NHS UNSAFE

Patient safety in hospitals, doctors' surgeries and clinics needs to be improved in the NHS and independent sectors, according to the Government's healthcare watchdog. Most patients received safe care, but standards were inconsistent across England and Wales, with vague and widely varying estimates on numbers of avoidable deaths and injuries, the Healthcare Commission said. Sir Ian Kennedy, the commission's chairman, spoke as its annual State of Healthcare report was presented to Parliament. He said: "The NHS needs to take safety more seriously. It is frustrating that in 2006 we do not have a clearer idea of how many people die or are harmed in hospitals. We should all be troubled when the National Audit Office states that `estimates of death as a result of patient safety incidents range from 840 to 34,000, but in reality the NHS simply does not know'. "I recognise that it is not easy to get this information and that all major countries struggle with it. But without that knowledge, and the reasons behind it, improvement cannot take place."

The report marks the first publication of an overview of standards in the independent sector in England, which includes private and voluntary providers. It discloses that one in ten NHS trusts could not confirm that it fully met core standards on safety and one in ten providers in the independent sector was ordered to improve its management of risks last year.

More than a fifth of the complaints the commission handles relate to safety, which includes infection control, drug administration, clinical negligence, accidents and general health and safety legislation.

One fifth of trusts told the Commission that they could not ensure that all their staff had attended compulsory health and safety training and 13 per cent could not be sure that medical devices were properly decontaminated.

Sir Ian said that failings could also involve things such as GPs not keeping records properly or the misreading of tests. "There is clearly room for improvement in compliance with standards on safety," he added. "And this goes for the independent sector as well as the NHS." About 50 per cent of independent providers met all 32 minimum standards, but one in ten failed five or more, broadly in line with NHS organisations.

Andrew Lansley, the Shadow Health Secretary, said yesterday: "It is a shame that this willingness to improve patient safety is not shared by the Department of Health. In December 2003 the Chief Medical Officer ordered an audit of deaths caused by hospitalacquired infections. We are still waiting for it to be published."

A spokeswoman from the National Patient Safety Agency said that an exact figure had proved difficult to obtain. "There are several disputed extrapolations of deaths due to patient safety problems using different data sources and methods. The most widely quoted figure is 40,000 deaths per year in England. However, in our Patient Safety Observatory report last year we estimated that each year in NHS acute hospitals in England there are approximately 840 reported deaths resulting from patient safety incidents. This is probably an underestimate, but not by 39,000."

A Department of Health spokesman said: "As in any modern health service, mistakes and unforeseen incidents can and will happen. Any mistake is one too many but similar rates of patient safety incidents occur worldwide."

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Hospital kitchen hygiene 'poor' in NHS



Shocking hygiene standards have been found in some UK hospital kitchens, a consumer group reports. Which? reviewed hygiene inspection reports for 50 hospitals and found evidence of cockroaches, mice and mouldy cooking equipment. An online survey by the organisation also revealed 29% of NHS patients still felt hungry after their meals. But the Department of Health said hospital food had improved in the last few years.

Which? said it's trawl of three years' worth of hygiene reports revealed problems such as dirty equipment, cockroach infestations, lack of soap or hot water, with poor refrigeration also cropping up regularly.

Other hospitals used food fridges to store medical supplies, had out-of-date foods and failings in food safety procedures, Which? added. But it said not all hospital catering facilities were dirty and some were highlighted for their cleanliness.

In a separate online survey of 833 hospital patients, the consumer group also found some patients were going hungry. Twenty-nine percent of NHS patients questioned said they felt hungry after their hospital meal compared with 4% of private patients. Neil Fowler, editor of Which?, said: "Hospital food hasn't got the best of reputations but you'd expect the kitchens to be clean at the very least. Unfortunately, we've found this isn't always the case. "Our survey shows a low level of satisfaction with hospital food in NHS hospitals. The government paints a rosy picture but the reality is very different, with many patients left with a nasty taste in their mouths."

A Department of Health spokesperson said: "Last month the independent Healthcare Commission found that nearly all trusts (over 96%) were meeting the core standards on hospital food. "Last year, the independent Patient Environment Action Teams found that 90% of hospitals were rated good or excellent for food standards compared with 17% in 2002. "There are some excellent menus around but we recognise that more needs to be done. The government has made a commitment to establish nutritional standards for the NHS and this work is now under way."

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THE ECONOMICS AND POLITICS OF CLIMATE CHANGE: AN APPEAL TO REASON

By Lord Lawson

(Nigel Lawson is a former British Chancellor of the Exchequer and Secretary of State for Energy. Excerpts only below:)

The Centre for Policy Studies has kindly agreed to publish a greatly extended version of this lecture as a pamphlet, in which I will be able to do greater justice to that complexity and to quote the sources of a number of the statements I propose to make this evening. It will also enable me to deal at slightly greater length with the scaremongering Stern Report, published earlier this week. But the essence of it is what I have to say tonight.

But first, a very brief comment on Stern. If scaremongering seems a trifle harsh, I should point out that, as a good civil servant, he was simply doing his masters' bidding. As Mr Blair's guru, Lord Giddens (the inventor of the so-called third way), laid down in this context in a speech last year, "In order to manage risk, you must scare people". In fact, the voluminous Stern Report adds disappointingly little to what was already the conventional wisdom - apart from a battery of essentially spurious statistics based on theoretical models and conjectural worst cases.

This is clearly no basis for policy decisions which could have the most profound adverse effect on people's lives, and at a cost which Stern almost certainly underestimates. It is, in a very real sense, the story of the Iraq war, writ large.

So let us get back to basics, and seek the answers to three questions, of increasing complexity. First, is global warming occurring? Second, if so, why? And third, what should be done about it? As to the first question, there is of course little doubt that the twentieth century ended warmer than it began. According to the Hadley Centre for Climate Prediction and Research, an offshoot of Britain's Met Office: "Although there is considerable year-to-year variability in annual-mean global temperature, an upward trend can be clearly seen; firstly over the period from about 1920-1940, with little change or a small cooling from 1940-1975, followed by a sustained rise over the last three decades since then."

This last part is a trifle disingenuous, since what the graph actually shows is that the sustained rise took place entirely during the last quarter of the last century. Moreover, according to the Hadley Centre's data, there has so far been no further global warming since 1998. Whether the seven-year hiatus since then marks a change of trend or merely an unexplained and unpredicted blip in a continuing upward trend, time will tell.

Apart from the trend, there is of course the matter of the absolute numbers. The Hadley Centre graph shows that, for the first phase, from 1920 to 1940, the increase was 0.4 degrees centigrade. From 1940 to 1975 there was a cooling of about 0.2 degrees. (It was during this phase that alarmist articles by Professor James Lovelock and a number of other scientists appeared, warning of the onset of a new ice age.) Finally, since 1975 there has been a further warming of about 0.5 degrees, making a total increase of some 0.7 degrees over the 20th century as a whole (from 1900 to 1920 there was no change).

Why, then, has this modest - if somewhat intermittent - degree of global warming seems to have occurred. Why has this happened, and what does it portend for the future? The only honest answer is that we don't know. The conventional wisdom is that the principal reason why it has happened is the greatly increased amount of carbon dioxide in the atmosphere as a result of the rapid worldwide growth of carbon-based energy consumption. Now, there is no doubt that atmospheric concentrations of carbon dioxide increased greatly during the 20th century - by some 30 per cent - and most scientists believe this increase to be largely man-made. And carbon dioxide is one of a number of so-called greenhouse gases whose combined effect in the earth's atmosphere is to keep the planet warmer than it would otherwise be.

Far and away the most important of these gases is water vapour, both in its gaseous form and suspended in clouds. Rather a long way back, carbon dioxide is the second most important greenhouse gas - and neither, incidentally, is a form of pollution. It is the published view of the Met Office that is it likely that more than half the warming of recent decades (say 0.3 degrees centigrade out of the overall 0.5 degrees increase between 1975 and 2000) is attributable to man-made sources of greenhouse gases - principally, although by no means exclusively, carbon dioxide. But this is highly uncertain, and reputable climate scientists differ sharply over the subject. It is simply not true to say that the science is settled; and the recent attempt of the Royal Society, of all bodies, to prevent the funding of climate scientists who do not share its alarmist view of the matter is truly shocking.

The uncertainty derives from a number of sources. For one thing, the science of clouds, which is clearly critical, is one of the least well understood aspects of climate science. Another uncertainty concerns the extent to which urbanisation (not least in the vicinity of climate stations) has contributed to the observed warming. There is no dispute that urbanisation raises near-surface temperatures: this has long been observed from satellite infra-red imagery. The uncertainty is over how much of the estimated 20th century warming this accounts for. Yet another uncertainty derives from the fact that, while the growth in manmade carbon dioxide emissions, and thus carbon dioxide concentrations in the atmosphere, continued relentlessly during the 20th century, the global mean surface temperature, as I have already remarked, increased in fits and starts, for which there us no adequate explanation.

But then - and this is the other great source of uncertainty - the earth's climate has always been subject to natural variation, wholly unrelated to man's activities. Climate scientists differ about the causes of this, although most agree that variations in solar radiation play a key part. It is well established, for example, from historical accounts, that a thousand years ago, well before the onset of industrialisation, there was - at least in Europe - what has become known as the mediaeval warm period, when temperatures were probably at least as high as, if not higher than, they are today. Going back even further, during the Roman empire, it may have been even warmer. There is archaeological evidence that in Roman Britain, vineyards existed on a commercial scale at least as far north as Northamptonshire. More recently, during the 17th and early 18th centuries, there was what has become known as the little ice age, when the Thames was regularly frozen over in winter, and substantial ice fairs held on the frozen river - immortalised in colourful prints produced at the time - became a popular attraction. Historical treeline studies, showing how far up mountains trees are able to grow at different times, which is clearly correlated with climate change, confirm that these variations occurred outside Europe as well.

A rather different account of the past was given by the so-called "hockey-stick" chart of global temperatures over the past millennium, which purported to show that the earth's temperature was constant until the industrialisation of the 20th century. Reproduced in its 2001 Report by the supposedly authoritative Intergovernmental Panel on Climate Change, set up under the auspices of the United Nations to advise governments on what is clearly a global issue, the chart featured prominently in (among other publications) the present Government's 2003 energy white paper. It has now been comprehensively discredited.

But it is not only over time that the earth's climate displays considerable natural variability. Change also varies geographically. For example, there are parts of the world where glaciers are retreating, and others where glaciers are advancing. The fringes of the Greenland ice shelf appear to be melting, while at the centre of the shelf the ice is thickening. Curiously enough, there are places where sea levels are perceptibly rising, while elsewhere they are static or even falling - suggesting that local factors still dominate any global warming effects on sea levels.

Again, extreme weather events, such as major storms in the Gulf of Mexico, have come and gone, at irregular intervals, for as long as records exist. Katrina, which caused so much damage to New Orleans, is regularly trotted out as a consequence of man-made climate change; yet the region's worst recorded hurricane was that which devastated Galveston in 1900. Following Katrina, the world's authorities on tropical storms set up an international panel, which included the relevant expert from the Met Office here in the UK. The panel reported, earlier this year, as follows: "The main conclusion we came to was that none of these high-impact tropical cyclones could be specifically attributed to global warming." This may not be all that surprising, given how little global warming has so far occurred; but I do not recall it featuring in Mr Gore's film.

But this diversity makes it all too easy for the Al Gores of this world to select local phenomena which best illustrate their predetermined alarmist global narrative. We need to stick firmly to the central point: what has been the rise in global mean temperatures over the past hundred years, why we believe this has occurred, how much temperatures are likely to rise over the next hundred years or so, and what the consequences are likely to be.

As is already clear, the only honest answer is that we do not know. Nevertheless, it is not unreasonable to try and guess; and this is essentially what the IPCC has devoted itself to doing. Its conclusion is that, by the end of this century, on a business-as-usual basis, global mean temperature might have risen by anything between 1 degree and 6 degrees centigrade. This is based on a combination of the immensely complex computer models of the relationship between carbon dioxide concentrations and global temperature, developed by the Hadley Centre and others, coupled with a range of different projections of the likely growth of carbon dioxide emissions.

This last part is not, of course, a scientific matter at all, but consists of economic forecasting. That is to say, it depends on the rate of world economic growth over the next hundred years (which in turn depends to a considerable extent on the projected world population), the energy-intensiveness of that growth, and the carbon-intensiveness of the energy used. The upper part of the IPCC's range of scenarios is distinctly unconvincing, depending as it does either on an implausibly high rate of population growth or, in particular, an unprecedented growth in energy intensiveness, which in fact has been steadily declining over the past 50 years. Equally implausible are its estimates of the costs of any warming that may occur.

For example, it makes great play of the damage to agriculture and food production from climate change. Quite apart from the fact there are many parts of the world where agriculture and food production would actually benefit from a warmer climate, the IPCC studies are vitiated by the fact that they assume that farmers would carry on much as before, growing the same crops in precisely the same way - the so-called 'dumb farmer' hypothesis. In reality, of course, farmers would adapt, switching as the need arose to strains or crops better suited to warmer climates, to improved methods of irrigation, and in many cases by cultivating areas which had hitherto been too cold to be economic.

It is important to bear in mind that, whatever climate alarmists like to make out, what we are confronted with, even on the Hadley Centre/IPCC hypothesis, is the probability of very gradual change over a large number of years. And this is something to which it is eminently practicable to adapt. This points to the first and most important part of the answer to the question of what we should do about the threat of global warming: adapt to it.

There are at least three reasons why adaptation is far and away the most cost-effective approach. The first is that many of the feared harmful consequences of climate change, such as coastal flooding in low-lying areas, are not new problems, but simply the exacerbation of existing ones; so that addressing these will bring benefits even if there is no further global warming at all. The second reason is that, unlike curbing carbon dioxide emissions, this approach will bring benefits whatever the cause of the warming, whether manmade or natural. And the third reason why adaptation - most of which, incidentally, will happen naturally, that is to say it will be market-driven, without much need for government intervention - is the most cost-effective approach is that all serious studies show that, not surprisingly, there are benefits as well as costs from global warming. Adaptation enables us to pocket the benefits while diminishing the costs.

The main argument advanced against relying principally on adaptation is that it is all right for the rich countries of the world, but not for the poor, which is unacceptable. As Professor Mendelsohn of Yale, author of a number of studies of the impact of climate change, has written, "The net damages to mid to high latitude countries [such as the UK] will be very small if not beneficial this coming century. The impacts to poor low latitude countries will be harmful across the board...Climate change will hurt the poorest people in the world most." This is no doubt true, although it is frequently exaggerated. But it does mean that those of us in the richer countries of the world have a clear moral obligation to do something about it - not least because, if the man-made warming thesis is correct, it is we who caused the problem. According to the IPCC, the greatest single threat posed by global warming is coastal flooding as sea levels rise. Sea levels have, in fact, been rising very gradually throughout the past hundred years, and even the last IPCC Report found little sign of any acceleration.

Nevertheless, Sir Nicholas Stern, charged by the Government to look into the economics of climate change is particularly concerned about this, especially the alleged melting of the Greenland ice sheet. He has written that: "The net effect of these changes is a release of 20 billion tonnes of water to the oceans each year, contributing around 0.05 millimetres a year to sea-level rise." This would imply an additional sea-level rise of less than a quarter of an inch per century, something it ought not to be too difficult to live with.

But the major source of projected sea-level rise is from ocean warming expanding the volume of water. As a result, some of those low-lying areas already subject to serious flooding could find things getting significantly worse, and there is a clear case for government money to be spent on improving sea defences in these areas. The Dutch, after all, have been doing this very effectively for the past 500 years. The governments of the richer countries, like the United States with its Gulf coast exposure, can be left to do it for themselves; but in the case of the poorer countries, such as Bangladesh, there is a powerful argument for international assistance.

Another problem for the poorer and hotter countries of the world, according to the IPCC, is an increase in vector-borne diseases, notably malaria. This is more controversial. Most experts believe that temperature has relatively little bearing on the spread of the disease, pointing out that it was endemic throughout Europe during the little ice age. Be that as it may, some two million children in the developing world die every year from malaria as it is; and the means of combating, if not eradicating, the scourge are well established. There is, again, a clear case for international assistance to achieve this. Of course assistance in either the building of effective sea defences or in the eradication of malaria will cost money. But that cost is only a very small fraction of what it would cost to attempt, by substantially curbing carbon dioxide emissions, to change the climate.

The argument that we need to cut back substantially on carbon dioxide emissions in order to help the world's poor is bizarre in the extreme. To the extent that their problems are climatic, these problems are not new ones, even if they may be exacerbated if current projections are correct. If, twenty years ago, when as Chancellor I was launching the first concerted poor-country debt forgiveness initiative, subsequently known as the Toronto terms, anyone had argued that the best way to help the developing countries was to make the world a colder place, I would probably have politely suggested that they see their doctor. It makes no more sense today than it would have done then. Indeed, it is worse than that. As Frances Cairncross, the Chairman of the Economic and Social Research Council, pointed out in her thoughtful and honest Presidential address on climate change to the British Association's annual conference in September, the cost of effectively curbing carbon dioxide emissions "will definitely be enormous". Precisely how large it is impossible to say - even by Sir Nicholas Stern.

Last year's report on the economics of climate change by the House of Lords Economic Affairs Committee quoted estimates ranging from $80 billion a year to $1,100 billion a year. It would depend greatly, among other things, on how it is achieved and how soon - the earlier it is done the greater the cost. Of critical importance is how great the increase in the price of carbon would need to be to stifle the demand for carbon sufficiently; and that we cannot know unless and until we do it. But it is clear that the cost will be large enough, among other consequences, to diminish significantly the export markets on which the future prosperity of the developing countries at least in part depends. So far from helping the world's poor, it is more likely to harm them.

Nevertheless, curbing carbon dioxide emissions, along the lines of the Kyoto accord, under which the industrialised countries of the world agreed to somewhat arbitrarily assigned limits to their CO2 emissions by 2012, remains the conventional answer to the challenge of global warming. It is hard to imagine a more absurd response. Even its strongest advocates admit that, even if fully implemented (which it is now clear it will not be, and there is no enforcement mechanism), the existing Kyoto agreement, which came into force last year, would do virtually nothing to reduce future rates of global warming.

Its importance, in their eyes, is as the first step towards further such agreements of a considerably more restrictive nature. But this is wholly unrealistic, and fundamentally flawed for a number of reasons. In the first place, the United States, the largest source of carbon dioxide emissions, has refused to ratify the treaty and has made clear its intention of having no part in any future such agreements. The principal American objection is that the developing countries - including such major contributors to future carbon dioxide emissions as China, India and Brazil - are effectively outside the process and determined to remain so. Indeed, both China and India currently subsidise carbon-based energy.

The developing countries' argument is a simple one. They contend that the industrialised countries of the western world achieved their prosperity on the basis of cheap carbon-based energy; and that it is now the turn of the poor developing countries to emulate them. And they add that if there is a problem now of excessive carbon dioxide concentrations in the earth's atmosphere, it is the responsibility of those that caused it to remedy it. Nor are they unaware of the uncertainty of the science on the basis of which they are being asked to slow down their people's escape from grinding poverty.

The consequences of the exclusion of the major developing countries from the process are immense. China alone last year embarked on a programme of building 562 large coal-fired power stations by 2012 - that is, a new coal-fired power station every five days for seven years. Putting it another way, China is adding the equivalent of Britain's entire power-generating capacity each year. Since coal-fired power stations emit roughly twice as much carbon dioxide per gigawatt of electricity as gas-fired ones, it is not surprising that it is generally accepted that within the next 20 years China will overtake the United States as the largest source of emissions.

India, which like China has substantial indigenous coal reserves, is set to follow a similar path, as is Brazil. Then there is the cost of the Kyoto approach to consider. The logic of Kyoto is to make emissions permits sufficiently scarce to raise their price to the point where carbon-based energy is so expensive that carbon-free energy sources, and other carbon-saving measures, become fully economic. This clearly involves a very much greater rise in energy prices than anything we have yet seen. The trebling of oil prices since Kyoto was agreed in 1997 has done little to reduce carbon emissions. There must be considerable doubt whether a rise in energy prices on the scale required would be politically sustainable. Particularly when the economic cost, in terms of slower economic growth, would be substantial.

In reality, if the Kyoto approach were to be pursued beyond 2012, which is - fortunately - unlikely, the price increase would in practice be mitigated in the global economy in which we now live. For as energy prices in Europe started to rise, with the prospect of further rises to come, energy-intensive industries and processes would progressively close down in Europe and relocate in countries like China, where relatively cheap energy was still available. No doubt Europe could, at some cost, adjust to this, as it has to the migration of most of its textile industry to China and elsewhere. But it is difficult to see the point of it. For if carbon dioxide emissions in Europe are reduced only to see them further increased in China, there is no net reduction in global emissions at all.

The extent of ill-informed wishful thinking on this issue is hard to exaggerate. To take just one example, the government's 2003 energy White Paper proposed a 60 per cent reduction in the UK's carbon dioxide emissions by 2050, based on the notion of supplying most if not all of the country's electricity needs from renewable sources, notably that particularly trendy source, wind power. But as experienced electrical engineers have pointed out, government estimates of the cost of wind power are grossly understated, since wind power (like most renewable sources of energy) is intermittent. In other words, the wind doesn't blow all the time. But the electricity supply does have to be on tap all the time. Given the fact that electricity cannot be economically stored on an industrial scale, this means that conventional generating capacity would have to be fully maintained to meet demand when the wind stops blowing, thus massively adding to the true cost of wind power.

There are all sorts of things we can do, from riding a bicycle to putting a windmill on our roof, that may make us feel good. But there is no escaping the two key truths. First, there is no way the growth in atmospheric carbon dioxide can be arrested without a very substantial rise in the cost of carbon, presumably via the imposition of a swingeing carbon tax, which would require, at least in the short to medium term, a radical change of lifestyle in the developed world. Are we seriously prepared to do this? (A tax would at least be preferable to the capricious and corrupt rationing system which half-heartedly exists today under Kyoto.)

And the second key truth is that, even if we were prepared to do this, it would still be useless unless the major developing nations - notably China, India and Brazil - were prepared to do the same, which they are manifestly and understandably not. So we are driven back to the need to adapt to a warmer world, and the moral obligation of the richer countries to help the poorer countries to do so.....

It is not difficult to understand, however, the appeal of the conventional climate change wisdom. Throughout the ages something deep in man's psyche has made him receptive to apocalyptic warnings: "the end of the world is nigh". Almost of all us are imbued with a sense of guilt and a sense of sin, and it is so much less uncomfortable to divert our attention away from our individual sins and causes of guilt, arising from how we have treated our neighbours, and to sublimate it in collective guilt and collective sin.

Throughout the ages, too, the weather has been an important part of the narrative. In primitive societies it was customary for extreme weather events to be explained as punishment from the gods for the sins of the people; and there is no shortage of examples of this theme in the Bible, either - particularly but not exclusively in the Old Testament. The main change is that the new priests are scientists (well rewarded with research grants for their pains) rather than clerics of the established religions, and the new religion is eco-fundamentalism. But it is a distinction without much of a difference.....

The second, and more fundamental, danger is that the global Salvationist movement is profoundly hostile to capitalism and the market economy. There are already increasing calls for green protectionism - for the imposition of trade restrictions against those countries which fail to agree to curb their carbon dioxide emissions. Given the fact that the only way in which the world's poor will ever be able to escape from their poverty is by embracing capitalism and the global market economy, this is not good news.

But the third danger is even more profound. Today we are very conscious of the threat we face from the supreme intolerance of Islamic fundamentalism. It could not be a worse time to abandon our own traditions of reason and tolerance, and to embrace instead the irrationality and intolerance of ecofundamentalism, where reasoned questioning of its mantras is regarded as a form of blasphemy. There is no greater threat to the people of this planet than the retreat from reason we see all around us today.

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Expensive Greenie roof in Scotland

Bosses of an acclaimed new government building with a grass roof were shocked to find it will cost 5,000 pounds to have it cut. The 13 million pound Scottish Natural Heritage HQ, praised for its eco-friendly credentials, includes a roof garden, reports the Daily Record. But health and safety regulations mean scaffolding and other safety measures must be installed when people are working above ground. It's believed one scaffolding firm tendered an estimate in the region of 5000 pounds.

It raises questions about the cost implications of the green credentials of Great Glen House in Inverness, opened last month by First Minister Jack McConnell. Local councillor Jimmy MacDonald said: "It seems the extra costs to cut the grass will make this building not as eco-friendly as first believed."

An SNH spokesman said: "The roof was chosen due to its low-maintenance regime, which is why it is so popular for green roof projects."

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The Sovietization of British school inspections

School inspections used to be about improving education. This is no longer the case, says Susan Elkin

I am teaching in an English department in a "bog standard" Kent high school and we are being inspected. Although we have only 500 pupils, we are joined by 13 men and women from London for a complete school week. One cerebral, interesting man is attached exclusively to the English department. Only five of us work in the department, so "our" inspector is with one or other of us almost continuously from Monday to Friday. He makes helpful comments and joins in. At the end of the week, he meets the whole department and shares some thoughts, ideas and observations with us. It is all very constructive.

When I pop along as usual to the music department at lunchtime on Tuesday to sing in the choir with the senior pupils, I find the music inspector helping our (only) music teacher by playing accompaniments so that she can get on with conducting. I also notice the science inspector apparently helping pupils with experiments when I pass the chemistry lab.

Did we know they were coming? Yes, we had a few weeks' notice and naturally we scurried around in advance to present our school in the best light. But there was no requirement to produce forests of pointless paper "policies" that no one ever looks at before or after the inspection. So, of course, this isn't Ofsted, with its dogma of discounting what isn't documented. I am winding the clock back more than 20 years to the early Eighties, when I was in a school that underwent a full inspection by Her Majesty's Inspectorate (HMI). Founded in the 19th century, HMI was the forerunner of Ofsted and has now been incorporated into it.

I was lucky to have this experience. HMI inspected schools like ours at random, but there was no brief to be exhaustive. It used to be said that, statistically, you could teach for 100 years and never see an inspector - clearly not ideal if you want teachers and schools to be accountable. Their method, however, was exemplary. No inspector in our school that week suggested there was one "correct" way of tackling a subject, organising a lesson, assessing work or relating to pupils. They had the wisdom to know that there are almost as many good learning methods as there are teachers, and that encouraging those who are clearly good at the job to build on their strengths and "to go with what works" is far more likely to get good results - and I don't mean just examination grades. There was no evidence of fixed criteria and there were certainly no tick boxes.

Compare that with the blinkered reductiveness of Ofsted, whose purpose is to enforce the Government's dumbed-down education policies and to suppress breadth and initiative. If a teacher isn't doing precisely what the Department for Education and Ofsted dictate, his or her lesson is publicly damned as "unsatisfactory". Anastasia de Waal, author of Inspection, Inspection, Inspection!, recently published by the think tank Civitas, argues that Ofsted is a Government lapdog, not the education watchdog it pretends to be. A spokesman for one of the schools Miss de Waal cites said: "If there is a box for it, it must be ticked and if something doesn't have box, it's ignored." Another commented: "When I challenged a judgment in discussion, the inspectors shrugged their shoulders, saying they simply had 'to follow the rules and tick the boxes'."

One of the Government's obsessions is with rigidly structured lessons. Mine always began with a greeting, a joke and then, mostly, "Let's start from where we got to yesterday". In 36 years of reasonably successful teaching, I rarely managed a self-contained lesson - because life and learning are simply not divisible into neat units for the convenience of petty bureaucrats. Moreover, good, confident teachers who know what they're doing and who care about learning can never quite predict where a lesson is going. A pupil might ask an interesting question and the discussion might veer off in a relevant, but unexpected, direction - anathema to control freaks and Ofsted inspectors.

Driven out partly by the absurdity of the Ofsted inspections, Sue Gibson no longer teaches garden history in a further education college. "I was criticised for not altering my method of delivery every 10 to 15 minutes," she says. "In a two-hour lesson, that would have meant changing my teaching method at least eight times. These were college students being prepared for the workplace. Producing students with a concentration span of only 15 minutes would, to any sane person's thinking, only add to the numbers of unemployed." Miss Gibson is relieved to be out of it, but says she regrets the waste of her years of experience and knowledge.

Ofsted has achieved what Miss de Waal calls the "homogenisation" of teaching. That means schools are getting worse, not better. They change to accommodate what Ofsted wants. Most are too frightened of the punishments that Ofsted can dole out - "special measures" and the like - to do anything else.

Although we weren't exactly thrilled to see HMI, there was mutual respect between teachers and inspectors in the 1980s. The inspectors were regarded as the creme de la creme in the teaching profession, and you had to be outstanding to make it as one. Today, the relationship of most teachers with Ofsted is based on well-founded mistrust and suspicion. Inspectors, typically, are part-time hirelings borrowed from schools that are clones of the ones they're inspecting. Independent they are not.

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