The NHS is set to break even this year, redeeming the promise made by Patricia Hewitt, the Health Secretary. But figures released yesterday covering the third quarter of the 2006-07 financial year paint a mixed picture. The most deficit-ridden of the NHS organisations appear to have got even further into trouble, but their deficits should be balanced by surpluses made elsewhere to create a small overall surplus of 13 million.
Last year, the gross deficit (the figure resulting from adding up the deficits of all NHS organisations that were in deficit) was 1,312 million. This year it is forecast to be 1,318 million. There are also more organisations forecasting a deficit (35 per cent) this year than there were last (33 per cent).
But the figures are misleading because the income of these organisations was “top-sliced” to create a reserve at the beginning of the year. This reduced their income, plunging more into deficit. The top-slicing removed 1.14 billion from primary care trust [PCT] budgets, and another 450 million was saved from training and public health budgets. An official said yesterday that up to 300 million might be restored to the trusts before the end of the financial year, which would enable many to present a better picture.
The economies have been made by delaying operations, not replacing staff and by deferring orders for supplies wherever possible until the next financial year. There will also be 1,446 compulsory redundancies in 2006-07, compared with 200-300 in a typical year.
Niall Dickson, chief executive of the King’s Fund health think-tank, said what had been done smacked of “a short-term fix for a long-standing problem”. He said: “The goal this year has been to ensure that the NHS as a whole makes a net surplus — turning around last year’s net deficit of 547 million. By holding back around 1.6 billion from PCT and other budgets this year the NHS will achieve this goal. “But financial performance across NHS organisations remains variable; in part as a result of these tactics, nearly half of all PCTs and a third of trusts forecast a deficit by the end of this year — an increase on last year. “Today’s figures once again highlight that if the NHS is going to survive and prosper it will need to get to grips with the underlying causes of the financial deficits.
“There is a need now to tackle low productivity, and deal with the widespread and often unexplained variations in performance. For some organisations this will demand a very different approach to delivery.” The report said that the NHS budget grew to 75 billion in 2006/07, an increase of 5.4 billion. But almost 700 million of that cash was used to pay off deficits from previous years.
Norman Lamb, the Liberal Democrat health spoksman, said: “The Government is employing all sorts of tricks by shifting debts from one organisation to another. These accounting rules would make Del Boy proud but won’t make the problem disappear.”
Andrew Lansley, the Shadow Health Secretary, said: “Labour are able to claim that the NHS will finish this year in surplus, but the surplus they have generated is a sham. “There are more NHS organisations, saddled with worse deficits, than there were last year. “Patricia Hewitt’s skin is being saved only by savage cuts to centrally held budgets, which will all need to be restored in the years to come.”
Peter Carter, general secretary of the Royal College of Nursing, said: “Ministers today might try to claim a small NHS surplus but this figure has only been achieved by raiding essential NHS training budgets, freezing posts, shedding jobs and cutting patient services.”
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GREENIE VERSUS GREENIE
Buying organic food grown locally may sometimes be more damaging to the environment than nipping down to the supermarket for produce that has been driven hundreds of miles across the country, a new study suggests. Research looking at the environmental impact of food from farm to the plate and beyond suggests that locally-grown food may not be as environmentally friendly as it's said to be. Similarly, long-distance transportation may not deserve the demonisation it has received for the emissions of carbon dioxide it generates. However, scientists questioned the growing use of aircraft to carry foods around the world.
The findings, from a study commissioned by the Department for Environment, Food and Rural Affairs to guide policy on which types of food production and consumption to encourage, prompted a furious response from the Soil Association, which promotes and certifies organic food.
The report concludes that so little is known about the overall environmental impact of any food produce that it is impossible to say which are the most environmentally friendly. But while the merits of some organic products were recognised by the study, researchers pointed out that others cause more damage than non-organic items.
Academics from the Manchester Business School, at the University of Manchester, carried out an assessment of 150 of the best-selling foods for the survey, dubbed the Shopping Trolley Report. "There is no clear-cut answer as to whether purchasing an organic or a conventional trolley of goods has more or less impact environmentally," they said. "For many foods the environmental impacts of organic agriculture are lower than for conventionally-grown food. "However, the evidence suggests that for some environmental themes organic agriculture has higher impacts than non-organic."
They said that calculations of every aspect of a food product's environmental impact - a life-cycle analysis - needs to be carried out to decide which forms of production are best. Factors would include uses of land, water, fertiliser, transportation, packaging and refrigeration. The impact of organic milk was singled out for doubts about its environmental-friendliness because, while having higher levels of nutrients and needing less fertiliser, its production generates more carbon dioxide emissions. Additionally, it takes up 80 per cent more land.
Neither, said the researchers, was buying locally produced food a guarantee of being environmentally-friendly when considering the transportation system, particularly bulk haulage. They suggested that the best thing consumers could do to reduce the carbon footprint of food production and consumption was to leave their cars at home and walk or get public transport to the supermarket. "The available data suggests that, looking at UK food transportation as a whole, the environmental impacts of car-based shopping are greater than those of transport within the distribution system itself," the report said. "The environmental impact of aviation are important for air-freighted products but such products are a very small proportion of food consumed."
Professor Ken Green, who led the study, said: "If you are concerned about the carbon footprint of foods, there can be a good case for importing some of them even if they can be grown in the UK. The evidence available so far shows that local is not always the best option for the environment."
The Soil Association criticised the authors for ignoring many of the benefits of organic production, such as improving biodiversity, and accused them of relying on an inapproporaite study which looked at a type of organic farming that is not used in Britain. It said: "Organic farming is much better for the environment than industrial methods."
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British judge rules against Muslim girl, 12, over veil in school
A girl aged 12 yesterday lost her fight to be allowed to wear a full-face veil in class when a High Court judge backed her school's decision to ban it. The Muslim girl's lawyers had argued that the school's actions were irrational and infringed her human rights, after it had allowed her older sisters to wear the niqab for nine years. But Mr Justice Silber ruled that the Buckinghamshire school's veil ban was "proportionate" for security reasons, that it upheld uniform policy, prevented others coming under pressure to wear it and because the veil stopped teachers from relating well to pupils.
Lawyers for the family said that were bitterly disappointed and were considering appealing against the judgment. Of the 120 Muslim girls in the 1,300plus pupil school, about half wear a headscarf, or hijab, but none wears a niqab.
During the case, the judge was told that the three older sisters had all played an active part in the school and that staff had never objected to their niqabs. All had achieved high A-level results, which showed that the veil had not impaired their learning, her lawyers argued. One was now in medical research, the second was training to be a doctor and the third was at university. As a result, they said, the ban on the youngest girl was irrational, thwarted her "legitimate expectation" to be allowed to wear it and breached her right to freedom of "thought, conscience and religion" under Article 9 of the European Convention on Human Rights.
The 12-year-old girl, known as claimant X for legal reasons, joined the grammar school in September 2005. She chose not to wear the veil in her first year, but last year, after reaching puberty, decided to wear it. The headmistress objected and she was removed. Although she is receiving tuition at home and was offered a place at a different, mixed grammar school that permits the niqab, she wishes to go back to her old school. But Mr Justice Silber, who stressed that he was dealing solely with the facts of one case and was not seeking to resolve the wider issue of wearing the niqab in schools, rejected her plea.
In a summary of the judgment, he said her human rights had not been breached because she had been offered another place at a similar school, where she could wear the niqab. Equally the school was within its rights to ban the veil for security reasons, the importance it attached to a uniform and the need not to put others under pressure into wearing it. "I took into account the margin of discretion allowed to the school and held that the decision of the school was proportionate," he wrote. He said that not only had no other girl tried to wear the niqab under the current headmistress, but that a long time had passed since the girl's sisters had left the school. "The evidence shows that there was now a greater concern for security and that the experience of the staff at the school is that they were impeded in teaching the sisters of the claimant because they wore the niqab," he added. The judge urged the girl to accept the offer of a place at a nearby grammar school, rather than continuing to miss out on a large part of her education.
The girl's headmistress said that she hoped her pupil would return, even though she was not allowed to wear the veil. "We want to focus now on supporting our student," she said. "We hope that she will return to school and resume her education as part of our community."
Andrew Adonis, the Schools Minister, welcomed the judgment, which came as the Government dismissed calls for schools to do more to accommodate Muslim pupils who want to wear a headscarf or grow a beard. The Muslim Council of Britain also accused state schools of failing to respect the wishes of Muslim children when organising sex education, changing rooms and religious assemblies.
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The wonders of British gun control: "Membership of a gang could add extra years to jail terms for violent knife and gun crime, under a review of policies to tackle the growth of firearms on the streets. John Reid, the Home Secretary, announced the plans after hearing that younger teenagers were now using guns and that Britain was in danger of producing a generation of urban “child soldiers”. The stark warnings from police about the trend towards younger people turning to firearms to settle trivial disputes came at a gun-crime summit at 10 Downing Street yesterday. Police in London have been told by community leaders that children as young as 8 and 9 are being used to carry and hide guns for teenagers. In Manchester teenagers aged 13 and 14 are wearing body armour. Mr Reid promised that ministers would clarify whether a five-year minimum jail term could be handed to those aged 18 to 21 for possessing firearms. He also pledged a wider-ranging review of sentencing for firearms offences, though a number of community leaders said that more criminal justice measures were not the answer."
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