Wednesday, February 21, 2007

Don't get ill late at night in Britain

Because I have a perversely nocturnal brain I often write late into the night. So I had only just gone to bed last Thursday when the phone rang. My bedside clock said 3.11am. I answered with a sense of foreboding. Aside from the odd wrong number, any call we get between three and seven in the morning usually means that someone we know well is in some sort of trouble.

So it proved. We had been called by a service called Lifeline. If you are old, infirm or housebound and live by yourself, you wear an electronic device like a pendant round your neck. Should you take a tumble and can't get up, you press it to speak to a central operator who has the phone numbers of your nearest and dearest. It's a reasonable system, though I can't help thinking guiltily that if we - we as individuals, and we as society - really cared about our elderly we wouldn't leave them quite so much to fend for themselves.

Anyway, we flung on pullovers and whizzed two miles up the road to see what had happened to the lady concerned: a close relative, aged 86. The sight that greeted us was shocking. She had fallen on her way to the loo, opened up an ulcer, was shivering and half-conscious. Her skin was a ghastly blue. Worst of all, she was crumpled into a pool of her own blood. To my untutored eye, she seemed to have lost pints.

It was just after 3.30am. I dialled 999. When I described the old lady's condition the operator gave clear, concise first-aid instructions and said an ambulance was on its way. We found blankets, made her as comfortable as we could, and prayed that help wouldn't arrive too late.

Alas, this is Britain, 2007. At around 3.45am the phone rang. It was the London Ambulance Service. The essence of the call was: we're a bit busy tonight, sorry; can you cope? We said we would do our best. Seven minutes later our patient lost consciousness. Panicking, we called 999 again. Hang on in there, we were told. More agonising minutes passed. There is no helplessness worse than watching someone's life slip away for lack of prompt medical care in the middle of one of the richest, most sophisticated cities on the planet.

At 4.05am we heard a noise outside and glimpsed a flashing blue light coming along the road. I raced down the stairs to guide the ambulance to the flat. But the surreal sight that greeted me almost made me keel over with amazement. It was a fire engine.

The crew were already running towards me, breathing-gear and hoses at the ready. "Where's the incident?" one shouted. "What incident?" I replied. "The incident at this address," he said. "Someone phoned 999 for the fire service." "We called for an ambulance," I said. "An old lady's had a bad fall."

The firemen looked bemused but undaunted. They leapt up the stairs with every bit of medical clobber they could find. But I sensed that the spectacle in the flat alarmed them almost as much as it terrified us. By now the pool of blood stretched a couple of feet in every direction from where the woman lay. It was 4.10am - 40 minutes after we had made the 999 call. Luckily, skilled help was soon on hand. A paramedic turned up in a car. She administered oxygen and issued an urgent request for an ambulance on her radio. Only then did it transpire that there were no ambulances available in our area: a huge swath of northwest London. One would have to be despatched from Islington. "Eight minutes max, this time of night," said one of the firemen, trying to be reassuring.

It took 25. At 4.35am, about 65 minutes after we had made the first call, the ambulance arrived. The old lady finally got to hospital more than two hours after she had pressed her alarm.

Interestingly, A&E was virtually empty. There had been - surprise, surprise - no horrific incident tying up all the ambulances in North London in the early hours of last Thursday morning. The truth, it seemed, was that there was only one manned ambulance covering the entire area that night. Why? Because (we were informally told) the authority concerned had suspended ambulance crews' overtime, presumably in an attempt to alleviate its well-publicised financial problems.

Once again, as so often in Blair's Britain, we had encountered a colossal gap between what the politicians tell us is right with the country, and what our own eyes and brains tell us is wrong. More than 92 billion of our taxes is poured into the health service annually. That's around 1,800 pounds a year for every man, woman and child in England and Wales. We are assured that things are getting better all the time. The NHS certainly boasts more bureaucrats and fancy computer programs than ever before. Yet a semiconscious 86-year-old lies in a pool of her blood for 65 minutes waiting for an ambulance. In what sense is that progress? What are the NHS's priorities, if not for dealing with that?

The old lady, you will be pleased to know, is slowly recovering. Those Blitz-generation Londoners are as tough as nails. I'm the one who's still in shock. Where on earth did that fire engine come from?



This is a truly terrible piece of research. It relies on people's recollection of what happened 60 years ago. Given the frailties of memory at that distance, the answers are far more likely to depend on stereotypes rather than on what actually happened. And note that the recollections called for are not even what the person did 60 years ago. The respondents were asked what their MOTHERS did when they were babies! No wonder the authors took nearly 10 years to get such nonsense into print! It's breastfeeding propaganda, nothing more

The secret to popularity may be set in the way mums feed their babies. A 70-year study in Britain has found those who were breastfed are more likely to climb the social ladder than those who were bottle-fed. The results have been backed by the Australian Breastfeeding Association. Spokeswoman Karen Ingram said breast milk aided cognitive and motor development, which contributes to social skills. "We know through research that the attachment to a mother through breastfeeding can help children attach to others, which makes them more secure and independent," she said.

More than 3000 babies from England and Scotland were monitored from birth in 1937-39. The findings were based on 1414 adults who are still being examined. The study found those who were breastfed were 41 per cent more likely to move up the social ladder as adults than those who had been bottle-fed.

The prevalence of breastfeeding was not dependent on income, siblings, or social class at birth, allowing researchers to disregard other social factors that may have influenced results. The authors suggest breastfeeding influences brain development, which then leads to better exam results and job prospects and greater income.


Journal abstract follows:

Breastfeeding in infancy and social mobility: 60 year follow-up of the Boyd Orr cohort

By Richard Michael Martin et al.

Objective: To assess the association of having been breastfed with social class mobility between childhood and adulthood.

Design: Historical cohort study with 60 year follow up from childhood into adulthood.

Setting: 16 urban and rural centres in England and Scotland.

Participants: 3182 original participants in the Boyd Orr Survey of Diet and Health in Pre-War Britain (1937-39) were sent follow-up questionnaires between 1997-1998. Analyses are based on 1414 (44%) responders with data on breastfeeding measured in childhood and occupational social class in both childhood and adulthood.

Main outcome: Odds of moving from a lower to a higher social class between childhood and adulthood in those who were ever breastfed versus those who were bottle-fed.

Results: The prevalence of breastfeeding varied by survey district (range: 45% to 86%) but not with household income (p = 0.7), expenditure on food (p=0.3), number of siblings (p = 0.7), birthorder (p = 0.5) or social class (p = 0.4) in childhood. Participants who had been breastfed were 41% (95% CI: 10% to 82%) more likely to move up a social class in adulthood (p=0.007) than bottle-fed infants. Longer breastfeeding duration was associated with greater odds of upward social mobility in fully adjusted models (p for trend = 0.003). Additionally controlling for survey district, household income and food expenditure in childhood, childhood height, birth order or number of siblings did not attenuate these associations. In an analysis comparing social mobility amongst children within families with discordant breastfeeding histories, the association was somewhat attenuated (odds ratio: 1.16; 95% CI: 0.74 to 1.80).

Conclusions: Breastfeeding was associated with upward social mobility. Confounding by other measured childhood predictors of social class in adulthood did not explain this effect, but we cannot exclude the possibility of residual or unmeasured confounding.

Too few science graduates in Britain

But plenty of sociologists, no doubt

GlaxoSmithKline has given warning that a lack of UK science graduates is forcing Britain's largest drugs company to recruit from overseas to fill key research posts. Jackie Hunter, a senior vice-president who leads one of GSK's main global drug development centres, said that Britain is suffering an acute shortfall of scientists. Dr Hunter said that it was "absolutely vital" for the UK to address the issue to ensure the long-term competitiveness of the country's pharmaceutical industry and to prevent a gradual drift of jobs and investment overseas. The sector contributed 3.4 billion pounds in exports to Britain's trade balance in 2004 - more than any other industry sector.

She said that the situation was forcing GSK to seek more and more recruits from France, Spain, Germany and India. In one area, synthetic chemistry, GSK said that just 40 of 70 new placements at its research facilities in Harlow, Essex, and Stevenage, Hertfordshire, were were graduates of UK universities. Dr Hunter said that the problem had been compounded by the decision of several universities, such as Cardiff and Exeter, to scrap their chemistry departments due to rising cost pressures. "A lot of universities look at laboratory-based courses as something that is very expensive for them to run," she said. "The issue is the number of places. There is a real need across the industry [for more UK graduates]."

In response to the staffing shortage, GSK has forged links with the Societe Francaise de Chimie and other overseas organisations to attract enough high-calibre graduates. "It's an increasingly globalised labour market," Dr Hunter said. GSK employs 15,000 people in research and development globally, 6,000 of them in the UK. Britain's pharmaceutical industry employed 73,000 people directly and hundreds of thousands more indirectly in support roles. The value of UK pharmaceutical exports in 2005 was 12.2 billion, or more than 166,000 pounds per employee.



We no longer build new roads in the UK. But we are world-leaders in constructing endless debates about roads - arguments that seem to go round and round in circles getting nowhere, like a long afternoon on the M25. The fewer miles we actually add to the road network, it seems, the more mileage there is in engineering big political controversies out of mundane roads-related matters. We could surely do with a u-turn in priorities here.

After years of pootling around the political backstreets, for example, road pricing - a system of charging motorists for the mileage they do - has been driven to the top of the agenda. Last year the government-initiated Eddington Report declared the need for a national system of road-charging to be an unarguable necessity - or an `economic no brainer' as former British Airways chief Rod Eddington put it.

Since then, no fewer than one-and-a-quarter million people - all of them presumably lacking a brain in the Treasury's view - have signed an online protest against the plans for road-pricing on the government's own petitions website. The idea that road-users are rising up against the authorities, over not only road-pricing but also congestion charges, speed cameras and the many other minor discomforts of driving, has reached the point where an unknown `disgruntled motorist' was made the prime suspect for the recent spate of little letter-bomb attacks, with some even implying that the government was to blame for `driving him to it'.

These rows are a sign that politics is currently on the road to nowhere. There is a crying need for investment in major new roads in the UK, an advanced economy with a sub-European road network that, in the past 10 years, has built barely 150 miles of new motorway to support traffic growth of more than 30 per cent. Yet the demand for substantial new roads is not even on the table in the `great congestion debate'. Instead we are left with an argument over how motorists should be made to make do and mend with what exists, which is about as productive as two motorists yelling at one another through a fug of exhaust fumes.

The Eddington Report was the latest example of how the authorities now routinely deploy green politics as the language of eco-austerity. In the spirit of other New Labour reports, it effectively sought to redefine the aim of government transport policy as making Britain less mobile, by using financial penalties to drive people off the roads (at least the busy ones they want to use, at the times they most want to use them) rather than expanding capacity to meet demand. It is another testament to the triumph of the miserly politics of lowering people's expectations.

Eddington suggests it is a no-brainer that we must have a national system of road-pricing, since the shock-horror alternative would be actually to invest in big new roads. He argues that smaller projects which fiddle with the existing system are best, and warns the government not to be seduced by `grand projects' (he is preaching to the converted there), before driving his point home by concluding that `ambitions and dreams of extensive new networks.should be put aside.. Some of the best projects are small-scale, such as walking and cycling.' That should get Britain moving!

As Austin Williams of the Future Cities Project has noted, what Eddington did was to reduce the planning of our future transport infrastructure to simple fiscal considerations, a crude cost-benefit analysis assuming the need for demand management (1). The wider needs of a modern, mobile society are discounted, any vision of a more free-travelling future dismissed as `dreams'. So at the same time as something as everyday as roads can be blown up into the stuff of political controversy, the issue can simultaneously be reduced to another of Gordon Brown's mean-spirited bean-counting exercises. And in another sign of the miserabilist times, Eddington makes clear that motorists must be punished if they insist on driving about doing their business - or in New Labour-speak, they must be made to `feel the consequences of their decisions'.

A few months on from the publication of the Eddington Report, however, it would appear that the government's attempt to start the road-pricing bandwagon has backfired. New Labour no doubt hoped that farming it out to `independent' experts (even if they were handpicked by the Treasury) would allow it to remain aloof. But fuelled by scaremongering headlines about how much it might cost mothers to take their kids to school or do the shopping etc, public opposition to the government has quickly blown up around the online petition.

Comparisons with the anti-poll tax protests that helped to bring down Margaret Thatcher have been overstated. But as they are popularly understood, the road-pricing proposals would appear to have one similar effect to the hated poll tax - making people pay more for less. You do not have to be an economist to grasp that the government already takes around œ45billion a year in taxes from road-users, and spends no more than œ7billion of it on the roads. The apparent prospect of paying more tax, with no promise of new investment, could hardly have been better designed to disgruntle middle-class motorists as well as white van man.

It looks like a classic New Labour cock-up. Deeply worried about its isolation from the electorate, the government sets up this website for public petitions, presumably on the basis that for a self-proclaimed `listening government', even having your policies complained about is better than being entirely ignored. Inevitably, however, given the breadth of cynicism about politics and government today, a big two-fingered protest soon emerges on the site - and perhaps equally inevitably, it is about the mundane stuff that seems to touch people's lives rather than Iraq.

And if the anti-road pricing petition confirms the isolation of the political class from the public, the government's response to it has made clear the deepening insecurity in Whitehall. No sooner had the million-signature petition started making headlines than ministers started suggesting there had been a misunderstanding and they wouldn't be bringing in any system of road-pricing that the public does not support.

Remember, the Tory poll tax had been in force for some time before the protests and a major riot in central London caused a government crisis in 1990. Nowadays all it takes to unnerve the authorities is a `virtual barricade' of an ephemeral online petition, at least five years before road-pricing could actually take effect. It appears that, in the last days of Tony Blair, New Labour has become even more shaky and bereft of a political sat-nav to guide it than when Mrs Thatcher's Conservative regime was in its final throes in the Downing Street bunker.

Yet at root this is another phoney war that New Labour and its opponents are fighting. One thing that is very unlikely to result is any fundamental change of policy as regards those seductive `grand projects' that Old Mother Eddington warned ministers about. The no-more-roads prejudice draws its authority from the green consensus that now extends pretty much across the mainstream political spectrum.

Although the likes of Tory leader David Cameron are now a prominent part of that consensus, it owes much of its strength to the old left. It was the rump of the left that helped to organise and support the anti-roads protests of the past 20 years, depicting motoring as an unnecessary evil and roads as a blot on the landscape. This attitude laid the foundations for today's narrow `debate' about how to restrict car travel; see for example the origins of London mayor Ken Livingstone's ever-expanding congestion charge in his statement, almost 20 years ago, that he hated cars and would like to `ban the lot'.

The left's enthusiastic embrace of the small-minded anti-road building lobby symbolised its political degeneration, its abandonment of the social - the progressive attempt to transform society through human action - in favour of the natural: the reactionary attempt to defend the environment against humanity.

In The Communist Manifesto, more than a century-and-a-half ago, Marx and Engels talked about the `wonders' of industrial capitalism. Now those wonders are condemned as evils. An understanding that capitalism had both a dynamic and a destructive aspect was always fundamental to a radical left view. More recently, however, what remains of the left has come to see them as the same thing, and to attack such modern achievements as flying or mass mobility as crimes against the environment. Throw in an unhealthy dose of antagonism towards the `greedy' cheap-flying, car-driving masses, and it becomes clear that while the left itself might have largely disappeared from the political roadmap, its misanthropic prejudices have done much to help consolidate the consensus against new road-building.

The fact remains, however, that our motorway-malnourished society needs bigger and better road networks, alongside a properly funded public transport system. We need far less effort to be put into constructing fuming rows about roads, and rather more into quietly building them. In the current phoney war over road-pricing, New Labour might think itself well-advised to follow the old advice: when in a hole, stop digging. But the authorities would do us all a favour if they also took heed of some alternative advice. When in a jam, start digging - more motorways.



That she is a vocal lesbian had nothing to do with it, of course

A senior British officer involved in the killing of a Brazilian mistaken for a suicide bomber on a London underground train was promoted today to a top policing job, looking after the royal family's safety. Cressida Dick was in charge of the operation that led to Jean Charles de Menezes, 27, being shot seven times in the head on an underground train at Stockwell station in south London in July 2005. His family said they are "disgusted" by Ms Dick's promotion.

The shooting came amid frenzy in London over the threat of suicide bombers. Two weeks earlier four British Islamists had blown themselves up on three underground trains and a bus, killing 52 people, and detectives say that the day before the shooting five other suspects had attempted to carry out copycat attacks.

The Metropolitan Police Authority (MPA), which oversees the London force, said, despite "unprecedented circumstances", Ms Dick had been promoted to the rank of Deputy Assistant Commissioner. Her job, which begins on March 19, has responsibility for the protection of the royal family and other senior individuals. "Having considered these circumstances, we are satisfied that our decision to confirm promotion is the right one to take at this time," said Len Duvall, the MPA's chairman. "The MPA is keenly aware that the people of London must have confidence in the police who work, in what are often difficult circumstances, to protect them. "By confirming this promotion we are making it clear that the officer retains our full confidence."

The family of Mr de Menezes said they were angry at the news. "The idea that police officers who were responsible for Jean's killing are being promoted makes me feel sick," said Patricia da Silva Armani, one of Jean's cousins. "I do not understand how people who kill innocent civilians are allowed to carry on working as if nothing has happened. To promote her is disgraceful."

Last July the BBC reported the police watchdog, the Independent Police Complaints Commission (IPCC), had recommended Ms Dick face criminal action for her handling of the operation. However, prosecutors decided no police officers involved in the incident should face action. The Crown Prosecution Service instead ruled the London force as a whole should be prosecuted under health and safety laws. Britain's top court, the House of Lords, will rule on a judicial review of the CPS decision not to hold any individual officers responsible after an appeal by Mr de Menezes's family. The full IPCC report into the shooting will not be made public until that legal action is completed.


The usual excuse for black crime crumbles: "The death of the City solicitor Tom ap Rhys Pryce, stabbed for his mobile phone and travelcard as he returned home one night last winter clutching his wedding plans, struck terror into urban professionals. At the time his killers were portrayed as feral youths who grew up without the guiding influence of their fathers. It triggered a debate about the role of fathers in the lives of urban boys. David Cameron, the Conservative leader, wrote of his hope that "the men who left those boys' mothers to bring them up alone are reflecting on their own responsibility". But The Times has discovered that Delano Brown and Donnel Carty had strong father figures whose attempts to play a formative role in their up-bringing were rejected."

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