The elderly must be kept out of ‘dangerous hospitals’, say GPs as they attack care standards and call for changes in the way the NHS is run
Hospitals are dangerous places and only the most serious cases should be treated there, GPs warned last night. In an extraordinary attack on standards of care, the leaders of Britain’s family doctors have called for a shift in the way the NHS is run to avoid a repeat of the Mid Staffordshire scandal.
The NHS Alliance, which represents GPs and other primary care staff, says many medical conditions could be better treated at patients’ homes.
Dr Michael Dixon, president and chairman of the alliance, said: ‘Hospitals can be dangerous, particularly for older patients and those with long-conditions. There is a risk of infection and nutrition is complicated for those who cannot feed themselves.
‘We should aim to keep them out of hospital for as long as possible. ‘We need to work towards the point when acute hospital admissions should be regarded as a failure rather than a default position.’
Tens of thousands of vulnerable and elderly patients should be treated in the community, the doctors say, where they will be more safe than in hospital.
The appeal follows the public inquiry into hundreds of avoidable deaths at Stafford Hospital.
In the appeal, sent to The Times newspaper, the GP, along with his colleague Dr Chris Drinkwater, also said the alliance will submit a five-point plan today to the NHS Commissioning Board – the new body responsible for the health service and whose chief executive is Sir David Nicholson.
Meanwhile, the health expert appointed to instil a culture of ‘zero harm’ in the NHS has said the health service can only be restored if there is a new culture that tolerates not a ‘single injury’.
Professor Don Berwick, a former adviser to US president Barack Obama, says all staff should aspire to provide the ‘safest health care in the world’.
‘Assuring patient safety and high quality care is never automatic,’ he said. ‘It requires the constant attention of leaders and continual support to the workforce.’
He added that he is committed to taking ‘serious and profound’ action to improve safety and that ‘there is no reason why English health care cannot aspire to be and become the safest health care in the world.’
A hero humiliated: Hospital left veteran, 94, in bloody pyjamas for FIVE hours
An elderly war hero was left sitting in a casualty department in his blood-soaked pyjamas for more than five hours while he waited to be seen by a doctor.
Rod Gray, 94, had been taken to hospital by ambulance after he cut his head in a fall at his home.
After having his wound treated with surgical ‘glue’, he was abandoned in a wheelchair in a waiting area, alone and desperate for the toilet.
When his family arrived at the Ipswich Hospital, they were repeatedly told that he would be seen next, but after five hours they took him home so they could clean him up themselves.
Mr Gray, who was awarded the Burma Star for helping to defeat the Japanese in the Second World War, said he felt ‘humiliated’ by the treatment he received.
Last night, his stepson Carl Puiy, 55, said he was ‘absolutely fuming’ about the lack of care shown by the hospital last Friday.
The retired Suffolk Police superintendent said: ‘He was on his own with pyjamas and a dressing gown on. It was not very dignified. There was blood all over him – they hadn’t even cleaned him up.’
‘We asked what was going on and were told he needed to see a doctor. He was asking to go home because he wanted to lie down – he was so uncomfortable and said he felt humiliated.’
Mr Gray, a retired accountant with the Eastern Electricity Board, was admitted to the hospital at around 4.30pm. Mr Puiy and his sister arrived within the hour.
Mr Puiy said: ‘At 8.20pm we were told he was next to be seen. I do understand they were very busy and had emergency cases to see.
‘But the problem seemed to be administrative staff on the front desk who didn’t seem to be doing anything to check if a doctor could see my 94-year-old stepfather. ‘By 10pm he still hadn’t been seen. We had to take him home. ‘We gave up as he was pleading with us to go home.
‘He was so uncomfortable and cold. All he wanted to do was lie down.’ He added: ‘When we lifted him out of the wheelchair his legs had gone numb and they gave way from under him.’
Mr Puiy said that he believes that his stepfather, who served in the Suffolk Regiment as part of General Bill Slim’s ‘Forgotten’ 14th Army in Burma, deserved better treatment. He said: ‘I have worked in the public sector myself and I can’t believe a 94-year-old man could be left in a wheelchair in his pyjamas.
‘It is a complete lack of dignity for someone who has fought bravely for his country and put his life on the line. They couldn’t even find him somewhere to lie down.’
Last night, Jan Ingle, a hospital spokesman, said: ‘The emergency department was exceptionally busy on Friday afternoon. ‘We had to see people according to their clinical priority and so it could well be the case Mr Gray waited longer than we would want anyone to wait.’
Two years ago the Care Quality Commission found the hospital was failing in the care of elderly patients, with a lack of dignity cited as a serious concern.
NHS ‘has a lot of work to do to improve quality and safety’
Chief Executive of the NHS Confederation, Mike Farrar, is confident that the health service will have “reduced error and harm dramatically” in five years’ time.
Mr Farrar said that it was important to recognise that the failings which took place in Mid Staffordshire, where hundreds of patients died needlessly as a result of substandard care, went “beyond human error,” and that there was “clearly very, very poor quality care and neglect”.
“In five years’ time I’m very confident that the NHS will have got more consistency, it’ll have reduced this variation in experience, it will have supported its staff well. I’m very confident that the public will see an NHS which has reduced error and harm dramatically,” he added.
In an interview with The Telegraph, Dr Donald Berwick, appointed by David Cameron to bring in a “zero-harm” agenda that would make sure patients are put first, said that the NHS needs an “attitude of culture” where “no harm should be regarded as acceptable”.
He suggested that the health service should have a level of safety comparable with that expected of the aviation industry.
“That may be very aspirational, but in the world class safety systems, they generally have an attitude that even a single injury is problematic,” he said.
Mr Farrar agreed that the NHS “has got a lot of work to do to really improve its quality and safety,” but pointed out that it could be “a longer job”.
“Providing medical services and health care is always going to be more difficult perhaps than flying aeroplanes, however hard that might seem for people to accept, because we do know there will be errors.
“What we have to do is where we know what works, is make sure that we’re applying those every time,” he said.
British government now plans £150m boost for primary school sports in wake of widespread criticism over proposed funding cuts
Ministers are preparing to plough up to £150million into primary schools to help them improve sports. Downing Street is expected to make an announcement in the next few days on a new scheme to give schools thousands of pounds which must be spent on sport.
The money will help ensure that children will continue to have access to specialist sports teaching at least once a week, with a focus on competitive sports.
National sports’ governing bodies will be encouraged to provide expertise and coaches to work alongside teachers.
It follows widespread criticism of the government for making cuts in schools sports.
In 2010, Education Secretary Michael Gove provoked an outcry by abolishing £162million of ring-fenced funding for the national School Sport Partnerships.
The BBC said the Football Association, England and Wales Cricket Board, Lawn Tennis Association and other organisations, inluding Olympic bodies funded by the taxpayer, will be briefed on the plans tomorrow.
The new funding is being drawn from across government departments, including education health and sport.
It comes after widespread calls for more investment in school sport to help build on the legacy potential of the 2012 London Olympics and Paralympics.
Lord Coe, who was chairman of the Game’ organising committee, is understood to have been a key advisor when the plans were drawn up.
Last year Education Secretary Michael Gove stopped ring-fencing school sports funding and scrapped £162million of annual funding for competitive school sport.
Lord Coe – who remains the only man to win gold in the 1500m at successive Olympics – has urged the Government to plough more cash into sport at schools.
Last night, a source told The Daily Telegraph: ‘This is a good package, with extra money, which should help ensure the lasting legacy from the London Games. It is the last piece of the legacy jigsaw.’
Dame Tessa Jowell, the former Labout Olympics minister, has called for a cross-party 10-year programme to guarantee funding for school sport.
The inconvenient truth about antibiotics
Doctors, patients and pharmaceutical companies must work together to tame the bacterial threat
When I’m not writing for The Daily Telegraph, I work for the pharmaceutical industry (or vice-versa, depending upon which employer is on the phone to me at the time). It’s difficult to know, sometimes, which is held in lower esteem by the public: newspapers aren’t exactly surfing the crest of a golden era, with the succession of Leveson-aired grievances. But tell people you work for “big pharma”, and depressingly – regardless of how many of them have had their lives improved by the medicines we research, license and sell – too many noses turn up. Yesterday’s news about the paucity of new therapies for antibiotic-resistant infections won’t help. “You make money out of illness” has felt at times the common, if unspoken, complaint.
Well, of course we do: make money, that is. Such income fuels the immense costs of research and development, the basic lab research and clinical development that produces new drugs. In the case of our health-care industries, that model has worked largely to society’s advantage, but the presence of profit doesn’t mean that those of us who work in such research aren’t motivated primarily by a very human mission. Our families acquire infections during routine stays in hospitals, too.
In the new fight against antibiotic resistance, we might learn from the past. I am of the generation of gay men that first confronted the reality of HIV, a virus that we thought would wipe us out. HIV remains a deadly threat, but the combination of refocused research and development, and an educated, activist population, led to the transformation of millions of lives: indeed, it led to the continuation of millions of lives.
A profitable drug industry – one of Britain’s last world-class endeavours – can work for the common good, as that fight against HIV demonstrates, so it is insufficient to lay the blame for the growing resistance of bacterial infections solely at industry’s door – which is not to say that industry shouldn’t change (again, as demonstrated by the retroviral breakthrough). That the threat from drug-resistant strains is real, and will have terrible consequences if not addressed, is not a matter of opinion. The Government’s chief medical officer, Professor Dame Sally Davies, is as right today to raise the danger of that growing resistance, and to demand that bacterial infections rise up the political priority list, as the health secretary, Norman Fowler, was to raise the stakes with viral infections in the Eighties.
The potential health-care crisis can be averted, but it will take a combination of players: big pharma, yes; but governments too (because their regulatory agencies, such as the US Food and Drug Administration or the EU’s European Medicines Agency, set the framework within which we operate, and license our medicines for sale); physicians (because the over-prescription of newer antibiotics in many countries is most probably driving the genetic mutations which lead to ever-more resistant strains; and although the evidence that prescription patterns across a community correlate with resistance within it is mixed, there is quite strong evidence to indicate that the more patients demand an antibiotic, the more likely their GP is to provide it); and farmers.
It beggars belief that American chickens are fed so many antibiotics. If livestock are prone to infection, then we might start by no longer rearing chickens in conditions so inhumane that we shudder to see images of them. The pressure for free-range animals shouldn’t be a middle-class fetish: 80 per cent of the antibiotics sold in the US are used to treat intensively reared chickens, pigs and cows. What’s more, American meat producers aren’t required to document and disclose how they use the drugs.
Regardless, the pharmaceutical industry is continuing to work on new models for R&D, to make antibacterial development more feasible, because the current requirements for such research are so burdensome that few players remain in the field. The EU’s Innovative Medicines Initiative – part-funded by industry – is bringing together major companies to target the development challenges.
Could we, for example, find a way to include data from previous clinical trials, when interpreting the results of the test of a new medicine? Regulators are cautious about such proposals – correctly so, since the use of such “historical controls” can occlude the interpretation of that new drug’s safety and efficacy profiles, upon which a licence to market a medicine is granted. But that challenge, though daunting, is not insuperable, which partly explains why yesterday I was reviewing the CVs of potential PhD students, who want to develop clinical trial methodology that would meet the needs of both regulators and drug developers. Find an acceptable way to maximise the power of existing data, and it could have a dramatic effect on the time required to get a new medicine to the market.
Patients have a role to play, too. When the doctor writes a script for an antibiotic, how many of us take only some of it – up until Friday night, perhaps, when it’s too much of a bore to avoid a drink? Or up until the point that our tummy feels a little queasy? Or until the symptoms diminish, even if doctor patiently underlined the importance of completing the course? How many of us demanded an antibiotic in the first place, when our physician’s opinion was that we didn’t have a bacterial infection?
If we – as physicians and as patients – continue with such behaviour, it will take more than a new clinical trial paradigm to save us. Listen to Dame Sally’s warning: this time, doctor really does know best.
New ‘green’ petrol could drive up prices and damage cars
Britain has signed up to an EU directive which means that suppliers must dilute petrol with environmentally-friendly alternatives.
The oil companies have chosen ethanol, made from corn, which will make up 10 per cent of a new petrol called E10.
Due to be launched later this year it will be available at the pump alongside standard petrol and other green fuels
However, a study today warns it will add around £80 a year extra to the average family’s fuel bill as it gives less miles to the gallon.
The high ethanol content could also ruin the engines of some older cars and motorbikes as it could melt some components,The Daily Mail reported.
The Department for Transport estimate that up to 8.6million vehicles may not be compatible with the new fuel, which is being introduced to cut the use of fossil fuels and reduce greenhouse gases.
Drivers may be confused by its arrival on forecourts unless pumps are clearly labelled and they know whether it is safe for their car.
The study by the respected think-tank warns: “The increased use of ethanol in petrol to meet EU sustainability targets is resulting in drivers paying extra at the pump.”
Under the EU’s Renewable Fuel Transport Obligation five per cent of fuel used in member states must be renewable by 2014, due to increase to 10 percent by 2020.
Oil companies have chosen ethanol, which mainly comes from the US, as this renewable source.
But using ethanol generally cuts a vehicle’s fuel efficiency. If the 2020 target of 10 per cent of transport energy coming from renewable sources had been applied in the UK last year it would have cost motorists £1.5billion.
Author of the study Rob Bailey, a senior research fellow at Chatham House, warned E10 petrol is not compatible with millions of older vehicles and could cause corrosion and drivability problems for vehicles of ten years or older.
The green petrol was introduced in Germany two years ago and many drivers decided not to use it in case it damages their engines and because they are uncertain about the wider “environmental and social impacts of ethanol,” said Mr Bailey.
The Government has asked suppliers to delay introducing of E10 to allow time so that drivers can be fully informed and a list of incompatible vehicles can be compiled.
Mr Bailey added that taking farmland out of food production to grow fuel crops also threatens to put up food prices.
The study was funded by Olleco, a business which collects and refines waste cooking oil to be used as biodiesel in vehicles, which Mr Bailey found was a better option to be mixed with fuel than ethanol.
Baby P sackings ‘WERE justified’: Two social workers lose appeals
It’s very hard to get evil British social workers fired
Two social workers responsible for the care of Baby P have lost their claim that they were unjustly fired because of the ‘hysterical media outcry’ after his death.
Maria ward and her supervisor Gillie Christou claim they were ‘hung out to dry’ by London’s Haringey Council after the tragic death of 17-month old Peter Connelly nearly six years ago.
But the Court of Appeal yesterday ruled that an employment tribunal was right to say the council acted reasonably in dismissing the two women in April 2009.
Sharon Shoesmith, the former Director of Social Services at the council, had previously won her own claim for unfair dismissal and is due £1m in compensation. Mrs Shoesmith had appeared in the public gallery to support Mrs Christou and Miss Ward at an earlier hearing last month.
Peter had suffered more than 50 injuries despite being on an at-risk register and receiving 60 visits from social workers, police and health professionals over eight months.
Peter’s mother, Tracey Connelly, her boyfriend Steven Barker – and Barker’s brother, Jason Owen – were jailed in 2009 for causing or allowing the toddler’s death.
Mrs Christou and Miss Ward were sacked after an investigation which discovered there was a period in mid-2007 when they did not know where the child was.
Peter’s mother claimed she had taken the little boy to visit her sick uncle in Cricklewood, north west London, despite being told to return home.
The pair’s legal teams had claimed they suffered ‘double jeopardy’ because they faced two Haringey misconduct panels looking at the same allegations against them.
The first simplified disciplinary procedure concluded that they only needed to receive written warnings. However later, more formal proceedings – after the criminal trial of those responsible for Peter’s death – resulted in summary dismissal for gross misconduct.
In their ruling Lord Justice Laws, Lord Justice Elias and Lord Justice McCombe dismissed their claims to have suffered ‘double jeopardy’.
You’ve no right to a house near your parents: National Trust chief warning to children of rural families
Housing is heavily regulated in Britain and efforts to free it up have met much opposition — example below
Children raised in the countryside have no automatic right to live near their parents’ homes when they grow up, the chairman of the National Trust declared yesterday.
Sir Simon Jenkins said the majority of new homes should be built in towns and cities, rather than in unspoilt rural areas.
His comments are at odds with existing policies that encourage affordable housing to be built in villages for local families.
Sir Simon said: ‘Somehow it is considered the right of people in the country to have their children living next door at public expense. I don’t understand it.
‘Are you going to say that people who have lived in the Windrush Valley [in the Cotswolds] for 100 years have a right to go on living there? No, I’m afraid they don’t. Sorry.’
Last night, some countryside groups attacked his comments, warning that villages without young families risked being turned into ‘little more than retirement ghettoes’.
But Sir Simon, who owns homes in west London and rural Wales, even called for areas of the countryside to be listed to protect the most beautiful parts. He suggested introducing four different listed ‘grades’ of countryside – one of which could include a ‘presumption against development’.
He said: ‘We should list the countryside as we list the town by virtue of its beauty.What it is that people want to retain.
‘We don’t want to pull down Belgravia. We don’t want to build housing estates in Hyde Park. We should adopt the same approach to the countryside.’
But opponents warned that house prices will rise even higher in rural areas if new homes are not built there.
The row comes at a time when the average home in the countryside costs around £200,000 – around £30,000 more than a town house.
The Windrush is a river in the Cotswolds, which flows through the famously picturesque village of Bourton-on-the-Water as well as the Prime Minister’s constituency town of Witney.
Prices of homes near the Windrush can be eye-watering, with bungalows in Bourton-on-the-Water selling for up to £645,000 in recent months.
But Sir Simon, who was speaking in a personal capacity, told the Home Builders’ Federation conference in central London: ‘I want building to take place in towns on the whole. I want there to be massive incentives to build in towns because it makes more sense.’
He said there will be many parts of the countryside – ‘on the whole, rather lovely parts of the countryside’ – that ‘just don’t want to take large numbers of more people.’
He singled out the Cotswolds village of Stow-on-the-Wold, where he said many residents are ‘seriously angry’ at proposals to build a large number of new homes.
Last night his comments were attacked by those who said more affordable rural homes were needed.
Stewart Baseley, executive chairman of the Home Builders’ Federation, said: ‘We need to be providing homes across the country in places where people want to live. We should not be trying to just pigeon-hole people into living in towns where they might not want to live.’
Kate Houghton, from the Campaign to Protect Rural England, said: ‘We do agree that the bulk of new housing should be built in or near to urban areas, so people have more easy access to public transport, community facilities and essential services.
‘However, if we don’t make provision for at least some affordable houses in rural areas, where it is clear that there is need and people do want to stay, then our villages could become little more than retirement ghettoes or commuter dormitories.’
At the conference, Malcolm Harris, chairman of house builders Bovis, accused Sir Simon of being ‘quite naïve’.
He said: ‘These are your children. These are people who already live in the community. We have failed for year after year after year to provide the housing. That is a real issue in Great Britain.’
In England, around 110,000 new homes are built ever year, but this is way behind the rate at which new households are being formed, estimated to be around 230,000 a year.
A spokesman for Priced Out, the first-time buyers’ campaign group, accused Sir Simon of being ‘out of touch with the aspirations of hard-working young adults who have been priced out of a home in their local area.’
Housing Minister Mark Prisk, who spoke at the same conference, said home ownership remains the dream of the vast majority of Britons.
He told builders that the quality of the homes they build is just as important as the quantity, calling on them to reject the stereotype of the ‘rabbit hutch’.
Sir Simon’s intervention comes weeks after Planning Minister Nick Boles warned Britain will be dragged back to the 19th century when home-ownership was the preserve of the wealthiest unless more homes are built.
He said: ‘We can pass by on the other side while working men and women in their twenties and thirties have to live with their parents or share bedrooms with friends.
We can shrug our shoulders as home ownership reverts to what it was in the 19th century: a privilege, the exclusive preserve of people with large incomes or wealthy parents.
‘Or we can accept that we are going to have to build on previously undeveloped land and resolve that we will make these decisions locally.’