British government faces first walkout by top GPs over controversial A&E cutbacks
Only a bureaucrat would come up with the idea of closing a successful hospital in order to prop up a failing one
Health Secretary Jeremy Hunt faces an unprecedented backlash from GPs who have threatened to quit executive roles over his controversial decision to downgrade a highly successful A&E unit.
In what would be the first walkout of its kind, senior GPs could resign over Mr Hunt’s decision last Thursday to disregard their views and turn Lewisham Hospital’s well-regarded casualty department – where 115,000 patients are treated every year – into ‘a tweaked urgent care centre’.
It means the most seriously ill patients will now be taken to other hospitals in a bid to divert Government money from Lewisham, South-East London, to a neighbouring NHS Trust which is in danger of going bankrupt.
The Minister has refused to answer questions from The Mail on Sunday about his decision and has ‘gone away for the weekend with his family’, according to a spokeswoman.
Mr Hunt has also left behind confusion among doctors and managers as to which services will be left intact at Lewisham, and the threat of a judicial review over his decision.
Seven GPs on the executive board of the local Clinical Commissioning Group (CCG), which represents 170 family doctors in the area, are now said to be ‘considering their position’ after claiming their overwhelming opposition to the proposals were ignored by the Minister.
Dr Helen Tattersfield, chairwoman of Lewisham CCG, said: ‘There’s a view that if we on the CCG board can’t influence something as important as this then how can we expect to influence anything? It’s a definite option for people, including me, to stand down.
‘Mr Hunt has clearly ignored our position and we have not been listened to at any stage. ‘He wouldn’t speak to us, but instead he was hearing from officials from NHS London and the Department of Health who are keen to produce this kind of result across the capital so were determined to make this work.’
Any resignations would prove highly embarrassing and potentially problematic for Mr Hunt because CCGs are set to take over responsibility for commissioning hospital services from Primary Care Trusts in April.
Dr Tattersfield explained: ‘We’ll have an impossible task to control our own budget because we can’t control where our patients will go for hospital treatment any more. I’ve been asked to do a task which is no longer possible. None of us on the board are prepared to lead an organisation into failure.’
Campaigners and Lewisham Council have threatened to launch a judicial review of the decision, supported by Shadow Health Secretary Andy Burnham. He said the doctors and residents of Lewisham had been ‘treated with contempt’.
A spokeswoman for Mr Hunt said it was ‘perfectly legal’ to alter services at the trust. She added: ‘The decision protects the clinical interests of patients in South-East London and helps relieve the burden of historic debt so money can be spent on high quality patient care.’
Only THREE managers in the dock over NHS scandal of up to 1,200 ‘unnecessary’ deaths
Three managers from Mid Staffordshire NHS Trust are to face public disciplinary hearings over their failings during the worst-ever NHS hospital scandal.
It is understood they will be the first to face the prospect of formal action over appalling standards of care at the trust between 2005 and 2009.
Staff there have been blamed for the ‘unnecessary’ deaths of up to 1,200 people because they put targets and cost-cutting ahead of patients’ needs.
The most shocking examples included receptionists assessing emergency cases, patients forced to drink from vases and the seriously ill being left in filthy bedsheets.
Only one suspended nurse has so far suffered any formal sanction – despite 79 doctors and nurses being reported to regulators for investigation.
Now the General Medical Council has confirmed that three doctors working as managers and another doctor have been summoned to appear before a fitness to practise tribunal following an investigation into their actions. The unnamed doctors face being struck off the medical register or having restrictions applied to their licenses.
However, critics have pointed out that many more managers and medical staff have been allowed to retire on lucrative pensions or find jobs elsewhere in the NHS.
Julie Bailey founded the Cure The NHS campaign group after her 86-year-old mother, Bella, died at Stafford Hospital in 2007 following a fall. During her mother’s stay, Mrs Bailey grew so appalled by conditions at the hospital that she began feeding and washing other patients.
Mrs Bailey, who campaigned alongside former nurse and agony aunt Claire Rayner, said: ‘This is long overdue. The GMC is far too late and the process takes far too long. ‘There’s no information about what allegations these doctors face.
‘There were between 400 and 1,200 unnecessary deaths and doctors stood by and watched this happen. Why aren’t they all facing sanctions? ‘We want accountability for the hundreds of deaths at that hospital.’
It comes as an official inquiry into the scandal, led by Robert Francis QC, will publish its final report on Wednesday. It is expected to recommend major NHS reforms, including controls to identify and remove bad managers, and an improved training programme for nurses and assistants.
British nursery education changes won’t benefit children or parents (?)
The mother below quite misses the point. She complains of the high cost of childcare but opposes what the government has just done to reduce that cost: Allow somewhat fewer teachers per child. And the imposition of an educational qualification is extremely modest. A GCSE (junior High School) pass is very low level. It will keep out the illiterate but not many others
My four-year-old daughter won a major award at school last Friday. She attends the nursery at her primary school, which is rated as “outstanding” by Ofsted, so the staff there clearly know a thing or two about laying the foundations for academic success.
My little girl stood up in front of all the other children at assembly and marched to the stage to collect her “Star of the Week” certificate from the headteacher. But what was it for, I hear the competitive mothers of Britain cry. After all, a shake-up of nursery care has just been announced, so lessons, quite literally, need to be learnt.
Presumably my daughter was given recognition for reading? Reading independently? For reading À la recherche du temps perdu in the original French? Or for writing, perhaps? Penning poetry, or inking her name in Mandarin?
Let us remember that education minister Liz Truss has just announced that child-care workers must have a PhD in non-Euclidean geometry (all right, a GCSE in maths) so that their pre-school charges can be given a proper grounding in the three Rs before they can walk.
By way of an incentive to nursery bosses, staff who have a grade C or above in maths and English at GCSE will be allowed to look after more children than those without these qualifications, as everyone knows that a sound working knowledge of Great Expectations is fundamental to finger-painting and the effective teaching of Hairy Maclary studies.
It would be funny if it weren’t so serious. It is an exceedingly rare working mother – even in these egalitarian times, guilt is still the preserve of the distaff side – who doesn’t agonise over her child-care choice at some point. Concerns about cost, quality, the calibre of staff, the consumption of vegetables, the exposure to books and the access to out-of-doors play areas come together in a Gordian knot (usually, located deep in the pit of the stomach).
Of these, the financial outlay is often the most pressing anxiety. And the truth is that, despite the fact that many nurseries employ teenagers with a level two child-care qualification on as little as £7 an hour, the cost to parents can run to £1,000 or more a month for a full-time place.
In Europe, on average, a family spends 13 per cent of its income on child care; in Britain that burden stands at 27 per cent. No wonder then, that a study by the politically independent think tank the Resolution Foundation, published in October last year, found women were being unwillingly forced out of the labour market; figures from the Organisation for Economic Co-operation and Development show that the UK ranks 16th in the league table of mothers going back to work, with 67.1 per cent, compared with 73.6 per cent in France and 84 per cent in Denmark.
“It’s hardly worth a typical second earner going out to work more than a couple of days a week, because the family will be barely better off,” is the verdict of Vidhya Alakeson, deputy chief executive of the Resolution Foundation.
“This is a serious concern because increasing the level of female employment is one of the key routes through which family living standards have increased. We need major change in our child-care system to ensure that work is always worthwhile – and that working more hours or a pay rise results in higher take-home pay.”
If the Government really wants mothers to get back to work – and clearly it does – it is going entirely the wrong way about it. Although there has been much talk of child-care tax breaks for working parents, the logical thing would be for the Government to pump money directly into the supply side of child care, so that costs plummet. That might not be ideologically palatable to a Conservative-led coalition, but it would be a genuine vote-winner among women, for whom having to pay most of their salary to a nursery or childminder sticks in the craw.
On the networking site Mumsnet, the Government’s suggestion that its proposed overhaul of nursery provision will make child-care cheaper has been met with blanket scepticism – and six pages of posts.
“I hear the idea is only nurseries with well- qualified staff will be able to raise ratios. That’s good,” writes Mumsnetter TiggyD. “Good staff will be more sought after, meaning their wages should go up. That’s good. Wonder how the wages will be paid? By not reducing fees, at a guess.”
Whether the girls who work at the nation’s nurseries have a couple of GCSEs to their name or not is a less immediate worry to British parents than the changes to staff ratios; the current one staff member for every four two-year-olds will change to one carer for every six, while one adult will be allowed to look after four babies instead of three.
Clearly no slouch at maths herself, TiggyD goes on to share the following calculation with other users. “There are times when numbers of staff count. Cuddles and hugs will drop by 12 per cent for a baby, as they will have 25 per cent of a staff member each as opposed to 33 per cent,” she says. “It’s harder to keep an eye on more children so bites, pushes and toy-snatching will increase. Eighteen toddlers will have to be led out of a burning building by just three staff instead of five.”
If that has an alarmist ring, an even shriller note is being sounded warning of the danger that “child-care will go the way of nursing”. Just as nursing graduates have been accused of balking at the messier, more hands-on aspects of patient care, so there is a fear that requiring higher qualifications may attract candidates into child care who do not necessarily have the emotional skills crucial to caring for babies and toddlers.
“I want a child carer with compassion, common sense, patience, kindness in abundance and a loving caring and warm personality,” says stormforce10. “If they have an A in GCSE maths, I really do not care. I want them to have enough time to give DS [my dear son] the love and security he needs. I want his nappy changed regularly and as required. I want him not to be battling with other babies for affection.
“I want him to be fed and cuddled. I want his tears wiped if he falls and his face wiped after he eats. I want him to be secure, happy and safe. Please drop these silly plans for the sake of our children.”
No sensible mother will be motivated to return to the office if the price is dropping her baby off in a super-nursery where reading, writing and numeracy are promoted at the expense of a 12 per cent reduction in cuddle time.
Some infants, of course, enjoy letters and numbers at an early age. It’s a rare youngster who doesn’t love a cracking good story about a fire engine or a kindly tree or a Gruffalo. But let them discover these things at their own pace; to effectively rob them of their childhood at the age of two by pushing them towards a school curriculum would be unforgivable.
The age of four, however, is an excellent point at which to show promise, as attested by my own daughter. Her state school nursery most definitely has its priorities right. Which is why she won her “Star of the Week” award for “Learning How to Skip From One Foot To Another”.
And hand on heart, Mrs Truss, I couldn’t be prouder if she’d bagged a Baccalaureate.
More environmental extremism
David Attenborough has made a good living out of wildlife but it is now clear that he is driven by a dislike of people rather than by a love of nature. If he were really a lover of nature he would be living somewhere like New Zealand’s unspoilt Southland rather than in London. The scenery is famous, the water is trustworthy, they all speak English (with a funny accent) and internet access is good in the Southland
A recent report out of England is a perfect illustration of the thesis that a major component of the modern environmentalist movement consists of religious worshipers of a decidedly peculiar pagan proclivity, to wit, worshipers of Thanatos, the god of death.
The story is about the famous BBC broadcaster and naturalist Sir David Attenborough, brother of the famous British actor Richard Attenborough. Sir David is a fixture of British TV, hosting various nature shows, including the acclaimed series Life on Earth.
Sir David has just put forward the simply lovely view that human beings are a disease afflicting the planet. He is greatly perturbed by the bête-noirs of the environmental movement: global warming and overpopulation. “We are plague on the Earth,” he cried piteously, adding, “It’s coming home to roost over the next 50 years or so. It’s not just climate change; it’s sheer space, places to grow food for this enormous horde. Either we limit our population growth or the natural world will do it for us, and the natural world is doing it for us right now.”
Need I add that Sir David is a big supporter of the Optimum Population Trust, an NGO devoted to curtailing growth of the population?
With folks like him, Thanatos is God and Malthus was His Prophet.
Citing as an example Ethiopia, the “compassionate” Sir David averred, “We keep putting on programmes about famine in Ethiopia; that’s what’s happening. Too many people there. They can’t support themselves — and that’s not an inhuman thing to say.”
No, Sir David, it isn’t an inhuman thing to say — just a stunningly simplistic thing to say. The endemic famine in Ethiopia — like all famines in the last century — is mainly the consequence of a bad government and economic system, merely triggered by natural calamity. In the case of Ethiopia, it was most recently a drought, a natural weather cycle that has happened throughout recorded history. In fact, as the brilliant Bjorn Lomborg noted just recently, there hasn’t been any significant increase in drought worldwide over the last 60 years. There has been more drought in southern Europe and western Africa, true enough, but there has been less in northwestern Australia and central North America.
And by the way, if you do want to limit population growth, what you need to do is limit government and promote free enterprise, which invariably results in higher living standards. As the middle class increases, population growth declines. Depend on it.