Unbelievable: Some NHS hospital staff get just one hour’s training
Patients are being put at risk because most staff on hospital wards for the elderly have had less than an hour’s training, the leader of Britain’s nurses has said.
Dr Peter Carter, the chief executive of the Royal College of Nursing (RCN), said vulnerable people were being failed because hospitals rely too heavily on healthcare assistants, who were “given a uniform, then left to flounder”.
Around 300,000 such workers, who are unregulated, and not required to have qualifications or training, are now employed by the health service. Hospitals have hired them in increasing numbers in a bid to limit costs, with the starting salary of £14,000 comparing to £21,000 for a junior nurse.
Six years ago, on average there were two nurses employed for every assistant; now the ratio is closer to one to one.
On Wednesday the public inquiry into one of the worst scandals in NHS history will recommend mandatory training for all such workers, in a bid to improve the standards of care received by millions of patients.
Robert Francis QC, the chairman of the inquiry into Mid Staffordshire Foundation trust, where up to 1,200 people died needlessly in appalling conditions, will call for the change as part of sweeping reforms to overhaul the health service and systems to protect the public.
Dr Carter said he had encountered cases where patients had been left embarrassed because assistants did not know what a colostomy bag is.
In others, doctors reported that assistants had recorded observations on a patient’s blood as requested, but failed to raise the alarm when pressure fell dangerously low, having no idea what the readings meant.
He said most healthcare assistants received less training for their roles than shop workers.
“At John Lewis and Marks & Spencer they don’t say ‘Put on a tunic and pick up the rest as you go along’. They have rigorous training and show them how to do them on the job before they put them on the till,” said Dr Carter.
NHS trusts can offer training to healthcare assistants, but do not have to. No records are held to show how much training the average worker receives before starting on the ward, but Dr Carter said he believed most received very little.
“What you will find nowadays on most older people’s wards is that most of the staff are not nurses, the majority are healthcare assistants – and most of them won’t have had as much as an hour’s training,” he said.
While the very best NHS trusts provided training to such workers, in many wards, patients were put at risk because those caring for them lacked the most basic skills and knowledge, especially to deal with elderly patients, who often had complex needs.
“When you have got all these staff who been given a uniform, so they look like a nurse but in fact are just floundering around, it is little wonder that we see these deficits in care,” he said.
Such assistants are not supposed to do skilled work carried out by nurses, but the role has increasingly expanded, so that as well as washing, dressing and feeding patients, they are expected to monitor patients’ conditions.
For the same £14,000 starting salary, nursery nurses are required to have a diploma or NVQ, which takes two years’ study.
In a survey of 600 nurses published today, 57 per cent described their wards and units as “dangerously understaffed”. Almost half of those polled by magazine Nursing Times said they believed many hospitals are failing patients in the way Stafford Hospital had.
The public inquiry heard how the scandal occurred after the trust’s board embarked on drastic cost-cutting measures, including cutting the number of nurses, as managers became “obsessed” with achieving Foundation trust status.
As the number of qualified nurses fell, wards became far more reliant on healthcare assistants. On one floor of the hospital, shortages of qualified staff became so extreme that two nurses were responsible for 40 patients.
During 137 days of hearings, the inquiry heard repeated concerns that similar trends are putting patients at risk elsewhere in the country.
Dr Carter said that while he believed most nurses came into the profession wanting to do a good job, compassion was being “drained out” of too many by a system which was overloaded.
“I think the system is under huge strain in a way that we have never seen before,” said Dr Carter. “I am not going to be an apologist of someone being wilfully neglectful – there are obviously examples of that which occur, but most of the time it’s the system that they are caught in that causes the problems.”
A spokesman for the Deparment of Health said it was developing minimum standards for health support workers, but that hospitals were responsible for setting their own staffing levels.
NHS chief Sir David Nicholson ‘should quit’over scandal
The head of the NHS should resign over his role in the Mid Staffs care scandal, the investigator who uncovered the abuse has said.
With a damning report from the public inquiry into the scandal to be published on Wednesday, Dr Heather Wood said Sir David Nicholson was intrinsically linked with the problems at the hospital.
Between 2003 and 2006 Sir David, who is now NHS chief executive, was in charge of the local strategic health authority, which is expected to be blamed for creating the target culture that contributed to patients receiving appalling care. “He is at the centre of it,” said Dr Wood. “One cannot have confidence in things changing if he is still there.”
Between 400 and 1,200 people died needlessly at Stafford hospital between 2005 and 2009 amid appalling care, with patients left in pain, thirsty and in their own excrement.
Dr Wood, who was investigations manager at the Healthcare Commission, the former health regulator, said the problems were a direct result of the “ruthless implementation of targets regardless of the cost downstream that came from the top, from No10 and from the Department of Health”.
She said there was a “horrific culture” of bullying, with local managers being directly threatened by their superiors that they must meet targets and that ultimately directors of finance were in charge instead of doctors. Dr Wood said Sir David had “an awful lot to answer for”.
A spokesman for Sir David, who this week apologised for the scandal as “a human being and as chief executive”, said he was not prepared to comment.
More privately-educated pupils win British university offers
And so they should. Elite people are smarter — and so are their kids
More pupils from top private schools are winning places at elite universities despite a Government drive to widen access to higher education, according to research.
More than three-quarters of applications made by pupils from Britain’s best independent schools last year resulted in the offer a place, it emerged.
The success rate was up from just over seven-in-10 in each of the previous two years.
Some 95 per cent of applications to one Russell Group university – Exeter – led to the award of a place, while numbers were well over 80 per cent at other leading institutions.
The disclosure – in data published by two of the leading private school organisations – comes despite the introduction of tough new targets designed to force top universities to take in more pupils from “under-represented” groups.
Controversially, around half of Russell Group universities have set themselves a benchmark to increase the proportion of places awarded to state school students under deals signed with the Government’s Office for Fair Access.
Last week, Anthony Seldon, the Master of Wellington College, Berkshire, warned that privately-educated pupils were being “discriminated against at the final hurdle” when they make university applications.
But the latest figures suggest that more pupils from Britain’s leading independent schools are actually winning higher education places.
Chris Ramsey, universities spokesman for the Headmasters’ and Headmistresses’ Conference, said: “No-one should face discrimination on account of school type and this evidence suggests that highly-selective universities are still giving a very high number of offers to our candidates.”
HMC and the Girls’ Schools Association surveyed members across Britain as part of an annual report on university applications.
Some 75.8 per cent of applications made to universities in 2012 resulted in an offer of a place, it emerged. This compared with 72 per cent in 2011 and 71.7 per cent a year earlier.
Figures show that 95 per cent of applications to Exeter resulted in an offer, while numbers were between 80 and 90 per cent at other Russell Group universities such as Leeds, Nottingham, Manchester, Newcastle Birmingham and Southampton.
Almost four-in-10 applications to Cambridge and three-in-10 to Oxford resulted in an offer, figures show.
Students can traditionally apply to up to five courses through the Universities and Colleges Admissions Service (UCAS).
In all, 97.3 per cent of pupils gained at least one offer – up from 96.9 per cent a year earlier.
Separate figures suggest the upward trend may continue into 2013. Some 55 teenagers from King’s College School, Wimbledon, have Oxbridge offers for courses starting this autumn, while numbers are as high as 40 at North London Collegiate School and 29 at Cheltenham Ladies’ College.
Keith Budge, headmaster of Bedales School, Hampshire, which sent 26 students to Oxbridge in recent years, said: “Universities are interested in attracting pupils with the greatest potential to succeed and most independent schools are taking advantage of the freedoms they have to help their pupils achieve this.”
Britain hands over £100m to Polish students
More than £100 million of taxpayers’ money has been awarded to Polish students over the last five years to allow them to take degree courses in the UK, official figures show.
Some 23,500 students have successfully applied for Government-backed loans to cover tuition fees or living expenses under EU rules that give Europeans access to the same funding as British students.
Data from the Student Loans Company suggests that average loans awarded to Poles have soared by almost 50 per cent this year to coincide with a sharp hike in university fees.
But it is feared that many students may return to Poland after graduating and fail to pay the money back – leaving a multi-million pound black-hole in the public finances.
It comes just days after it emerged that Polish had officially become England’s second language after an influx in the number of workers from Eastern Europe over the last decade.
The latest disclosure sparked claims that students from outside Britain were accounting for an increasingly large share of the universities budget despite severe cutbacks across the public sector.
Andrew Percy, the Conservative MP for Brigg and Goole, said: “It is unacceptable at a time when British students are paying increased tuition fees that £100m is being used to provide loans to Polish students. A large number of them will never pay it back.
“This demonstrates why the Government needs to reopen negotiations with the EU on these issues.”
Data obtained through the Freedom of Information Act by students at Westminster University showed that £102.8m worth of loans had been provisionally awarded to Polish nationals between 2008/9 and 2012/13.
Some 23,500 separate applications for loans had been made over the period, although many students may have applied in more than one year.
Of those, around six-in-10 borrowers were living in Poland or elsewhere in Europe, while the remainder were already in the UK.
In total, £21.5m was awarded to 3,580 Poles in the current academic year – an average of just over £6,000 per student.
By comparison, the equivalent of £4,200 was awarded to each applicant a year earlier.
Under European law, students from EU member states can apply for the same Government-backed loans as British students. They also count towards strict controls on the overall number of students that each university can recruit – limiting costs to the taxpayer.
But it is feared that the system used to reclaim money from those returning to their own country after graduating is not robust enough.
Separate figures show 2,400 EU students failed to provide the Student Loans Company with details of their income and were “placed in arrears” in 2010/11, while another 400 defaulted on their repayments.
The annual repayment threshold for Poland is currently £9,480, rising to £9,825 in April this year.
The Student Loans Company insisted the figures covered the amount of money awarded to students after a successful application for funding, but pointed out that loans were dependent on them taking up a course place.
Kevin O’Connor, SLC head of repayment, said: “The Student Loans Company expects to receive payments from all customers in repayment. Depending on status and circumstances we adopt various collection methods to recover outstanding payments.
“If you fail to make repayments, your account will start to accrue an arrears balance and SLC will chase that as an arrears account.”
Epilepsy drug linked to tenfold increase in autism: researchers
The numbers in this study are too small to be taken very seriously by themselves and it is surprising that none of the mothers were given phenytoin, known as unusually safe. Medical fashion, no doubt.
But teratogenesis of some kind is a known side-effect for anti-epileptic drugs — including phenytoin — so the study takes on some significance because of that. The options for epileptic mothers are not good
Children born to mothers who took an epilepsy drug while pregnant are up to ten times more likely to suffer autism or similar conditions, a study has found.
The study found children born to women who took sodium valproate, known as Epilim, were significantly more likely to suffer autism, attention deficit hyperactivity disorder or dyspraxia.
Researchers warned that women should not stop taking the drug suddenly as fits can harm their unborn child and most women went on to have healthy children.
The findings were published online in the Journal of Neurology Neurosurgery and Psychiatry.
Researchers from Liverpool University, studied 528 women in the north west of England.
Just fewer than half the mothers had epilepsy and all but 34 of whom took antiepileptic drugs during their pregnancy.
Fifty nine mums took carbamazepine; 59 took valproate; 36 took lamotrigine; 41 took a combination; and 15 took other drugs.
Their children were assessed three times up to the age for/of six and their mothers asked if they had consulted specialists about their child’s development.
By the age of six, 19 children had been diagnosed with a neurodevelopmental disorder, of these 12 had autism, one had both autism and ADHD, three had ADHD and four had dyspraxia.
Children exposed to valproate alone in the womb were six times more likely to be diagnosed with a neurodevelopmental disorder.
Those exposed to valproate plus other drugs were ten times more likely to have a diagnosis than children whose mothers did not have epilepsy.
It means 12 per cent of children whose mums had taken valproate alone during their pregnancy had a neurodevelopmental problem, as did one in seven of those whose mums had taken valproate with other drugs.
No child born to a mum with epilepsy, but who didn’t take drugs for the condition during her pregnancy, was diagnosed with a neurodevelopmental disorder.
Boys were three times more likely than girls to be diagnosed with a neurodevelopmental disorder, but no significant associations were found for the mother’s age or IQ, length of pregnancy, or epileptic seizure type.
Author of the study Dr Rebecca Bromley, of the Department of Molecular and Clinical Pharmacology, said: “If sodium valproate is the treatment of choice, women should be provided with as much information as possible to enable them to make an informed decision.
“But on no account should pregnant women just stop taking the drug for fear of harming their developing child.”
Dr Gavin Woodhall, Reader in Neuropharmacology at Aston University, said: “This study in man is consistent with what is seen in animal models and should come as no major surprise.
“However, this is only a small study as yet, and it is important to take into account the fact that controlling epilepsy in pregnancy is very important, and most women who are treated for epilepsy during pregnancy go on to have perfectly normal babies.”
Christian symbolism wrong but homosexual symbolism fine?
British Christians can be punished for wearing a cross but flying a homosexual flag is OK?
Police and councils are flying a rainbow flag outside their bases to show support for the gay community.
The flag is flying outside Leicestershire Police headquarters in Enderby, County Hall in Glenfield and Leicester Town Hall to mark the national launch of Lesbian Gay Bisexual and Transgender, (LGBT), History Month.
Leicestershire’s Assistant Chief Constable Steph Morgan, who speaks on LGBT issues for the Association of Chief Police Officers, said: “Flying the rainbow flag together in this way is a symbol of our joint commitment to the LGBT community locally and is part of ongoing work with our local authority partners to create a just and fair society for all.
“As national LGBT strategic policing lead, I was pleased to see 10 police forces, including Leicestershire Police, featured in the Stonewall 100 Index of gay-friendly employers in January 2013.
LGBT History Month is a great opportunity to become aware of the challenges LGBT people face everyday, and to recognise their valuable contribution to wider society.”
Councillor Nick Rushton, leader of Leicestershire County Council, said: “We are delighted to be joining our colleagues at Leicestershire Police and Leicester City Council in raising the flag to mark the start of LGBT History month.
“LGBT people have overcome huge challenges throughout history, both here in Leicestershire, and across the world.
“This month is about remembering the contribution of those people and celebrating the diversity of our city and county.”
Councillor Manjula Sood, assistant mayor of Leicester, said: “The city council is committed to celebrating Leicester’s diversity, and flying the rainbow flags is a very visual way of acknowledging LGBT history month and the contribution made by the LGBT community to our city.”
This Equality obsession is mad, bad and very dangerous
The great doctrine of our time is pursued at all costs – but it reduces our freedoms
Last week, I appeared on the panel of the BBC’s Any Questions? in Guildford. We were asked whether we thought women should be allowed to take part in full front-line combat roles in the Armed Services. I said I didn’t think that it would be an advance in human civilisation if women abandoned their traditional association with peace and started killing people as men do.
This did not please the questioner, an intelligent student from the politics department of Surrey University, or her supporters sitting with her. They thought that the only question was the ability of the woman – if she was fit to fight, fight she should, and no one should stop her.
Afterwards, I reflected on the oddity of the situation. It did not seem that the student and her colleagues were particularly interested in military matters in themselves. They also did not seem the sort of people who, in other circumstances, would be at all keen on people killing people. I could imagine them protesting against militarism. Yet here they were, pushing for a woman’s right to kill.
Why? Because of Equality, of course. It gets you into strange situations.
I put a capital e on Equality because, more than we recognise, it has become the public doctrine of our time. If you believe in big-E Equality, you are not merely saying, as most would, that people should try to make life fairer for all. You are making Equality the all-conquering principle of social organisation and human life. It is like a religion but, unlike actual religions in the West today, it is backed by the full force of law. Since 2009, when Labour’s Equality Act consolidated all previous bits of legislation, there have been seven strands of Equality, the creed’s equivalent of the seven sacraments of the Roman Catholic Church. They are: race, age, disability, sexual orientation, gender, gender reassignment and religion/belief itself. In this seven, the last is the odd one out: I’ll come back to it. Through these seven channels, the grace of Equality must be poured.
When David Cameron set out on his quest for gay marriage (and exactly when he did is a matter of some interest, since he denied any plans for gay marriage three days before the last general election), he probably saw this as a simple matter of being nicer to homosexuals and making the Tories seem less unpleasant. But now that the Government has moved to actual law, and will debate the Bill in Parliament on Tuesday, he is well and truly trapped by Equality.
In recent months, officials drafting the Bill have struggled to fulfil Equality’s aim of making same-sex marriage identical to marriage as the world has known it for most of human history. They have come across an insuperable barrier. It reminds me of the moment when, in trendy Islington in the 1980s, I was summoned by the health authority for a cervical smear. Some things just cannot be done.
The drafters have belatedly realised that, since there is no procreative act which defines homosexual behaviour, there can be no consummation, or non-consummation, and no adultery. These will not, therefore, be grounds for gay divorce. If your gay husband offers you no nookie, or if he avails himself of large amounts of nookie elsewhere (or both), he gives you no legal cause to divorce him.
So what they have ended up offering, strangely enough, is a law of marriage with no sexual element whatever. This has never happened before (although there have been plenty of sexless marriages). There is nothing in Mr Cameron’s new law to say that same-sex marriages must be between homosexuals. If I were a bachelor, I could marry a straight male friend just to get whatever tax advantages, travel deals and insurance discounts might be going.
Incestuous marriage remains forbidden, but I don’t see why, in Mr Cameron’s vision of same-sex marriage, a mother could not marry her daughter or a sister her sister or a father his son. No sexual act is expected of them and even if – distressing thought – it did take place, it could have no genetic consequences. Why should such pairs not just agree that they fancy the married couple’s exemption from inheritance tax, and hurry down the aisle? How long before a same-sex, keep-it-in-the-family couple tries to make a fight of it, and wins a case against the British Government at the European Court of Human Rights (ECHR)?
This is the real point about Equality. Because it is now considered both a sacred and a legal principle, it is heaven on earth for lawyers, if for no one else. Just as the Jewish Beth Din, or rabbinical court, has endless work precisely interpreting exactly how the Torah applies to real life, so our own courts are starting to do the same with their Torah, Equality.
This in turn means that Mr Cameron’s promises, however sincere, that religious objections to same-sex marriage will be protected by the Bill cannot be fulfilled. Although religion is one of the seven “strands” of Equality, it is only one, no more important in Equality’s great scheme of things than gender reassignment. And so, although, under the new law, an Anglican priest remains free to marry only people of the opposite sex, if he is also chaplain of a hospital, the hospital will probably be entitled to dismiss him because his “homophobic” views about marriage break their “public sector equality duty” which the Equality Act lays down. On similar principles, a church might not be allowed to hire a public hall because of its views on marriage and a Christian, Jewish or Muslim teacher could be dismissed for refusing to teach that marriage was what Equality said it was.
None of these results is certain. Where would the legal fun be if it were? But what is certain is that such things will be legally contested, that they will be expensive, exhausting and dangerous, and that, by taking the matter to the ECHR, complainants will be able to go to a place where Mr Cameron’s promises are void.
If you stand back to look at how Equality works, you notice three things.
One is that it undermines freedom. It specialises in attacking ways of living which people have developed for themselves, often using the law and even the police to do so.
The second is that it undermines institutions. The bulwarks of a free society are not atomised individuals, but businesses, families, schools, clubs, churches, charities, sports teams – the Big Society we seem recently to have stopped hearing about. Equality is the government’s instrument for nationalising them.
The third is that Equality makes everyone (except lawyers and other activists) very unhappy. No one knows where she or he (you see!) stands, what law he might inadvertently be breaking, what “inappropriate” remark he might have made. And those who invoke Equality to advance their collective cause, far from being pleased by what they have won, are in a semi-permanent state of rage about any remaining imperfection. They are trained to identify grievance, so naturally they are aggrieved.
There is one additional point. The doctrine of Equality is mad. Like extreme post-Reformation Protestantism, it perverts a good inclination and turns it into a lunatic theocracy. Some of the Anabaptists who swept through Germany in the 16th century enforced Christ’s teaching that one must be as little children to enter the Kingdom of Heaven by running about naked and babbling like babies. It is surprising that their modern equivalents will be found on the Conservative front bench next week.