacuum has been in those situations, people lack a willingness to stand up and be counted and to do the right thing at the right time.
‘That might be because they are afraid, or because of the culture, that if you whistle-blow you will be in trouble, or it might be that they just don’t want the hassle.’
Professor Brown, who is director of the National Centre for Post Qualifying Social Work, added: ‘I think that most people who come into this line of work – whether it is nursing, social care, or in care homes – want to care but somehow it gets knocked out of them.
‘They end up in systems and structures that make them feel anxious or nervous. ‘It might be the pressure of work or the culture of the organisation just setting inappropriate targets where you can measure the measurable but not the qualities of what it feels like.’
Professor Brown told the Daily Telegraph there had been a growth in ‘daft’ targets within the care system.
He said: ‘A lot of the leadership development through the whole sector is based on a business school type ideology, because we haven’t got a clear leadership development framework based on social work or social care principles.
‘Instead of being taught how to care for people, they are being taught how to meet targets.’
He added: ‘Of course you are going to get the odd rogue but the million people involved in social care came in to it for good reasons, we need to switch that back on again. ‘We need to stop it being knocked out of them or crushed so that they don’t exercise it any more.
‘Experience is crushing it but maybe training should give then resilience to stop them being crushed.’
Christian doctors call for ban on NHS ‘bribing’ hospitals to put more patients on controversial death pathway
An influential group of Christian doctors yesterday called for an end to financial ‘bribes’ that encourage hospitals to place dying patients on the controversial Liverpool Care Pathway.
The Christian Medical Fellowship said judgments about whether to withdraw treatment from terminally-ill patients should be made solely on clinical grounds.
The CMF, which represents more than 4,000 doctors, said financial incentives for hospitals to use the system – thought to run at more than £10million a year in total – should be ‘eradicated’ immediately.
It also urged ministers to tighten controls to end the ‘undoubted abuses’ of a system designed to ensure patients die with dignity.
Dr Jeff Stephenson, a Devon-based consultant in palliative care, said the care pathway could help ease suffering if used properly.
But he added: ‘It remains a tool, and it is only as good as those who use it. There is always potential for misuse and abuse and there are undoubtedly instances where this occurs. ‘Where these arise by intention then those involved should be held to account, but more often they occur through poor understanding and inadequate training.
‘We owe it to patients to not only furnish the means to better care, but also to equip adequately those who provide it.’
The LCP was developed in a Liverpool hospital and has been in use across the NHS for the past four years. Payments to hospitals to introduce it are made through a system called Commissioning for Quality and Innovation, which channels money to hospital trusts through NHS ‘commissioners’.
But ministers were forced to launch an independent review of the pathway in November following a public outcry about a string of disturbing cases in which people’s loved ones had their treatment, including food, fluids and medication, withdrawn without their knowledge or consent.
In some cases, patients have survived for months or even years after their relatives fought to have their treatment restored.
In a provocative intervention at the weekend, the Health Secretary Jeremy Hunt appeared to pre-judge his own inquiry by hailing the LCP as a ‘fantastic step forward’ for the dying. Mr Hunt said it should not be ‘discredited’ because of events ‘going wrong in one or two cases’.
But the CMF said a number of urgent steps were needed to restore public confidence in a system used in around 130,000 cases a year.
Hospitals are thought to have been rewarded with an extra £30million over the past three years for increasing their use of the LCP. The CMF said these payments should be ended, with the cash diverted into better training for staff.
It said: ‘Non-clinical priorities in the use of the pathway, especially financial priorities, must be eradicated and every patient treated solely according to their need.’
The organisation also said no patient should be placed on the LCP unless they were ‘imminently dying’.
Assessments should only be made by senior doctors and the decision should be discussed with patients and their families.
Anyone placed on the pathway who shows signs of improvement should be taken off it immediately.
A shocking national audit recently revealed that up to 60,000 people die on the LCP every year without ever being told their treatment is being withdrawn, despite being conscious when doctors make the decision.
The CMF also called for an annual audit of the care pathway to ensure it is being used properly. Cases of abuse should be reported to the appropriate medical body, such as the General Medical Council, for possible disciplinary action.
British school that spent £500,000 giving its pupils iPads admits that HALF are now broken
The old story: What is “free” is not respected
A school which gave out iPads to every pupil in hope of improving their education has admitted that just a year later half the costly devices have been broken.
Honywood Community Science School dished out iPad2 tablets to its 1,200 pupils a year ago, at vast cost to the taxpayer.
Despite warnings that children would not be able to look after the fragile computer tablet, the school in Coggeshall, Essex, allowed children to take the device outside the classroom, playground and street and home at evenings and weekends.
It was hoped that the iPads would be a useful learning tool, as well as keep the school up to pace with international competitors embracing the technology in the classroom.
But after just one year, more than four in ten of the iPads had been sent off for repair, after being knocked, dropped or scratched. Figures obtained under the Freedom of Information Act reveal 489 had to be replaced after being found to be beyond repair. About a fifth of those sent for repair – 112 – had to be sent back more than once.
Pupils said in some of the younger classes, around half the class had broken their tablet at least once, and some as many as three times. Despite the threat of confiscation after three tablets, ultimately none were taken away from pupils.
The school argues that since introducing the devices, it has seen improvements in pupil discipline, attendance, and exam results.
Apple, the manufacturer of iPads, is said to be aggressively targeting the school market and at the time headteachers were accused of ‘falling for a gimmick’.
Honywood, which gained academy status last year, giving it greater control over its budget, gave out the tablets last September, at an estimated cost of £500,000, or £400 per iPad. Parents were asked only to pay £50 towards insuring the device.
At the time headteacher Simon Mason said the investment represented 2.3 per cent of the school’s budget, and did not want to publicise the scheme for fear of putting the safety of pupils at risk.
On the latest figures, he said: ‘The breakage rate resulted from using a recommended case which was insufficiently robust. Since replacing cases this year, breakage has fallen to 1.2 per cent.’
He added: ‘Exam results at the end of our first year of using tablets were the highest in the school’s 48-year history. ‘Attendance has risen and we’ve seen our lowest rate of fixed-term exclusions for ten years.’
Peter Inson, a former school headmaster and a commentator on education, said the breakages were hardly surprising. He said: ‘In my view you cannot expect children of 11 and 12 to be responsible for a delicate gadget.
‘They are still running around using jumpers for goal- posts and being generally rambunctious.’
Handing out equipment without expecting the parents to contribute financially only increases the likelihood of something being lost or damaged, he added.
Matthew Sinclair, of the TaxPayers’ Alliance, said: ‘Buying technology for schools has to be about educational results, not just trying to appear cutting edge for the sake of it.
‘Not many parents would trust their 11-year-old to look after such an expensive piece of kit so it is wrong for the school to do so just because taxpayers are picking up the bill.’
Each NHS trust needs a tsar to tackle obesity crisis, say top British doctors as UK’s fat epidemic shows no sign of slowing
The “leading doctors” concerned are certainly not scientists. Otherwise they would first look for evidence that their proposals would do any good. It’s unlikely, to say the least
An obesity ‘tsar’ should be appointed at every NHS trust to tackle a crisis affecting millions, leading doctors say.
They also want an individual appointed at government level to oversee the new health drive.
A study by The Royal College of Physicians found that the UK is second only to the US for weight problems and the situation is getting worse.
Yet treatment is still ‘inadequate’ adding to the annual £5billion cost of dealing with the issue. The Royal College said two out of three hospitals lack ‘joined-up’ services for patients who are obese or overweight.
Complications the patients face include heart disease, diabetes, arthritis, sleep disorders and gynaecological problems.
The RCP said every NHS trust should have an obesity champion to co-ordinate services and improve staff training.
Nationally, a government appointee should drive an obesity strategy across a number of ministries including health, the Treasury, education and sport.
‘The Government has failed to address this in a joined-up way which is essential if we are to make an impact,’ said the report. The obesity tsar or figurehead could come from the House of Lords and should be politically independent, according to RCP vice-president Professor John Wass.
Monumental deceit: How Britain’s politicians have lied and lied about the true purpose of the European behemoth
By Christopher Booker
Forty years ago today, in what was arguably the most fateful political move ever made by a British Prime Minister, Edward Heath took us into what was then called the ‘Common Market’.
Such a step had scarcely been mentioned at the previous General Election, and the British people had very little idea of what they were letting themselves in for, other than a trading arrangement that might make it easier for us to sell our goods to our Continental neighbours.
Four decades later, the picture could scarcely look more different. We have seen that supposedly cosy club we joined transformed, step by step, into a vast, bloated bureaucratic empire, imposing its suffocating rule over 27 nations.
We have also seen it plunged into the most destructive crisis in its history — one it has brought entirely on itself by its reckless dream of locking the countries of Europe together into the straitjacket of the euro.
During those 40 years the British have never been happy members of this club. Too often we have been out of step, and even bitterly at odds, with the rest — as in our refusal to join that single currency.
But today, as the EU’s inner core of countries drive towards ‘full political union’ in a desperate bid to save their doomed euro, the British now look at this swollen political monster with fearful bemusement.
Politicians of every party talk plaintively about the need for us to negotiate a ‘looser relationship’ with the EU, while opinion polls consistently show a growing majority wanting to leave it altogether — an option that even David Cameron no longer rules out.
Even on the Continent, influential voices are now recognising that something very significant is happening in Britain, as they suggest we should perhaps be allowed something never seen before — a mere ‘associate membership’ of the EU, allowing us to continue trading with it but without all its political superstructure.
How did we come to such a pass? Are we today looking at another historic crossroads, in its own way just as fateful as the one we faced back in 1973?
The real problem the British people have had with the ‘European project’, as its insiders call it, is that they have never really begun to understand its real nature, and what was always intended to be its ultimate goal.
The chief reason for this is that our politicians have never properly explained it to us.
What makes this so much worse is that those who were most enthused by it, such as Heath, knew full well what ‘the project’ was really about — the plan to weld all Europe together under an unprecedented form of super-government.
They deliberately decided to conceal it from us, for fear that our anxieties about our loss of sovereignty might prevent them from being allowed to join.
Ten years ago, with my co-author Richard North, I wrote a comprehensively researched history of the ‘European project’.
I had already been reporting for years on the incredible damage membership of the EU was doing to British life, through thousands of crazy directives and regulations, through the destruction of our proud fishing industry and the undermining of our agriculture, which was until 1973 the most efficient in Europe.
The real story, surprisingly, goes back to the 1920s, when a senior League of Nations official, Frenchman Jean Monnet, first began to dream of building a ‘United States of Europe’, very much on the lines that decades later would shape the European Union as it is today.
After World War II, Monnet, by then the second most powerful man in France, finally set the project on its way. He knew there was no chance of bringing such an astonishingly ambitious vision into being all at once. So his plan was that it should gradually be constructed, piece by stealthy piece, without ever declaring too openly what was intended to be its ultimate goal.
At first it should be presented as just a trading arrangement, the ‘Common Market’ set up in 1957 by the Treaty of Rome. But the essence of that treaty was to create the core institutions of what Monnet always intended should one day be the ‘Government of Europe’.
The idea was to work for ‘ever closer union’. Treaty by treaty, it would take over more powers from national governments, based on the sacred principle that once power to make laws was handed over to Brussels it could never be given back.
Ever more countries would be brought into the net, until the project reached its ultimate goal as a super-government, with its own president and parliament, its own currency and armed forces, its own flag and anthem — all the attributes of a fully-fledged nation state.
Thus, stealthily assembled over decades, would this new ‘country called Europe’ finally take its place on the world stage. What we found most shocking in researching this story was that, when Britain’s leaders first considered joining the project, they were made fully aware of this hidden agenda.
As we see from Cabinet papers and other documents of the early Sixties, Prime Minister Harold Macmillan and his ‘Europe Minister’ Edward Heath were put completely in the picture about the secret ‘grand plan’. But in June 1961 the Cabinet formally agreed that it must not be revealed to the British people.
In Macmillan’s words, to admit ‘the political objectives’ of the Rome Treaty would raise ‘problems of public relations’ so ‘considerable’ that they should be kept under wraps. It was vital to emphasise only the economic advantages of British entry.
Thus did Macmillan and Heath become drawn into complicity with that same web of deceit which was driving the ‘project’ itself (which is why we called our book The Great Deception).
Twice in the Sixties Britain made failed attempts to join the project — but within weeks of Heath entering Downing Street in 1970, he applied to Brussels a third time. Scarcely had negotiations begun than he learned that his future partners were already discussing the next steps along their path to full integration: a single currency, European defence forces, a common foreign policy.
Heath immediately sent word to Brussels pleading for all this to be kept quiet, because it might blow the gaffe with British voters.
For two years the negotiations continued, with Heath handing over all he was asked for, from giving away Britain’s fishing waters, the richest in the world, to become ‘a common European resource’, to the betrayal of our Commonwealth partners by excluding their goods from what had been for many their main export market.
Finally, Heath got what he was after: entry to the club — although he still pretended that the Common Market was little more than a trading arrangement.
On the day we entered, he told the British people on television that any fears that ‘we shall in some way sacrifice independence and sovereignty’ were ‘completely unjustified’.
This was a deliberate lie, as no one knew better than him and the senior Foreign Office official who two years earlier had written a secret paper on ‘Sovereignty’.
The paper chillingly spelled out how it would be the end of the century before the British people woke up to how much of their power to govern themselves and make their own laws had been given away — by which time it would be too late.
So began the dismal story which has been unfolding ever since. Already by the late Seventies, as the Common Market morphed into ‘the European Community’, we were becoming known in Brussels as ‘the awkward partner’.
Then came Mrs Thatcher’s five-year battle to win that rebate on our payments into the EU budget which, thanks to the ludicrously lop-sided conditions accepted by Heath, would have made us the largest single contributor by 1985.
In 1986 came the treaty called the Single European Act, which not only set up the Single Market but handed over to Brussels all sorts of other powers, including environmental laws which were to lead to everything from the shambles of our rubbish collections to building thousands of hated and useless wind turbines.
In 1990, nothing did more to inspire hostility to Mrs Thatcher among her European colleagues, led by Jacques Delors, than her defiant opposition to the Maastricht Treaty, designed to create the European Union, introduce the ‘social chapter’ and, above all, to launch the single currency.
As soon as he replaced her, John Major proclaimed his wish for Britain to be ‘at the heart of Europe’ and signed the Maastricht Treaty (admittedly with those vital opt-outs for Britain on the single currency and the social chapter).
But seven years later he ended up more at odds with his partners than ever, as they imposed their worldwide ban on the export of all British beef products over ‘mad cow disease’, tried to sneak us into the social chapter under ‘health and safety’ rules and laid their plans for yet another integrationist treaty in Amsterdam.
Tony Blair, too, wanted to be ‘at the heart of Europe’, as the single currency approached (which he would love to have joined), signing us up to the social chapter with its damaging working-time rules, and two more treaties, at Amsterdam and Nice.
But he too found it hard to keep up with that relentless drive for ever closer union, as it led to seven years of tortuous negotiation to create ‘A Constitution for Europe’, eventually sabotaged by the voters of France and Holland, so that it had to be smuggled in by deceit as the Lisbon Treaty (which, among much else, incorporated the Court of Human Rights into the EU).
Scarcely was the ink dry on Prime Minister Gordon Brown’s signature on that treaty than the EU was plunged into its worst-ever crisis over the euro, which today is spreading misery across southern Europe.
As always, the response of the EU’s leaders has been to call for yet ‘more Europe’, and a new treaty to force the eurozone members into ‘full political union’.
This is now leaving Britain more obviously marginalised than ever, condemned to remain in the outer ring of a club, many members of which would now be only too pleased to see the back of us.
This humiliating prospect has seen our politicians running around like bewildered sheep, bleating about the need for Britain to negotiate a ‘looser relationship’ with the EU, to get back to that trading arrangement we thought we were entering 40 years ago.
Astonishingly, this is now even being echoed as a possibility by those influential voices in Europe itself — even though the most fundamental rule of the club we joined back then was that, once powers are passed to Brussels, they can never be given back.
As David Cameron prepares to give that ‘very important speech on Europe’ he has promised us very soon, he could not do better than to meditate on the shrewdest words ever uttered by a Prime Minister about Britain and Europe. In 1973, as a junior member of Heath’s Cabinet, Margaret Thatcher made all the approved noises about how wonderful it was for Britain to join this club.
Once in office, however, she went on a painful learning curve, as she saw from the inside just what the real game was and how ruthlessly it was played. She was brought down in 1990 by an alliance of Europhiles in her party and their Brussels allies, because she was the last real obstacle to their Maastricht Treaty.
What really riled them was that she had seen through their true agenda and the disastrous course on which they were set.
With even Jacques Delors, the chief architect of Maastricht, suggesting it might be best for Britain to leave the EU, Mr Cameron should dwell on a passage from her last book, Statecraft.
‘That such an unnecessary and irrational project as building a European super-state was ever embarked on,’ wrote Lady Thatcher, ‘will seem in future years to be perhaps the greatest folly of the modern era. And that Britain . . . should ever have become part of it will appear a political error of the first magnitude.’
If Mr Cameron truly wishes to speak for the British people and our country’s future, he should bear those prophetic thoughts in mind.
British Town hall staff pay in only a QUARTER of the cost of their pensions while taxpayers fork out £6billion a year
Council workers paid in only £1 for every £4 paid out in town hall pensions last year. Nearly £6billion of the £8billion cost of the scheme came from taxpayers, an official report has found. Council workers stumped up just £1.8billion.
The research undermines claims that the public employees deserve special treatment because they pay for their own retirement benefits in a sustainable manner.
The generous final salary pensions – now largely denied to workers in private businesses – are enjoyed by council workers from bin men and canteen staff to social workers and planning officials.
The cost of town hall pensions to the public is equivalent to £386 a year for every household paying the benchmark Band D council tax.
Details of council pension costs came as Communities Secretary Eric Pickles prepared to finalise a deal with unions to try to rein in pensions spending.
Unions agreed in the summer to a new scale that will pay benefits based on career average rather than final salaries.
This will also gradually see the town hall pension age pushed up to 68 in line with the state pension age.
Brandon Lewis, a Tory local government minister, said: ‘Under the last administration, the cost of town hall pensions trebled.
‘Town hall pensions were costing over £300 a year to every family and pensioner paying council tax, diverting funds from emptying bins, cleaning the streets and keeping council tax down. Hard-pressed taxpayers simply could not afford to foot an ever-growing bill.
‘This is why this Government is taking action to reduce the massive and unsustainable cost of state sector pensions, and for the first year, the cost of town hall pensions has actually fallen.’
In 1997 the price to taxpayers of town hall pensions came to just over £1.5billion, less than a quarter of this year’s bill.
Only ten years ago the contributions of employees covered almost half the full cost of their payouts.
The latest accounts show some of the reasons why the cost to taxpayers has been rising so steeply.
The scheme paid out £7.5billion to pensioners in the year that ended in March, 12 per cent up on the benefits paid in the previous year.
But the contributions paid by town hall workers dropped from £1.966billion to £1.839billion, largely because there were fewer staff.
The number of workers on the scheme fell by 66,000 during the year, partly because of 27,500 redundancies, and the number of scheme members fell below 1.6million.
A report released last July revealed that nearly one million former council staff were drawing pensions.
The situation was described as ‘a ticking financial time bomb’ by the Taxpayers’ Alliance, which commissioned the study.
The group’s Matthew Sinclair said at the time: ‘The local government pension scheme faces a bleak future. Unions and councils need to be realistic.’
Union leaders insisted the scheme was ‘viable and strong’.
Anti-Semitism in the UK is on the rise again
A report published this week by the Community Security Trust (CST) shows that anti-Semitic incidents in the UK have risen in the months January- June 2012, compared with last year’s figures.
In the first six months of this year, 513 potential incidents of anti-Semitism were reported to the CST; of which the CST deemed 299 cases to be anti-Semitic.
In comparison to 2010 figures, evidence from the report suggest two opposing trends; an increase in reported incidents in London and similarly a large fall in the number of incident reports in Greater Manchester.
Figures suggest that anti-Semitism across the capital is heavily on the rise, a total of 148 incidents were recorded by the CST in the first half of 2012, a 48 percent increase when compared to 2011 figures (100).
In terms of monthly incidents, March 2012 saw a significant rise in anti-Semitic incidents with a total of 73 cases being recorded by the CST. According to the report, the ‘total appears to have beeninfluenced by the reactions to the terrorist shooting at the Ozar Hatorah Jewish School in Toulouse, France’. Two –thirds (49) of incidents were reported on or after 19 March 2012 and may have reflected ‘a greater motivation on the part of British Jews to report anti-Semitic incidents’.
Breakdown of incident categories:
In the first half of 2012, CST recorded 33 violent anti-Semitic assaults, one of which was so serious it was classified as extreme violence – meaning it posed a threat to life or constituted grievous bodily harm (GBH).
There were 28 incidents of damage and desecration of Jewish property in the first six months of 2012. There has been a rise in the number of direct anti-Semitic threats recorded by the CST (19) in 2012, compared with 15 threat incidents in January to June 2011.
Of the total incidents logged by the CST, the majority fall under the category of abusive behaviour which can range from anti-Semitic graffiti, one-off hate mail, and anti-Semitic verbal abuse.
Abusive behaviour accounts for 217 of the incidents recorded, a massive 10 percent increase from the 197 incidents documented in the first half of 2011. CST identified three incidents of mass-produced or mass-emailed anti-Semitic literature between January-June 2012.
Incident victims for the first half of 2012
– 136 incidents in which victims were random Jewish individuals in public
– 67 incidents involved victims who were visibly Jewish – wore religious or traditional Jewish clothing
– 36 incidents involved abuse shouted at a passing vehicle
– 12 incidents at Jewish Schools
– 11 incidents involved Jewish staff or schoolchildren on their way to or from school
– 7 incidents involved Jewish schoolchildren or staff at non-faith schools
– 14 incidents affecting Jewish academics, students, student unions or other student bodies (nine on campus, five off campus)
– 21 incidents involved synagogues
– 15 incidents targeted synagogues congregates or rabbis on their way to and from prayers
– 5 incidents involved a prominent Jewish individual or public figure
– 2 desecrations of Jewish cemeteries
One of the starkest statistics from the breakdown of victims is the total number of incidents (30) which took place in or around a schooling environment. Does this suggest that a younger generation of Britons are succumbing to racial hatred or discrimination among their peers?
Who are the perpetrators?
Of course while difficult to identify each individual or group guilty of such anti-Semitism within the UK, the CST report did record some statistics based on ethnicity, age and gender.
– In 76 of 299 anti-Semitic incidents – 57 percent were describes as white-north European, 29 percent as South Asian, 13 percent as Arab or north African and 1 was described as black.
– In 139 of 299 anti-Semitic incidents – 79 percent were male perpetrators, 18 percent were female and perpetrators in four incidents were mixed groups of males and females
– In 118 of 299 anti-Semitic incidents – 63 percent were adults, 35 percent were describes as minors and three incidents of mixed groups of adults and minors.