Sunday, December 17, 2006


Even if the means is abandonment of the historic rule of law in Britain. Comment below by Daniel Mandel. A more extended comment is available from from Oliver Kamm

In his book The Closed Circle: An Interpretation of the Arabs, David Pryce-Jones writes at length of the time-honoured "extension into the West of [Saudi] money-favouring" - a subject now in the British headlines for a startling instance of its power: the halt called in Britain to the Serious Fraud Office (SFO) investigation into a 60 million pound slush fund for Saudi royals. The SFO was investigating payments to the Saudis in the form of lavish holidays, luxury cars and rented apartments which were apparently made to guarantee Saudi commitment to Britain's largest ever defence contract, the so-called Yamamah deal.

Under this deal, Saudi Arabia agreed in 1985 to buy from BAE Systems, Britain's biggest military contractor, 72 Tornados and 30 Hawk fighter aircraft, plus a further 48 Tornados in 1993. This year Saudi Arabia agreed to pay 10 billion pounds for 72 aircraft, part of a package that was expected to grow. The agreement has kept BAE in business for 20 years.

However, Saudi displeasure and British loss of nerve has resulted in a spectacular climb-down: following a Saudi threatened rupture of ties and loss of future contracts (worth 2.5 million pounds annually), the Attorney-General, Lord Goldsmith, has announced the suspension of the SFO's investigation. The SFO says it called off its investigation after representations made "both to the Attorney General and the Director [of the SFO] concerning the need to safeguard national and international security … It has been necessary to balance the need to maintain the rule of law against the wider public interest."

That is a statement of forensic significance. The rule of law is the special achievement of democratic society and its purpose, among other things, has always been the protection of what the SFO calls "the wider public interest." How is it possible, then, that protection of the "wider public interest" is now deemed to lie in the suspension of the rule of law under foreign pressure?

More detail of this disquieting episode is available on Pryce-Jones' blog.

Christmas Carols now "Too Noisy"

The latest excuse for stopping Christmas celebrations:

"A children's Christmas choir was left in tears after shopping centre security guards told them to shut up. The 23 children - aged three to five - were ordered to stop singing carols because they were too noisy.

Nursery school teachers had taken the kids to entertain shoppers at Nottingham's Exchange Arcade, reports the Sun. Claire Ellis, 38, mother of three-year-old singer Harrison, said: "It's disgusting. Christmas is a time for hearing little ones sing. Naturally they get excited but this was a special day for them."

Sharon Hastings, supervisor at Jesters Child Care Nursery, in Gedling, Notts, said: "I couldn't believe it when we were asked to leave. We hadn't caused any disruption and we weren't being loud." And store manager Lorraine Harvey said: "None of our customers complained about the kids."


The fact that they were upsetting little kids did not matter of course. Any normal person would love to hear the little kiddies sing.


By Jeff Jacoby

From the land that produced "A Christmas Carol" and Handel's "Messiah," more evidence that Christianity is fading in Western Europe: Nearly 99 percent of Christmas cards sold in Great Britain contain no religious message or imagery. "Traditional pictures such as angels blowing trumpets over a stable, Jesus in his manger, the shepherds and three wise men following the star to Bethlehem are dying out," the Daily Mail reports. A review of some 5,500 Christmas cards turns up fewer than 70 that make any reference to the birth of Jesus. "Hundreds . . . avoided any image linked to Christmas at all" -- even those with no spiritual significance, such as Christmas trees or Santa Claus.

Presumably the greeting-card industry is only supplying what the market demands; if Christian belief and practice weren't vanishing from the British scene, Christian-themed cards wouldn't be, either. But some Britons, not all of them devout, are resisting the tide. Writing in the Telegraph, editor-at-large Jeff Randall -- who describes himself as "somewhere between an agnostic and a mild believer" -- announces that any Christmas card he receives that doesn't at least mention the word "Christmas" goes straight into the trash. "Jettisoning Christmas-less cards is my tiny, almost certainly futile, gesture against the dark forces of political correctness," he writes. "It's a swipe at those who would prefer to abolish Christmas altogether, in case it offends 'minorities.' Someone should tell them that, with only one in 15 Britons going to church on Sundays, Christians are a minority."

Meanwhile, the employment law firm Peninsula says that 75 percent of British companies have banned Christmas decorations for fear of being sued by someone who finds the holiday offensive. And it isn't only in December that this anti-Christian animus rears its head. British Airways triggered a furor when it ordered an employee to hide the tiny cross she wears around her neck. At the BBC, senior executives agreed that they would not air a program showing a Koran being thrown in the garbage -- but that the trashing of a Bible would be acceptable. "It's extraordinary," remarks Randall. "In an increasingly godless age, there is a rising tide of hatred against those who adhere to biblical values." A "tyrannical minority" of intolerant secularists is openly contemptuous of traditional moral norms. "The teachings and guidance of old-fashioned Christianity offend them, so they seek to remove all traces of it from public life."

You don't have to be especially pious to find this atheist zealotry alarming. Nor do you have to live in Europe. Though religion remains important in American life, antireligious passion is surging here, too. Examples abound: In two recent best sellers (The End of Faith and Letter to a Christian Nation), Sam Harris heaps scorn on religious believers, whose faith he derides as "a few products of ancient ignorance and derangement." A study in the Journal of Religion and Society claims that belief in God correlates with higher rates of homicide, sexual promiscuity, and other social ills, and that when compared with relatively secular democracies, the churchgoing United States "is almost always the most dysfunctional." Secular absolutists demand that schools and government venues be cleansed of any hint of religious expression -- be it a cross on the Los Angeles County seal, a courthouse display of the Ten Commandments, or the words "under God" in the Pledge of Allegiance.

What is at stake in all this isn't just angels on Christmas cards. What society loses when it discards Judeo-Christian faith and belief in God is something far more difficult to replace: the value system most likely to promote ethical behavior and sustain a decent society. That is because without God, the difference between good and evil becomes purely subjective. What makes murder inherently wrong is not that it feels wrong,but that a transcendent Creator to whom we are answerable commands: "Thou shalt not murder." What makes kindness to others inherently right is not that human reason says so, but that God does: "Love thy neighbor as thyself; I am the Lord."

Obviously this doesn't mean that religious people are always good, or that religion itself cannot lead to cruelty. Nor does it mean that atheists cannot be beautiful, ethical human beings. Belief in God alone does not guarantee goodness. But belief tethered to clear ethical values -- Judeo-Christian monotheism -- is society's best bet for restraining our worst moral impulses and encouraging our best ones. The atheist alternative is a world in which right and wrong are ultimately matters of opinion, and in which we are finally accountable to no one but ourselves. That is anything but a tiding of comfort and joy.


Britain: The "One size fits all" battle of the lunchbox

Parents are quite capable of feeding their children - despite what the government's School Food Trust would have us believe.

It’s bad enough having Jamie Oliver telling us how to feed our children without another celebrity chef joining in. But in January, Prue Leith, cookery writer and restaurateur, takes up her position as chair of the School Food Trust. ‘This is the most important job I have ever had,’ she said on her appointment. ‘I believe we can really change attitudes through the trust’s mission to help schools teach every pupil about food and nutrition and to give them cooking lessons.

The School Food Trust is yet another government-knows-best initiative set up to propagate myths about diet and intervene into areas where government should fear to tread. It’s website states as fact the horrors of the epidemic of obese children. In fact, the level of obesity is generally overstated (see Fattened statistics, by Peter Marsh) and the solutions are generally worse than the ‘problem’ (see Stop bullying fat kids, by Dr Michael Fitzpatrick).

The one thing we do know is that people are living longer and healthier than ever before. The mortality rate for five year olds fell by 98 per cent from 1901 to 2001. In 1901, the UK average life expectancy was 46 years for men, and 50 years for women. In 2001 this had risen to 76 years for men and 81 years for women. Hardly doomsday scenarios.

As a parent who is the intended recipient of such initiatives, what makes my blood boil is they reveal exactly what the government thinks of me. Here is what actually happens. Parents want their children to be happy and healthy. They want their children to eat food that will make them strong and grow. Parents are also pragmatic with their children. They would rather their children ate something rather than nothing (an admirable idea, I hope you’ll agree) and so work out what that means. This might mean a whole host of different things, from mini pizzas to sweet potatoes, because children all have their individual tastes and quirks.

The School Food Trust site however assumes that parents are complete idiots and then goes from there. For example, one of the factsheets for parents is on the sticky subject of the humble packed lunch. The factsheet tells us ignorant parents that ‘packing a lunch can be done in five minutes before school. Or, if you’re usually pushed for time, pack it the night before and put it in the fridge.’ Thanks for that because we’d obviously never be able to manage without such words of advice. With that sort of view of how impotent we are, it is amazing that the children in question have lived long enough to go to school to have a packed lunch. How did we know not to immerse our children in boiling hot water when bathing them as infants? However did we manage to heat up their baby food?

After assuming we have so little intelligence, the site then continues in a patronising vein to advise us not to put the same thing in our children’s lunchbox every day. ‘Try to have a different type of fruit every day - don’t always pick an orange and an apple, why not try kiwi, mango, grapes, pear, chunks of melon or small packets of dried fruit.’

So, we’re apparently so useless we can’t even work out when and how to make our kids’ lunches but somehow we have the time to wander around sourcing a variety of fruits. Nor does it stop at fruit. There are all sorts of interesting breads we should search for, too. Examples given to put in our children’s lunchboxes are pittas, bagels, baguettes, ciabatta, rice crackers, rolls, wraps - anything but the humble white loaf which somehow has assumed the moral status of heroin.

To be fair, the School Food Trust is not alone in deciding they know better than parents. That other great government-funded institution, the BBC, has decided that mother does not know best. The BBC’s ‘Big Challenge’ is to transform the state of the lunchbox as we know it. As with the School Food Trust, bog standard white sliced bread is the loaf that dare not speak its name. Any old pitta, bagel or wrap will do in place of Sunblest or Mothers Pride. Once again, parents are meant to be sourcing a whole range of products from pasta-based salads to small packs of nuts and seeds.

At one point, it occurs to the author of this advice, nutritionist Lyndel Costain, that children may not rejoice when being offered a bit of pasta and a few nuts to sustain them through the school day. But never fear! There is more sound advice to dole out to us stupid parents. ‘Involve them in lunchbox planning’ or ‘give them a star’ if they try a ‘new, healthier lunchbox food’. After five stars ‘give them a small reward, such as… [wait for it] ... a family walk’!

Please! My 4 year old and 7 year old are involved in lunchbox planning in that they are very sure of what they like and don’t like and a packet of seeds, however much planned, will not be eaten. And a family walk, for my kids at least, is not an incentive to look with delight on a vegetable stick with a dip but an onerous activity they are dragged on under great duress.

If it sounds like I have a personal axe to grind, I do. In my children’s primary school they have embraced the healthy eating agenda with a vengeance. This includes inspecting the children’s lunchboxes and giving awards to the child who brings the ‘healthiest’ lunch to school, while telling those who have biscuits in their box to bring an apple instead.

Perhaps I should think myself lucky compared to the parents of little Ryan Stupples, who was excluded from the school dining hall and made to eat in the headmaster’s office for having - shock, horror - two snack items in his lunchbox. The headmaster told the Daily Telegraph: ‘We take healthy eating very seriously and everyone is aware of our new policies.’ The thought of a 10 year old boy being told by their school that they’ve done something naughty because of what mum and dad put in their lunchbox sends shivers down the spine.

If the lunchbox inspections are bad, the battle for young hearts, minds and stomachs is even worse. When I went to see an assembly that my daughter’s class staged for parents, the tour de force was six year old girls reading their poems about healthy eating. I found myself feeling queasy as they told us about how you must not eat fatty things, because it is important to be thin! The following week there was yet another healthy eating day which involved trying ‘healthy’ foods. Discussing this with friends in the parents forum that I run, it was clear that everyone had their own little horror story to tell of their child’s school cracking down on contraband lunchbox items or brainwashing them about the dangers of their food.

Call me old fashioned but shouldn’t school be trying to develop knowledge and imagination, whether through fantastic literary tales or inspiring science? Why instead are we infecting such young children with an obsession with their bodies?

Parents will remain pragmatic and keep focused on doing what is best for their children, giving them what they will eat, and sometimes getting them to stretch the boundaries of what that means. But at the same time, parents shouldn’t be complacent about the patronising messages coming from something like the School Food Trust. These messages show that the government holds us in high contempt and doesn’t like it when we don’t bow before their codes and guidelines, that we can work out for ourselves what is best for our children. It has imbued food stuffs with moral characteristics - sliced white bread bad, ciabatta good - and it wants to ensure that morality is enforced.

Parents: you can expect plenty of arguments with schools over how to feed your children in the coming months. Stand by what is right for your child. Hold onto your children’s lunchboxes and let the battle commence!



Nice toys for the rich -- thanks to a Leftist government!

One minute the quirky electric cars are as rare as a bobby on the beat. Next minute they are as common as parking wardens - you'd swear there's one on every corner. And in a stroll through highly-fashionable and well-heeled Mayfair in London the Daily Mail spotted all these G-Wiz electric cars - and more.

The reason for the boom is simple - these 'plug and play' cars are exempt from the London Mayor Ken Livingstone's controversial congestion charge of o8 a day - which he wants to increase from 8 pounds a day to 10 - adding a whopping 25 pound levy for the most polluting 'gas-guzzlers.'

Costing from 6,999 pounds, these electric cars have a range of about 40 miles per charge - though you can knock-off 10 miles if you put on the heater in chilly weather. Top speed is a pedestrian 42mph - but fast enough in 30mph and 20mph zones. But fuel efficiency is immense - and equivalent to between 200mpg and 600 miles to the gallon, depending on conditions. Range is about 40 miles before the battery needs a re-charge. But there's another downside - they have all the excitement of a milk-float. Trendy or planet-conscious owners include TV presenter Jonathan Ross and Guardian editor Alan Rusbridger. It will also get you a free parking permit in Richmond on Thames where council chiefs are cracking down on 'Chelsea Tractor' 4X4s,

Charging your electric car overnight adds around 30p to your electricity bill, giving a fuel cost of under a penny a mile compared to around 15p for the average petrol car. But there are only two on-street chargers in Westminster. So you need off-street parking to juice it up. And there is a sting in the tail - electric cars need new batteries every three years or so, at a cost of around 1,200 pounds. And although they produce no pollutants themselves, electric cars aren't necessarily the greenest vehicles on the road. With normal power from the mains you'll create less carbon dioxide (CO2) the so-called 'greenhouse gas than with a regular car. But the emissions, though lower, are merely displaced to the power station.


Robust NHS patient killed by disorganized and poorly-trained doctors

Elaine Bromiley kissed her husband Martin and their children Victoria, then six, and Adam, five. "Bye-ee," she called to them, waving as she was wheeled down the corridor towards the operating theatre. The otherwise healthy 37-year-old had suffered for years from chronic sinusitis, an inflammation of the nasal passages. Then, early in 2005, one of her eye sockets became infected. The threat of permanent damage to the optic nerve led her surgeon to recommend a minor operation to straighten the inside of the nose - a possible contributory factor.

Once they'd said their goodbyes, Martin and the children went home to wait for word that Elaine was awake and ready to see them all again. It never came. Two hours after she'd gone into theatre, Martin received a call from the Ear, Nose and Throat (ENT) surgeon to say Elaine was having difficulty waking up. Even then, Martin wasn't unduly worried. But when he arrived at the hospital, he was told Elaine was in intensive care, and, because she'd been deprived of oxygen during the operation, there was a risk of significant brain damage. The next few days were a blur as, numb with shock, Martin, with the help of friends, did his best to care for his family. Desperately anxious about his wife, he tried to maintain as normal a life as possible for the children, who continued going to school.

Meanwhile, Elaine was put into a medically-induced coma for three days to give her swollen brain a chance to recover. "I spent every minute I could with Elaine, holding her hand and telling her how much I loved her," says Martin. "The day after the operation was the 21st anniversary of our first date. I was told that the eventual outcome could be a full recovery, or that my wife could be alive but in a vegetative state - or any point between the two extremes. "My head was spinning. I couldn't grasp how life could change so quickly and in such a devastating way. I really couldn't see past the next day and had no idea what the future held for us."

Five days after the operation, a brain scan indicated little if any activity and Martin was told Elaine had suffered brain death. "It was like a TV screen covered in static: no shape, no texture, no colour to show that anything was working," he recalls. "Years ago, Elaine had told me that she did not wish to live as a vegetable. I made the decision that life support should be withdrawn and I prepared myself for a life without Elaine that I could not begin to imagine." Mrs Bromiley was observed for three days and then taken off life support. She survived for another four days, dying in the middle of the night when Martin was at home with the children. "I'd decided that they were the priority now," he says.

He had kept the children informed of their mother's progress, telling them "first that Mummy was going to be ill, just like Granny was when she had a stroke, but that she will get better". Then he had to explain that "Mummy wasn't going to wake up, she was going to die". Martin recalls those desolate days. "I just couldn't imagine how life would go on," he says. What Martin hung on to, he says, was his professional work ethic as a pilot. He took it for granted that - as is routine in aviation - an investigation would automatically be carried out. His hope was that at the very least lessons would be learnt to protect other patients in the future. He felt, if anything, comradeship with the operating team responsible. "I was 99.9 per cent sure that what had happened to Elaine could not have been predicted and that when the emergency occurred, the team did what they believed to be right but things just didn't work out."

When he discovered that no inquiry would be carried out unless he sued or made a complaint, he walked into the hospital chief executive's office to insist there was one. The subsequent investigation was headed by Professor Michael Harmer, a former president of the Association of Anaesthetists. The inquiry revealed that Elaine's operation was a textbook example of how surgery, carried out by technically proficient professionals, can go horribly wrong. The cause: human error. So much is made of the latest medical advances that it comes as something of a shock to learn that human error still figures significantly in modern healthcare.

Yet last month, the Chief Medical Officer, Sir Liam Donaldson, warned that the odds of dying as a result of clinical error in hospital are 33,000 times higher than those of dying in an air crash. "In the airline industry, the risk of death is one in 10 million. If you go into a hospital, the risk of death from a medical error is one in 300," he said. And yet it seems little is being done to improve those odds. Five years after chairing the inquiry into the deaths of 29 babies during heart surgery at Bristol Royal Infirmary, Sir Ian Kennedy, now chairman of the Health Commission, drew attention to the lack of progress. "It is almost as though avoidable deaths and injuries are accepted as part of the risk of care and treatment," he told a meeting of clinicians in London in July.

And it gets worse: the National Patient Safety Agency (NPSA), which was set up by the Government in response to the Bristol inquiry, with a brief to ensure that patient safety was a priority within the NHS, was recently described as "dysfunctional" by the National Audit Office. The agency has no idea how many people die each year as a result of medical error. It is currently under investigation, with a report on its future due out this week. The National Audit Office estimates that there may be up to 34,000 deaths annually as a result of patient safety incidents. But in reality the NHS simply does not know.

Contrast this with the approach taken by other high-risk industries. For years, businesses from motor racing to oil refining have recognised the dangers of human error, and the importance of communication and teamwork in dealing with emergencies. They have introduced what is known as Human Factors (HF) training, which teaches basic skills designed to promote safety. While much-prized technical skills are essential, they are not always enough in a fast-moving, high-risk situation. At critical moments, organisational and social skills are just as important. This means good communication and an ability to work together with each member of the team.

It appears that moments after being sedated, Elaine's airway collapsed, preventing adequate levels of oxygen from reaching her brain. Though potentially an emergency, the event is a recognised risk during an anaesthetic and, as such, should be manageable. Surgeons and anaesthetists are drilled to follow a series of steps at this point - beginning with a non-invasive attempt to get the patient breathing normally, and ending, as a last resort, with an emergency surgical procedure. This is usually a tracheotomy - where the surgeon cuts through the windpipe, inserting a tube directly into the airway through the throat.

At first the drill was followed impeccably. But then a problem arose: the surgical team tried to get a tube into the airway to help Elaine breathe, but encountered some kind of blockage. According to the drill, this was the time to consider doing a tracheotomy. Elaine, by this point, was turning blue in the face and one of the nurses fetched tracheotomy equipment. A second nurse phoned through to the intensive care unit to check there was a spare bed available.

But the three consultants appear to have made the sort of human error that is horribly common in crisis situations. They became fixated on what they were doing. The consultants also appear to have ignored the junior staff and remained intent on finding a way to insert a tube into the airway. The minutes ticked by. After 25 minutes, they were finally able to get a tube into her airway -but even then, the team failed to secure the tube and it was a full 35 minutes before adequate oxygen levels to the brain were restored.

At the inquest, held in October last year, the lead anaesthetist admitted that he had lost control and there was a dispute over exactly who was in charge of the procedure, making life-and-death decisions.

All of which could have been the end of the investigation. But Martin Bromiley had an unusual insight into the factors that led to his wife's death. He is both a pilot and a specialist in HF training, which has been mandatory for British pilots and crew since the mid-1990s. "Fixation is a normal reaction to stress. HF training teaches people that it's normal to carry on trying to take the usual action, even when it's clearly not working," he says. "But at some point, a decision has to be made to break out of that pattern of behaviour. The way to ensure that happens is for all members of the team to see it as their duty to speak out to keep the patient safe." There was no comfort in knowing that two of the nurses knew how to save his wife's life. "What they didn't know - and what HF would have taught them - is how to broach the subject with their bosses," he says.

"The same problem used to exist in aviation. It was common for the evidence from black boxes to show that junior members of staff had been aware that a mistake had been made and had either kept quiet or been ignored." Clinicians tended to view human error as a sign of weakness or the result of poor performance, says Martin. "Yet high-risk industries have shown that by accepting that it is normal to make mistakes, it becomes the team's responsibility to watch out for errors and catch them before they cause significant harm."

Martin began to ask questions and soon found that he was not the only person to be concerned about the risks of modern surgery. Indeed, for the past year the Royal College of Surgeons has been developing HF training courses in which surgeons have worked with experts from the aviation industry. Last month, it also organised a conference where leading doctors, nurses and managers heard speakers from the military, the oil industry and motor racing, among others, all described the dramatic impact on safety levels following the introduction of HF training. Martin himself also addressed the conference. "Patients want surgeons who can communicate well with them and effectively with members of the team,' says Tony Giddings, the Royal College of Surgeons council member responsible for patient safety issues and a former surgeon and trained pilot. "And there is a growing understanding of their importance within the profession. These skills are not unique to medicine; they are skills for life itself. They enable people to be confident and self-assured yet acknowledge they are not infallible. "Unless people have these skills intuitively, they need to be trained. Surgeons, anaesthetists, nurses and other members of the team can be trained together to develop these essential skills."

However, unless such training is mandatory, the surgeons who need it most won't participate, says Mr Giddings. It also needs funding. HF training could save thousands of lives every year, yet he says there is a reluctance at government level to commit resources to a scheme which could cost millions of pounds every year. "But however expensive mandatory training is, there is considerable evidence that human error in medicine is far more costly, both in human and financial terms." For Roger Goss, co-director of campaign group Patient Concern, there is no question that HF training must be implemented. "If the aviation industry uses this type of training, then that's good enough for me: flying is the safest mode of transport," he says. "Patient safety must become a priority in health care. It's not at the moment. Chief executives are constantly being criticised for failing to make it a priority, and instead focusing on keeping within their budget. The NHS has a moral obligation to do anything humanly possible to minimise the risks of surgery."

This week, Martin is meeting the Deputy Chief Medical Officer to discuss a number of initiatives. As he approaches a second Christmas without his wife, he is determined that his family's terrible experience will have a positive impact on the culture of surgery. "There is no question in my mind that Elaine's death will bring enormous change to clinical practice," he says with quiet determination


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