Saturday, September 30, 2006

NHS HOSPITAL TREATS ELDERLY PATIENTS LIKE ANIMALS

And kills them!

A coroner has criticised a hospital for offering "despicable" and chaotic treatment after hearing that four elderly patients died in painful and degrading circumstances. John Pollard, who conducted inquests into all the deaths on the same day, said that he would be raising his concerns with the management of Tameside General Hospital in Ashton-under-Lyne, Lancashire. He condemned as "absolutely despicable" the treatment of Watkins Davies, an 84-year-old war veteran, who went into hospital with a fractured hip and contracted MRSA, the hospital superbug, The inquest was told that Mr Watkins, a widower, was the victim of a catalogue of failures in basic nursing care. When he fell out of his chair, while trying to wash himself, no X-ray was carried out to assess any additional injuries.

His family claim that he was left to lie in his own waste and was in severe pain for hours because of shortages in nursing staff. His meals were left up to 6ft out of his reach. Relatives told the inquest that they repeatedly had to ask a nurse to help him. Ivor Davies, his son, said: "My father did not receive adequate medical and nursing care. There was a lack of communication between nursing staff and us. "I went in one day and my dad was lying in excrement. God only knows how long he was like that. I asked whether the infection was MRSA, only to be told it wasn't. A couple of days later I was told it was MRSA after all."

Mr Pollard recorded a verdict of accidental death. He also heard that Hilda Douglas, 75, died at the hospital from a heart attack after fracturing her pelvis. The family of Mrs Douglas, a voluntary worker from Droylsden, near Manchester, said that she broke her hip when she fell from a hospital trolley without sides. There was no record of the fall. Edward Douglas, her son, said: "There was one nurse per three beds and the nurse said she could not cope." He said that medication had been left on the floor.

Recording a verdict of death by natural causes, the coroner said he found this astonishing. "What if that had been vital medication?" he asked. "It is absolutely chaotic." A third inquest heard that Raymond Lees, from Ashton-under-Lyne, who died in May, contracted MRSA after undergoing a knee replacement operation. During his time in the hospital his waist shrank by 14 inches. John Lees, his son, said that it had taken him three hours to discover that his father had not been bathed and that hospital staff did not appear to know his name. "The nurse said, `He gets himself up, dresses himself and does his own teeth'," Mr Lees said. "In fact, he was wearing the same pyjamas he had been wearing for three days. The nurse was cruel and cynical."

A fourth inquest was told that James Kelly, a pensioner from Stalybridge, Tameside, was recovering from surgery but died from pneumonia after he was left sitting in his dressing gown in a draught. Mr Pollard said: "In most of the issues, the nursing care, not the operations or the general medical staff, but the basic care of people, has been in question. I shall be contacting the chief executive and looking at all future deaths at Tameside General Hospital very carefully."

Andrew Burnham, a Health Minister, said: "I understand that the hospital trust has in place a range of measures to ensure that patients receive the high-quality nursing care they have every right to expect. These include daily rounds by matrons to check on patient care, including nutrition and hydration, all of which are reported back to the director of nursing, who has ultimate responsibility for the standard of care." A spokesman for Tameside and Glossop Acute Services NHS Trust said: "These cases are being investigated internally and the trust will act on the results of these investigations."

Source





CANADIANS NOT GOOD ENOUGH FOR THE NHS

Too white, probably. That many Canadians and Australians died for England in two world wars apparently deserves no gratitude or recognition from England's present Leftist government -- regardless of the offence that causes to Canadians and Australians

As many of you know my wife and I have recently emigrated to the UK from Edmonton, Alberta. My wife is a Canadian nurse with a first class degree in nursing from an English speaking university, and she herself is a native English speaker. In fact it is her only language, though, like many English-speaking Canadians, she does have 'cereal packet French'.

Before coming to the UK we had to travel down to Calgary, some 300km away, in order that she could sit an British Council English exam (cost $400), which is a prerequisite for 'foreign' nurses coming to work in the NHS (perhaps unsurprisingly for a native English speaker with a degree from an English-speaking university she passed the six hour ordeal - spoken English, understanding spoken English, written English and reading - with a 100% pass mark). Canadian nurses have to go through this costly ordeal in order to get professional registration with the Nursing and Midwifery Council, bizarrely EU nurses do not.

Upon getting here she understood that she would have to be retrained to 'NHS standards', which in itself is laughable due to the fact that Canadian nurses are trained to a much higher level than the average UK nurse. But still, we accepted that this was the price (œ300 to be precise) that we would have to pay.

The whole moving and shipping process took some time, as you can imagine, and when we arrived in the UK and phoned the Nursing and Midwifery Council (NMC) we were informed that it was not really worth her while retraining and applying to register as a nurse in the UK because the Government had just changed the rules of engagement between health sector employers and foreign nurses. Essentially employers, if they wanted to employ a foreign nurse, had to prove that there was no British or EU nurse that could fill the role. Consequently she would be unable to get a job. Tears.

Eventually, after several weeks enquiry, and in the face of ongoing and insistantly negative NMC advice, a man at the Foreign Office informed us, as we expected, that it was illegal to discriminate against anyone with a valid UK work permit (which of course we obtained when we were in Canada). The bureaucracy of the NMC (a body created by Nu Labour); their general incompetence and bad advice; added to the fact that retraining courses for foreign nurses are now very difficult to come by because foreign nurses are actively discriminated against and no longer come here, means that by the time she can get on a course and retrain she will have been out of work as a nurse for six months. And incurring retraining costs along the way.

She (we) decided not to bother. The result is that the NHS, and the country, has lost a specialist paediatric nurse, a skilled immigrant, who can work to an extremely high standard to the benefit of us all. But this is not a story of complete woe; as soon as she decided not to persue a career in the NHS she was immediately snapped up by the private sector to fulfill a paediatric training role. She now earns about the same as she would as a nurse in Canada - 40% more than a UK nurse - but the problem is that she desperately wants to nurse; it is a vocation, not just a career. And to add insult to injury there is a chronic national shotage of paediatric intensive care nurses.

The result of all this is that I have on my hands a wife who is deeply embittered about the way she has been treated by the UK Government. I regret, and she regrets, that we came back, which is a crying shame as we moved here because we love England.

Anyway, I thought I would get that off my chest. In our dealings with government organisations (mostly the NMC) during this whole saga (which would take me a week to relate to you in full) we have found them to be, almost to a man and woman, completely incompetent and unhelpful. The one redeeming organisation was a non-governmental professional body called the Royal College of Nursing, the general secretary of whom is Dr Beverley Malone.

Dr Malone is an extremely politically astute woman, a credit to her organisation, who has railed against the Government's discrimination against foreign health workers. She objects, in particular, to the way the government cherry picked third world nurses from abroad, depleting those countries of their greatest natural resource, and now intends to pack them off against their wishes as soon as their work permit expires and their employers are forced to employ an EU nurse.

We have been the unfortunate victims of the Government's scramle to recruit foreign nurses and then their scramble to unemploy them in the face of criticism of falling standards, poor English, and third world cherry-picking. Wrong place. Wrong time. But our experience probably pales into insignificance compared to some poor souls.

Dr Beverley Malone now turns her attention to government discrimination against the English:

Under English law, patients in homes are entitled to state support for their nursing care but must foot the bill for "personal" care. In Scotland, by contrast, the whole bill is paid.

And there have been allegations that English patients have been subject to a "postcode lottery" caused by variations in interpretation of the rules around the country.

The Royal College of Nursing claimed the new proposals would fail to solve the problems. It called for a single national policy - and objected to plans to hand policy-making to local primary care trusts.

RCN general secretary Dr Beverley Malone,pictured, said: "It is nurses who are put in the impossible position of having to explain complicated and often unfair decisions to patients and their families.

"The RCN believes that anyone who needs nursing in a care home should get this care fully funded by the NHS. Nursing care is a fundamental part of healthcare and should be funded by the NHS.


Well said that woman. The sad fact is that we no longer have a national health service. It is, of course, beyond her remit to point out the constitutional and funding reasons why this might be so. But I have no doubt that she is aware of the facts.

Source






BRITISH LEFTIST LEADER FINALLY FACES THE OBVIOUS

Alan Johnson displayed his leadership credentials to the Labour Party conference yesterday when he announced plans to restore confidence in school exams and to help children in care. The Education Secretary unveiled an overhaul of GCSE coursework to combat internet plagiarism by pupils. He said that all coursework for maths would be scrapped and that coursework for other subjects would be supervised in classroom-style conditions. "Technology has changed the way we teach, but can also be used by some students to gain an unfair advantage," Mr Johnson said. "We have one of the most rigorous exam systems in the world [Who does he think he is kidding??] - we cannot have it devalued and undermined by the few who cheat by copying from the internet."

He also announced extra funding for children in care, including a 2,000 pound bursary for those who wanted to go to university. "Every child in our society must have access to the educational opportunities that have always been available to a small elite," he said.

The tone of Mr Johnson's speech was crafted deliberately to dampen speculation about his leadership ambitions and instead concentrated on policy, with a theme of using education as a tool to tackle inequality, poverty and injustice. Received politely rather than enthusiastically, it came amidst a heated row over health policy - a distracting backdrop for Mr Johnson.....

Mr Johnson's decision to halt GCSE maths coursework comes after two reviews by the Qualifications and Curriculum Authority, the examination watchdog, which reported last November that there was widespread evidence of cheating. Maths was the subject that gave rise to the greatest concern. Two thirds of maths teachers questioned said that they suspected students had cheated by using the internet or asking parents or siblings for help. However, the authority also expressed concern about science coursework, which Mr Johnson will let continue, but under tighter supervision. The changes may take two years to introduce and enforce.

More here







Town planning blamed for obesity (!)

Poor town planning which limits opportunities for children to take exercise has been blamed for fuelling an increase in obesity. Leading US paediatrician Professor Richard Jackson called for a rethink in the way towns and cities are developed. He said living in a walkable neighbourhood helped people keep off an average of seven pounds (3.17kg). Professor Jackson made his comments at a lecture at London's Institute of Child Health.

He said humans were so adaptable that they quickly adjusted to the environment in which they found themselves. However, while this was an advantage in evolutionary terms, it spelled bad news when that environment provided little opportunity for exercise. Humans were designed to keep active, he said, and they were not designed for the modern, sedentary lifestyle that had become the norm. He said the environment should support people to make healthy choices, but increasingly children were not given the option of walking. "Prescribing a minimum of physical activity is useless if there is nowhere to exercise," he said. "How a neighbourhood is designed dictates how people get around, for example walking or bicycling versus automobile use."

Professor Jackson, who is professor in both public health and urban design at the University of California at Berkeley, said technology had brought both "good" and "bad" news. He said: "Technology has eliminated a lot of the really backbreaking labour from our lives. "But we have also "designed" a lot of incidental exercise out of our lives, such as walking. "In 1969, 48% of American students (90% of those who lived within a mile) walked or bicycled to school. "In 1999, only 19% of children walked to or from school and 6% rode bicycles to school."

Dr Ian Campbell, medical director of the charity Weight Concern, said Professor Jackson was "absolutely right". He said: "The development of obesity in the past 30 years is a direct result of environmental change. "The fact that environment sustainability and health are inextricably linked needs to be recognised by politicians and public health officials and definitive action taken. "Then, and only then, will we see decreases in levels of childhood obesity in this country."

Source






Scotland: More Encouragement for Lying, Deception and Dissimulation

We read:

"Screening tests might be used to bar corrupt and bigoted police officers from promotion. Senior officers yesterday said they will look to extend psychometric tests, which will be introduced to identify racist applicants from the spring, to other ethical concerns, in particular sectarianism, sexism and dishonesty.

Source


We have of course known since La Piere's study in the 1930s that attitudes are no guide to actions but that will no doubt not deter the dumb Scottish cops concerned.

Reference:

La Piere, R. (1934) Attitudes and actions. Social Forces 13, 230-237

Friday, September 29, 2006

BUREAUCRATIC HEAVEN PROPOSED FOR THE NHS

For the past couple of days I've been wondering what it is that the rest of the world sees in Mr Brown's NHS reform that I've missed. Those people who don't confidently reply "son of the manse" when asked about Mr Brown instead say "man of substance" and cite his NHS reform plan as evidence of his sagacity. And there am I thinking that it is completely daft.

The policy of giving the Bank of England the power to set interest rates, free from political interference, has been an undoubted success. So now Mr Brown wants to extend that model to the public services, with the NHS most commonly named as the first to be reformed in this way. An independent board will be established to administer the service, with the role of politicians restricted to setting overall goals and strategy. Conservatives are sufficiently enthusiastic about the idea to claim that Mr Brown has stolen it from them. The day will come when the Tories will pretend that they had nothing whatsoever to do with it....

The NHS is not like the Bank of England. The Bank is setting the price of money. The NHS has an output not far off that of Portugal. It handles something like 10 per cent of our national income. It employs thousands and thousands of people. It is a very different animal.

There are two ways of holding such a body to account. The first is through voice - the right to protest to a political representative who depends on your vote. The alternative is exit - the right to take your custom elsewhere, with the seller dependent on your patronage in order to thrive. Mr Brown plans to remove both these forms of accountability. When he describes the new board as independent, you just have to ask: independent of what, exactly? And the answer, it turns out, is independent of you and me.

Sir Peter Lachmann, former president of the Royal College of Pathologists, felt moved to write to this newspaper that Mr Brown's new policy was "probably the best news the NHS has had in the past 30 years". I was not surprised to read this endorsement. The senior management of the service is bound to conclude that the interference of meddling politicians is nothing but a nuisance. They want to run their NHS with our money and without us pesky voters sticking our nose in the whole time.

The Chancellor is arguing that the closure of a local hospital ought to be decided by health service managers without the right of politicians to prevent it. If he isn't saying this, he is saying nothing. But is it really acceptable that such sensitive decisions be made only by a group of unelected people, accountable only to each other and without appeal to the local electorate? The model that Mr Brown intends to apply to the NHS is not really the Bank of England at all. It is, well, the model that the Tories tried to apply to the NHS in the mid-1980s.

In 1985 Norman Fowler, then the Health Secretary, appointed Victor Page as the chief executive of the NHS with the idea of relinquishing political control of administrative matters. It was perhaps with this experience in mind that another former Health Secretary yesterday told me that he thought Mr Brown's plan was "bonkers". Political pressure from voters and the media ensured that it didn't last five minutes. And neither will Mr Brown's plan.

There is an alternative. If Mr Brown truly wants to stop political interference in the day-to-day decisions made by clinical staff and local management there is something he can do. He can replace accountability by voice with accountability by exit. If a local hospital were to close because everyone was using a better service near by it might anger some residents. But no one could claim that the service providers were unaccountable.

The Chancellor has set his face against such a Blairite (actually Tory) solution. But his third way between two forms of accountability is to provide no accountability of all. His NHS board idea was intended to reinforce his image as a man of substance. I think he would have been better off with one of Doddy's wisecracks.

More here





BRITISH TEACHERS BAD AT TEACHING CITIZENSHIP

Compulsory citizenship classes covering subjects such as the law, the electoral system, human rights and economics are unsatisfactory in a quarter of all secondary schools - often because teachers do not know what they are talking about, research suggests. A devastating report from the schools watchdog Ofsted has found that gaps in teachers' subject knowledge and an insecure grasp of what the lessons were supposed to achieve, led to dull or irrelevant classes that were counter-productive. The report called for more training of specialist teachers and gave warning that the subject citizenship often strayed into areas such as immigration or racial, religious and ethnic diversity, "where little knowledge can be a dangerous thing".

In one of the worst classes observed by inspectors, a lesson on the principles of decision-making in society drifted into a discussion of the bodily needs of people stranded on a desert island. A more common failing was for lessons on conflict resolution - which should include discussions of the role of Parliament, the UN, nongovernmental organisations, and pressure groups - to turn into discussions on friendships and relationships. Inspectors were also appalled by the lack of written work, which they attributed not to any failing by the children but to the low expectations of their teachers. "Very good and lively discussion can be followed by dismal written activities," the report said.

Citizenship education has been part of the national curriculum in secondary schools since 2002 and is compulsory for pupils aged 11 to 16, but there have long been concerns that teachers are ill-prepared to teach it. The report found that while a minority of schools teach it well, in most the teaching was found to be merely adequate. Provision in a quarter of schools was inadequate.

Although growing numbers of schools are entering pupils for a short GCSE course, the report concluded that too few schools taught citizenship as a subject in its own right, with many lumping it in with classes in other core subjects, such as history or geography. Some schools merely assumed that the good ethos and behaviour of their pupils meant they were "doing it already". Others were wary of engaging pupils in political discussions.

The findings raise important questions about the purpose of citizenship education, which was introduced amid concerns about political apathy among young people and fears that society faced a "moral crisis". These worries have since been overtaken by public and political concerns about immigration, diversity and multiculturalism, raising questions about what the focus of citizenship lessons should be. Sir Bernard Crick, one of the architects of citizenship teaching in schools, said the subject should educate children in how to be politically literate, using real issues.

The Department for Education said that 1,200 new citizenship teachers were being trained over the next two years. "Citizenship has had a positive impact on the curriculum in the majority of schools and we are confident it will continue to improve as it becomes more embedded," a spokesman said.

More here

Thursday, September 28, 2006

ARTS CENTRE FUNDED BY BIG BUSINESS SHOWS UP THE REST

(The "City" is London's financial district. It is a very small part of London as a whole)

Should we be surprised that the best-run and most critically acclaimed arts centre in Britain receives not a penny from the Arts Council? Should we be astounded that, without the benefit of a single directive from the Government’s culture quango about the importance of multiculturalism, access, diversity, outreach — or any of the other new Labour buzzwords rammed down the throats of people in the arts for the past nine years — this arts centre should nevertheless be pulling in 770,000 socially diverse punters a year? And what does this say, by inference, about the stifling effect of the nanny state on less independent organisations?

These questions popped into my head last week as the Barbican Centre in London announced plans to celebrate its 25th birthday in March with 25 brilliantly devised “landmark events”, ranging from an Icelandic epic and an Islamic festival to glitzy concerts and a celebration of punk. At the same time its management unveiled the finishing touches to a £30 million transformation that has swept away the worst features of the once-derided architecture. The hopeless non-entrance, Kafkaesque corridors, baffling signs and dry-as-dust acoustics in the concert hall: all have been remedied, leaving the place looking sleek, chic, and fit for service for at least the next 50 years.


What makes this feat close to miraculous is that, only 12 years ago, the Barbican was a byword for fear, loathing and chaos. The Royal Shakespeare Company, then resident in the centre, was locked in perpetual war with the management, which was itself chronically dysfunctional. When an abrasive woman from the Milk Marketing Board was appointed to run the centre — on the grounds that if you can sell a full range of dairy products you can surely flog King Lear — the nadir was reached. Even the City of London Corporation, which built the place, seemed in despair about its future.

But in 1995 John Tusa, a former BBC mandarin with an insatiable taste for culture, was appointed managing director, and a quiet visionary called Graham Sheffield brought in as artistic director. They have wrought a renaissance. Today, the Barbican must rank as the world’s top arts centre — easily outclassing the Lincoln Centre in New York for adventurous programming and sustained quality.

Enough about Tusa and Sheffield, however. They aren’t short of cheerleaders. What interests me about the Barbican is its funding. Its £18 million subsidy comes not from the Government via its poodle, the Arts Council — with the mandatory clump of social-engineering strings attached — but from the City of London Corporation. Which, rather astonishingly, makes that local authority the third biggest funder of the arts in Britain.

I have my dozy moments, but I’m not so naive as to think that the City is coughing up such substantial dosh out of pure altruism. In case you hadn’t noticed, there’s a war going on. The Square Mile, centre of the financial universe for so long, is facing competition not just from Frankfurt and Tokyo, but from an upstart on its doorstep — Canary Wharf. The battle to retain the big bank HQs and dealing-rooms is being fought on many fronts, not least the phallic rush to erect the tallest tower in town. But one vital area is “quality of life”. And the fact that the City has an arts centre that mounts 900 top-class events a year is a huge advantage.

But the City’s motives for funding the Barbican don’t really matter. What’s important is that it doesn’t interfere in how the centre is run. It appoints top arts professionals, then lets them get on with the job. It doesn’t try to micro-manage areas beyond its competence. It liberates those it finances, rather than stifling creativity with endless red tape and petty “accountability” procedures.

Well, you can see where I’m heading. The way the Barbican is run is in stark contrast not only to every other subsidised arts organisation, but to most other areas of public life in Blair’s Britain. What we have seen over the past nine years has been an unprecedented increase in the number of political diktats that attempt to regiment every facet of our existence — from health, diet and education to the law and liberty. At the root of this trend are power mania and arrogance. We are now ruled by people who not only want to control the smallest aspects of our lives, but who are vain enough to think that they know better than the experts in any field.

Of course I accept that, in a democracy, politicians must regularly scrutinise publicly-funded professions on our behalf. But it’s a question of degree. The endless, pointless meddling of recent years has simply stopped good people doing their jobs well. I see that Gordon Brown has promised more “devolved” decision-making in future. It’s hard to believe, since under his iron rule the Treasury has broken all known records for control-freakery and arrogant interference in areas that have nothing to do with the economy — a prime instance being the way that arts organisations operate. The Barbican is a shining example of the good things that can happen when politicians keep their clumsy fingers out of the pie. Let’s see more abstinence in future.

Source





BENEDICTINE SCAPEGOAT IN SCOTLAND



A sleepy community of Benedictine monks in south Devon is the latest, and perhaps most unlikely, target in the battle against binge drinking. Alcopops come and go, but Buckfast wine is a perennial favourite among young drinkers keen to test their alcohol limit. Now the tonic wine produced by the Benedictine monks of Buckfast Abbey, Devon, has fallen foul of law makers, who believe it has much to answer for. Scottish health minister Andy Kerr is the latest politician north of the border to express concerns about the effects of the drink commonly known as Buckie - citing its link to binge drinking. "There's something different about that drink," says Mr Kerr, calling it "seriously bad".

Buckfast Tonic Wine originates from Roman Catholic monks - not a group traditionally associated with the drunken masses - and was first produced by them more than 100 years ago, using a recipe brought from France. It is red wine-based, with a high caffeine content. Tellingly, the label on the bottle reads "the name tonic wine does not imply health giving or medicinal properties." It is sweet and viscous. At 5 pounds for a 750ml bottle, it is cheap but powerful - alcohol content is 15% - and considered a rite of passage by many an ambitious young drinker. "It tended to precede a rather spectacular night, because it's horribly potent," recalls Paul, a former student at Manchester.

But it is the drink's prevalence in the so-called Buckfast Triangle - an area east of Glasgow between Airdrie, Coatbridge and Cumbernauld - that has raised concerns. It even spawned its own episode of the Scottish TV comedy Rab C Nesbitt and is known locally by several pet names: Buckie Baracas, a bottle of "what the hell are you looking at?", Wreck the Hoose Juice and Coatbridge Table Wine. More seriously, there have been calls to have it sold in plastic bottles, because of the mess created by broken ones on the street, and, in court, it has been implicated, along with vodka, in one car crash death in Doune, north of Stirling.

David, a Glasgow pub manager, confesses to having enjoyed Buckfast in his formative drinking days, and perceives a strong social stigma linked to its abuse. "There's a huge problem with it in the streets," he says. "Fifteen and sixteen-year-olds drink Buckfast and they'll have no qualms about tooting someone over the head. It all stems from boredom. They'll have two to three bottles and it's like lighting a touch-paper, they go wild." But the drinks industry, and Buckfast's maker, say it is being made a scapegoat for what is a wider social problem of alcohol abuse. Spokesman for distributors J Chandler & Co (Buckfast) Ltd, Jim Wilson, points out that Buckfast trails other drinks, like whisky, in sales. It has only a half a per cent of the total alcohol market and does not feature in the top 100 brands.

Of its £30m annual turnover, 10% is sold in Lanarkshire and much exported to Spain, Australia, and the Caribbean - where its not blamed for a society's ills, says Mr Wilson. At the request of the monks, Buckfast is not advertised in areas perceived to have difficulties, no two-for-one or 20p off offers here. Talks between the distributor and Mr Kerr have been slated for 30 October. "The problem with anything alcoholic is if it's abused," says Mr Wilson. "Why target Buckfast? If your policies aren't working, and you're looking for a scapegoat, have a go."

Source





KILLER NHS HOSPITAL

Government health inspectors are to investigate how Maidstone Hospital in Kent handled an outbreak of an infection that killed six patients and contributed to the deaths of fourteen others. The Healthcare Commission announced an inquiry yesterday into Clostridium difficile, which it said followed concerns about the rates of infection at the hospital since 2004. C. difficile is the main cause of diarrhoea infections in British hospitals, and contributes to more deaths than MRSA.

The inquiry into Maidstone and Tunbridge Wells NHS Trust will examine whether the rates of C. difficile are high, taking into account all factors. The investigation, one of only two the commission has conducted into C. difficile, will look at outbreaks of the infection and evaluate the trust's systems and procedures for controlling it. It is also likely to consider the trust's arrangements for identifying and notifying cases, the factors contributing to the rates of infection, the trust's response on the wards, and the priority given to its control.

The investigation was requested by the South East Coast Strategic Health Authority and the trust, whose three hospitals serve Maidstone and Tunbridge Wells and surrounding areas including Tonbridge, Sevenoaks and parts of East Sussex. C. difficile can cause a wide range of symptoms, from mild diarrhoea to life-threatening conditions.

Nigel Ellis, head of investigations at the Healthcare Commission, said: "Our investigation will examine how the trust identified and dealt with cases of C. difficile. "We recognise that outbreaks of infection are not always easy to control, but when they do happen they pose a very serious risk to patient safety. "We need to find out what happened, what systems the trust has in place to ensure this does not happen again and whether further improvements are needed to protect the safety of patients."

The commission, which is the independent inspection body for the NHS and the private and voluntary healthcare sectors, will publish its findings and recommendations for improvement in a report expected next year.

Maidstone is by no means the first hospital to suffer a serious outbreak of C. difficile. A total of 334 patients were infected with the bacterium and at least 33 died between October 2003 and June last year at Stoke Mandeville Hospital in Aylesbury, Buckinghamshire. In a highly critical report into that outbreak, published in July, the commission said that there had been serious and significant failings in the way in which senior hospital managers had responded to it.

According to the Office for National Statistics, in 2003 there were 1,748 mentions of C. difficile on death certificates, of which 934 noted the infection as the underlying cause of death. Between April and June, 136 patients at Maidstone Hospital were found to be infected with C. difficile, the trust said. The infection was the definite cause of death of six patients; in fourteen others it contributed to their deaths but was not the main cause, and it was unlikely to have led to the deaths of four other patients who had had the infection.

Source

Wednesday, September 27, 2006

HOLLOW VICTORY AGAINST THE NHS OVER HOSPITAL CLOSURE

A former nurse who won her High Court battle against hospital ward closures yesterday said that it was not a genuine victory. Pat Morris, from Altrincham, Greater Manchester, risked her home and savings on waging a campaign against Trafford Healthcare NHS Trust after it decided to cut beds at her local hospital without consulting the community. Mrs Morris, 65, resigned her nursing job to concentrate on her legal battle and faced having to pay the trust's legal costs had she lost the case.

Yesterday Mr Justice Hodge backed her view that the trust's decision in March to close 26 rehabilitation beds for older people without consultation had been illegal, and ordered that it be quashed. However, he refused to order that the two wards at Altrincham General Hospital, where Mrs Morris worked for several decades, be reopened immediately. Mrs Morris and her barrister, Anthony Eyers, who worked on her case for no charge, said that they expected NHS managers to pay lipservice to consultation but to keep the wards closed.

Mrs Morris said: "There are no winners today, only losers. They will just go through the motions only to tell us the wards will stay closed. The challenge has been made and the trust have been found wanting, but the elderly, vulnerable people of Altrincham still don't have their care close to home. "I don't have to pay thousands of pounds, but in human terms we have still lost a lot in the last few months. I have no regrets about bringing the case, except that the judge decided it was not his duty at this time to reopen the beds."

Mr Justice Hodge said that the trust would have to reach a new decision after public consultation. He added: "It cannot be right for this court in its discretion to order the reopening of the wards on the basis that there will be a public consultation which might legitimately then decide to close them again."

Mrs Morris has led the campaign against the cuts at Altrincham General since resigning from her job there in 2003 after 16 beds were cut. She was a member of the Patient and Public Involvement Group, a watchdog representing local residents, but left to fight her battle. At one stage the entire hospital was threatened with closure, but Mrs Morris, a former Tory councillor, organised a self-funded series of public rallies, letters and petitions. Hundreds of people turned up to her public meetings, but it was Mrs Morris who sought the judicial review on behalf of the group Health in Trafford. She risked an 80,000 pound bill for legal costs if the judgment had been made against her.

Trafford Healthcare NHS Trust, which is 9 million in debt, will now have to pay its own legal costs. Mrs Morris was awarded her costs, which were less than 1,000 pounds.

Mr Eyers described the ruling as a "Phyrric victory". He said: "It has ramifications for the whole country because it gives a green light to trusts that they can act first and take the legal flak later. They may have to fight, but they can act with some certainty that their decisions will not be reversed. I now expect the trust to make a series of empty promises that they won't deliver on." Mr Eyers said he had taken the case pro bono as a matter of principle: "I live in the Altrincham area and so it had some personal resonance, but NHS trusts, like any public body, should be accountable to the people they serve." He said the same principles had been behind Mrs Morris's fight: "She would have given every last penny she had if it had achieved something for the people of Altrincham."

Trafford Healthcare NHS Trust said that it had cut the beds because "it was no longer a safe place for patients to receive care. Anyone visiting the hospital would be struck by the dilapidated state of the buildings and the nursing and medical staff were no longer confident that they could provide safe services". [And whose fault would that be?] It added that four public meetings would be held next month to decide the future of in-patient wards at the hospital

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Jamie Oliver: what a 'tosser' [jerk]

St Jamie's school-dinners crusade returns tonight, providing yet another unhealthy serving of food fears with a side order of parent-bashing bile.

The man in the checked shirt wobbles towards the bus, ice-cream cone in hand, not sure whether to keep licking or run faster. Then disaster strikes: he drops the cone. As he looks down in horror, the bus pulls away. Unperturbed, the fat feckless f*** scoops up the ice-cream from the ground and stuffs it in his mouth.

The man in the checked shirt is Jamie Oliver, all padded up in a fat suit. And the scene is the trailer for the latest phase in his ‘school meals revolution’, Jamie’s Return to School Dinners, which airs tonight on Channel 4. The implication is that unless we all respond to Jamie’s call to arms, we’re ignorant scum condemning many of today’s children to a life of disabling obesity and chronic ill-health.

Giving children the option to eat relatively fresh and nutritious food during the school day is an attractive one. But Oliver’s crusade is based on distortions about the quality and importance of children’s diets, and a contempt for any parent who doesn’t fit in with his idea of how they should be raising their kids.

This contempt no doubt extends to Julie Critchlow and Sam Walker, two mums who have started a ‘junk food’ run for kids at a school in Rotherham, northern England. They’re taking orders and cash through the school fence and returning with food from local takeaways. ‘This is all down to Jamie Oliver. I just don’t like him and what he stands for’, Walker told the Sun. The Sun, never afraid to take a cheap shot, described the women as ‘junk mothers’ who exhibit ‘the kind of feeble parenting that turns kids into fat, lethargic burger addicts in the first place’ (1). Oliver is not the only one who thinks that parents who won’t toe the line are neglecting their kids.

In tonight’s programme, Oliver doesn’t hold back. ‘I’ve spent two years being PC about parents. It’s kind of time to say if you’re giving very young kids bottles and bottles of fizzy drink you’re a fucking arsehole, you’re a tosser. If you’ve giving bags of shitty sweets at that very young age, you’re an idiot.’

The programme demonstrates that running a one-man revolution is hard work. In Lincolnshire (a relatively poor farming county) he discovers that many children aren’t offered hot meals at all because school kitchens were closed under the last Conservative government. He tries to get local businesses to fill the gap – and then discovers that even those model ‘healthy schools’ he set up down south are running into problems. Kidbrooke School in the London borough of Greenwich, the place where it all started in the first series of Jamie’s School Dinners, is losing thousands of pounds because it no longer sells crisps, chocolate and fizzy drinks at break times. The kids buy their treats on the way to school, handing their money to local shops rather than the school. The extra government money provided after the last series is insufficient to cover the shortfall.

Oliver seems to spend his whole time firefighting. Up in Lincolnshire, he arranges for a local pub to provide meals to nearby primary schools. That means mass catering in a totally unsuitable kitchen before parents and taxi drivers deliver the food to the schools. Unsurprisingly, hygiene standards at the pub are well below what would be expected in a school, the food quality suffers as the chef tries to eke out a profit, and parents drop out as their initial enthusiasm fades. In the end, the pub pulls out, no doubt thinking they needed the whole loss-making operation and bad publicity like a hole in the head.

Oliver makes his life a lot harder by his prejudices about processed food and local production. Why a Panini filled with meat and a couple of sprigs of basil is any better in terms of nutrition than a ham sandwich made with white sliced bread is never explained. He insists on emphasising small and local provision – even when it is clearly unsuitable – over trying to persuade the big caterers with their economies of scale to alter what they provide. The whole operation is doomed to be unprofitable, so businesses quickly lose interest. His schemes only keep going because dinner ladies work unpaid overtime – which they eventually tire of, considering that even when they’re getting paid, it is only the measly minimum wage.

So Oliver’s tone becomes increasingly intolerant. He is unable to comprehend why others are not as motivated as he is. ‘This is not the Jamie Oliver show, this is not a fucking pantomime.… I’m here because I truly care. I’ve got other shit to do’, he says. When a mother drops out of the Lincolnshire pub scheme because her little boy isn’t keen on the pasta and rice served up, Oliver suggests dismissively that they have a chat with the nutritionist who came up with the menus, implying that she was letting her son down. And when a young teacher is found with some junk food ‘contraband’ in her bag, he charmingly suggests: ‘That’s no way to live, darling. You’ve got to have some pride in yourself.’

Oliver’s crusade is the product of the panic over obesity and children’s diets and his campaign only helps to stoke these fears further. Far from being an unwelcome critic, he is helpfully touting the New Labour line on food, health and the inadequacies of parents. No wonder that when he meets Tony Blair at the end of the latest programme, Blair says he will happily extend the increased funding for school dinners for another three years. Oliver leaves triumphant, perhaps forgetting that at the start of the show he was moaning that the same amount of money was inadequate.

If we were facing an impending health disaster, changing the kind of meals children are served during the school year would make little impact. But in fact, as we’ve noted elsewhere on spiked, no such disaster looms. A diet of Turkey Twizzlers, chips and beans is not perfect, but it is perfectly adequate. Oliver’s horror stories about children vomiting their own faeces and dying en masse before their parents have no basis in reality.

As for adult eating habits, they are not determined in the school canteen. Children have always been rather conservative eaters who prefer all the ‘wrong’ foods, yet experience shows that they still grow up healthy and that their tastes mature. If our childhood eating habits mattered that much, most of us would have long since perished. What Oliver fails to comprehend is that he could provide haute cuisine and lots of kids would still refuse. Rejecting school meals in favour of bunking off down the chip shop is just another minor act of teenage rebellion.

While Oliver has been received with almost universal praise in the media, there are signs of a backlash from catering staff sick of working longer hours and parents sick of being lectured on how to bring up their kids. If the Rotherham example is anything to go by, maybe eating junk food will become more than teenage rebellion – perhaps it’s a way for parents to tell the patronising ‘tosser’ where to go, too.

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BRITISH CEMETERIES GOING MUSLIM

A new cemetery is to have all its graves aligned with Mecca - making it the first council graveyard in the country to bury the dead in Islamic tradition, regardless of their religion. Headstones in the new 2.5 million pound High Wood Cemetery in Nottingham will face north-east - as Muslims believe the dead look over their shoulder towards Mecca. This is the way in which all followers of Islam in the UK are buried. But the move has upset the Church and led to complaints that the policy discriminates against the city's majority Christian population. The traditional direction of burial for Christians is facing east.

The Bishop of Southwell and Nottingham, the Rt Rev George Cassidy, criticised the decision. He said: "This is a sensitive issue to all people. I hope the situation will be reviewed with wide consultation and a policy introduced that takes account of the needs of all." The decision was made by Steve Dowling, Nottingham City Council's Services Director for Environment and Public Protection, after liaising with the city's multi-faith Cemeteries Consultative Committee. He said: "For people of the Muslim faith this fits in with a religious requirement, but it will also ensure a tidy appearance for the site. People can choose to be buried facing another direction but if they do not specify that, they will be buried facing north-east. The vast majority of people do not express a preference."

But Brendan Clarke-Smith, Tory councillor for Clifton North, said: "I was totally bewildered when I read about this decision. I spoke to one of the local Muslim groups in my area and they were equally surprised by what had been done. It is utterly ridiculous and I know it'll create a lot of ill feeling both in Nottingham and the country generally." The clergy and critics of the policy at the new 40-acre cemetery are supported by Raza Ul Haq, Imam at the Madni Masjid Mosque. He said: "It is part of our religion for the dead to be aligned with Mecca. It is very important. But for Christians, if they want to face somewhere else we support them."

Last night a spokesman for the Institute of Cemeteries and Crematorium Management said it was the first time he had heard of any public cemetery in Britain choosing to have all its gravestones facing north-east, in line with Muslim tradition. "It is unusual,' he said. "It would seem appropriate if there was a large population of Muslims." In Nottingham, however, Muslims make up less than five per cent of the region's 500,000 population.

Nigel Lymn Rose managing director of A.W. Lymn Funeral Directors, and a past president of the National Association of Funeral Directors, said Mr Dowling had told him of the decision when he went to High Wood for a site visit and asked whether Muslims had been taken into account. He said: "I was astonished to be told, "Oh yes, we're burying everyone so they are aligned to Mecca. It will make things easier." "It's one thing to be buried facing north-east because that is the way the cemetery lies, or the plot within it - it is quite another thing to learn that you have been buried facing that direction because it follows Islamic law."

Brian Grocock, a councillor who took part in the consultation process, said: "I don't know how this has become such a big issue. "The consultations went on for three or four years. We had people of all faiths represented at the meetings - or they certainly had the chance to attend. Nobody I know had any objections to the plan." So far at Highwood there have been just six burials - of which three were Muslim.

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Should childhood come with a health warning?

This week, a group of experts raised critical questions about how we mollycoddle children - but they also indulged some childish prejudices

The modern world is damaging our children, according to a group of eminent experts. More than 100 children's authors, scientists, health professionals, teachers and academics joined Sue Palmer - education consultant, broadcaster and author of Toxic Childhood: How The Modern World Is Damaging Our Children And What We Can Do About It - in signing a letter to the London Daily Telegraph on 12 September 2006. It ran under the headline: `Have we forgotten how to bring up our children?'

Children are suffering, the experts claim, as a result of junk food, school targets and mass marketing. The modern world is not providing them with what they need to develop, apparently, which includes: `real food (as opposed to processed "junk"), real play (as opposed to sedentary, screen-based entertainment), first-hand experience of the world they live in, and regular interaction with the real-life significant adults in their lives.'

I share some of the concerns of the signatories, particularly the fact that children now have fewer and fewer opportunities to play outdoors. Children are often no longer able to play in the streets, walk or cycle to school, play in local parks, or just mess about with their friends away from the supervision of parents and teachers. And yet, many of the letter-signers' concerns seem to be shaped more by contemporary prejudices about modern living than by expert insights into what makes children tick.

Take the denunciation of junk food. As has been argued elsewhere on spiked, `there is no such thing as "junk" food. Our digestive systems do not distinguish between fish fingers and caviar.' (See Hard to swallow, by Rob Lyons.) We are bombarded with warnings about unhealthy modern diets and eating habits, yet life expectancies continue to rise - in great part due to vast improvements in most children's diets over the past 100 years.

And consider the warnings about new technologies. We are told that `since children's brains are still developing, they cannot adjust - as full-grown adults can - to the effects of ever more rapid technological and cultural change'. Most serious neuroscientists would dispute such a crass statement. Also, the idea that children find it difficult to adjust to `ever more rapid technological and cultural change' runs entirely counter to our everyday experience and to most scientific research. Numerous studies highlight the extent to which children are able to grasp and master new technologies. Indeed, many adults don't understand or use new technologies with the same ease that children do, which perhaps explains why they are so prone to seeing such technology as scary. We should be careful not to transpose our own, adult discomfort with technological and cultural changes on to children.

As former commissioning editor of spiked and freelance writer Jennie Bristow argues in an online debate sponsored by O2 to be launched on spiked next week, titled `Young People, Mobiles And Social Networking': `The fact that mobiles and the internet allow children access to "social networks" beyond the geographical boundaries of their daily lives is often seen as deeply scary, but it shouldn't take too much imagination to see that there is a positive side as well.'

It is not screen-based entertainment that is restricting children's play-space. Instead, it is adults' over-anxious desire to remove children from all risks. Adults are overly concerned with keeping children under their control and protection, and out of harm's way - which means they often end up restricting children's opportunities for `real' play. It could be argued that it is precisely because children are increasingly denied the freedom and space for experimentation and play in the `real' world that they are using the virtual world to try to gain some autonomy and independence.

The best thing experts can do for children is to argue for them to be given more freedom - not to do whatever they want, of course; they need clear boundaries set by parents. But unsupervised play isn't just some kind of childhood luxury that kids can do without. It is vital for children's healthy emotional and social development. Study after study has shown that it helps to develop children's ability to negotiate social rules and to create their own rules. Children need to learn to deal with risks and develop the capacity to assess challenges. They also need to be given the opportunity to develop resilience to life's inevitable blows. In short, taking risks in childhood goes hand-in-hand with developing new skills.

There is a danger that the experts feed into current fears for children's safety, thereby exacerbating the problem they are trying to alleviate. As Frank Furedi, spiked contributor and author of Paranoid Parenting, argued in the online magazine The First Post this week: `Despite their admirable intention, the authors of this letter may unintentionally contribute towards reinforcing a culture where every childhood experience comes with a health warning.'

The letter in the Telegraph ends with a call for a public debate `as a matter of urgency', in order to address the `complex socio-cultural problem' of an increasingly restricted childhood. Although children's lives have improved in very many ways over the decades, the signatories are right in highlighting that we do face a problem. Clearly, we need to ask some serious questions about what an increasingly structured, sanitised and relentlessly supervised world is doing to children. But it is important that we identify what the real problem is, rather than pointing the finger at easy `junk' targets and labelling children as fragile and easily damaged. So, let the debate begin.

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Impoverishing and disruptive effects of land-use restrictions in Britain

Appeasing the property-owning English middle classes, the green lobby, the National Trust and the Campaign to Protect Rural England, the government insists that newly-built housing confine itself to brownfield sites. Britain's antiquated planning system is always absorbing yet more government guidance on housing design, energy use and all the rest. But it gets more Byzantine each year for a reason: to make houses more difficult to build. In particular, the government will not allow working-class people to spread out and invade Britain's green and virgin soil.

The government prefers to cram people it regards as plebs into transport-free cities that are more and more tightly packed. Land must not be claimed, cheaply and easily, from nature. Instead, it must be expensively and with great effort `reclaimed' from horrid, man-made contamination.

As prices for houses around East London's Olympic Village will soon attest, the result is, once again, that the demand for a decent home with reasonable transport links far exceeds supply. It has long been evident that the Thames Gateway area, billed as Europe's largest housing development, will in fact see relatively few new homes built. But it has now become clear that the 40-odd overlapping quangos responsible for the Thames Gateway have, to all intents and purposes, turned it into the London Thames Gateway. An area which was supposed to fan houses out to the east coast will confine them to the east of the nation's capital.

Powered by green dogma, the government's rush for brownfield development is truly zealous. Some 74 per cent of new dwellings in England are now on brownfield land. By reaching this figure, the government is, in 2006, far exceeding its own target for 2008, which was that 60 per cent of new-build should by then be brownfield.

What an achievement! This is a beating of targets of which Joe Stalin would be proud. But through its eagerness to achieve high levels of housing density, the government also fuels the current wave of Malthusian sentiment around the issue of immigration.

As Neil Davenport has pointed out previously on spiked, today's elite outcry over levels of immigration panders to the backward idea that society's problems are caused by there being too many people. But a recent report by the Centre for Economics and Business Research, a London think-tank, has just highlighted a related but highly important issue. `What will bring the worst of all worlds', its chief executive Douglas McWilliams writes, `is to have the immigration but not the infrastructure, which will condemn all of us to traffic jams, rising house prices and overcrowding in schools, hospitals and elsewhere'.

We can leave Mr McWilliams to his own views on immigration. But his point about infrastructure is absolutely right. In certain local authorities, services such as education and health may well be unprepared for a relatively rapid build-up of local concentrations of immigrants. But in relation to accommodation, it is not the immigrant influx that leads to the perception that Britain is overcrowded and overpopulated, so much as the government's fanatical pursuit of high density in housing - a kind of Brownfield Brutalism that would condemn us all to a nicely designed broom cupboard. I am always suspicious of the view that the white working class feels itself `swamped' by immigrants. But to the extent that towns - Dover, for example - feel this way, it might be apt to blame, not immigrants, but the government's failure to fund expanding infrastructure and greenfield housing.

Ministers fairly crow that the average density being achieved across England is now 42 dwellings per hectare (6). Indeed, Yvette Cooper, minister for housing and planning, has boasted that while densities were `only' 25 homes per hectare in 1997, New Labour can now build 1.1million homes `on less land than the previous government set aside for just 900,000 homes - saving an area of greenfield land greater than the size of Oxford'. But what is a hectare, anyway? It is 10,000 square metres. So 25 dwellings per hectare of land in 1997 = 400sqm for each dwelling, or a land area of 20x20m. And 42 dwellings per hectare in 2006? That's 238sqm for each dwelling - in other words, little more than 15x15m of land.

This is a really drastic reduction in living space - and New Labour has achieved it in just nine years. Today, when so many of New Labour's policies increase urban atomisation and anomie, we are forced into a cheek-by-jowl huddle of smaller and smaller flats, at bigger and bigger prices. And then New Labour has the nerve to turn around and blame a surge of Rumanian criminals as a threat to Britain's social fabric.

Like Gordon Brown's sale of public sector assets, and like green efforts to conserve energy, the rush for brownfield land in fact produces very few savings - in this case, of greenfield land. Why? For two reasons. First, Britain is already predominantly green. Brownfield land is so modest an expanse that even the tightest patterns of house-packing can, at best, free up little land for greenfield status. Second, the government, not content with restricting people's ability to find housing, has anyway long been busy creating new green pastures.

Take Yvette Cooper's saving achieved by going brownfield - an area `the size of Oxford'. That turns out to be a saving of 3,300 hectares; in other words, a colossal 0.01 per cent of the land cover of Great Britain. On top of that, the government has already been adding more land for the Green Belt: a total of 19,000 hectares between 1998 and 2003. A further potential 12,000 hectares of Green Belt has been proposed in emerging development plans.

As it happens, 19,000 hectares is an area the size of Liverpool. So the Green Belt, which we are always being told is on the point of being `concreted over', has actually undergone an expansion that is modest, but much bigger than Cooper's Oxford-sized `saving' of greenfield land through Brownfield Brutalism. It bears remembering that the land cover of Great Britain is 23.5million hectares, used in 2002 as follows:

-- intensive agricultural land - 10.8million hectares, or 45.96 per cent;

-- semi-natural land - 7.0million hectares, or 29.78 per cent;

-- woodland - 2.8million hectares, or 11.91 per cent;

-- settled land accounts for 1.8million hectares, or 7.65 per cent;

-- water bodies - 0.3million hectares, or 1.28 per cent;

-- sundry other categories - 0.8million hectares, or 3.42 per cent.

If settlements are added to the `sundry' component (largely transport infrastructure such as roads and railways), then built-up Great Britain consists of about 2.3million hectares, or just 10 per cent of the land available. But in terms of `settled' houses and workplaces, the figure is actually well under 10 per cent - it's 7.65 per cent. In terms of housing alone, it must be heading towards five per cent, or lower, perhaps. But there is more. It turns out that more than half the land cover of England - 55.2 per cent of the most urbanised part of the UK - is officially `designated' as more or less untouchable: it is of special scientific interest, a special protection area, a special area of conservation, an area of outstanding natural beauty, a National Park, or a part of the Green Belt. In fact, among countries belonging to the Organisation of Economic and Commercial Development (OECD), the UK as a whole has about twice as high a proportion of protected land as the average. Everything is already being done, and then some, to ring-fence the pastoral idyll of the property-owning classes.

We can now see just how immature Ruth Kelly's call for a `mature' debate about immigration really is. Even when we omit Dartmoor, Snowdonia and other great swathes of beauty, Britain has room enough for immigration. But in practice, government policy continues to ensure that housing is both a growing symptom of the British economy's narcissism, and something that is powerfully hard for anyone - immigrant or not - to get hold of. The British economy is narcissistic because its whole focus is on face, not on the creation of genuine wealth. `Look at me!', cries the City to international money capital: `Come into my parlour.' `Look at me!', cries Britain's housing stock: `I am an ageing legacy of the past, but the government guarantees that I will always cost you more and more money.' ....

For the middle classes and a fair bit of the working class, housing has become that much more central to students, newlyweds and parents. For fortysomething parents, indeed, `parenting' is an issue that, to a large degree, revolves around housing. And as if that were not enough, Blairite ex-minister Stephen Byers has confirmed the centrality of housing to family discourse in the UK by setting a hare running about the abolition of inheritance tax, most of which revolves around houses. Alasdair Darling, tipped as Brown's successor at the Treasury, has repudiated Byers. But whatever the outcome, Britain's preoccupation with the money tied up in housing promises only to grow more intense.

Britain's problem is too few houses, not too many immigrants. Nowadays, all roads lead to housing - even if none of them are real roads. In more than seven years, from 1997 to 2004, New Labour has managed to build just 145km of new motorways. It has blighted rural areas with a colossal 400km, or 250 miles, of A roads. And in urban areas it has managed just 99km of A roads. No wonder people feel congested in cities, and cut off in rural areas. The genuine wealth that investment in new infrastructure represents is not part of Gordon Brown's brief. He would rather delude himself, and us, that he is taking what he calls `tough' choices; choices, he says, that will `safeguard stability'. His choices are not tough. They are all too easy. Sooner or later, Brown's choices will bring financial and social instability

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Tuesday, September 26, 2006

POLITICALLY CORRECT BRITISH POLICE RAID A SERIOUS CRIMINAL

They regularly ignore complaints about "Yobs", and Muslims can do as they please but a cat with one flea is a serious matter

Pet owner Robert Emberson was stunned as two cops swooped on his home - to seize his KITTEN. The bobbies went round after pet charity workers were tipped off that the moggy missed a routine appointment. Robert had adopted the rescue kitten named Plume.

But Cat Protection workers swooped to demand it back - and called in a police escort in case there was trouble. Horticultural student Robert, 18, accused the charity of being heavy-handed. He said: "They were so rude - barging in without warning. I was horrified." It followed an earlier visit by a Cat Protection worker who claimed to have seen a SINGLE FLEA on the cat. Robert, of Canvey Island, Essex, agreed to treat Plume. But he was waiting for his pay from his part-time job.

He said: "The flea treatment cost me a day's wages, but I paid for Plume to be vaccinated and everything. "I missed just one treatment, but they said they might take Plume away." The charity - criticised for refusing to let a man with an artificial leg adopt a cat - refused to comment. Robert was eventually allowed to keep the cat.

An Essex Police spokeswoman said: "We are frequently asked by other agencies to support them when there could be public order issues." [Fierce cat?]

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NHS SEMI-PRIVATIZATION WORKING -- BUT NOT WHOLLY AS INTENDED

They are helping BritGov's battle with its public servants, but at a cost

Private health centres are being paid tens of millions of pounds by the NHS for operations that are not happening. Hardly any of the independent centres set up under generous contracts are meeting their targets, an investigation by Health Service Journal has found. But they still get paid, unlike NHS hospitals, which are paid on the basis of how many operations they do.

The 20 centres were open by March. Information gathered by the journal from public documents, freedom of information requests and parliamentary answers indicates that so far they are doing only 59 per cent of the operations for which they are contracted. The Will Adams Treatment Centre in Gillingham, Kent, is performing at the rate of 945 procedures a year, compared with the 3,954 needed to meet its targets. It carries out hernia operations and day-surgery orthopaedic, gastroenterology and urology procedures.

The Department of Health denies that there is a problem. The centres were set up with five-year contracts and a spokesman said that it was completely misleading to say that activity below 100 per cent represented a waste of money. That could be determined only at the end of the contracts, when it would be clear how many operations the centres had done.

Its own figures put a different gloss on the situation by including other short-term programmes launched to shift the backlog. When those are included, it says that the programme is working at 84 per cent of capacity. Independent sector treatment centres (ISTCs) are controversial because NHS traditionalists say that they take money away from health service hospitals, disrupting their finances. The first ISTCs were set up under contracts that guaranteed an income based on the number of patients they undertook to treat, regardless of whether that many were treated.

Overall, HSJ calculated that the 20 centres should be treating patients at the rate of 78,242 a year, assuming that the target numbers are averaged over the whole of the five-year contract. But in the period to March their treatment rate was 46,073 patients a year, 59 per cent of the target.

In defence of the centres, many have not been open long, and the numbers they treat have not had time to build up. The main cause of the shortfall appears to be a reluctance by doctors to refer patients to them. Attempts have been made to persuade GPs to increase referral rates, but one obstacle is that ISTCs are staffed largely by doctors from abroad who are not known personally to GPs. This may affect judgments and make it less likely that patients will choose to go there.

The centres are costing primary care trusts a lot of money. Local reports suggest, for example, that the underperformance of the Will Adams ISTC is costing Medway PCT 100,000 pounds a month. The trust’s deficit in 2005-06 was £2.4 million.

A survey by HSJ of 42 NHS chief executives found considerable disquiet. More than three quarters felt that their own finances had been damaged by the centres — including 7 per cent who called the effect disastrous. Almost 60 per cent doubted that the centres had added to NHS capacity, and question marks were raised about whether the NHS needed any extra capacity anyway.

The health department, and 10 Downing Street, are unlikely to be unduly alarmed by the findings. The hidden agenda behind the ISTCs was an attempt to break the power of surgeons in NHS hospitals to control waiting lists, and that seems to be succeeding. The policy to allow patients a choice as to where they are treated has had such a dramatic effect on waiting times that top advisers regret that it was not introduced much sooner.

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NHS fails as an insurer once again

A new drug that could transform the lives of children with a rare genetic condition might be judged too expensive for the NHS. Hunter Syndrome was in the headlines last year when Andrew Wragg, 40, a former SAS soldier, was driven to despair by the decline of his son Jacob, 10, and smothered him with a pillow. The father, from Worthing, was cleared of murder and given a suspended sentence for manslaughter with diminished responsibility.

The fatal syndrome, suffered almost exclusively by boys, is caused by a defective enzyme that is unable to break down complex sugars produced as waste products in the body. These compounds, called mucopolysaccharides, accumulate in the tissues and organs and cause worsening physical and mental health problems.

The new drug, Elaprase, developed by Shire Pharmaceuticals, has been approved in the US and is expected to be licensed in Europe by the end of the year. Given by infusion, it improves breathing and movement. Parents of some Hunter children say it has transformed them. But it will cost at least 100,000 pounds per child per year, and as much as 300,000 for older, heavier patients who need bigger doses. Although the number of Hunter children in the UK is small — no more than about 100 — the cost of providing it for all of them could well be prohibitive.

A patients’ group has been lobbying ministers to confirm that the drug will be funded under a special scheme for children with rare diseases. Christine Lavery, chief executive of The Society for Mucopolysaccharide Diseases (SMD), said: “Funding for treatments for rare diseases similar to Hunter Syndrome is due to end at Christmas. We expect that to be extended. But there has been no promise that the DoH will fund the new drug for Hunter Syndrome. “All our questions and requests for clarification of the position have met with a lack of response, which leads us to fear the worst.”

Although not a cure the drug, which replaces the missing enzyme, may allow affected children to lead near-normal lives if the condition is picked up early. Dr Ed Wraith, a consultant at the Royal Manchester Children’s Hospital, said: “With this disease, there is damage to the heart, liver, brain and other organs which invariably leads to death well before the age of 20. The treatment is a major breakthrough and it would be a tragedy if the Department of Health didn’t provide the money.”

The Department of Health said: “No decision has yet been made on whether this expensive drug will be funded.” The same is likely to be the case north of the Border, where the Scottish Medicines Consortium has refused a related drug for a girl with a similar condition.

Bob Wragg, 64, grandfather of Jacob, said: “Thank God they have found a treatment at last.” His wife, Anne, a nurse, said: “A lot of people just don’t understand the torment that Andrew went through caring for Jacob and seeing him get worse and worse.” An adult sufferer of the syndrome, Colin Arrowsmith, 26, from Newcastle, has been receiving Elaprase weekly as part of a trial since February 2004. He had already defied doctors’ predictions that he would be dead by his early teens and until five years ago was able to live independently. He worked in the mailroom of an electricity company but was forced to give it up because his hips began to crumble. This forced him into a wheelchair and made him more reliant on his parents.

His mother, Barbara, said: “He was picking up lots of infections and his liver and spleen were very large. Since he began the weekly infusions his general health is better and his liver and spleen are no longer swollen. He has a lot more energy. “The treatment won’t reverse the damage done but we’ve been told that it should prevent further damage.”

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'Cool Maths': The sum of all fears

Schoolchildren will never learn to love abstract subjects like maths if teachers are afraid to challenge them

One of the central themes in modern education debates is how to motivate pupils. How do we make learning maths, science, history or English an interesting, enjoyable, and rewarding experience for pupils? It is widely believed that if we fail to convince pupils that studying a particular subject is both relevant to their personal experience and enjoyable they will never learn it properly. This point was emphasised by Charles Clarke three years and two education secretaries ago: `Enjoyment is the birthright of every child. Children learn better when they are excited and engaged ... When there is joy in what they are doing, they learn to love learning.'

One of the subjects that most worries educationalists and policy makers is mathematics. Being the most abstract subject in the curriculum, maths is almost universally considered a hard subject, which is difficult to make relevant to pupils' lives. Minister for Higher Education Bill Rammell notes that `mathematics is too often seen as difficult or boring' and `we have a curriculum that all too often fails to excite and motivate learners'. Educationalist Adrian Smith, author in 2004 of a major inquiry into the state of post-14 mathematics, Making Mathematics Count, states in his report that there has long `been considerable concern about many young people's perception of mathematics as being "boring and irrelevant" and "too difficult", compared with other subjects'.

For the Office for Standards in Education (Ofsted), maths is worse than boring. It must be truly terrifying, as `the best teachers' build confidence by `enabling [students] to talk through misconceptions in a non-threatening way'. Ofsted cites as an example of a good lesson one where `the teacher valued and used all answers from students, whether correct or not'. As a result, the students were `highly motivated'. Ofsted wants to see lessons with pace, like stand-up comedy, in order to ensure the full attention of the audience. Yet in 2005 it criticised maths teachers for not slowing down the pace of the lesson when necessary: `In many of the less effective lessons, the teaching moves on before pupils have understood the concept; the pressure to cover new content as quickly as possible results in shallow coverage and lack of depth in learning.' Ofsted also implies that there must be a trade off between serious learning and entertainment: `A stimulating session with hairdressing students struck just the right balance between engaging the learners and keeping their mathematics moving forward.' But why should we strike a balance between engaging the learners and learning maths? It seems that we can only sell learning in an underhand way, as something else.

In June 2006, various newspapers reported as `cool maths' a 4 million pound initiative by the secretary of state for education Alan Johnson aimed at `giving teachers new and innovative ways to engage with pupils at Key Stage 3'. Johnson explained that the programme `will make learning engaging and fascinating [as] the problems will be based around things which appeal to pupils, such as fashion, football, or the Olympics'. But Johnson gave away his real views on serious learning when he stated that `the questions will be open, so that the answers will be found through discussion, activity and ingenuity, rather than sitting in a dark room with a wet towel around the head'. Like a self-conscious teenager, Mr Johnson seems so desperate to look cool that he doesn't hesitate to declare his disgust for swots.

However, the prize for coolest educators must go to the chemistry lecturers at Leicester University, who dressed up as Harry Potter characters to motivate primary school children to study their academic discipline. According to the BBC, `Dr Jonny Woodward is putting on a "Gryffindor gown" to become Harry while Dr Paul Jenkins dresses up as the headmaster, Professor Albus Dumbledore, and Mrs Tracy McGhie is transfigured into Professor Minerva McGonagall'.

We should be more honest and tell children what they already know: that maths has very little to do with fashion, football and the Olympics; that chemistry has nothing to do with Harry Potter. Middle-aged educators who try to jump on to every fashionable bandwagon like a bunch of groupies don't even look cool, never mind motivate pupils to study.

The real problem, then, is not that modern pupils are in any way different from previous generations. The problem is the era these children have been born into. Adults no longer believe that education is a worthwhile thing in its own right. It must always be made `relevant'. They have so little faith in pupils that they believe that children are now incapable of grasping abstract concepts, never mind developing a love of books. Learning necessarily involves hard work and individual effort. Teachers are unlikely to convince children that learning a school subject is worth the effort if we believe so little in our discipline and in our pupils' intelligence.

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Brits are abandoning public transport

Despite the efforts of their very "Green" government

Thousands of daily bus services will be scrapped and fares will rise by 20 per cent during the next decade in a continuing exodus from public transport to the car, a report has found. The Government is falling well short of its official target of increasing bus use in every region. Passenger numbers are declining in every large city apart from London, the only area where services remain under public control.

The report, commissioned by the Passenger Transport Executive Group (PTEG), which represents local authorities in Manchester, Leeds, Liverpool, Sheffield, Newcastle upon Tyne and Birmingham, found that bus companies were exploiting local monopolies to make excessive profits. Fares have increased by 86 per cent above inflation since 1986 and passengers have fallen by half in those cities. By contrast, the cost of motoring has remained stable and the total distance travelled by car in Britain since 1986 has increased by 50 per cent.

John Prescott, the Deputy Prime Minister, said in 1997: "I will have failed if in five years' time there are not many more people using public transport and far fewer journeys by car. It's a tall order but I urge you to hold me to it." Rail travel has increased by a quarter since Mr Prescott made his pledge but the decline in bus services means the proportion of journeys made by bus, tram or train has fallen from 15 per cent to 12 per cent.

The Government's official target is to increase bus and tram journeys by 12 per cent in England by 2012 and to deliver growth in each region. Last year bus and tram journeys rose by 1.9 per cent in London but fell by 1.2 per cent in the rest of England. The report found that bus services had declined by 41 per cent in Tyne and Wear, 31 per cent in South Yorkshire and 20 per cent in the West Midlands since 1995. Services in Manchester, West Yorkshire and on Merseyside fell by 10 per cent to 12 per cent.

The report concludes: "Projecting these numbers forward gives an estimate that over the ten years from 2004-05 to 2014-15, bus patronage will fall by 20 per cent, fares will rise by about 20 per cent and service levels will fall by about 20 per cent. "Bus services are not providing a high-quality alternative to the private car and so motorists do not have incentives to switch to the only public transport mode that may be available to them."

In London, where the average fare is the same in real terms as a decade ago, bus passenger numbers have risen by 50 per cent since 2000. The services are controlled by Ken Livingstone, the mayor, who sets fare levels and determines the frequency and quality of the service under tightly drawn contracts with bus companies.

In the rest of England, private operators control all aspects of the service and can withdraw from routes with 56 days' notice. PTEG wants its members to be given similar powers to the London mayor. It believes that this will allow cities to offer a better service by cross-subsidising lightly used routes with the profits made from the busiest ones. It claims that private operators are contributing to decline by cherry-picking the most profitable routes, leaving others with an infrequent service that results in increasing numbers of people switching to cars.

The Government has begun a review of the way buses are regulated outside London and is drawing up proposals that would allow local authorities and bus companies to co-operate more closely on service levels. But ministers have balked at the idea of giving authorities the power to set fares, routes and frequencies. The report found one company dominating bus services in each of the biggest six English regional cities. National Express runs 81 per cent of buses in Birmingham and makes an estimated 21 to 35 per cent return on investment. The other companies also make "excess profits" despite presiding over declining services, and often failing to fulfil commitments to invest in newer, more reliable vehicles.

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Racist Revving??

From Scotland we read:

"A driver spent two nights in jail after being accused of "revving his car in a racist manner".

Mechanic Ronnie Hutton, 49, yesterday described his court ordeal which finally ended when prosecutors dropped the allegation of racism.

But he was still convicted of a breach of the peace for revving the engine of his 25,000 pound Lotus.

Witnesses claimed he had been trying to intimidate a Libyan couple on the pavement. Ronnie, of Stirling, claims he was only revving the powerful V8 engine to avoid another 15,000 pound repair bill....

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Liver cure: "British scientists have discovered a drug that could cure liver disease, even in alcoholics who continue drinking. The medicine, found by a team of doctors and scientists at Newcastle University, could become a potential alternative to liver transplants. Until now cirrhosis of the liver, caused by alcohol, obesity or the hepatitis C virus, was considered incurable in all but the rarest of cases. The only option for patients in the final stages of liver disease was to wait for a liver transplant. However, because of organ shortages many die while on the waiting list. Clinical trials of the drug Sulphasalazine are expected to begin in Britain next year. If these prove successful, the drug could be used to treat heavy drinkers, whose plight was recently illustrated by George Best, the former Manchester United footballer who died from liver disease last year. Sulphasalazine, which already has a licence to treat arthritis and inflammatory bowel disease, acts by preventing scarring from developing on the liver."

Monday, September 25, 2006

SHOULD BRITAIN APOLOGIZE FOR SLAVERY?

My family lived near Bristol when that city would have been living high on the hog from the profit of slave trafficking. Yet if we got our hands on any of that cash you have my solemn oath that none of it has trickled down the generations. So I was rather annoyed to learn last week that the government is planning to apologise on the nation's behalf for the slave trade.

A committee headed by John Prescott is considering something called "a statement of regret" to be issued solemnly on March 25 next year, the date that marks the 200th anniversary of the abolition of the slave trade. This is not technically an apology, but is something that parents will recognise as the next best thing. It is the government looking at its feet and mumbling a few words because it knows that otherwise it will be spending the next half an hour on the naughty step.

I don't know who will be making this apology, but I would be very grateful if they would make it clear that they have no authority to speak on behalf of the White family, late of Westbury-on-Trym in Gloucestershire. Because, like many other families throughout the land, we do not appear to have actually done anything. Not only did we play no part in slavery, but when we had a moment off from ploughing fields and building dry stone walls and sucking up to the Saxe-Coburgs we might even have been swept along in our modest way by the moral outrage that gripped the country in the late 18th century.

Far from being apologetic about slavery this country has much to be proud of. The abolition campaign had government support from an early stage. It was William Pitt, the dominant figure in the politics of the day, who urged his friend William Wilberforce to push the measure through the House of Commons.

Of course, we know that any apology is not really about slavery. It is about a much more modern issue: the uneasy relationship between black people and white people that can partly be blamed on the legacy of slavery in the West Indies and America. But slavery is not entirely what would be referred to these days as a white-on-black crime.

Years ago I watched a documentary about a group of black Americans who were on holiday in Africa, touring the slave sites. Many were in tears, having just discovered what went on at this end of the operation. They had just learnt the awful truth that the main suppliers of African slaves were themselves African. It was common practice for many years for the victors in battle to enslave their opponents. Suddenly, these victors discovered that they could also make a bit of money.

Jolly good business it was, too. King Tegbesu, who ruled what is now Benin, apparently made 250,000 pounds a year from selling slaves in 1750. According to my own rough calculations, this is the modern equivalent of 25 million pounds a year. And he is not the only African who grew fat on the profits of slave trading. The word "slave" is derived from the Slavs who were shipped from central Europe across the Mediterranean to Africa. From a book called The Slave Trade by Hugh Thomas, I also learn that 30,000 Christian slaves were sent to Damascus when the Moors conquered Spain in the 8th century. According to the Domesday Book there were 25,000 slaves in England in the 11th century.

So let's all enjoy a good knees-up in March. Let's have street parties and debates on Start The Week and we might even sit quietly while Prescott makes a speech about Wilberforce and Hull. But let's not pretend that the British were wholly responsible for the plight of African slaves. Slavery was a long established and widespread evil: the difference is that the British were one of the first to recognise it as evil and to do something about it.

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Rebel mothers interviewed

Julie Critchlow, housewife turned Antichrist, is standing outside Chubby's sandwich bar drawing angrily on a cigarette and glaring at the secondary school opposite. Her children - Rachel, 15, and Steven, 11 - are coming home for lunch so she is buying crisps and pop. Although Chubby's is less than 200 yards from her front door, Critchlow has brought the car. Still, it's an improvement of sorts. This time last week she was in the graveyard over the road, with fellow "sinner ladies" Sam Walker and Marie Hamshaw, posting burgers and chips through the school fence to a throng of mutinous sugar-deprived schoolchildren. Pictures of the scene - which looked like some grotesque Little Britain sketch - were splashed across the newspapers and Critchlow was called "the worst mum in Britain".

The trouble began at the start of term when Rawmarsh community school in Rotherham, South Yorkshire, banned pupils from leaving the premises during their lunch break. Even more incendiary, the school then started peddling a Jamie Oliver-inspired school dinner menu of "healthy" fare, such as ratatouille pancakes and salad. Unlike the grateful urchins who feature on Jamie's School Dinners (Oliver's fiercely popular television crusade for better food in schools), the Rawmarsh children came home complaining of overpriced baked potatoes, yucky tomatoes and not enough chips. Some of the mothers began delivering them fast food in the lunch hour, first to their own children, then to 60 or more of their friends. The school freaked out and tried to ban the mums. The mums screamed bloody murder. The police were called and, last Monday, a very uneasy peace was reached.

To an outsider, Rawmarsh sounds like hell; a place where fat stupid mothers fight for the right to raise fat stupid children. Did these women care nothing for St Jamie, terrifying obesity rates or early onset diabetes? Did they not read the daily horror statistics? Only last week it was revealed that children who eat a packet of crisps a day end up drinking more than five litres of cooking oil a year. A first glance at the town suggests that the answer to all that is "nope". Rawmarsh is Jamie's worst nightmare; shop shelves lined with cherry colas, toddlers eating Monster Munch in the street and the locals either bandy-legged twigs or, more often, fat - really, really fat in some cases. Some aren't even ashamed of it: one fat man has taken his shirt off to eat a battered sausage in the afternoon sun.

Surprisingly, Critchlow, 43, having refused all other interview requests, invites me to join Walker, 39, and Hamshaw, 44, in her front room. As the place fills with fag smoke and cackling laughter, it seems impossible to imagine three women more at odds with the current trend for health obsessed parenting. Critchlow's favourite adjective is disgusting. This is how she describes the food that the school is now serving and "totally disgusting" is what she calls John Lambert, the headmaster. "None of this would have happened if he hadn't locked these kids up," she says. "I don't have a problem with the school not selling them fatty food. My problem is that some of these kids are 16 and they're not allowed to choose what they eat for lunch." "Next they'll be going through our cupboards telling us what we can feed them at home," says Hamshaw, who has two children, aged 13 and 16, at the school. "But we know how to give our children a proper meal better than any school."

Er, weren't you taking them chips every day for lunch? "That is such a lie," says Critchlow. "We were taking all sorts - baked potatoes, salads, tuna sandwiches. You try getting teenage girls to eat a hamburger every day. Most of them won't touch the things." "There were a few chips," admits Walker, mother of an 11-year-old and 16-year-old, "but any nutritionist will say that a little bit of fat now and then isn't the end of the world." "But Lambert labelled us junk food pushers," says Hamshaw, "We're not stupid, though. I saw Supersize Me. No one in their right mind would feed their children fast food every day."

In fact, they say, the school's food laws are promoting bad habits. "All kids are fussy eaters," continues Hamshaw. "If they don't like something they won't eat it, so lots of the kids take one look at what's on offer at lunch and then eat crisps. "Every mother knows that it's an art to get your kids to eat good food, like I know my Gary won't eat greens but will eat carrots. This `we know best', one-size-fits-all attitude they've got at the school definitely means he ends up eating more rubbish. "But Jamie Oliver has come in his shiny armour and people think everything he says is right," says Walker, "like calling parents names if they let their kids have a can of Coke. Life isn't that simple though, Jamie. It's always a compromise." "You have to be clever," says Critchlow. "Kids have got their own minds and sometimes all you can do is try and persuade them to do the right thing."

Who could have expected such wisdom? While the mums don't have an A-level between them, when it comes to child rearing they've got more than 60 years' experience. "I don't want to sound hysterical," says Hamshaw, "but Adolf Hitler tried putting kids into summer camps to create perfect children and he faced the same problem this government is going to face - there is no such thing as a perfect child. You can't make carbon-copy kids who all love tomatoes. Schools should stick to educating children, not trying to raise them."

The school is not backing down, saying that for the children's safety they must stay in at lunch (unless collected by parents). The headmaster, uncharacteristically taciturn, declined to speak to me but released a statement to say he has now met the mums and progress was being made.

Sonia Sharp, of Rotherham council, insisted that the food at the school is very nice and cheaper than anything else on offer, and pointed out that uptake of school meals has risen from 350 to 600. She conceded that this might have something to do with the fact that the school has now got a captive audience.

More than food, what grates upon the Rawmarsh mums is the feeling that their choices as parents are being undermined by their government. "This country is turning into big brother," sighs Hamshaw, "and it's not like we need a nanny state. We nanny our kids quite enough on our own." The women nod gravely and light more cigarettes. "This battle," says Critchlow, "has only just begun."

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Another regulatory failure seen in British drug trial disaster

A "reckless" mistake apparently overlooked by government regulators lay behind the drug trial disaster that saw six young volunteers badly injured by an experimental medicine. Confidential documents obtained by The Sunday Times and Channel 4's Dispatches programme reveal the drug was administered on average 15 times more quickly to the volunteers than to monkeys in earlier safety studies. The possibility that such a crude error led to the disaster is likely to raise questions over whether the government's Medicines and Healthcare products Regulatory Agency (MHRA) scrutinises trials adequately and protects the public from the risks of new medicines.

After the "Elephant Man" trials at Northwick Park hospital, London, in March, which left two men fighting for their lives and all six in intensive care, the agency said the reactions resulted from an "unexpected biological effect". However, experts say the drug, TGN1412 - one of a new generation of "magic bullet" treatments targeting the immune system - was infused so quickly into the volunteers that the potential for life-threatening problems was foreseeable. "When you give an antibody . . . the quicker you put it in, the more likely you are to get an infusion reaction," said Professor Terry Hamblin of Southampton University, a leading authority on monoclonal antibodies, the family of drugs to which the trial medicine belonged.

The volunteers were given TGN1412 in only three to six minutes. "To quickly infuse it over three to six minutes in six individuals I think is . . . reckless," said Hamblin. Ryan Wilson, 20, a former apprentice plumber, who suffered total organ failure, was the most seriously injured. He was given the drug in just four minutes. The monkeys, by contrast, received the antibody by a one-hour "slow infusion".

Hamblin's judgment is backed by other experts, including Dr David Glover, formerly chief medical officer of Cambridge Antibody Technology. He concludes: "The drug was given too quickly."

The speed at which the monkeys received TGN1412 was set out in the application to the MHRA for permission to carry out the trial. This was submitted by Parexel International, a contract research company, on behalf of TeGenero, a tiny German drug developer. But the paperwork did not explicitly detail how quickly the volunteers would be given the drug, although this could be calculated from the information given.

Professor Kent Woods, the agency's chief executive, said this weekend the results of the monkey trial had reassured his staff that the human project should be allowed to go ahead. "They did not show toxicity and the dose was 500 times higher on a weight-for-weight basis than that first used at Northwick Park," said Woods. "That is the key issue."

There was another apparent oversight in the agency's scrutiny. Parexel's paperwork did not include data on test-tube experiments designed to show the drug's effect on human cells. One specialist said she was "pretty astonished" this was left out, although it is unlikely the data could have predicted the disaster. This omission was only revealed after an appeal by The Sunday Times and Dispatches under the Freedom of Information Act for the reinstatement of paragraphs cut from documents released by the MHRA.

While the agency suggests in its assessment of the trial that the problems could not have been foreseen, experts say the reactions to TGN1412 - pain, vomiting and organ failure - have long been linked to first doses of monoclonal antibodies, and in previous incidents infusion time has been a critical factor.

Parexel declined to comment, and in Thursday's Dispatches the company's chairman, Josef von Rickenbach, takes refuge in a hotel lavatory.

Wilson has severe injuries. He has had his toes and sections of his feet amputated. Parts of his fingers have dropped off; others have died and are hard as wood to the touch where the blood supply was cut off as his body reacted to the drug. He is the worst afflicted of the victims from the tests on March 13, but all suffered life-threatening injuries. For development of new medicines, it was the worst calamity since the 1960s Thalidomide disaster.

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SMART STUDENTS DISADVANTAGED IN BRITAIN

Bright pupils are being marked down in their A-level exams for giving "too sophisticated" answers, jeopardising their chances of winning places at their chosen universities. Schools complain that candidates who display originality are being let down by inflexible marking schemes and poorly qualified examiners. In one case a state grammar school was so angry when one of its pupils was given a D grade that it asked Cambridge, where he had an offer of a place, to re-mark the paper. The university judged that it should have been at least two grades higher and awarded him a place.

In another case a teacher at an independent school and a former examiner complained when a pupil was marked down to a D after presenting a carefully argued case that the Vietnam war could be partly explained by decolonisation. The exam board claimed the pupil, who was holding an offer from Oxford that he lost as a result, gave "too much context". When he answered a similar question in a similar way in a re-take, he got an A grade.

The cases underline a growing dissatisfaction among schools that "tick-box" marking schemes are failing to give credit to exceptional work. The number of A-level papers where schools have sought re-marks has risen by 20% in two years. In 2003, schools requested re-marks on 36,000 A-level papers because they judged the grades "unfairly low". By 2005 it had risen to 43,500, with 5,273 resulting in higher grades. At GCSE, re-marks have increased by more than half to 55,400, of which 10,848 were upgraded. Eton College returned 500 A-level papers last year. Exam boards gave higher marks to 299, 113 of them enough to raise grades.

John Bald, an education consultant, said: "Boards are trying to get a grip on the expansion in numbers of pupils getting top grades by using rigid mark systems that do not take account of exceptional intellectual ability."

Adam Bracey, then a pupil at Maidstone grammar in Kent, was awarded a D in one paper, dropping him from an overall A to B in history. He needed three As to take up his offer from Cambridge. "I was devastated," said Bracey, "some of my friends had got into university without the grades they had been asked for, but Cambridge was insistent." The Edexcel board refused to accept the D grade had been mismarked. Neil Turrell, his headmaster, sent the script to Cambridge after two staff concluded the grade was too low. Bracey, 20, got the place after a history don at Homerton College, where he is studying, agreed it was worth a higher grade. Garth Collard, a former history teacher who had been part of the team inspecting Maidstone grammar for Ofsted, also read Bracey's returned script. "I was shocked at the quality of the marking," he said. "The mark scheme was very mechanistic . . . there was no recognition this was a high calibre answer."

Other schools are concerned boards are not employing enough high-quality markers. This year Portsmouth grammar had a number of AS-level papers in English upgraded, including one from D to A. It comes as more than 100 independent schools are planning to ditch A-levels in favour a tougher qualification that places less emphasis on "mechanistic" course work and unlimited resits of exams.

Sophie Garrett, 18, who took A-levels this summer at Tormead, an independent girls' school in Guildford, Surrey, had her music coursework regraded from unclassified to B. Her mother Valerie said: "The original mark meant she failed to get an A. It didn't matter for her place at Surrey University, but she had put hours and hours into it."

Exam boards said their marking schemes did not hold back brighter students. Edexcel said: "Candidates will always receive a fair mark for their work. All examiners must meet certain criteria. Markers are trained and tested to ensure they understand and follow the mark scheme."

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