Saturday, January 13, 2007


And all this is after a huge increase in funding

The NHS will miss its target of halving superbug infections by 2008 and may never be able to control the problem effectively, the Government has admitted secretly. A leaked Department of Health memo has revealed that officials believe that government pledges to cut cases of MRSA substantially are not achievable, while the even more deadly Clostridium difficile is now "endemic throughout the health service".

More embarrassing still, much of the memo is devoted to "spinning" the failure to meet the targets so as to minimise its public impact. The memo was sent last October by Liz Woodeson, director of health protection at the Department of Health, to ministers. Politicians and health campaigners said that it deepened the sense that ministers and department officials were more interested in spin than substance.

The memo, leaked to Health Service Journal, states that the target to cut cases of the superbug methicillin-resistant Staphylococcus aureus (MRSA) by 50 per cent by April 2008, set by the former health secretary John Reid in November 2004, is unlikely to be met. There were more than 7,000 cases of MRSA in patients' blood-streams recorded in 2004, since when the number has dropped only slightly. "Although the numbers are coming down, we are not on course to hit that target and there is some doubt about whether it is in fact achievable," the memo said. "The opinion of infection experts is that we will succeed in reducing MRSA bloodstream infections by a third rather than half - and that, even if we had a longer period of time, it may not be possible to get it down to half." The memo adds that C. diff is now endemic throughout the health service, and poses an even greater threat to patient health. It gives warning that it is harder to tackle than MRSA, and that some techniques used to cut MRSA, such as alcohol rubs, do not work for C. diff.

The leaked memo sets out six ways of handling the failure to meet the MRSA target, including driving at the target as it is and face the consequences (a policy favoured by Downing Street), extending the target or accepting that it is unworkable and dropping it completely. Another tactic suggested is to enlarge the target to include C. diff, or even all hospital-acquired infections without specifying which ones.

Ms Woodeson admits in the memo that the battle to combat MRSA "doesn't seem to be having much impact on C. difficile, which is a far bigger problem". The note quotes figures from 2004 showing that while MRSA caused 360 deaths, C. diff was responsible for an estimated 1,300.

A Department of Health spokesman said of the memo: "We deplore this leak. This paper confirms that from the Prime Minister and Health Secretary downwards, the Government is determined that the NHS should get on top of the problem of MRSA and other infections." He admitted that progress had been slower than anticipated and that faster progress is needed to meet the target. "We have always said the target is challenging; that is why we set it. We remain committed to this target."

The memo is the second damaging leak to the HSJ from the department in successive weeks, suggesting that there are disgruntled civil servants prepared to risk their jobs to reveal what is going on. Andrew Lansley, the Shadow Health Secretary, said: "The Government needs to get a grip. Gordon Brown's target culture has increased costs with little improvement in care."

[And now for examples of the famous British "fudge"]

Six ways to fudge a target

* Keep it as it is, and drive as hard as we can to meet it - the policy favoured by the No 10 Delivery Unit. But Liz Woodeson, director of health protection at the Department of Health, admits: "We will be criticised if we fail to meet the target"

* Drop the target altogether, but this would be hard to get past No 10, and handling would be "extremely tricky" given media interest. "Dropping the target would probably provoke more criticism than failing to meet it in 2008," she says

* Extend the target to 2009. That would give more time, but would be open to charges of fiddling, and it may still be missed "because a certain level of MRSA infection is unavoidable"

* Extend the target, adding something on C. diff. That would be welcomed by people and might make hospitals take C. diff seriously, "as we suspect some simply see it as unavoidable". But there are many other hospital-acquired infections. It would be absurd to set a target for each, she said

* Change the target to hospital-acquired infections generally. That could not be done as mandatory reporting covers only five infections and there are "dozens of others"

* Switch to locally set targets. That would have the advantage of including C. diff, but "would be presented by the media as a cop-out because we knew we weren't going to hit the national target"



Health tourists are receiving free National Health Service kidney treatment worth about œ30,000 a year, and potentially competing with British patients for scarce transplants, according to new data. The information, released under the Freedom of Information Act, shows that one hospital is spending up to a million pounds a year on dialysis for nearly 40 non-British residents; another has placed two asylum seekers on its waiting list for transplants and a third has recovered only 2% of its costs from overseas patients.

Doctors and patient groups say the NHS is struggling to provide kidney dialysis for British patients and is ill-equipped to cope with the extra demand. They warned of an acute moral dilemma as doctors balance their overriding responsibility to help those in greatest need with the fact that the patient may not be legally entitled to treatment.

There are fears some foreign patients, so-called "health tourists", may travel to Britain to take advantage of free NHS care. Dr Jonathan Kwan, head of renal services at Epsom and St Helier hospitals trust in Surrey, said: "Non-UK residents are putting pressure on the system, which is already under too much pressure." Kwan said British patients risked losing out to those from overseas who needed treatment more urgently. "Patients waiting for dialysis may be displaced by a clinically urgent case. Doctors try to prioritise the urgent cases irrespective of residency status."

There are a record 6,000 patients on the kidney transplant waiting list, with about 400 dying each year in Britain before an organ becomes available. Patient groups say some British sufferers are forced by a lack of dialysis machines to receive treatment at night. While most health tourists seek one-off operations, patients suffering from kidney failure require dialysis three times a week for life unless given a transplant.

According to the figures, Barts and The London NHS Trust, which covers two of the largest hospitals in the capital, is providing 37 non-UK residents and an extra 14 asylum seekers with dialysis. Two asylum seekers are on the kidney transplant waiting list at the Royal Berkshire NHS Foundation Trust in Reading.

Although trusts may try to invoice non-UK residents for treatment, they usually recover only a fraction of the cost. Asylum seekers are entitled to free treatment while their case is being considered. In the last financial year St George's hospital in south London spent about 100,000 on dialysis for overseas patients but has recovered only 2,100.

Timothy Statham, chief executive of The National Kidney Federation, said: "Capacity is at breaking point," he said. "We have very ill British patients needing to dialyse through the night because there is not sufficient capacity. Some patients may come from abroad because dialysis was not available in their country. We seem to be offering a world health service."


Less than half of the students passed overall -- even including lots of "soft" subjects -- and BritGov says that's good! And the teachers want grading scrapped so nobody will know how badly the schools are doing. What a mess! Marvellous what years of Leftist educational practices will do. Note: Passing is no longer called passing. It is now called meeting a "gold standard". Beware the dreaded "tinplate standard", I guess. Amazing rubbish!

More than 300,000 secondary school pupils failed to reach the Government's target of five good GCSE passes in subjects including English and maths, league tables released yesterday show. In a quarter of England's 3,100 secondary schools, 70 per cent of pupils (105,000), failed to meet the gold standard of five A* to C grade passes in subjects including maths and English. Overall, 45 per cent of 15-year-olds achieved five A* to C grade passes at GCSEs including maths and English. When those two core subjects were not included, 58.5 per cent achieved five good GCSE passes.

The poverty of teenagers' literacy and numeracy skills was most acute in one in ten secondaries, where four fifths of pupils failed to meet the benchmark. It was also revealed that 26,000 pupils sat neither maths nor English GCSE last summer and less than half (49.8 per cent) took an examination in English, maths, science or a modern foreign language.

Nevertheless the Government insists that standards are rising and 375,000 more pupils have gained 5 GCSE passes in the past nine years. Jim Knight, the Schools Minister, said that he was determined to continue working to improve underperforming schools, but praised pupils for getting record numbers of five good GCSEs. "The results clearly show that our record investment continues to drive up standards faster than ever," he said.

However, many schools plummeted down the league tables after Ruth Kelly, when she was Education Secretary, insisted last year on the new target. In the past heads have admitted that they have encouraged children to take easier vocational exams in an effort to push their schools up the tables.

Tony Blair wants 400 schools to become academies [charters] by 2010. But yesterday's results showed that only a fifth of pupils in the 46 new schools gained 5 good GCSEs, including maths and English. Mr Knight defended the schools and said that huge parental demand for places was proof of their success. Of those pupils who achieved five good GCSEs, 88 per cent took academic subjects, while 9.7 per cent of them took vocational qualifications as part of their five passes. All students of English and maths passed GCSEs.

But David Willetts, the Shadow Education Secretary, said that pupils were being short-changed as less than half had attempted "rigorous core subjects". "We need to ensure that every pupil leaves school with a decent education in the basics - not just in maths and English, but in the sciences, history, and modern languages. "Instead pupils are being pushed into subjects which will meet targets without providing them with an education which will benefit them throughout life," he added.

Sarah Teather, the Liberal Democrat education spokeswoman, said that the new benchmark showed the "perverse incentives" created by the league tables and called for them to be scrapped. Steve Sinnott, general secretary of the National Union of Teachers, echoed her call and said that children should not be written off for failing to gain a C grade. "They may have achieved wonders to get to a grade D," he added.

Last night independent schools reacted angrily to the exclusion of International GCSE (IGCSE) results, for academic subjects such as maths and physics, from the tables.



Panic: `Health warning over safety of bottled water', says the UK Independent, among others, following a report by the food and farming campaign Sustain. The report argues that consumers often buy bottled water because they believe it is healthier than tap water. However, the bottled variety can contain sodium, contaminants (like the benzene found in Perrier in 1989), and the heavy metal antimony. The report notes that the French Senate has recommended switching brands regularly to reduce the risk of harmful effects.

Don't panic: The real aim of the report seems to be to emphasise that bottled water is less environmentally efficient than tap water - so why create a health panic about the bottled stuff?

The authors make a perfectly reasonable defence of tap water. They rightly point out that there are no particular health benefits from bottled water, and nor do we need to drink `eight glasses per day' as is routinely cited. Tap water is now produced to very high standards - 99.96 per cent of UK mains supply now meets national standards. Tap water is generally purer and fresher than the bottled variety, and also much cheaper.

However, some of the other claims in the report are dubious. The risks of sodium in the diet are overhyped anyway, but there is at least 25 times more sodium in a single slice of bread than to be found in a regular 500ml bottle of water. To reach the recommended sodium intake for a day from water would require drinking about 200 such bottles.

As for the claim about antimony, the report cites research from Germany which actually states `all the water tested contained antimony below the guidelines recommended for drinking water'. In other words, as far as anyone can tell, it is safe. While dismissing health fears about tap water, the report prefers to stoke fears about bottled water using innuendo rather than evidence.

Bottled water is convenient and usually preferable to the saccharin-sweet fizzy drinks that are the only alternative when you need to quench your thirst while out and about - even if it is sometimes ridiculously expensive. Claiming that it is potentially bad for your health is cynical, however. If Sustain think the world would be a better place if we only drank tap water, or at least recycled the plastic mineral water bottles, then they should make the case without promoting a different set of anxieties instead.


1 comment:

Anonymous said...

.........Ms Woodeson admits in the memo that the battle to combat MRSA "doesn't seem to be having much impact on C. difficile, which is a far bigger problem".......

You mentioned the above in your bog,if there is a 'battle' then I must have missed it the last time I visited my local hospital.I think they had long ago given up the fight with bulging rubbish bags, over flowing dirty linen bags, dirty floors and nurses, doctors and other medical professionals failing to wash their hands between patients, touching equipment or their own uniforms.When they did wash their hands it was sadly lacking. As somebody who has contracted MRSA in the past I was not impressed.