Thursday, October 12, 2006


A hardcore group of debt-ridden hospitals are offering poor-quality patient care, Patricia Hewitt, the Health Secretary, will admit today. The chief health watchdog in England is expected to expose these hospitals, declaring them “weak”. The Healthcare Commission’s annual assessment of the NHS, to be released tomorrow, comes as many hospitals and health trusts, struggling to curb spending, are cutting frontline services. A group of 63 trusts are responsible for 70 per cent of the NHS’s deficit.

Ms Hewitt told The Times that trusts that were running up debts were also likely to be mismanaging parients and have worse waiting times, cleanliness and MRSA infections. “I’m afraid that a lot of the trusts with the worst financial records are also weak on quality of care,” she said. “You can see why when you visit hospitals like that. “They are not making the best use of their resources, not working through the processes of making sure everybody is paying attention to hygiene and cleanliness, and if they’re not doing that, they’re probably not going through the processes of making sure everything else is being done properly.”

Nearly a third of hospitals and a quarter of all 570 NHS organisations failed to balance their books in 2005-06, leaving the NHS with a net deficit of 547 million pounds, the Health Department announced this week.

Ms Hewitt will ask failing trusts to propose and implement an action or improvement plan within a month, if measures are not in place. “We are going to be asking all of those trusts to sit down with their strategic health authority and set out very clearly what they can do and what more they intend to do,” she said.

However, the commission will paint a varied picture. “The report will show considerable variation in performance across the country,” she said. “Clearly, we will have some trusts that are excellent on quality, but also excellent on financial management, but we will also have trusts that fail on both.”

Five years ago the Government introduced hotel-style star ratings for hospitals to encourage them to improve quality of care. However, a new system uses a wider range of measures, including clinical and financial performance, to rate trusts as excellent, good, fair or weak. The inclusion of financial management will damage the ratings of many hospitals. The NHS deficit has more than doubled in the past 12 months, with the biggest problems concentrated in the South East and eastern England. In recent months, thousands of job cuts have been announced in order to make savings.

Ms Hewitt said that the previous system of assessment had not helped to tackle the problem. “Star ratings muddled up the quality of care with the use of resources and financial management,” she said. “One of the problems we identified last year when the deficit came out was that the star ratings system was ignoring small deficits and not sending out the right message to trusts who overspent. When you’ve got a trust that is quite weak in its financial management, they are generally weak at other things as well.” The latest figures show that 120 of 548 NHS organisations are now predicting deficits for the current financial year, with 90 per cent of the estimated gross deficit originating from 71 of the trusts.

The commission’s report will be published along with a website that will provide information about the performance of all NHS trusts in England, and offer comparisons. The commission is likely to support strongly early action on those trusts judged to be weak. It has promised the assessment will be tougher than star ratings, with fewer trusts falling in to the top category. The score for the quality-of-services rating will be based on how well trusts meet the commission’s 24 core standards in areas such as safety and clinical effectiveness. “In general I would expect that trusts that were doing well under the old system will do well under the new system,” Ms Hewitt said. “But this is a tougher assessment and it’s designed to be because what the NHS can do for patients is much greater that it used to be, and patient expectation is rising every year, so it’s right that the commission should be setting the bar higher.”



Muslims are not doing enough to engage with Britain's otherwise thriving multicultural society, Martin Amis has said. Commenting on the recent row over Islamic veils, the author said at the Festival: "The only element that's not fitting in is Islam. Who else is not fitting in?"

Amis, who has written extensively about Islamist terrorism, and wrote a short story imagining the last days of Muhammad Atta, the 9/11 hijacker, said that home-grown terrorism was a separate problem, bound up in the allure that "death cults" have to the vulnerable young men who become suicide bombers. "In this country what's happening is that young men in late adolescence and early manhood have a period of self-hatred and disgust and thoughts of suicide," he said. "The idea you can turn this into world history is tremendously powerful. "The absolutely crucial thing is to see whether it mutates. Death cults take on a terrible momentum."

The allure of a philosophy based on the rejection of reason and embrace of death was intense but short-lived, Amis said. However, if this fused with a sense of the individual exerting an influence on history "then al-Qaedaism will mutate as we feared".

Amis, 57, returned to Britain last month after 2® years in Uruguay, where part of his wife's family lives. He said that he had been struck by how successful British society appeared when viewed through fresh eyes. "It looks like a multicultural society that's working apart from a few miserable bastards." Amis's father, Sir Kingsley, was a passionate communist who became a virulent anti-communist after the Soviet Union's crushing of the Hungarian Uprising in 1956.

Amis himself is suspicious of ideologies and says he welcomes the similarity between the two main political parties in Britain. "All the big [political] battles have been won. We no longer rule a quarter of the world but we are supposed to feel relieved about that because we don't like empires, do we?" he said. "What we have now in England is an evolved market state that doesn't feel humiliated about the loss of its position at the highest table. The result seems to be an increasing concentration on surfaces, outlines and glitter without substance. "As The New Yorker said, `the Brits are now at the point where they feel Schadenfreude about themselves'."



They prohibit or prevent almost all outdoors activity at schools on "safety" grounds so that the kids get no exercise -- and then they think that can all be fixed by handing out free vegetables!! It's like a comic opera!

Vouchers for milk, fruit, vegetables and vitamins are to be handed out to pregnant women and the parents of young children as part of moves to improve the health of the nation. The scheme, announced yesterday, replaces an initiative introduced during the Second World War under which young children were given free milk.

It came as a report released by the Department of Health revealed that Britain is the fattest country in Europe, with one in seven children obese. Caroline Flint, the Public Health Minister, announced the voucher scheme as she issued a statistical profile of England designed to highlight health blackspots. The profile breaks England into regions and shows a strong North-South divide on health, with people in the North East dying two years earlier on average than those in the South West. Vouchers are to be distributed from next month to parents on benefits to encourage them to give their children healthier diets. Ms Flint hopes that this will make it easier for the poorest sectors of society to buy fruit and vegetables.

The Government is already campaigning for people to eat at least five portions of fruit and vegetables a day. Fewer than a quarter do so and the consumption of healthy food in Britain is below the European average. A pilot voucher scheme carried out in Devon and Cornwall found that fruit and vegetable intake increased and the range of products stocked by rural grocers improved. Ms Flint said: “It’s a reinvigoration of the Welfare Food Scheme. Since the Second World War, vouchers for milk have been available. Now the vouchers can be used for milk, fruit, vegetables and vitamins. “We’ve found parents are buying the fruit and vegetables and small retailers in rural parts are bringing in more fruit and vegetables.”

Under the scheme, pregnant woman will receive 2.80 pounds a week. Parents will receive 5.60 a week for each child under a year old and 2.80 for each child aged 1 to 5. The vouchers will be redeemable at a range of grocery stores and supermarkets.

Ms Flint said that obesity was the largest problem faced by public health professionals, with 14.3 per cent of children aged 2 to 10 classified as obese. She suggested that supermarkets could help to improve the national diet by showing customers how to cook and eat more unusual fruit and vegetables.



A new science GCSE [junior High School course] that replaces traditional physics, chemistry and biology with discussions about topical issues such as GM crops and the MMR vaccine is attacked today by leading academics as "more suitable to the pub than the schoolroom". The reformed curriculum will not inspire more children to study science at a higher level, while also failing in its main goal of breeding a more scientifically literate public, senior researchers, educationists and ethicists said. The critics, who include Baroness Warnock, the philosopher who framed the embryo research laws, and Sir Richard Sykes, Rector of Imperial College London and a former chairman of GlaxoSmithKline, say that the new course teaches too little about basic concepts to be of much use either to the next generation of scientists, doctors and engineers, or to those who will drop science at 16.

The "Twenty-First Century Science" GCSE, introduced nationally last month, is being taken by pupils at a third of England's secondary schools. Experts say that its replacement of practical experiments and understanding of fundamental principles with debate about the "impact of science and technology on modern life" will leave students poorly prepared to pursue all sciences at A level and university. They argue that it will also encourage pupils to develop opinions before they understand the underlying research, potentially undermining the scientific literacy that the course seeks to build.

The new syllabus is designed to make science more relevant to teenagers by engaging them with issues of public concern, such as nuclear power or bird flu, rather than teaching traditional physics, chemistry and biology. Pupils also have the option to take a second GCSE that teaches the basics required if they wish to pursue one of these subjects in the sixth form. It is one of two new GCSEs that are replacing the double science award, which used to be taken by most state school pupils. Another alternative is a multiple-choice-based option that has also been severely criticsed for failing to stretch students. Fears have been raised that many hundreds of schools will be attracted to the new exams, after it emerged that from next year their success at GCSE level in the national league tables would also be measured on the percentage of pupils achieving two or more passes in science.

Sir Richard said that it was impossible to have meaningful and informed debate about science and society without first understanding how science works, which is best learnt by practical experiment and mastering fundamental principles. "A science curriculum based on encouraging pupils to debate science in the news is taking a back-to-front approach," he said. "Science should inform the news agenda, not the other way around. "Before we can engage the public in an informed debate we need the scientists to do the science. And before the future citizen can contribute to the decision-making process, they need to have a good grounding in the fundamentals of science and technology, rather than the soundbite science that state school curriculums are increasingly moving towards."

Lady Warnock said: "The present policy has two incompatible aims: to give all pupils some understanding of the subject matter of the sciences, and to so fire the imagination of a substantial minority of them that they want to pursue their interest into the sixth form and beyond. "The new syllabus encourages a postmodern view that science is just one of many ways of finding out about the world, and that its claims are as open to challenge as those of any interested pressure group," she said. The agenda is set by the press, creating debates that are "more suitable for the pub than the school room".

Their criticisms are voiced in What is Science Education For?, published today by the Institute of Ideas, an independent think-tank. In its lead essay, David Perks, head of physics at Graveney School in Wandsworth, southwest London, said that a better way of improving science education would be to return to teaching physics, chemistry and biology as separate disciplines.

Maths and physics A levels will no longer be mandatory for students wishing to study physics at the University of East Anglia, London South Bank University, University of Leicester and University of Surrey. The new "integrated sciences" degree follows the University of Reading's decision to close its physics department last week.



The entire global warming scare is based on similar arbitrary "models"

We are used to politicians suppressing the truth. When scientists do it as well, we are in trouble. Not one of the Government's senior advisers, from Sir David King, the chief scientist, downwards, has yet dared to confirm in public what most experts in private now accept, that the mass slaughter of farm animals in the 2001 foot-and-mouth outbreak was not only unnecessary and inhumane, but was also based on false statistics, bad science and wrong deductions.

The mistakes that were made in attempting to control the outbreak are laid bare in a devastating paper recently compiled by Paul Kitching, one of the world's leading veterinary experts, and published by the World Organisation for Animal Health. It finds that, of the ten million animals slaughtered, more than a third were perfectly healthy; out of the 10,000 or so farms where sheep were killed, only 1,300 were infected with the disease; scientists were wrong to claim that the FMD virus was being spread through airborne infection; the epidemic had reached its peak before the culling began; the infamous 3km killing zone was without justification; estimates of infected premises were little better than guesswork.

The language used in Dr Kitching's report has a controlled anger about it. He talks of "a culling policy driven by unvalidated predictive models", mentions the "public disgust with the magnitude of the slaughter" and concludes: "The UK experience provides a salutary warning of how models [statistics used to predict the course of an epidemic] can be abused in the interests of scientific opportunism."

Those models used by the Government were badly flawed because they relied on computers rather than advice from vets and virologists who understood the nature of the disease. "No model will produce the right output when fed the wrong input," says the report. The Government, late in reacting to the outbreak, fatally moved decision-making away from FMD experts to the Cabinet Office briefing room (Cobra). The result was "carnage by computer" , as one farmer put it - a slaughter that was "grossly excessive", according to the report.

There are vital lessons here about how we should control future outbreaks, avoiding the horrendous cost and slaughter of the last. Thus far, there is no sign that those lessons have been learnt.


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